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Bololoi AE, Geambazu LE, Antoniac IV, Bololoi RV, Manea CA, Cojocaru VD, Pătroi D. Solid-State Processing of CoCrMoNbTi High-Entropy Alloy for Biomedical Applications. MATERIALS (BASEL, SWITZERLAND) 2023; 16:6520. [PMID: 37834657 PMCID: PMC10573847 DOI: 10.3390/ma16196520] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 09/26/2023] [Accepted: 09/27/2023] [Indexed: 10/15/2023]
Abstract
High-entropy alloys (HEAs) gained interest in the field of biomedical applications due to their unique effects and to the combination of the properties of the constituent elements. In addition to the required property of biocompatibility, other requirements include properties such as mechanical resistance, bioactivity, sterility, stability, cost effectiveness, etc. For this paper, a biocompatible high-entropy alloy, defined as bio-HEA by the literature, can be considered as an alternative to the market-available materials due to their superior properties. According to the calculation of the valence electron concentration, a majority of body-centered cubic (BCC) phases were expected, resulting in properties such as high strength and plasticity for the studied alloy, confirmed by the XRD analysis. The tetragonal (TVC) phase was also identified, indicating that the presence of face-centered cubic (FCC) phases in the alloyed materials resulted in high ductility. Microstructural and compositional analyses revealed refined and uniform metallic powder particles, with a homogeneous distribution of the elemental particles observed from the mapping analyses, indicating that alloying had occurred. The technological characterization of the high-entropy alloy-elaborated powder revealed the particle dimension reduction due to the welding and fracturing process that occurs during mechanical alloying, with a calculated average particle size of 45.12 µm.
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Affiliation(s)
- Alina Elena Bololoi
- Materials Science and Engineering Faculty, National University of Science and Technology Politehnica Bucharest, Splaiul Independentei 313, 060042 Bucharest, Romania; (A.E.B.); (I.V.A.); (R.V.B.); (C.A.M.); (V.D.C.)
| | - Laura Elena Geambazu
- Materials Science and Engineering Faculty, National University of Science and Technology Politehnica Bucharest, Splaiul Independentei 313, 060042 Bucharest, Romania; (A.E.B.); (I.V.A.); (R.V.B.); (C.A.M.); (V.D.C.)
- National Institute for R&D in Electrical Engineering ICPE-CA Bucharest, Splaiul Unirii 313, 030138 Bucharest, Romania;
| | - Iulian Vasile Antoniac
- Materials Science and Engineering Faculty, National University of Science and Technology Politehnica Bucharest, Splaiul Independentei 313, 060042 Bucharest, Romania; (A.E.B.); (I.V.A.); (R.V.B.); (C.A.M.); (V.D.C.)
| | - Robert Viorel Bololoi
- Materials Science and Engineering Faculty, National University of Science and Technology Politehnica Bucharest, Splaiul Independentei 313, 060042 Bucharest, Romania; (A.E.B.); (I.V.A.); (R.V.B.); (C.A.M.); (V.D.C.)
| | - Ciprian Alexandru Manea
- Materials Science and Engineering Faculty, National University of Science and Technology Politehnica Bucharest, Splaiul Independentei 313, 060042 Bucharest, Romania; (A.E.B.); (I.V.A.); (R.V.B.); (C.A.M.); (V.D.C.)
- National Institute for R&D in Electrical Engineering ICPE-CA Bucharest, Splaiul Unirii 313, 030138 Bucharest, Romania;
| | - Vasile Dănuţ Cojocaru
- Materials Science and Engineering Faculty, National University of Science and Technology Politehnica Bucharest, Splaiul Independentei 313, 060042 Bucharest, Romania; (A.E.B.); (I.V.A.); (R.V.B.); (C.A.M.); (V.D.C.)
