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08 February 2025, Volume 29 Issue 4 Previous Issue    Next Issue

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Adhesion, proliferation, and vascular smooth muscle differentiation of bone marrow mesenchymal stem cells on different electrospinning membranes  Sun Xianjuan, Wang Qiuhua, Zhang Jinyi, Yang Yangyang, Wang Wenshuang, Zhang Xiaoqing 2025, 29 (4):  661-669.  doi: 10.12307/2025.217 Abstract ( 129 )   PDF (2444KB) ( 196 )   Save BACKGROUND: Small diameter artificial vessels are urgently needed to treat coronary artery and peripheral artery diseases in clinical practice. At present, vascular tissue engineering has become the main method for preparing small diameter artificial vessels. Selecting suitable biomaterials and cell sources is the key factor for successful construction of small diameter tissue engineered vessels.  OBJECTIVE: To observe the effect of four kinds of electrospinning membrane materials on proliferation, adhesion and differentiation of bone marrow mesenchymal stem cells into vascular smooth muscle cells.  METHODS: Bone marrow mesenchymal stem cells were isolated and extracted from SD rats. The bone marrow mesenchymal stem cells were inoculated separately on polycaprolactone (PCL), polycaprolactone-hyaluronic acid (PCL-HA), polycaprolactone-silk-filament proteins (PCL-SF), and polycaprolactone-gelatin (PCL-GEL) electrospinning membrane materials. After 1, 3, and 7 days of culture, the cell arrangement on the material was observed under scanning electron microscope. The proliferation and adhesion of the material were observed by phalloidin staining. The mRNA expressions of CD90, Meflin, and transforming growth factor β were detected by qRT-PCR. After 7 days of induced differentiation into vascular smooth muscle cells, the mRNA expression of ɑ-smooth muscle actin on the material was detected by qRT-PCR. RESULTS AND CONCLUSION: (1) Bone marrow mesenchymal stem cells were arranged along the fibers of the four kinds of electrospinning membranes under scanning electron microscopy. (2) Phalloidin staining showed the regular distribution of bone marrow mesenchymal stem cells on the four kinds of electrospinning membranes and parallel distribution along the fiber direction. Moreover, PCL-HA, PCL-SF, and PCL-GEL electrospinning membranes were more conducive to the proliferation and adhesion of bone marrow mesenchymal stem cells than PCL electrospinning membranes. Compared with PCL-HA and PCL-GEL electrospinning membranes, PCL-SF electrospinning membranes were more conducive to the proliferation and adhesion of bone marrow mesenchymal stem cells. (3) qRT-PCR showed that the four kinds of electrospun membrane materials could maintain the mRNA expression of CD90 and Meflin in bone marrow mesenchymal stem cells, but there was no significant difference between groups (P > 0.05). The mRNA expression of transforming growth factor β in PCL-HA, PCL-SF, and PCL-GEL groups was higher than that in PCL group on days 1 and 7 (P < 0.05), and the mRNA expression of transforming growth factor β in PCL-SF group was higher than that in the other three groups on days 3 and 7 (P < 0.05). The mRNA expression of transforming growth factor β in PCL-HA group was higher than that in PCL-GEL group on day 7 (P < 0.05). (4) qRT-PCR showed that the mRNA expression of ɑ-smooth muscle actin in PCL-SF group was higher than that in the other three groups (P < 0.05), and that in PCL-HA group was higher than that in PCL group (P < 0.05). (5) The results indicate that compared with PCL, PCL-HA and PCL-GEL electrospinning membranes, PCL-SF electrospinning membranes combined with bone marrow mesenchymal stem cells are more suitable for the preparation of small diameter tissue engineered vessels. Figures and Tables | References | Related Articles | Metrics

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Preparation and osteogenic properties of liquid crystal display light-cured polylactic acid scaffold loaded with nano-tantalum  Li Mingzhe, Ye Xiangling, Wang Bing, Yu Xiang 2025, 29 (4):  670-677.  doi: 10.12307/2025.228 Abstract ( 153 )   PDF (2322KB) ( 167 )   Save BACKGROUND: Polylactic acid (PLA) has good biocompatibility and a controllable degradation rate and is currently widely used in biomedical engineering. However, PLA has shortcomings such as low mechanical strength and insufficient biological activity, which limits its further application in bone tissue engineering. OBJECTIVE: To construct polylactic acid/polydopamine/tantalum (PLA/PDA/Ta) bone tissue engineering scaffolds, and explore their biosafety and in vitro osteogenesis. METHODS: A PLA scaffold with a porous structure was prepared through liquid crystal display light-curing technology. PLA/PDA scaffolds and PLA/PDA/Ta scaffolds were prepared by soaking PLA scaffolds in dopamine solution and dopamine-tantalum nanoparticle solution, respectively. The microstructure and water contact angle of scaffolds were characterized. MC3T3-E1 cells were co-cultured with PLA, PLA/PDA, and PLA/PDA/Ta scaffolds, respectively, and CCK-8 assay and live/dead cell staining were performed. After osteogenic differentiation, alkaline phosphatase, alizarin red staining, and osteogenic gene detection were performed. RESULTS AND CONCLUSION: (1) The scanning electron microscope results exhibited that the three kinds of prepared scaffolds had an interconnected porous three-dimensional structure, and the average pore diameter was 200 μm. The water contact angle of PLA/PDA/Ta scaffolds was lower than that of PLA and PLA/PDA scaffolds (P < 0.05). (2) CCK-8 assay showed that compared with PLA and PLA/PDA scaffolds, PLA/PDA/Ta scaffolds could promote cell proliferation (P < 0.05). Live/dead cell staining showed good cell proliferation in the three groups. (3) Alkaline phosphatase and alizarin red staining showed that compared with PLA and PLA/PDA scaffolds, PLA/PDA/Ta scaffolds could promote the expression of alkaline phosphatase and the formation of mineralized nodules. RT-qPCR showed that compared with PLA and PLA/PDA scaffolds, PLA/PDA/Ta scaffolds could enhance the mRNA expression of cell bone morphogenetic protein, Runx-2, and type I collagen (P < 0.05, P < 0.01). (4) The results showed that the PLA/PDA/Ta scaffold had excellent osteogenic activity and the ability to promote cell proliferation. Figures and Tables | References | Related Articles | Metrics

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Anti-inflammatory and osteogenic effects of chitosan/sodium glycerophosphate/sodium alginate/leonurine hydrogel  Zhao Zengbo, Li Chenxi, Dou Chenlei, Ma Na, Zhou Guanjun 2025, 29 (4):  678-685.  doi: 10.12307/2025.264 Abstract ( 232 )   PDF (1548KB) ( 214 )   Save BACKGROUND: Leonurine has many biological activities such as improving microcirculation, anti-oxidation, anti-apoptosis, scavenging free radicals, anti-inflammation, and anti-fibrosis, and can promote osteogenic differentiation of bone marrow mesenchymal stem cells, which has the potential to be applied in the treatment of periodontitis. OBJECTIVE: To explore the anti-inflammatory and osteogenic effects of leonurine loading into chitosan/sodium glycerophosphate/sodium alginate hydrogel. METHODS: (1) Chitosan/sodium glycerophosphate/sodium alginate hydrogel (blank hydrogel) and chitosan/sodium glycerophosphate/sodium alginate/leonurus alkali hydrogel were prepared respectively. RAW 264.7 and MC3T3-E1 cells were inoculated with the two kinds of hydrogel. The cytotoxicity of hydrogels was detected by CCK-8 assay and live/dead cell staining. (2) RAW 264.7 cells were cultured in five groups. The blank group was cultured for 24 hours routinely. The lipopolysaccharide group was treated with lipopolysaccharide. The simple hydrogel group was treated with lipopolysaccharide and blank hydrogel. The drug-loaded hydrogel group was treated with lipopolysaccharide and drug-loaded hydrogel. The inhibitor group was treated with lippolysaccharide, drug-loaded hydrogel, and PI3K inhibitor LY294002. 24 hours later, mRNA expression of inflammation-related factors was detected by qRT-PCR. Western blot assay was utilized to detect the protein expression of inflammation-related factors and PI3K/AKT signaling pathway. (3) MC3T3-E1 cells were inoculated in four groups. The blank group was cultured without any material. The simple hydrogel group was treated with blank hydrogel. The drug-loaded hydrogel group was treated with drug-loaded hydrogel. The inhibitor group was treated with drug-loaded hydrogel and PI3K inhibitor LY294002 for 7 days. Alkaline phosphatase staining was performed. mRNA expression levels of osteogenic factors were detected by qRT-PCR. The protein expression levels of the PI3K/AKT signaling pathway were detected by western blot assay. RESULTS AND CONCLUSION: (1) The results of CCK-8 assay and live/dead cell staining showed that the two kinds of hydrogels had no cytotoxic effect and had good cytocompatibility. (2) Compared with the blank group, the mRNA and protein expression levels of interleukin 6, tumor necrosis factor α, and interleukin 1β were significantly increased (P < 0.05), and the protein expression levels of p-AKT, p-PI3K, p-p65, and p-IκBα were significantly increased in the lipopolysaccharide group (P < 0.05). Compared with lipopolysaccharide group, mRNA and protein expression levels of the above indexes were decreased in drug-loaded hydrogel group (P < 0.05). Compared with the drug-loaded hydrogel group, the mRNA and protein expression levels of the above indexes were decreased in the inhibitor group (P < 0.05). (3) The activity of alkaline phosphatase in drug-loaded hydrogel group was higher than that in the blank group, simple hydrogel group, and inhibitor group (P < 0.05). Compared with blank group, the mRNA expression levels of alkaline phosphatase, Runx2, osteocalcin, and type I collagen were increased (P < 0.05), and the protein expression levels of p-AKT and p-PI3K were increased in the simple hydrogel group (P < 0.05). Compared with the simple hydrogel group, the mRNA and protein expression levels of the above indexes were increased in the drug-loaded hydrogel group (P < 0.05). Compared with the drug-loaded hydrogel group, the mRNA and protein expression levels of the above indexes were decreased in the inhibitor group (P < 0.05). (4) These findings conclude that chitosan/sodium glycerophosphate/sodium alginate/leonurine hydrogel has anti-inflammatory and osteogenic effects, which may be related to the regulation of PI3K/AKT signaling pathway.  Figures and Tables | References | Related Articles | Metrics

