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Cao B, Xie L, Xu Y, Shen J, Zhang Y, Wang Y, Weng X, Bao Z, Yang X, Gou Z, Wang C. Dual-core-component multiphasic bioceramic granules with selective-area porous structures facilitating bone tissue regeneration and repair. RSC Adv 2024; 14:10526-10537. [PMID: 38567335 PMCID: PMC10985589 DOI: 10.1039/d4ra00911h] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2024] [Accepted: 03/18/2024] [Indexed: 04/04/2024] Open
Abstract
Ca-phosphate/-silicate ceramic granules have been widely studied because their biodegradable fillers can enhance bone defect repair accompanied with bioactive ion release and material degradation; however, it is a challenge to endow bioceramic composites with time-dependent ion release and highly efficient osteogenesis in vivo. Herein, we prepared dual-core-type bioceramic granules with varying chemical compositions beneficial for controlling ion release and stimulating osteogenic capability. Core-shell-structured bioceramic granules (P8-Sr4@Zn3, P8-Sr4@TCP, and P8-Sr4@HAR) composed of 8% P- and 4% Sr-substituting wollastonite (P8, Sr4) dual core components and different shell components, such as 3% Zn-substituting wollastonite (Zn3), β-tricalcium phosphate (β-TCP), and hardystonite (HAR), were prepared by cutting extruded core-shell fibers through dual-core ternary nozzles, followed by high-temperature sintering post-treatment. The experimental results showed that nonstoichiometric wollastonite core components contributed to more biologically active ion release in Tris buffer in vitro, and the sparingly dissolvable shell component readily maintained the granule morphology in vivo; thus, such bioceramic implants can adjust new bone growth and material degradation over time. In particular, bioceramic granules encapsulated by the TCP shell exhibited the most appreciable osteogenic capacity and expected biodegradation, which was mostly favorable for bone repair in critical bone defects. It is reasonable to consider that this new multiphasic bioceramic granule design is versatile for developing next-generation implants for various bone damage repairs.
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Affiliation(s)
- Binji Cao
- Department of Orthopedic Surgery, The Second Affiliated Hospital, Zhejiang University School of Medicine #88 Jiefang Road Hangzhou 310009 Zhejiang Province China
| | - Lijun Xie
- Department of Orthopedic Surgery, The Second Affiliated Hospital, Zhejiang University School of Medicine #88 Jiefang Road Hangzhou 310009 Zhejiang Province China
| | - Yan Xu
- Bio-nanomaterials and Regenerative Medicine Research Division, Zhejiang-California International Nanosystem Institute, Zhejiang University Hangzhou 310058 China (+86) 571-8697 1539 (+86) 571-8820 8353
| | - Jian Shen
- Department of Emergency Medicine, The Second Affiliated Hospital, Zhejiang University School of Medicine and Institute of Emergency Medicine #88 Jiefang Road Hangzhou 310009 Zhejiang Province China
| | - Yan Zhang
- Bio-nanomaterials and Regenerative Medicine Research Division, Zhejiang-California International Nanosystem Institute, Zhejiang University Hangzhou 310058 China (+86) 571-8697 1539 (+86) 571-8820 8353
| | - Yingjie Wang
- Department of Orthopedic Surgery, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College Beijing 100730 China
| | - Xisheng Weng
- Department of Orthopedic Surgery, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College Beijing 100730 China
| | - Zhaonan Bao
- Bio-nanomaterials and Regenerative Medicine Research Division, Zhejiang-California International Nanosystem Institute, Zhejiang University Hangzhou 310058 China (+86) 571-8697 1539 (+86) 571-8820 8353
| | - Xianyan Yang
- Bio-nanomaterials and Regenerative Medicine Research Division, Zhejiang-California International Nanosystem Institute, Zhejiang University Hangzhou 310058 China (+86) 571-8697 1539 (+86) 571-8820 8353
| | - Zhongru Gou
- Bio-nanomaterials and Regenerative Medicine Research Division, Zhejiang-California International Nanosystem Institute, Zhejiang University Hangzhou 310058 China (+86) 571-8697 1539 (+86) 571-8820 8353
| | - Cong Wang
- Department of Orthopedic Surgery, The Second Affiliated Hospital, Zhejiang University School of Medicine #88 Jiefang Road Hangzhou 310009 Zhejiang Province China
