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Tang Z, Yu D, Bao S, Li C, Wu H, Dong H, Wang N, Liu Y, Wu Q, Chen C, Wang M, Cao P, Zheng Z, Huang H, Li X, Guo Z. Porous Titanium Scaffolds with Mechanoelectrical Conversion and Photothermal Function: A Win-Win Strategy for Bone Reconstruction of Tumor-Resected Defects. Adv Healthc Mater 2024; 13:e2302901. [PMID: 38102773 DOI: 10.1002/adhm.202302901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 11/22/2023] [Indexed: 12/17/2023]
Abstract
Bone metastases severely threaten the lives of patients. Although surgical treatment combined with adjuvant chemotherapy significantly improves the survival rate of patients, tumor recurrence, or metastasis after surgical resection and bone defects caused by surgical treatment remain major challenges for clinicians. Given the abovementioned clinical requirements, barium titanate-containing iron-coated porous titanium alloy scaffolds have been proposed to promote bone defect repair and inhibit tumor recurrence. Fortunately, in vitro and in vivo experimental research confirms that barium titanate containing iron-coated porous titanium alloy scaffolds promote osteogenesis and bone reconstruction in defect repair via mechanoelectric conversion and inhibit tumor recurrence via photothermal effects. Furthermore, the underlying and intricate mechanisms of bone defect repair and tumor recurrence prevention of barium titanate-containing iron-coated porous titanium alloy scaffolds are explored. A win-win strategy for mechanoelectrical conversion and photothermal functionalization provides promising insights into bone reconstruction of tumor-resected defects.
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Affiliation(s)
- Zhen Tang
- Department of Orthopaedics, Tangdu Hospital, Fourth Military Medical University, Xi'an, 710038, China
| | - Dongmei Yu
- Department of Orthopaedics, Tangdu Hospital, Fourth Military Medical University, Xi'an, 710038, China
| | - Shusen Bao
- Department of Orthopaedics, Tangdu Hospital, Fourth Military Medical University, Xi'an, 710038, China
| | - Chenyu Li
- Department of Orthopaedics, Tangdu Hospital, Fourth Military Medical University, Xi'an, 710038, China
| | - Hao Wu
- Department of Orthopaedics, Tangdu Hospital, Fourth Military Medical University, Xi'an, 710038, China
| | - Hui Dong
- Department of Orthopaedics, Tangdu Hospital, Fourth Military Medical University, Xi'an, 710038, China
| | - Ning Wang
- Department of Orthopaedics, Tangdu Hospital, Fourth Military Medical University, Xi'an, 710038, China
| | - Yichao Liu
- Department of Orthopaedics, Tangdu Hospital, Fourth Military Medical University, Xi'an, 710038, China
| | - Qi Wu
- Department of Orthopaedics, Tangdu Hospital, Fourth Military Medical University, Xi'an, 710038, China
| | - Changcheng Chen
- Department of Orthopaedics, Tangdu Hospital, Fourth Military Medical University, Xi'an, 710038, China
| | - Mo Wang
- Department of Orthopaedics, Tangdu Hospital, Fourth Military Medical University, Xi'an, 710038, China
| | - Pengfei Cao
- Department of Orthopaedics, Tangdu Hospital, Fourth Military Medical University, Xi'an, 710038, China
| | - Zenghui Zheng
- Department of Orthopaedics, Tangdu Hospital, Fourth Military Medical University, Xi'an, 710038, China
| | - Hai Huang
- Department of Orthopaedics, Tangdu Hospital, Fourth Military Medical University, Xi'an, 710038, China
| | - Xiaokang Li
- Department of Orthopaedics, Tangdu Hospital, Fourth Military Medical University, Xi'an, 710038, China
| | - Zheng Guo
- Department of Orthopaedics, Tangdu Hospital, Fourth Military Medical University, Xi'an, 710038, China
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Li M, Wu J, Geng W, Gao P, Yang Y, Li X, Xu K, Liao Q, Cai K. Interaction pathways of implant metal localized corrosion and macrophage inflammatory reactions. Bioact Mater 2024; 31:355-367. [PMID: 37663618 PMCID: PMC10474585 DOI: 10.1016/j.bioactmat.2023.08.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 07/29/2023] [Accepted: 08/19/2023] [Indexed: 09/05/2023] Open
Abstract