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Infiltration resin combined with whitening technique on micro-cracked dental fluorosis Zhang Wenyi, Yin Zhao, Zhang Jian 2025, 29 (4):  686-691.  doi: 10.12307/2025.256 Abstract ( 203 )   PDF (892KB) ( 227 )   Save BACKGROUND: Micro-abrasion, at-home whitening combined with infiltration resin have a good effect on dental fluorosis, but the effect of this method on micro-cracks in dental fluorosis is still unclear.  OBJECTIVE: To explore the effect of micro-abrasion, at-home whitening combined with infiltration resin on micro-cracked dental fluorosis. METHODS: (1) Clinical research: A total of 23 patients with micro-cracked dental fluorosis, including 255 micro-cracked dental fluorosis, were selected from July 2020 to March 2021 in the Department of Prosthodontics, Stomatology Hospital, Tianjin Medical University. All of them received combined treatment of tooth micro-abrasion, at-home whitening and infiltration resin. The tooth color, tooth sensitivity, and tooth pain threshold were compared before treatment and 1 week and 1 month after treatment. (2) In vitro experiment: 60 teeth with fluorosis with at least one crack on the tooth surface were collected and randomly divided into three groups for treatment. The control group was treated without any treatment. The whitening group was treated with micro-abrasion and at-home whitening, and the combined group was treated with micro-abrasion, at-home whitening, and infiltration resin, with 20 teeth in each group. The microhardness of the three groups of teeth samples after treatment was measured. RESULTS AND CONCLUSION: (1) Clinical study: 6 months after treatment, among 255 teeth with micro-cracked dental fluorosis, whitening treatment for 207 teeth was significantly effective and whitening treatment for 48 teeth was effective, and the overall treatment efficiency was 100%. With the extension of treatment time, the proportion of moderate and severe dental sensitivity showed a decreasing trend. At 6 months after treatment, 255 teeth with dental fluorosis had no severe sensitivity, 15 with moderate sensitivity, 125 with mild sensitivity, and 115 with no sensitivity, and the difference was significant compared with the sensitivity before treatment (P < 0.05). There was no significant difference in the threshold of tooth pain before treatment and 1 week and 6 months after treatment (P > 0.05). (2) In vitro experiment: The tooth microhardness of the whitening group was lower than that of the control group and the combined group (P < 0.05), but there was no significant difference between the control group and the combined group (P > 0.05). (3) The results show that the methods of micro-abrasion, at-home whitening combined with infiltration resin have good clinical efficacy in the treatment of micro-cracked dental fluorosis. Figures and Tables | References | Related Articles | Metrics

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Quercetin-loaded carboxymethyl chitosan hydrogel promotes wound healing in diabetic rats Dong Meilin, Du Haiyu, Liu Yuan 2025, 29 (4):  692-699.  doi: 10.12307/2025.218 Abstract ( 312 )   PDF (1469KB) ( 171 )   Save BACKGROUND: Quercetin has anti-inflammatory, anti-cancer, anti-oxidation, anti-aging, anti-depression and other pharmacological effects, and has high medicinal value. Quercetin can promote wound healing in normal rats, but few drugs with quercetin as the main component have been developed, which limits its wide application in clinical practice. OBJECTIVE: To investigate the application effect of quercetin-carboxymethyl chitosan hydrogel on diabetic wound in rats by loading quercetin with hydrogel material. METHODS: (1) Carboxymethyl chitosan hydrogels and quercetin-carboxymethyl chitosan hydrogels were prepared respectively, and the micromorphology and in vitro drug release properties of the hydrogels were characterized. (2) Cell experiment: Mouse L929 fibroblasts were cultured in four groups. The blank control group was cultured conventionally. Carboxymethyl chitosan hydrogel, quercetin solution and quercetin-carboxymethyl chitosan hydrogel were added to pure hydrogel group, drug group, and drug-loaded hydrogel group, respectively, to detect cell proliferation and migration ability. (3) Animal experiments: Diabetic models were established in 80 SD rats. After successful modeling, full-layer skin defect wounds with a diameter of 2 cm were made on the back of rats, and these models were randomly divided into four groups. Normal saline, carboxymethyl chitosan hydrogel, quercetin solution, and quercetin-carboxymethyl chitosan hydrogel were injected into the wounds of blank control group, pure hydrogel group, drug group, and drug-loaded hydrogel group, respectively. Each group contained 20 animals, which were bound with sterile gauze. Wound healing, pathological morphology, expression of inflammatory factors, and angiogenesis were observed after operation. RESULTS AND CONCLUSION: (1) Under scanning electron microscope, the microstructures of the two hydrogels were similar, both showed loose porous network structure, and quercetin-carboxymethyl chitosan hydrogels had good drug release performance in vitro. (2) Compared with blank control group, the cell proliferation and mobility of the other three groups were increased (P < 0.05). The cell proliferation and mobility of drug-loaded hydrogel group were higher than those of pure hydrogel group and drug group (P < 0.05). (3) The wound healing rate of the drug-loaded hydrogel group was higher than that of the other three groups at 5 and 11 days after operation. The wound healing rate of rats in the hydrogel group, pure hydrogel group, and drug group reached 100% 18 days after operation, which was higher than that in the blank control group (P < 0.05). Hematoxylin-eosin staining showed that intact skin and skin appendages were visible on the wounds of rats in the drug-loaded hydrogel group 18 days after surgery, while intact skin and skin appendages were visible on the wounds of rats in the blank control group, pure hydrogel group, and drug group 25 days after surgery. The levels of tumor necrosis factor α and interleukin-6 in the drug-loaded hydrogel group were lower than those in the blank control group at 5, 11, and 18 days after surgery (P < 0.05), and the levels of transforming growth factor β1 at 11 and 18 days after surgery were lower than those in the blank control group (P < 0.05). The mRNA expressions of CD31 and vascular endothelial growth factor α in the drug-loaded hydrogel group were higher than those in the other three groups at 11 and 18 days after operation (P < 0.05). (4) These findings indicate that quercetin in quercetin carboxymethyl chitosan hydrogel can regulate inflammatory response, accelerate angiogenesis, promote the proliferation and migration of fibroblasts, and enhance the healing of diabetic wounds in rats. Figures and Tables | References | Related Articles | Metrics

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Isolation and protection of organs at risk by crosslinked sodium hyaluronate gel during brachytherapy Liu Jianjian, Zhang Yan, Cui Zhiwei, Wang Dongfang, Liu Xu, Yang Shenglin, Chai Qian, Liu Fenglin 2025, 29 (4):  700-706.  doi: 10.12307/2025.252 Abstract ( 123 )   PDF (1291KB) ( 258 )   Save BACKGROUND: Crosslinked sodium hyaluronate gel has good mechanical property, biocompatibility, and biodegradability, and can be used as an isolated protective material in tumor radiation therapy to protect endangered organs from damage caused by excess radiation dose. OBJECTIVE : To investigate the safety and efficacy of crosslinked sodium hyaluronate gel in reducing the dose of radiation to dangerous organs during brachytherapy. METHODS: A total of 16 specific pathogen-free Kunming mice of the same age and similar body weight were selected as experimental subjects and divided into experimental group and control group by the random number table method, with 8 mice in each group. 125I seeds were implanted subcutaneously in the back of mice in the experimental group, and then crosslinked sodium hyaluronate gel was injected around the radioactive particles. Only 125I seeds were implanted subcutaneously in the back of mice in the control group. After injection, the distance between the radioactive particles and the epidermis was measured by spiral CT scan, and the surface radiation dose was measured by radiation dosimeter. Within 10 weeks after injection, the growth state, survival rate, skin radiation damage, and gel retention of mice were observed. RESULTS AND CONCLUSION: (1) Spiral CT scan showed that the implanted gel was relatively concentrated and created an effective distance between the radioactive seeds and the epidermis. The body surface radiation dose of the experimental group was significantly lower than that of the control group (P < 0.01). (2) During the experimental observation period, mice in both groups survived; mice in the control group showed obvious irritability and other unstable behavior in the late experimental period, and some mice in the experimental group showed similar behavior. The daily food intake of mice in the two groups had no significant change, and the body mass showed the same increasing trend. After implantation of radioactive seeds, the two groups of mice showed different degrees of radioactive skin injury. From day 23 after injection to the end of the experiment, the skin radiation injury score of the experimental group was lower than that of the control group (P < 0.01). At week 10 after implantation, 6 mice in the experimental group had no obvious gel residue under their skin, and 2 mice had a very small amount of scattered gel-like samples under their skin. (3) Therefore, the crosslinked sodium hyaluronate injection technique can increase the space between the radioactive target area of 125I seeds and the organ at risk outside the target through physical space occupying, which can effectively reduce the dose of the organ at risk, and play a role in the isolation and protection of the organ at risk. Figures and Tables | References | Related Articles | Metrics