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Wu Y, Yang L, Chen L, Geng M, Xing Z, Chen S, Zeng Y, Zhou J, Sun K, Yang X, Shen B. Core-Shell Structured Porous Calcium Phosphate Bioceramic Spheres for Enhanced Bone Regeneration. ACS APPLIED MATERIALS & INTERFACES 2022; 14:47491-47506. [PMID: 36251859 DOI: 10.1021/acsami.2c15614] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Adequate new bone regeneration in bone defects has always been a challenge as it requires excellent and efficient osteogenesis. Calcium phosphate (CaP) bioceramics, including hydroxyapatite (HA) and biphasic calcium phosphates (BCPs), have been extensively used in clinical bone defect filling due to their good osteoinductivity and biodegradability. Here, for the first time, we designed and fabricated two porous CaP bioceramic granules with core-shell structures, named in accordance with their composition as BCP@HA and HA@BCP (core@shell). The spherical shape and the porous structure of these granules were achieved by the calcium alginate gel molding technology combined with a H2O2 foaming process. These granules could be stacked to build a porous structure with a porosity of 65-70% and a micropore size distribution between 150 and 450 μm, which is reported to be good for new bone ingrowth. In vitro experiments confirmed that HA@BCP bioceramic granules could promote the proliferation and osteogenic ability when cocultured with bone marrow mesenchymal stem cells, while inhibiting the differentiation of RAW264.7 cells into osteoclasts. In vivo, 12 weeks of implantation in a critical-sized femoral bone defect animal model showed a higher bone volume fraction and bone mineral density in the HA@BCP group than in the BCP@HA or pure HA or BCP groups. From histological analysis, we discovered that the new bone tissue in the HA@BCP group was invading from the surface to the inside of the granules, and most of the bioceramic phase was replaced by the new bone. A higher degree of vascularization at the defect region repaired by HA@BCP was revealed by 3D microvascular perfusion angiography in terms of a higher vessel volume fraction. The current study demonstrated that the core-shell structured HA@BCP bioceramic granules could be a promising candidate for bone defect repair.
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Affiliation(s)
- Yuangang Wu
- Orthopedic Research Institute, Department of Orthopedics, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Long Yang
- National Engineering Research Center for Biomaterials, Sichuan University, Chengdu 610064, China
| | - Li Chen
- Analytical & Testing Center, Sichuan University, No. 29 Jiuyanqiao Wangjiang Road, Chengdu 610064, China
| | - Mengyu Geng
- National Engineering Research Center for Biomaterials, Sichuan University, Chengdu 610064, China
| | - Zhengyi Xing
- National Engineering Research Center for Biomaterials, Sichuan University, Chengdu 610064, China
| | - Siyu Chen
- National Engineering Research Center for Biomaterials, Sichuan University, Chengdu 610064, China
| | - Yi Zeng
- Orthopedic Research Institute, Department of Orthopedics, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Jinhan Zhou
- Core Facilities of West China Hospital, Sichuan University, Chengdu 610041, China
| | - Kaibo Sun
- Orthopedic Research Institute, Department of Orthopedics, West China Hospital, Sichuan University, Chengdu 610041, China
| | - Xiao Yang
- National Engineering Research Center for Biomaterials, Sichuan University, Chengdu 610064, China
| | - Bin Shen
- Orthopedic Research Institute, Department of Orthopedics, West China Hospital, Sichuan University, Chengdu 610041, China
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Lei L, Han J, Wen J, Yu Y, Ke T, Wu Y, Yang X, Chen L, Gou Z. Biphasic ceramic biomaterials with tunable spatiotemporal evolution for highly efficient alveolar bone repair. J Mater Chem B 2020; 8:8037-8049. [PMID: 32766660 DOI: 10.1039/d0tb01447h] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Alveolar bone defects, which are characterized by a relatively narrow space and location adjacent to the cementum, require promising substitute biomaterials for their regeneration. In this study, we introduced novel yolk-shell biphasic bio-ceramic granules with/without a customized porous shell and evaluated their biological effect together with structural transformation. Firstly, a self-made coaxial bilayer capillary system was applied for the fabrication of granules. Secondly, thorough morphological and physicochemical characterizations were performed in vitro. Subsequently, the granules were implanted into critical-size alveolar bone defects (10 × 4 × 3 mm) in New Zealand white rabbits, with Bio-Oss® as the positive control. Finally, at 2, 4, 8, and 16 weeks postoperatively, the alveolar bone specimens were harvested and assessed via radiological and histological examination. Our results showed that the yolk-shell biphasic bio-ceramic granules, especially those with porous shells, exhibited a tunable ion release performance, improved biodegradation behavior and satisfactory osteogenesis compared with the homogeneously hybrid and Bio-Oss® granules both in vitro and in vivo. This study provides the first evidence that novel yolk-shell bio-ceramic granules, on account of their adjustable porous microstructure, have great potential in alveolar bone repair.