| | - Delia Pătroi
- National Institute for R&D in Electrical Engineering ICPE-CA Bucharest, Splaiul Unirii 313, 030138 Bucharest, Romania;
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Queiroz MB, Inada RNH, Lopes CS, Guerreiro-Tanomaru JM, Sasso-Cerri E, Tanomaru-Filho M, Cerri PS. Bioactive potential of Bio-C Pulpo is evidenced by presence of birefringent calcite and osteocalcin immunoexpression in the rat subcutaneous tissue. J Biomed Mater Res B Appl Biomater 2022; 110:2369-2380. [PMID: 35583398 DOI: 10.1002/jbm.b.35083] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 04/27/2022] [Accepted: 05/02/2022] [Indexed: 11/11/2022]
Abstract
As the biocompatibility and bioactive potential of repair materials are desired characteristics in dentistry, the tissue response of Bio-C Pulpo, a bioceramic material launched on the marked by Angelus (Brazil), was compared with Biodentine (Septodont, France) and White MTA (WMTA; Angelus, Brazil). In 32 rats, 148 polyethylene tubes filled with Bio-C Pulpo, Biodentine or WMTA, and empty (CG, control group) were implanted into subcutaneous tissues for 7, 15, 30, and 60 days. The capsule thickness, numerical density of inflammatory cells (IC) and fibroblasts (Fb), amount of collagen, immunohistochemistry detection of interleukin-6 (IL-6) and osteocalcin (OCN), von Kossa and analysis under polarized light were performed. Data were subjected to two-way ANOVA followed by Tukey's test (p ≤ 0.05). At 7 and 15 days, the capsules around Bio-C Pulpo were thicker than in WMTA while, at 30 and 60 days, significant differences were not observed among the groups. Although at 7, 15, and 30 days, a greater number of IL-6-immunostained cells was found in Bio-C Pulpo and Biodentine than in WMTA, no significant difference was detected among the groups at 60 days. In all groups, the number of Fb and collagen content increased significantly over time. The capsules around materials exhibited von Kossa-positive and birefringent structures, and OCN-immunostained cells whereas, in the CG, these structures were not observed. Bio-C Pulpo, similarly to Biodentine and WMTA, is biocompatible, allows the connective tissue repair and presents bioactive potential in connective tissue of rats.
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Affiliation(s)
- Marcela Borsatto Queiroz
- Department of Restorative Dentistry, Universidade Estadual Paulista Julio de Mesquita Filho Faculdade de Odontologia Campus de Araraquara, Araraquara, Brazil.,Laboratory of Histology and Embryology, Department of Morphology, Genetics, Orthodontics and Pediatric Dentistry, Dental School, São Paulo State University (UNESP), Araraquara, Brazil
| | - Rafaela Nanami Handa Inada
- Department of Restorative Dentistry, Universidade Estadual Paulista Julio de Mesquita Filho Faculdade de Odontologia Campus de Araraquara, Araraquara, Brazil.,Laboratory of Histology and Embryology, Department of Morphology, Genetics, Orthodontics and Pediatric Dentistry, Dental School, São Paulo State University (UNESP), Araraquara, Brazil
| | - Camila Soares Lopes
- Department of Restorative Dentistry, Universidade Estadual Paulista Julio de Mesquita Filho Faculdade de Odontologia Campus de Araraquara, Araraquara, Brazil.,Laboratory of Histology and Embryology, Department of Morphology, Genetics, Orthodontics and Pediatric Dentistry, Dental School, São Paulo State University (UNESP), Araraquara, Brazil
| | - Juliane Maria Guerreiro-Tanomaru
- Department of Restorative Dentistry, Universidade Estadual Paulista Julio de Mesquita Filho Faculdade de Odontologia Campus de Araraquara, Araraquara, Brazil
| | - Estela Sasso-Cerri
- Laboratory of Histology and Embryology, Department of Morphology, Genetics, Orthodontics and Pediatric Dentistry, Dental School, São Paulo State University (UNESP), Araraquara, Brazil
| | - Mário Tanomaru-Filho
- Department of Restorative Dentistry, Universidade Estadual Paulista Julio de Mesquita Filho Faculdade de Odontologia Campus de Araraquara, Araraquara, Brazil
| | - Paulo Sérgio Cerri
- Laboratory of Histology and Embryology, Department of Morphology, Genetics, Orthodontics and Pediatric Dentistry, Dental School, São Paulo State University (UNESP), Araraquara, Brazil