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Effects of polylactic acid-glycolic acid copolymer/lysine-grafted graphene oxide nanoparticle composite scaffolds on osteogenic differentiation of MC3T3 cells Yu Shuangqi, Ding Fan, Wan Song, Chen Wei, Zhang Xuejun, Chen Dong, Li Qiang, Lin Zuoli 2025, 29 (4):  707-712.  doi: 10.12307/2025.259 Abstract ( 112 )   PDF (1631KB) ( 119 )   Save BACKGROUND: How to effectively promote bone regeneration and bone reconstruction after bone injury has always been a key issue in clinical bone repair research. The use of biological and degradable materials loaded with bioactive factors to treat bone defects has excellent application prospects in bone repair. OBJECTIVE: To investigate the effect of polylactic acid-glycolic acid copolymer (PLGA) composite scaffold modified by lysine-grafted graphene oxide nanoparticles (LGA-g-GO) on osteogenic differentiation and new bone formation. METHODS: PLGA was dissolved in dichloromethane and PLGA scaffold was prepared by solvent evaporation method. PLGA/GO composite scaffolds were prepared by dispersing graphene oxide uniformly in PLGA solution. LGA-g-GO nanoparticles were prepared by chemical grafting method, and the PLGA/LGA-g-GO composite scaffolds were constructed by blending LGA-g-GO nanoparticles at different mass ratios (1%, 2%, and 3%) with PLGA. The micromorphology,  hydrophilicity, and protein adsorption capacity of scaffolds of five groups were characterized. MC3T3 cells were inoculated on the surface of scaffolds of five groups to detect cell proliferation and osteogenic differentiation.   RESULTS AND CONCLUSION: (1) The surface of PLGA scaffolds was smooth and flat under scanning electron microscope, while the surface of the other four scaffolds was rough. The surface roughness of the composite scaffolds increased with the increase of the addition of LGA-g-GO nanoparticles. The water contact angle of PLGA/LGA-g-GO (3%) composite scaffolds was lower than that of the other four groups (P < 0.05). The protein adsorption capacity of PLGA/LGA-g-GO (1%, 2%, and 3%) composite scaffolds was stronger than PLGA and PLGA/GO scaffolds (P < 0.05). (2) CCK-8 assay showed that PLGA/LGA-g-GO (2%, 3%) composite scaffold could promote the proliferation of MC3T3 cells. Alkaline phosphatase staining and alizarin red staining showed that the cell alkaline phosphatase activity in PLGA/LGA-g-GO (2%, 3%) group was higher than that in the other three groups (P < 0.05). The calcium deposition in the PLGA/GO and PLGA/LGA-g-GO (1%, 2%, and 3%) groups was higher than that in the PLGA group (P < 0.05). (3) In summary, PLGA/LGA-g-GO composite scaffold can promote the proliferation and osteogenic differentiation of osteoblasts, and is conducive to bone regeneration and bone reconstruction after bone injury. Figures and Tables | References | Related Articles | Metrics

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Internal tension relieving technique assisted anterior cruciate ligament reconstruction to promote ligamentization of Achilles tendon grafts in small ear pigs in southern Yunnan province Xiong Bohan, Wang Guoliang, Yu Yang, Xue Wenqiang, Yu Hong, Liu Jinrui, Ruan Zhaohui, Li Yajuan, Liu Haolong, Dong Kaiyan, Long Dan, Chen Zhao 2025, 29 (4):  713-720.  doi: 10.12307/2025.222 Abstract ( 123 )   PDF (3793KB) ( 205 )   Save BACKGROUND: We have successfully established an animal model of small ear pig in southern Yunnan province with internal tension relieving technique combined with autologous Achilles tendon for anterior cruciate ligament reconstruction, and verified the stability and reliability of the model. However, whether internal tension relieving technique can promote the ligamentalization process of autologous Achilles tendon graft has not been studied. OBJECTIVE: To investigate the differences in the process of ligamentalization between conventional reconstruction and internal reduction reconstruction of the anterior cruciate ligament by gross view, histology and electron microscopy. METHODS: Thirty adult female small ear pigs in southern Yunnan province were selected. Anterior cruciate ligament reconstruction was performed on the left knee joint with the ipsilateral knee Achilles tendon (n=30 in the normal group), and anterior cruciate ligament reconstruction was performed on the right knee joint with the ipsilateral knee Achilles tendon combined with the internal relaxation and enhancement system (n=30 in the relaxation group). The autogenous right forelimb was used as the control group; the anterior cruciate ligament was exposed but not severed or surgically treated. At 12, 24, and 48 weeks after surgery, 10 animals were sacrificed, respectively. The left and right knee joint specimens were taken for gross morphological observation to evaluate the graft morphology. MAS score was used to evaluate the excellent and good rate of the ligament at each time point. Hematoxylin-eosin staining was used to evaluate the degree of ligament graft vascularization. Collagen fibers and nuclear morphology were observed, and nuclear morphology was scored. Ultrastructural remodeling was evaluated by scanning electron microscopy and transmission electron microscopy. RESULTS AND CONCLUSION: (1) The ligament healing shape of the relaxation group was better at various time points after surgery, and the excellent and good rate of MAS score was higher (P < 0.05). Moreover, the relaxation group could obtain higher ligament vascularization score (P < 0.05). (2) The arrangement of collagen bundles and fiber bundles in the two groups gradually tended to be orderly, and the transverse fiber connections between collagen gradually increased and thickened, suggesting that the strength and shape degree of the grafts were gradually improved, but the ligament remodeling in the relaxation group was always faster than that in the normal group at various time points after surgery. (3) The diameter, distribution density, and arrangement degree of collagen fibers in the relaxation group were better than those in the normal group at all time points, especially in the comparison of collagen fiber diameter between and within the relaxation group (P < 0.05).  Figures and Tables | References | Related Articles | Metrics

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Tannic acid modified interpenetrating network hydrogel promotes tissue remodeling of ruptured Achilles tendon after surgery#br# #br# Zhang Bo, Zhang Zhen, Jiang Dong 2025, 29 (4):  721-729.  doi: 10.12307/2025.251 Abstract ( 167 )   PDF (2442KB) ( 286 )   Save BACKGROUND: The regeneration and remodeling of Achilles tendon rupture after surgery are difficulties in clinical treatment. Tissue engineering hydrogels afford the possibility on the healing of postoperative Achilles tendon. OBJECTIVE: To investigate the effect of tannic acid modified interpenetrating network hydrogel on tissue regeneration and remodeling of ruptured Achilles tendon in rats. METHODS: (1) The interpenetrating network hydrogel was prepared under the blue light and the immersion of CaSO4 solution. The micromorphology, mechanical properties, adhesion properties, in vitro drug release properties, and biocompatibility of hydrogels were characterized. (2) Thirty Sprague-Dawley rats were randomly divided into sham operation group, operation group, and hydrogel group, with 10 rats in each group. The animal model of Achilles tendon rupture was established in the latter two groups. In the operation group, the ruptured Achilles tendon was sutured using the modified Kessler method. In the hydrogel group, the ruptured Achilles tendon was repaired by the same method, and the tannic acid modified interpenetrating network hydrogel patch was completely wrapped around the joint of the broken end. Four weeks after the operation, imaging examination, histological evaluation, biomechanical test, and the level test of inflammatory factors were performed.  RESULTS AND CONCLUSION: (1) Scanning electron microscope showed that tannic acid modified interpenetrating network hydrogels had porous microstructure with pore size of 3-10 μm, and the hydrogels had good in vitro drug release properties, adhesion strength and tensile strength. CCK-8 assay and live/dead staining showed that the hydrogel had no significant effect on the proliferation activity of rat bone marrow mesenchymal stem cells, and had good biocompatibility. (2) MRI imaging showed that compared with the operation group, the Achilles tendon in the hydrogel group showed uniform low signal, the thickness of the anteroposterior diameter of the Achilles tendon was reduced, and the boundary between the Achilles tendon and the surrounding tissue was more clear, and the performance was more similar to that of the sham operation group. Hematoxylin-eosin staining and Masson staining showed that the tendon fibers in the operation group were arranged in a loose and chaotic manner, with increased cell density and disordered arrangement, accompanied by obvious inflammatory cell infiltration, and intratendinous ossification appeared in some areas. In the hydrogel group, the tendon fibers were arranged in an orderly manner; the cell density was reduced and arranged orderly; the inflammatory cell infiltration was significantly reduced. The tensile strength of Achilles tendon in the operation group was lower than that in the sham operation group (P < 0.05). The tensile strength of Achilles tendon in the hydrogel group was higher than that in the operation group (P < 0.05). Compared with sham operation group, the mass concentration and mRNA expression of interleukin-1β, interleukin-6, and tumor necrosis factor α in Achilles tendon of rats were increased in the operation group (P < 0.05). Compared with the operation group, the level and mRNA expression of three inflammatory factors were decreased in the hydrogel group. (3) It is concluded that tannic acid modified interpenetrating network hydrogel can inhibit the local inflammatory response and promote the tendon remodeling. Figures and Tables | References | Related Articles | Metrics

