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Liu L, Hou S, Xu G, Gao J, Mu J, Gao M, He J, Su X, Yang Z, Liu Y, Chen T, Dong Z, Cheng L, Shi Z. Evaluation of osteogenic properties of a novel injectable bone-repair material containing strontium in vitro and in vivo. Front Bioeng Biotechnol 2024; 12:1390337. [PMID: 38707496 PMCID: PMC11069309 DOI: 10.3389/fbioe.2024.1390337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2024] [Accepted: 04/11/2024] [Indexed: 05/07/2024] Open
Abstract
Objective: This study aims to develop and evaluate the biocompatibility and osteogenic potential of a novel injectable strontium-doped hydroxyapatite bone-repair material. Methods: The properties of strontium-doped hydroxyapatite/chitosan (Sr-HA/CS), hydroxyapatite/chitosan (HA/CS) and calcium phosphate/chitosan (CAP/CS) were assessed following their preparation via physical cross-linking and a one-step simplified method. Petri dishes containing Escherichia coli and Staphylococcus epidermidis were inoculated with the material for in vitro investigations. The material was also co-cultured with stem cells derived from human exfoliated deciduous teeth (SHEDs), to assess the morphology and proliferation capability of the SHEDs, Calcein-AM staining and the Cell Counting Kit-8 assay were employed. Osteogenic differentiation of SHEDs was determined using alkaline phosphatase (ALP) staining and Alizarin Red staining. For in vivo studies, Sr-HA/CS was implanted into the muscle pouch of mice and in a rat model of ovariectomy-induced femoral defects. Hematoxylin-eosin (HE) staining was performed to determine the extent of bone formation and defect healing. The formation of new bone was determined using Masson's trichrome staining. The osteogenic mechanism of the material was investigated using Tartrate-resistant acid phosphatase (TRAP) staining and immunohistochemical studies. Results: X-ray diffraction (XRD) and energy-dispersive spectroscopy (EDS) showed that strontium was successfully doped into HA. The Sr-HA/CS material can be uniformly squeezed using a syringe with a 13% swelling rate. Sr-HA/CS had a significant antibacterial effect against both E. coli and S. epidermidis (p < 0.05), with a stronger effect observed against E. coli. The Sr-HA/CS significantly improved cell proliferation and cell viability in vitro studies (p < 0.05). Compared to CAP/CS and CS, Sr-HA/CS generated a substantially greater new bone area during osteoinduction experiments (p < 0.05, p < 0.001). The Sr-HA/CS material demonstrated a significantly higher rate of bone repair in the bone defeat studies compared to the CAP/CS and CS materials (p < 0.01). The OCN-positive area and TRAP-positive cells in Sr-HA/CS were greater than those in control groups (p < 0.05). Conclusion: A novel injectable strontium-doped HA bone-repair material with good antibacterial properties, biocompatibility, and osteoinductivity was successfully prepared.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | - Lijia Cheng
- Clinical Medical College, Affiliated Hospital, School of Basic Medical Sciences of Chengdu University, Chengdu, China
| | - Zheng Shi
- Clinical Medical College, Affiliated Hospital, School of Basic Medical Sciences of Chengdu University, Chengdu, China
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Cheng B, Chen QY, Zhang X, He J, Cui Q, Ma C, Jiao J. Improved Biocompatibility and Angiogenesis of the Bone Titanium Scaffold through ERK1/2 Signaling Mediated by an Attached Strontium Element. Biol Trace Elem Res 2024; 202:1559-1567. [PMID: 37491616 DOI: 10.1007/s12011-023-03772-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Accepted: 07/10/2023] [Indexed: 07/27/2023]
Abstract
The promotion of early osseointegration is crucial for the success of biomedical titanium implants. Physical and chemical modifications to the material surface can significantly compensate for the lack of biocompatibility and early osseointegration of the implant. In this study, we implanted strontium onto titanium plates and analyzed the effect of strontium-doped materials on angiogenesis and biocompatibility in the human bone structure. Our findings demonstrated that strontium-loaded titanium sheet materials effectively promote human umbilical vein endothelial cell (HUVEC) biocompatibility and vascular differentiation ability, as evidenced by proliferation-apoptosis assays, RT-qPCR for vascular neogenesis markers, ELISA for vascular endothelial growth factor (VEGF) levels, and nitric oxide (NO) analysis. Mechanism studies based on RNAseq and Western blotting analysis revealed that strontium can promote titanium material biocompatibility with HUVEC cells and vascular neovascularization ability by activating the extracellular signal-regulated kinase 1/2 (ERK1/2) signaling pathway. Meanwhile, blocking the ERK1/2 signaling pathway could reverse the promotional effect of vascular formation. Overall, we have successfully fabricated a multifunctional biocompatible bone implant with better histocompatibility and angiogenesis compared to uncoated implants.
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Affiliation(s)
- Bingkun Cheng
- Department of Oral and Maxillofacial Surgery, Handan Central Hospital, Handan, HeBei, China
| | - Qing Yong Chen
- Department of Stomatology, Handan Central Hospital, Handan, HeBei, China
| | - Xueqiang Zhang
- Department of Oral and Maxillofacial Surgery, Handan Central Hospital, Handan, HeBei, China
| | - Jiahuan He
- Department of Stomatology, Handan Central Hospital, Handan, HeBei, China
| | - Qingqing Cui
- Department of Oral and Maxillofacial Surgery, Handan Central Hospital, Handan, HeBei, China
| | - Chao Ma
- Department of Oral and Maxillofacial Surgery, Handan Central Hospital, Handan, HeBei, China
| | - Jianjun Jiao
- Department of Oral and Maxillofacial Surgery, Handan Central Hospital, Handan, HeBei, China.
