ObjectiveTo explore the degradation of AZ31 magnesium alloy and poly (lactic-co-glycolic acid) (PLGA) in the femoral condyle, and then evaluate the laws of degradation of AZ31 magnesium alloy by Micro-CT images and data. MethodsForty 3-month-old male New Zealand white rabbits (weighing, 2.5 kg) were randomly divided into 4 groups, 10 rabbits each group. Forty micro-arc-oxidized AZ31 magnesium alloy pins and 40 PLGA pins were implanted into the right and left femoral condyle, respectively. Micro-CT images and data analysis were used to evaluate the degradation at 4, 8, 12, and 16 weeks after operation (n=10). Degradation was evaluated by weight difference between pre-and post-implantation. The inflammatory response was observed around the implants by HE staining. The weight loss of magnesium alloy and Micro-CT results were compared. ResultsThe Micro-CT images showed that PLGA pins had gray low signal, which was similar to the soft tissue around. At 4 weeks after operation, no signs of degradation were observed, and there were little corrosion pitting on the magnesium alloy. At 8 weeks, corrosion pitting gradually expanded, the boundary between the longitudinal axis and the cross section became blurred; at 16 weeks, corrosion pitting became bigger, and the boundary was discontinuous. Micro-CT quantitative analysis showed that the volume fraction of magnesium pins decreased slowly at 4 and 8 weeks; it was significantly lower at 12 and 16 weeks than 4 and 8 weeks (P < 0.05). The magnesium cylinder mineral density continuously decreased during the study period, it had a rapidly speed from 12 to 16 weeks (P < 0.05). However, the magnesium CT image density showed a slight change (P>0.05). The surface-to-volume ratio of the pins constantly increased, and the ratio was significantly larger at 12 and 16 weeks than 4 and 8 weeks, and at 16 weeks than 12 weeks (P < 0.05). There was more and more corrosion pitting on the surface with time, which resulted in a decrease in the radius that mean trabecular thickness gradually decreased, showing significant difference between different time points after 8 weeks (P < 0.05). The weight loss detection showed that the degradation of magnesium pin and PLGA gradually increased with time (P < 0.05), and the degradation rate of magnesium pin was significantly lower than that of PLGA at 8-12 weeks (P < 0.05), but the degradation rate of magnesium pin was higher than that of PLGA at 16 weeks. At each time point, the weight loss of magnesium alloy was similar to that by Micro-CT, but mass fraction was lower than volume fraction and had significant differences at 8, 12, and 16 weeks (P < 0.05). HE staining revealed that slight inflammatory response was observed around the magnesium pins at 4 weeks, and inflammatory reaction gradually reduced with time and disappeared at 16 weeks, but no inflammatory reaction was seen around PLGA. ConclusionMicro-CT has the advantages of non-trauma, in vivo detection, quantitative analysis, and precise data in evaluating the degradation of AZ31 magnesium alloy. Regarding the degradation of the magnesium alloy and PLGA in vivo, the degradation rate is slow in the early stage, and then increases with time. The degradation of PLGA is faster and earlier but it is then overtaken by AZ31 magnesium alloy at 16 weeks. During the degradation, the density of the magnesium has almost no change. The biomaterials can not firmly attach to the surrounding tissues due to inadequate holding forces.
Objective To investigate the effect of magnesium phosphate cement (MPC) to fix fractures.Methods In vitro: fifty four pairs of fresh pig femoral heads were made 1 cm2 fracture and divided into 6 groups(n=9 pairs ). MPC was used to agglutinate fracture of femoral headsat 100% humidity and at 25℃, 37℃ respectively. At 30 minutes, 2 and 24hours after agglutination, the biomechanical strength was measured. In vivo:the tibia plateau fracture models on both sides of 24 rabbits were made, one side was fixed with “L” shaped plate, and the other side was fixed with MPC. Then the effect of treatment was investigated by macrography, micrography, radiography and the changes of serum electrolyte levels at 3 days, 3，6 and 9 weeks after operation. Results In vitro: the adhesive ability of MPCwas b. At 24 hours after MPC agglutination, the average tensile strength was 117.16±23.29 N/cm2. In vivo:after 6 weeks of fixation, the X-ray results showed that all rabbits’ tibia plateau fractures were healed without displacement, and MPC was absorbed gradually. The changes ofserum electrolyte levels were very minimal. The macrography observation showed that reduction of fracture were good at 3 days after operation, partial MPC remained in fracture end at 3 weeks, fracture line disappeared at 6 weeks and good remodeling was achieved at 9 weeks after operation in the experimental group. Themicrography observation showed that the interface between bone and MPC was distinct at 3 days, MPC was degraded gradually and trabeculae began to grow into MPCat 3 weeks, and almost all MPC was degraded at 6 and 9 weeks of operation. Conclusion MPC is a promising biomaterial, and might potentially be used for fracture treatment.
