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Huang L, Kang J, Zhong Y, Zhang J, Qiang M, Feng Z. A predictive model for awakening in patients with prolonged disorders of consciousness after craniocerebral injury. Medicine (Baltimore) 2024; 103:e36701. [PMID: 38215152 PMCID: PMC10783300 DOI: 10.1097/md.0000000000036701] [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: 03/23/2023] [Accepted: 11/27/2023] [Indexed: 01/14/2024] Open
Abstract
This study aimed to develop and validate a nomogram to predict awakening at 1 year in patients with prolonged disorders of consciousness (pDOC). We retrospectively analyzed the data of 381 patients with pDOC at 2 centers. The data were randomly divided into training and validation sets using a ratio of 6:4. For the training set, univariate and multivariate logical regression analyses were used to identify the predictive variables. Receiver operating characteristic curves, calibration curves, and a decision curve analysis were utilized to assess the predictive accuracy, discriminative ability, and clinical utility of the model, respectively. The final model included age, Glasgow Coma Scale score, serum albumin level, and computed tomography midline shift, all of which had a significant effect on awakening after pDOC. For the 1-year awakening in the training set, the model had good discriminative power, with an area under the curve of 0.733 (95% confidence interval: 0.667-0.789). For the validation set, the area under the curve for 1-year awakening was 0.721 (95% confidence interval: 0.617-0.826). Model performance was good for both the training and validation sets according to calibration plots and decision curve analysis. We developed a precise, effective nomogram to assist clinicians in better assessing patients' outcomes, guiding clinical judgment, and personalizing the therapeutic process.
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Affiliation(s)
- Lianghua Huang
- First Department of Rehabilitation Medicine, Affiliated Hospital with Jiangxi University of Traditional Chinese Medicine, Nanchang, Jiangxi, P.R. China
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, P.R. China
| | - Junwei Kang
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, P.R. China
| | - Yuan Zhong
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, P.R. China
| | - Jieyuan Zhang
- First Clinical Medical School, Nanchang University, Nanchang, Jiangxi, P.R. China
| | - Mengxiang Qiang
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, P.R. China
| | - Zhen Feng
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, P.R. China
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Feehan J, Jacques M, Kondrikov D, Eynon N, Wijeratne T, Apostolopoulos V, Gimble JM, Hill WD, Duque G. Circulating Osteoprogenitor Cells Have a Mixed Immune and Mesenchymal Progenitor Function in Humans. Stem Cells 2023; 41:1060-1075. [PMID: 37609930 PMCID: PMC10631805 DOI: 10.1093/stmcls/sxad064] [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: 04/04/2023] [Accepted: 07/24/2023] [Indexed: 08/24/2023]
Abstract
BACKGROUND Circulating osteoprogenitors (COP) are a population of cells in the peripheral circulation that possess functional and phenotypical characteristics of multipotent stromal cells (MSCs). This population has a solid potential to become an abundant, accessible, and replenishable source of MSCs with multiple potential clinical applications. However, a comprehensive functional characterization of COP cells is still required to test and fully develop their use in clinical settings. METHODS This study characterized COP cells by comparing them to bone marrow-derived MSCs (BM-MSCs) and adipose-derived MSCs (ASCs) through detailed transcriptomic and proteomic analyses. RESULTS We demonstrate that COP cells have a distinct gene and protein expression pattern with a significantly stronger immune footprint, likely owing to their hematopoietic lineage. In addition, regarding progenitor cell differentiation and proliferation pathways, COP cells have a similar expression pattern to BM-MSCs and ASCs. CONCLUSION COP cells are a unique but functionally similar population to BM-MSCs and ASCs, sharing their proliferation and differentiation capacity, thus presenting an accessible source of MSCs with strong potential for translational regenerative medicine strategies.
