Table of Content

08 April 2024, Volume 28 Issue 10 Previous Issue    Next Issue

For Selected:

Download Citations EndNote Reference Manager ProCite BibTeX RefWorks

Toggle Thumbnails

Select

Physicochemical properties and biocompatibility of graphene oxide-hydroxyapatite composite coating materials Lyu Shangyi, He Huiyu, Wufanbieke · Baheti, Yang Quan, Ma Lisha, Han Xiangzhen 2024, 28 (10):  1477-1483.  doi: 10.12307/2024.259 Abstract ( 224 )   PDF (3104KB) ( 65 )   Save BACKGROUND: Medical titanium and titanium alloy have achieved good therapeutic effects in clinical applications, but there are still some phenomena such as peri-implant inflammation, loosening and shedding. OBJECTIVE: To explore the physicochemical properties of graphene oxide coating materials and their effects on bone marrow mesenchymal stem cells. METHODS: (1) Hydroxyapatite coating and graphene oxide/hydroxyapatite composite coating were prepared on a titanium surface by electrochemical deposition. The surface morphology, phase structure, functional groups, elemental composition and surface hydrophilicity of the coating were analyzed by scanning electron microscopy, X-ray energy dispersion spectroscopy, X-ray photoelectron spectroscopy, X-ray diffraction, Raman spectroscopy, and contact angle measurement instrument. (2) Mouse bone marrow mesenchymal stem cells were isolated and cultured and inoculated on pure titanium, hydroxyapatite coating and graphene oxide/hydroxyapatite composite coating, respectively. CCK-8 assay and scanning electron microscopy were used to evaluate the proliferation, morphology and growth status of the coated cells.  RESULTS AND CONCLUSION: (1) Scanning electron microscopy and X-ray energy dispersion spectra showed that the surface of graphene oxide/hydroxyapatite composite coating was more flat, compact and uniform than that of hydroxyapatite coating and pure titanium. X-ray photoelectron spectroscopy, X-ray diffraction and Raman spectroscopy showed that hydroxyapatite coating and graphene oxide/hydroxyapatite composite coating were successfully prepared on the surface of the titanium sheet. The hydrophilicity of graphene oxide/hydroxyapatite composite coating was better than that of hydroxyapatite coating and pure titanium. (2) CCK-8 assay showed that the number of bone marrow mesenchymal stem cells on the surface of the three groups increased with the extension of co-culture time. On days 1, 4, and 7, the proliferative absorbance of the cells on the graphene oxide/hydroxyapatite composite coating was higher than that on hydroxyapatite coating and pure titanium (P < 0.000 1). Scanning electron microscopy after 4 days of co-culture showed that bone marrow mesenchymal stem cells on the surface of the three groups of materials were fusiform. The cells on the surface of graphene oxide/hydroxyapatite composite coating showed good tensile properties and were polygonal. Multiple antennae could be seen attached to the coating surface at the edge of the cells, and the elongation of the filamentous foot on the surface was more than that on pure titanium and hydroxyapatite coatings. (3) The results show that graphene oxide/hydroxyapatite composite coating material is a kind of coating material with excellent physicochemical and biological properties. Figures and Tables | References | Related Articles | Metrics

Select

Melatonin alleviates CoCrMo particle-induced osteolysis by inhibiting NLRP3 inflammasome activation Zhang Chenhui, Fu Tingting, Wu Yanglin, Zhang Qin, Liu Ang, Yang Huilin, Lin Jun 2024, 28 (10):  1484-1489.  doi: 10.12307/2024.261 Abstract ( 190 )   PDF (1683KB) ( 13 )   Save BACKGROUND: Periprosthetic osteolysis is the most common long-term complication of total joint arthroplasty. Many studies suggest that the inflammasome may play an important role during the osteolysis. Melatonin is a rhythm-regulated hormone secreted by the pineal gland with many functions including anti-inflammatory, anti-oxidation, and antitumor, but its effects on osteolysis and inflammasome have yet to be explored. OBJECTIVE: To explore the effect of melatonin on the osteolysis induced by wear particles and the role of melatonin on the activation of NLRP3 inflammasome. METHODS: (1) In vivo test: Fifteen C57BL/6 mice were randomly divided into sham operation group, osteolysis group and melatonin group by random number table method, with 5 mice in each group. The osteolysis model of the osteolysis group and the melatonin group was established by injecting cobalt-chromium-molybdenum (CoCrMo) particles into the sagittal suture of the skull. After injection, the melatonin group was intraperitoneally injected with 50 mg/(kg•d) of melatonin for 14 consecutive days. After drug intervention, the mouse calvarium was collected for micro-CT analysis to observe the micro-structural changes around the sagittal suture. (2) In vitro test: Mouse bone marrow-derived macrophages and THP-1 cells (which had been induced to differentiate into macrophages) were taken and divided into seven groups: normal group, lipopolysaccharide group, lipopolysaccharide+CoCrMo group and melatonin 0.5, 1, 1.5, 2 mmol/L groups (lipopolysaccharide and CoCrMo were added to the melatonin intervention groups). After the intervention for 6 hours, the expression of related proteins (NLRP3, Caspase-1, interleukin-1β, and gasdermin D, gasdermin D-N terminal) in the inflammasome of cell lysate or cell culture supernatant was detected by western blot assay. Cytotoxicity and cell death were observed through lactate dehydrogenase release and live-dead fluorescence staining.  RESULTS AND CONCLUSION: (1) In vivo test: Micro-CT scanning 3D reconstruction images showed that the bone mass around the sagittal suture of the skull of mice in the osteolysis group was significantly reduced, and the bone tissue structure was severely damaged. Compared with the osteolysis group, the bone mass around the sagittal suture of the skull in the melatonin group was significantly increased, and the destruction of tissue structure was reduced. (2) In vitro test: For mouse bone marrow-derived macrophages, lipopolysaccharide significantly up-regulated NLRP3 protein expression in cell lysate, and melatonin intervention could reduce NLRP3 protein expression in a dose-dependent manner. CoCrMo particles significantly up-regulated the protein expressions of the gasdermin D-N terminal in cell lysate and Caspase-1 and interleukin-1β in the supernatant of cell culture, while melatonin intervention could reduce the expression of these proteins in a dose-dependent manner. For THP-1 cells, the protein expressions of Caspase-1 and interleukin-1β in the supernatant of cell culture were significantly up-regulated by CoCrMo particles, and the expression of these proteins was decreased dose-dependent by melatonin intervention. Lactate dehydrogenase release and live-dead fluorescence staining showed that CoCrMo particles significantly increased the release of lactate dehydrogenase and cell death in the supernatant of mouse bone marrow-derived macrophage culture, and melatonin intervention could reduce the release of lactate dehydrogenase and cell death. (3) The results show that melatonin can inhibit particle-induced inflammasome activation and pyroptosis to suppress periprosthetic osteolysis. Figures and Tables | References | Related Articles | Metrics

Select

Hemostatic effect of oxidized regenerated cellulose hemostatic material on minipig liver hemorrhage models Huo Yun, Sun Xiaoqing 2024, 28 (10):  1490-1496.  doi: 10.12307/2024.370 Abstract ( 180 )   PDF (3796KB) ( 68 )   Save BACKGROUND: At present, plant-derived absorbable hemostats are mainly imported, so it is necessary to develop domestic alternatives that are not inferior to similar imported products. OBJECTIVE: To investigate the hemostatic effect of oxidized regenerated cellulose hemostatic material on a model of minipig liver hemorrhage. METHODS: A total of 24 Bama minipigs were selected and randomly divided into three groups. In the sham operation group (n=6), only an open operation was performed, and the damaged side of the liver was removed and put back in situ. In the experimental group (n=12), the liver hemorrhage model was established, and the oxidized regenerated cellulose hemostatic material was applied to the wound. In the control group (n=6), commercially available absorbable hemostatic gauze was used on the wound after establishing liver hemorrhage models. Hemostatic time and blood loss were recorded. The venous blood of the minipig anterior cavity was collected at different time points before and after modeling, and the blood routine and liver and kidney functions were analyzed. Hematoxylin-eosin staining and Masson staining were performed at 2, 6, and 14 weeks after modeling. The main organs were observed by histopathology at 14 weeks after modeling. A liver ultrasound examination was performed at different time points after modeling to observe the degradation and absorption of materials. RESULTS AND CONCLUSION: (1) There was no significant difference in intraoperative hemostatic time and blood loss between the experimental group and the control group (P > 0.05). (2) The monitoring results of blood biochemical indexes demonstrated that the levels of aspartate transaminase and glutamic pyruvic transaminase in the three groups were higher 24 hours after modeling than before modeling, and the indexes basically recovered to the normal levels 72 hours after modeling. There were no significant differences in blood biochemical indexes such as liver and kidney functions, blood glucose and inflammatory factors among the three groups (P > 0.05). (3) Hematoxylin-eosin staining and Masson staining of histopathology revealed that 2 weeks after surgery, granulation tissue formation and a large amount of collagen fiber deposition were observed on the liver wounds of the two groups, and there were obvious fibrous hyperplasia zones and inflammatory cell infiltration, and the wound healed well. 14 weeks after modeling, the liver wounds of two groups of minipigs exhibited mild fibrous hyperplasia zone, collagen fiber deposition and a small amount of inflammatory cell infiltration, complete material degradation, and the healed wound. Hematoxylin-eosin staining showed no significant pathological changes in major organs. (4) Ultrasonic examination demonstrated that the materials of both groups were degraded gradually with the extension of implantation time, and most of them were degraded and absorbed by 56 days after molding. (5) The results confirm that the oxidized regenerated cellulose hemostatic material can effectively prevent liver wound hemorrhage in minipigs, and the hemostats are safe and reliable. Figures and Tables | References | Related Articles | Metrics