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Li J, Zheng Y, Yu Z, Kankala RK, Lin Q, Shi J, Chen C, Luo K, Chen A, Zhong Q. Surface-modified titanium and titanium-based alloys for improved osteogenesis: A critical review. Heliyon 2024; 10:e23779. [PMID: 38223705 PMCID: PMC10784177 DOI: 10.1016/j.heliyon.2023.e23779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Revised: 12/05/2023] [Accepted: 12/13/2023] [Indexed: 01/16/2024] Open
Abstract
As implantable materials, titanium, and its alloys have garnered enormous interest from researchers for dental and orthopedic procedures. Despite their success in wide clinical applications, titanium, and its alloys fail to stimulate osteogenesis, resulting in poor bonding strength with surrounding bone tissue. Optimizing the surface topology and altered compositions of titanium and titanium-based alloys substantially promotes peri-implant bone regeneration. This review summarizes the utilization and importance of various osteogenesis components loaded onto titanium and its alloys. Further, different surface-modification methods and the release efficacy of loaded substances are emphasized. Finally, we summarize the article with prospects. We believe that further investigation studies must focus on identifying novel loading components, exploring various innovative, optimized surface-modification methods, and developing a sustained-release system on implant surfaces to improve peri-implant bone formation.
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Affiliation(s)
- Jingling Li
- Fujian Key Laboratory of Oral Diseases & Fujian Provincial Engineering Research Center of Oral Biomaterial & Stomatological Key Laboratory of Fujian College and University, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, 350002, China
- Institute of Stomatology & Laboratory of Oral Tissue Engineering, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, 350002, China
| | - Yaxin Zheng
- Fujian Key Laboratory of Oral Diseases & Fujian Provincial Engineering Research Center of Oral Biomaterial & Stomatological Key Laboratory of Fujian College and University, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, 350002, China
- Institute of Stomatology & Laboratory of Oral Tissue Engineering, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, 350002, China
| | - Zihe Yu
- Fujian Key Laboratory of Oral Diseases & Fujian Provincial Engineering Research Center of Oral Biomaterial & Stomatological Key Laboratory of Fujian College and University, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, 350002, China
- Institute of Stomatology & Laboratory of Oral Tissue Engineering, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, 350002, China
| | - Ranjith Kumar Kankala
- Institute of Biomaterials and Tissue Engineering, Fujian Provincial Key Laboratory of Biochemical Technology, Huaqiao University, Xiamen, 361021, China
| | - Qianying Lin
- Fujian Key Laboratory of Oral Diseases & Fujian Provincial Engineering Research Center of Oral Biomaterial & Stomatological Key Laboratory of Fujian College and University, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, 350002, China
- Institute of Stomatology & Laboratory of Oral Tissue Engineering, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, 350002, China
| | - Jingbo Shi
- Fujian Key Laboratory of Oral Diseases & Fujian Provincial Engineering Research Center of Oral Biomaterial & Stomatological Key Laboratory of Fujian College and University, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, 350002, China
- Institute of Stomatology & Laboratory of Oral Tissue Engineering, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, 350002, China
| | - Chao Chen
- Fujian Key Laboratory of Oral Diseases & Fujian Provincial Engineering Research Center of Oral Biomaterial & Stomatological Key Laboratory of Fujian College and University, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, 350002, China
- Institute of Stomatology & Laboratory of Oral Tissue Engineering, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, 350002, China
| | - Kai Luo
- Fujian Key Laboratory of Oral Diseases & Fujian Provincial Engineering Research Center of Oral Biomaterial & Stomatological Key Laboratory of Fujian College and University, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, 350002, China
- Institute of Stomatology & Laboratory of Oral Tissue Engineering, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, 350002, China
| | - Aizheng Chen
- Institute of Biomaterials and Tissue Engineering, Fujian Provincial Key Laboratory of Biochemical Technology, Huaqiao University, Xiamen, 361021, China
| | - Quan Zhong
- Fujian Key Laboratory of Oral Diseases & Fujian Provincial Engineering Research Center of Oral Biomaterial & Stomatological Key Laboratory of Fujian College and University, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, 350002, China
- Institute of Stomatology & Laboratory of Oral Tissue Engineering, School and Hospital of Stomatology, Fujian Medical University, Fuzhou, 350002, China
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Liang J, Lu X, Zheng X, Li YR, Geng X, Sun K, Cai H, Jia Q, Jiang HB, Liu K. Modification of titanium orthopedic implants with bioactive glass: a systematic review of in vivo and in vitro studies. Front Bioeng Biotechnol 2023; 11:1269223. [PMID: 38033819 PMCID: PMC10686101 DOI: 10.3389/fbioe.2023.1269223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2023] [Accepted: 09/18/2023] [Indexed: 12/02/2023] Open
Abstract
Bioactive glasses (BGs) are ideal biomaterials in the field of bio-restoration due to their excellent biocompatibility. Titanium alloys are widely used as a bone graft substitute material because of their excellent corrosion resistance and mechanical properties; however, their biological inertness makes them prone to clinical failure. Surface modification of titanium alloys with bioactive glass can effectively combine the superior mechanical properties of the substrate with the biological properties of the coating material. In this review, the relevant articles published from 2013 to the present were searched in four databases, namely, Web of Science, PubMed, Embase, and Scopus, and after screening, 49 studies were included. We systematically reviewed the basic information and the study types of the included studies, which comprise in vitro experiments, animal tests, and clinical trials. In addition, we summarized the applied coating technologies, which include pulsed laser deposition (PLD), electrophoretic deposition, dip coating, and magnetron sputtering deposition. The superior biocompatibility of the materials in terms of cytotoxicity, cell activity, hemocompatibility, anti-inflammatory properties, bioactivity, and their good bioactivity in terms of osseointegration, osteogenesis, angiogenesis, and soft tissue adhesion are discussed. We also analyzed the advantages of the existing materials and the prospects for further research. Even though the current research status is not extensive enough, it is still believed that BG-coated Ti implants have great clinical application prospects.