Macrophages play a central role in immunological responses to metallic species associated with the localized corrosion of metallic implants, and mediating in peri-implant inflammations. Herein, the pathways of localized corrosion-macrophage interactions were systematically investigated on 316L stainless steel (SS) implant metals. Electrochemical monitoring under macrophage-mediated inflammatory conditions showed a decreased pitting corrosion resistance of 316L SSs in the presence of RAW264.7 cells as the cells would disrupt biomolecule adsorbed layer on the metal surface. The pitting potentials were furtherly decreased when the RAW264.7 cells were induced to the M1 pro-inflammatory phenotype by the addition of lipopolysaccharide (LPS), and pitting corrosion preferentially initiated at the peripheries of macrophages. The overproduction of aggressive ROS under inflammatory conditions would accelerate the localized corrosion of 316L SS around macrophages. Under pitting corrosion condition, the viability and pro-inflammatory polarization of RAW264.7 cells were region-dependent, lower viability and more remarkable morphology transformation of macrophages in the pitting corrosion region than the pitting-free region. The pitting corrosion of 316L SS induced high expression of CD86, TNF-α, IL-6 and high level of intracellular ROS in macrophages. Uneven release of metallic species (Fe2+, Cr3+, Ni2+, etc) and uneven distribution of surface overpotential stimulated macrophage inflammatory responses near the corrosion pits. A synergetic effect of localized corrosion and macrophages was revealed, which could furtherly promote localized corrosion of 316L SS and macrophage inflammatory reactions. Our results provided direct evidence of corrosion-macrophage interaction in metallic implants and disclosed the pathways of this mutual stimulation effect.
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Affiliation(s)
- Meng Li
- Key Laboratory of Biorheological Science and Technology, Ministry of Education, College of Bioengineering, Chongqing University, Chongqing, 400044, PR China
| | - Jing Wu
- Key Laboratory of Biorheological Science and Technology, Ministry of Education, College of Bioengineering, Chongqing University, Chongqing, 400044, PR China
| | - Wenbo Geng
- Key Laboratory of Biorheological Science and Technology, Ministry of Education, College of Bioengineering, Chongqing University, Chongqing, 400044, PR China
| | - Pengfei Gao
- Key Laboratory of Biorheological Science and Technology, Ministry of Education, College of Bioengineering, Chongqing University, Chongqing, 400044, PR China
| | - Yulu Yang
- Key Laboratory of Biorheological Science and Technology, Ministry of Education, College of Bioengineering, Chongqing University, Chongqing, 400044, PR China
| | - Xuan Li
- Key Laboratory of Biorheological Science and Technology, Ministry of Education, College of Bioengineering, Chongqing University, Chongqing, 400044, PR China
| | - Kun Xu
- Key Laboratory of Biorheological Science and Technology, Ministry of Education, College of Bioengineering, Chongqing University, Chongqing, 400044, PR China
| | - Qiang Liao
- Key Laboratory of Low-grade Energy Utilization Technologies and Systems, Chongqing University, Ministry of Education, School of Energy and Power Engineering, Chongqing, 400044, PR China
| | - Kaiyong Cai
- Key Laboratory of Biorheological Science and Technology, Ministry of Education, College of Bioengineering, Chongqing University, Chongqing, 400044, PR China
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Sun W, Ye B, Chen S, Zeng L, Lu H, Wan Y, Gao Q, Chen K, Qu Y, Wu B, Lv X, Guo X. Neuro-bone tissue engineering: emerging mechanisms, potential strategies, and current challenges. Bone Res 2023; 11:65. [PMID: 38123549 PMCID: PMC10733346 DOI: 10.1038/s41413-023-00302-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Revised: 10/08/2023] [Accepted: 10/31/2023] [Indexed: 12/23/2023] Open
Abstract
The skeleton is a highly innervated organ in which nerve fibers interact with various skeletal cells. Peripheral nerve endings release neurogenic factors and sense skeletal signals, which mediate bone metabolism and skeletal pain. In recent years, bone tissue engineering has increasingly focused on the effects of the nervous system on bone regeneration. Simultaneous regeneration of bone and nerves through the use of materials or by the enhancement of endogenous neurogenic repair signals has been proven to promote functional bone regeneration. Additionally, emerging information on the mechanisms of skeletal interoception and the central nervous system regulation of bone homeostasis provide an opportunity for advancing biomaterials. However, comprehensive reviews of this topic are lacking. Therefore, this review provides an overview of the relationship between nerves and bone regeneration, focusing on tissue engineering applications. We discuss novel regulatory mechanisms and explore innovative approaches based on nerve-bone interactions for bone regeneration. Finally, the challenges and future prospects of this field are briefly discussed.