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Affiliation(s)
- Lihong Lei
- Department of Stomatology, the Second Affiliated Hospital of Zhejiang, University School of Medicine, Hangzhou 310009, China.
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The Impact of Bioceramic Scaffolds on Bone Regeneration in Preclinical In Vivo Studies: A Systematic Review. MATERIALS 2020; 13:ma13071500. [PMID: 32218290 PMCID: PMC7177381 DOI: 10.3390/ma13071500] [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: 03/04/2020] [Revised: 03/20/2020] [Accepted: 03/23/2020] [Indexed: 02/07/2023]
Abstract
Bioceramic scaffolds are appealing for alveolar bone regeneration, because they are emerging as promising alternatives to autogenous and heterogenous bone grafts. The aim of this systematic review is to answer to the focal question: in critical-sized bone defects in experimental animal models, does the use of a bioceramic scaffolds improve new bone formation, compared with leaving the empty defect without grafting materials or using autogenous bone or deproteinized bovine-derived bone substitutes? Electronic databases were searched using specific search terms. A hand search was also undertaken. Only randomized and controlled studies in the English language, published in peer-reviewed journals between 2013 and 2018, using critical-sized bone defect models in non-medically compromised animals, were considered. Risk of bias assessment was performed using the SYRCLE tool. A meta-analysis was planned to synthesize the evidence, if possible. Thirteen studies reporting on small animal models (six studies on rats and seven on rabbits) were included. The calvarial bone defect was the most common experimental site. The empty defect was used as the only control in all studies except one. In all studies the bioceramic materials demonstrated a trend for better outcomes compared to an empty control. Due to heterogeneity in protocols and outcomes among the included studies, no meta-analysis could be performed. Bioceramics can be considered promising grafting materials, though further evidence is needed.
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Shen J, Wu R, Shen M, Wei Y, Lei L, Chen L, Yang X, Jin Z, Xu S, Gou Z. Effect of Foreign Ion Substitution and Micropore Tuning in Robocasting Single-Phase Bioceramic Scaffolds on the Physicochemical Property and Vascularization. ACS APPLIED BIO MATERIALS 2020; 3:292-301. [PMID: 35019445 DOI: 10.1021/acsabm.9b00817] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
The inorganic powder slurry extrusion printing technique known as robocasting is an interesting method to fabricate complex porous architectures whereby feedstocks containing organic binders and powders are printed and the resulting scaffolds are subjected to sintering. A major limiting factor of this technique is the simultaneous tailoring of vascularization efficacy and osteogenic activity, usually done by adding the secondary phase in the organic slurry before the writing step. Mechanical mixing of biphasic powders is required to avoid compromising the biological performance and physical defects caused by significantly different physicochemical properties. This study addresses this issue by developing a selective ion doping and microstructure tuning for the production of bioceramic scaffolds with a binozzle robocasting process. Different metal ions (Sr2+, Mg2+) were doped into wollastonite (CaSiO3; CSi) powders considering the mechanical stability and bioactive enhancement of the bioceramic scaffolds. Subsequently, the Mg-doped CSi slurries were used as shell-nozzle feedstocks added with 5, 10, and 15 μm diameter polystyrene microbeads that allowed shell-layer micropore production in pore struts during sintering. Finally, the most promising pore-strut microstructures and mechanical evolution of scaffolds were evaluated, and especially the enhanced fibrovascularization potential was confirmed in dorsal muscle embedding model in rabbits. This study may open an avenue to designing multiproperty-tuned macro- and microporous bioceramics for bone regenerative medicine, especially in challenging bone defect conditions.
