Electrodes, Implanted

电极,植入
  • 文章类型: Journal Article
    开发了一种基于生物可吸收Mg-Nd-Zn-Zr合金的可植入电极,用于下一代射频(RF)组织焊接应用,旨在减少热损伤,提高吻合口强度。镁合金焊条在焊接区域设计了圆柱面(CS)和连续长环(LR)不同的结构特征,并通过有限元分析(FEA)对电热模拟进行了研究。同时,监测组织焊接过程中的温度变化,并通过测量撕脱力和爆裂压力评估焊接组织的吻合强度。FEA结果表明,当将110V的交流电施加到LR电极10s时,焊接区域的平均温度和坏死组织的比例显着降低。在离体组织焊接实验中,LR电极焊接组织的最高温度和平均温度也明显降低,焊接组织的吻合强度明显提高。总的来说,应用LR电极后可获得满足临床要求的理想焊接温度和吻合强度,表明,优化结构设计的Mg-Nd-Zn-Zr合金显示出开发用于下一代射频组织焊接应用的植入式电极的巨大潜力。
    An implantable electrode based on bioresorbable Mg-Nd-Zn-Zr alloy was developed for next-generation radiofrequency (RF) tissue welding application, aiming to reduce thermal damage and enhance anastomotic strength. The Mg alloy electrode was designed with different structural features of cylindrical surface (CS) and continuous long ring (LR) in the welding area, and the electrothermal simulations were studied by finite element analysis (FEA). Meanwhile, the temperature variation during tissue welding was monitored and the anastomotic strength of welded tissue was assessed by measuring the avulsion force and burst pressure. FEA results showed that the mean temperature in the welding area and the proportion of necrotic tissue were significantly reduced when applying an alternating current of 110 V for 10 s to the LR electrode. In the experiment of tissue welding ex vivo, the maximum and mean temperatures of tissues welded by the LR electrode were also significantly reduced and the anastomotic strength of welded tissue could be obviously improved. Overall, an ideal welding temperature and anastomotic strength which meet the clinical requirement can be obtained after applying the LR electrode, suggesting that Mg-Nd-Zn-Zr alloy with optimal structure design shows great potential to develop implantable electrode for next-generation RF tissue welding application.
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  • 文章类型: Journal Article
    目前临床上使用的电子植入物,包括用于心外膜监测和心脏刺激的心脏起搏导线,依靠手术缝合或将电极直接插入心脏组织。这些方法可能会在植入和取回起搏导线期间造成组织创伤,有可能出血,组织损伤,和设备故障。这里,我们报告了一种生物粘附性起搏导线,该导线可通过物理和共价相互作用直接与心脏组织连接,以支持微创粘合剂植入和使用脱离溶液轻柔地按需移除装置.我们开发了可3D打印的生物粘附材料,用于通过在亲水性聚氨酯上接枝聚合聚丙烯酸并与聚(3,4-亚乙基二氧噻吩):聚(苯乙烯磺酸盐)(PEDOT:PSS)混合以获得导电性来定制制造该设备。生物粘附构建体表现出与心脏组织相似的机械性能和强组织粘附性,支持稳定的电气接口。输注脱离溶液以裂解粘附界面与组织之间的物理和共价交联,可以在大鼠和猪模型中恢复生物粘附起搏引线,而不会造成明显的组织损伤。对啮齿动物和猪的心脏进行连续可靠的心脏监测和起搏,持续2周,具有一致的捕获阈值和感知幅度,与市售替代品相反。在猪模型中实现了起搏和连续遥测监测。这些发现可能为用于心脏监测和治疗的粘附生物电子设备提供有希望的平台。
    Current clinically used electronic implants, including cardiac pacing leads for epicardial monitoring and stimulation of the heart, rely on surgical suturing or direct insertion of electrodes to the heart tissue. These approaches can cause tissue trauma during the implantation and retrieval of the pacing leads, with the potential for bleeding, tissue damage, and device failure. Here, we report a bioadhesive pacing lead that can directly interface with cardiac tissue through physical and covalent interactions to support minimally invasive adhesive implantation and gentle on-demand removal of the device with a detachment solution. We developed 3D-printable bioadhesive materials for customized fabrication of the device by graft-polymerizing polyacrylic acid on hydrophilic polyurethane and mixing with poly(3,4-ethylenedioxythiophene):poly(styrenesulfonate) (PEDOT:PSS) to obtain electrical conductivity. The bioadhesive construct exhibited mechanical properties similar to cardiac tissue and strong tissue adhesion, supporting stable electrical interfacing. Infusion of a detachment solution to cleave physical and covalent cross-links between the adhesive interface and the tissue allowed retrieval of the bioadhesive pacing leads in rat and porcine models without apparent tissue damage. Continuous and reliable cardiac monitoring and pacing of rodent and porcine hearts were demonstrated for 2 weeks with consistent capture threshold and sensing amplitude, in contrast to a commercially available alternative. Pacing and continuous telemetric monitoring were achieved in a porcine model. These findings may offer a promising platform for adhesive bioelectronic devices for cardiac monitoring and treatment.