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Zuo W, Yu L, Lin J, Yang Y, Fei Q. Properties improvement of titanium alloys scaffolds in bone tissue engineering: a literature review. ANNALS OF TRANSLATIONAL MEDICINE 2021; 9:1259. [PMID: 34532396 PMCID: PMC8421948 DOI: 10.21037/atm-20-8175] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/27/2020] [Accepted: 05/28/2021] [Indexed: 12/19/2022]
Abstract
Owing to their excellent biocompatibility and corrosion-resistant properties, titanium (Ti) (and its alloy) are essential artificial substitute biomaterials for orthopedics. However, flaws, such as weak osteogenic induction ability and higher Young's modulus, have been observed during clinical application. As a result, short- and long-term postoperative follow-up has found that several complications have occurred. For decades, scientists have exerted efforts to compensate for these deficiencies. Different modification methods have been investigated, including changing alloy contents, surface structure transformation, three-dimensional (3D) structure transformation, coating, and surface functionalization technologies. The cell-surface interaction effect and imitation of the natural 3D bone structure are the two main mechanisms of these improved methods. In recent years, significant progress has been made in materials science research methods, including thorough research of titanium alloys of different compositions, precise surface pattern control technology, controllable 3D structure construction technology, improvement of coating technologies, and novel concepts of surface functionalization. These improvements facilitate the possibility for further research in the field of bone tissue engineering. Although the underlying mechanism is still not fully understood, these studies still have some implications for clinical practice. Therefore, for the direction of further research, it is beneficial to summarize these studies according to the basal method used. This literature review aimed to classify these technologies, thereby providing beginners with a preliminary understanding of the field.
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Affiliation(s)
- Weiyang Zuo
- Department of Orthopedics, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Lingjia Yu
- Department of Orthopedics, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Jisheng Lin
- Department of Orthopedics, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Yong Yang
- Department of Orthopedics, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Qi Fei
- Department of Orthopedics, Beijing Friendship Hospital, Capital Medical University, Beijing, China
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Careta O, Fornell J, Pellicer E, Ibañez E, Blanquer A, Esteve J, Sort J, Murillo G, Nogués C. ZnO Nanosheet-Coated TiZrPdSiNb Alloy as a Piezoelectric Hybrid Material for Self-Stimulating Orthopedic Implants. Biomedicines 2021; 9:biomedicines9040352. [PMID: 33808338 PMCID: PMC8065972 DOI: 10.3390/biomedicines9040352] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2021] [Revised: 03/24/2021] [Accepted: 03/27/2021] [Indexed: 12/22/2022] Open
Abstract
A Ti-based alloy (Ti45Zr15Pd30Si5Nb5) with already proven excellent mechanical and biocompatibility features has been coated with piezoelectric zinc oxide (ZnO) to induce the electrical self-stimulation of cells. ZnO was grown onto the pristine alloy in two different morphologies: a flat dense film and an array of nanosheets. The effect of the combined material on osteoblasts (electrically stimulable cells) was analyzed in terms of proliferation, cell adhesion, expression of differentiation markers and induction of calcium transients. Although both ZnO structures were biocompatible and did not induce inflammatory response, only the array of ZnO nanosheets was able to induce calcium transients, which improved the proliferation of Saos-2 cells and enhanced the expression of some early differentiation expression genes. The usual motion of the cells imposes strain to the ZnO nanosheets, which, in turn, create local electric fields owing to their piezoelectric character. These electric fields cause the opening of calcium voltage gates and boost cell proliferation and early differentiation. Thus, the modification of the Ti45Zr15Pd30Si5Nb5 surface with an array of ZnO nanosheets endows the alloy with smart characteristics, making it capable of electric self-stimulation.