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Affiliation(s)
- Jianhua Shen
- Bio-nanomaterials and Regenerative Medicine Research Division, Zhejiang-California International Nanosystem Institute, Zhejiang University, Hangzhou 310058, China
| | - Ronghuan Wu
- Department of Orthopedics, the First Affiliated Hospital, School of Medicine of Zhejiang University, Hangzhou 310003, China
| | - Miaoda Shen
- Department of Orthopedics, the First Affiliated Hospital, School of Medicine of Zhejiang University, Hangzhou 310003, China
| | - Yingming Wei
- Department of Oral Medicine, the Second Affiliated hospital, School of Medicine of Zhejiang University, Hangzhou 310009, China
| | - Lihong Lei
- Department of Oral Medicine, the Second Affiliated hospital, School of Medicine of Zhejiang University, Hangzhou 310009, China
| | - Lili Chen
- Department of Oral Medicine, the Second Affiliated hospital, School of Medicine of Zhejiang University, Hangzhou 310009, China
| | - Xianyan Yang
- Bio-nanomaterials and Regenerative Medicine Research Division, Zhejiang-California International Nanosystem Institute, Zhejiang University, Hangzhou 310058, China
| | - Zhouwen Jin
- Bio-nanomaterials and Regenerative Medicine Research Division, Zhejiang-California International Nanosystem Institute, Zhejiang University, Hangzhou 310058, China
| | - Sanzhong Xu
- Department of Orthopedics, the First Affiliated Hospital, School of Medicine of Zhejiang University, Hangzhou 310003, China
| | - Zhongru Gou
- Bio-nanomaterials and Regenerative Medicine Research Division, Zhejiang-California International Nanosystem Institute, Zhejiang University, Hangzhou 310058, China
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Ghamor‐Amegavi EP, Yang X, Qiu J, Xie L, Pan Z, Wang J, Zhang X, Ke X, Zhao T, Zhang L, Gou Z. Composition control in biphasic silicate microspheres on stimulating new bone regeneration and repair of osteoporotic femoral bone defect. J Biomed Mater Res B Appl Biomater 2019; 108:377-390. [PMID: 31037822 DOI: 10.1002/jbm.b.34396] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2019] [Revised: 04/09/2019] [Accepted: 04/17/2019] [Indexed: 11/07/2022]
Affiliation(s)
- Edem P. Ghamor‐Amegavi
- Department of Orthopedic Surgerythe Second Affiliated Hospital, Zhejiang University School of Medicine Hangzhou China
- Orthopedics Research InstituteZhejiang University Hangzhou China
| | - Xianyan Yang
- Bio‐Nanomaterials and Regenerative Medicine Research DivisionZhejiang‐California International Nanosystem Institute, Zhejiang University Hangzhou China
| | - Jiandi Qiu
- Department of Orthopaedic Surgerythe 3rd Hospital Affiliated to Wenzhou Medical College Rui'an China
| | - Lijun Xie
- Department of Orthopedic Surgerythe Second Affiliated Hospital, Zhejiang University School of Medicine Hangzhou China
- Orthopedics Research InstituteZhejiang University Hangzhou China
| | - Zhijun Pan
- Department of Orthopedic Surgerythe Second Affiliated Hospital, Zhejiang University School of Medicine Hangzhou China
- Orthopedics Research InstituteZhejiang University Hangzhou China
| | - Juncheng Wang
- Department of Orthopaedic Surgerythe 3rd Hospital Affiliated to Wenzhou Medical College Rui'an China
| | - Xiangfeng Zhang
- Department of Orthopedic Surgerythe Second Affiliated Hospital, Zhejiang University School of Medicine Hangzhou China
- Orthopedics Research InstituteZhejiang University Hangzhou China
| | - Xiurong Ke
- Department of Orthopaedic Surgerythe 3rd Hospital Affiliated to Wenzhou Medical College Rui'an China
| | - Tengfei Zhao
- Department of Orthopedic Surgerythe Second Affiliated Hospital, Zhejiang University School of Medicine Hangzhou China
- Orthopedics Research InstituteZhejiang University Hangzhou China
| | - Lei Zhang