Objective To review the progress of in vivo study on degradable magnesium alloys application as bone-implant materials. Methods Recent literature was extensively reviewed and summarized, concerning the in vivo study on degradable magnesium alloys as orthopaedic implants. Results Magnesium alloys possess a natural ability to degrade via corrosion in vivo, which is promising candidate material for orthopaedic medical device applications. A great progress has been made to improve in vivo performance and integration with bone tissue. However, the degradation mechanism of magnesium-based materials in the physiological environment and long-term effect on body are not available. The modulation of the corrosion rate of magnesium alloys must also be accomplished. Conclusion Magnesium alloys have the potential to serve as degradable implants for orthopaedic applications, but a great deal of further investigation is still necessary.
Objective To systematically evaluate the effects of magnesium sulfate on postoperative pain and complications after general anesthesia. Methods A literature search was conducted in following databases as The Cochrane Library, EMbase, PubMed, EBSCO, Springer, Ovid, CNKI and CBM from the date of establishment to September 2011 to identify randomized controlled trials (RCTs) about intravenous infusion of magnesium sulfate during general anesthesia. All included RCTs were assessed and the data were extracted according to the standard of Cochrane systematic review. The homogenous studies were pooled using RevMan 5.1 software. Results A total of 11 RCTs involving 905 patients were included. The results of meta-analyses showed that compared with the control group, intravenous infusion of magnesium sulfate during general anesthesia significantly reduced the visual analog scale (VAS) scores at the time-points of 2, 4, 6, 8, 16, and 24 hours, respectively, after surgery, the postoperative 24 hours morphine requirements, and the incidents of postoperative nausea and vomiting (RR=0.61, 95%CI 0.40 to 0.91, P=0.02) and chilling (RR=0.29, 95%CI 0.14 to 0.59, P=0.000 7). Although the incidents of bradycardia (RR=1.93, 95%CI 1.05 to 3.53, P=0.03) increased, there were no adverse events or significant differences in the incidents of hypotension and serum concentration changes of magnesium. Conclusion Intravenous infusion of magnesium sulfate during general anesthesia may obviously decrease the pain intensity, and the incidents of nausea and vomiting and chilling after surgery, without increasing cardiovascular adverse events and risk of hypermagnesemia. The results still need to be confirmed by more high-quality and large-sample RCTs.
