Objective To summarize the biomechanical research progress of biomaterials in rotator cuff injury repair and to explore how biomaterials can restore the native histological and mechanical properties of the rotator cuff. Methods The relevant literature at home and abroad were widely reviewed to analyze the biomechanical properties of synthetic biomaterials, naturally derived biomaterials, and tissue grafts in the repair of rotator cuff injuries. ResultsSynthetic biomaterials [such as poly (lactic-co-glycolic acid) and polycaprolactone] can provide initial stable mechanical support due to their adjustable mechanical properties and degradation characteristics, while naturally derived biomaterials (such as collagen and hyaluronic acid) can promote cell adhesion and tissue integration due to their biocompatibility and bioactivity. Tissue grafts exhibit significant clinical utility by providing immediate mechanical stability and promoting tendon-to-bone healing. Three-dimensional bioprinting technology provides new possibilities for personalized repair of rotator cuff injuries by precisely controlling the spatial distribution and mechanical properties of biomaterials. Conclusion Future studies should further optimize the design of bioprinting materials, cell sources, and scaffolds to achieve better mechanical properties and clinical efficacy of biomaterials in the repair of rotator cuff injuries.
ObjectiveTo systematically review the efficacy and safety of angiotensin-converting enzyme inhibitor (ACEI) and/or angiotensin receptor blocker (ARB) in the treatment of patients with diastolic heart failure (DHF). MethodsPubMed, EMbase, The Cochrane Library (Issue 11, 2014), CNKI, WanFang Data, VIP and CBM were electronically searched from inception to November 2014 for randomized controlled trials (RCTs) of ACEI/ARB for DHF patients. References of included studies were also retrieved. Two reviewers independently screened literature according to the inclusion and exclusion criteria, extracted data and assessed the risk of bias of included studies. Then, meta-analysis was performed using RevMan 5.2 software. ResultsA total of 22 RCTs involving 9 557 patients were included. The results of meta-analysis indicated that, compared with the control group, the ACEI/ARB group had significant improvements in exercise capacity (6-minute walk distance:SMD=0.02, 95% CI 0.05 to 0.38, P=0.01; Exercise time:MD=40.58, 95% CI 14.06 to 67.10, P=0.003) and diastolic function (E/A ratio:MD=0.20, 95% CI 0.09 to 0.31, P=0.000 4; E/E' ratio:MD=-1.69, 95% CI -2.11 to -1.27, P<0.000 01). In addition, compared with the control treatment, ACEI/ARB could significantly decrease the serum BNP level (SMD=-0.44, 95% CI -0.72 to -0.16, P=0.002) and NT-proBNP level (SMD=-0.68, 95% CI -1.24 to -0.12, P=0.02). ConclusionCurrent evidence shows that ACEI/ARB can improve the exercise capacity and diastolic function, and reduce the levels of serum BNP and NT-proBNP in DHF patients. Due to the limited quality of the included studies and discrepancies in the diagnostic criteria of DHF, more high-quality studies are needed to verify the above conclusion.
ObjectiveTo evaluate the efficacy and safety of Xueshuantong combined with conventional western medicine for angina pectoris in coronary heart disease (CHD) patients. MethodsWe searched the Cochrane Library (2013.12), Medline (2013.10), EMbase (unlimited-2013.10), China Nation Knowledge Infrastructure (unlimited-2013.10) and the Wanfang Database (unlimitied-2013.10), Weipu Database (unlimited-2013.10), and CBM (unlimited-2013.10) on computers for parallel group randomized controlled trials (RCTs) comparing Xueshuantong and placebo for patients with angina pectoris. Three researchers selected the trials based on the inclusion and exclusion criteria and then extracted the data, assessed the quality of each trial independently. After cross checking, the Cochrane Collaboration's RevMan 5.1 software was used to perform Meta-analysis. ResultsThirteen RCTs and a total of 1 298 participants were involved. Meta-analysis showed that Xueshuantong combined with the conventional western medicine had better curative effect on angina pectoris for CHD than conventional therapy; stable angina pectoris [RR=1.24, 95%CI (1.12, 1.37), P<0.000 1]; unstable angina pectoris [RR=1.22, 95%CI (1.15, 1.29), P<0.000 01]. There was also significant difference in total curative effect between the two groups [RR=1.22, 95%CI (1.16, 1.29), P<0.000 01]. Xueshuantong also had better curative effect on improving performance of electrocardiogtram (ECG): stable angina pectoris [RR=1.30, 95%CI (1.11, 1.51), P=0.000 8]; unstable angina pectoris [RR=1.18, 95%CI (1.10, 1.28), P<0.000 1]. There was also significant difference in total curative effect on improving performance of ECG between the two groups [RR=1.21, 95%CI (1.13, 1.29), P<0.000 01]. But there was no significant difference in adverse effects rate between the two groups [RR=4.50, 95%CI (0.99, 20.53), P=0.05]. ConclusionCompared with conventional therapy, Xueshuantong combined with conventional western medicine has better curative effect with improved performance of ECG. The adverse effect rate between the two groups is not significantly different. But because of the small scale, inferior quality, and bias risk of these trials, large-scale, rational designed, multicenter RCTs are needed to confirm our conclusions.
ObjectiveTo compare the mid-term effectiveness of arthroscopic shoulder capsular release combined with acromiohumeral distance (AHD) restoration in the treatment of diabetic secondary stiff shoulder and primary frozen shoulder. Methods A retrospective analysis was conducted on clinical data of 22 patients with diabetic secondary stiff shoulder (group A) and 33 patients with primary frozen shoulder (group B), who underwent arthroscopic 270° capsular release combined with AHD restoration treatment. There was no significant difference between the two groups in gender, age, affected side, disease duration, and preoperative AHD, shoulder flexion range of motion, abduction range of motion, American Shoulder and Elbow Surgeons (ASES) score, visual analogue scale (VAS) score, and Constant score (P>0.05). Only the difference in the internal rotation cone rank and external rotation range of motion between the two groups showed significant differences (P<0.05). The improvement in shoulder pain and function was evaluated by using VAS score, ASES score, and Constant score before operation and at last follow-up. Active flexion, abduction, external rotation range of motion, and internal rotation cone rank were recorded and compared. AHD was measured on X-ray films.Results All patients were followed up 24-92 months (median, 57 months). There was no significant difference in follow-up time between group A and group B (P>0.05). No fractures or glenoid labrum tears occurred during operation, all incisions healed by first intention, and no complication such as wound infection or nerve injury was observed during the follow-up. At last follow-up, there were significant improvements in active flexion, abduction, external rotation range of motion, internal rotation cone rank, AHD, VAS score, ASES score, and Constant score when compared with preoperative ones in both groups (P<0.05). Except for the difference in change in external rotation range of motion, which had significant difference between the two groups (P<0.05), there was no significant difference in other indicators between the two groups (P>0.05). ConclusionArthroscopic capsular release combined with AHD restoration can achieve good mid-term effectiveness in the treatment of diabetic secondary stiff shoulder and primary frozen shoulder. However, the improvement in external rotation range of motion is more significant in the patients with diabetic secondary stiff shoulder.