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      Three-dimensional bioprinting collagen/silk fibroin scaffold combined with neural stem cells promotes nerve regeneration after spinal cord injury

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          Abstract

          Abstract

          Many studies have shown that bio-scaffolds have important value for promoting axonal regeneration of injured spinal cord. Indeed, cell transplantation and bio-scaffold implantation are considered to be effective methods for neural regeneration. This study was designed to fabricate a type of three-dimensional collagen/silk fibroin scaffold (3D-CF) with cavities that simulate the anatomy of normal spinal cord. This scaffold allows cell growth in vitro and in vivo. To observe the effects of combined transplantation of neural stem cells (NSCs) and 3D-CF on the repair of spinal cord injury. Forty Sprague-Dawley rats were divided into four groups: sham (only laminectomy was performed), spinal cord injury (transection injury of T10 spinal cord without any transplantation), 3D-CF (3D scaffold was transplanted into the local injured cavity), and 3D-CF + NSCs (3D scaffold co-cultured with NSCs was transplanted into the local injured cavity. Neuroelectrophysiology, imaging, hematoxylin-eosin staining, argentaffin staining, immunofluorescence staining, and western blot assay were performed. Apart from the sham group, neurological scores were significantly higher in the 3D-CF + NSCs group compared with other groups. Moreover, latency of the 3D-CF + NSCs group was significantly reduced, while the amplitude was significantly increased in motor evoked potential tests. The results of magnetic resonance imaging and diffusion tensor imaging showed that both spinal cord continuity and the filling of injury cavity were the best in the 3D-CF + NSCs group. Moreover, regenerative axons were abundant and glial scarring was reduced in the 3D-CF + NSCs group compared with other groups. These results confirm that implantation of 3D-CF combined with NSCs can promote the repair of injured spinal cord. This study was approved by the Institutional Animal Care and Use Committee of People’s Armed Police Force Medical Center in 2017 (approval No. 2017-0007.2).

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          Biomaterial design strategies for the treatment of spinal cord injuries.

          The highly debilitating nature of spinal cord injuries has provided much inspiration for the design of novel biomaterials that can stimulate cellular regeneration and functional recovery. Many experts agree that the greatest hope for treatment of spinal cord injuries will involve a combinatorial approach that integrates biomaterial scaffolds, cell transplantation, and molecule delivery. This manuscript presents a comprehensive review of biomaterial-scaffold design strategies currently being applied to the development of nerve guidance channels and hydrogels that more effectively stimulate spinal cord tissue regeneration. To enhance the regenerative capacity of these two scaffold types, researchers are focusing on optimizing the mechanical properties, cell-adhesivity, biodegradability, electrical activity, and topography of synthetic and natural materials, and are developing mechanisms to use these scaffolds to deliver cells and biomolecules. Developing scaffolds that address several of these key design parameters will lead to more successful therapies for the regeneration of spinal cord tissue.
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            Arthroscopic replacement of massive, irreparable rotator cuff tears using a GraftJacket allograft: technique and preliminary results.

            Our purpose was to assess the short-term results and describe the technique of arthroscopic repair of irreparable rotator cuff tears by use of a GraftJacket allograft (Wright Medical Technology, Arlington, TN). Between March 2003 and February 2004, 16 patients with massive, contracted, immobile rotator cuff tears were treated with arthroscopic placement of a GraftJacket allograft by a single surgeon. Patients were followed up for 1 to 2 years. All were evaluated preoperatively and postoperatively by use of the modified University of California, Los Angeles scoring system, Constant score, and Simple Shoulder Test. Magnetic resonance imaging was performed postoperatively at 3 months and 1 year. At a mean follow-up of 26.8 months (range, 12 to 38 months), 15 of 16 patients were satisfied with the procedure. The mean University of California, Los Angeles score increased from 18.4 preoperatively to 30.4 postoperatively (P = .0001). The Constant score increased from 53.8 to 84.0 (P = .0001). Statistically significant improvements were seen in pain, forward flexion, and external rotation strength. Thirteen patients had full incorporation of the graft into the native tissue as documented on magnetic resonance imaging. There were no complications in this cohort of patients. Our study supports GraftJacket allograft as a viable solution for surgical salvage in select cases of massive, irreparable rotator cuff pathology. This treatment option may provide patients with decreased pain and increased function despite a previously irreparable rotator cuff tear. Level IV, therapeutic case series.
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              Combinatorial Therapies After Spinal Cord Injury: How Can Biomaterials Help?

              Traumatic spinal cord injury (SCI) results in an immediate loss of motor and sensory function below the injury site and is associated with a poor prognosis. The inhibitory environment that develops in response to the injury is mainly due to local expression of inhibitory factors, scarring and the formation of cystic cavitations, all of which limit the regenerative capacity of endogenous or transplanted cells. Strategies that demonstrate promising results induce a change in the microenvironment at- and around the lesion site to promote endogenous cell repair, including axonal regeneration or the integration of transplanted cells. To date, many of these strategies target only a single aspect of SCI; however, the multifaceted nature of SCI suggests that combinatorial strategies will likely be more effective. Biomaterials are a key component of combinatorial strategies, as they have the potential to deliver drugs locally over a prolonged period of time and aid in cell survival, integration and differentiation. Here we summarize the advantages and limitations of widely used strategies to promote recovery after injury and highlight recent research where biomaterials aided combinatorial strategies to overcome some of the barriers of spinal cord regeneration.
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                Author and article information

                Journal
                Neural Regen Res
                Neural Regen Res
                NRR
                Neural Regeneration Research
                Wolters Kluwer - Medknow (India )
                1673-5374
                1876-7958
                May 2020
                08 November 2019
                : 15
                : 5
                : 959-968
                Affiliations
                [1 ]Department of Thoracic Surgery, General Hospital of People's Liberation Army (PLA), Beijing, China
                [2 ]Tianjin Key Laboratory of Neurotrauma Repair, Institute of Traumatic Brain Injury and Neuroscience, Center for Neurology and Neurosurgery of Chinese People's Armed Police Force (PAP) Medical Center, Tianjin, China
                [3 ]Tianjin Medical University, Tianjin, China
                [4 ]Department of Neurology, Luoyang First Hospital of Traditional Chinese Medicine, Luoyang, Henan Province, China
                [5 ]Department of Neurosurgery, Fourth Central Hospital of Tianjin, Tianjin, China
                Author notes
                [* ] Correspondence to: Xu-Yi Chen, chenxuyi1979@ 123456126.com ; Sai Zhang, zhangsai718@ 123456vip.126.com .
                [#]

                These authors contributed equally to this work.

                Author contributions: Study design: JPJ, XYL, XYC; experimental implementation: JPJ, XYL, FZ, XZ, XYL, CD, HYX, KM, ZTY; data analysis: JPJ, XGN; material contribution and equipment coordination: SZ, XYC; paper writing: JPJ, XYL. All authors approved the final version of the paper.

                Author information
                http://orcid.org/0000-0002-0420-8349
                http://orcid.org/0000-0002-8028-4183
                Article
                NRR-15-959
                10.4103/1673-5374.268974
                6990792
                31719263
                26f96425-872f-486e-baeb-a66527839f9f
                Copyright: © Neural Regeneration Research

                This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.

                History
                : 22 November 2018
                : 03 December 2018
                : 26 August 2019
                Categories
                Research Article

                3d bioprinting,collagen,diffusion tensor imaging,functional recovery,magnetic resonance imaging,nerve regeneration,neural regeneration,neural stem cell,scaffold,silk fibroin,spinal cord injury

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