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  • 文章类型: Journal Article
    目的:周围神经刺激(PNS)已被证明是选择性激活肌肉并产生精细手部运动的有效方法。然而,连续多关节上肢运动,这对瘫痪康复至关重要,尚未使用PNS进行测试。这里,我们的目的是恢复多个上肢关节运动,通过一个单电极的神经内接口,通过顺序刺激实现连贯的伸手-抓-拉运动任务。
    方法:在大鼠上肢的腋下植入横行内多通道电极(TIME),穿过肌肉皮肤,径向,中位数,尺神经.肌内电极植入肱二头肌(BB),肱三头肌(TB),径向腕屈肌(FCR),和伸肌(ECR)肌来记录肌电图(EMG)活动和视频记录用于捕获肘关节的运动学,手腕,和手指关节。将电荷平衡的双相脉冲施加到不同的通道以招募不同的上肢肌肉,同时记录肌电图信号和关节运动学,以评估刺激的有效性。最后,通过在不同通道中产生协调脉冲,采用了序贯刺激方案.
    结果:BB,TB,FCR和ECR肌肉被选择性地激活,各种上肢运动,包括肘部屈曲,弯头延伸,手腕屈曲,手腕延伸,手指屈曲,和数字扩展名,可靠地生成。刺激参数的调制效应,包括脉冲宽度,振幅,和频率,对诱导的关节运动进行了研究,并通过顺序刺激引起了伸手-抓-拉运动。
    结论:我们的结果证明了连续神经内刺激用于功能性多关节运动恢复的可行性,为瘫痪患者的临床康复提供了新的途径。
    Objective.Peripheral nerve stimulation (PNS) has been demonstrated as an effective way to selectively activate muscles and to produce fine hand movements. However, sequential multi-joint upper limb movements, which are critical for paralysis rehabilitation, has not been tested with PNS. Here, we aimed to restore multiple upper limb joint movements through an intraneural interface with a single electrode, achieving coherent reach-grasp-pull movement tasks through sequential stimulation.Approach.A transverse intrafascicular multichannel electrode was implanted under the axilla of the rat\'s upper limb, traversing the musculocutaneous, radial, median, and ulnar nerves. Intramuscular electrodes were implanted into the biceps brachii (BB), triceps brachii (TB), flexor carpi radialis (FCR), and extensor carpi radialis (ECR) muscles to record electromyographic (EMG) activity and video recordings were used to capture the kinematics of elbow, wrist, and digit joints. Charge-balanced biphasic pulses were applied to different channels to recruit distinct upper limb muscles, with concurrent recording of EMG signals and joint kinematics to assess the efficacy of the stimulation. Finally, a sequential stimulation protocol was employed by generating coordinated pulses in different channels.Main results.BB, TB, FCR and ECR muscles were selectively activated and various upper limb movements, including elbow flexion, elbow extension, wrist flexion, wrist extension, digit flexion, and digit extension, were reliably generated. The modulation effects of stimulation parameters, including pulse width, amplitude, and frequency, on induced joint movements were investigated and reach-grasp-pull movement was elicited by sequential stimulation.Significance.Our results demonstrated the feasibility of sequential intraneural stimulation for functional multi-joint movement restoration, providing a new approach for clinical rehabilitation in paralyzed patients.