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Biocompatibility of poly(vinylidene fluoride) piezoelectric bionic periosteum prepared by electrospinning Zhao Shuai, Li Dongyao, Wei Suiyan, Cao Yijing, Xu Yan, Xu Guoqiang 2025, 29 (4):  730-737.  doi: 10.12307/2025.257 Abstract ( 130 )   PDF (1576KB) ( 158 )   Save BACKGROUND: Our previous studies have found that poly(vinylidene fluoride) bionic periosteum prepared by electrospinning has good cytocompatibility, but its biocompatibility is unknown. OBJECTIVE: To evaluate the biocompatibility of poly(vinylidene fluoride) bionic periosteum doped with Zn2+ and Mg2+.  METHODS: Poly(vinylidene fluoride), poly(vinylidene fluoride) bionic periosteum doped with 1% Zn2+, doped with 1% Mg2+, and doped with 1% (Zn2++Mg2+) were prepared by electrospinning to make bionic periosteum extract. SD rats were selected as the experimental subjects for hemolysis test, short-term systemic toxicity test, and heat source test. Guinea pigs were selected as the experimental subjects for skin sensitization test. The biocompatibility of bionic periosteum of four groups was tested.  RESULTS AND CONCLUSION: (1) The hemolysis test results showed that the hemolysis rates of 1% Zn2+ poly(vinylidene fluoride), 1% Mg2+ poly (vinylidene fluoride), 1% Zn2++1% Mg2+ poly(vinylidene fluoride) bionic periosteum and poly(vinylidene fluoride) extract were (0.130±0.013)%, (0.149±0.020)%, (0.466±0.018)%, and (0.037±0.018)%, respectively, which met the hemocompatibility standard of biomaterials. (2) The results of short-term systemic toxicity test showed that the four groups of bionic periosteal extract had no toxic signs such as body mass reduction, food intake changes, and dyspnea in SD rats, and had no toxic effects on major organs of rats. (3) Heat source test results showed that after intervention with poly(vinylidene fluoride) bionic periosteum doped with 1% Zn2+, doped with 1% Mg2+, and doped with 1% (Zn2++Mg2+),  and poly(vinylidene fluoride) bionic periosteum extract, the elevated body temperature values of SD rats were (0.133±0.058), (0.100±0.010), (0.300±0.010), and (0.300±0.017) °C, respectively. All were less than 0.6 °C, and the total temperature increase was less than 1.4 °C. (4) The results of skin sensitization test showed that no erythema or edema was observed under the skin of guinea pigs after the intervention of bionic periosteum extract of four groups. (5) The results showed that poly(vinylidene fluoride) and poly(vinylidene fluoride) bionic periosteum doped with Zn2+ and Mg2+ had good biocompatibility.  Figures and Tables | References | Related Articles | Metrics

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Accuracy of modified implant template of assisted implantation in missing second molars Zhang Yuhang, Zeng Yuning, Zeng Jindi, Lu Yixuan, Ye Hui, Ji Jianxin 2025, 29 (4):  738-744.  doi: 10.12307/2025.220 Abstract ( 113 )   PDF (1245KB) ( 211 )   Save BACKGROUND: Computer-assisted implant surgery can improve implantation accuracy, but the use of implant template in the posterior tooth area is limited for patients with small opening and small interocclusal distance. Therefore, the digital guide has been improved. OBJECTIVE: To study the effect of modified implant template on the accuracy of assisted implantation in missing second molars. METHODS: From July 2020 to July 2023, 40 patients who received digital guide plate implantation or free hand implantation to repair missing second molars were selected from First Affiliated Hospital of Guangzhou Medical University. According to the coin toss method, patients were randomly divided into a trial group (n=22; modified digital guide assisted implantation) and a control group (n=18; free hand implantation). The data of neck deviation, tip deviation, depth deviation, and angle deviation were compared between groups for preoperative and postoperative cone beam CT overlap analysis. One week after the operation, the patients’ satisfaction with the operation was assessed by visual analog scale score. RESULTS AND CONCLUSION: (1) The trial group included 25 implants (12 in the upper jaw and 13 in the lower jaw); the control group included 23 implants (8 in the upper jaw and 15 in the lower jaw). The neck deviation, tip deviation, depth deviation, and angle deviation of the trial group were all smaller than those of the control group (P < 0.05, P < 0.001). There was no significant difference in accuracy between the maxillary and mandibular implant site in the trial group  (P > 0.05). (2) There was no significant difference in satisfaction with the operation between the two groups (P > 0.05). (3) The results showed that improving the digital guide plate for assisted implantation for missing second molar can improve surgical accuracy and is suitable for patients with small opening and small interocclusal distance in the posterior tooth area. Figures and Tables | References | Related Articles | Metrics

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Decellularized skin matrix/polyurethane blended fibrous scaffolds promote repair of skin defects in rats Wu Chen, Jiang Jiahui, Su Dou, Liu Chen, Ci Chao 2025, 29 (4):  745-751.  doi: 10.12307/2025.229 Abstract ( 116 )   PDF (2858KB) ( 173 )   Save BACKGROUND: It has been confirmed that the mixing of decellularized matrix and polymer electrospinning can not only improve the structural properties of fibers, but also preserve the biological decellularized of decellularized matrix. However, there is no relevant report on the preparation of skin tissue engineering scaffolds by electrospinning polyurethane and decellularized skin matrix. OBJECTIVE: To investigate the reparative effect of a decellularized skin matrix/polyurethane blended fibrous scaffold on rat skin defects.  METHODS: Polyurethane electrospun fibrous scaffold and decellularized skin matrix/polyurethane blended fibrous scaffold were fabricated using the electrospinning technique. The fiber structure was observed under scanning electron microscope. Rat adipose mesenchymal stem cells were inoculated on two kinds of scaffolds respectively. The morphology of the scaffolds was observed under scanning electron microscope. Three full-thickness skin defects of 1 cm×1 cm were fabricated on the back of 10 SD rats. Polyurethane electrospun fibrous scaffolds (control group) and decellularized skin matrix/polyurethane blended fibrous scaffolds (experimental group) were implanted in two of the defects, and no material was implanted in the remaining defects (blank control group). The skin wound healing was observed at 1, 2, and 3 weeks after operation. At 3 weeks after implantation, the wound was stained with hematoxylin and eosin and the scar area was calculated. RESULTS AND CONCLUSION: (1) Under scanning electron microscope, the two kinds of electrospun fibers were reticulated, and the rat adipose mesenchymal stem cells attached to the fibers on the two kinds of scaffolds, and the adhesion was good. (2) With the extension of the postoperative time, the skin wounds of each group gradually healed. By week 3 after the operation, the skin wounds of the experimental group and the control group were basically healed, and small ulcers could be seen on the wounds of the blank control group. Hematoxylin-eosin staining of skin wounds showed that the epidermal coverage of the wound was basically complete in the control group and the experimental group, and fibroblast growth and inflammatory cell infiltration could be seen in the dermis. In addition, the collagen fibers of the wound in the experimental group were abundant and arranged in a regular order, basically parallel to the epidermal surface. The wound epidermis of blank control group was still defective. The scar area of the experimental group was smaller than that of the other two groups (P < 0.05, P < 0.01). (3) These results indicate that the decellularized skin matrix/polyurethane blended fibrous scaffold can effectively repair full-thickness skin defects and improve scar formation in rats.  Figures and Tables | References | Related Articles | Metrics

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Research frontiers and hotspots of carbon nanomaterials in biomedical field over the past 10 years Dang Xiaowen, Huang Hailiang, Huang Lei, Wang Yajie 2025, 29 (4):  752-760.  doi: 10.12307/2024.812 Abstract ( 367 )   PDF (2080KB) ( 407 )   Save BACKGROUND: Research on carbon nanomaterials in the biomedical field is booming, and related scientific research results are increasing year by year. However, visualization analysis of the annual number of publications, the research status of countries, institutions, authors, and research hotspots and trends in this field is relatively scarce.  OBJECTIVE: To present the research status of carbon nanomaterials in biomedical field, reveal the main research subjects, explore the research hotspots and development trends, and provide a reference for the future development of this field.  METHODS: The core data set of Web of Science was used as the literature source to search the relevant researches on carbon nanomaterials in the biomedical field from 2012 to 2023. The knowledge map was generated by using Citespace software with countries, institutions, authors, keywords, and co-citations as nodes and for visualization analysis.  RESULTS AND CONCLUSION: (1) A total of 2 932 papers were included in this study. In the medical field, carbon nanomaterials had a large number of papers and a fast growth rate. The United States has a large number of papers; China is an emerging force in this field, although the number of papers is the largest, but the level of research and influence need to be improved. The Chinese Academy of Sciences is the largest cooperative network institution, which mainly targets domestic institutions and lacks cooperation with well-known foreign institutions. (2) Keyword analysis displays that the green synthesis method and application of displaying carbon points have been the focus of research, followed by the new method of combining carbon nanomaterials with cancer phototherapy and immunotherapy, the key direction of future research. (3) The dynamic development trend of co-citations suggests that tissue engineering is a hot research topic of carbon nanomaterials in the field of biomedicine, mainly including the research of carbon nanomaterials for the repair and regeneration of heart and nerve tissue and as a bio-ink additive for 3D and 4D bioprinting. (4) In the future, with the development of the biomedical field in the direction of precision and treatment, researchers should speed up the creation of carbon-based systems formed by the combination of scientific and effective carbon nanomaterials with science and technology, new polymers or organic molecules, and new therapeutic methods, so as to give full play to the maximum effect of carbon nanomaterials. Figures and Tables | References | Related Articles | Metrics