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Affiliation(s)
- Oriol Careta
- Departament de Biologia Cel·lular, Fisiologia i Immunologia, Universitat Autònoma de Barcelona, E-08193 Bellaterra (Cerdanyola del Vallès), Spain; (O.C.); (E.I.); (A.B.)
| | - Jordina Fornell
- Departament de Física, Universitat Autònoma de Barcelona, E-08193 Bellaterra (Cerdanyola del Vallès), Spain; (J.F.); (J.S.)
| | - Eva Pellicer
- Departament de Física, Universitat Autònoma de Barcelona, E-08193 Bellaterra (Cerdanyola del Vallès), Spain; (J.F.); (J.S.)
- Correspondence: (E.P.); (G.M.); (C.N.); Tel.: +34-935812776 (C.N.)
| | - Elena Ibañez
- Departament de Biologia Cel·lular, Fisiologia i Immunologia, Universitat Autònoma de Barcelona, E-08193 Bellaterra (Cerdanyola del Vallès), Spain; (O.C.); (E.I.); (A.B.)
| | - Andreu Blanquer
- Departament de Biologia Cel·lular, Fisiologia i Immunologia, Universitat Autònoma de Barcelona, E-08193 Bellaterra (Cerdanyola del Vallès), Spain; (O.C.); (E.I.); (A.B.)
| | - Jaume Esteve
- Instituto de Microelectrónica de Barcelona, IMB-CNM (CSIC), C/del Til·lers, Campus UAB, E-08193 Bellaterra (Cerdanyola del Vallès), Spain;
| | - Jordi Sort
- Departament de Física, Universitat Autònoma de Barcelona, E-08193 Bellaterra (Cerdanyola del Vallès), Spain; (J.F.); (J.S.)
- Institució Catalana de Recerca i Estudis Avançats (ICREA), Pg. Lluís Companys 23, E-08180 Barcelona, Spain
| | - Gonzalo Murillo
- Instituto de Microelectrónica de Barcelona, IMB-CNM (CSIC), C/del Til·lers, Campus UAB, E-08193 Bellaterra (Cerdanyola del Vallès), Spain;
- Correspondence: (E.P.); (G.M.); (C.N.); Tel.: +34-935812776 (C.N.)
| | - Carme Nogués
- Departament de Biologia Cel·lular, Fisiologia i Immunologia, Universitat Autònoma de Barcelona, E-08193 Bellaterra (Cerdanyola del Vallès), Spain; (O.C.); (E.I.); (A.B.)
- Correspondence: (E.P.); (G.M.); (C.N.); Tel.: +34-935812776 (C.N.)
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Barberi J, Spriano S. Titanium and Protein Adsorption: An Overview of Mechanisms and Effects of Surface Features. MATERIALS (BASEL, SWITZERLAND) 2021; 14:1590. [PMID: 33805137 PMCID: PMC8037091 DOI: 10.3390/ma14071590] [Citation(s) in RCA: 53] [Impact Index Per Article: 17.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Revised: 03/09/2021] [Accepted: 03/19/2021] [Indexed: 12/14/2022]
Abstract
Titanium and its alloys, specially Ti6Al4V, are among the most employed materials in orthopedic and dental implants. Cells response and osseointegration of implant devices are strongly dependent on the body-biomaterial interface zone. This interface is mainly defined by proteins: They adsorb immediately after implantation from blood and biological fluids, forming a layer on implant surfaces. Therefore, it is of utmost importance to understand which features of biomaterials surfaces influence formation of the protein layer and how to guide it. In this paper, relevant literature of the last 15 years about protein adsorption on titanium-based materials is reviewed. How the surface characteristics affect protein adsorption is investigated, aiming to provide an as comprehensive a picture as possible of adsorption mechanisms and type of chemical bonding with the surface, as well as of the characterization techniques effectively applied to model and real implant surfaces. Surface free energy, charge, microroughness, and hydroxylation degree have been found to be the main surface parameters to affect the amount of adsorbed proteins. On the other hand, the conformation of adsorbed proteins is mainly dictated by the protein structure, surface topography at the nano-scale, and exposed functional groups. Protein adsorption on titanium surfaces still needs further clarification, in particular concerning adsorption from complex protein solutions. In addition, characterization techniques to investigate and compare the different aspects of protein adsorption on different surfaces (in terms of roughness and chemistry) shall be developed.