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Affiliation(s)
- Jin Liang
- Department of Oral and Maxillofacial Surgery, School of Stomatology, Shandong First Medical University, Jinan, Shandong, China
| | - XinYue Lu
- The CONVERSATIONALIST Club and Department of Stomatological Technology, School of Stomatology, Shandong First Medical University, Jinan, Shandong, China
| | - XinRu Zheng
- The CONVERSATIONALIST Club and Department of Stomatological Technology, School of Stomatology, Shandong First Medical University, Jinan, Shandong, China
| | - Yu Ru Li
- The CONVERSATIONALIST Club and Department of Stomatological Technology, School of Stomatology, Shandong First Medical University, Jinan, Shandong, China
| | - XiaoYu Geng
- The CONVERSATIONALIST Club and Department of Stomatological Technology, School of Stomatology, Shandong First Medical University, Jinan, Shandong, China
| | - KeXin Sun
- The CONVERSATIONALIST Club and Department of Stomatological Technology, School of Stomatology, Shandong First Medical University, Jinan, Shandong, China
| | - HongXin Cai
- Department and Research Institute of Dental Biomaterials and Bioengineering, Yonsei University College of Dentistry, Seoul, Republic of Korea
| | - Qi Jia
- Department and Research Institute of Dental Biomaterials and Bioengineering, Yonsei University College of Dentistry, Seoul, Republic of Korea
| | - Heng Bo Jiang
- The CONVERSATIONALIST Club and Department of Stomatological Technology, School of Stomatology, Shandong First Medical University, Jinan, Shandong, China
| | - Kai Liu
- School of Basic Medicine, Shandong First Medical University, Jinan, Shandong, China
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Yuan X, Wu T, Lu T, Ye J. Effects of Zinc and Strontium Doping on In Vitro Osteogenesis and Angiogenesis of Calcium Silicate/Calcium Phosphate Cement. ACS Biomater Sci Eng 2023; 9:5761-5771. [PMID: 37676927 DOI: 10.1021/acsbiomaterials.3c00193] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/09/2023]
Abstract
Based on multiple biological functions (mainly osteogenesis and angiogenesis) of bioactive ions, Zn/Sr-doped calcium silicate/calcium phosphate cements (Zn/Sr-CS/CPCs, including 10Zn-CS/CPC, 20Sr-CS/CPC, and 10Zn/20Sr-CS/CPC) were prepared by the addition of Zn and Sr dual active ions into CS/CPC to further accelerate its bone regeneration in this study. The physicochemical and biological properties of the Zn/Sr-CS/CPCs were systematically investigated. The results showed that the setting time was slightly prolonged, the compressive strength and porosity did not change much, and all groups maintained good injectability after the doping of Zn and Sr. Besides, the doping of Zn and Sr had little effect on the phase and microstructure of hydrated products of CS/CPC. The degradation rate of Zn/Sr-CS/CPCs decreased after doping with Zn and Sr. In mouse bone marrow mesenchymal stem cells (mBMSC) experiments, all Zn/Sr-CS/CPCs stimulated the viability, adhesion, proliferation, and alkaline phosphatase (ALP) activity together with osteogenesis-related genes (ALP, Runx2, Col-I, OCN, and OPN). The further addition of Zn and Sr played better and synergistic roles in in vitro osteogenesis. Thereinto, 10Zn/20Sr-CS/CPC manifested the optimum in vitro osteogenic performance. As for human umbilical vein endothelial cell (HUVEC) experiments, the incorporation of CS doped with Zn and Sr into CPC possessed good vascularization properties of proliferation, NO secretion, tube formation, and the expression of angiogenesis-related genes (VEGF, bFGF, and eNOS). In conclusion, the doping of Zn and Sr into CS/CPC could exhibit excellent osteogenesis and good angiogenesis potentials and 10Zn/20Sr-CS/CPC could be considered as a promising candidate in bone repair.
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Affiliation(s)
- Xinyuan Yuan
- School of Materials Science and Engineering and Key Laboratory of Biomedical Materials of Ministry of Education, South China University of Technology, Guangzhou 510641, P. R. China
- National Engineering Research Center for Tissue Restoration and Reconstruction, Guangzhou 510006, P. R. China
| | - Tingting Wu
- National Engineering Research Center for Healthcare Devices, Guangdong Key Lab of Medical Electronic Instruments and Polymer Material Products, Institute of Biological and Medical Engineering, Guangdong Academy of Sciences, Guangzhou 510536, P. R. China
| | - Teliang Lu
- Department of Orthopedics, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou 510080, P. R. China
| | - Jiandong Ye
- School of Materials Science and Engineering and Key Laboratory of Biomedical Materials of Ministry of Education, South China University of Technology, Guangzhou 510641, P. R. China
- National Engineering Research Center for Tissue Restoration and Reconstruction, Guangzhou 510006, P. R. China
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Huang B, Yin Z, Zhou F, Su J. Functional anti-bone tumor biomaterial scaffold: construction and application. J Mater Chem B 2023; 11:8565-8585. [PMID: 37415547 DOI: 10.1039/d3tb00925d] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/08/2023]
Abstract
Bone tumors, including primary bone tumors and bone metastases, have been plagued by poor prognosis for decades. Although most tumor tissue is removed, clinicians are still confronted with the dilemma of eliminating residual cancer cells and regenerating defective bone tissue after surgery. Therefore, functional biomaterial scaffolds are considered to be the ideal candidates to bridge defective tissues and restrain cancer recurrence. Through functionalized structural modifications or coupled therapeutic agents, they provide sufficient mechanical strength and osteoinductive effects while eliminating cancer cells. Numerous novel approaches such as photodynamic, photothermal, drug-conjugated, and immune adjuvant-assisted therapies have exhibited remarkable efficacy against tumors while exhibiting low immunogenicity. This review summarizes the progress of research on biomaterial scaffolds based on different functionalization strategies in bone tumors. We also discuss the feasibility and advantages of the combined application of multiple functionalization strategies. Finally, potential obstacles to the clinical translation of anti-tumor bone bioscaffolds are highlighted. This review will provide valuable references for future advanced biomaterial scaffold design and clinical bone tumor therapy.
