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8. Bifunctional Hydrogel-Integrated 3D Printed Scaffold for Repairing Infected Bone Defects

Author

Zhang, Qianqian, Zhou, Xiaojun, Du, Haibo, Ha, Yujie, Xu, Yao, Ao, Rongguang, and He, Chuanglong

Abstract

The clinical treatment of infectious bone defects is difficult and time-consuming due to the coexistence of infection and bone defects, and the simultaneous control of infection and repair of bone defects is considered a promising therapy. In this study, a dual-drug delivery scaffold system was fabricated by the combination of a three-dimensional (3D) printed scaffold with hydrogel for infected bone defects repair. The 3D printed polycaprolactone scaffold was incorporated with biodegradable mesoporous silica nanoparticles containing the small molecular drug fingolimod (FTY720) to provide structural support and promote angiogenesis and osteogenesis. The vancomycin (Van)-loaded hydrogel was prepared from aldehyde hyaluronic acid (AHA) and carboxymethyl chitosan (NOCC) by the Schiff base reaction, which can fill the pores of the 3D-printed scaffold to produce a bifunctional composite scaffold. The in vitroresults demonstrated that the composite scaffold had Van concentration-dependent antimicrobial properties. Furthermore, the FTY720-loaded composite scaffold demonstrated excellent biocompatibility, vascularization, and osteogenic ability in vitro. In the rat femoral defect model with bacterial infection, the dual-drug composite scaffold showed a better outcome in both infection control and bone regeneration compared to other groups. Therefore, the prepared bifunctional composite scaffold has potential application in the treatment of infected bone defects.

Published
2023
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12. Hip hemiarthroplasty for senile femoral neck fractures: Minimally invasive SuperPath approach versus traditional posterior approach

Author

Ao Rongguang, Yu Baoqing, Wu Lianghao, Jia Jianbo, Liu Xinxin, and Ji Ying

Subjects
Male, medicine.medical_specialty, Percutaneous, medicine.medical_treatment, Femoral Neck Fractures, 03 medical and health sciences, Femoral head, 0302 clinical medicine, Humans, Minimally Invasive Surgical Procedures, Medicine, Prospective Studies, Prospective cohort study, Aged, General Environmental Science, Femoral neck, Aged, 80 and over, 030222 orthopedics, business.industry, 030208 emergency & critical care medicine, Acetabulum, Arthroplasty, Surgery, Treatment Outcome, medicine.anatomical_structure, Harris Hip Score, General Earth and Planetary Sciences, Female, Hemiarthroplasty, business
Abstract

Background The supercapsular percutaneously-assisted total hip (SuperPATH®) approach was created by combining the percutaneous preparation of the acetabulum using the percutaneously-assisted total hip (PATH), femoral reaming, and broaching of superior capsulotomy (SuperCap) approach. This technique reported a low complication rate, excellent gait kinematics, low transfusion rate, a shorter length of hospital stay, and a high proportion of discharge from the hospital. As minimally invasive SuperPath approach is designed for both trauma and end-stage degenerative joint disease, we investigated if this technique and standard surgical tools can replace artificial femoral head in elderly patients with femoral neck fracture. We also tested if it has advantages over the traditional posterior approach. Methods A prospective study was performed in 100 cases of eligible femoral neck fractures from May 01, 2015 to October 31, 2016. They were randomly divided into SuperPath and traditional group. The outcomes were evaluated using preoperative index, intraoperative data, and postoperative function data. Results No significant difference was detected in the operation time between the two groups. Compared with the traditional group, SuperPath group had smaller incision length, less intraoperative bleeding, lower transfusion rate, and a shorter starting time of weight-bearing activity. Harris Hip Score, Barthel Index, and VAS for pain-level scores in the SuperPath group at 1-week follow-up intervals were significantly lower than the conventional group, but not significantly different at 3-month and 2-year follow-up post-operation. Conclusions SuperPath approach for artificial femoral head replacement can reduce surgical injury due to smaller size of incision and accelerate weight-bearing activities post-operation to treat senile femoral neck fractures compared with traditional posterior approach surgeries.

Published
2019

14. Ipsilateral midshaft clavicle fracture and acromioclavicular joint dislocation: a review of literature and evidence-based diagnosis guidelines

Author

Yu Baoqing, Ao Rongguang, Jianhua Zhou, Jinhong Chen, Zhen Jian, Xinhua Jiang, Dejian Li, and Zhang Xu

Subjects
Orthodontics, medicine.anatomical_structure, business.industry, Clavicle, Dislocation (syntax), Fracture (geology), Medicine, Acromioclavicular joint, business
Abstract