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Affiliation(s)
- Jack Feehan
- Department of Medicine - Western Health, The University of Melbourne, Melbourne, Victoria (VIC), Australia
- Australian Institute for Musculoskeletal Science (AIMSS), Western Health, Victoria University and University of Melbourne, Melbourne, Victoria (VIC), Australia
- Institute for Health and Sport, Victoria University, Melbourne, Victoria (VIC), Australia
| | - Macsue Jacques
- Institute for Health and Sport, Victoria University, Melbourne, Victoria (VIC), Australia
| | - Dmitry Kondrikov
- Department of Pathology and Laboratory Medicine, The Medical University of South Carolina, Charleston, SC, USA
| | - Nir Eynon
- Institute for Health and Sport, Victoria University, Melbourne, Victoria (VIC), Australia
- Australian Regenerative Medicine Institute, Monash University, Clayton, Victoria, Australia
| | - Tissa Wijeratne
- Australian Institute for Musculoskeletal Science (AIMSS), Western Health, Victoria University and University of Melbourne, Melbourne, Victoria (VIC), Australia
- Institute for Health and Sport, Victoria University, Melbourne, Victoria (VIC), Australia
| | - Vasso Apostolopoulos
- Australian Institute for Musculoskeletal Science (AIMSS), Western Health, Victoria University and University of Melbourne, Melbourne, Victoria (VIC), Australia
- Institute for Health and Sport, Victoria University, Melbourne, Victoria (VIC), Australia
| | - Jeffrey M Gimble
- Center for Stem Cell Research and Regenerative Medicine, Tulane University School of Medicine, New Orleans, LA, USA
| | - William D Hill
- Department of Pathology and Laboratory Medicine, The Medical University of South Carolina, Charleston, SC, USA
- Department of Veterans Affairs, Ralph H Johnson VA Medical Center, Charleston, SC, USA
| | - Gustavo Duque
- Department of Medicine - Western Health, The University of Melbourne, Melbourne, Victoria (VIC), Australia
- Australian Institute for Musculoskeletal Science (AIMSS), Western Health, Victoria University and University of Melbourne, Melbourne, Victoria (VIC), Australia
- Institute for Health and Sport, Victoria University, Melbourne, Victoria (VIC), Australia
- Bone, Muscle and Geroscience Research Group, Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
- Dr. Joseph Kaufmann Chair in Geriatric Medicine, Department of Medicine, McGill University, Montreal, Quebec, Canada
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Wang K, Frey N, Garcia A, Man K, Yang Y, Gualerzi A, Clemens ZJ, Bedoni M, LeDuc PR, Ambrosio F. Nanotopographical Cues Tune the Therapeutic Potential of Extracellular Vesicles for the Treatment of Aged Skeletal Muscle Injuries. ACS NANO 2023; 17:19640-19651. [PMID: 37797946 PMCID: PMC10603813 DOI: 10.1021/acsnano.3c02269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Accepted: 09/22/2023] [Indexed: 10/07/2023]
Abstract
Skeletal muscle regeneration relies on the tightly temporally regulated lineage progression of muscle stem/progenitor cells (MPCs) from activation to proliferation and, finally, differentiation. However, with aging, MPC lineage progression is disrupted and delayed, ultimately causing impaired muscle regeneration. Extracellular vesicles (EVs) have attracted broad attention as next-generation therapeutics for promoting tissue regeneration. As a next step toward clinical translation, strategies to manipulate EV effects on downstream cellular targets are needed. Here, we developed an engineering strategy to tune the therapeutic potential of EVs using nanotopographical cues. We found that EVs released by young MPCs cultured on flat substrates (fEVs) promoted the proliferation of aged MPCs while EVs released by MPCs cultured on nanogratings (nEVs) promoted myogenic differentiation. We then employed a bioengineered 3D muscle aging model to optimize the administration protocol and test the therapeutic potential of fEVs and nEVs in a high-throughput manner. We found that the sequential administration first of fEVs during the phase of MPC proliferative expansion (i.e., 1 day after injury) followed by nEV administration at the stage of MPC differentiation (i.e., 3 days after injury) enhanced aged muscle regeneration to a significantly greater extent than fEVs and nEVs delivered either in isolation or mixed. The beneficial effects of the sequential EV treatment strategy were further validated in vivo, as evidenced by increased myofiber size and improved functional recovery. Collectively, our study demonstrates the ability of topographical cues to tune EV therapeutic potential and highlights the importance of optimizing the EV administration strategy to accelerate aged skeletal muscle regeneration.