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  • 文章类型: Journal Article
    在长期人工耳蜗使用者的颞骨标本中,耳蜗内的异物反应已得到证实。然而,植入后的听力变化和纤维化在耳蜗内的进展是未知的。
    研究电极阵列插入后小型猪的听力和耳蜗组织病理学的短期动态变化。
    选择12只小型猪进行电极阵列插入(EAI)和对照。听力测试在术前和术后第0、7、14和28天进行,术后7、14和28天进行听力检查后进行耳蜗组织病理学检查。
    电极阵列插入对测试的频率范围(1kHz-20kHz)具有显着影响。电极阵列插入后一周,渗出明显;术后四周,在电极周围形成的纤维鞘。在每个时间点,发现了内淋巴积水;未观察到螺旋神经节神经元的形态和堆积密度的显着变化。
    电极阵列插入对听力和耳蜗内纤维化的影响显着。纤维化和内淋巴积液的过程似乎与听力损失的程度无关,在术后4周期间,它也不影响螺旋神经节神经元的完整性。
    UNASSIGNED: In temporal bone specimens from long-term cochlear implant users, foreign body response within the cochlea has been demonstrated. However, how hearing changes after implantation and fibrosis progresses within the cochlea is unknown.
    UNASSIGNED: To investigate the short-term dynamic changes in hearing and cochlear histopathology in minipigs after electrode array insertion.
    UNASSIGNED: Twelve minipigs were selected for electrode array insertion (EAI) and the Control. Hearing tests were performed preoperatively and on 0, 7, 14, and 28 day(s) postoperatively, and cochlear histopathology was performed after the hearing tests on 7, 14, and 28 days after surgery.
    UNASSIGNED: Electrode array insertion had a significant effect for the frequency range tested (1 kHz-20kHz). Exudation was evident one week after electrode array insertion; at four weeks postoperatively, a fibrous sheath formed around the electrode. At each time point, the endolymphatic hydrops was found; no significant changes in the morphology and packing density of the spiral ganglion neurons were observed.
    UNASSIGNED: The effect of electrode array insertion on hearing and intracochlear fibrosis was significant. The process of fibrosis and endolymphatic hydrops seemed to not correlate with the degree of hearing loss, nor did it affect spiral ganglion neuron integrity in the 4-week postoperative period.
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  • 文章类型: Journal Article
    超声驱动的生物电子学可以提供具有可持续电源的无线方案;然而,当前的超声可植入系统在与铅/无铅压电材料和设备相关的生物相容性和收获性能方面提出了严峻的挑战。这里,我们报告了一种用于无线的无铅双频超声植入物,双相脑深部刺激,它集成了两个开发的无铅夹层多孔1-3型压电复合元件,在柔性印刷电路板中具有增强的收获性能。植入物通过便携式外部双频换能器超声供电,并以临床相关频率生成可编程的双相刺激脉冲。此外,我们通过癫痫啮齿动物模型演示了超声驱动植入物在深部脑刺激中用于长期生物安全性治疗.具有生物相容性和改善的电气性能,本文介绍的无铅材料和器件可以为将来开发植入式超声电子器件提供一个有前途的平台。
    Ultrasound-driven bioelectronics could offer a wireless scheme with sustainable power supply; however, current ultrasound implantable systems present critical challenges in biocompatibility and harvesting performance related to lead/lead-free piezoelectric materials and devices. Here, we report a lead-free dual-frequency ultrasound implants for wireless, biphasic deep brain stimulation, which integrates two developed lead-free sandwich porous 1-3-type piezoelectric composite elements with enhanced harvesting performance in a flexible printed circuit board. The implant is ultrasonically powered through a portable external dual-frequency transducer and generates programmable biphasic stimulus pulses in clinically relevant frequencies. Furthermore, we demonstrate ultrasound-driven implants for long-term biosafety therapy in deep brain stimulation through an epileptic rodent model. With biocompatibility and improved electrical performance, the lead-free materials and devices presented here could provide a promising platform for developing implantable ultrasonic electronics in the future.
