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D'Agostino A, Misiti G, Scalia AC, Pavarini M, Fiorati A, Cochis A, Rimondini L, Borrini VF, Manfredi M, Andena L, De Nardo L, Chiesa R. Gallium-doped zirconia coatings modulate microbiological outcomes in dental implant surfaces. J Biomed Mater Res A 2024; 112:2098-2109. [PMID: 38884299 DOI: 10.1002/jbm.a.37727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 01/22/2024] [Accepted: 04/14/2024] [Indexed: 06/18/2024]
Abstract
Despite the significant recent advances in manufacturing materials supporting advanced dental therapies, peri-implantitis still represents a severe complication in dental implantology. Herein, a sol-gel process is proposed to easily deposit antibacterial zirconia coatings onto bulk zirconia, material, which is becoming very popular for the manufacturing of abutments. The coatings' physicochemical properties were analyzed through x-ray diffraction and scanning electron microscopy-energy-dispersive x-ray spectroscopy investigations, while their stability and wettability were assessed by microscratch testing and static contact angle measurements. Uniform gallium-doped tetragonal zirconia coatings were obtained, featuring optimal mechanical stability and a hydrophilic behavior. The biological investigations pointed out that gallium-doped zirconia coatings: (i) displayed full cytocompatibility toward human gingival fibroblasts; (ii) exhibited significant antimicrobial activity against the Aggregatibacter actinomycetemcomitans pathogen; (iii) were able to preserve the commensal Streptococcus salivarius. Furthermore, the proteomic analyses revealed that the presence of Ga did not impair the normal oral microbiota. Still, interestingly, it decreased by 17% the presence of Fusobacterium nucleatum, a gram-negative, strictly anaerobic bacteria that is naturally present in the gastrointestinal tract. Therefore, this work can provide a valuable starting point for the development of coatings aimed at easily improving zirconia dental implants' performance.
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Affiliation(s)
- Agnese D'Agostino
- National Interuniversity Consortium of Materials Science and Technology (INSTM), local unit Politecnico di Milano, Milan, Lombardy, Italy
- Department of Chemistry, Materials and Chemical Engineering "G. Natta", Politecnico di Milano, Milan, Lombardy, Italy
| | - Giulia Misiti
- Department of Chemistry, Materials and Chemical Engineering "G. Natta", Politecnico di Milano, Milan, Lombardy, Italy
| | | | - Matteo Pavarini
- Department of Chemistry, Materials and Chemical Engineering "G. Natta", Politecnico di Milano, Milan, Lombardy, Italy
| | - Andrea Fiorati
- National Interuniversity Consortium of Materials Science and Technology (INSTM), local unit Politecnico di Milano, Milan, Lombardy, Italy
- Department of Chemistry, Materials and Chemical Engineering "G. Natta", Politecnico di Milano, Milan, Lombardy, Italy
| | - Andrea Cochis
- Department of Health Sciences, Università del Piemonte Orientale, Novara, Piedmont, Italy
| | - Lia Rimondini
- Department of Health Sciences, Università del Piemonte Orientale, Novara, Piedmont, Italy
| | | | - Marcello Manfredi
- Department of Translational Medicine, Università del Piemonte Orientale, Novara, Piedmont, Italy
| | - Luca Andena
- Department of Chemistry, Materials and Chemical Engineering "G. Natta", Politecnico di Milano, Milan, Lombardy, Italy
| | - Luigi De Nardo
