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Strategies for decellularization, re-cellularIzation and crosslinking in liver bioengineering. 肝脏生物工程中的脱细胞、再细胞化和交联策略。
IF 1.7 4区 医学 Q4 ENGINEERING, BIOMEDICAL Pub Date : 2024-03-01 Epub Date: 2024-01-22 DOI: 10.1177/03913988231218566
Jiajia Wang, Xiaojun Jin

Liver transplantation is the only definitive treatment for end-stage liver disease and its availability is restricted by organ donor shortages. The development of liver bioengineering provides the probability to create a functional alternative to reduce the gap in organ demand and supply. Decellularized liver scaffolds have been widely applied in bioengineering because they can mimic the native liver microenvironment and retain extracellular matrix (ECM) components. Multiple approaches including chemical, physical and biological methods have been developed for liver decellularization in current studies, but a full set of unified criteria has not yet been established. Each method has its advantages and drawbacks that influence the microstructure and ligand landscape of decellularized liver scaffolds. Optimizing a decellularization method to eliminate cell material while retaining as much of the ECM intact as possible is therefore important for biological scaffold applications. Furthermore, crosslinking strategies can improve the biological performance of scaffolds, including reinforcing biomechanics, delaying degradation in vivo and reducing immune rejection, which can better promote the integration of re-cellularized scaffolds with host tissue and influence the reconstruction process. In this review, we aim to present the different liver decellularization techniques, the crosslinking methods to improve scaffold characteristics with crosslinking and the preparation of soluble ECM.

肝移植是治疗终末期肝病的唯一确切方法,但由于器官捐献者短缺,肝移植的可用性受到限制。肝脏生物工程的发展为创造一种功能性替代品以减少器官供需缺口提供了可能。脱细胞肝脏支架可模仿原生肝脏微环境并保留细胞外基质(ECM)成分,因此被广泛应用于生物工程领域。目前的研究已开发出多种肝脏脱细胞方法,包括化学、物理和生物方法,但尚未建立一套完整的统一标准。每种方法都有其优点和缺点,这些优点和缺点会影响脱细胞肝脏支架的微观结构和配体结构。因此,优化脱细胞方法以消除细胞物质,同时尽可能保留完整的 ECM 对生物支架的应用非常重要。此外,交联策略可以改善支架的生物学性能,包括增强生物力学、延缓体内降解和减少免疫排斥反应,从而更好地促进再细胞化支架与宿主组织的整合,并影响重建过程。在本综述中,我们旨在介绍不同的肝脏脱细胞技术、通过交联改善支架特性的交联方法以及可溶性 ECM 的制备方法。
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引用次数: 0
Influence of rotor impeller structure on performance improvement of suspended axial flow blood pumps. 转子叶轮结构对提高悬挂式轴流血泵性能的影响
IF 1.7 4区 医学 Q4 ENGINEERING, BIOMEDICAL Pub Date : 2024-03-01 Epub Date: 2024-03-07 DOI: 10.1177/03913988231225128
Liang Wang, Zhong Yun, Xiaoyan Tang, Chuang Xiang

Background: The hydrodynamic suspension structure design of the axial blood pump impeller can avoid the problems associated with using mechanical bearings. However, the particular impeller structure will impact the hydraulic performance and hemolysis of the blood pump.

Method: This article combines computational fluid dynamics (CFD) with the Lagrange particle tracking method, aiming to improve the blood pump's hydraulic and hemolysis performance. It analyzes the flow characteristics and hemolysis performance inside the pump. It optimizes the taper of the impeller hub, the number of blades, and the inclination angle of the circumferential groove at the top of the blade.

Results: Under certain rotational speed conditions, an increase in the taper of the impeller hub or the number of blades can increase the pumping pressure of a blood pump, but an increase in the number of blades will reduce the flow rate. The design of circumferential grooves at the top of the blade can increase the pumping pressure to a certain extent, with little impact on the hemolysis performance. The impeller structure is optimized based on the estimated hemolysis of each impeller model blood pump. It could be seen that when the pump blood pressure and flow rate were reached, the optimized impeller speed was reduced by 11.4%, and the estimated hemolysis value was reduced by 10.5%.