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Affiliation(s)
- Biaotong Huang
- Institute of Translational Medicine, Shanghai University, Shanghai, 200444, China.
- Organoid Research Center, Shanghai University, Shanghai, 200444, China
- Wenzhou Institute of Shanghai University, Wenzhou 325000, China
| | - Zhifeng Yin
- Department of Orthopedics, Shanghai Zhongye Hospital, Shanghai, 200444, China
| | - Fengjin Zhou
- Department of Orthopedics, Honghui Hospital, Xi'an Jiao Tong University, Xi'an, 710000, China.
| | - Jiacan Su
- Institute of Translational Medicine, Shanghai University, Shanghai, 200444, China.
- Organoid Research Center, Shanghai University, Shanghai, 200444, China
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Xi X, Gao Y, Wang J, Zheng N. Strontium chloride improves bone mass by affecting the gut microbiota in young male rats. Front Endocrinol (Lausanne) 2023; 14:1198475. [PMID: 37795367 PMCID: PMC10545847 DOI: 10.3389/fendo.2023.1198475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Accepted: 08/21/2023] [Indexed: 10/06/2023] Open
Abstract
Introduction Bone mass accumulated in early adulthood is an important determinant of bone mass throughout the lifespan, and inadequate bone deposition may lead to associated skeletal diseases. Recent studies suggest that gut bacteria may be potential factors in boosting bone mass. Strontium (Sr) as a key bioactive element has been shown to improve bone quality, but the precise way that maintains the equilibrium of the gut microbiome and bone health is still not well understood. Methods We explored the capacity of SrCl2 solutions of varying concentrations (0, 100, 200 and 400 mg/kg BW) on bone quality in 7-week-old male Wistar rats and attempted to elucidate the mechanism through gut microbes. Results The results showed that in a Wistar rat model under normal growth conditions, serum Ca levels increased after Sr-treatment and showed a dose-dependent increase with Sr concentration. Three-point mechanics and Micro-CT results showed that Sr exposure enhanced bone biomechanical properties and improved bone microarchitecture. In addition, the osteoblast gene markers BMP, BGP, RUNX2, OPG and ALP mRNA levels were significantly increased to varying degrees after Sr treatment, and the osteoclast markers RANKL and TRAP were accompanied by varying degrees of reduction. These experimental results show that Sr improves bones from multiple angles. Further investigation of the microbial population revealed that the composition of the gut microbiome was changed due to Sr, with the abundance of 6 of the bacteria showing a different dose dependence with Sr concentration than the control group. To investigate whether alterations in bacterial flora were responsible for the effects of Sr on bone remodeling, a further pearson correlation analysis was done, 4 types of bacteria (Ruminococcaceae_UCG-014, Lachnospiraceae_NK4A136_group, Alistipes and Weissella) were deduced to be the primary contributors to Sr-relieved bone loss. Of these, we focused our analysis on the most firmly associated Ruminococcaceae_UCG-014. Discussion To summarize, our current research explores changes in bone mass following Sr intervention in young individuals, and the connection between Sr-altered intestinal flora and potentially beneficial bacteria in the attenuation of bone loss. These discoveries underscore the importance of the "gut-bone" axis, contributing to an understanding of how Sr affects bone quality, and providing a fresh idea for bone mass accumulation in young individuals and thereby preventing disease due to acquired bone mass deficiency.
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Affiliation(s)
- Xueyao Xi
- Key Laboratory of Quality & Safety Control for Milk and Dairy Products of Ministry of Agriculture and Rural Affairs, Institute of Animal Sciences, Chinese Academy of Agricultural Sciences, Beijing, China
- Laboratory of Quality and Safety Risk Assessment for Dairy Products of Ministry of Agriculture and Rural Affairs, Institute of Animal Sciences, Chinese Academy of Agricultural Sciences, Beijing, China
- State Key Laboratory of Animal Nutrition, Institute of Animal Sciences, Chinese Academy of Agricultural Sciences, Beijing, China
| | - Yanan Gao
- Key Laboratory of Quality & Safety Control for Milk and Dairy Products of Ministry of Agriculture and Rural Affairs, Institute of Animal Sciences, Chinese Academy of Agricultural Sciences, Beijing, China
- Laboratory of Quality and Safety Risk Assessment for Dairy Products of Ministry of Agriculture and Rural Affairs, Institute of Animal Sciences, Chinese Academy of Agricultural Sciences, Beijing, China
- State Key Laboratory of Animal Nutrition, Institute of Animal Sciences, Chinese Academy of Agricultural Sciences, Beijing, China
| | - Jiaqi Wang
- Key Laboratory of Quality & Safety Control for Milk and Dairy Products of Ministry of Agriculture and Rural Affairs, Institute of Animal Sciences, Chinese Academy of Agricultural Sciences, Beijing, China
- Laboratory of Quality and Safety Risk Assessment for Dairy Products of Ministry of Agriculture and Rural Affairs, Institute of Animal Sciences, Chinese Academy of Agricultural Sciences, Beijing, China
- State Key Laboratory of Animal Nutrition, Institute of Animal Sciences, Chinese Academy of Agricultural Sciences, Beijing, China
| | - Nan Zheng
- Key Laboratory of Quality & Safety Control for Milk and Dairy Products of Ministry of Agriculture and Rural Affairs, Institute of Animal Sciences, Chinese Academy of Agricultural Sciences, Beijing, China
- Laboratory of Quality and Safety Risk Assessment for Dairy Products of Ministry of Agriculture and Rural Affairs, Institute of Animal Sciences, Chinese Academy of Agricultural Sciences, Beijing, China
- State Key Laboratory of Animal Nutrition, Institute of Animal Sciences, Chinese Academy of Agricultural Sciences, Beijing, China