Select

Various arginine configurations-modified chitosan hydrogels promote skin wound repair Deng Jing, Li Tinghua, Zhu Hai, Yang Xiao, Cao Jun, Zhu Xiangdong 2024, 28 (10):  1497-1504.  doi: 10.12307/2024.374 Abstract ( 205 )   PDF (3302KB) ( 57 )   Save BACKGROUND: Clinical skin wound healing continues to be a significant concern, and tissue repair research has moved to the forefront with the development of biomaterials with immunomodulatory properties. Therefore, it is crucial to research wound dressings that have immunomodulatory properties. OBJECTIVE: To prepare chitosan hydrogels that have been modified by arginine with different configurations and assess their capacity to speed up wound healing in a rat animal model. METHODS: (1) In vitro trial: Chitosan modified by pure L-arginine, pure D-arginine, and L-arginine and D-arginine was synthesized by EDC/NHS system, which was then crosslinked with aldehyde-modified four-arm polyethylene glycol. Different chitosan-based hydrogels (CS-L, CS-D, and CS-DL) were finally formed via the Schiff base reaction. Three kinds of hydrogel extracts were co-cultured with fibroblasts respectively. Hydrogel cytocompatibility was assessed using the CCK-8 assay and live/dead staining. The effect of hydrogel on the migration capacity of fibroblasts was assessed by using a scratch test. Three kinds of hydrogels were incubated with rat erythrocyte suspension respectively to evaluate the hemocompatibility of the hydrogels. The hydrogel extract was co-cultured with RAW264.7 macrophages to test the hydrogels’ capacity to enhance macrophage NO generation and polarize macrophage phenotype. (2) In vivo experiment: A total of 36 adult SD rats were divided into 4 groups with 9 rats in each group by the random number table method. Two full-layer skin defect wounds of 2 cm×2 cm were made on the back of each rat. Normal saline was added to the wounds of the control group, and corresponding hydrogel was added to the wounds of the CS-L, CS-D, and CS-DL groups, respectively, and then bandaged and fixed. The wound healing was observed regularly after operation. Hematoxylin-eosin staining was performed at 3, 10, and 21 days after operation. The samples were collected 10 days after operation and M2 macrophage immunofluorescence staining was performed. RESULTS AND CONCLUSION: (1) In vitro experiments: Under scanning electron microscopy, the three kinds of hydrogels exhibited obvious interpenetrating network structures with pore sizes ranging from 70-200 µm. The three kinds of hydrogels have good swelling performance, degradation performance, self-healing performance, and suitable mechanical strength. The three kinds of hydrogels had good cytocompatibility and hemocompatibility and could promote the migration of fibroblasts. All three kinds of hydrogels had the ability to promote the polarization of macrophages, and CS-D hydrogels had the strongest ability to promote the polarization of macrophages. CS-L hydrogel could significantly promote the production of NO in macrophages. (2) In vivo experiment: 3 and 10 days after operation, the wound healing rate in the CS-L and CS-D groups was higher than that in the control group (P < 0.05). After 21 days, the wound healing rate of the three hydrogel groups was higher than that of the control group. Hematoxylin-eosin staining displayed that a large number of inflammatory cells were infiltrated in the wound tissue of rats in all groups, accompanied by neovessels and fibroblasts 3 days after operation. 10 days after operation, there was still more inflammatory cell infiltration in the wound of the control group, and the inflammation of the other three groups was improved, especially the decrease of inflammatory cells in the CS-D group was more obvious. 21 days after operation, the wound epithelium of each group was well repaired, and there was basically no inflammatory cell infiltration in the CS-L and CS-D groups, while there was still a small amount of inflammatory cell infiltration in the control group. Immunofluorescence staining revealed that the number of M2-type macrophages in the CS-D group was higher than that in the other three groups (P < 0.05). (3) The results conclude that chitosan hydrogels modified by different configurations of arginine can promote wound healing through different mechanisms.  Figures and Tables | References | Related Articles | Metrics

Select

Characterization and repair effect of supramolecular conducting hydrogel carrying ligustrazine on spinal cord injury in rats Wu Yangpeng, Yang Xiaohui, Lao Kecheng, Dai Shiyou, Fan Xiao 2024, 28 (10):  1505-1511.  doi: 10.12307/2024.320 Abstract ( 206 )   PDF (2045KB) ( 60 )   Save BACKGROUND: Based on the concept of the combination of medicine and industry and the advantages of traditional Chinese medicine treatment, the construction of a new composite material loaded with the effective active ingredient of traditional Chinese medicine is a hot research spot in the repair of spinal cord injury, and is expected to become an effective means to solve this problem. OBJECTIVE: To observe the effect of supramolecular conducting hydrogel carrying ligustrazine in repairing spinal cord injury in rats. METHODS: The supramolecular conducting hydrogel carrying ligustrazine was prepared and its microstructure, conductivity, rheology, swelling rate and in vitro release performance were characterized. 45 SD rats were divided into 3 groups by random number table method, with 15 rats in each group: no spinal cord injury in the sham operation group; spinal cord injury model was established in the model group; and supramolecular conducting hydrogel carrying ligustrazine was injected into the spinal cord injury area after model establishment in hydrogel group. BBB score was used to evaluate the recovery of hind limb motor function of each group before and 1, 7, 14, 21 and 28 days after modeling, respectively. 28 days after the model establishment, the spinal cord tissues were collected and analyzed by hematoxylin-eosin staining, immunohistochemical staining and western blot assay. RESULTS AND CONCLUSION: (1) Under scanning electron microscopy, the supramolecular conducting hydrogel with ligustrazine displayed a three-dimensional micrometer-scale porous network structure with high porosity and a pore size of approximately 100 µm. The conductivity of the hydrogel was 7.66 S/m; the swelling rate was 3 764.42%, and it had certain mechanical stability and injection property. In vitro sustained release experiments demonstrated that the supramolecular conducting hydrogel with ligustrazine sustainably released ligustrazine for more than 800 hours. With the extension of time, the cumulative release of ligustrazine exhibited an increasing trend. (2) With the extension of modeling time, the hind limb motor function gradually recovered in the model group and the hydrogel group, and the hind limb motor function of the hydrogel group was better than that of the model group on 14, 21, and 28 days after modeling (P < 0.05). Hematoxylin-eosin staining demonstrated that the spinal cord tissue of the model group had cavities and a large number of inflammatory cells could be seen at the stump. In the hydrogel group, some inflammatory cells were infiltrated in the injured area of the spinal cord; the void area of the injured area was reduced; neuron cells appeared in the junction area, and the tissue arrangement was relatively neat. Immunohistochemical staining and western blot assay exhibited that the expression of tumor necrosis factor α and interleukin-6 protein in the rat spinal cord of the hydrogel group was lower than that in the model group (P < 0.05), and the expression of neuronal nuclear antigen protein was higher than that in the model group (P < 0.05). (3) These findings confirm that the supramolecular conducting hydrogel carrying ligustrazine can promote the repair of spinal cord injury. Figures and Tables | References | Related Articles | Metrics