Conclusion: In this paper, the rotor impeller structure of the blood pump was optimized to improve the hydraulic and hemolytic performance effectively, which can provide a reference for the related research of the axial flow blood pump using hydraulic suspension.

背景:轴流式血泵叶轮的流体悬浮结构设计可以避免使用机械轴承带来的问题。然而,特殊的叶轮结构会影响血泵的水力性能和溶血情况:本文将计算流体动力学(CFD)与拉格朗日粒子跟踪法相结合,旨在改善血泵的水力和溶血性能。它分析了血泵内部的流动特性和溶血性能。它优化了叶轮轮毂的锥度、叶片数量和叶片顶部圆周凹槽的倾角:结果:在一定转速条件下,增加叶轮轮毂锥度或叶片数量可提高血泵的泵送压力,但增加叶片数量会降低流速。在叶片顶部设计圆周凹槽可在一定程度上增加泵压,但对溶血性能影响不大。根据各叶轮型号血泵的估计溶血量,对叶轮结构进行了优化。可以看出,当达到泵血压和流量时,优化后的叶轮转速降低了 11.4%,估计溶血值降低了 10.5%:本文对血泵转子叶轮结构进行了优化,有效改善了血泵的水力和溶血性能,可为采用水力悬浮的轴流式血泵的相关研究提供参考。
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引用次数: 0
Hemoperfusion with high-affinity polyethylene microbeads (Seraph-100®) for the removal of pathogens in chronic critically ill patients: Clinical experience. 使用高亲和力聚乙烯微珠(Seraph-100®)进行血液灌流,清除慢性重症患者体内的病原体:临床经验。
IF 1.7 4区 医学 Q4 ENGINEERING, BIOMEDICAL Pub Date : 2024-02-01 Epub Date: 2024-01-05 DOI: 10.1177/03913988231221405
Valentina Votrico, Matteo Grilli, Ugo Gerini, Giorgio Berlot

Critically ill septic patients present variable clinical trajectories, with some succumbing to hyperinflammatory responses while others develop a chronic critical illness, characterized by a prolonged low-grade inflammation, muscle atrophy, and mechanical ventilation dependency and often develop secondary infections often caused by from low-virulence microorganisms or reactivated latent viruses. The Seraph-100® hemoperfusion cartridge takes advantage from heparin-coated ultra-high molecular weight polyethylene microbeads mimicking pathogen-binding cell receptors and can adsorb both pathogens and damage-associated molecular patterns released by injured tissues. We describe two chronic critically ill patients who developed secondary viral bloodstream infections successfully treated with this device.

重症脓毒症患者的临床表现各不相同,有些患者会因过度炎症反应而死亡,而另一些患者则会发展为慢性危重病,其特点是长期低度炎症、肌肉萎缩、依赖机械通气,并经常出现由低毒性微生物或重新激活的潜伏病毒引起的继发性感染。Seraph-100® 血液灌流盒利用肝素涂层的超高分子量聚乙烯微珠模拟病原体结合细胞受体,可以吸附病原体和损伤组织释放的损伤相关分子模式。我们介绍了两名使用该装置成功治疗继发性病毒性血流感染的慢性重症患者。
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引用次数: 0
Driveline infection according to driveline positioning in left ventricular assist device implant recipients. 根据左心室辅助装置植入者的干线定位确定干线感染。
IF 1.7 4区 医学 Q4 ENGINEERING, BIOMEDICAL Pub Date : 2024-02-01 Epub Date: 2024-01-05 DOI: 10.1177/03913988231220268
Volker Lauenroth, Armin Zittermann, Stefan Lucke, Jan F Gummert, Michiel Morshuis