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Affiliation(s)
- Wenzhe Sun
- Department of Orthopaedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
| | - Bing Ye
- Department of Orthopaedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
| | - Siyue Chen
- School of Basic Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
| | - Lian Zeng
- Department of Orthopaedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
| | - Hongwei Lu
- Department of Orthopaedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
| | - Yizhou Wan
- Department of Orthopaedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
| | - Qing Gao
- Department of Orthopaedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
| | - Kaifang Chen
- Department of Orthopaedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
| | - Yanzhen Qu
- Department of Orthopaedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
| | - Bin Wu
- Department of Orthopaedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
| | - Xiao Lv
- Department of Orthopaedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China.
| | - Xiaodong Guo
- Department of Orthopaedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China.
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Finze R, Laubach M, Russo Serafini M, Kneser U, Medeiros Savi F. Histological and Immunohistochemical Characterization of Osteoimmunological Processes in Scaffold-Guided Bone Regeneration in an Ovine Large Segmental Defect Model. Biomedicines 2023; 11:2781. [PMID: 37893154 PMCID: PMC10604530 DOI: 10.3390/biomedicines11102781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 10/06/2023] [Accepted: 10/09/2023] [Indexed: 10/29/2023] Open
Abstract
Large-volume bone defect regeneration is complex and demands time to complete. Several regeneration phases with unique characteristics, including immune responses, follow, overlap, and interdepend on each other and, if successful, lead to the regeneration of the organ bone's form and function. However, during traumatic, infectious, or neoplastic clinical cases, the intrinsic bone regeneration capacity may exceed, and surgical intervention is indicated. Scaffold-guided bone regeneration (SGBR) has recently shown efficacy in preclinical and clinical studies. To investigate different SGBR strategies over periods of up to three years, we have established a well-characterized ovine large segmental tibial bone defect model, for which we have developed and optimized immunohistochemistry (IHC) protocols. We present an overview of the immunohistochemical characterization of different experimental groups, in which all ovine segmental defects were treated with a bone grafting technique combined with an additively manufactured medical-grade polycaprolactone/tricalcium phosphate (mPCL-TCP) scaffold. The qualitative dataset was based on osteoimmunological findings gained from IHC analyses of over 350 sheep surgeries over the past two decades. Our systematic and standardized IHC protocols enabled us to gain further insight into the complex and long-drawn-out bone regeneration processes, which ultimately proved to be a critical element for successful translational research.
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Affiliation(s)
- Ronja Finze
- Centre for Biomedical Technologies, School of Mechanical, Medical and Process Engineering, Queensland University of Technology, Brisbane, QLD 4059, Australia; (R.F.)
- Department of Hand-, Plastic and Reconstructive Surgery, Burn Center, BG Trauma Center Ludwigshafen, University of Heidelberg, 67071 Ludwigshafen, Germany;
| | - Markus Laubach
- Centre for Biomedical Technologies, School of Mechanical, Medical and Process Engineering, Queensland University of Technology, Brisbane, QLD 4059, Australia; (R.F.)
- Australian Research Council (ARC) Training Centre for Multiscale 3D Imaging, Modelling and Manufacturing (M3D Innovation), Queensland University of Technology, Brisbane, QLD 4000, Australia
- Department of Orthopaedics and Trauma Surgery, Musculoskeletal University Center Munich (MUM), LMU University Hospital, LMU Munich, 81377 Munich, Germany
| | - Mairim Russo Serafini
- Department of Pharmacy, Universidade Federal de Sergipe, Sao Cristovao 49100-000, Brazil;
| | - Ulrich Kneser
- Department of Hand-, Plastic and Reconstructive Surgery, Burn Center, BG Trauma Center Ludwigshafen, University of Heidelberg, 67071 Ludwigshafen, Germany;
| | - Flavia Medeiros Savi
- Centre for Biomedical Technologies, School of Mechanical, Medical and Process Engineering, Queensland University of Technology, Brisbane, QLD 4059, Australia; (R.F.)