- Department of Orthopaedic Surgerythe 3rd Hospital Affiliated to Wenzhou Medical College Rui'an China
| | - Zhongru Gou
- Bio‐Nanomaterials and Regenerative Medicine Research DivisionZhejiang‐California International Nanosystem Institute, Zhejiang University Hangzhou China
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Fu J, Zhuang C, Qiu J, Ke X, Yang X, Jin Z, Zhang L, Yang G, Xie L, Xu S, Gao C, Gou Z. Core-Shell Biphasic Microspheres with Tunable Density of Shell Micropores Providing Tailorable Bone Regeneration. Tissue Eng Part A 2018; 25:588-602. [PMID: 30215296 DOI: 10.1089/ten.tea.2018.0174] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
IMPACT STATEMENT We have developed the new core-shell bioceramic CSi-Sr4@CaP-px microspheres with tuning porous shell layer so that the biodegradation of both CSi-Sr4 core and CaP shell is readily adjusted synergistically. This is for the first time, to the best of our knowledge, that the bioceramic scaffolds concerning gradient distribution and microstructure-tailoring design is available for tailoring biodegradation and ion release (bioactivity) to optimizing osteogenesis. Furthermore, it is possibly helpful to develop new bioactive scaffold system for time-dependent tailoring bioactivity and microporous structure to significantly enhance bone regeneration and repair applications, especially in some non-load-bearing arbitrary 3D anatomical bone and teeth defects.
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Affiliation(s)
- Jia Fu
- 1 Department of Orthopaedic Surgery, The Third Hospital Affiliated to Wenzhou Medical University , Rui'an, China
| | - Chen Zhuang
- 2 Bio-Nanomaterials and Regenerative Medicine Research Division, Zhejiang-California International Nanosystem Institute, Zhejiang University , Hangzhou, China
| | - Jiandi Qiu
- 1 Department of Orthopaedic Surgery, The Third Hospital Affiliated to Wenzhou Medical University , Rui'an, China
| | - Xiurong Ke
- 1 Department of Orthopaedic Surgery, The Third Hospital Affiliated to Wenzhou Medical University , Rui'an, China
| | - Xianyan Yang
- 2 Bio-Nanomaterials and Regenerative Medicine Research Division, Zhejiang-California International Nanosystem Institute, Zhejiang University , Hangzhou, China
| | - Zhouwen Jin
- 2 Bio-Nanomaterials and Regenerative Medicine Research Division, Zhejiang-California International Nanosystem Institute, Zhejiang University , Hangzhou, China
| | - Lei Zhang
- 1 Department of Orthopaedic Surgery, The Third Hospital Affiliated to Wenzhou Medical University , Rui'an, China
| | - Guojing Yang
- 1 Department of Orthopaedic Surgery, The Third Hospital Affiliated to Wenzhou Medical University , Rui'an, China
| | - Lijun Xie
- 3 Department of Orthopaedic Surgery, The Second Affiliated Hospital, School of Medicine of Zhejiang University , Hangzhou, China
| | - Sanzhong Xu
- 4 Department of Orthopaedic Surgery, The First Affiliated Hospital, School of Medicine of Zhejiang University , Hangzhou, China
| | - Changyou Gao
- 2 Bio-Nanomaterials and Regenerative Medicine Research Division, Zhejiang-California International Nanosystem Institute, Zhejiang University , Hangzhou, China
| | - Zhongru Gou
- 2 Bio-Nanomaterials and Regenerative Medicine Research Division, Zhejiang-California International Nanosystem Institute, Zhejiang University , Hangzhou, China
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Jin Z, Wu R, Shen J, Yang X, Shen M, Xu W, Huang R, Zhang L, Yang G, Gao C, Gou Z, Xu S. Nonstoichiometric wollastonite bioceramic scaffolds with core-shell pore struts and adjustable mechanical and biodegradable properties. J Mech Behav Biomed Mater 2018; 88:140-149. [PMID: 30170193 DOI: 10.1016/j.jmbbm.2018.08.018] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Revised: 08/14/2018] [Accepted: 08/19/2018] [Indexed: 02/06/2023]