We conducted a prospective, open-labeled, clinical trial, with a two-by-two factorial design, of argon cold plasma application and two different types of driveline positioning for the prevention of driveline infection (DLI) in 80 patients with a left ventricular assist device (LVAD) implant. Here, we present the results of intracorporeal loop positioning (n = 40) versus no intracorporeal loop positioning (n = 40). Patients were followed up for 1 year. According to the Driveline Expert STagINg and carE grading (DESTINE) system, a DLI was considered in case of a stage 2 or higher graded infection. During follow-up, 29 (36%) patients experienced a DLI, 16 in the group with intracorporeal loop positioning and 13 in the group with no intracorporeal loop positioning. Kaplan-Meier estimates of freedom from DLI showed no statistically significant difference between study groups during follow-up (p = 0.33). In detail, 30-day freedom from DLI was for the groups with and without intracorporeal loop positioning 92 and 92%, respectively, and 1-year freedom from DLI was 51 and 62%, respectively. In conclusion, this controlled clinical trial was unable to show a statistically significant difference in freedom from DLI during one year of follow-up in groups with or without intracorporeal loop positioning. However, larger trials have to confirm these results.

我们对 80 名植入左心室辅助装置(LVAD)的患者进行了一项前瞻性、开放标签临床试验,试验采用两两因子设计,分别应用氩冷等离子体和两种不同类型的驱动管定位来预防驱动管感染(DLI)。在此,我们介绍了体外循环定位(40 例)与无体外循环定位(40 例)的对比结果。对患者进行了为期一年的随访。根据Driveline专家STagINg和carE分级(DESTINE)系统,如果出现2期或更高分级的感染,则考虑进行DLI。在随访期间,29 名(36%)患者出现了 DLI,其中 16 名患者进行了体外循环定位,13 名患者未进行体外循环定位。卡普兰-梅耶估计值显示,在随访期间,各研究组之间免于 DLI 的差异无统计学意义(p = 0.33)。具体而言,采用体腔内循环定位和未采用体腔内循环定位的研究组 30 天无 DLI 的比例分别为 92% 和 92%,1 年无 DLI 的比例分别为 51% 和 62%。总之,在这项临床对照试验中,采用体外循环定位和未采用体外循环定位的组别在随访一年期间免于 DLI 的比例差异并不明显。不过,还需要更大规模的试验来证实这些结果。
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引用次数: 0
Citrate anticoagulation in plasma exchange followed by continuous renal replacement therapy in critically ill children. 危重症儿童血浆置换后持续肾脏替代疗法中的柠檬酸盐抗凝剂。
IF 1.7 4区 医学 Q4 ENGINEERING, BIOMEDICAL Pub Date : 2024-02-01 Epub Date: 2024-01-16 DOI: 10.1177/03913988231223375
Zhang Xinping, He Jie, Yao Zhenya, Zhu Desheng, Zhou Xiong

Objective: To investigate the effectiveness and safety of regional citrate-anticoagulated (RCA) plasma exchange (PE) and whether citrate-related metabolic disorders can be improved by sequential RCA continuous renal replacement therapy (CRRT).

Methods: This retrospective, single-center observational study included 79 critically ill children requiring PE followed by CRRT (June 2018 to June 2021) at the Pediatric Intensive Care Unit of Hunan Children's Hospital, China. Patients were divided into the RCA-PE (n = 30) and systemic heparin anticoagulation (SHA-PE) (n = 49) groups. Filter level comparison post-PE assessed RCA-PE efficacy, and metabolic changes occurring pre- and post-PE and CRRT were used to evaluate the effect of CRRT on RCA-based anticoagulation safety.

Results: The RCA-PE group had a better overall filter performance than the SHA-PE group. Two hours after PE, pH and HCO₃- levels increased more significantly for the RCA-PE than the SHA-PE group. The RCA-PE incidence of metabolic alkalosis was 48.3%, higher by 4.2% (p < 0.001) compared to the SHA-PE group. In the RCA-PE group, pH and HCO₃- decreased significantly 4 h after CRRT; the metabolic alkalosis caused by RCA-PE decreased to 13.8% (p = 0.005). No significant difference in pH, HCO₃-, and metabolic alkalosis incidence was observed between the two groups 4 h after CRRT.