- National Interuniversity Consortium of Materials Science and Technology (INSTM), local unit Politecnico di Milano, Milan, Lombardy, Italy
- Department of Chemistry, Materials and Chemical Engineering "G. Natta", Politecnico di Milano, Milan, Lombardy, Italy
| | - Roberto Chiesa
- National Interuniversity Consortium of Materials Science and Technology (INSTM), local unit Politecnico di Milano, Milan, Lombardy, Italy
- Department of Chemistry, Materials and Chemical Engineering "G. Natta", Politecnico di Milano, Milan, Lombardy, Italy
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Gokyer S, Monsef YA, Buyuksungur S, Schmidt J, Vladescu Dragomir A, Uygur S, Oto C, Orhan K, Hasirci V, Hasirci N, Yilgor P. MgCa-Based Alloys Modified with Zn- and Ga-Doped CaP Coatings Lead to Controlled Degradation and Enhanced Bone Formation in a Sheep Cranium Defect Model. ACS Biomater Sci Eng 2024; 10:4452-4462. [PMID: 38875708 PMCID: PMC11234335 DOI: 10.1021/acsbiomaterials.4c00358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2024]
Abstract
Mg-based biodegradable metallic implants are gaining increased attraction for applications in orthopedics and dentistry. However, their current applications are hampered by their high rate of corrosion, degradation, and rapid release of ions and gas bubbles into the physiological medium. The aim of the present study is to investigate the osteogenic and angiogenic potential of coated Mg-based implants in a sheep cranial defect model. Although their osteogenic potential was studied to some extent, their potential to regenerate vascularized bone formation was not studied in detail. We have studied the potential of magnesium-calcium (MgCa)-based alloys modified with zinc (Zn)- or gallium (Ga)-doped calcium phosphate (CaP) coatings as a strategy to control their degradation rate while enhancing bone regeneration capacity. MgCa and its implants with CaP coatings (MgCa/CaP) as undoped or as doped with Zn or Ga (MgCa/CaP + Zn and MgCa/CaP + Ga, respectively) were implanted in bone defects created in the sheep cranium. MgCa implants degraded faster than the others at 4 weeks postop and the weight loss was ca. 50%, while it was ca. 15% for MgCa/CaP and <10% in the presence of Zn and Ga with CaP coating. Scanning electron microscopy (SEM) analysis of the implant surfaces also revealed that the MgCa implants had the largest degree of structural breakdown of all the groups. Radiological evaluation revealed that surface modification with CaP to the MgCa implants induced better bone regeneration within the defects as well as the enhancement of bone-implant surface integration. Bone volume (%) within the defect was ca. 25% in the case of MgCa/CaP + Ga, while it was around 15% for undoped MgCa group upon micro-CT evaluation. This >1.5-fold increase in bone regeneration for MgCa/CaP + Ga implant was also observed in the histopathological examination of the H&E- and Masson's trichrome-stained sections. Immunohistochemical analysis of the bone regeneration (antiosteopontin) and neovascularization (anti-CD31) at the defect sites revealed >2-fold increase in the expression of the markers in both Ga- and Zn-doped, CaP-coated implants. Zn-doped implants further presented low inflammatory reaction, notable bone regeneration, and neovascularization among all the implant groups. These findings indicated that Ga- and Zn-doped CaP coating is an important strategy to control the degradation rate as well as to achieve enhanced bone regeneration capacity of the implants made of Mg-based alloys.