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  • 文章类型: Journal Article
    脑机接口(BCI)允许人类或动物的大脑通过神经接口直接与外部环境进行交互,从而发挥监测的作用,保护,改善/恢复,增强,和替换。记录脑神经信号等电生理信息在健康监测和疾病诊断中具有重要意义。根据电极位置,它可以分为非植入式,半植入式,和可植入的。其中,植入式神经电极可以获得最高质量的电生理信息,所以它们有最有希望的应用。然而,由于设备和组织之间的化学机械不匹配,随着时间的推移,不良的异物反应和性能损失严重制约了植入式神经电极的开发和应用。鉴于挑战,基于导电水凝胶的神经电极最近引起了很多关注,由于许多优点,如良好的机械匹配与天然组织,可忽略的异物反应,和最小的信号衰减。本文主要关注导电水凝胶作为神经组织的生物相容性框架和用于神经组织电信号传输以加速电再生的导电性支持基底的当前发展及其在神经传感和记录以及刺激中的应用。
    The brain-computer interface (BCI) allows the human or animal brain to directly interact with the external environment through the neural interfaces, thus playing the role of monitoring, protecting, improving/restoring, enhancing, and replacing. Recording electrophysiological information such as brain neural signals is of great importance in health monitoring and disease diagnosis. According to the electrode position, it can be divided into non-implantable, semi-implantable, and implantable. Among them, implantable neural electrodes can obtain the highest-quality electrophysiological information, so they have the most promising application. However, due to the chemo-mechanical mismatch between devices and tissues, the adverse foreign body response and performance loss over time seriously restrict the development and application of implantable neural electrodes. Given the challenges, conductive hydrogel-based neural electrodes have recently attracted much attention, owing to many advantages such as good mechanical match with the native tissues, negligible foreign body response, and minimal signal attenuation. This review mainly focuses on the current development of conductive hydrogels as a biocompatible framework for neural tissue and conductivity-supporting substrates for the transmission of electrical signals of neural tissue to speed up electrical regeneration and their applications in neural sensing and recording as well as stimulation.
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  • 文章类型: Journal Article
    植入式神经微电极具有出色的亚毫秒级精度准确捕获单个神经元的电生理信号的能力,拥有推进脑科学研究的巨大潜力,以及为神经系统疾病治疗提供有希望的途径。尽管在可植入神经微电极的通道和密度方面取得了重大进展,在延长这些微电极的稳定记录持续时间方面存在挑战。植入的电极信号的持久稳定性主要受到由电极在神经组织内的轻微移动触发的慢性免疫应答的影响。该免疫应答的强度随着电极的更高的弯曲刚度而增加。这篇评论彻底分析了大脑中植入电极引起的顺序反应,并强调了旨在减轻慢性免疫反应的策略。最小化免疫应答主要包括设计微电极结构,选择柔性材料,表面改性,并控制药物释放。本文旨在为降低植入式神经微电极的免疫反应,激发其在脑科学领域的进一步探索提供有价值的参考和思路。
    Implantable neural microelectrodes exhibit the great ability to accurately capture the electrophysiological signals from individual neurons with exceptional submillisecond precision, holding tremendous potential for advancing brain science research, as well as offering promising avenues for neurological disease therapy. Although significant advancements have been made in the channel and density of implantable neural microelectrodes, challenges persist in extending the stable recording duration of these microelectrodes. The enduring stability of implanted electrode signals is primarily influenced by the chronic immune response triggered by the slight movement of the electrode within the neural tissue. The intensity of this immune response increases with a higher bending stiffness of the electrode. This Review thoroughly analyzes the sequential reactions evoked by implanted electrodes in the brain and highlights strategies aimed at mitigating chronic immune responses. Minimizing immune response mainly includes designing the microelectrode structure, selecting flexible materials, surface modification, and controlling drug release. The purpose of this paper is to provide valuable references and ideas for reducing the immune response of implantable neural microelectrodes and stimulate their further exploration in the field of brain science.