Conclusions: The overall filtration performance of RCA-PE is superior to that of SHA-PE followed by CRRT. The metabolic complications associated with RCA-PE are mainly metabolic alkalosis that can be improved by using CRRT after RCA-PE and this is a better alternative for anticoagulation during PE in critically ill children.

目的研究区域性枸橼酸盐-抗凝血浆置换术(PE)的有效性和安全性,以及枸橼酸盐相关代谢紊乱是否可通过序贯RCA持续肾脏替代治疗(CRRT)得到改善:这项回顾性、单中心观察研究纳入了中国湖南省儿童医院儿科重症监护室79名需要PE后进行CRRT治疗的重症患儿(2018年6月至2021年6月)。患者被分为RCA-PE组(n = 30)和全身肝素抗凝(SHA-PE)组(n = 49)。PE后滤光片水平比较评估RCA-PE的疗效,PE和CRRT前后发生的代谢变化用于评估CRRT对基于RCA的抗凝安全性的影响:结果:RCA-PE 组的整体过滤性能优于 SHA-PE 组。PE 两小时后,RCA-PE 组的 pH 和 HCO₃- 水平比 SHA-PE 组有更明显的升高。RCA-PE组代谢性碱中毒的发生率为48.3%,比CRRT后4小时的发生率高4.2%(p - 显著下降);RCA-PE组代谢性碱中毒的发生率降至13.8%(p = 0.005)。CRRT后4小时,两组的pH值、HCO₃-和代谢性碱中毒发生率无明显差异:结论:RCA-PE 的总体滤过效果优于 SHA-PE 之后的 CRRT。与RCA-PE相关的代谢并发症主要是代谢性碱中毒,在RCA-PE后使用CRRT可改善代谢性碱中毒,是重症儿童 PE期间抗凝治疗的更好选择。
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引用次数: 0
Biomaterials for bone defect repair: Types, mechanisms and effects. 用于骨缺损修复的生物材料:类型、机制和效果。
IF 1.7 4区 医学 Q4 ENGINEERING, BIOMEDICAL Pub Date : 2024-02-01 Epub Date: 2024-01-02 DOI: 10.1177/03913988231218884
Jiaming Wang, Mingchong Liu, Chensong Yang, Yutao Pan, Shengchao Ji, Ning Han, Guixin Sun

Bone defects or bone discontinuities caused by trauma, infection, tumours and other diseases have led to an increasing demand for bone grafts and biomaterials. Autologous bone grafts, bone grafts with vascular tips, anastomosed vascular bone grafts and autologous bone marrow components are all commonly used in clinical practice, while oversized bone defects require the use of bone tissue engineering-related biomaterials to repair bone defects and promote bone regeneration. Currently, inorganic components such as polysaccharides and bioceramics, as well as a variety of bioactive proteins, metal ions and stem cells can be loaded into hydrogels or 3D printed scaffold materials to achieve better therapeutic results. In this review, we provide an overview of the types of materials, applications, potential mechanisms and current developments in the repair of bone defects.

由于创伤、感染、肿瘤和其他疾病造成的骨缺损或骨不连续性,导致对骨移植物和生物材料的需求不断增加。自体骨移植物、带血管蒂的骨移植物、吻合血管骨移植物和自体骨髓成分都是临床上常用的骨移植材料,而过大的骨缺损则需要使用骨组织工程相关的生物材料来修复骨缺损,促进骨再生。目前,多糖、生物陶瓷等无机成分以及各种生物活性蛋白、金属离子和干细胞都可以被载入水凝胶或三维打印支架材料中,以达到更好的治疗效果。在本综述中,我们将概述骨缺损修复材料的类型、应用、潜在机制和当前的发展情况。
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引用次数: 0
Osteogenic organoid for bone regeneration: Healing of bone defect in congenital pseudoarthrosis of the tibia. 用于骨再生的成骨有机体:胫骨先天性假关节的骨缺损愈合。
IF 1.7 4区 医学 Q4 ENGINEERING, BIOMEDICAL Pub Date : 2024-02-01 Epub Date: 2024-01-05 DOI: 10.1177/03913988231220844
Jose E Cardier, Dylana Diaz-Solano, Olga Wittig, Giuseppe Sierra, Jose Pulido, Rita Moreno, Soraima Fuentes, Fredy Leal