Select

Inhibitory effect of bovine serum albumin-chitosan nanoparticles loaded with EPZ6438 on osteosarcoma Liu Chang, Zhang Wen, Zhu Can, Sun Jie, Ding Yicheng, Shi Qin 2024, 28 (10):  1512-1518.  doi: 10.12307/2024.368 Abstract ( 232 )   PDF (2239KB) ( 10 )   Save BACKGROUND: The most prominent transcription factor activated by tumor stem cells in osteosarcoma is EZH2, and silencing of EZH2 has been reported to inhibit osteosarcoma cell growth. Studies have confirmed that bovine serum albumin-chitosan nanoparticles are a drug delivery vector with excellent biocompatibility and biodegradability, and the albumin carrier can provide tumor-targeted drug delivery function.  OBJECTIVE: To investigate the effect and mechanism of bovine serum albumin-chitosan nanoparticles loaded with EPZ6438 (EZH2 inhibitor) for the treatment of osteosarcoma.  METHODS: (1) Bovine serum albumin-chitosan nanoparticles loaded with and without EPZ6438 were prepared. The drug encapsulation rate and drug release rate of serum albumin-chitosan nanoparticles loaded with EPZ6438 were detected. (2) MG-63 cells were divided into four groups and added with PBS (control group), serum albumin-chitosan nanoparticle extract solution (blank nanoparticle group), EPZ6438 solution (free drug group), and serum albumin-chitosan nanoparticle extract loaded with EPZ6438 (drug-loaded nanoparticle group), respectively. After 3 days of culture, cell apoptosis was detected by flow cytometry and the expression of caspase-3 mRNA was detected by RT-PCR. (3) Twelve nude mice were selected and the subcutaneous tumor-bearing mouse model was established by injecting MG-63 cell suspension under the armpit. After successful modeling, the mice were randomly divided into four groups for intervention. Normal saline (control group), serum albumin-chitosan nanoparticle solution (blank nanoparticle group), EPZ6438 solution (free drug group) and serum albumin-chitosan nanoparticle solution loaded with EPZ6438 (drug-loaded nanoparticle group) were injected into tumor tissues, with three animals in each group. After 7 days of injection, the tumor volume and frozen sections of tumor tissue were observed by TUNEL staining.   RESULTS AND CONCLUSION: (1) The drug encapsulation rate of the nanoparticles was about 8.8%, and the nanoparticles had a good drug release effect in pure water. The drug release amount was (34.72±1.93) μg at 24 hours, (48.58±1.10) μg at 72 hours, (49.18±1.24) μg at 120 hours, and (50.25±1.13) μg at 168 hours. The drug release reached the plateau at 120 hours, and the release rate was about 97.9%. (2) After 3 days of cell culture with MG-63, the apoptotic rate in the control group and blank nanoparticle group was lower than that in the free drug group and drug-loaded nanoparticle group (P < 0.001), and the expression of caspase 3 mRNA was lower than that in the free drug group and drug-loaded nanoparticle group (P < 0.000 1). (3) After 7 days of injection, the tumor volume of nude mice in the drug-loaded nanoparticle group was smaller than that in the other three groups (P < 0.05), and the percentage of TUNEL-positive cells in tumor tissue was higher than that in the other three groups (P < 0.000 1). (4) The results verify that serum albumin-chitosan nanoparticles loaded with EPZ6438 can inhibit the growth of osteosarcoma by inducing apoptosis of tumor cells. Figures and Tables | References | Related Articles | Metrics

Select

Tabersonine alleviates wear particle-induced inflammatory osteolysis by inhibiting osteoclast activation Zhang Wei, Yu Lei, Yang Peng, Geng Dechun 2024, 28 (10):  1519-1525.  doi: 10.12307/2024.317 Abstract ( 183 )   PDF (1596KB) ( 19 )   Save BACKGROUND: Tabersonine has shown good therapeutic effects in diseases such as myocardial remodeling, acute kidney injury and lung injury due to its anti-inflammatory biological activity. Prosthetic wear particles often lead to aseptic inflammation, and the massive release of inflammatory factors further promotes periprosthetic bone destruction and bone loss; however, there are no basic studies on the efficacy of tabersonine on periprosthetic osteolysis. OBJECTIVE: To investigate the effects of tabersonine on osteoclast activation, expression of inflammatory factors and inflammatory osteolysis induced by wear particles.  METHODS: (1) Cell experiment: RAW264.7 cells were divided into four groups for culture. A complete medium was added in the control group. Osteoclast induction medium (50 ng/mL RANKL+complete medium) was added to the osteoclast induction group. 1 and 5 μmol/L tabersonine was added for 4 hours, and then osteoclast induction medium was added to the low- and high-dose tabersonine groups, respectively. After 5 days of induction, tartrate-resistant acid phosphatase staining, F-actin staining and RT-PCR were performed. (2) Animal experiments: Twenty C57BL/6J mice were randomly divided into sham operation group, osteolysis group, low-dose tabersonine group and high-dose tabersonine group (n=5 per group). Skull osteolysis model of the skull was established by injecting titanium pellets on the skull surface in the osteolysis group, low-dose tabersonine group and high-dose tabersonine group. On day 2 after model establishment, mice in the low-dose and high-dose tabersonine groups received intraperitoneal injections of 10 and 20 mg/kg tabersonine every 2 days, respectively. 2 weeks after surgery, mouse sera were collected for detecting inflammatory factors (interleukin 1β, interleukin 6, and tumor necrosis factor α), and cranial bones were collected for micro-CT scan and bone parameter analysis. RESULTS AND CONCLUSION: (1) Cellular experiments: Tartrate-resistant acid phosphatase staining and F-actin staining showed that compared with the osteoclast induction group, low-dose and high-dose tabersonine significantly inhibited osteoclast activation and bone resorption, and the inhibition was more significant in the high-dose tabersonine group. RT-PCR results showed that compared with the control group, the mRNA expressions of three kinds of inflammatory factors were increased in the osteoclast induction group (P < 0.01). Compared with the osteoclast induction group, the mRNA expressions of three kinds of inflammatory factors were decreased in low- and high-dose tabersonine groups (P < 0.01), and the decrease was more obvious in the high-dose tabersonine group. (2) Animal experiments: Compared with the sham operation group, the levels of three kinds of inflammatory factors were increased in the osteolysis group (P < 0.01). Compared with the osteolysis group, the levels of three kinds of inflammatory factors were decreased in the low- and high-dose tabersonine groups (P < 0.05, P < 0.01), and the decrease was more obvious in the high-dose tabersonine group. The micro-CT scan results revealed that titanium particles caused the destruction of cranial osteolysis, and tabersonine could inhibit the osteolysis induced by titanium particles, especially in the high-dose tabersonine group. (3) The results confirm that tabersonine can enhance the osteolysis and bone destruction induced by titanium particles by inhibiting the release of inflammatory factors and down-regulating the bone absorption function of osteoclasts. Figures and Tables | References | Related Articles | Metrics

Select

Prussian blue nanoparticles promote wound healing of diabetic skin Bei Ying, Li Wenjing, Li Meiyun, Su Meng, Zhang Jin, Huang Yu, Zhu Yanzhao, Li Jiali, Wu Yan 2024, 28 (10):  1526-1532.  doi: 10.12307/2024.249 Abstract ( 264 )   PDF (1895KB) ( 163 )   Save BACKGROUND: Inflammation, oxidative stress and bacterial infection are the main causes of delayed wound healing in diabetes. In recent years, various inorganic nanomaterials have been widely used in the treatment of skin wound healing due to their antibacterial activities, but their effects on anti-oxidation and anti-inflammation are limited. OBJECTIVE: To investigate the effect of Prussian blue nanoparticles on the wound repair of diabetes in terms of antioxidant, anti-inflammatory and photothermal antibacterial activities. METHODS: Prussian blue nanoparticles were prepared and characterized. (1) In vitro: The biocompatibility of Prussian blue nanoparticles with different concentrations was detected by MTT assay. The cytoprotective effect of Prussian blue nanoparticles and the intracellular reactive oxidative species level were examined under the condition of hydrogen peroxide. The ability of Prussian blue nanoparticles to decompose hydrogen peroxide and superoxide anion radicals was tested; the effect of Prussian blue nanoparticles on lipopolysaccharide-induced macrophage inflammation was investigated. The photothermal antibacterial activity of Prussian blue nanoparticles was detected by the plate colony counting method. (2) In vivo: ICR mice were intraperitoneally injected with streptozotocin to establish a diabetes mouse model. After the model was successfully established, a 6 mm wound was created on the back with a hole punch. There were the control group (no treatment), the Prussian blue group and the Prussian blue with light group. The wound healing and histomorphological changes were observed. RESULTS AND CONCLUSION: (1) In vitro: Prussian blue nanoparticles in 25-200 μg/mL were non-toxic to cells. Prussian blue nanoparticles had the extremely strong antioxidant capacity and mitigated the intracellular reactive oxidative species at a high oxidative stress environment, resulting in a pronounced cytoprotective effect. The Prussian blue nanoparticles not only exhibited hydrogen peroxide degradation activity but also showed strong superoxide scavenging ability. Prussian blue nanoparticles also displayed significant anti-inflammatory activity and extremely strong antibacterial ability after light irradiation. (2) In vivo: After 14 days, the wound sizes of the Prussian blue group and Prussian blue with light group were significantly reduced, and the healing speed of Prussian blue with light group was the fastest. Hematoxylin-eosin and Masson staining showed a lot of granulation tissue formation and collagen deposition in the Prussian blue group and the Prussian blue with light group, of which the Prussian blue with light group was the most. Immunofluorescence staining displayed that, compared with the control group, the expressions of α-SMA and CD31 were increased significantly in Prussian blue group and Prussian blue with light group (P < 0.05), but F4/80 expression was decreased significantly in Prussian blue group and Prussian blue with light group (P < 0.05), indicating more obvious improvement in the Prussian blue with light group. (3) These results showed that Prussian blue nanoparticles could promote the skin wound healing of the diabetes mouse model by exerting anti-inflammatory, antioxidant and antibacterial effects. Figures and Tables | References | Related Articles | Metrics