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Visualization analysis of research hotspots of artificial intelligence in field of spinal cord nerve injury and repair Yang Bin, Tao Guangyi, Yang Shun, Xu Junjie, Huang Junqing 2025, 29 (4):  761-770.  doi: 10.12307/2025.216 Abstract ( 326 )   PDF (2336KB) ( 453 )   Save BACKGROUND: In recent years, artificial intelligence has gradually emerged and has been applied in various fields such as spinal cord nerve injury and repair, which has a positive impact on clinical treatment. OBJECTIVE: To study the application progress of artificial intelligence in the diagnosis, treatment, and rehabilitation of spinal cord nerve injury and repair, clarify the research hotspots and shortcomings in this field, and provide suggestions for future research work. METHODS: Relevant literature on artificial intelligence in the field of spinal cord nerve injury and repair was retrieved on the Web of Science core collection database until 2023. CiteSpace 6.1.R6 and VOSviewer 1.6.19 software was used to perform general literature analysis, co-citation of literature, co-citation of journals, double image overlay of journals, keyword clustering, and other visual analysis on the literature data. RESULTS AND CONCLUSION: (1) A total of 1 713 articles were selected, and the annual publication volume in this field showed a fluctuating upward trend, with the United States taking the lead, and Kadone and Hideki being the authors with the highest publication volume. ARCH PHYS MED REHAB was the journal with the highest number of citations. (2) Keyword co-occurrence and cluster analysis showed that after removing keywords similar to the search terms, the main keywords were divided into three main clusters: Exoskeleton and exercise rehabilitation (the largest core hotspot); machine learning and neural plasticity; robotics and rehabilitation training. (3) Keyword burst analysis showed that deep learning and artificial intelligence had become burst terms in the past five years. (4) The results of in-depth analysis of co cited and highly cited literature showed that the hotspots of artificial intelligence in the field of spinal cord nerve injury and repair were mainly focused on powered exoskeletons, gaits, electrical nerve stimulation, intracortical brain-computer interface (IBCI), robots, and polymer biomaterials, and neural stem cell. (5) The research on artificial intelligence in the field of spinal cord nerve injury and repair has shown an upward trend in recent years. The focus of this field had gradually shifted from single treatment methods such as exoskeletons and electrical stimulation to intelligent, precise, and personalized directions. (6) There were some limitations in this field, such as the consequences of missing or imbalanced data, low data accuracy and reproducibility, and ethical issues (such as privacy, research transparency, and clinical reliability). Future research should address the issue of data collection, requiring large sample, high-quality clinical datasets to establish effective artificial intelligence models. At the same time, the research on genomics and other mechanisms in this field is very weak. In the future, various machine learning technologies such as brain chips can be used, and gene editing therapy, single-cell spatial transcriptome and other methods can be used to study the basic mechanisms of regeneration-related gene upregulation and axon growth structural protein production. Figures and Tables | References | Related Articles | Metrics

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Protective effects of platelet-rich plasma hydrogel on oxidative damage in L929 cells Wang Zilin, Mu Qiuju, Liu Hongjie, Shen Yuxue, Zhu Lili 2025, 29 (4):  771-779.  doi: 10.12307/2025.215 Abstract ( 178 )   PDF (4194KB) ( 161 )   Save BACKGROUND: During healing process of chronic wounds, excessive production of reactive oxygen species can impair the function of L929 fibroblasts, thereby delaying wound repair. Therefore, protecting fibroblasts from oxidative stress is important to promote wound healing.  OBJECTIVE: To assess the protective effects of carboxymethyl chitosan-oxidized chondroitin sulfate/platelet-rich plasma (CMC-OCS/PRP) hydrogel on L929 cells under H2O2 stimulation.   METHODS: CMC-OCS/PRP hydrogels were prepared, and the micromorphology, degradation performance, scavenging ability of H2O2 and hydroxyl radical and biocompatibility of the hydrogels were characterized. L929 cells with good growth state were taken and cultured in five groups. The control group was cultured conventionally. H2O2 was added to the H2O2 group. Carboxymethyl chitosan-oxidized chondroitin sulfate hydrogel extract + H2O2 was added to the CMC-OCS group. Platelet-rich plasma gel extract + H2O2 was added to the PRP group. The CMC-OCS/PRP group was treated with carboxymethyl chitosan-oxidized chondroitin sulfate/platelet-rich plasma hydrogel extract + H2O2. Each group was treated with hydrogel extract for 6 hours, and then H2O2 for 24 hours. After culture, the levels of active oxygen and malondialdehyde, apoptosis and expression of collagen fiber I protein were detected. In the presence of H2O2, the above hydrogel extracts were directly or indirectly co-cultured with L929 fibroblasts for 36 hours, respectively. Migration ability of the cells was detected by scratch test and Transwell chamber test. RESULTS AND CONCLUSION: (1) CMC-OCS/PRP hydrogels had uniform and interrelated porous structure and good degradation ability, could effectively remove H2O2 and hydroxyl radicals in vitro, and had good biocompatibility. (2) Compared with the control group, the apoptosis rate, reactive oxygen species, and malondialdehyde levels were increased (P < 0.05); the spread area of cells was decreased (P < 0.05), and the expression of collagen fiber I protein had no significant changes (P > 0.05) in the H2O2 group. Compared with the H2O2 group, reactive oxygen species level was decreased in the CMC-OCS group (P < 0.05), malondialdehyde level was decreased (P < 0.05), and cell spread area was increased (P <0.05) in the PRP group, CMC-OCS group, and CMC-OCS/PRP group; apoptosis rate was decreased in the CMC-OCS/PRP group (P < 0.05), and collagen fiber I protein expression was increased in the PRP group, CMC-OCS group, and CMC-OCS/PRP group (P < 0.05). (3) Compared with the control group, the number of cell migration was decreased (P < 0.05), and the migration area had no significant change (P > 0.05) in the H2O2 group. Compared with the H2O2 group, the number and area of cell migration were increased in the PRP group, CMC-OCS group, and CMC-OCS/PRP group (P < 0.05), and the increase was most significant in the CMC-OCS/PRP group. (4) Under oxidative stress, CMC-OCS/PRP hydrogel can improve the migration ability of fibroblasts, resist cell apoptosis, and preserve cell extension function. Figures and Tables | References | Related Articles | Metrics

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Near-infrared photoresponsive h-PCuNF nanoparticles mediate multimodal therapeutics against malignant tumors Chen Yaodong, Ren Jiayi, Cao Jingwei, Fan Wenwen, Chen Wu 2025, 29 (4):  780-788.  doi: 10.12307/2025.255 Abstract ( 120 )   PDF (4538KB) ( 201 )   Save BACKGROUND: Precision therapy based on multifunctional nanomaterials is a novel therapeutic model for malignancies that can integrate multiple imaging and therapeutic models into one nanoscale platform to achieve visual combination treatment. OBJECTIVE: To prepare novel nanoparticles loaded with Cu2(OH)PO4 nanoparticles (CuNPs) and nuciferine (NF) (h-PCuNF), and to explore their ability to mediate combined photothermal therapy/photodynamic therapy/chemodynamic therapy/chemotherapy for malignancy.  METHODS: The h-PCuNF nanoparticles were synthesized through a double-emulsion procedure, through which the CuNPs and NF were loaded into the shell of hollow poly(lactic-co-glycolic) acid nanocarriers. The morphology, structure, particle size, and zeta potential of the h-PCuNF nanoparticles were characterized. In deionized water, the magnetic resonance imaging and photothermal conversion performances of the h-PCuNF nanoparticles, as well as their capability to implement reactive oxygen species production by mediating photocatalysis and Fenton-like reactions, were evaluated. In liver malignant tumor cell line HepG2 cells, the effectiveness of the photothermal therapy/photodynamic therapy/chemodynamic therapy/chemotherapy combination therapy mediated by the nanoparticles was detected by employing fluorescence imaging and MTT assay. RESULTS AND CONCLUSION: (1) The h-PCuNF nanoparticles possessed a hollow spherical structure in which the CuNPs (drug loading rate and encapsulation rate were 26.3% and 63.2%, respectively) and NF (drug loading rate and encapsulation rate were 11.0% and 52.6%, respectively) were loaded into the shell. The average particle size of the h-PCuNF nanoparticles was (309.2±10.0) nm, while the zeta potential was determined to be (-12.5±0.9) mV. In physiological environments, the nanoparticles possess favorable suspension stability. (2) In deionized water, the h-PCuNF nanoparticles could markedly enhance T1-weighted magnetic resonance imaging images. The h-PCuNF nanoparticles showed remarkable photothermal conversion and photocatalytic reactive oxygen species generation capabilities under near infrared laser irradiation. In addition, the h-PCuNF nanoparticles could consume glutathione and mediate Fenton-like reactions to produce ·OH. (3) The h-PCuNF nanoparticles could be taken up by HepG2 tumor cells and were mainly distributed in the cytoplasm. The synergistic therapeutic effect was demonstrated after the nanoparticles were activated by near infrared laser irradiation, because CuNPs mediated photothermal therapy/photodynamic therapy/chemodynamic therapy and NF mediated chemotherapy could synergistically eliminate the tumor cells. Figures and Tables | References | Related Articles | Metrics

