The Promotion of Mechanical Properties by Bone Ingrowth in Additive-Manufactured Titanium Scaffolds

Although the initial mechanical properties of additive-manufactured (AM) metal scaffolds have been thoroughly studied and have become a cornerstone in the design of porous orthopaedic implants, the potential promotion of the mechanical properties of the scaffolds by bone ingrowth has barely been studied. In this study, the promotion of bone ingrowth on the mechanical properties of AM titanium alloy scaffolds was investigated through in vivo experiments and numerical simulation. On one hand, the osseointegration characteristics of scaffolds with architectures of body-centred cubic (BCC) and diamond were compared through animal experiments in which the mechanical properties of both scaffolds were not enhanced by the four-week implantation. On the other hand, the influences of the type and morphology of bone tissue in the BCC scaffolds on its mechanical properties were investigated by the finite element model of osseointegrated scaffolds, which was calibrated by the results of biomechanical testing. Significant promotion of the mechanical properties of AM metal scaffolds was only found when cortical bone filled the pores in the scaffolds. This paper provides a numerical prediction method to investigate the effect of bone ingrowth on the mechanical properties of AM porous implants, which might be valuable for the design of porous implants

Classical risk factors of cardiovascular disease among Chinese male steel workers: a prospective cohort study for 20 years

<p>Abstract</p> <p>Background</p> <p>Cardiovascular disease (CVD) constitutes a major public health problem in China and worldwide. We aimed to examine classical risk factors and their magnitudes for CVD in a Chinese cohort with over 20 years follow-up.</p> <p>Methods</p> <p>A cohort of 5092 male steelworkers recruited from 1974 to 1980 in Beijing of China was followed up for an average of 20.84 years. Cox proportional-hazards regression model were used to evaluate the risk of developing a first CVD event in the study participants who were free of CVD at the baseline.</p> <p>Results</p> <p>The multivariable-adjusted hazard ratio (HR) associated with every 20 mmHg rise in systolic blood pressure (SBP) was 1.63 in this Chinese male population, which was higher than in Caucasians. Compared to non-smokers, men who smoked not less than one-pack-a-day had a HR of 2.43 (95% confidence interval [CI], 1.75-3.38). The HR (95% CI) for every 20 mg/dl increase in total serum cholesterol (TC) and for every point rise in body mass index (BMI) was 1.13 (1.04-1.23) and 1.06 (1.02-1.09), respectively.</p> <p>Conclusions</p> <p>Our study documents that hypertension, smoking, overweight and hypercholesterolemia are major conventional risk factors of CVD in Chinese male adults. Continued strengthening programs for prevention and intervention on these risk factors are needed to reduce the incidence of CVD in China.</p

The Current Status and Influencing Factors of Clinical Inertia in Type 2 Diabetes Patients in Community

Background Although type 2 diabetes mellitus (T2DM) cannot be completely cured, however, there is a consensus that timely community management of T2DM patients following guidelines can lead to good glycemic control. However, blood glucose of the patients is chronically suboptimal due to T2DM-related clinical inertia. It is crucial for improving the effectiveness of diabetes control to determine the current status and influencing factors of clinical inertia in T2DM patients in community, but there is limited literature on this topic. Objective To investigate current status and influencing factors of clinical inertia during health management in T2DM patients in community. Methods From January to December 2020, T2DM patients receiving health management services from the national basic public health services in Qingjiangpu and Huaian Districts, Huaian City, Jiangsu Province, were recruited using cluster random sampling method to perform face-to-face questionnaire survey, physical examination, and laboratory tests. Clinical inertia was defined as the absence of intensification in antidiabetic treatment for patients with inadequate HbA1c control (HbA1c≥7.0%) in the past three months. Stepwise multiple Logistic regression analysis was performed to identify influencing factors of the detection of clinical inertia in T2DM patients in community. Results A total of 3 346 T2DM patients with inadequate glycemic control (HbA1c≥7.0%) were included in the study, with the overall detection rate of clinical inertia in T2DM patients of 93.96% (3 144/3 346), 94.84% (1 139/1 201) in men and 93.47% (2 005/2 145) in women, respectively. There were significant differences in the detection rate of clinical inertia among T2DM patients with different levels of dietary control, physical activity, blood glucose monitoring periods, diabetic complications, dyslipidemia (history), and history of coronary heart disease, stroke, and cancer. Stepwise multiple Logistic regression analysis showed that dietary control〔OR (95%CI) =0.585 (0.382, 0.894) 〕, glucose monitoring period≤1 week〔OR (95%CI) =0.470 (0.344, 0.644) 〕, presence of diabetic complications〔OR (95%CI) =0.606 (0.423, 0.868) 〕, dyslipidemia (history) 〔OR (95%CI) =0.725 (0.532, 0.988) 〕, history of coronary artery disease〔OR (95%CI) =0.659 (0.458, 0.949) 〕, and stroke〔OR (95%CI) =0.699 (0.511, 0.955) 〕were associated with a lower prevalence of clinical inertia in T2DM patients (P&lt;0.05) . Conclusion There is a serious problem of clinical inertia in T2DM patients undergoing health management in community, the prevalence of clinical inertia is closely related to patients&apos; dietary control, glucose monitoring period, presence of diabetic complications, and comorbid diseases (history)

Identification of Plasma Metabolomic Profiling for Diagnosis of Esophageal Squamous-Cell Carcinoma Using an UPLC/TOF/MS Platform