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  • 文章类型: Journal Article
    周围神经和肌肉系统,人类生理学的基石,在确保人体的无缝功能方面起着举足轻重的作用。这个错综复杂的网络,包括遍布全身的神经和肌肉,对电机控制至关重要,感官反馈,以及自主性身体功能的调节。合格的植入式周边接口可以准确监测靶组织的生物电势,并进行刺激治疗,加强了人机交互和疾病治疗的新成就。植入式电极彻底改变了神经肌肉接口领域,在神经肌肉系统和外部设备之间提供精确的双向通信。它们可以对肢体丧失的人进行自然控制,弥合心灵和机器之间的差距,并帮助神经肌肉康复。在研究和医学诊断中,植入式电极为研究神经肌肉功能和治疗方法的发展提供了宝贵的工具。然而,由于周围神经肌肉系统的动态特性,传统的刚性电极面临挑战。灵活且可拉伸的设备在适应动态变化方面显示出巨大的希望,提供适应性,和电生理信号的精确监测。这篇综述深入研究了与外设接口相关的挑战,主要集中在监测和刺激上。然后提供了常见材料和结构设计优化的总结,讨论了增强界面附着力和表面功能化的技术,并探讨了植入器械的封装方法。能源供应和植入式应用的最新进展,灵活,可拉伸装置也进行了全面审查,适当考虑道德问题和信号分析。最后提出了有希望的方向,为未来高性能传感器-组织接口提供启示,这将促进临床和人机交互研究的深刻进步。灵活且可拉伸的设备处于医疗保健的最前沿,有可能改变神经肌肉疾病的治疗方法并增强人类的功能,模糊自然和假肢之间的界限。它们代表了未来的前景,在医疗保健领域令人兴奋的应用,科学,和技术,承诺使我们更接近神经肌肉接口领域的人与机器的无缝集成。
    The peripheral nervous and muscular system, a cornerstone of human physiology, plays a pivotal role in ensuring the seamless functioning of the human body. This intricate network, comprising nerves and muscles extending throughout the body, is essential for motor control, sensory feedback, and the regulation of autonomic bodily functions. The qualified implantable peripheral interface can accurately monitor the biopotential of the target tissue and conduct treatment with stimulation, enhancing the human-machine interaction and new achievements in disease cure. Implantable electrodes have revolutionized the field of neuromuscular interfaces, offering precise bidirectional communication between the neuromuscular system and external devices. They enable natural control for individuals with limb loss, bridging the gap between mind and machine and aiding neuromuscular rehabilitation. In research and medical diagnostics, implantable electrodes provide invaluable tools for studying neuromuscular function and the development of therapies. However, traditional rigid electrodes face challenges due to the dynamic nature of the peripheral neuromuscular system. Flexible and stretchable devices show immense promise in accommodating dynamic alterations, offering adaptability, and accurate monitoring of electrophysiological signals. This review delves into the challenges associated with the peripheral interface, primarily focusing on monitoring and stimulation. It then provides a summary of common materials and structural design optimizations, discusses technologies for enhancing interface adhesion and surface functionalization, and explores encapsulation methods for implanted devices. Recent advancements in energy supply and the applications of implantable, flexible, and stretchable devices are also comprehensively reviewed, with due consideration given to ethical concerns and signal analysis. The promising directions are finally presented to provide enlightenment for high-performance sensor-tissue interfaces in the future, which will promote profound progress in clinical and human-machine interaction research. Flexible and stretchable devices are at the forefront of healthcare, with the potential to transform the treatment of neuromuscular disorders and enhance human augmentation, blurring the lines between natural and artificial limbs. They represent a promising avenue for the future, with exciting applications in healthcare, science, and technology, promising to bring us closer to the seamless integration of human and machine in the realm of neuromuscular interfaces.
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  • 文章类型: Journal Article
    目的:分析耐药性癫痫患者的轨迹-颅骨角度与立体脑电图(SEEG)电极植入准确性之间的关系,旨在指导临床电极放置,提高手术精度和安全性。
    方法:我们对32例连续诊断为耐药性癫痫的患者的病历和手术特点进行了回顾性分析,他们于2020年6月至2023年6月在我们中心接受了SEEG程序。为了评估电极植入的准确性,我们利用术前和术后CT扫描融合SinoPlan软件计划轨迹.评估进入径向误差和目标矢量误差作为电极植入精度的测量值。
    结果:调整混杂因素后,我们发现轨迹-颅骨角度与进入径向误差之间存在显着正相关(β=0.02,95%CI:0.01-0.03,P<0.001)。同样,在所有三个模型中,轨迹-颅骨角度与目标矢量误差之间存在显着正相关(β=0.03,95%CI:0.01-0.04,P<0.001)。此外,使用平滑曲线拟合确定了轨迹-颅骨角度与目标矢量误差之间的U形关系。这种U形模式在基于框架和机器人引导的立体定向技术中都持续存在。根据两分段线性回归模型,在基于框架的组中,拐点为9°,在机器人引导组中为16°。
    结论:这项研究建立了轨迹-颅骨角度与进入径向误差之间的显着正线性相关,以及轨迹-头骨角度与目标矢量误差之间的关系中独特的U形图案。我们的发现表明,9°(基于框架)和16°(机器人引导)的轨迹-头骨角度可以优化目标矢量误差的准确性。
    To analyze the relationship between trajectory-skull angle and stereoelectroencephalography electrode implantation accuracy in drug-resistant epilepsy patients, aiming to guide clinical electrode placement and enhance surgical precision and safety.