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Affiliation(s)
- Kai Wang
- Discovery
Center for Musculoskeletal Recovery, Schoen
Adams Research Institute at Spaulding, Charlestown, Massachusetts 02129, United States
- Department
of Physical Medicine & Rehabilitation, Harvard Medical School, Boston, Massachusetts 02115, United States
- Department
of Physical Medicine & Rehabilitation, Spaulding Rehabilitation Hospital, Charlestown, Massachusetts 02129, United States
- Department
of Physical Medicine & Rehabilitation, University of Pittsburgh, Pittsburgh, Pennsylvania 15213, United States
| | - Nolan Frey
- Department
of Biological Sciences, Carnegie Mellon
University, Pittsburgh, Pennsylvania 15213, United States
| | - Andres Garcia
- Department
of Mechanical Engineering, Carnegie Mellon
University, Pittsburgh, Pennsylvania 15213, United States
| | - Kun Man
- Department
of Biomedical Engineering, University of
North Texas, Denton, Texas 76207, United States
| | - Yong Yang
- Department
of Biomedical Engineering, University of
North Texas, Denton, Texas 76207, United States
| | - Alice Gualerzi
- IRCCS
Fondazione Don Carlo Gnocchi ONLUS, Milan 20148, Italy
| | - Zachary J. Clemens
- Department
of Environmental and Occupational Health, University of Pittsburgh, Pittsburgh, Pennsylvania 15213, United States
| | - Marzia Bedoni
- IRCCS
Fondazione Don Carlo Gnocchi ONLUS, Milan 20148, Italy
| | - Philip R. LeDuc
- Department
of Biological Sciences, Carnegie Mellon
University, Pittsburgh, Pennsylvania 15213, United States
- Department
of Mechanical Engineering, Carnegie Mellon
University, Pittsburgh, Pennsylvania 15213, United States
- Department
of Computational Biology, Carnegie Mellon
University, Pittsburgh, Pennsylvania 15213, United States
- Department
of Biomedical Engineering, Carnegie Mellon
University, Pittsburgh, Pennsylvania 15213, United States
- Department
of Electrical and Computer Engineering, Carnegie Mellon University, Pittsburgh, Pennsylvania 15213, United States
| | - Fabrisia Ambrosio
- Discovery
Center for Musculoskeletal Recovery, Schoen
Adams Research Institute at Spaulding, Charlestown, Massachusetts 02129, United States
- Department
of Physical Medicine & Rehabilitation, Harvard Medical School, Boston, Massachusetts 02115, United States
- Department
of Physical Medicine & Rehabilitation, Spaulding Rehabilitation Hospital, Charlestown, Massachusetts 02129, United States
- Department
of Physical Medicine & Rehabilitation, University of Pittsburgh, Pittsburgh, Pennsylvania 15213, United States
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Potential Therapeutic Strategies for Skeletal Muscle Atrophy. Antioxidants (Basel) 2022; 12:antiox12010044. [PMID: 36670909 PMCID: PMC9854691 DOI: 10.3390/antiox12010044] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Revised: 12/13/2022] [Accepted: 12/22/2022] [Indexed: 12/28/2022] Open
Abstract
The maintenance of muscle homeostasis is vital for life and health. Skeletal muscle atrophy not only seriously reduces people's quality of life and increases morbidity and mortality, but also causes a huge socioeconomic burden. To date, no effective treatment has been developed for skeletal muscle atrophy owing to an incomplete understanding of its molecular mechanisms. Exercise therapy is the most effective treatment for skeletal muscle atrophy. Unfortunately, it is not suitable for all patients, such as fractured patients and bedridden patients with nerve damage. Therefore, understanding the molecular mechanism of skeletal muscle atrophy is crucial for developing new therapies for skeletal muscle atrophy. In this review, PubMed was systematically screened for articles that appeared in the past 5 years about potential therapeutic strategies for skeletal muscle atrophy. Herein, we summarize the roles of inflammation, oxidative stress, ubiquitin-proteasome system, autophagic-lysosomal pathway, caspases, and calpains in skeletal muscle atrophy and systematically expound the potential drug targets and therapeutic progress against skeletal muscle atrophy. This review focuses on current treatments and strategies for skeletal muscle atrophy, including drug treatment (active substances of traditional Chinese medicine, chemical drugs, antioxidants, enzyme and enzyme inhibitors, hormone drugs, etc.), gene therapy, stem cell and exosome therapy (muscle-derived stem cells, non-myogenic stem cells, and exosomes), cytokine therapy, physical therapy (electroacupuncture, electrical stimulation, optogenetic technology, heat therapy, and low-level laser therapy), nutrition support (protein, essential amino acids, creatine, β-hydroxy-β-methylbutyrate, and vitamin D), and other therapies (biomaterial adjuvant therapy, intestinal microbial regulation, and oxygen supplementation). Considering many treatments have been developed for skeletal muscle atrophy, we propose a combination of proper treatments for individual needs, which may yield better treatment outcomes.
