The increasing rate of injuries to the meniscus indicates the urgent need to develop effective repair strategies. Irreparably damaged menisci can be replaced and meniscus allografts represent the treatment of choice; however, they have several limitations, including availability and compatibility. Another approach is the use of artificial implants but their chondroprotective activities are still not proved clinically. In this situation, tissue engineering offers alternative natural decellularized extracellular matrix (ECM) scaffolds, which have shown biomechanical properties comparable to those of native menisci and are characterized by low immunogenicity and promising regenerative potential. In this article, we present an overview of meniscus decellularization methods and discuss their relative merits. In addition, we comparatively evaluate cell types used to repopulate decellularized scaffolds and analyze the biocompatibility of the existing experimental models. At present, acellular ECM hydrogels, as well as slices and powders, have been explored, which seems to be promising for partial meniscus regeneration. However, their inferior biomechanical properties (compressive and tensile stiffness) compared to natural menisci should be improved. Although an optimal decellularized meniscus scaffold still needs to be developed and thoroughly validated for its regenerative potential in vivo, we believe that decellularized ECM scaffolds are the future biomaterials for successful structural and functional replacement of menisci.
The evidence to support use of danshen preparations is too weak to make any judgement about its effects. Evidence from RCTs is insufficient and of low quality. The safety of danshen preparations is unproven, although some adverse events have been reported. More evidence from high quality trials is needed to support the clinical use of danshen preparations.
Tongxinluo in combination with routine angina therapy appears to reduce the risk of subsequent AMI, PTCA or CABG, angina attacks and severity, as well as improving symptoms and ischaemic changes on the electrocardiogram (ECG). Due to the methodological limitations of the studies, the evidence is insufficient to make any conclusive recommendations about the use of this treatment for patients presenting with unstable angina. Large high quality randomised controlled trials are warranted.
BackgroundEmergence agitation (EA) is one of the most common postoperative complications in children. The purpose of this meta-analysis is to assess the effect of dexmedetomidine for preventing postoperative agitation in children.MethodsWe searched the Cochrane Central Register of Controlled Trails, MEDLINE, and EMBASE. Randomized controlled trials were included. The following outcome measures were evaluated: incidence of EA, number of patients requiring rescue, time to eye-open, time to extubation, time to discharge from the postanesthesia care unit (PACU).ResultsWe analyzed 19 trials (1608 patients) that met the inclusion criteria. Compared with placebo, intravenous dexmedetomidine significantly reduced the incidence of EA [risk ratio (RR) 0.34, 95% confidence interval (CI) 0.25–0.44, P<0.00001). Dexmedetomidine also decreased the incidence of severe pain (RR 0.41, 95% CI 0.27–0.62, P<0.0001) and requirement of a rescue drug (RR 0.31, 95% CI 0.18–0.53, P<0.0001). However, compared with placebo, dexmedetomidine increased the time to eye-open by 0.98 min (P = 0.01) and the time to PACU discharge by 4.63 min (P = 0.02). Dexmedetomidine was also compared with midazolam, propofol, ketamine, and fentanyl, among others. No significant difference was found in the incidence of EA for most of these comparisons, with the exception of fentanyl and propofol, where dexmedetomidine was more beneficial.ConclusionsDexmedetomidine was proved effective for preventing EA and for reducing severe pain and the requirement of rescue drugs. It slightly increased the time to eye-open and the time to PACU discharge. Dexmedetomidine was also more beneficial than propofol or fentanyl in preventing EA.
The preparation of nitrogen-doped activated carbon (NACs) has received significant attention because of their applications in CO2 capture and sequestration (CCS) owing to abundant nitrogen atoms on their surface and controllable pore structures by carefully controlled carbonization. We report high-surface-area porous N-doped activated carbons (NAC) by using soft-template-assisted self-assembly followed by thermal decomposition and KOH activation. The activation process was carried out under different temperature conditions (600–800 °C) using polyimine as precursor. The NAC-800 was found to have a high specific surface area (1900 m2 g−1), a desirable micropore size below 1 nm and, more importantly, a large micropore volume (0.98 cm3 g−1). NAC-800 also exhibits a significant capacity of CO2 capture i.e., over 6. 25 and 4.87 mmol g−1 at 273 K and 298 K respectively at 1.13 bar, which is one of among the highest values reported for porous carbons so far. Moreover, NAC also shows an excellent separation selectivity for CO2 over N2.
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