Select

Artificial dermis combined with autologous scar epidermis composite transplantation in repair of joint site scar deformities in the later stage of extensive burns Fu Quanyou, Xing Fuxi, Li Lin, Li Yong, Liu Jisong 2024, 28 (10):  1533-1539.  doi: 10.12307/2024.319 Abstract ( 187 )   PDF (1237KB) ( 52 )   Save BACKGROUND: How to provide sufficient skin resources for scar plastic surgery and repair of extensive deep burn patients while avoiding the re-proliferation of scar tissue in the surgical area has always been an important topic in burn and wound repair research.  OBJECTIVE: To observe the clinical application effects of artificial dermis combined with autologous scar epidermis in the repair of scar after extensive burns.   METHODS: Retrospective analysis was performed on 73 patients with scar hyperplasia and contracture deformity after extensive burns in Bengbu Third People’s Hospital Affiliated to Bengbu Medical College from January 2021 to January 2023. The patients were divided into three groups according to the treatment method: Group A (n=21, artificial dermis combined with autologous scar epidermis transplantation was used for treatment), group B (n=27, scar epidermis was transplanted after scar release in the functional site), and group C (n=25, functional site scar release after transplantation of thick skin treatment). Skin survival and infection at the receiving site, wound healing time at the receiving site and the donor site were recorded in the three groups. The scar status and functional recovery of the recipient area and donor area were evaluated by the Vancouver Scar Scale and activities of daily living.  RESULTS AND CONCLUSION: (1) The skin infection rate was lower in group B than that in groups A and C (P < 0.05). The survival grade was higher in group B than that in groups A and C (P < 0.05). (2) The wound healing time at the receiving site was longer in group A than that in groups B and C (P < 0.05). The wound healing time at the receiving site was longer in group C than that in group B (P < 0.05). The wound healing time at the donor site was longer in group C than that in groups A and B (P < 0.05). (3) Vancouver Scar Scale score was higher in group B than that in groups A and C at 12 months postoperatively (P < 0.05). Vancouver Scar Scale score was higher in group C than that in groups A and B at 6 and 12 months postoperatively (P < 0.05). The excellent grade of activities of daily living in groups A and C was significantly higher than that of group B at 12 months postoperatively (P < 0.05). (4) The results showed that the application of artificial dermis combined with autologous scar epidermis composite transplantation in the treatment of scar contracture after extensive burn could not only achieve the same effect as that of intermediate-thickness skin, but also avoid postoperative scar re-hyperplasia at the donor site and shorten the time of complete wound healing at the donor site. Compared with scar epidermal transplantation, this treatment has obvious advantages. Figures and Tables | References | Related Articles | Metrics

Select

In vitro experiment of stem cell engineered two-sided anisotropic electrospun membranes for promoting dural repair Xu Jingzhi, Wang Wenbo, Sun Huiwen, Gu Yong 2024, 28 (10):  1540-1546.  doi: 10.12307/2024.248 Abstract ( 184 )   PDF (2042KB) ( 25 )   Save BACKGROUND: Currently, the dura mater is clinically repaired using autologous tissue or materials such as gelatin sponge, but all of them have their inherent defects. Therefore, there is an urgent need for a biomaterial that can promote dural repair. OBJECTIVE: The two-sided anisotropic electrospun membrane was constructed by using directional electrospinning technology and collagen self-assembly technology, and was used as a carrier for bone marrow mesenchymal stem cells to investigate various physicochemical properties and biological characteristics of the artificial dura mater. METHODS: Ordered polylactic acid electrospun fibers with double-sided (collagen protein on one side and polylactic acid on the other side) anisotropic electrospun membranes (collagen group), disordered polylactic acid electrospun membranes (disordered fiber group), and ordered oriented polylactic acid electrospun membranes (ordered fiber group) were prepared by electrospinning technique as well as collagen self-assembly technique. Scanning electron microscopy, mechanical stretching, water contact angle testing, and degradation experiments were used to characterize the physicochemical properties of the electrospun membranes. Electrospun membranes in the collagen group (bone marrow mesenchymal stem cells were inoculated on the collagen surface to obtain the stem cell-engineered electrospun membranes), disordered fiber group and ordered fiber group were cocultured with bone marrow mesenchymal stem cells. The biocompatibility of electrospun membranes was evaluated using CCK-8 assay and live/dead staining. Integrin β1 immunofluorescence staining was used to evaluate the adhesion characteristics of electrospun membranes. The stem cell-engineered electrospun membrane and the electrospun membrane in the collagen group were cocultured with bone marrow macrophages respectively. Immunomodulatory properties were assessed by detecting the expression of inflammation-related genes using inducible nitric oxide synthase (M1 type), CD206 (M2 type) immunofluorescence staining, and qRT-PCR. RESULTS AND CONCLUSION: (1) The oriented electrospun fiber membrane could mimic the structure of the longitudinally aligned natural dura mater, and the addition of collagen increased the hydrophilicity of the fiber membrane by about 2-fold and the mechanical properties by 1.2-fold. (2) When cocultured with bone marrow mesenchymal stem cells, CCK-8 assay and live/dead staining suggested that the cellular bioactivity in the collagen group was significantly higher than that in the disordered fiber group and ordered fiber group. Immunofluorescence staining revealed that the expression of integrin β1 in the collagen group was about 2.6 times higher than that of the disordered and ordered fiber groups, and the cell spreading morphology was good. (3) When cocultured with bone marrow macrophages, immunofluorescence staining exhibited that the fluorescence intensity of M1 type macrophages in the stem cell-engineered electrospun membrane group was lower than that in the collagen group (P < 0.01), and the fluorescence intensity of M2 type macrophages was higher than that in the collagen group (P < 0.01). qRT-PCR demonstrated that proinflammatory gene tumor necrosis factor α and interleukin-1β mRNA expression in the stem cell-engineered electrospun membrane group was lower than that of the collagen group (P < 0.001); anti-inflammatory genes such as interleukin-10 and transforming growth factor β mRNA expressions were higher than those in the collagen group (P < 0.001). (4) The above results suggest that the stem cell-engineered amphipathic artificial dura mimics the directional structure of normal dura, with the inner surface facilitating cell growth and adhesion and the outer edge avoiding tissue adhesion, while the polarization of macrophages to the M2 subtype is promoted and the local inflammatory microenvironment is regulated through the mesenchymal stem cell paracrine component. Figures and Tables | References | Related Articles | Metrics