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Affiliation(s)
- Jacopo Barberi
- Department of Applied Science and Technology, Politecnico di Torino, 10129 Turin, Italy;
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Mishchenko O, Ovchynnykov O, Kapustian O, Pogorielov M. New Zr-Ti-Nb Alloy for Medical Application: Development, Chemical and Mechanical Properties, and Biocompatibility. MATERIALS 2020; 13:ma13061306. [PMID: 32183125 PMCID: PMC7142640 DOI: 10.3390/ma13061306] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Revised: 02/25/2020] [Accepted: 02/27/2020] [Indexed: 02/06/2023]
Abstract
The concept of mechanical biocompatibilities is considered an important factor for orthopedics and dental implants. The high Young modulus of traditional Ti-based alloys can lead to stress-shielding syndrome and late postoperative complications. The development of new Al- and V-free Ti alloys with a low elastic modulus is a critical task for implantology. Despite the relatively low Young modulus and appropriate biological response of metastable beta-Ti alloys, their production requires complex metallurgical solutions and a high final cost that limit commercial application. The current research aimed to develop a Zr-Ti-Nb system with a low Young modulus suitable for biomedical application, including orthopedics and dental implantology. Two different charges were used for new alloy production with melting in a vacuum-arc furnace VDP-1 under atmospheric control (argon + helium) with a non-consumable tungsten electrode and a water-cooled copper crystallizer. Post-treatment included a forging-rolling process to produce a bar suitable for implant production. SEM with EDX and the mechanical parameters of the new alloy were evaluated, and a cell culture experiment provided a biocompatibility assessment. The chemical composition of the new alloy can be represented as 59.57-19.02-21.41 mass% of Zr-Ti-Nb. The mechanical properties are characterized by an extremely low Young modulus—27,27 GPa for the alloy and 34.85 GPa for the bar. The different master alloys used for Zr-Ti-Nb production did not affect the chemical compound and mechanical parameters so it was possible to use affordable raw materials to decrease the final price of the new product. The cell culture experiment demonstrated a full biocompatibility, indicating that this new alloy can be used for dental and orthopedics implant production.
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Affiliation(s)
- Oleg Mishchenko
- NanoPrime, 25 Metalowcow Str., Dedice 39-200, Poland;
- Department of Surgical and Propaedeutic Dentistry, Zaporizhzhia State Medical University, 26, Prosp.Mayakovskogo, Zaporizhzhia 69035, Ukraine
| | - Oleksandr Ovchynnykov
- Department of Physics and Engineering, Zaporizhzhia Polytechnic National University, 64 Zhukovsky Str, Zaporizhzhia 69063, Ukraine; (O.O.); (O.K.)
| | - Oleksii Kapustian
- Department of Physics and Engineering, Zaporizhzhia Polytechnic National University, 64 Zhukovsky Str, Zaporizhzhia 69063, Ukraine; (O.O.); (O.K.)