- Australian Research Council (ARC) Training Centre for Multiscale 3D Imaging, Modelling and Manufacturing (M3D Innovation), Queensland University of Technology, Brisbane, QLD 4000, Australia
- Max Planck Queensland Center for the Materials Science of Extracellular Matrices, Queensland University of Technology, Brisbane, QLD 4059, Australia
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Zhang Z, Zhang X, Zheng Z, Xin J, Han S, Qi J, Zhang T, Wang Y, Zhang S. Latest advances: Improving the anti-inflammatory and immunomodulatory properties of PEEK materials. Mater Today Bio 2023; 22:100748. [PMID: 37600350 PMCID: PMC10432209 DOI: 10.1016/j.mtbio.2023.100748] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 07/18/2023] [Accepted: 07/25/2023] [Indexed: 08/22/2023] Open
Abstract
Excellent biocompatibility, mechanical properties, chemical stability, and elastic modulus close to bone tissue make polyetheretherketone (PEEK) a promising orthopedic implant material. However, biological inertness has hindered the clinical applications of PEEK. The immune responses and inflammatory reactions after implantation would interfere with the osteogenic process. Eventually, the proliferation of fibrous tissue and the formation of fibrous capsules would result in a loose connection between PEEK and bone, leading to implantation failure. Previous studies focused on improving the osteogenic properties and antibacterial ability of PEEK with various modification techniques. However, few studies have been conducted on the immunomodulatory capacity of PEEK. New clinical applications and advances in processing technology, research, and reports on the immunomodulatory capacity of PEEK have received increasing attention in recent years. Researchers have designed numerous modification techniques, including drug delivery systems, surface chemical modifications, and surface porous treatments, to modulate the post-implantation immune response to address the regulatory factors of the mechanism. These studies provide essential ideas and technical preconditions for the development and research of the next generation of PEEK biological implant materials. This paper summarizes the mechanism by which the immune response after PEEK implantation leads to fibrous capsule formation; it also focuses on modification techniques to improve the anti-inflammatory and immunomodulatory abilities of PEEK. We also discuss the limitations of the existing modification techniques and present the corresponding future perspectives.
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Affiliation(s)
- Zilin Zhang
- Department of Spine Surgery, Center of Orthopedics, First Hospital of Jilin University, Changchun, 130021, China
- Jilin Engineering Research Center for Spine and Spinal Cord Injury, Changchun, 130021, China
| | - Xingmin Zhang
- Department of Spine Surgery, Center of Orthopedics, First Hospital of Jilin University, Changchun, 130021, China
- Jilin Engineering Research Center for Spine and Spinal Cord Injury, Changchun, 130021, China
| | - Zhi Zheng
- Department of Spine Surgery, Center of Orthopedics, First Hospital of Jilin University, Changchun, 130021, China
- Jilin Engineering Research Center for Spine and Spinal Cord Injury, Changchun, 130021, China
| | - Jingguo Xin
- Department of Spine Surgery, Center of Orthopedics, First Hospital of Jilin University, Changchun, 130021, China
- Jilin Engineering Research Center for Spine and Spinal Cord Injury, Changchun, 130021, China
| | - Song Han
- Department of Spine Surgery, Center of Orthopedics, First Hospital of Jilin University, Changchun, 130021, China
- Jilin Engineering Research Center for Spine and Spinal Cord Injury, Changchun, 130021, China
| | - Jinwei Qi
- Department of Spine Surgery, Center of Orthopedics, First Hospital of Jilin University, Changchun, 130021, China
- Jilin Engineering Research Center for Spine and Spinal Cord Injury, Changchun, 130021, China
| | - Tianhui Zhang
- Department of Spine Surgery, Center of Orthopedics, First Hospital of Jilin University, Changchun, 130021, China
- Jilin Engineering Research Center for Spine and Spinal Cord Injury, Changchun, 130021, China
| | - Yongjie Wang
- Department of Spine Surgery, Center of Orthopedics, First Hospital of Jilin University, Changchun, 130021, China
- Jilin Engineering Research Center for Spine and Spinal Cord Injury, Changchun, 130021, China
| | - Shaokun Zhang
- Department of Spine Surgery, Center of Orthopedics, First Hospital of Jilin University, Changchun, 130021, China
- Jilin Engineering Research Center for Spine and Spinal Cord Injury, Changchun, 130021, China