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Affiliation(s)
- Seyda Gokyer
- Department of Biomedical Engineering, Ankara University, Ankara 06830, Turkey
| | - Yanad Abou Monsef
- Anatomic Pathology Department, National Veterinary School of Toulouse, Toulouse 31300, France
| | - Senem Buyuksungur
- BIOMATEN, Center of Excellence in Biomaterials and Tissue Engineering, Middle East Technical University (METU), Ankara 06800, Turkey
| | - Jurgen Schmidt
- Gruppenleiter Elektrochemie, Prüssingstraße 27b, INNOVENT e.V. Technologieentwicklung, Jena 07745, Germany
| | - Alina Vladescu Dragomir
- 409 Atomistilor St., National Institute of R&D for Optoelectronics─INOE 2000, Magurele 77125, Romania
- Research School of Chemistry & Applied Biomedical Sciences, National Research Tomsk Polytechnic University, Tomsk 634050, Russia
| | | | | | | | - Vasif Hasirci
- BIOMATEN, Center of Excellence in Biomaterials and Tissue Engineering, Middle East Technical University (METU), Ankara 06800, Turkey
| | - Nesrin Hasirci
- BIOMATEN, Center of Excellence in Biomaterials and Tissue Engineering, Middle East Technical University (METU), Ankara 06800, Turkey
- METU Department of Chemistry, Ankara 06800, Turkey
- Near East University Tissue Engineering and Biomaterials Research Center, Nicosia 99138, TRNC Mersin 10, Turkey
| | - Pinar Yilgor
- Department of Biomedical Engineering, Ankara University, Ankara 06830, Turkey
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Sun W, Yang K, Zou Y, Ren Y, Zhang L, Zhang F, Zeng R. In vitro and in vivo degradation, biocompatibility and bone repair performance of strontium-doped montmorillonite coating on Mg-Ca alloy. Regen Biomater 2024; 11:rbae027. [PMID: 38605854 PMCID: PMC11007119 DOI: 10.1093/rb/rbae027] [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: 11/23/2023] [Revised: 02/22/2024] [Accepted: 03/07/2024] [Indexed: 04/13/2024] Open
Abstract
Poor bone growth remains a challenge for degradable bone implants. Montmorillonite and strontium were selected as the carrier and bone growth promoting elements to prepare strontium-doped montmorillonite coating on Mg-Ca alloy. The surface morphology and composition were characterized by SEM, EDS, XPS, FT-IR and XRD. The hydrogen evolution experiment and electrochemical test results showed that the Mg-Ca alloy coated with Sr-MMT coating possessed optimal corrosion resistance performance. Furthermore, in vitro studies on cell activity, ALP activity, and cell morphology confirmed that Sr-MMT coating had satisfactory biocompatibility, which can significantly avail the proliferation, differentiation, and adhesion of osteoblasts. Moreover, the results of the 90-day implantation experiment in rats indicated that, the preparation of Sr-MMT coating effectively advanced the biocompatibility and bone repair performance of Mg-Ca alloy. In addition, The Osteogenic ability of Sr-MMT coating may be due to the combined effect of the precipitation of Si4+ and Sr2+ in Sr-MMT coating and the dissolution of Mg2+ and Ca2+ during the degradation of Mg-Ca alloy. By using coating technology, this study provides a late-model strategy for biodegradable Mg alloys with good corrosion resistance, biocompatibility. This new material will bring more possibilities in bone repair.
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Affiliation(s)
- Wenxin Sun
- Department of Bioengineering, College of Chemical and Biological Engineering, Shandong University of Science and Technology, Qingdao 266590, China
| | - Kaining Yang
- Department of Bioengineering, College of Chemical and Biological Engineering, Shandong University of Science and Technology, Qingdao 266590, China
| | - Yuhong Zou
- Department of Bioengineering, College of Chemical and Biological Engineering, Shandong University of Science and Technology, Qingdao 266590, China
| | - Yande Ren
- Affiliated Hospital of Medical College Qingdao University, Qingdao 266555, China
| | - Lin Zhang
- Hospital of Shandong, University of Science and Technology, Qingdao 266590, China
| | - Fen Zhang
- Corrosion Laboratory for Light Metals, College of Materials Science and Engineering, Shandong University of Science and Technology, Qingdao 266590, China
| | - Rongchang Zeng
- Corrosion Laboratory for Light Metals, College of Materials Science and Engineering, Shandong University of Science and Technology, Qingdao 266590, China