| | - Maksym Pogorielov
- NanoPrime, 25 Metalowcow Str., Dedice 39-200, Poland;
- Centre of Collective Use of Scientific Equipment, Sumy State University, 2 R-Korsakova Str, Sumy 40007, Ukraine
- Correspondence: or ; Tel.: +38-066-900-5448
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Cosme‐Silva L, Gomes‐Filho JE, Benetti F, Dal‐Fabbro R, Sakai VT, Cintra LTA, Ervolino E, Viola NV. Biocompatibility and immunohistochemical evaluation of a new calcium silicate‐based cement, Bio‐C Pulpo. Int Endod J 2019; 52:689-700. [DOI: 10.1111/iej.13052] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2018] [Accepted: 11/29/2018] [Indexed: 02/06/2023]
Affiliation(s)
- L. Cosme‐Silva
- Department of Endodontics Araçatuba School of Dentisty São Paulo State University (UNESP) Araçatuba SPBrazil
| | - J. E. Gomes‐Filho
- Department of Endodontics Araçatuba School of Dentisty São Paulo State University (UNESP) Araçatuba SPBrazil
| | - F. Benetti
- Department of Endodontics Araçatuba School of Dentisty São Paulo State University (UNESP) Araçatuba SPBrazil
| | - R. Dal‐Fabbro
- Department of Endodontics Araçatuba School of Dentisty São Paulo State University (UNESP) Araçatuba SPBrazil
| | - V. T. Sakai
- Department of Clinics and Surgery School of Dentistry Federal University of Alfenas (UNIFAL‐MG) Alfenas MGBrazil
| | - L. T. A. Cintra
- Department of Endodontics Araçatuba School of Dentisty São Paulo State University (UNESP) Araçatuba SPBrazil
| | - E. Ervolino
- Department of Basic Sciences Araçatuba School of Dentisty São Paulo State University (UNESP) Araçatuba SP Brazil
| | - N. V. Viola
- Department of Clinics and Surgery School of Dentistry Federal University of Alfenas (UNIFAL‐MG) Alfenas MGBrazil
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Qi Z, Xia P, Pan S, Zheng S, Fu C, Chang Y, Ma Y, Wang J, Yang X. Combined treatment with electrical stimulation and insulin-like growth factor-1 promotes bone regeneration in vitro. PLoS One 2018; 13:e0197006. [PMID: 29746517 PMCID: PMC5944947 DOI: 10.1371/journal.pone.0197006] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2018] [Accepted: 04/24/2018] [Indexed: 12/12/2022] Open
Abstract
Electrical stimulation (ES) and insulin-like growth factor-1 (IGF-1) are widely used in bone regeneration because of their osteogenic activity. However, the combined effects of ES and supplemental IGF-1 on the whole bone formation process remain unclear. In this study, fluorescence staining and an MTT assay were first utilized to observe the influence of ES and IGF-1 on MC3T3-E1 cell proliferation and adhesion in vitro. Subsequently, osteogenic differentiation was evaluated by the alkaline phosphatase activity (ALP) and the expression of osteogenic marker genes. In addition, cell mineralization was determined by alizarin red staining and scanning electron microscopy (SEM). We demonstrated that the MC3T3-E1 cell proliferation was significantly higher for treatments combining IGF-1 and ES than for treatments with IGF-1 alone. The combination of IGF-1 and ES increased the MC3T3-E1 cell ALP activity, the expression of osteogenesis-related genes and the calcium deposition with a clear dose-dependent effect. Our data show the synergistic effect of IGF-1 and ES in promoting the proliferation, differentiation and mineralization of MC3T3-E1 cells, which suggests that it would be more effective to combine the proper dose of IGF-1 with ES to promote local bone damage repair and regeneration.
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Affiliation(s)
- Zhiping Qi
- Department of Orthopedic Surgery, the Second Hospital of Jilin University, Changchun, PR China
| | - Peng Xia
- Department of Orthopedic Surgery, the Second Hospital of Jilin University, Changchun, PR China
| | - Su Pan
- Department of Orthopedic Surgery, the Second Hospital of Jilin University, Changchun, PR China
| | - Shuang Zheng
- Department of Orthopedic Surgery, the Second Hospital of Jilin University, Changchun, PR China
| | - Chuan Fu
- Department of Orthopedic Surgery, the Second Hospital of Jilin University, Changchun, PR China
| | - Yuxin Chang
- Department of Orthopedic Surgery, the Second Hospital of Jilin University, Changchun, PR China
| | - Yue Ma
- Department of Gynecological Oncology, the First Hospital of Jilin University, Changchun, PR China
| | - Jincheng Wang
- Department of Orthopedic Surgery, the Second Hospital of Jilin University, Changchun, PR China
- * E-mail: (JW); (XY)
| | - Xiaoyu Yang
- Department of Orthopedic Surgery, the Second Hospital of Jilin University, Changchun, PR China
- * E-mail: (JW); (XY)
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