Tweenty-one SD rats with streptozotocin-induced diabetes were investigated for the influence of magnesium in cAMP level in the retina of the diabetic rats. The diabetic rats were divided into 3 groups: group 1, drinking tap hehwater; group 2, drinking 0.5% MgSO4 solution and group 3, receiving intramuscular MgSO4(0.1g/kg) once a month. In addition, group 4, a controlgroup of normal nondiabetic rats fed with tap water. In aperiod of 5 months examination, the growth and health conditions of diabetic rats were found to be nearly normal in group 2, 3 and 4, manifested by gaining weight and soft, smooth hairs on the skin, in contrast with loss in weight, rough hairs and even dying of infection in 2 of the diabetic rats in group 1. furthermore, the level of cAMP content in retina was found significantly higher in the diabetic rats taking Mg++ in spite of the route of administration(group 2, 3), as well as in the control group(group 4) than that of the diabetic rats which were fed with tap water. These results demonstrated that Mg++ might play an important role in improving the metabolism of diabetic rats including the retinal tissue by influencing the level of cAMP content, which is necessary in nuclear acid metabolism, protein synthesis, proliferation and differentiation, and other intracellular metabolic processes. （Chin J Ocul Fundus Dis,1992,8:141-143）
ObjectiveTo summarize the research and application progress of magnesium and magnesium alloys implants in the orthopedics. MethodsThe domestic and foreign related literature about the research progress and application of magnesium and magnesium alloys implants in the orthopedics was reviewed. ResultsCurrently approved and commonly used metallic implants in orthopedics include stainless steels, titanium alloys, and chromium alloys having many disadvantages of poor biocompatibility, mismatch with the biomechanical properties of the bone tissue, and need of second surgical procedure to remove. Compared with traditional implants, magnesium and magnesium alloys have biomechanical properties closer to natural bone tissue, and in vivo degradation, which have the potential to serve as new biocompatible and degradable implants. Although magnesium and magnesium alloy materials have their own advantages, but the degradation rate is still too fast and so on. At present, the research and development of medical magnesium and magnesium alloy materials are to improve their corrosion resistance and control the rate of degradation. ConclusionMagnesium and magnesium alloys have great potential as a implant material in the orthopedics, through further systematic and in-depth study, it is expected to become a new generation of degradation biological implant materials.
ObjectiveTo explore the effects of postoperative magnesium sulphate on pain relief after open gynecological surgery. MethodsSixty women who were diagnosed as hysteromyoma in Lucheng People' Hospital in Wenzhou city and underwent open hysterectomy from July 2011 to May 2012 were randomly divided into two groups (30 women in each group). Applying epidural administration of magnesium sulfate, the magnesium sulfate group (n=30) was given 500 μg magnesium sulfate and 1 mg morphine, while the control group (n=30) was only given 1 mg morphine. Pain scores (at 2 h, 4 h, 8 h, 16 h and 24 h, respectively) as well as complications were observed. Plasma levels of β-endorphin (β-EP) (in 4 h and 24 h, respectively) and the first time when needs postoperative analgesia were recorded. ResultsCompared with the control group, pain scores during 24 h after operation, levels of β-EP at 4 h and 24 h, and the first time for postoperative analgesia were better improved in the magnesium sulfate group. ConclusionEpidural administration of magnesium sulfate combined with morphine is an effective and safe method to improve the effects of postoperative magnesium sulphate on pain relief after open gynecological surgery.
Objective To assess the systematic reviews of magnesium sulfate used to treat severe asthma. Methods An electronic search was performed in The Cochrane Library (Issue 2, 2008), ACP Journal Club (1991 to June 2008), MEDLINE (1990 to June 2008), Chinese Journal Full-text Database (1979 to June 2008), Chinese Scientific and Technological Periodical Databases (VIP) (1980 to June 2008), and Chinese Bio-medicine Database (CBM) (1980 to June 2008) to collect systematic reviews of magnesium sulfate treatment for severe asthma. The retrieved systematic reviews were reassessed, and then we adopted the evidence for clinical practice. Results Nine systematic reviews were included, and all of them included 14.1 ± 2.9 items of QUOROM (the quality of reporting of Meta-analyses) on average. In general, the included systematic reviews had comparatively high quality. Evidence illustrated that intravenous infusion of magnesium sulfate could improve pulmonary function and reduce hospital admission without any serious side effects. However, no evidence could verify that patients with asthma can benefit from aerosolized and oral magnesium sulfate. In a specific case with severe asthma, we used magnesium sulfate via intravenous infusion which helped the control of symptoms with no adverse reactions. Conclusion Magnesium sulfate via intravenous infusion can improve pulmonary function and reduce hospital admission rates. Due to its effectiveness, safety, and low cost, it deserves widespread application in patients with severe asthma.