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Liu Y, Wu H, Bao S, Huang H, Tang Z, Dong H, Liu J, Chen S, Wang N, Wu Z, Zhang Z, Shi L, Li X, Guo Z. Clinical application of 3D-printed biodegradable lumbar interbody cage (polycaprolactone/β-tricalcium phosphate) for posterior lumbar interbody fusion. J Biomed Mater Res B Appl Biomater 2023; 111:1398-1406. [PMID: 36883804 DOI: 10.1002/jbm.b.35244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2022] [Revised: 02/16/2023] [Accepted: 02/23/2023] [Indexed: 03/09/2023]
Abstract
A novel 3D-printed biodegradable cage composed of polycaprolactone (PCL) and beta-tricalcium phosphate (β-TCP) in a mass ratio of 50:50, with stable resorption patterns and mechanical strength has been developed for lumbar interbody fusion. This is a prospective cohort study to evaluate the short- and mid-term safety and efficacy of this biodegradable cage in posterior lumbar interbody fusion (PLIF) surgery. This was a prospective single-arm pilot clinical trial in 22 patients with a follow-up time of 1, 3, 6, and 12 months, postoperatively. Clinical outcomes were assessed using the Japanese Orthopedic Association Back Pain Evaluation Questionnaire (JOABPEQ) and Visual analogue scale (VAS) for leg pain and low back pain. Radiological examination included X-ray, CT scan, and three-dimensional reconstruction to evaluate surgical indications, intervertebral space height (ISH), intervertebral bone fusion and cage degradation. A total of 22 patients was included, with an average age of 53.5 years. Among 22 patients, one patient lost to follow-up and one patient withdrew from the clinical trial because of cage retropulsion. The remaining 20 patients showed significant improvement in clinical and imaging outcomes compared to the preoperative period. The overall mean VAS for back decreased from 5.85 ± 0.99 preoperatively to 1.15 ± 0.86 at the 12-month follow-up (p < .001); the VAS for leg decreased from 5.75 ± 1.11 to 1.05 ± 0.76 (p < .001); the JOA score improved from 13.8 ± 2.64 to 26.45 ± 2.46 (p < .001). The mean intervertebral space height (ISH) increased from 11.01 ± 1.75 mm preoperatively to 12.67 ± 1.89 mm at the 12-month follow-up and the bone fusion reached 95.2% (20/21 disc segments). Partial resorption (inferior to 50% compared with the initial cage size) were found in all cages (21/21). The clinical and radiological assessments showed that the application of 3D-printed biodegradable PCL/β-TCP cages in PLIF yielded satisfactory results at the 12-month follow-up. In the future, long-term clinical observations and controlled clinical trials are required to further validate the safety and efficacy of this novel cage.
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Affiliation(s)
- Yichao Liu
- Department of Orthopaedics, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, People's Republic of China
| | - Hao Wu
- Department of Orthopaedics, Tangdu Hospital
- , Fourth Military Medical University, Xi'an, Shaanxi, People's Republic of China
| | - Shusen Bao
- Department of Orthopaedics, Tangdu Hospital
- , Fourth Military Medical University, Xi'an, Shaanxi, People's Republic of China
| | - Hai Huang
- Department of Orthopaedics, Tangdu Hospital
- , Fourth Military Medical University, Xi'an, Shaanxi, People's Republic of China
| | - Zhen Tang
- Department of Orthopaedics, Tangdu Hospital
- , Fourth Military Medical University, Xi'an, Shaanxi, People's Republic of China
| | - Hui Dong
- Department of Orthopaedics, Tangdu Hospital
- , Fourth Military Medical University, Xi'an, Shaanxi, People's Republic of China
| | - Jiaqi Liu
- Student Brigade of Basic Medicine School, Fourth Military Medical University, Xi'an, Shaanxi, People's Republic of China
| | - Shengxiu Chen
- Student Brigade of Basic Medicine School, Fourth Military Medical University, Xi'an, Shaanxi, People's Republic of China
| | - Ning Wang
- Department of Orthopaedics, Tangdu Hospital
- , Fourth Military Medical University, Xi'an, Shaanxi, People's Republic of China
| | - Zhigang Wu
- Department of Orthopaedics, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, People's Republic of China
| | - Zhiyong Zhang
- Center of Translational Research in Regenerative Medicine, Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, People's Republic of China
| | - Lei Shi
- Department of Orthopaedics, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, People's Republic of China
| | - Xiaokang Li
- Department of Orthopaedics, Tangdu Hospital
- , Fourth Military Medical University, Xi'an, Shaanxi, People's Republic of China
| | - Zheng Guo
- Department of Orthopaedics, Tangdu Hospital
- , Fourth Military Medical University, Xi'an, Shaanxi, People's Republic of China
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