Background: Congenital pseudoarthrosis of the tibia (CPT) is an uncommon disease associated with failure to achieve bone union and recurrent fractures. There is evidence showing that CPT is associated with decreased osteogenesis. Based on the capacity of mesenchymal stromal cells (MSCs) to induce osteogenesis, we develop an osteogenic organoid (OstO) constituted by these cells, and other components of the bone niche, for inducing bone formation in a child diagnosed with CPT.

Aim: To evaluate the capacity of an OstO to induce bone formation in a patient with CPT.

Methods: The OstO was fabricated with allogeneic bone marrow MSCs from a healthy donor, collagen microbeads (CM) and PRP clot. The CM and PRP function as extracellular matrix and scaffolds for MSC. The OstO was placed at the site of non-union. Internal and external fixation was placed in the tibia. Radiological evaluation was performed after MSCs transplantation.

Results: After 4 months of MSCs transplantation, radiographic imaging showed evidence of osteogenesis at the site of CPT lesion. The tibia showed bone consolidation and complete healing of the non-union CPT lesion after 6 months. Functional improvement was observed after 1 year of MSC transplantation.

Conclusions: The OstO is a bone-like niche which promote osteogenesis in patients with failure in bone formation, such as CPT. To our knowledge, these results provide the first evidence showing CPT healing induced by an OstO constituted by allogeneic MSCs. Future studies incorporating a larger number of patients may confirm these results.

背景:先天性胫骨假关节(CPT)是一种不常见的疾病,与无法实现骨结合和复发性骨折有关。有证据表明,先天性假性胫骨关节病与成骨能力下降有关。基于间充质基质细胞(MSCs)诱导骨生成的能力,我们开发了一种由这些细胞和其他骨龛成分构成的骨生成类器官(OstO),用于诱导一名被诊断为CPT的儿童的骨形成:方法:用来自健康供体的异体骨髓间充质干细胞、胶原微珠(CM)和PRP凝块制作OstO。CM和PRP具有细胞外基质和间充质干细胞支架的功能。OstO 被放置在骨不连的部位。对胫骨进行内外固定。间充质干细胞移植后进行了放射学评估:结果:间充质干细胞移植 4 个月后,放射影像学显示 CPT 病变部位有骨生成的迹象。6 个月后,胫骨显示骨质巩固,未愈合的 CPT 病灶完全愈合。间充质干细胞移植一年后,功能得到改善:结论:OstO是一种骨样龛,可促进骨形成失败(如CPT)患者的骨生成。据我们所知,这些结果首次提供了由异体间充质干细胞构成的 OstO 诱导 CPT 愈合的证据。未来纳入更多患者的研究可能会证实这些结果。
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引用次数: 0
Clinical effect of pulmonary rehabilitation in patients with mechanical ventilation: A meta-analysis. 机械通气患者的肺康复临床效果:荟萃分析
IF 1.7 4区 医学 Q4 ENGINEERING, BIOMEDICAL Pub Date : 2024-02-01 Epub Date: 2024-01-07 DOI: 10.1177/03913988231218116
Yang Yang, Rong-Ju Zhang, Xi-Na Yuan, Yue-Qin Gu, Yong-Nan Li, Shu-Ping Wu, Yan-Shuang Cheng

Objective: To systematically evaluate the clinical efficacy of pulmonary rehabilitation in patients with mechanical ventilation in an intensive care unit (ICU).