    We conducted a retrospective analysis of medical records and surgical characteristics of 32 consecutive patients diagnosed with drug-resistant epilepsy, who underwent stereoelectroencephalography procedures at our center from June 2020 to June 2023. To evaluate the accuracy of electrode implantation, we utilized preoperative and postoperative computed tomography scans fused with SinoPlan software-planned trajectories. Entry radial error and target vector error were assessed as measurements of electrode implantation accuracy.
    After adjusting for confounders, we found a significant positive correlation between trajectory-skull angle and entry radial error (β = 0.02, 95% CI: 0.01-0.03, P < 0.001). Likewise, a significant positive correlation existed between trajectory-skull angle and target vector error in all three models (β = 0.03, 95% CI: 0.01-0.04, P < 0.001). Additionally, a U-shaped relationship between trajectory-skull angle and target vector error was identified using smooth curve fitting. This U-shaped pattern persisted in both frame-based and robot-guided stereotactic techniques. According to the two-piecewise linear regression model, the inflection points were 9° in the frame-based group and 16° in the robot-guided group.
    This study establishes a significant positive linear correlation between trajectory-skull angle and entry radial error, along with a distinctive U-shaped pattern in the relationship between trajectory-skull angle and target vector error. Our findings suggest that trajectory-skull angles of 9° (frame-based) and 16° (robot-guided) may optimize the accuracy of target vector error.
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  • 文章类型: Journal Article
    近年来,随着神经退行性疾病发病率的增加,可植入电极引起了极大的兴趣。对于大脑植入装置,一些导致胶质疤痕形成的关键因素,如机械不匹配和急性损伤引起的炎症,应该考虑材料设计。因此,在这项研究中,通过在丝素蛋白/明胶/还原氧化石墨烯复合水凝胶上施加直流电压,通过电凝胶作用开发了在正电极上具有任意形状的新型生物相容性柔性电极(e-SgG)。rGO含量为1.23%的可植入柔性e-SgG-2膜显示出高杨氏模量(11-150MPa),在干燥条件下足以穿透,但随后在插入脑后成为具有低杨氏模量(50-3200kPa)的仿生脑组织。同时,例如,掺入到e-SgG-2膜中的抗炎药(DEX)可以被电刺激以表现出两阶段释放,从而通过施加AC场通过降解克服循环伏安法期间的组织炎症。细胞对SF/明胶/rGO/DEX复合膜的反应结果表明,释放的DEX可以中断星形胶质细胞的生长,减轻炎症反应,但对神经元无毒性,这证明了生物相容性和可降解的e-SgG-D电极在改善神经组织修复方面的巨大潜力。
    Implantable electrodes have raised great interest over the last years with the increasing incidence of neurodegenerative disorders. For brain implant devices, some key factors resulting in the formation of glial scars, such as mechanical mismatch and acute injury-induced inflammation, should be considered for material design. Therefore, in this study, a new biocompatible flexible electrode (e-SgG) with arbitrary shapes on a positive electrode was developed via electrogelation by applying a direct electrical voltage on a silk fibroin/gelatin/reduced graphene oxide composite hydrogel. The implantable flexible e-SgG-2 film with 1.23% rGO content showed high Young\'s modulus (11-150 MPa), which was sufficient for penetration under dried conditions but subsequently became a biomimetic brain tissue with low Young\'s modulus (50-3200 kPa) after insertion in the brain. At the same time, an anti-inflammatory drug (DEX) incorporated into the e-SgG-2 film can be electrically stimulated to exhibit two-stage release to overcome tissue inflammation during cyclic voltammetry via degradation by applying an AC field. The results of cell response to the SF/gelatin/rGO/DEX composite film showed that the released DEX could interrupt astrocyte growth to reduce the inflammatory response but showed non-toxicity toward neurons, which demonstrated a great potential for the application of the biocompatible and degradable e-SgG-D electrodes in the improvement of nerve tissue repair.
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