Epidemiological studies indicated that esophageal squamous-cell carcinoma (ESCC) is still one of the most common causes of cancer incidence in the world. Searching for valuable markers including circulating endogenous metabolites associated with the risk of esophageal cancer, is extremely important A comparative metabolomics study was performed by using ultraperformance liquid chromatography-electrospray ionization-accurate mass time-of-flight mass spectrometry to analyze 53 pairs of plasma samples from ESCC patients and healthy controls recruited in Huaian, China. The result identified a metabolomic profiling of plasma including 25 upregulated metabolites and five downregulated metabolites, for early diagnosis of ESCC. With a database-based verification protocol, 11 molecules were identified, and six upregulated molecules of interest in ESCC were found to belong to phospholipids as follows: phosphatidylserine, phosphatidic acid, phosphatidyl choline, phosphatidylinositol, phosphatidyl ethanolamine, and sphinganine 1-phosphate. Clinical estimation of metabolic biomarkers through hierarchical cluster analysis in plasma samples from 17 ESCC patients and 29 healthy volunteers indicated that the present metabolite profile could distinguish ESCC patients from healthy individuals. The cluster of aberrant expression of these metabolites in ESCC indicates the critical role of phospholipid metabolism in the oncogenesis of ESCC and suggests its potential ability to assess the risk of ESCC development in addition to currently used risk factors

Application of 3D-printed PEEK scapula prosthesis in the treatment of scapular benign fibrous histiocytoma: A case report

Background: Bone benign fibrous histiocytoma (BFH) is an invasive primary bone tumor. When the local excision is not complete, the risk of recurrence is high, and hence, one-piece resection is necessary. The major challenge for clinicians is to reconstruct the bone after resection of the tumor. The present study investigated the efficacy of 3-dimensional (3D) printing technique in the treatment of benign fibrous histiocytoma of the scapula. Methods: The patient with benign fibrous histiocytoma of scapular bone was treated with PEEK (polyetheretherketone) prosthesis replacement using the 3D printing technique. X-ray and computed tomography (CT) scans evaluated the relationship between the position of the prosthesis and that of the shoulder joint. Also, the constant score of the shoulder joint was calculated. Results: The anteroposterior radiograph showed that the position of the left scapula prosthesis is satisfactory and that of the shoulder joint is normal. Three months after the operation, the X-ray examination indicated the lack of flexibility and shift, as well as, dislocation and disjunction of PEEK prosthesis. The constant score of the left shoulder function was 68 points. Active shoulder joint activity: 120° on the lift, 90° on abduction, 50° on the external rotation, and 70° on internal rotation. Conclusions: The application of 3D-printed PEEK scapula prosthesis with total shoulder replacement offers the possibility of accurate reconstruction, improves the operability of surgery, shortens the operation time, and allows early functional recovery of the patients. Keywords: Polyetheretherketone, Implant, Benign fibrous histiocytom

Epigenetic Repression of miR-218 Promotes Esophageal Carcinogenesis by Targeting ROBO1

miR-218, consisting of miR-218-1 at 4p15.31 and miR-218-2 at 5q35.1, was significantly decreased in esophageal squamous cell carcinoma (ESCC) in our previous study. The aim of this study was to determine whether aberrant methylation is associated with miR-218 repression. Bisulfite sequencing analysis (BSP), methylation specific PCR (MSP), and 5-aza-2′-deoxycytidine treatment assay were applied to determine the methyaltion status of miR-218 in cells and clinical samples. In vitro assays were performed to explore the role of miR-218. Results showed that miR-218-1 was significantly CpG hypermethylated in tumor tissues (81%, 34/42) compared with paired non-tumor tissues (33%, 14/42) (p &lt; 0.05). However, no statistical difference was found in miR-218-2. Accordingly, expression of miR-218 was negatively correlated with miR-218-1 methylation status (p &lt; 0.05). After demethylation treatment by 5-aza-2′-deoxycytidine, there was a 2.53- and 2.40-fold increase of miR-218 expression in EC109 and EC9706, respectively. miR-218 suppressed cell proliferation and arrested cells at G1 phase by targeting 3′ untranslated region (3′UTR) of roundabout guidance receptor 1 (ROBO1). A negative correlation was found between miR-218 and ROBO1 mRNA expression in clinical samples. In conclusion, our results support that aberrant CpG hypermethylation at least partly accounts for miR-218 silencing in ESCC, which impairs its tumor-suppressive function

Functional biomimetic design of 3D printed polyether-ether-ketone flexible chest wall reconstruction implants for restoration of the respiration

The lack of deformability of rigid chest wall reconstruction (CWR) implants presents a challenge in reducing postoperative respiratory function in patients with large chest wall defects. Flexible poly-ether-ether-ketone (PEEK) CWR implants, consisting of rib components with elliptical cross-section and costal cartilage components featuring wavy structures, were developed with adjustable design parameters that allow quantitative restoration of respiratory function. During the design process, the equivalent elastic moduli of the rib and costal cartilage components were parametrically adjusted in a validated finite element (FE) model of the chest wall to maximise chest wall deformation during respiration, while considering mechanical safety as the boundary condition. The optimal equivalent elastic moduli were then translated into design parameters for the rib and costal cartilage components, based on a database relating the equivalent elastic modulus to the design parameters of the components with elliptical cross-section and wavy structures. The flexible PEEK CWR implant increased the difference in chest circumference during respiration by 12.2% compared to rigid PEEK implant in a clinical case-based study. This study presents a strategy to address the reduced respiratory function in 3D printed CWR implants, providing a pathway for quantitative restoration of respiratory function through parameterised optimisation