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Rabadjieva D, Gergulova R, Sezanova K, Kovacheva D, Titorenkova R. Mg, Zn Substituted Calcium Phosphates-Thermodynamic Modeling, Biomimetic Synthesis in the Presence of Low-Weight Amino Acids and High Temperature Properties. MATERIALS (BASEL, SWITZERLAND) 2023; 16:6638. [PMID: 37895620 PMCID: PMC10608216 DOI: 10.3390/ma16206638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/17/2023] [Revised: 10/05/2023] [Accepted: 10/09/2023] [Indexed: 10/29/2023]
Abstract
The preparation of specially doped calcium phosphates (CaPs) is receiving a great deal of attention from researchers due to CaPs' enhanced capabilities for application in medicine. Complexation and precipitation in a complicated electrolyte system including simulated body fluids that are enriched with Mg2+ and Zn2+ ions and modified with glycine, alanine and valine were first evaluated using a thermodynamic equilibrium model. The influence of the type and concentration of amino acid on the incorporation degree of Mg and Zn into the solid phases was predicted. Experimental studies, designed on the basis of thermodynamic calculations, confirmed the predictions. Amorphous calcium phosphates double-doped with Mg and Zn were biomimetically precipitated and transformed into Mg, Zn-β-tricalcium phosphates (TCP) upon calcination. The Rietveld refinement confirmed that Mg2+ and Zn2+ substituted Ca2+ only at the octahedral sites of β-TCP, and in some cases, fully displacing the Ca2+ from them. The resulting Mg, Zn-β-TCP can serve as a reservoir for Mg and Zn ions when included in the formulation of a biomaterial for bone remodeling. The research conducted reveals the effect of combining mathematical models with experimental studies to pre-evaluate the influence of various additives in the design of materials with predetermined properties.
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Affiliation(s)
- Diana Rabadjieva
- Institute of General and Inorganic Chemistry, Bulgarian Academy of Sciences, Acad. G. Bonchev Str., bl. 11, 1113 Sofia, Bulgaria
| | - Rumiana Gergulova
- Institute of General and Inorganic Chemistry, Bulgarian Academy of Sciences, Acad. G. Bonchev Str., bl. 11, 1113 Sofia, Bulgaria
| | - Kostadinka Sezanova
- Institute of General and Inorganic Chemistry, Bulgarian Academy of Sciences, Acad. G. Bonchev Str., bl. 11, 1113 Sofia, Bulgaria
| | - Daniela Kovacheva
- Institute of General and Inorganic Chemistry, Bulgarian Academy of Sciences, Acad. G. Bonchev Str., bl. 11, 1113 Sofia, Bulgaria
| | - Rositsa Titorenkova
- Institute of Mineralogy and Crystallography, Bulgarian Academy of Sciences, Acad. G. Bonchev Str., bl. 107, 1113 Sofia, Bulgaria
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Rabeeh VPM, Rahim SA, Kinattingara Parambath S, Rajanikant GK, Hanas T. Iron-Gold Composites for Biodegradable Implants: In Vitro Investigation on Biodegradation and Biomineralization. ACS Biomater Sci Eng 2023; 9:4255-4268. [PMID: 37452568 DOI: 10.1021/acsbiomaterials.3c00513] [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: 07/18/2023]
Abstract
The biocompatibility and biodegradation of iron (Fe) make it a suitable candidate for developing biodegradable metallic implants. However, the degradation rate of Fe in a physiological environment is extremely slow and needs to be enhanced to a rate compatible with tissue growth. Incorporating noble metals improves the Fe degradation rate by forming galvanic couples. This study incorporated gold (Au) into Fe at very low concentrations of 1.25 and 2.37 μg/g to improve the degradation rate. The electrochemical corrosion test of the samples revealed that the Au-containing samples showed a four-time and nine-time faster degradation rate than pure Fe. Furthermore, the immersion test and long-term electrochemical impedance spectroscopy conducted in simulated body fluid (SBF) revealed that the Au-incorporated samples exhibited increased bioactivity and degraded faster than pure Fe. Integrating nanogold into a Fe matrix increased the in situ formation of hydroxyapatite on the sample's surface and did not cause toxicity to L929-murine fibroblast cells. It is suggested that Fe-Au composites with low concentrations of Au can be used to tailor the biodegradation rate and promote the biomineralization of Fe-based implants in the physiological environment.