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miRNA-378a overexpression of macrophage cell line composite collagen sponge: anti-inflammation and tissue repair promotion Wang Sifan, He Huiyu, Yang Quan, Han Xiangzhen 2025, 29 (4):  789-799.  doi: 10.12307/2025.263 Abstract ( 102 )   PDF (3658KB) ( 259 )   Save BACKGROUND: The regulation of M1/M2 polarization direction of macrophages is particularly critical in tissue engineering applications, and timely regulation can minimize proinflammatory, anti-inflammatory, or tissue healing responses. OBJECTIVE: To implant lentivirus-mediated miRNA-378a macrophage strain complex collagen to detect the expression level of immune regulation in the in vivo environment, and further clarify the influence of miRNA-378a in promoting macrophage M2 polarization in immune regulation and tissue repair in the in vivo environment. METHODS: Lentivirus-mediated miRNA-378a overexpressing macrophage cell lines and negative control virus macrophage lines were amplified and screened, and the macrophage lines were recovered and cultured together with collagen sponge to form a composite scaffold, which was divided into the following groups: (1) Positive group: miRNA-378a overexpressing macrophage-collagen sponge composite; (2) negative group: negative control of virus-mediated miRNA-378a macrophage-collagen sponge composite; (3) control group: macrophage-collagen sponge; (4) blank control group: collagen sponge. The cell density, phenotype, and adhesion of each group were observed by immunofluorescence and scanning electron microscopy. The cells were implanted into the subcutaneous model of the back of mice, and the mice were sacrificed 4 and 7 days after modeling. The direction of macrophage polarization in the collagen sponge composite of macrophages with miRNA-378a overexpression mediated by lentivirus and its effect on immune regulation and tissue repair were analyzed by gross observation, hematoxylin-eosin staining, MASSON staining, and immunohistochemistry. RESULTS AND CONCLUSION: (1) Under immunofluorescence microscopy, the macrophage cell lines in each group were observed to form a composite scaffold with the collagen sponge. (2) Under scanning electron microscope, lentivirus-mediated miRNA-378a macrophages in the positive group proliferated in cell density, had spherical, elliptic and polygonal differentiation, and had more pseudofeet than other groups. (3) Under general observation, the overall 7-day healing was better than that at 4 days. Lentivirus-mediated miRNA-378a macrophages in the positive group healed better than other groups regardless of 4 and 7 days. (4) Lentivirus-mediated miRNA-378a macrophages in the positive group under hematoxylin-eosin staining and MASSON staining had more amounts of fibrocytes, capillaries, fibroblasts, and collagen fiber hyperplasia. (5) Immunohistochemistry showed that lentivirus-mediated miRNA-378a macrophages in the positive group were more positive in 4- and 7-day M2 polarized cells than in other groups. The macrophages of the control and negative groups in 4- and 7-day M2 polarized cells were greater than that of the blank control group. There was no statistical difference between the control group and the negative group. The number of stained cells in the positive, negative, and control groups regardless of 4 and 7 days was higher than that in the blank control group, and the positive group > negative group ≈ control group > blank control group. (6) It is concluded that macrophages with miRNA-378a overexpression have a large amount of fibroblasts, capillaries, fibroblasts, and collagen fiber hyperplasia in vivo, which has a positive effect on tissue repair, and can promote the polarization of macrophages towards M2 type and inhibit the polarization of M1 type, thus contributing to reducing the inflammatory response of the body.  Figures and Tables | References | Related Articles | Metrics

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Dispersion effect of bone cement after vertebroplasty using individualized unilateral external pedicle approach and bilateral pedicle approach Zhang Lichuang, Yang Wen, Ding Guangjiang, Li Peikun, Xiao Zhongyu, Chen Ying, Fang Xue, Zhang Teng 2025, 29 (4):  800-808.  doi: 10.12307/2025.253 Abstract ( 106 )   PDF (2129KB) ( 177 )   Save BACKGROUND: According to existing clinical studies, vertebroplasty treatment with both the external pedicle approach and the pedicle approach can improve the pain and quality of life of patients with spinal compression fractures. Compared with the pedicle approach, the external pedicle approach has a freer puncture angle, and good bone cement dispersion effect can be obtained by adjusting the puncture angle. OBJECTIVE: To compare the impact of vertebroplasty through individualized unilateral external pedicle approach and bilateral pedicle approach on the treatment of spinal compression fractures by quantifying the dispersion effect of bone cement. METHODS: A total of 80 patients with thoracolumbar compression fracture were divided into two groups by random number table method. The bilateral pedicle group (n=40) underwent vertebroplasty through a bilateral pedicle approach, while the unilateral external pedicle group (n=40) underwent individualized vertebroplasty through a unilateral external pedicle approach. Anteroposterior and lateral X-rays of the affected vertebrae from two groups of patients were photographed to assess effect and type of bone cement dispersion within 3 days after surgery. Visual analog scale score, tenderness threshold around fracture, and Oswestry dysfunction index were assessed before, 1, 7 days, and 1 month after surgery.  RESULTS AND CONCLUSION: (1) Dispersion effect of bone cement in unilateral external pedicle group was better than that in bilateral pedicle group (P < 0.001), and the amount of bone cement perfusion was higher than that in bilateral pedicle group (P < 0.001). In the bilateral pedicle group, the bone cement dispersion types were mainly concentrated in type I and type III, while in the unilateral external pedicle group, the bone cement dispersion types were mainly concentrated in type I and type II, and there was a significant difference in bone cement dispersion types between the two groups (P < 0.001). (2) Postoperative visual analog scale scores and Oswestry disability index of both groups were lower than those before surgery (P < 0.001), and postoperative tenderness threshold around fracture showed a trend of decreasing first and then increasing. At the same time point after treatment, there were no significant differences in visual analog scale score, Oswestry disability index, and tenderness threshold around fracture between the two groups (P > 0.05). (3) The results indicate that individualized vertebroplasty via unilateral external pedicle approach can achieve better bone cement dispersion, and the treatment effect is consistent with the vertebroplasty via classical bilateral pedicle approach. Figures and Tables | References | Related Articles | Metrics

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Osteogenic properties of platelet-rich fibrin combined with gelatin methacryloyl hydrogel Zhao Hongxia, Sun Zhengwei, Han Yang, Wu Xuechao , Han Jing 2025, 29 (4):  809-817.  doi: 10.12307/2025.227 Abstract ( 178 )   PDF (2492KB) ( 231 )   Save BACKGROUND: Platelet-rich fibrin (PRF) has many advantages, such as simple preparation, low production cost, and high safety, and has been widely used in the study of bone defect repair in oral and maxillofacial surgery, but there are problems such as too fast degradation rate and short release time of growth factors. OBJECTIVE: PRF was loaded into gelatin methacryloyl (GelMA) hydrogel and its osteogenic properties were analyzed by in vivo and in vitro experiments.  METHODS：(1) New Zealand white rabbit venous blood was extracted to prepare PRF. GelMA hydrogels containing 0, 0.05, 0.075, : and 0.1 g PRF were prepared, respectively, and were recorded as GelMA, GelMA/PRF-0.05, GelMA/PRF-0.075, and GelMA/PRF-0.1, respectively, to characterize the micromorphology and in vitro slow-release properties of the hydrogels. (2) Four kinds of hydrogels were co-cultured with MC3T3-E1 cells, respectively, and the cell proliferation activity was detected with the single cultured cells as the control. After osteogenic induction, alkaline phosphatase activity, mineralization ability, mRNA and protein expression levels of osteogenic genes (osteocalcin, osteopontin, RUNX2), ERK1/2-p38 MAPK pathway protein mRNA and protein expression levels were detected. (3) Fifteen New Zealand white rabbits were taken. Four full-layer bone defects of 8 mm diameter were prepared in the skull of each rabbit, one of which was implanted without any material (blank control group), and the other three were implanted with GelMA hydrogel, PRF, and GelMA/PRF-0.1 hydrogel, respectively. The bone defect was detected by Micro-CT and bone morphology was observed at 4, 8, and 12 weeks after operation. RESULTS AND CONCLUSION: (1) Scanning electron microscopy observed that all the hydrogels of the four groups had honeycomb pore structure, and the pore size of the hydrogels decreased slightly with the increase of PRF content, but there was no significant difference between the groups. The three groups of GelMA/PRF hydrogel could release transforming growth factor β1 and insulin-like growth factor 1 at a certain rate, and the cumulative release of transforming growth factor β1 and insulin-like growth factor 1 increased significantly with the extension of time. (2) CCK-8 assay and live/dead staining showed that GelMA/PRF hydrogel could promote the proliferation of MC3T3-E1 cells. The results of alkaline phosphatase staining, alizarin red staining, and osteogenic gene detection showed that GelMA/PRF hydrogel could promote the osteogenic differentiation of MC3T3-E1 cells, and inhibit the expression of ERK1/2-p38 MAPK pathway protein, and showed a PRF content dependence. (3) Micro-CT scan showed that the bone mineral density and bone volume fraction in the bone defect of GelMA/PRF-0.1 hydrogel group were higher than those in the other three groups (P < 0.05). Hematoxylin-eosin staining showed that compared with the other three groups, GelMA/PRF-0.1 hydrogel group had faster and more mature new bone formation at the bone defect. (4) These findings indicate that GelMA/PRF hydrogel has good osteogenic activity both in vivo and in vitro, which may be related to inhibiting the expression of ERK1/2-p38 MAPK pathway protein. Figures and Tables | References | Related Articles | Metrics