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Wang J, Yang B, Guo S, Yu S, Li H. Manufacture of titanium alloy materials with bioactive sandblasted surfaces and evaluation of osseointegration properties. Front Bioeng Biotechnol 2023; 11:1251947. [PMID: 37671189 PMCID: PMC10475539 DOI: 10.3389/fbioe.2023.1251947] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Accepted: 08/11/2023] [Indexed: 09/07/2023] Open
Abstract
Titanium alloys are some of the most important orthopedic implant materials currently available. However, their lack of bioactivity and osteoinductivity limits their osseointegration properties, resulting in suboptimal osseointegration between titanium alloy materials and bone interfaces. In this study, we used a novel sandblasting surface modification process to manufacture titanium alloy materials with bioactive sandblasted surfaces and systematically characterized their surface morphology and physicochemical properties. We also analyzed and evaluated the osseointegration between titanium alloy materials with bioactive sandblasted surfaces and bone interfaces by in vitro experiments with co-culture of osteoblasts and in vivo experiments with a rabbit model. In our in vitro experiments, the proliferation, differentiation, and mineralization of the osteoblasts on the surfaces of the materials with bioactive sandblasted surfaces were better than those in the control group. In addition, our in vivo experiments showed that the titanium alloy materials with bioactive sandblasted surfaces were able to promote the growth of trabecular bone on their surfaces compared to controls. These results indicate that the novel titanium alloy material with bioactive sandblasted surface has satisfactory bioactivity and osteoinductivity and exhibit good osseointegration properties, resulting in improved osseointegration between the material and bone interface. This work lays a foundation for subsequent clinical application research into titanium alloy materials with bioactive sandblasted surfaces.
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Affiliation(s)
- Jie Wang
- Department of Orthopedic Surgery, Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Baohui Yang
- Department of Orthopedic Surgery, Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Shuai Guo
- Department of Orthopedic Surgery, Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Sen Yu
- Shaanxi Key Laboratory of Biomedical Metal Materials, Northwest Institute for Nonferrous Metal Research, Xi’an, China
| | - Haopeng Li
- Department of Orthopedic Surgery, Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
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Dias AM, do Nascimento Canhas I, Bruziquesi CGO, Speziali MG, Sinisterra RD, Cortés ME. Magnesium (Mg2 +), Strontium (Sr2 +), and Zinc (Zn2 +) Co-substituted Bone Cements Based on Nano-hydroxyapatite/Monetite for Bone Regeneration. Biol Trace Elem Res 2023; 201:2963-2981. [PMID: 35994139 DOI: 10.1007/s12011-022-03382-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Accepted: 08/06/2022] [Indexed: 11/30/2022]
Abstract
New bone cement type that combines Sr2 + /Mg2 + or Sr2 + /Zn2 + co-substituted nano-hydroxyapatite (n-HAs) with calcium phosphate dibasic and chitosan/gelatin polymers was developed to increase adhesion and cellular response. The cements were physicochemically described and tested in vitro using cell cultures. All cements exhibited quite hydrophilic and had high washout resistance. Cement releases Ca2 + , Mg2 + , Sr2 + , and Zn2 + in concentrations that are suitable for osteoblast proliferation and development. All of the cements stimulated cell proliferation in fibroblasts, endothelial cells, and osteoblasts, were non-cytotoxic, and produced apatite. Cements containing co-substituted n-HAs had excellent cytocompatibility, which improved osteoblast adhesion and cell proliferation. These cements had osteoinductive potential, stimulating extracellular matrix (ECM) mineralization and differentiation of MC3T3-E1 cells by increasing ALP and NO production. The ions Ca2 + , Mg2 + , Zn2 + , and Sr2 + appear to cooperate in promoting osteoblast function. The C3 cement (HA-SrMg5%), which was made up of n-HA co-substituted with 5 mol% Sr and 5 mol% Mg, showed exceptional osteoinductive capacity in terms of bone regeneration, indicating that this new bone cement could be a promising material for bone replacement.
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Affiliation(s)
- Alexa Magalhães Dias
- Dentistry Department, Faculty of Dentistry, Universidade Federal de Juiz de Fora, Rua São Paulo, 745 Governador Valadares/MG Brazil, Governador Valadares, MG, CEP, 31270901, Brazil
- Restorative Dentistry Department, Faculty of Dentistry, Universidade Federal de Minas Gerais, Av. Presidente Antônio Carlos 6627, Belo Horizonte, MG, CEP, 31270901, Brazil
| | - Isabela do Nascimento Canhas
- Biopharmaceutical and Technology Innovation Graduate Program, ICB, Universidade Federal de Minas Gerais, Av. Presidente Antônio Carlos 6627, Belo Horizonte, MG, CEP, 31270901, Brazil
| | - Carlos Giovani Oliveira Bruziquesi
- Chemistry Department, Instituto de Ciências Exatas, Universidade Federal de Minas Gerais, Av. Presidente Antônio Carlos 6627, Belo Horizonte, MG, CEP, 31270901, Brazil
| | - Marcelo Gomes Speziali
- Biopharmaceutical and Technology Innovation Graduate Program, ICB, Universidade Federal de Minas Gerais, Av. Presidente Antônio Carlos 6627, Belo Horizonte, MG, CEP, 31270901, Brazil
- Chemistry Department, Instituto de Ciências Exatas E Biológicas, Universidade Federal de Ouro Preto, Campus Morro do Cruzeiro s/n, Ouro Preto, MG, CEP, 35400000, Brazil
| | - Rubén Dario Sinisterra
- Biopharmaceutical and Technology Innovation Graduate Program, ICB, Universidade Federal de Minas Gerais, Av. Presidente Antônio Carlos 6627, Belo Horizonte, MG, CEP, 31270901, Brazil
- Chemistry Department, Instituto de Ciências Exatas, Universidade Federal de Minas Gerais, Av. Presidente Antônio Carlos 6627, Belo Horizonte, MG, CEP, 31270901, Brazil
| | - Maria Esperanza Cortés
- Biopharmaceutical and Technology Innovation Graduate Program, ICB, Universidade Federal de Minas Gerais, Av. Presidente Antônio Carlos 6627, Belo Horizonte, MG, CEP, 31270901, Brazil.