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Affiliation(s)
- V P Muhammad Rabeeh
- Nanomaterials Research Laboratory, School of Materials Science and Engineering, National Institute of Technology Calicut, Kozhikode 673601, India
| | - Shebeer A Rahim
- Department of Mechanical Engineering, National Institute of Technology Calicut, Kozhikode 673601, India
| | | | - G K Rajanikant
- School of Biotechnology, National Institute of Technology Calicut, Kozhikode 673601, India
| | - T Hanas
- Nanomaterials Research Laboratory, School of Materials Science and Engineering, National Institute of Technology Calicut, Kozhikode 673601, India
- Department of Mechanical Engineering, National Institute of Technology Calicut, Kozhikode 673601, India
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Zn doped CaP coatings used for controlling the degradation rate of MgCa1 alloy: In vitro anticorrosive properties, sterilization and bacteria/cell-material interactions. Colloids Surf B Biointerfaces 2023; 222:113087. [PMID: 36542955 DOI: 10.1016/j.colsurfb.2022.113087] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 11/12/2022] [Accepted: 12/09/2022] [Indexed: 12/23/2022]
Abstract
The purpose of this study was to investigate the effect of Zn doped CaP coatings prepared by micro-arc oxidation method, as a possible approach to control MgCa1 alloy degradation. All the prepared coatings comprised a calcium deficient CaP phase. The control in this evaluation was performed with undoped CaP coating in SBF solution at body temperature (37 ± 0.5⁰C). The investigation involved determination of microchemical, mechanical, morphological, properties along with anticorrosive, cytocompatibility and antibacterial efficacy. The effect of sterilization process on the properties of the surfaces was also investigated. The results showed that the addition of Zn into CaP increased the corrosion resistance of MgCa1 alloy. Moreover, the adhesion strength of the coatings to MgCa1 alloy was enhanced by Zn addition. In cytotoxicity testing of the samples, extracts of the samples in MEM were incubated with L929 cells and malformation, degeneration and lysis of the cells were examined microscopically after 72 h. The results showed that all samples were cytocompatible. The degradation of MgCa1 alloy in the simulated body fluids (SBF) or DMEM was decreased by coating with CaP. Moreover, the degradation rate of CaP was further decreased by adding a small amount of Zn into the CaP matrix. The samples having CaP coatings and Zn doped CaP coating demonstrated antibacterial efficacy against E.coli. As a result, coating of magnesium alloy with Zn-doped CaP decreased the degradation rate, increased the corrosion resistance, cytocompatibility and the antibacterial effects of the alloys.
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Pei S, Zhou Y, Li Y, Azar T, Wang W, Kim DG, Liu XS. Instrumented nanoindentation in musculoskeletal research. PROGRESS IN BIOPHYSICS AND MOLECULAR BIOLOGY 2022; 176:38-51. [PMID: 35660010 DOI: 10.1016/j.pbiomolbio.2022.05.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Revised: 05/24/2022] [Accepted: 05/31/2022] [Indexed: 06/15/2023]
Abstract
Musculoskeletal tissues, such as bone, cartilage, and muscle, are natural composite materials that are constructed with a hierarchical structure ranging from the cell to tissue level. The component differences and structural complexity, together, require comprehensive multiscale mechanical characterization. In this review, we focus on nanoindentation testing, which is used for nanometer to sub-micrometer length scale mechanical characterization. In the following context, we will summarize studies of nanoindentation in musculoskeletal research, examine the critical factors that affect nanoindentation testing results, and briefly summarize other commonly used techniques that can be conjoined with nanoindentation for synchronized imaging and colocalized characterization.
