BackgroundTo explore the clinical efficacy of 3D printing fracture models to assist in creating pre-contoured plates to treat proximal third humeral shaft fractures.MethodsWe retrospectively identified proximal third humeral shaft fractures treated between February 2012 and February 2015. The patients were divided into two groups according to the treatment procedure: a Synbone group and a 3D-printed group. In the Synbone group, long proximal humeral internal locking system plates were pre-contoured into helical shape on Synbones before surgery, while in the 3D-printed group, they were contoured on 3D-printed bone models. The pre-contoured plates were sterilized before surgery and were then used for fracture fixation during surgery. Duration of surgeries, blood loss volumes, the incidence of complications, and the time to fracture union were recorded, and functional outcomes were assessed by the Constant-Murley shoulder score and the Mayo Elbow Performance Score (MEPS) at 1-year follow-up.ResultsThe subjects comprised 46 patients; 25 patients were allocated to the Synbone group and the remaining 21 to the 3D-printed group. There was no significant difference between the baseline characteristics of the two groups. At the 1-year follow-up visit, all fractures were healed and showed a satisfactory outcome. There were no instances of iatrogenic radial nerve injury, and there was no significant difference between the two groups with regard to fracture union time, Constant-Murley score, or MEPS score. Surgery duration was significantly shorter in the 3D-printed group compared to the Synbone group (42.62 vs. 60.36 min, P = 0.001), and the 3D-printed group lost less blood during surgery (105.19 vs. 120.80 ml, P = 0.001). In addition, in the 3D-printed group, 9 surgeries were finished by senior attending doctors and 12 were finished by junior attending doctors; however, there was no significant difference between the 1-year outcomes of the two grades of surgeons.ConclusionsOur results show that the 3D printing technique is helpful in shortening the duration of surgery, reducing blood loss volume, and in making this surgical procedure easier for less-experienced surgeons.Trial registrationThis clinical study was registered in CHICTR on September 30, 2017 (number 17012852).

Early detection of diabetic microvascular complications is of great significance for disease prognosis. This systematic review and meta-analysis aimed to investigate the correlation among diabetic microvascular complications which may indicate the importance of screening for other complications in the presence of one disorder. PubMed, Embase, and the Cochrane Library were searched and a total of 26 cross-sectional studies met our inclusion criteria. Diabetic retinopathy (DR) had a proven risk association with diabetic kidney disease (DKD) [odds ratio (OR): 4.64, 95% confidence interval (CI): 2.47–8.75, p < 0.01], while DKD also related to DR (OR: 2.37, 95% CI: 1.79–3.15, p < 0.01). In addition, DR was associated with diabetic neuropathy (DN) (OR: 2.22, 95% CI: 1.70–2.90, p < 0.01), and DN was related to DR (OR: 1.73, 95% CI: 1.19–2.51, p < 0.01). However, the risk correlation between DKD and DN was not definite. Therefore, regular screening for the other two microvascular complications in the case of one complication makes sense, especially for patients with DR. The secondary results presented some physical conditions and comorbidities which were correlated with these three complications and thus should be paid more attention.

BackgroundBone tissue engineering, a powerful tool to treat bone defects, is highly dependent on use of scaffolds. Both silk fibroin (SF) and chitosan (Cs) are biocompatible and actively studied for reconstruction of tissue engineering. Gelatin (Gel) is also widely applied in the biomedical field due to its low antigenicity and physicochemical stability.Material/MethodsIn this study, 4 different types of scaffolds were constructed – SF, SF/Cs, SF/Gel, and SF/Cs/Gel – and we compared their physical and chemical properties as well as biological characterization of these scaffolds to determine the most suitable scaffold for use in bone regeneration. First, these scaffolds were produced via chemical cross-linking method and freeze-drying technique. Next, the characterization of internal structure was studied using scanning electron microscopy and the porosity was evaluated by liquid displacement method. Then, we compared physicochemical properties such as water absorption rate and degradation property. Finally, MC3T3-E1 cells were inoculated on the scaffolds to study the biocompatibility and osteogenesis of the three-dimensional (3D) scaffolds in vitro.ResultsThe composite scaffold formed by all 3 components was the best for use in bone regeneration.ConclusionsWe conclude that the best scaffold among the 4 studied for MC3T3-E1 cells is our SF/Cs/Gel scaffold, suggesting a new choice for bone regeneration that can be used to treat bone defects or fractures in clinical practice.