Background: Ipsilateral midshaft clavicle fracture and AC joint dislocation are rare, with very few cases reported. Once the AC joint dislocation were missed diagnosis, the shoulder function may be affected and medical dispute was easy to occur. The aim of this study was to gather data relating to ipsilateral midshaft clavicle fracture and AC joint dislocation to develop evidence-based diagnosis guidelines as none are currently available.Methods: A study was conducted of the PubMed and Google Scholar databases to identify cases of ipsilateral midshaft clavicle fracture and AC joint dislocation. Data collected about each case included age and gender of the patient, mechanism of injury, fracture and dislocation classification. The authors report 2 additional ipsilateral midshaft clavicle fracture and AC joint dislocation cases.Results: 21 cases were identified for inclusion in this research, 19 from the literature and 2 reported by the authors. All the patients were injured by high energy trauma. For the midshaft fracture, 16/21 (76.2%) patients belonged to Type A classification, and 5/21 (23.8%) patients belonged to Type B classification. For AC joint dislocation, 11/21 (47.6%) patients belonged to Type IV classification, 4/21 (19.0%) patients belonged to Type VI classification, 5/21 (23.8%) patients belonged to Type III classification and 1/21 (4.7%) patients belonged to Type V classification.Conclusions: There are limited data available about the diagnosis of ipsilateral midshaft clavicle fracture and AC joint dislocation. From the cases reviewed, we find that simple midshaft clavicle caused by high energy injuries may be associated with ipsilateral AC joint dislocation. Physical examination, careful observation of preoperative X-ray and fluoroscopy including the AC joint during operation were key to diagnose the injury. Level of Evidence Level III, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.

Published
2020

19. Surgical Treatment of Displaced Midshaft Clavicle Fractures: Precontoured Plates Versus Noncontoured Plates

Author

Ao Rongguang, Zhou Jianhua, Jiang Xinhua, Shi Ji-fei, Jian Zhen, and Yu Baoqing

Subjects
Adult, Male, medicine.medical_specialty, medicine.medical_treatment, Dentistry, Fracture Fixation, Internal, Fractures, Bone, 03 medical and health sciences, 0302 clinical medicine, Blood loss, Bone plate, medicine, Humans, Internal fixation, Orthopedics and Sports Medicine, In patient, 030212 general & internal medicine, Surgical treatment, Reduction (orthopedic surgery), Retrospective Studies, 030222 orthopedics, business.industry, Significant difference, Middle Aged, Clavicle, Surgery, medicine.anatomical_structure, Female, business, Bone Plates
Abstract

Purpose To compare the outcomes and complications of open reduction and internal fixation using precontoured versus noncontoured plates for the treatment of midshaft clavicle fractures. Methods Open reduction and internal fixation using was performed on 130 patients with a midshaft clavicle fracture. Precontoured plates were used in 69 cases (group A) and noncontoured plates in 61 cases (group B). Results The average follow-up in both groups was approximately 21 months. There was a significant difference between the 2 groups in mean surgery duration and blood loss, although Disabilities of the Arm, Shoulder, and Hand and Constant-Murley Shoulder scores at final follow-up were similar. Plate removal was required in 44.9% (31 of 69) of the precontoured group and 65.6% (40 of 61) of the noncontoured group. The indication was prominence of the hardware in 27.5% (19 of 69) of the precontoured group and 54.1% (33 of 61) of the noncontoured. In both groups, body mass index was lower in patients requiring implant removal because of hardware prominence. A higher proportion of females in both groups required implant removal. Conclusions Precontoured plates are associated with a lower rate of hardware removal. Body mass index and gender may be factors that influence the rate of hardware removal. Type of study/level of evidence Therapeutic IV.

Published
2016

25. miR‐21 and miR‐19b delivered by hMSC‐derived EVs regulate the apoptosis and differentiation of neurons in patients with spinal cord injury.