Methods: Relevant studies were identified in the PubMed, Web of Science, National Library of Medicine, China National Knowledge Infrastructure and Wanfang databases. A meta-analysis was performed after screening based on the inclusion and exclusion criteria, data extraction and literature quality evaluation.

Results: In total, 19 studies involving 2181 participants were included. The results of the meta-analysis revealed that compared with patients with conventional rehabilitation measures, patients with pulmonary rehabilitation measures had a higher offline success rate (relative risk (RR) = 1.16; 95% confidence interval (CI): 1.09, 1.24; p < 0.00001) and higher arterial oxygen partial pressure levels (mean difference (MD) = 8.96; 95%CI: 5.98, 11.94; p < 0.0001) and these measures significantly shortened the duration of mechanical ventilation (standardised MD (SMD) = -1.08; 95%CI: -1.58, -0.59; p < 0.0001) and ICU stay (SMD = -1.41; 95%CI: -1.94, -0.88; p < 0.0001). Aspiration significantly reduced the incidence of ventilator-associated pneumonia (RR = 0.35; 95%CI: 0.24, 0.51; p < 0.00001) and deep vein thrombosis (RR = 0.32; 95%CI: 0.13, 0.76; p = 0.01) in ICU patients with mechanical ventilation.

Conclusion: Pulmonary rehabilitation measures can improve the success rate of weaning from mechanical ventilation in ICU patients, shorten the time of mechanical ventilation and ICU hospitalisation and reduce the incidence of related adverse reactions, but the impact on mortality requires further study.

目的:系统评估重症监护病房机械通气患者肺康复治疗的临床疗效:系统评估肺康复治疗在重症监护病房(ICU)机械通气患者中的临床疗效:在 PubMed、Web of Science、美国国家医学图书馆、中国国家知识基础设施和万方数据库中查找相关研究。根据纳入和排除标准进行筛选、数据提取和文献质量评估后,进行荟萃分析:结果:共纳入 19 项研究,涉及 2181 名参与者。荟萃分析结果显示,与采用常规康复措施的患者相比,采用肺康复措施的 ICU 患者机械通气的脱机成功率更高(相对风险(RR)= 1.16;95% 置信区间(CI):1.09,1.24;P P P P = 0.01):肺康复措施可提高 ICU 患者机械通气断流的成功率,缩短机械通气和 ICU 住院时间,降低相关不良反应的发生率,但对死亡率的影响还需进一步研究。
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引用次数: 0
Comparison of different 3D printers in terms of dimensional stability by image data of a dry human mandible obtained from CBCT and CT. 不同3D打印机尺寸稳定性的比较,由CBCT和CT获得的干人下颌骨图像数据。
IF 1.7 4区 医学 Q4 ENGINEERING, BIOMEDICAL Pub Date : 2024-01-01 Epub Date: 2023-11-19 DOI: 10.1177/03913988231212405
Hilal Peker Ozturk, Simel Ayyıldız

Objectives: To manage the mandibular traumas, for the expression of the complex anatomy or pathology in education of health sciences related branches, a model of the traumatized mandible is indispensable. For these, different 3D-print-technologies can be used. The aim of this study is, to measure how close these 3D-printed-models are to human-mandible (trueness) and the effectiveness of CT and CBCT at this point.

Study design: One-dry-human-mandible and 10-models manufactured by five different 3D-printers in four different-kinds of additive-manufacturing technology (Fused-Deposition-Modeling (FDM), Stereolithography (SLA), Binder-jetting (BJ), Polyjet (PJ)) were used, five-anatomic-landmarks and eight-distances were measured and evaluated. Mandible's data were constructed based on DICOM-3.0 data from CBCT and CT scans. Images were opened in MIMICS (software-program).

Results: Study compared the devices that produced models with the same dry human-mandible. It was seen that the model with the highest margin of error (132.5 mm) was manufactured by Fused-deposition-modeling device using CT-data. In terms of distance to real-data, the model with the lowest error was generated by Binder-Jetting (ZCorp) with CBCT-data. Models produced with CBCT-data are closer to dry-human-mandible than models with CT-data.