Select

Evaluation of antibacterial properties of uniaxial and coaxial minocycline hydrochloride-loaded bone scaffolds Cao Yijing, Wei Suiyan, Zhao Shuai, Li Dongyao, Wei Qin, Zhang Xujing, Xu Yan, Xu Guoqiang 2024, 28 (10):  1547-1553.  doi: 10.12307/2024.318 Abstract ( 173 )   PDF (1733KB) ( 15 )   Save BACKGROUND: Due to the unstable drug release rate of uniaxial bone scaffolds, multi-structure composite printing methods have been sought in and outside China in recent years. Currently, coaxial drug-loaded bone scaffolds, which combine drug-loaded sustained release system with bone transplantation and repair technology, not only replace the defective bone after implantation, but also release drugs slowly, providing a microenvironment conducive to bone formation at the implant site.  OBJECTIVE: To explore and assess the in vitro antibacterial properties of uniaxial and coaxial minocycline hydrochloride bone scaffolds.  METHODS: Rapid prototyping technology was used to prepare uniaxial hydroxyapatite/silk fibroin-polyvinyl alcohol scaffold, uniaxial hydroxyapatite/silk fibroin-polyvinyl alcohol scaffold, coaxial hydroxyapatite/silk fibroin-polyvinyl alcohol scaffold, and coaxial hydroxyapatite/silk fibroin-polyvinyl alcohol scaffold, respectively, which were named S1, S2, T1 and T2. The morphology, porosity, degradation performance, in vitro sustained-release performance and cytotoxicity of scaffolds were characterized. Four kinds of bone scaffolds were immersed in PBS to prepare the extracts at different time points (1, 3, 5, 7, 14, 21, and 28 days). The qualitative filter paper was placed into the extract for 24 hours. The filter paper was co-cultured with Porphyromonas gingivalis and Fusobacterium nucleatum for 72 hours. The bacteriostatic effect of four groups of scaffolds was detected by the agar diffusion method. RESULTS AND CONCLUSION: (1) Scaffold characterization: Four groups of scaffolds were well formed. The surface of micro-wires in the S1 and S2 groups was dense and smooth, and the surface of micro-wires in the T1 and T2 groups was rough. Porosity was between 40%-47% and met the requirements of bone scaffolds. Compared with the S2 group, sustained release time was longer in the T2 group. The sustained release concentration of the drug was between 1-10 µg/mL for a long time, which was more conducive to bacteriostasis and osteogenesis. After 10 weeks of immersion in PBS in vitro, the degradation rate of the coaxial printed bone scaffold was faster than that of the corresponding uniaxial printed bone scaffold, and the degradation rate of the coaxial loaded bone scaffold was lower than that of the coaxial non-loaded bone scaffold. The four groups of scaffold extracts were co-cultured with osteoblasts respectively. CCK-8 assay displayed that the cell proliferation rate was greater than 75%, which met the requirements of biocompatibility. (2) In vitro antibacterial effect: S1 and T1 did not have antibacterial activity. S2 and T2 had an obvious antibacterial effect. Under the extraction solution on day 28, the diameter of Porphyromonas gingivalis and Fusobacterium nucleatum inhibition zone in the S2 group was smaller than that in the T2 group (P < 0.05). (3) These findings exhibit that hydroxyapatite/silk fibroin-polyvinyl alcohol scaffolds with coaxial minocycline have good physical properties and bacteriostatic properties. Figures and Tables | References | Related Articles | Metrics

Select

Screening and mechanism of the best treatment of red light and silver ion dressing for treatment of chronic non-healing wounds Lu Jie, Jin Jie, Yu Lichao, Ma Shasha, Xu Hongmei 2024, 28 (10):  1554-1561.  doi: 10.12307/2024.361 Abstract ( 174 )   PDF (2539KB) ( 68 )   Save BACKGROUND: Red light irradiation and silver ion dressing are mostly used to treat chronic difficult healing wounds clinically, but the optimal irradiation time of red light irradiation and silver ion dressing for chronic non-healing wounds, and the combination of different silver ion dressings have not been determined.  OBJECTIVE: To investigate the optimal irradiation time and dressing combination of red light and silver ion dressing in the therapy of chronic non-healing wounds. METHODS: The chronic non-healing wound model was made by applying Staphylococcus aureus on the whole skin defect and subcutaneous hydrocortisone injection in SD rats. 72 rat models were randomly divided into 4 groups with 18 rats in each group by random number table method. The rats were treated on the basis of standard dressing change and the following therapy: A1B1 group (red irradiation 20 minutes + lipid hydrocolloidal silver sulfate dressing), A1B2 group (red light irradiation 20 minutes + calcium alginate fiber dressing), A2B1 group (red light irradiation 30 minutes + lipid hydrocolloidal silver sulfate dressing), and A2B2 group (red light irradiation 30 minutes + calcium alginate fiber dressing); change dressing, irradiate once, and change dressing every 24 hours. After 14 days of continuous treatment, wound healing rate, bacterial colony number, inflammatory response, histomorphology and angiogenesis were detected in each group.  RESULTS AND CONCLUSION: (1) With the extension of treatment time, the wound healing rate of rats in the four groups was increased, and the wound healing rate of rats in the A2B2 group at 3, 7, and 14 days after treatment was higher than that in the other three groups (P < 0.05). (2) The wound bacterial culture results on day 7 after treatment demonstrated that the number of bacterial colonies in the A2B2 group was lower than that in the other three groups (P < 0.05). Western blot assay exhibited that with the extension of treatment time, the protein expressions of tumor necrosis factor α and interleukin-6 in wound tissue of rats in the four groups were decreased, while the protein expressions of interleukin-10 were increased. The protein expressions of tumor necrosis factor α and interleukin-6 in the A2B2 group were lower than those in the other three groups (P < 0.05). The protein expression of interleukin-10 in the A2B2 group was higher than that of the other three groups (P < 0.05). (3) The wound hematoxylin-eosin staining on day 14 after treatment demonstrated that a large number of collagen fibers in the A2B2 group were parallel distributed and the most closely connected, which was significantly better than the other three groups. (4) The results of immunofluorescence staining indicated that the fluorescence intensity expression of CD31 in the A2B2 group was higher than that in the A1B1, A1B2 and A2B1 groups (P < 0.05). q-PCR detection at 3, 7, and 14 days after treatment exhibited that the mRNA expressions of vascular endothelial growth factor a and vascular endothelial growth factor receptor 2 in the A2B2 group were higher than those in the other three groups (P < 0.05). Western blot assay at 3, 7 and 14 days after treatment revealed that the protein expressions of vascular endothelial growth factor a and vascular endothelial growth factor receptor 2 in the A2B2 group were higher than those in the other three groups (P < 0.05). (5) These findings confirm that 30 minutes of red light irradiation combined with silver alginate fiber dressing has better results in treatment of chronic non-healing wounds.  Figures and Tables | References | Related Articles | Metrics

Select

3D-printed multifunctional wound dressing for combined radiation and wound injury Jiao Wencheng, Dai Jing, Yan Wenrui, Shen Jintao, Hu Jinglu, Jin Yiguang, Du Lina 2024, 28 (10):  1562-1567.  doi: 10.12307/2024.371 Abstract ( 218 )   PDF (2237KB) ( 56 )   Save BACKGROUND: Combined radiation and wound injury appeared mainly in patients with tumor radiotherapy and nuclear radiation accidents. The radiation destroys the repair mechanism, resulting in delayed or prolonged wound healing. It still lacks an effective therapeutic strategy currently.  OBJECTIVE: To prepare multifunctional wound dressings based on the multiple clinical symptoms of combined radiation and wound injury, which are designed to be antibacteria, promoted healing and analgesics.  METHODS: Using levofloxacin, fibroin and lidocaine hydrochloride as raw materials, 3D bioprinting technology was applied to prepare the multifunctional wound dressing. (1) The multifunctional dressing was placed on a fixed culture plate coated with Staphylococcus aureus, Escherichia coli and Pseudomonas aeruginosa, and incubated at 37 °C overnight to detect the diameter of the antibacterial zone. (2) 40 Kunming mice were randomly divided into trauma group, radiation and trauma model group, treatment group and positive drug group, with 10 mice in each group. Mice in the radiation and trauma model group, treatment group and positive drug group were irradiated by 60Co gamma rays. After 1 hour of radiation, a full-layer skin defect wound with a diameter of 1 cm was made on the back of each mouse in the four groups. Normal saline was applied to the wounds of the trauma group and the radiation and trauma model group. Trethanolamine cream was applied to the wounds of the positive drug group. Multifunctional dressing was applied to the wounds of the treatment group. The dressing was changed every 2 days, and the treatment was continued for 14 days. Wound healing rate and serum interleukin-6 level were measured at 3, 7 and 14 days after wound modeling. 14 days after the wound modeling, the skin tissue of the wound was obtained and received hematoxylin-eosin staining, Masson staining and cytokeratin-14 immunohistochemical staining.  RESULTS AND CONCLUSION: (1) 3D-printed multifunctional wound dressing had good antibacterial activity. The antibacterial zone diameters against Staphylococcus aureus, Escherichia coli and Pseudomonas aeruginosa were (4.15±0.09), (4.18±0.23) and (4.35±0.13) cm, respectively. (2) With the extension of modeling time, the wound healed gradually. The wound healing rate of the treatment group and the positive drug group was higher than that of the radiation and trauma model group at 3, 7 and 14 days after modeling (P < 0.01, P < 0.001). The wound healing rate of the treatment group was higher than that of the positive drug group. With the extension of modeling time, the serum interleukin level of mice increased first and then decreased. The serum interleukin level in the treatment group at 3, 7 and 14 days after modeling was lower than that in the radiation and trauma model group. Hematoxylin-eosin staining and Masson staining exhibited that inflammatory cells infiltrated the granuloma tissue in the trauma group, and the dermal collagen fibers were densely arranged. The normal structure of epidermis and dermis was destroyed and inflammatory cells were infiltrated in the radiation and trauma model group. In the treatment group, normal skin mucosal tissue was observed, the epidermis was arranged closely, and the sweat glands, hair follicles and dermal collagen fibers were arranged regularly. In the positive drug group, the arrangement of epidermal layer was tight, and the arrangement of sweat glands, hair follicles and dermal collagen fibers was regular. Cytokeratin-14 immunohistochemical staining displayed that the epidermal tissue thickness in the treatment group was lower than that in the other three groups (P < 0.01, P < 0.001). (3) The results confirm that the 3D-printed multifunctional dressing has multiple functions of local anesthesia, anti-infection and promoting healing. Figures and Tables | References | Related Articles | Metrics

