Long-term stability of titanium implants are dependent on a variety of factors. Nanocoating with organic molecules is one of the methods used to improve osseointegration. Therefore, the aim of this study is to evaluate the in vitro effect of nanocoating with pectic rhamnogalacturonan-I (RG-I) on surface properties and osteoblasts response. Three different RG-Is from apple and lupin pectins were modified and coated on amino-functionalized tissue culture polystyrene plates (aminated TCPS). Surface properties were evaluated by scanning electron microscopy, contact angle measurement, atomic force microscopy, and X-ray photoelectron spectroscopy. The effects of nanocoating on proliferation, matrix formation and mineralization, and expression of genes (real-time PCR) related to osteoblast differentiation and activity were tested using human osteoblast-like SaOS-2 cells. It was shown that RG-I coatings affected the surface properties. All three RG-I induced bone matrix formation and mineralization, which was also supported by the finding that gene expression levels of alkaline phosphatase, osteocalcin, and collagen type-1 were increased in cells cultured on the RG-I coated surface, indicating a more differentiated osteoblastic phenotype. This makes RG-I coating a promising and novel candidate for nanocoatings of implants.

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This review attempts to combine the existing researches

The titanium implant surface plays a crucial role for implant incorporation into bone. A new strategy to improve implant integration in a bone is to develop surface nanocoatings with plant-derived polysaccharides able to increase adhesion of bone cells to the implant surface. The aim of the present study was to physically characterize and compare polystyrene and titanium surfaces nanocoated with different Rhamnogalacturonan-Is (RG-I) and to visualize RG-I nanocoatings. RG-Is from potato and apple were coated on aminated surfaces of polystyrene, titianium discs and titanium implants. To characterize, compare and visualize the surface nanocoatings measurements of contact angle measurements and surface roughness with atomic force microscopy, scanning electron microscopy, and confocal microscopy was performed. We found that, both unmodified and enzymatic modified RG-Is influenced surface wettability, without any major effect on surface roughness (Sa, Sdr). Furthermore, we demonstrated that it is possible to visualize the pectin RG-Is molecules and even the nanocoatings on titanium surfaces, which have not been presented before. The comparison between polystyrene and titanium surface showed that the used material affected the physical properties of non-coated and coated surfaces. RG-Is should be considered as a candidate for new materials as organic nanocoatings for biomaterials in order to improve bone healing.

Background Airway pressure release ventilation (APRV) has been described many years, however, it is still unclear whether APRV improves outcomes in critically ill patients admitted to Intensive Care Unit with acute respiratory distress syndrome (ARDS). Methods 3 databases were searched for randomized controlled trials (RCTs) until 8 August 2019. The relative risk (RR), mean difference (MD) and 95% confidence intervals (CI) were determined. Results A total of six randomized controlled trials (RCTs) were included with 360 ARDS patients. The Meta analysis showed that the mean arterial pressure (MAP) in APRV group is higher than traditional mechanical ventilation group [MD = 2.35, 95% CI=(1.05,3.64), P = 0.0004], and the airway peak pressure (Ppeak) is lower in APRV group with statistical difference [MD=-2.04,95% CI=(-3.33,-0.75), P = 0.002]. However, no significant beneficial effect on oxygen index (PaO2/FiO2) was shown between two groups (MD = 26.24, 95% CI=(-26.50,78.97), P = 0.33). Compared with conventional mechanical ventilation, APRV significantly improved 28-day mortality [RR = 0.66, 95% CI=(0.47,0.94), P = 0.02]. Conclusions For critically ill patients with ARDS, application of APRV is associated with the increase of MAP, the reduction of the airway Ppeak and 28-day mortality, while there is no sufficient evidence to support the APRV is superior to conventional mechanical ventilation in PaO2/FiO2.