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Chen H, Zhang R, Yan K, Wang W, Chen Z, Yao X. Comparing the effectiveness of type of the traditional Chinese exercises, frequency, intensity, time in osteoporosis: a protocol for systematic evaluation and network meta-analysis of randomised controlled trials. BMJ Open 2022; 12:e063878. [PMID: 36424112 PMCID: PMC9693647 DOI: 10.1136/bmjopen-2022-063878] [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] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION As populations age, osteoporosis has become a hot topic of global public concern. The beneficial effects of traditional Chinese exercises on the musculoskeletal system have been demonstrated. However, previous research findings on osteoporosis are inconsistent, and it is unclear which type of exercise and its frequency and duration have the best effect on osteoporosis. This study aims to investigate the most appropriate exercise modality for people with osteoporosis through systematic evaluation and network meta-analysis to guide clinical practice. METHODS AND ANALYSIS The Cochrane Library, Web of Science, MEDLINE, Embase, China Biomedical Literature, China Knowledge Network, China Science and Technology Journal and Wanfang databases will be searched until January 2022. The language of the articles should be English or Chinese. All clinical randomised controlled trials on the effect of traditional Chinese exercises on osteoporosis will be included. We will use RevMan, Stata and GeMTC software to complete our network meta-analysis. We will perform risk of bias assessment, subgroup analysis and sensitivity analysis to correct the results. Finally, we will use the Grading of Recommendations Assessment, Development and Evaluation guideline development tool and Confidence in Network Meta-Analysis (CINeMA, a new method for assessing CINeMA results) approach to evaluate the reliability of our final results. ETHICS AND DISSEMINATION All data for this study will be obtained from published studies, so no ethical review will be needed. We will publish the results of the study in a peer-reviewed journal. PROSPERO REGISTRATION NUMBER CRD42022323622.
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Affiliation(s)
- Haifeng Chen
- Zhejiang Chinese Medical University Third Clinical College, Hangzhou, Zhejiang, China
| | - Ruikun Zhang
- Zhejiang Chinese Medical University Third Clinical College, Hangzhou, Zhejiang, China
| | - Kun Yan
- Zhejiang Chinese Medical University Third Clinical College, Hangzhou, Zhejiang, China
| | - Wenyi Wang
- Zhejiang Chinese Medical University Third Clinical College, Hangzhou, Zhejiang, China
| | - Zhineng Chen
- Department of Orthopedics, Zhejiang Chinese Medical University Third Clinical College, Hangzhou, Zhejiang, China
| | - Xinmiao Yao
- Department of Orthopedics, Zhejiang Chinese Medical University Third Clinical College, Hangzhou, Zhejiang, China
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Fraile M, Eiro N, Costa LA, Martín A, Vizoso FJ. Aging and Mesenchymal Stem Cells: Basic Concepts, Challenges and Strategies. BIOLOGY 2022; 11:1678. [PMID: 36421393 PMCID: PMC9687158 DOI: 10.3390/biology11111678] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Revised: 11/08/2022] [Accepted: 11/15/2022] [Indexed: 08/27/2023]
Abstract
Aging and frailty are complex processes implicating multifactorial mechanisms, such as replicative senescence, oxidative stress, mitochondrial dysfunction, or autophagy disorder. All of these mechanisms drive dramatic changes in the tissue environment, such as senescence-associated secretory phenotype factors and inflamm-aging. Thus, there is a demand for new therapeutic strategies against the devastating effects of the aging and associated diseases. Mesenchymal stem cells (MSC) participate in a "galaxy" of tissue signals (proliferative, anti-inflammatory, and antioxidative stress, and proangiogenic, antitumor, antifibrotic, and antimicrobial effects) contributing to tissue homeostasis. However, MSC are also not immune to aging. Three strategies based on MSC have been proposed: remove, rejuvenate, or replace the senescent MSC. These strategies include the use of senolytic drugs, antioxidant agents and genetic engineering, or transplantation of younger MSC. Nevertheless, these strategies may have the drawback of the adverse effects of prolonged use of the different drugs used or, where appropriate, those of cell therapy. In this review, we propose the new strategy of "Exogenous Restitution of Intercellular Signalling of Stem Cells" (ERISSC). This concept is based on the potential use of secretome from MSC, which are composed of molecules such as growth factors, cytokines, and extracellular vesicles and have the same biological effects as their parent cells. To face this cell-free regenerative therapy challenge, we have to clarify key strategy aspects, such as establishing tools that allow us a more precise diagnosis of aging frailty in order to identify the therapeutic requirements adapted to each case, identify the ideal type of MSC in the context of the functional heterogeneity of these cellular populations, to optimize the mass production and standardization of the primary materials (cells) and their secretome-derived products, to establish the appropriate methods to validate the anti-aging effects and to determine the most appropriate route of administration for each case.