Select

Strontium ranelate-loaded sodium alginate/collagen hydrogel promotes bone defect repair in osteoarthritis Su Kunyang, Chen Bineng, Chen Yiliang, Jin Shaofeng 2024, 28 (10):  1568-1574.  doi: 10.12307/2024.363 Abstract ( 201 )   PDF (3021KB) ( 18 )   Save BACKGROUND: Cartilage degeneration and subchondral bone damage are the main pathological features of osteoarthritis, and treatment based on this pathological feature will be a promising improvement for osteoarthritis. OBJECTIVE: To design and study an annotated strontium ranelate-loaded drug delivery system and to observe its therapeutic effect on promoting cartilage repair and improving subchondral bone structure in osteoarthritis.  METHODS: (1) In vitro experiment: Strontium ranelate was loaded into sodium alginate/collagen hydrogel matrix to construct in situ drug delivery system, and the in vitro slow release performance of the system was characterized. Strontium ranelate-loaded sodium alginate/collagen hydrogel (experimental group) and alginate sodium/collagen hydrogel (control group) were co-cultured with bone marrow mesenchymal stem cells, respectively, and cultured cells were used as a blank control group to detect cell proliferative activity. After chondroblast-induced differentiation, saffron O staining, Alcian blue staining and RT-qPCR were performed respectively. The two hydrogels were co-cultured with osteoblasts, and the cultured cells were used as a blank control group for immunofluorescence staining and RT-qPCR. (2) In vivo experiment: A total of 18 adult SD rats were selected and the model of right posterior knee osteoarthritis was established by the method of medial meniscectomy. After 1 week, the rats were divided into three groups by the random number table method: The blank group did not receive any treatment. The control group was injected with sodium alginate/collagen hydrogel in the knee, and the experimental group was injected with strontium ranelate-loaded sodium alginate/collagen hydrogel, with 6 rats in each group. After 6 weeks, the samples were subjected to Micro-CT scanning, hematoxylin-eosin staining, saffron O-solid green staining and immunofluorescence staining. RESULTS AND CONCLUSION: (1) In vitro experiment: Strontium ranelate-loaded sodium alginate/collagen hydrogel had porous microstructure and sustainable release of strontium ranelate. At 21 days, the cumulative release reached (60.89±0.58)%. Bone marrow mesenchymal stem cell staining showed that both hydrogels had good cytocompatibility. The results of the CCK-8 assay demonstrated that strontium ranelate-loaded sodium alginate/collagen hydrogel could promote the proliferation of bone marrow mesenchymal stem cells. The results of Safranin O staining, Alcian blue staining, immunofluorescence staining and RT-qPCR exhibited that strontium ranelate-loaded sodium alginate/collagen hydrogel could promote chondrogenic differentiation of bone marrow mesenchymal stem cells. Immunofluorescence staining and RT-qPCR revealed that strontium ranelate-loaded sodium alginate/collagen hydrogel could decrease bone resorptivity by increasing the ratio of osteophosphorin/nuclear factor κB receptor activator ligand. (2) In vivo experiment: Micro-CT scan verified that compared with the blank group and control group, the subchondral bone volume fraction and bone mineral density of the knee of rats were increased in the experimental group (P < 0.05, P < 0.01). Histological staining displayed that compared with the blank group and control group, the knee cartilage injury was significantly reduced; the expression of type II collagen was promoted, and the expression of matrix metalloproteinase 2 protein was inhibited in the experimental group (P < 0.05, P < 0.01). (3) These results confirm that the strontium ranelate-loaded sodium alginate/collagen hydrogel can promote the repair of cartilage defects in osteoarthritis and reconstruct the complex interface between cartilage and subchondral bone. Figures and Tables | References | Related Articles | Metrics

Select

Three-dimensional finite element analysis of distal proximal occlusal defect of short crown molar restored with endocrown Zhao Yuanyuan, Shang Weihua, He Jingyi, Li Weixin, Wang Tao 2024, 28 (10):  1575-1579.  doi: 10.12307/2024.258 Abstract ( 178 )   PDF (1464KB) ( 61 )   Save BACKGROUND: For teeth with normal dental crown height, pulp cavity retention crown restoration with different depths of the pulp cavity and different repair materials affects the stress and flexural strength of tooth tissue. For short crown molar defects, the research on pulp cavity repair mainly focuses on clinical observation and in vitro flexural strength experiments.  OBJECTIVE: To establish a three-dimensional finite element model for short crown molar restored by the endocrown after root canal treatment to analyze the effects of different pulp cavity retention depths and different repair materials on the distribution and size of dentin equivalent stress. METHODS: Based on establishing the complete model of the short crown mandible first molar, a three-dimensional finite element model was established for repairing the distal adjacent defect of the short crown molar with different pulp cavity retention depths (h=2, 3, 4 mm) and different repair materials (zirconia, lithium disilicate). Under the oblique loading, the equivalent stress distribution was observed. The peak value of dentin equivalent stress and the mean value of equivalent stress near the bottom of the mesial pulp cavity wall were calculated. RESULTS AND CONCLUSION: (1) Equivalent stress concentration areas: The stress of complete short crown molar and restored models mainly concentrated in the mesial root mesial neck and mesial root lingual neck. The stress concentration area was found in the mesial pulp cavity wall corresponding to the bottom layer of restored models, and the stress concentration was obvious in the 4 mm retention depth group. (2) Under the same repair material, the peak value of dentin equivalent stress was the lowest at 3 mm for all models after repair. The average value of equivalent stress near the bottom of the mesial pulp cavity wall was lowest at 3 mm. (3) Under the same retention depth, there was no significant difference between the two materials in the dentin equivalent stress peak and the mean value near the bottom of the mesial pulp cavity. (4) The results showed that under the conditions of this experiment, the endocrown was used to repair the defect of the short crown molar and the retention depth was 3 mm, which was more beneficial to protect the remaining dental tissue. The selection of zirconia or lithium disilicate as the repair material had little effect on the dentin stress.  Figures and Tables | References | Related Articles | Metrics

Select

Compound cottonrose hibiscus leaf gel plaster of optimal “Xiaozhongsan” formulation for knee synovitis Yan Wei, Kong Bo, Xi Xiaobing, Xu Yong, Jia Youji, Ruan Beite, Zhang Jiahui, Ma Honghong, Li Zhongwei 2024, 28 (10):  1580-1585.  doi: 10.12307/2024.367 Abstract ( 222 )   PDF (1230KB) ( 15 )   Save BACKGROUND: Previous studies have confirmed that the new compound cottonrose hibiscus leaf gel plaster has a good effect in the treatment of acute soft tissue swelling. OBJECTIVE: To observe the clinical efficacy of compound cottonrose hibiscus leaf gel plaster in the treatment of synovitis of the knee joint.  METHODS: Seventy-two patients with knee synovitis were selected from Ruijin Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from December 2019 to May 2021. These patients were randomly divided into a trial group and a control group, with 36 cases in each group. The trial group was treated with compound cottonrose hibiscus leaf gel plaster, once a day, 12 hours each time, while the control group was treated with Diclofenac Diethylamine Emulgel, twice a day. After 28 days of treatment, visual analog scale score, WOMAC Osteoarthritis Index score, quality of life score (SF-36), thickness of knee synovium and comprehensive curative effect were compared between the two groups.  RESULTS AND CONCLUSION: (1) Visual analog scale scores after treatment were lower than those before treatment (P < 0.05). Visual analog scale scores in the trial group after 7, 14 and 28 days of treatment were lower than those in the control group (P < 0.05). The WOMAC Osteoarthritis Index scores of the two groups after treatment were lower than those before treatment (P < 0.05), and the WOMAC Osteoarthritis Index scores in the trial group after 7, 14 and 28 days of treatment were lower than those in the control group (P < 0.05). (3) The SF-36 quality of life score in the two groups after 28 days of treatment was higher than that before treatment (P < 0.05). SF-36 quality of life score in the trial group after 28 days of treatment was higher than that in the control group (P < 0.05). (4) After 28 days of treatment, the thickness of knee synovium in the trial group was less than that in the control group (P < 0.05), and the effective rate in the trial group was higher than that in the control group (P < 0.05). (5) These findings indicate that compared with Diclofenac Diethylamine Emulgel, the compound cottonrose hibiscus leaf gel plaster can better relieve knee pain, enhance knee joint function, reduce synovial hyperplasia, and elevate the overall quality of life of patients.  Figures and Tables | References | Related Articles | Metrics