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Finite element analysis of bioabsorbable plates versus miniature titanium plates in mandibular fracture fixation in different bone qualities Zhou Zonghao, Luo Siyang, Chen Jiawen, Chen Guangneng, Feng Hongchao 2025, 29 (4):  818-826.  doi: 10.12307/2025.223 Abstract ( 136 )   PDF (2988KB) ( 233 )   Save BACKGROUND: The healing of mandibular fractures after rigid internal fixation is influenced by many factors, including the material of the bone plate, fracture site, and bone density of the patient. However, there are relatively few studies on the relationship between the stability of mandibular fracture fixation in different bone qualities and they lack a scientific basis.  OBJECTIVE: To analyze the stability of fixation of mandibular fractures with different bone qualities with bioabsorbable plates and miniature titanium plates by finite element analysis. METHODS: Three-dimensional finite element models of class I-IV mandibular fractures were developed according to the bone quality classification method proposed by ZARB and LEKHOLM. The fractures at the median mandibular symphysis, mandibular body, and mandibular angle were simulated under different bone qualities. Bioabsorbable bone grafting plates (or miniature titanium plates) were placed at each fracture site for fixation and to simulate the state of healthy side occlusion. Finite element analysis on the model was used to analyze the relative displacement of the fracture segments and the stress distribution of fixators.  RESULTS AND CONCLUSION: (1) The maximum stress value during fixation with titanium plates increased gradually with the increase of bone class, in which the maximum stress value of titanium plates was the highest in the mandibular body class IV bone group, which was 382.74 MPa and 96.11 MPa in the miniature titanium plate and bioabsorbable plate groups. The results for mandibles of the same bone type showed that the maximum stress value of titanium plates was much higher than that of bioabsorbable plates. (2) For fractures of the median middle of the mandible in types III and IV, the displacement of the fracture breaks at the fixation site was large and exceeded the limiting value of bone healing (> 150 µm), regardless of whether the fixation was performed with a miniature titanium plate or a bioabsorbable plate. For type IV mandibular fractures, the fracture end displacement in the bioabsorbable plate group exceeded the healing limit value, and the fracture end displacement in the miniature titanium plate group was close to the healing limit value. Under the same bone quality and fracture site, the fracture displacement of the miniature titanium plate group was smaller than that of the bioabsorbable plate group. (3) The results showed that the strength and stiffness of the two internal fixations were sufficient to support bone healing of fractures at three sites of the types I-IV mandible, and the fixation stability of the bioabsorbable plate was almost the same as that of the miniature titanium plate, which could provide early healing conditions for fractures. Mandibular bone type should be taken into consideration in the treatment of mandibular fracture. The higher the mandibular bone grade, the worse the stability of fracture fixation, and the more likely the complications such as poor bone healing will occur after surgery. Figures and Tables | References | Related Articles | Metrics

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Magnetic nanomaterials and magnetic field effects accelerate bone injury repair Xiao Fang, Huang Lei, Wang Lin 2025, 29 (4):  827-838.  doi: 10.12307/2024.811 Abstract ( 288 )   PDF (1837KB) ( 335 )   Save BACKGROUND: Magnetic nanomaterials have biological activities such as promoting osteogenic differentiation of stem cells and inhibiting osteoclast formation, and can effectively promote the healing of injured bone tissue under the synergistic effect of magnetic fields. They have a very broad application prospect in bone injury repair.  OBJECTIVE: To review the mechanism of magnetic nanomaterials and magnetic fields promoting bone repair, as well as their research progress in the field of bone injury repair. METHODS: Relevant literature search was conducted in PubMed and Web of Science databases with the search terms “magnetic nanomaterials, magnetic field, bone repair, bone tissue engineering, stem cell, osteoblast, osteoclast.” The time limit of literature search was from 2003 to 2023, which was screened and analyzed. Some classic articles were manually retrieved, and 98 articles were finally included for analysis.   RESULTS AND CONCLUSION: (1) Magnetic nanomaterials have biological effects such as promoting osteoblast differentiation, inhibiting osteoclast formation and regulating the immune microenvironment. In addition, magnetic nanomaterials can regulate the physicochemical properties of tissue engineering scaffolds, such as mechanical properties and surface morphology, and endowed with magnetic properties, which is conducive to the regulation of the adhesion, proliferation and osteogenic differentiation of stem cells. (2) The magnetic field has the ability to regulate multiple cell signaling pathways to promote osteoblast differentiation, inhibit osteoclast formation, stimulate angiogenesis and other biological effects, thus accelerating the healing of damaged bone tissue. (3) The joint application of magnetic nanomaterials and magnetic field accelerates the repair of bone damage by activating mechanotransduction, increasing the content of intracellular magnetic nanoparticles, and enhancing the effect of micro-magnetic field, which provides a new idea for the research of bone tissue engineering. (4) Magnetic field has demonstrated definite efficacy in the treatment of clinical fractures, osteoporosis, and osteoarthritis diseases, which is beneficial for bone tissue growth, reducing bone loss, alleviating pain, and improving the quality of life of patients. (5) Magnetic nanomaterials and magnetic fields have great potential for application in bone damage repair and regeneration, but the interaction mechanism between magnetic nanomaterials, magnetic fields, and cells has not been fully elucidated. Moreover, the key parameters of magnetic fields that regulate intracellular molecular events, including the type, intensity, frequency, duration, and mode of the magnetic field, as well as the precise biological effects of a specific magnetic field on osteoblasts and the underlying mechanisms, have yet to be defined. (6) Further attention needs to be paid to the effects on osteoclasts, nerves, blood vessels, and immune cells in the microenvironment of damaged tissues. Finally, the safety of magnetic materials for human use is yet to be systematically studied in terms of their distribution, metabolism, and acute and chronic toxicities. Figures and Tables | References | Related Articles | Metrics

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Application, research hotspots, and shortcomings of degradable zinc-based alloys in bone defect repair and reconstruction Liu Haoyang, Xie Qiang, Shen Mengran, Ren Yansong, Ma Jinhui, Wang Bailiang, Yue Debo, Wang Weiguo 2025, 29 (4):  839-845.  doi: 10.12307/2025.213 Abstract ( 224 )   PDF (1190KB) ( 164 )   Save BACKGROUND: Zinc-based alloy medical implant materials have excellent mechanical properties, complete degradability and good biocompatibility, and are mainly used in orthopedic implants, cardiovascular stents, bile duct stents, tracheal stents, nerve catheters, etc. OBJECTIVE: To review the research progress of biodegradable zinc-based alloys in bone defect repair and prospect the promising research direction and achievements of zinc-based materials.  METHODS: After searching PubMed, Web of Science, WanFang Data, and CNKI databases from the establishment of the database to June 2023, various relevant articles on biodegradable zinc-based alloys for bone implant material research were collected. The basic characteristics of biodegradable zinc based alloys were summarized, and the role of zinc-based alloys in promoting bone tissue repair was sorted and summarized. The current research hotspots and shortcomings were discussed. RESULTS AND CONCLUSION: (1) Zinc-based alloys have good biocompatibility. Using zinc-based alloys as the matrix material, with the help of scaffold structure construction technology and coating optimization process, the bone conductivity of zinc-based alloys will be effectively improved, and their degradation products will have efficient bone induction to regulate the gene expression of osteoblasts and osteoclasts, thereby promoting the repair and reconstruction of bone defects. (2) However, in the research on optimizing zinc-based alloys, the coating process is relatively insufficient, and additive loading technology is still lacking. (3) Zinc-based alloys have excellent mechanical and biological properties. Through special processes, their bone conductivity and osteoinductivity can be increased to effectively improve their ability to promote bone repair and reconstruction, and it is expected to further achieve the development of personalized transplant materials. Further research and development are needed to optimize the integration of coating and additive loading technologies into zinc-based alloys. Figures and Tables | References | Related Articles | Metrics