- Restorative Dentistry Department, Faculty of Dentistry, Universidade Federal de Minas Gerais, Av. Presidente Antônio Carlos 6627, Belo Horizonte, MG, CEP, 31270901, Brazil.
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Liu Z, Jiang X, Wang K, Zhou Y, Li T, Gao J, Wang L. Preparation of fish decalcified bone matrix and its bone repair effect in rats. Front Bioeng Biotechnol 2023; 11:1134992. [PMID: 36860886 PMCID: PMC9968849 DOI: 10.3389/fbioe.2023.1134992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Accepted: 01/30/2023] [Indexed: 02/16/2023] Open
Abstract
Decalcified bone matrix has great potential and application prospects in the repair of bone defects due to its good biocompatibility and osteogenic activity. In order to verify whether fish decalcified bone matrix (FDBM) has similar structure and efficacy, this study used the principle of HCl decalcification to prepare the FDBM by using fresh halibut bone as the raw material, and then degreasing, decalcifying, dehydrating and freeze-drying it. Its physicochemical properties were analyzed by scanning electron microscopy and other methods, and then its biocompatibility was tested by in vitro and in vivo experiments. At the same time, an animal model of femoral defect in rats was established, and commercially available bovine decalcified bone matrix (BDBM) was used as the control group, and the area of femoral defect in rats was filled with the two materials respectively. The changes in the implant material and the repair of the defect area were observed by various aspects such as imaging and histology, and its osteoinductive repair capacity and degradation properties were studied. The experiments showed that the FDBM is a form of biomaterial with high bone repair capacity and lower economic cost than other related materials such as bovine decalcified bone matrix. FDBM is simpler to extract and the raw materials are more abundant, which can greatly improve the utilization of marine resources. Our results show that FDBM not only has a good repair effect on bone defects, but also has good physicochemical properties, biosafety and cell adhesion, and is a promising medical biomaterial for the treatment of bone defects, which can basically meet the clinical requirements for bone tissue repair engineering materials.
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Affiliation(s)
- Zichao Liu
- College of Life Sciences, Shihezi University, Shihezi, Xinjiang, China
| | - Xiaorui Jiang
- Department of Hand and foot Surgery, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, China
| | - Kai Wang
- Department of Hand and foot Surgery, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, China
| | - Yongshun Zhou
- College of Life Sciences, Shihezi University, Shihezi, Xinjiang, China
| | - Tingting Li
- College of Life Sciences, Shihezi University, Shihezi, Xinjiang, China
| | - Jianfeng Gao
- College of Life Sciences, Shihezi University, Shihezi, Xinjiang, China,*Correspondence: Jianfeng Gao, ; Lei Wang,
| | - Lei Wang
- The Affiliated Hospital of Weifang Medical University, Yantai, China,*Correspondence: Jianfeng Gao, ; Lei Wang,
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11
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Yang X, Xiong S, Zhou J, Zhang Y, He H, Chen P, Li C, Wang Q, Shao Z, Wang L. Coating of manganese functional polyetheretherketone implants for osseous interface integration. Front Bioeng Biotechnol 2023; 11:1182187. [PMID: 37207123 PMCID: PMC10191212 DOI: 10.3389/fbioe.2023.1182187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 04/19/2023] [Indexed: 05/21/2023] Open
Abstract
Polyetheretherketone (PEEK) has been used extensively in biomedical engineering and it is highly desirable for PEEK implant to possess the ability to promote cell growth and significant osteogenic properties and consequently stimulate bone regeneration. In this study, a manganese modified PEEK implant (PEEK-PDA-Mn) was fabricated via polydopamine chemical treatment. The results showed that manganese was successfully immobilized on PEEK surface, and the surface roughness and hydrophilicity significantly improved after surface modification. Cell experiments in vitro demonstrated that the PEEK-PDA-Mn possesses superior cytocompatibility in cell adhesion and spread. Moreover, the osteogenic properties of PEEK-PDA-Mn were proved by the increased expression of osteogenic genes, alkaline phosphatase (ALP), and mineralization in vitro. Further rat femoral condyle defect model was utilized to assess bone formation ability of different PEEK implants in vivo. The results revealed that the PEEK-PDA-Mn group promoted bone tissue regeneration in defect area. Taken together, the simple immersing method can modify the surface of PEEK, giving outstanding biocompatibility and enhanced bone tissue regeneration ability to the modified PEEK, which could be applied as an orthopedic implant in clinical.