Abstract
Controllable mechanical strength and biodegradation of bioceramic scaffolds is a great challenge to treat the load-bearing bone defects. Herein a new strategy has been developed to fabricate porous bioceramic scaffolds with adjustable component distributions based on varying the core-shell-structured nozzles in three-dimensional (3D) direct ink writing platform. The porous bioceramic scaffolds composed of different nonstoichiometic calcium silicate (nCSi) with 0%, 4% or 10% of magnesium-substituting-calcium ratio (CSi, CSi-Mg4, CSi-Mg10) was fabricated. Beyond the mechanically mixed composite scaffolds, varying the different nCSi slurries through the coaxially aligned bilayer nozzle makes it easy to create core-shell bilayer bioceramic filaments and better control of the different nCSi distribution in pore strut after sintering. It was evident that the magnesium substitution in CSi contributed to the increase of compressive strength for the single-phasic scaffolds from 11.2 MPa (CSi), to 39.4 MPa (CSi-Mg4) and 80 MPa (CSi-Mg10). The nCSi distribution in pore struts in the series of core-shell-strut scaffolds could significantly adjust the strength [e.g. CSi@CSi-Mg10 (58.9 MPa) vs CSi-Mg10@CSi (30.4 MPa)] and biodegradation ratio in Tris buffer for a long time stage (6 weeks). These findings demonstrate that the nCSi components with different distributions in core or shell layer of pore struts lead to tunable strength and biodegradation inside their interconnected macropore architectures of the scaffolds. It is possibly helpful to develop new bioactive scaffolds for time-dependent tailoring mechanical and biological performances to significantly enhance bone regeneration and repair applications, especially in some load-bearing bone defects.
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Affiliation(s)
- Zhouwen Jin
- Bio-nanomaterials and Regenerative Medicine Research Division, Zhejiang-California International Nanosystem Institute, Zhejiang University, Hangzhou 310058, China
| | - Ronghuan Wu
- Department of Orthopedics, The First Affiliated Hospital, School of Medicine of Zhejiang University, Hangzhou 310003, China
| | - Jianhua Shen
- Bio-nanomaterials and Regenerative Medicine Research Division, Zhejiang-California International Nanosystem Institute, Zhejiang University, Hangzhou 310058, China
| | - Xianyan Yang
- Bio-nanomaterials and Regenerative Medicine Research Division, Zhejiang-California International Nanosystem Institute, Zhejiang University, Hangzhou 310058, China
| | - Miaoda Shen
- Department of Orthopedics, The First Affiliated Hospital, School of Medicine of Zhejiang University, Hangzhou 310003, China
| | - Wangqiong Xu
- Key Laboratory of Polar Materials and Devices, Ministry of Education, East China Normal University, Shanghai 200062, China
| | - Rong Huang
- Key Laboratory of Polar Materials and Devices, Ministry of Education, East China Normal University, Shanghai 200062, China
| | - Lei Zhang
- Department of Orthopdedic Surgery, The 3rd Hospital Affiliated to Wenzhou Medical University, Rui'an 325200, China
| | - Guojing Yang
- Department of Orthopdedic Surgery, The 3rd Hospital Affiliated to Wenzhou Medical University, Rui'an 325200, China
| | - Changyou Gao
- Bio-nanomaterials and Regenerative Medicine Research Division, Zhejiang-California International Nanosystem Institute, Zhejiang University, Hangzhou 310058, China
| | - Zhongru Gou
- Bio-nanomaterials and Regenerative Medicine Research Division, Zhejiang-California International Nanosystem Institute, Zhejiang University, Hangzhou 310058, China.
| | - Sanzhong Xu
- Department of Orthopedics, The First Affiliated Hospital, School of Medicine of Zhejiang University, Hangzhou 310003, China.
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