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Gradient artificial bone repair scaffold regulates skeletal system tissue repair and regeneration Zhang Yu, Xu Ruian, Fang Lei, Li Longfei, Liu Shuyan, Ding Lingxue, Wang Yuexi, Guo Ziyan, Tian Feng, Xue Jiajia 2025, 29 (4):  846-855.  doi: 10.12307/2025.214 Abstract ( 274 )   PDF (1070KB) ( 469 )   Save BACKGROUND: Gradient artificial bone repair scaffolds can mimic unique anatomical features in musculoskeletal tissues, showing great potential for repairing injured musculoskeletal tissues. OBJECTIVE: To review the latest research advances in gradient artificial bone repair scaffolds for tissue engineering in the musculoskeletal system and describe their advantages and fabrication strategies. METHODS: The first author of the article searched the Web of Science and PubMed databases for articles published from 2000 to 2023 with search terms “gradient, bone regeneration, scaffold”. Finally, 76 papers were analyzed and summarized after the screening. RESULTS AND CONCLUSION: (1) As an important means of efficient and high-quality repair of skeletal system tissues, gradient artificial bone repair scaffolds are currently designed bionically for the natural gradient characteristics of bone tissue, bone-cartilage, and tendon-bone tissue. These scaffolds can mimic the extracellular matrix of native tissues to a certain extent in terms of structure and composition, thus promoting cell adhesion, migration, proliferation, differentiation, and regenerative recovery of damaged tissues to their native state. (2) Advanced manufacturing technology provides more possibilities for gradient artificial bone repair scaffold preparation: Gradient electrospun fiber scaffolds constructed by spatially differentiated fiber arrangement and loading of biologically active substances have been developed; gradient 3D printed scaffolds fabricated by layered stacking, graded porosity, and bio-3D printing technology; gradient hydrogel scaffolds fabricated by in-situ layered injections, simple layer-by-layer stacking, and freeze-drying method; and in addition, there are also scaffolds made by other modalities or multi-method coupling. These scaffolds have demonstrated good biocompatibility in vitro experiments, were able to accelerate tissue regeneration in small animal tests, and were observed to have significantly improved histological structure. (3) The currently developed gradient artificial bone repair scaffolds have problems such as mismatch of gradient scales, unclear material-tissue interactions, and side effects caused by degradation products, which need to be further optimized by combining the strengths of related disciplines and clinical needs in the future.  Figures and Tables | References | Related Articles | Metrics

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Role and mechanism of biomimetic remineralization therapy for early enamel demineralization Lin Xiaohui, Yang Mengyuan, Li Chunnian 2025, 29 (4):  856-865.  doi: 10.12307/2024.590 Abstract ( 443 )   PDF (1392KB) ( 295 )   Save BACKGROUND: With the improvement of diet and living standards, acidic diet and orthodontic treatment have become the main causes of enamel surface demineralization. As the first step of dental caries, enamel demineralization should be actively intervened. Mechanical grinding has great damage and does not conform to the concept of minimally invasive medicine. Biomimetic remineralization is the best way to deal with enamel demineralization at present.  OBJECTIVE: To summarize the mechanism, application and research progress of biomimetic remineralization of early enamel demineralization, and provide ideas for further overcoming the hot issues of biomimetic remineralization.  METHODS: English keywords “enamel demineralization, biomimetic remineralization, amelogenin, amorphous calcium phosphate” were used to search PubMed. Chinese keywords “enamel demineralization, biomimetic remineralization, amelogenin” were used to search CNKI. Through screening, 72 articles were finally obtained for review.  RESULTS AND CONCLUSION: (1) At present, there are drug treatments for enamel demineralization, such as fluoride preparations, laser treatment, resin penetration, remineralization treatment and other treatment methods. Biomimetic remineralization is the most ideal repair method for early enamel demineralization. (2) In the narrow sense, enamel remineralization refers to the mineral re-deposition inside the enamel after early enamel demineralization. In the broad sense, enamel remineralization includes the mineralization deposition on the surface and inside of enamel. (3) Clinical biomimetic remineralization reagents are mainly composed of amelogenin, non amelogenin, amelogenin peptide, casein phosphopeptide-amorphous calcium phosphate complex, etc. The advantages of protein and peptide materials are that they conform to the physiological mechanism and can generate high-strength remineralized materials by inducing orientation. The disadvantages are that the manufacturing process is relatively complex and the cost is high. The remineralization effect of amorphous calcium phosphate complex is good, but it needs to be combined with other materials to play a role. Other calcium phosphate materials are easy to carry and beautiful, but they are easy to cause the formation of dental calculus. (4) Future research should focus on the following aspects: increasing experimental data and clinical results, and clarifying the indications of various methods; explore more biomimetic remineralization methods and find suitable alternative materials; find a reasonable way to combine materials, so that their advantages and disadvantages complement each other. The portability of clinical application can be strengthened to increase the frequency of daily use, so that short-term experimental conclusions can be supported by long-term clinical data.  Figures and Tables | References | Related Articles | Metrics

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Mechanical analysis of fiber post combined with different crown restorations for endodontically treated non-carious cervical lesions Chen Yilong, Zhang Xu, Li Hong 2025, 29 (4):  866-871.  doi: 10.12307/2025.219 Abstract ( 118 )   PDF (821KB) ( 169 )   Save BACKGROUND: The use of fiber post to repair the endodontically treated non-carious cervical lesions teeth can change the stress distribution of the tooth and significantly reduce the risk of fracture of the affected tooth. However, the mechanical mechanism of fiber posts improving tooth fracture resistance and the optimal crown restoration for endodontically treated non-carious cervical lesions teeth are still debated. OBJECTIVE: To review the stress distribution pattern after restoration of endodontically treated non-carious cervical lesions teeth with fiber posts, the fracture resistance and fracture pattern under various stress states, and the latest research progress on fiber posts combined with different crown restorations.  METHODS: The computerized search was applied in PubMed and CNKI to retrieve articles published from September 2008 to September 2023 with Chinese and English search terms “non-carious cervical lesions, endodontically treated teeth restoration, endodontically treated teeth stress distribution.” Finally, 56 articles were included for analysis. RESULTS AND CONCLUSION: The application of fiber post restoration for endodontically treated non-carious cervical lesion teeth can partially improve the cervical stress of the tooth without increasing the risk of vertical root fracture, can lead to a more consistent distribution of stress and enhance the tooth’s ability to withstand fractures. Non-carious cervical lesion teeth with fiber posts that fracture would show favorable, restorable, or repairable fracture patterns. Fiber posts in combination with porcelain veneers or veneer-type inlays may become a more desirable minimally invasive restoration for repairing endodontically treated non-carious cervical lesion teeth. Figures and Tables | References | Related Articles | Metrics

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Posterior cruciate ligament tibial attachment point avulsion fracture: materials, implants, and internal fixation techniques in arthroscopic treatment  Yu Ming, Wang Wen 2025, 29 (4):  872-880.  doi: 10.12307/2025.225 Abstract ( 119 )   PDF (915KB) ( 257 )   Save BACKGROUND: The optimal surgical technique for treating posterior cruciate ligament tibial attachment point avulsion injuries is debatable. With the application and maturity of arthroscopic surgery, it has great prospects in the diagnosis and treatment of posterior cruciate ligament tibial attachment point avulsion fractures. OBJECTIVE: To summarize the application and progress of arthroscopic technology in the treatment of posterior cruciate ligament tibial attachment point avulsion fractures, including different arthroscopic treatment methods, surgical approach, tibial tunnel design, suture material selection, and internal fixation implant selection.  METHODS: Relevant literature was retrieved from PubMed, Web of Science, and ScienceDirect databases through computers. The search period was from January 2003 to November 2023. Chinese search terms were “posterior cruciate ligament, posterior cruciate ligament, avulsion fracture, arthroscopy”. English search terms were “posterior cruciate ligament, injury, fracture, tibia, arthroscopic, operation, fixation, treatment”. Totally 97 articles were included for review. RESULTS AND CONCLUSION: Arthroscopic technology provides a reliable treatment for posterior cruciate ligament tibial attachment point avulsion fractures. Arthroscopic treatment for avulsion fractures of the tibial attachment point of the cruciate ligament can be divided into several categories based on the type of approach, suture material, and the number of approaches used for suture and fixation of the tibial tunnel: arthroscopic suture fixation combined with autologous graft enhancement and reconstruction, arthroscopic multi cross band suture bridge fixation, arthroscopic strong thread fixation, and arthroscopic direct anterior posterior suture suspension fixation. In various studies, commonly used outcome measures include knee range of motion, Lysholm scale, International Knee Documentation Committee, and KT-2000 arthrometer. Studies have shown that at the last follow-up, the score results showed significant improvement compared to surgery. In the radiological follow-up results of various arthroscopic techniques, all studies have shown satisfactory results. During the follow-up process, all types of patients who received arthroscopic treatment for cruciate ligament tibial attachment point avulsion fractures did not experience serious complications, such as traumatic arthritis, neurovascular injury, perioperative wound infection, thrombosis, and nonunion of fractures. Figures and Tables | References | Related Articles | Metrics