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Affiliation(s)
- Xin Yang
- Department of Orthopedics, The First Affiliated Hospital of Wannan Medical College, Wuhu, Anhui, China
| | - Shouliang Xiong
- Department of Orthopedics, The First Affiliated Hospital of Wannan Medical College, Wuhu, Anhui, China
| | - Jing Zhou
- Orthopedics and Sports Medicine Center, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou, China
| | - Yinchang Zhang
- Department of Orthopedics, The First Affiliated Hospital of Wannan Medical College, Wuhu, Anhui, China
| | - Huazheng He
- Department of Orthopedics, The First Affiliated Hospital of Wannan Medical College, Wuhu, Anhui, China
| | - Pingbo Chen
- Department of Orthopedics, The First Affiliated Hospital of Wannan Medical College, Wuhu, Anhui, China
| | - Congming Li
- Department of Orthopedics, The First Affiliated Hospital of Wannan Medical College, Wuhu, Anhui, China
| | - Qiang Wang
- Department of Orthopedics, The First Affiliated Hospital of Wannan Medical College, Wuhu, Anhui, China
- *Correspondence: Qiang Wang, ; Zhiqiang Shao, ; Lei Wang,
| | - Zhiqiang Shao
- Orthopedics and Sports Medicine Center, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou, China
- *Correspondence: Qiang Wang, ; Zhiqiang Shao, ; Lei Wang,
| | - Lei Wang
- Department of Orthopedics, The First Affiliated Hospital of Wannan Medical College, Wuhu, Anhui, China
- *Correspondence: Qiang Wang, ; Zhiqiang Shao, ; Lei Wang,
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12
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Chen Y, Zhu M, Huang B, Jiang Y, Su J. Advances in cell membrane-coated nanoparticles and their applications for bone therapy. BIOMATERIALS ADVANCES 2023; 144:213232. [PMID: 36502750 DOI: 10.1016/j.bioadv.2022.213232] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 11/24/2022] [Accepted: 11/29/2022] [Indexed: 06/17/2023]
Abstract
Due to the specific structure of natural bone, most of the therapeutics are incapable to be delivered into the targeted site with effective concentrations. Nanotechnology has provided a good way to improve this issue, cell membrane mimetic nanoparticles (NPs) have been emerging as an ideal nanomaterial which integrates the advantages of natural cell membranes with synthetic NPs to significantly improve the biocompatibility as well as achieving long-lasting circulation and targeted delivery. In addition, functionalized modifications of the cell membrane facilitate more precise targeting and therapy. Here, an overview of the preparation of cell membrane-coated NPs and the properties of cell membranes from different cell sources has been given to expatiate their function and potential applications. Strategies for functionalized modification of cell membranes are also briefly described. The application of cell membrane-coated NPs for bone therapy is then presented according to the function of cell membranes. Moreover, the prospects and challenges of cell membrane-coated NPs for translational medicine have also been discussed.
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Affiliation(s)
- Yutong Chen
- Organoid Research Centre, Institute of Translational Medicine, Shanghai University, Shanghai 200444, PR China; School of Medicine, Shanghai University, Shanghai 200444, PR China; School of Life Sciences, Shanghai University, Shanghai 200444, PR China
| | - Mengru Zhu
- Organoid Research Centre, Institute of Translational Medicine, Shanghai University, Shanghai 200444, PR China; School of Medicine, Shanghai University, Shanghai 200444, PR China
| | - Biaotong Huang
- Organoid Research Centre, Institute of Translational Medicine, Shanghai University, Shanghai 200444, PR China; Wenzhou Institute of Shanghai University, Wenzhou 325000, PR China.
| | - Yingying Jiang
- Organoid Research Centre, Institute of Translational Medicine, Shanghai University, Shanghai 200444, PR China.
| | - Jiacan Su
- Organoid Research Centre, Institute of Translational Medicine, Shanghai University, Shanghai 200444, PR China.
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13
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Zhou Z, Cui J, Wu S, Geng Z, Su J. Silk fibroin-based biomaterials for cartilage/osteochondral repair. Am J Cancer Res 2022; 12:5103-5124. [PMID: 35836802 PMCID: PMC9274741 DOI: 10.7150/thno.74548] [Citation(s) in RCA: 47] [Impact Index Per Article: 23.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Accepted: 06/18/2022] [Indexed: 02/07/2023] Open
Abstract
Osteoarthritis (OA) is a common joint disease with a high disability rate. In addition, OA not only causes great physiological and psychological harm to patients, but also puts great pressure on the social healthcare system. Pathologically, the disintegration of cartilage and the lesions of subchondral bone are related to OA. Currently, tissue engineering, which is expected to overcome the defects of existing treatment methods, had a lot of research in the field of cartilage/osteochondral repair. Silk fibroin (SF), as a natural macromolecular material with good biocompatibility, unique mechanical properties, excellent processability and degradability, holds great potential in the field of tissue engineering. Nowadays, SF had been prepared into various materials to adapt to the demands of cartilage/osteochondral repair. SF-based biomaterials can also be functionally modified to enhance repair performance further. In this review, the preparation methods, types, structures, mechanical properties, and functional modifications of SF-based biomaterials used for cartilage/osteochondral repair are summarized and discussed. We hope that this review will provide a reference for the design and development of SF-based biomaterials in cartilage/osteochondral repair field.