Author

Xu, Guanghui, Ao, Rongguang, Zhi, Zhongzheng, Jia, Jianbo, and Yu, Baoqing

Subjects
*MESENCHYMAL stem cells, *SPINAL cord injuries
Abstract

Background: In this study, we aimed to evaluate the therapeutic effects of extracellular vesicles (EVs), which were collected from differentiated PC12 cells and mesenchymal cells (MSCs), on the treatment of spinal cord injury (SCI). In addition, we aimed to identify miRNAs related to the inhibitory effect of EVs against cell apoptosis. Methods: Electron microscopy was used to observe the distributions of EVs in the samples. Real‐time PCR, western blot, thiazolyl blue tetrazolium bromide (MTT) assay, and flow cytometry were performed to establish the molecular signaling pathway underlying the effect of EVs in SCI. In addition, a Basso–Beattie–Bresnahan (BBB) score system, Nissl staining, immunohistochemistry assay, and TdT‐mediated dUTP nick‐end labeling (TUNEL) assay were conducted to validate the molecular signaling pathway established above. Results: The expression of miR‐21 and miR‐19b was upregulated in EVs isolated from induced PC12 cells and MSCs, along with decreased expression of phosphatase and tensin homolog (PTEN) messenger RNA (mRNA)/protein and a lower level of cell apoptosis. The transfection of miR‐21/miR‐19b precursors into the cells also exhibited an inhibitory effect on cell apoptosis. In addition, in‐silicon analysis and luciferase assays validated the role of PTEN as a virtual target of miR‐21/miR‐19b. Finally, the BBB scores and Nissl staining also validated the therapeutic effects of EVs derived from differentiated P12 cells/MSCs in SCI rats. Accordingly, the negative correlations between miR‐21/miR‐19b and PTEN mRNA/protein were implicated in the post‐SCI recovery. Conclusions: The increased levels of miR‐21/miR‐19b in the EVs derived from differentiated PC12 cells and MSCs suppresses the apoptosis of neuron cells by downregulating the expression of PTEN. In this study, we aimed to evaluate the therapeutic effects of extracellular vesicles (EVs), which were collected from differentiated PC12 cells and mesenchymal cells (MSCs), on the treatment of spinal cord injury (SCI). In addition, we aimed to identify miRNAs related to the inhibitory effect of EVs against cell apoptosis. As a conclusion, we found that the increased levels of miR‐21/miR‐19b in the EVs derived from differentiated PC12 cells and MSCs suppresses the apoptosis of neuron cells by downregulating the expression of phosphatase and tensin homolog (PTEN). [ABSTRACT FROM AUTHOR]

Published
2019
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27. Three dimensionally printed pearl powder/poly-caprolactone composite scaffolds for bone regeneration**.

Author

Zhang, Xu, Du, Xiaoyu, Li, Dejian, Ao, Rongguang, Yu, Bin, and Yu, Baoqing

Subjects
BIOMATERIALS, THREE-dimensional printing, PEARLS, POLYCAPROLACTONE, TISSUE engineering
Abstract

Pearl has great potential as a natural biomaterial for bone tissue engineering, but it suffers from low porosity, difficulty in molding, and poor anti-buckling property. In this study, we used the 3-D printing technique to fabricate original pearl powder and PCL composite scaffolds with different concentrations of pearl powder. The four groups of scaffolds were termed PCL, 30% Pearl/PCL, 50% Pearl/PCL and 80% Pearl/PCL scaffolds according to the proportion of pearl powder. The samples were systematically investigated by scanning electron microscopy (SEM), wide-angle XRD, liquid substitution, Zwick static materials testing, and energy dispersive X-ray analysis. Biological characterization included SEM, fluorescent staining using calcein-AM, cell counting kit-8 assay, alkaline phosphatase and qRT-PCR analysis. The results show that the pore size and the pore morphology of the scaffolds are closely controlled via 3-D printing. This is very beneficial for tissue growth and nutrition transmission. The regular and uniform square macropore structure ensured that the pearl powder/PCL scaffolds had favorable mechanical strength. As the concentration of pearl powder in the scaffolds increase, the compressive strength and apatite formation increase as well as cell adhesion, proliferation, and osteogenic differentiation. These results show that pearl powder/PCL scaffolds fit the requirements of bone tissue engineering. The structures as well as physicochemical and biological properties of pearl powder/PCL composite scaffolds are positively associated with pearl powder concentrations. [ABSTRACT FROM AUTHOR]

Published
2018
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31. Three dimensionally printed pearl powder/poly-caprolactone composite scaffolds for bone regeneration**.

Author

Zhang, Xu, Du, Xiaoyu, Li, Dejian, Ao, Rongguang, Yu, Bin, and Yu, Baoqing

Subjects
*BIOMATERIALS, *THREE-dimensional printing, *PEARLS, *POLYCAPROLACTONE, *TISSUE engineering
Abstract

Pearl has great potential as a natural biomaterial for bone tissue engineering, but it suffers from low porosity, difficulty in molding, and poor anti-buckling property. In this study, we used the 3-D printing technique to fabricate original pearl powder and PCL composite scaffolds with different concentrations of pearl powder. The four groups of scaffolds were termed PCL, 30% Pearl/PCL, 50% Pearl/PCL and 80% Pearl/PCL scaffolds according to the proportion of pearl powder. The samples were systematically investigated by scanning electron microscopy (SEM), wide-angle XRD, liquid substitution, Zwick static materials testing, and energy dispersive X-ray analysis. Biological characterization included SEM, fluorescent staining using calcein-AM, cell counting kit-8 assay, alkaline phosphatase and qRT-PCR analysis. The results show that the pore size and the pore morphology of the scaffolds are closely controlled via 3-D printing. This is very beneficial for tissue growth and nutrition transmission. The regular and uniform square macropore structure ensured that the pearl powder/PCL scaffolds had favorable mechanical strength. As the concentration of pearl powder in the scaffolds increase, the compressive strength and apatite formation increase as well as cell adhesion, proliferation, and osteogenic differentiation. These results show that pearl powder/PCL scaffolds fit the requirements of bone tissue engineering. The structures as well as physicochemical and biological properties of pearl powder/PCL composite scaffolds are positively associated with pearl powder concentrations. [ABSTRACT FROM AUTHOR]

Published
2018
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