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Affiliation(s)
- Shaopeng Pei
- McKay Orthopaedic Research Laboratory, Department of Orthopaedic Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, United States
| | - Yilu Zhou
- McKay Orthopaedic Research Laboratory, Department of Orthopaedic Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, United States
| | - Yihan Li
- McKay Orthopaedic Research Laboratory, Department of Orthopaedic Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, United States
| | - Tala Azar
- McKay Orthopaedic Research Laboratory, Department of Orthopaedic Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, United States
| | - Wenzheng Wang
- McKay Orthopaedic Research Laboratory, Department of Orthopaedic Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, United States; Department of Orthopaedic Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, China
| | - Do-Gyoon Kim
- Division of Orthodontics, College of Dentistry, The Ohio State University, Columbus, OH, 43210, USA
| | - X Sherry Liu
- McKay Orthopaedic Research Laboratory, Department of Orthopaedic Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, United States.
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Investigation on the control effect of benzotriazole and two derivatives on cobalt pitting corrosion in chemical mechanical polishing process: A combination of experiments and theoretical simulations. J Mol Liq 2022. [DOI: 10.1016/j.molliq.2022.120487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Qi H, Liu Y, Wu L, Liu C, Ni S, Liu Q, Ni X, Sun Q. Mg-HA-C/C Composites Promote Osteogenic Differentiation and Repair Bone Defects Through Inhibiting miR-16. Front Bioeng Biotechnol 2022; 10:838842. [PMID: 35186909 PMCID: PMC8854763 DOI: 10.3389/fbioe.2022.838842] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2021] [Accepted: 01/10/2022] [Indexed: 11/13/2022] Open
Abstract
The hydroxyapatite (HA) coating on carbon/carbon (C/C) is reasonable and feasible to obtain bone graft materials with appropriate mechanical and biological properties. However, improvement of the physical and chemical properties of HA-C/C composites to promote bone regeneration and healing remains a challenge. In our present study, the HA coatings on C/C with magnesium (Mg) (Mg-HA-C/C) composites were synthesized that Ca (NO3)2, Mg (NO3)2, and NH4H2PO4 were mixed and coatings were made by electromagnetic induction deposition’s heating. As determined with in vitro experiments, Mg-HA-C/C composites containing 10 and 20% Mg decreased miR-16 levels, increased cell viability, elevated the levels of osteogenesis-related genes, and promoted osteogenic differentiation of bone marrow mesenchymal stem cells (BMSCs) seeded on their surfaces. In a rat model of skull defects, compared to the control group, at 4 and 12 weeks after the operation, the bone volume fraction (BV/TV) of Mg-HA-C/C composite group was increased by 8.439 ± 2.681% and 23.837 ± 7.845%, as well as the trabecular thickness (Tb.Th) was 56.247 ± 24.238 μm and 114.911 ± 34.015 μm more. These composites also increased the levels of ALP and RUNX2 in skull. The Mg-HA-C/C composite-enhanced bone regeneration and healing were blocked by in situ injection of an miR-16 mimic lentivirus vector. Thus, Mg-HA-C/C composites promote osteogenic differentiation and repair bone defects through inhibiting miR-16.
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Affiliation(s)
- Hong Qi
- Center for Global Health, The Key Laboratory of Modern Toxicology, Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Yang Liu
- Department of Orthopedics, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Lu Wu
- Center for Global Health, The Key Laboratory of Modern Toxicology, Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Chun Liu
- Second People’s Hospital of Changzhou, Nanjing Medical University, Changzhou, China
| | - Su Ni
- Second People’s Hospital of Changzhou, Nanjing Medical University, Changzhou, China
| | - Qizhan Liu
- Center for Global Health, The Key Laboratory of Modern Toxicology, Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing, China
| | - Xinye Ni
- Second People’s Hospital of Changzhou, Nanjing Medical University, Changzhou, China
- *Correspondence: Xinye Ni, ; Qiang Sun,
| | - Qiang Sun
- Department of Orthopedics, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
- *Correspondence: Xinye Ni, ; Qiang Sun,
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