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Affiliation(s)
- Maria Fraile
- Research Unit, Fundación Hospital de Jove, Avda. Eduardo Castro, 161, 33920 Gijon, Spain
| | - Noemi Eiro
- Research Unit, Fundación Hospital de Jove, Avda. Eduardo Castro, 161, 33920 Gijon, Spain
| | - Luis A. Costa
- Research Unit, Fundación Hospital de Jove, Avda. Eduardo Castro, 161, 33920 Gijon, Spain
| | - Arancha Martín
- Research Unit, Fundación Hospital de Jove, Avda. Eduardo Castro, 161, 33920 Gijon, Spain
- Department of Emergency, Hospital Universitario de Cabueñes, Los Prados, 395, 33394 Gijon, Spain
| | - Francisco J. Vizoso
- Research Unit, Fundación Hospital de Jove, Avda. Eduardo Castro, 161, 33920 Gijon, Spain
- Department of Surgery, Fundación Hospital de Jove, Avda. Eduardo Castro, 161, 33920 Gijon, Spain
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Liu C, Liu N, Xia Y, Zhao Z, Xiao T, Li H. Osteoporosis and sarcopenia-related traits: A bi-directional Mendelian randomization study. Front Endocrinol (Lausanne) 2022; 13:975647. [PMID: 36187130 PMCID: PMC9515352 DOI: 10.3389/fendo.2022.975647] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Accepted: 08/22/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND With the advancement of world population aging, age-related osteoporosis (OP) and sarcopenia (SP) impose enormous clinical and economic burden on society. Evidence from accumulating studies indicates that they mutually influence one another. However, an observational study may be affected by potential confounders. Meanwhile, a Mendelian randomization (MR) study can overcome these confounders to assess causality. OBJECTIVES The aim of this study was to evaluate the causality between OP and SP, informing new strategies for prevention, diagnosis, and treatment of osteosarcopenia. METHODS Instrumental variables (IVs) at the genome-wide significance level were obtained from published summary statistics, and the inverse variance weighted method and several other MR methods were conducted to evaluate the bi-directional causality between SP and OP. Myopia was analyzed as a negative control outcome to test the validity of IVs. RESULTS Femoral neck bone mineral density (FN BMD), lumbar spine BMD (LS BMD), and forearm BMD (FA BMD) had a direct causal effect on appendicular lean mass (ALM) [FA BMD-related analysis: odds ratio (OR) = 1.028, 95% confidence interval (CI) = (1.008,1.049), p = 0.006; FN BMD-related analysis: OR (95% CI) = 1.131 (1.092,1.170), p = 3.18E-12; LS BMD-related analysis: OR (95% CI) = 1.080 (1.062,1.098), p = 2.86E-19]. ALM had a significant causal effect on LS BMD [OR (95% CI) = (1.033,1.147), p = 0.001]. There was no evidence for causal association between BMD and low grip strength. CONCLUSIONS OP and SP might mutually have a significant causal effect on each other. Our results supported the idea that the patient with severe OP was more susceptible to lose ALM and severe ALM loss might reduce LS BMD.
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Affiliation(s)
- Chao Liu
- Department of Orthopedics, the Second Xiangya Hospital of Central South University, Changsha, China
- Orthopedic Biomedical Materials Engineering Laboratory of Hunan Province, Changsha, China
| | - Ningyuan Liu
- Department of Orthopedics, the Second Xiangya Hospital of Central South University, Changsha, China
| | - Yu Xia
- Department of Orthopedics, the Second Xiangya Hospital of Central South University, Changsha, China
- Orthopedic Biomedical Materials Engineering Laboratory of Hunan Province, Changsha, China
| | - Ziyue Zhao
- Department of Orthopedics, the Second Xiangya Hospital of Central South University, Changsha, China
- Orthopedic Biomedical Materials Engineering Laboratory of Hunan Province, Changsha, China
| | - Tao Xiao
- Department of Orthopedics, the Second Xiangya Hospital of Central South University, Changsha, China
- Orthopedic Biomedical Materials Engineering Laboratory of Hunan Province, Changsha, China
- *Correspondence: Hui Li, ; Tao Xiao,
| | - Hui Li
- Department of Orthopedics, the Second Xiangya Hospital of Central South University, Changsha, China
- Orthopedic Biomedical Materials Engineering Laboratory of Hunan Province, Changsha, China
- *Correspondence: Hui Li, ; Tao Xiao,
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