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Affiliation(s)
- Ziyang Zhou
- Institute of Translational Medicine, Shanghai University, Shanghai, 200444, China,Musculoskeletal Organoid Research Center, Shanghai University, Shanghai, 200444, China,School of Medicine, Shanghai University, Shanghai 200444, China,School of Life Sciences, Shanghai University, Shanghai 200444, China
| | - Jin Cui
- Institute of Translational Medicine, Shanghai University, Shanghai, 200444, China,Musculoskeletal Organoid Research Center, Shanghai University, Shanghai, 200444, China,Department of Orthopedics Trauma, Changhai Hospital, Second Military Medical University, Shanghai, 200433, China
| | - Shunli Wu
- Institute of Translational Medicine, Shanghai University, Shanghai, 200444, China,Musculoskeletal Organoid Research Center, Shanghai University, Shanghai, 200444, China,School of Medicine, Shanghai University, Shanghai 200444, China,School of Environmental and Chemical Engineering, Shanghai University, Shanghai 200444, China
| | - Zhen Geng
- Institute of Translational Medicine, Shanghai University, Shanghai, 200444, China,Musculoskeletal Organoid Research Center, Shanghai University, Shanghai, 200444, China,✉ Corresponding authors: Zhen Geng, ; Jiacan Su,
| | - Jiacan Su
- Institute of Translational Medicine, Shanghai University, Shanghai, 200444, China,Musculoskeletal Organoid Research Center, Shanghai University, Shanghai, 200444, China,✉ Corresponding authors: Zhen Geng, ; Jiacan Su,
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14
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Zhang H, Hu Y, Chen X, Wang S, Cao L, Dong S, Shi Z, Chen Y, Xiong L, Zhang Y, Zhang D, Yu B, Chen W, Wang Q, Tong P, Liu X, Zhang J, Zhou Q, Niu F, Yang W, Zhang W, Wang Y, Chen S, Jia J, Yang Q, Zhang P, Zhang Y, Miao J, Sun K, Shen T, Yu B, Yang L, Zhang L, Wang D, Liu G, Zhang Y, Su J. Expert consensus on the bone repair strategy for osteoporotic fractures in China. Front Endocrinol (Lausanne) 2022; 13:989648. [PMID: 36387842 PMCID: PMC9643410 DOI: 10.3389/fendo.2022.989648] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Accepted: 10/03/2022] [Indexed: 11/13/2022] Open
Abstract
Osteoporotic fractures, also known as fragility fractures, are prevalent in the elderly and bring tremendous social burdens. Poor bone quality, weak repair capacity, instability, and high failure rate of internal fixation are main characteristics of osteoporotic fractures. Osteoporotic bone defects are common and need to be repaired by appropriate materials. Proximal humerus, distal radius, tibia plateau, calcaneus, and spine are common osteoporotic fractures with bone defect. Here, the consensus from the Osteoporosis Group of Chinese Orthopaedic Association concentrates on the epidemiology, characters, and management strategies of common osteoporotic fractures with bone defect to standardize clinical practice in bone repair of osteoporotic fractures.
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Affiliation(s)
- Hao Zhang
- Institute of Translational Medicine, Shanghai University, Shanghai, China
- Changhai Hospital, Naval Medical University, Shanghai, China
| | - Yan Hu
- Institute of Translational Medicine, Shanghai University, Shanghai, China
| | - Xiao Chen
- Changhai Hospital, Naval Medical University, Shanghai, China
| | - Sicheng Wang
- Department of Orthopedics, Shanghai Zhongye Hospital, Shanghai, China
| | - Liehu Cao
- Department of Orthopedics, Shanghai Baoshan Luodian Hospital, Shanghai, China
| | - Shiwu Dong
- Department of Biomedical Materials Science, Army Medical University, Chongqing, China
| | - Zhongmin Shi
- Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, China
| | - Yanxi Chen
- Zhongshan Hospital, Fudan University, Shanghai, China
| | - Liming Xiong
- Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yunfei Zhang
- Tangdu Hospital, Air Force Medical University, Xi'an, China
| | | | - Baoqing Yu
- Department of Orthopedics, Shanghai Pudong Hospital, Shanghai, China
| | - Wenming Chen
- Institute of Biomedical Engineering, Academy for Engineering and Technology, Fudan University, Shanghai, China
| | - Qining Wang
- Department of Advanced Manufacturing and Robotics, College of Engineering, Peking University, Beijing, China
| | - Peijian Tong
- Department of Orthopedics, The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China
| | - Ximing Liu
- Department of Orthopedics, General Hospital of Central Theater Command, Wuhan, China
| | - Jianzheng Zhang
- Department of Orthopedic Surgery, People's Liberation Army (PLA), Army General Hospital, Beijing, China
| | - Qiang Zhou
- Department of Orthopedics, The Third Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Feng Niu
- Department of Orthopedics, The First Hospital of Jilin University, Changchun, China
| | - Weiguo Yang
- Li Ka Shing Faculty of Medicine, Hongkong University, Hong Kong, Hong Kong SAR, China
| | - Wencai Zhang
- Department of Orthopedics, The Third Affiliated Hospital of Guangzhou University of Traditional Chinese medicine (TCM), Guangzhou, China
| | - Yong Wang
- Department of Orthopedics, Wenzhou Hospital of Integrated Traditional Chinese and Western Medicine, Wenzhou, China
| | - Shijie Chen
- Department of Orthopedics, The Third Xiangya Hospital of Central South University, Changsha, China
| | - Jinpeng Jia
- Department of Orthopedics, Chinese People’s Liberation Army General Hospital, Beijing, China
| | - Qiang Yang
- Department of Orthopedics, Tianjin Hospital, Tianjin, China
| | - Peng Zhang
- Department of Orthopedics, Shandong Province Hospital, Jinan, China
| | - Yong Zhang
- Tangdu Hospital, Air Force Medical University, Xi'an, China
| | - Jun Miao
- Department of Orthopedics, Tianjin Hospital, Tianjin, China
| | - Kuo Sun
- Department of Orthopedics, The Second Affiliated Hospital of Nanchang University, Nanchang, China
| | - Tao Shen
- Department of Orthopedics, The Second Affiliated Hospital of Nanchang University, Nanchang, China
| | - Bin Yu
- Department of Orthopedics, Peking Union Medical College Hospital, Beijing, China
| | - Lei Yang
- Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou, China
| | - Lei Zhang
- Shuguang Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Dongliang Wang
- Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- *Correspondence: Dongliang Wang, ; Guohui Liu, ; Yingze Zhang, ; Jiacan Su,
| | - Guohui Liu
- Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- *Correspondence: Dongliang Wang, ; Guohui Liu, ; Yingze Zhang, ; Jiacan Su,
| | - Yingze Zhang
- Department of Orthopedics, Third Hospital of Hebei Medical University, Shijiazhuang, China
- *Correspondence: Dongliang Wang, ; Guohui Liu, ; Yingze Zhang, ; Jiacan Su,
| | - Jiacan Su
- Institute of Translational Medicine, Shanghai University, Shanghai, China
- Changhai Hospital, Naval Medical University, Shanghai, China
- *Correspondence: Dongliang Wang, ; Guohui Liu, ; Yingze Zhang, ; Jiacan Su,
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