Select

Influence of bone cement volume and distribution on surgical and adjacent vertebral refractures after percutaneous vertebroplasty#br# Abuduwupuer•Haibier, Alimujiang•Yusufu, Maimaitimin•Abulimiti, Maihemuti•Yakufu, Aiben•Kayierhan, Yimuran•Abudukelimu, Alimujiang•Aximu, Lin Hang, Tuerhongjiang•Abudurexiti 2024, 28 (10):  1586.  doi: 10.12307/2024.364 Abstract ( 239 )   PDF (1095KB) ( 88 )   Save BACKGROUND: Studies have exhibited that symmetrical distribution and effective dose of bone cement can reduce postoperative vertebral refractures and help improve outcomes, but obtaining better distribution and dose of bone cement during percutaneous vertebroplasty remains an issue for surgeons. OBJECTIVE: To investigate the risk factors of percutaneous vertebroplasty in the treatment of osteoporotic vertebral compression fracture, and to analyze the correlation between these factors and recurrent fractures of the operative vertebral body and adjacent vertebral bodies after percutaneous vertebroplasty.  METHODS: 111 patients who underwent unilateral approach percutaneous vertebroplasty in Sixth Affiliated Hospital of Xinjiang Medical University from January 2018 to December 2021 were screened and divided into fracture group (n=17) and non-fracture group (n=94) according to whether refracture was observed during follow-up. The following variables were reviewed in both groups: Gender, age, body mass index, operation time, menopause age, bone cement distribution index, bone density T value, bone cement dose, location of bone cement distribution, percutaneous vertebroplasty stage, past history, adverse reactions and disc cement leakage of patients. These variables were analyzed by univariate analysis. The statistically significant factors were replaced by a binary Logistic regression model to analyze the correlation with vertebral refracture after percutaneous vertebroplasty.  RESULTS AND CONCLUSION: (1) Univariate analysis demonstrated that after percutaneous vertebroplasty, vertebral refracture was associated with disc cement leakage (P=0.000), cement dose (P=0.049), and cement distribution location (P=0.017). (2) Binary Logistic regression revealed that bone cement leakage (P=0.000), cement dose (P=0.031), and location of cement distribution (P=0.015) were risk factors for recurrent fracture of the operative vertebral body and adjacent vertebral body after percutaneous vertebroplasty. Compared with cement distribution types I, II, and III, the risk of recurrent fracture in the operative and adjacent vertebrae was higher in cement distribution types IV and V (OR=36.340, P=0.016; OR=27.755, P=0.017). (3) It is concluded that recurrent fractures of the surgically operated vertebral body and adjacent vertebral bodies are caused by the interaction of multiple risk factors. Bone cement distribution and bone cement leakage were independent risk factors. Recurrent fractures of the operative vertebra and adjacent vertebrae are more likely when the cement is distributed in type IV and type V. Surgeons should fully assess these risk factors before surgery and develop targeted prevention and treatment strategies to help reduce the risk of future refractures. Figures and Tables | References | Related Articles | Metrics

Select

Characteristics and problems of hydroxyapatite/polymer bone repair material Qi Junqiang, Wang Haotian, Xiao Bing, Liu Jia, Liu Yifei, Xu Guohua 2024, 28 (10):  1592-1598.  doi: 10.12307/2024.313 Abstract ( 246 )   PDF (991KB) ( 45 )   Save BACKGROUND: Hydroxyapatite is the main inorganic component of bone tissue. The polymer has the structure and function of a biomimetic extracellular matrix. The composites of hydroxyapatite and polymer have been widely studied. OBJECTIVE: To summarize the research status of hydroxyapatite composite polymer materials for bone tissue repair. METHODS: The articles collected in PubMed, Web of Science, CNKI and WanFang databases were searched from January 2010 to April 2023. The Chinese and English search terms were “hydroxyapatite, polymer, composites, degradability, bone defect, bone repair”. Finally, 75 articles were included for review. RESULTS AND CONCLUSION: Polymers often used in composite with hydroxyapatite for bone tissue repair include natural polymers (collagen, chitosan, alginate, serine protein, cellulose, hyaluronic acid,and polyhydroxybutyrate) and synthetic polymers [polylactic acid, polylactic acid-hydroxyacetic acid copolymer, poly(has-lactide), poly(amino acid) and poly(vinyl alcohol)]. The mechanical properties and osteoinductivity of hydroxyapatite/polymer composites were improved compared with pure hydroxyapatite. Hydroxyapatite composite with polymers can be made into porous scaffolds, hydrogels, and coatings for bone repair. Hydroxyapatite/polymer composites can accelerate bone reconstruction with a slow release of loaded drugs and cytokines due to their bionic extracellular matrix structure and function. Based on the diversity of causes of bone defects and the fact that bone repair is a complex continuous process involving multiple biological factors and proteins, repair materials with mechanical properties matching bone tissue, degradation processes synchronized with bone repair, and efficient osteogenesis and vascularization need to be further investigated. Figures and Tables | References | Related Articles | Metrics

Select

Application of synthetic and biological materials in articular cartilage repair Zhang Bentuo, Yang Xin 2024, 28 (10):  1599-1605.  doi: 10.12307/2024.314 Abstract ( 288 )   PDF (910KB) ( 45 )   Save BACKGROUND: The repair of articular cartilage injury remains a difficult problem to be solved urgently in clinical practice. Utilizing synthetic or biological materials to promote cartilage regeneration has been a research hotspot.  OBJECTIVE: To review the research progress of synthetic and biological materials in articular cartilage repair. METHODS: PubMed and CNKI databases were searched for articles about the progress of synthetic and biological materials utilized in articular cartilage repair. “Collagen, gelatin, silk, chitosan, alginate, PEG, PCL, PLA, cartilage tissue engineering, cartilage tissue engineering materials” were used as English and Chinese search terms, respectively. After preliminary screening based on the inclusion and exclusion criteria, 98 articles with high quality and relevance were retained for review.   RESULTS AND CONCLUSION: Natural materials, including collagen, gelatin, silk, chitosan, and alginate, have good biocompatibility and degradability. Synthetic materials, containing polyethylene glycol, polycaprolactone, and polylactic acid, have good mechanical properties. Modification and composition of materials can overcome the inherent defects in materials and show better cartilage repair ability. Studies about multi-layer scaffolds based on hierarchical structure are rare, and it is more targeted at osteochondral injury repair rather than simple cartilage injury repair. At present, scaffold research is focused on the synthetic research and development stage, and the corresponding clinical trials are few, so it is necessary to pay attention to clinical transformation in the future. Figures and Tables | References | Related Articles | Metrics