Objective To evaluate the effect of biodegradable magnesium alloy materials in promoting tendon-bone healing during rotator cuff tear repair and to investigate their potential underlying biological mechanisms.Methods Forty-eight 8-week-old Sprague Dawley rats were taken and randomly divided into groups A, B, and C. Rotator cuff tear models were created and repaired using magnesium alloy sutures in group A and Vicryl Plus 4-0 absorbable sutures in group B, while only subcutaneous incisions and sutures were performed in group C. Organ samples of groups A and B were taken for HE staining at 1 and 2 weeks after operation to evaluate the safety of magnesium alloy, and specimens from the supraspinatus tendon and proximal humerus were harvested at 2, 4, 8, and 12 weeks after operation. The specimens were observed macroscopically at 4 and 12 weeks after operation. Biomechanical tests were performed at 4, 8, and 12 weeks to test the ultimate load and stiffness of the healing sites in groups A and B. At 2, 4, and 12 weeks, the specimens were subjected to the following tests: Micro-CT to evaluate the formation of bone tunnels in groups A and B, HE staining and Masson staining to observe the regeneration of fibrocartilage at the tendon-bone interface after decalcification and sectioning, and Goldner trichrome staining to evaluate the calcification. Immunohistochemical staining was performed to detect the expressions of angiogenic factors, including vascular endothelial growth factor (VEGF) and bone morphogenetic protein 2 (BMP-2), as well as osteogenic factors at the tendon-bone interface. Additionally, immunofluorescence staining was used to examine the expressions of Arginase 1 and Integrin beta-2 to assess M1 and M2 macrophage polarization at the tendon-bone interface. The role of the phosphatidylinositol 3-kinase (PI3K)/protein kinase B (AKT) signaling pathway in tendon-bone healing was further analyzed using real-time fluorescence quantitative PCR. Results Analysis of visceral sections revealed that magnesium ions released during the degradation of magnesium alloys did not cause significant toxic effects on organs such as the heart, liver, spleen, lungs, and kidneys, indicating good biosafety. Histological analysis further demonstrated that fibrocartilage regeneration at the tendon-bone interface in group A occurred earlier, and the amount of fibrocartilage was significantly greater compared to group B, suggesting a positive effect of magnesium alloy material on tendon-bone interface repair. Additionally, Micro-CT analysis results revealed that bone tunnel formation occurred more rapidly in group A compared to group B, further supporting the beneficial effect of magnesium alloy on bone healing. Biomechanical testing showed that the ultimate load in group A was consistently higher than in group B, and the stiffness of group A was also greater than that of group B at 4 weeks, indicating stronger tissue-carrying capacity following tendon-bone interface repair and highlighting the potential of magnesium alloy in enhancing tendon-bone healing. Immunohistochemical staining results indicated that the expressions of VEGF and BMP-2 were significantly upregulated during the early stages of healing, suggesting that magnesium alloy effectively promoted angiogenesis and bone formation, thereby accelerating the tendon-bone healing process. Immunofluorescence staining further revealed that magnesium ions exerted significant anti-inflammatory effects by regulating macrophage polarization, promoting their shift toward the M2 phenotype. Real-time fluorescence quantitative PCR results demonstrated that magnesium ions could facilitate tendon-bone healing by modulating the PI3K/AKT signaling pathway. ConclusionBiodegradable magnesium alloy material accelerated fibrocartilage regeneration and calcification at the tendon-bone interface in rat rotator cuff tear repair by regulating the PI3K/AKT signaling pathway, thereby significantly enhancing tendon-bone healing.
Objective To review the research progress of magnesium and magnesium alloy implants in the repair and reconstruction of sports injury. Methods Relevant literature of magnesium and magnesium alloys for sports injury repair and reconstruction was extensively reviewed. The characteristics of magnesium and its alloys and their applications in the repair and reconstruction of sports injuries across various anatomical sites were thoroughly discussed and summarized. Results Magnesium and magnesium alloys have advantages in mechanical properties, biosafety, and promoting tendon-bone interface healing. Many preclinical studies on magnesium and magnesium alloy implants for repairing and reconstructing sports injuries have yielded promising results. However, successful clinical translation still requires addressing issues related to mechanical strength and degradation behavior, where alloying and surface treatments offer feasible solutions. Conclusion The clinical translation of magnesium and magnesium alloy implants for repairing and reconstructing sports injuries holds promise. Subsequent efforts should focus on optimizing the mechanical strength and degradation behavior of magnesium and magnesium alloy implants. Conducting larger-scale biocompatibility testing and developing novel magnesium-containing implants represent new directions for future research.