Conclusion: The current study shows that CBCT generates significantly better data than CT in producing mandibular models. The first choice for manufacturing of human mandible is BJ and the second choice is the technology of SLA.

目的:在健康科学相关学科的教学中,为了表达复杂的解剖或病理,创伤下颌骨模型是必不可少的。对于这些,可以使用不同的3d打印技术。本研究的目的是测量这些3d打印模型与人类下颌骨的接近程度(真实性)以及CT和CBCT在这一点上的有效性。研究设计:使用5台不同的3d打印机以4种不同的增材制造技术(熔融沉积建模(FDM)、立体光刻(SLA)、粘结剂喷射(BJ)、Polyjet (PJ))制造的1个干式人体下颌骨和10个模型,测量和评估5个解剖标志和8个距离。下颌骨数据基于CBCT和CT扫描的DICOM-3.0数据构建。在MIMICS(软件程序)中打开图像。结果:研究比较了同种干燥人体下颌骨的模型。结果表明,利用ct数据,采用熔融沉积建模装置制造出误差最大的模型(132.5 mm)。在与实际数据的距离方面,使用cbct数据的Binder-Jetting (ZCorp)生成的模型误差最小。用cbct数据制作的模型比用ct数据制作的模型更接近于干人下颌骨。结论:目前的研究表明,CBCT在制作下颌骨模型方面的数据明显优于CT。制造人类下颌骨的首选技术是BJ,其次是SLA技术。
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引用次数: 0
The alterations of cardiac function during venovenous artificial placenta support in fetal goats. 胎儿山羊静脉人工胎盘支持过程中心脏功能的改变。
IF 1.7 4区 医学 Q4 ENGINEERING, BIOMEDICAL Pub Date : 2024-01-01 Epub Date: 2023-12-19 DOI: 10.1177/03913988231215905
Guanhua Li, Mingliang Li, Yun Teng, Li Zhang, Chengcheng Pang, Jianfeng Tan, Jimei Chen, Jian Zhuang, Chengbin Zhou

Introduction: Venovenous artificial placenta (VVAP) may mimic the intrauterine environment for maintaining fetal circulation. However, changes in ventricular function in fetal goats undergoing VVAP support remain unclear.

Methods: Pump-assisted VVAPs were established in five fetal goats for 9 h. The myocardial performance index (Tei index), cardiac output (CO), and blood biochemical parameters were measured during VVAP support.

Results: An increasing trend of the right ventricular (RV) Tei index was seen during VVAP support (p for trend < 0.01). The right ventricular cardiac output (RVCO) increased after the initiation of VVAP, while a significant trend of reduction was observed after 3 h (p for trend = 0.03). During VVAP support, we observed remarkable elevations of plasma cTnI and arterial lactic acid, which were positively correlated with the RV Tei index, but not the left ventricular (LV) Tei index, LVCO, and RVCO.

Conclusions: The RVCO increases initially while a tendency of decrease could be observed during VVAP support. Special attention should be paid to right ventricular dysfunction during VVAP support.

导言:静脉人工胎盘(VVAP)可模拟宫内环境以维持胎儿循环。然而,接受 VVAP 支持的胎儿山羊心室功能的变化仍不清楚:在 VVAP 支持期间测量了心肌性能指数(Tei 指数)、心输出量(CO)和血液生化指标:结果:在 VVAP 支持期间,右心室 Tei 指数呈上升趋势(p for trend p for trend = 0.03)。在 VVAP 支持期间,我们观察到血浆 cTnI 和动脉乳酸显著升高,这与 RV Tei 指数呈正相关,但与左心室 Tei 指数、LVCO 和 RVCO 无关:结论:在 VVAP 支持期间,RVCO 最初会增加,但随后会呈下降趋势。结论:在 VVAP 支持过程中,RVCO 最初会增加,但随后会呈下降趋势。在 VVAP 支持过程中,应特别注意右心室功能障碍。
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引用次数: 0
期刊
International Journal of Artificial Organs
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