The relationship between pore architecture and structure performance needs to be explored, as well as confirm the optimized porous structure. Because of the linear correlation between constant C and pore architecture, triply periodic minimal surface (TPMS) based porous structures could be a controllable model for the investigation of the optimized porous structure. In the present work, three types of TPMS porous scaffolds (S, D and G) combined with four constants (0.0, 0.2, 0.4 and 0.6) were designed, and built successfully via the selective laser melting (SLM) technology. The designed feature and mechanical property of porous scaffolds were investigated through mathematical method and compression test. And the manufactured samples were co-cultured with rMSCs for the compatibility study. The results indicated that the whole manufacturing procedure was good in controllability, repeatability, and accuracy. The linear correlation between the porosity of TPMS porous scaffolds and the constant C in equations was established. The different TPMS porous scaffolds possess the disparate feature in structure, mechanical property and cell compatibility. Comprehensive consideration of the structure features, mechanical property and biology performance, different TPMS structures should be applied in appropriate field. The results could guide the feasibility of apply the different TPMS architectures into the different part of orthopedic implants.
Background Autogenous granular bone graft (AG), autogenous massive bone graft (AM), and titanium mesh bone graft (TM) are the three commonly utilized bone implant methods for spinal tuberculosis. However, the gold standard is still controversial. Therefore, this study aimed to compare the clinical efficacy and surgical safety of three primary bone graft modalities. Methods For systematic literature review, several databases, including PubMed, Embase, and Web of Science, were searched up to December 2022. Stata (version 14.0) was employed for data analysis. Results Our network meta-analysis included 517 patients from 7 articles whose qualities are acceptable based on our quality assessment criteria. In direct comparison, AG was associated with a shorter operation time (MD = 73.51; CI 30.65–116.37) and a lesser blood loss (MD = 214.30; CI 7.17–421.44) than AM. TM had fewer loss of Cobb angle than AG (MD = 1.45; CI 0.13–2.76) and AM (MD = 1.21; CI 0.42–1.99). Compared with AG, TM (MD = 0.96; CI 0.06–1.87) was related to a shorter bone graft fusion time. In indirect comparison, for the clinical parameters, the rank of CRP (from best to worst) was as follows: TM (58%) > AM (27%) > AG (15%), the rank of ESR (from best to worst) was as follows: AG (61%) > AM (21%) > TM (18%), and the rank of VAS (from best to worst) was as follows: AG (65%) > TM (33%) > AM (2%). In the aspect of surgical data, what is noteworthy is that AG showed less blood loss [AG (93%) > TM (6%) > AM (1%)], operative time [AG (97%) > TM (3%) > AM (0)], and complications [AG (75%) > TM (21%) > AM (4%)] than AM and TM. As for imaging parameters, the rank of the loss of Cobb angle (from best to worst) was as follows: TM (99%) > AM (1%) > AG (0). Moreover, TM showed a shorter bone graft fusion time than AM and AG: TM (96%) > AM (3%) > AG (1%). Conclusions The results indicated that AG might be the optional treatment for spinal tuberculosis owing to the outcomes of surgical safety. Moreover, TM is another right choice which can significantly reduce the loss of Cobb angle and shorten bone graft fusion time with long‐term follow‐up.
Background Silencing of the periostin gene (POSTN) can inhibit the biological process of several different cancers, and this inhibition may be related to down-regulation of PI3K/AKT signaling. However, the effect of POSTN on the progression, proliferation, and invasion of osteosarcoma (OS) remain unclear. Methods We used the Gene Expression Omnibus (GEO) database to screen datasets on in situ OS and lung metastases to identify core genes and potential pathways. We used additional bioinformatics tools to identify protein–protein interactions (PPIs) and gene networks, and selected the top seven genes whose expression had the strongest correlations with other genes. Results The results indicated that POSTN was a major hub gene. Subsequent analysis of gene expression profiles showed that POSTN was highly expressed in 262 cases with sarcoma and expression was closely related to poor prognosis. We also performed enrichment analysis to identify differentially expressed genes and used real-time PCR, western blotting, and immunohistochemistry analyses to measure POSTN expression in cells and tissues. Transfection of a POSTN-shRNA plasmid into cultured OS cells (Saos-2) effectively inhibited the proliferation, invasion, and migration of these cells. Taken together, our results suggest that POSTN may play a role in promoting the proliferation and metastasis of OS by activation of the PI3K/Akt signaling pathway. Conclusions Our results provide a preliminary characterization of the mechanism by which POSTN may regulate the migration and invasion of OS cells and also provide a theoretical basis for identifying biomarkers that have potential use for the diagnosis and treatment of OS.
Objective: Total en bloc spondylectomy (TES) is an important surgical treatment for spinal tumors that can achieve en bloc resection of the affected vertebral body by using the T-saw. However, the conventional TES process and the surgical instruments currently in use have some inconveniences, which may lead to longer operative times and a higher incidence of complications. To address these obstacles, we developed a modified TES technique using a homemade intervertebral hook blade. The objectives of this study were to describe our modified total en bloc spondylectomy (TES) using a homemade intervertebral hook blade and to assess its clinical effects in patients with spinal tumors. Methods: Twenty-three consecutive patients with spinal tumors were included from September 2018 to November 2021. Eleven patients underwent a modified TES using an intervertebral hook blade, and 12 patients underwent a conventional TES using a wire saw. Details of the modified technique for TES were depicted, and the intraoperative blood loss, operative time, and improvement in pain symptom and neurological function measured by visual analog score (VAS) and American Spinal Injury Association (ASIA) score of all patients was reviewed and analyzed. Nonparametric analysis of covariates (ANCOVA) was performed to compare the clinical outcomes between patients treated with modified TES and conventional TES. Results:The modified TES significantly reduced operative time (F = 7.935, p = 0.010) and achieved favorable improvement of neurological function (F = 0.570, p = 0.459) and relief of pain (F = 3.196, p = 0.088) compared with the conventional TES group. The mean intraoperative blood loss in the modified TES group (2381.82 ml) was lower than that in the conventional TES group (3558.33 ml), although the difference was not statistically significant (F = 0.677, p = 0.420).Conclusions: Modified TES using the intervertebral hook blade can effectively reduce the operation time and intraoperative bleeding, and meanwhile ensure the improvement of neurological function and relief of pain symptoms, suggesting that this modified technique is feasible, safe, and effective for spinal tumors.
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