Select

Application of melt electrowriting technology in tissue engineering Jiang Yu, He Feng, Liu Huan, Wu Ruixin 2024, 28 (10):  1606-1612.  doi: 10.12307/2024.316 Abstract ( 313 )   PDF (1188KB) ( 102 )   Save BACKGROUND: With computer-aided design, melt electrowriting technology can precisely construct 3D tissue engineering scaffolds with specific morphology, which has attracted increasing attention in tissue engineering. OBJECTIVE: To elaborate on the progress of melt electrowriting technology in tissue engineering in recent years. METHODS: PubMed and CNKI were used to retrieve articles about applications of melt electrowriting technology in tissue engineering. The search time was from March 2008 to February 2023. The search terms were “melt electrowriting, melt electrospinning, electrospinning, tissue engineering, scaffold, regeneration” in English and “melt electrowriting, electrospinning, tissue engineering” in Chinese. A preliminary screening of articles was performed by reading the titles and abstracts. Finally, 69 articles were included for review. RESULTS AND CONCLUSION: (1) Melt electrowriting technology can achieve precise layer-by-layer deposition of fibers compared to traditional electrospinning technology, which better simulates the complex structure of natural tissues. Compared to other 3D printing technologies, smaller-diameter fibers can be prepared by melt electrowriting technology, resulting in highly ordered porous structures. (2) By combining with other scaffold preparation techniques or materials, such as fused deposition modeling, solution electrospinning technology, and hydrogel, melt electrowriting technology shows great potential in preparing complex tissue engineering scaffolds, which provides certain possibilities for achieving complex tissue regeneration. (3) The regeneration of complex tissues often involves blood vessels, nerves, and soft and hard tissues at the same time. The regeneration of blood vessels and nerves is of great significance to realize the physiological reconstruction of tissues. However, soft and hard tissues have certain difficulties to realize the coordinated regeneration of both due to their different biological and mechanical properties. Melt electrowriting technology has certain advantages in the field of bionic scaffolds due to its good biocompatibility, the ability to prepare multi-scale scaffolds and high porosity. Figures and Tables | References | Related Articles | Metrics

Select

Regulatory effects of micro-arc oxidation on anti-bacterial and anti-inflammatory properties of metal implants Yu Dehao, Ning Fengting, Du Yilang, Wang Yeyuan, Bai Bing 2024, 28 (10):  1613-1619.  doi: 10.12307/2024.266 Abstract ( 226 )   PDF (982KB) ( 43 )   Save BACKGROUND: Micro-arc oxidation can effectively add bioactive elements to the metal surface and improve the anti-bacterial and anti-inflammatory properties of biomedical metal materials, so this technology has become one of the hotspots of biomedical materials.  OBJECTIVE: To summarize the anti-bacterial and anti-inflammatory properties of surface coatings prepared by the combination of micro-arc oxidation and other surface modification technologies.  METHODS: Articles from January 1996 to December 2022 were searched on CNKI, WanFang and PubMed databases using Chinese and English search terms “micro-arc oxidation, antibacterial properties, anti-inflammatory properties, metal implants”. After preliminary screening according to inclusion and exclusion criteria, 89 articles were retained and summarized. RESULTS AND CONCLUSION: The ceramic layer prepared by micro-arc oxidation can improve the anti-bacterial and anti-inflammatory properties of titanium, magnesium and other alloys. Combination with other surface modification technologies can effectively solve the effect of pores on the surface properties of the alloy, and further improve the biological properties of the oxide film. It has a wide application prospect in orthopedics and dentistry. At present, most studies are limited to metal coatings, and most of them focus on metal elements with good antibacterial properties such as silver and copper, while only a few studies mention non-metallic coatings such as graphene oxide, hydroxyapatite and chitosan. In the future, extensive studies can be conducted on inorganic coatings and polymer coatings, and more combinations of different bioactive elements can also be adopted to improve antibacterial properties. Currently, studies on the inflammation of implant coatings prepared by micro-arc oxidation are mostly limited to the immune system and focused on macrophages, while studies on neutrophils and platelets are scarce. In the future, a variety of advanced technologies should be combined to explore the specific effects of micro-arc oxidation coating on other immune cells and inflammatory cells. Figures and Tables | References | Related Articles | Metrics

Select

Regenerative endodontic therapy based on tissue engineering mediating by inflammatory microenvironment Rao Jin, Jiang Shui, Shi Haishan 2024, 28 (10):  1620-1625.  doi: 10.12307/2024.311 Abstract ( 210 )   PDF (1137KB) ( 137 )   Save BACKGROUND: Recently, regenerative endodontic therapy is a promising alternative to the maturation of tissue engineering. Inflammatory microenvironment plays a key role in regulating pulp regeneration. OBJECTIVE: To focus on the change in the inflammatory pulp microenvironment, the balance between inflammation and regeneration, and the research advances in tissue-engineered regenerative endodontic therapy within the context of the inflammatory microenvironment to provide a reference for future investigations into regenerative endodontic therapy. METHODS: We conducted a literature search on PubMed and CNKI using search terms “pulp regeneration, inflammation, regenerative endodontic therapy, tissue engineering” in Chinese and English for articles published between 2013 and 2023. The review finally included 61 relevant articles. RESULTS AND CONCLUSION: (1) The changes in the microenvironment of pulpitis involve a complex interplay of cellular and molecular reactions, which, as inflammation progresses, ultimately the microenvironment hinders tissue repair more than facilitates it. (2) Inflammation can promote dental pulp regeneration through stem cell recruitment and activate the complement system, but it can also hinder the regenerative process through immunosuppression and fibrosis. (3) Tissue engineering’s three components (stem cells, growth factors, scaffold materials) collaborate to balance inflammation and regeneration, for example, by using interleukin-6 to regulate dental pulp stem cells and foster a regenerative environment. (4) Current research has been largely silent on infection and inflammation issues. The mechanisms underlying changes in the microenvironment of pulpitis are still not fully understood. One promising avenue for improving the clinical applicability of regenerative dental pulp therapy is to achieve precise regulation of the inflammatory-regeneration balance and create a regenerative microenvironment by synergistically leveraging the three elements of tissue engineering. However, this field of investigation still exhibits significant gaps in understanding, necessitating further exploration into innovative strategies for facilitating dental pulp regeneration under inflammation. As such, additional animal experimentation and randomized clinical trials are required to establish a robust foundation for the clinical practice of tissue engineering-based regenerative dental pulp therapy. Figures and Tables | References | Related Articles | Metrics

Select

Molecular mechanisms of anti-inflammatory effects of metal ions Jiang Chunjing, Yang Chengxue, Yu Zhengwen, Zhang Jian 2024, 28 (10):  1626-1633.  doi: 10.12307/2024.267 Abstract ( 276 )   PDF (1506KB) ( 23 )   Save Figures and Tables | References | Related Articles | Metrics

Select

Application of biomaterials in Masquelet technology Han Fengping, Li Huairen, Chang Wenli, Tian Baofang, Feng Li 2024, 28 (10):  1634-1640.  doi: 10.12307/2024.365 Abstract ( 193 )   PDF (903KB) ( 17 )   Save BACKGROUND: The remediation and treatment of bone defects present considerable challenges, with a variety of clinical intervention strategies available. One such approach, the Masquelet technique, has demonstrated high rates of success and reliable outcomes and is currently employed in clinical practice. However, the underlying mechanisms of this technique remain incompletely understood, and certain challenges persist in its clinical application, indicating that this technique is not yet fully mature.  OBJECTIVE: To compile and categorize the biomaterials currently employed in research aimed at improving the Masquelet technique, in order to provide insights and references for the further development of this technique. METHODS: A literature search of the China National Knowledge Infrastructure and PubMed databases was conducted, spanning publications from January 2013 to November 2022. The search terms used included “Masquelet technique; induced membrane technique; induced membrane; biomaterial; bone defect” in both Chinese and English. A total of 58 articles meeting the inclusion criteria were reviewed. RESULTS AND CONCLUSION: (1) The emergence and continual development of the Masquelet technique provide a therapeutic strategy for treating bone defects. Some researchers are focusing on developing superior spacer materials, autograft substitutes, and membrane materials that mimic the properties of the induced membrane, to simplify the two-stage procedure, shorten treatment duration, and reduce patient distress. (2) Calcium sulfate, silicone, poly(lactic-co-glycolic acid), and polypropylene can replace polymethylmethacrylate bone cement to form induced membranes in animal experiments or clinical applications, each with their advantages. Contrary to expectations, common materials such as titanium and polyvinyl alcohol sponge cannot replace polymethylmethacrylate bone cement. (3) Autograft substitutes are diverse, with allograft bone, β-tricalcium phosphate, absorbable gelatin sponge, α-calcium sulfate hemihydrate, bioactive glass, titanium, and tantalum demonstrating their ability to reduce the quantity of autologous cancellous bone graft required in the second stage of the procedure. Among them, allograft bone, β-tricalcium phosphate, bioactive glass, titanium and tantalum can replace autogenous bone as grafts, and other materials need to be mixed with autogenous bone, in both clinical and fundamental experiments. (4) Biomimetic-induced membranes, human amnion, human decellularized dermis, polytetrafluoroethylene, and even autogenous cortical bone have been shown to possess properties similar to the induced membrane. (5) Most of the application and research of biomaterials in this technology still exist in the stage of basic research and have not been applied in clinical practice or popularized on a large scale, but the above materials can provide more sufficient theoretical basis and new ideas for the exploration of Masquelet technical mechanism, the improvement of surgical methods and clinical application. Figures and Tables | References | Related Articles | Metrics