Fabrication of Ti + Mg composites by three-dimensional printing of porous Ti and subsequent pressureless infiltration of biodegradable Mg

Current developments and future perspectives of nanotechnology in orthopedic implants: an updated review

Orthopedic implants are the most commonly used fracture fixation devices for facilitating the growth and development of incipient bone and treating bone diseases and defects. However, most orthopedic implants suffer from various drawbacks and complications, including bacterial adhesion, poor cell proliferation, and limited resistance to corrosion. One of the major drawbacks of currently available orthopedic implants is their inadequate osseointegration at the tissue-implant interface. This leads to loosening as a result of immunological rejection, wear debris formation, low mechanical fixation, and implant-related infections. Nanotechnology holds the promise to offer a wide range of innovative technologies for use in translational orthopedic research. Nanomaterials have great potential for use in orthopedic applications due to their exceptional tribological qualities, high resistance to wear and tear, ability to maintain drug release, capacity for osseointegration, and capability to regenerate tissue. Furthermore, nanostructured materials possess the ability to mimic the features and hierarchical structure of native bones. They facilitate cell proliferation, decrease the rate of infection, and prevent biofilm formation, among other diverse functions. The emergence of nanostructured polymers, metals, ceramics, and carbon materials has enabled novel approaches in orthopaedic research. This review provides a concise overview of nanotechnology-based biomaterials utilized in orthopedics, encompassing metallic and nonmetallic nanomaterials. A further overview is provided regarding the biomedical applications of nanotechnology-based biomaterials, including their application in orthopedics for drug delivery systems and bone tissue engineering to facilitate scaffold preparation, surface modification of implantable materials to improve their osteointegration properties, and treatment of musculoskeletal infections. Hence, this review article offers a contemporary overview of the current applications of nanotechnology in orthopedic implants and bone tissue engineering, as well as its prospective future applications.

Recent advances in 3D printing of biodegradable metals for orthopaedic applications

The use of biodegradable polymers for treating bone-related diseases has become a focal point in the field of biomedicine. Recent advancements in material technology have expanded the range of materials suitable for orthopaedic implants. Three-dimensional (3D) printing technology has become prevalent in healthcare, and while organ printing is still in its early stages and faces ethical and technical hurdles, 3D printing is capable of creating 3D structures that are supportive and controllable. The technique has shown promise in fields such as tissue engineering and regenerative medicine, and new innovations in cell and bio-printing and printing materials have expanded its possibilities. In clinical settings, 3D printing of biodegradable metals is mainly used in orthopedics and stomatology. 3D-printed patient-specific osteotomy instruments, orthopedic implants, and dental implants have been approved by the US FDA for clinical use. Metals are often used to provide support for hard tissue and prevent complications. Currently, 70-80% of clinically used implants are made from niobium, tantalum, nitinol, titanium alloys, cobalt-chromium alloys, and stainless steels. However, there has been increasing interest in biodegradable metals such as magnesium, calcium, zinc, and iron, with numerous recent findings. The advantages of 3D printing, such as low manufacturing costs, complex geometry capabilities, and short fabrication periods, have led to widespread adoption in academia and industry. 3D printing of metals with controllable structures represents a cutting-edge technology for developing metallic implants for biomedical applications. This review explores existing biomaterials used in 3D printing-based orthopedics as well as biodegradable metals and their applications in developing metallic medical implants and devices. The challenges and future directions of this technology are also discussed.

Novel 3D printable PEEK-HA-Mg2SiO4 composite material for spine implants: biocompatibility and imaging compatibility assessments

PURPOSE

To develop a novel 3D printable polyether ether ketone (PEEK)-hydroxyapatite (HA)-magnesium orthosilicate (Mg2SiO4) composite material with enhanced properties for potential use in tumour, osteoporosis and other spinal conditions. We aim to evaluate biocompatibility and imaging compatibility of the material.

METHODS

Materials were prepared in three different compositions, namely composite A: 75 weight % PEEK, 20 weight % HA, 5 weight % Mg2SiO4; composite B: 70 weight% PEEK, 25 weight % HA, 5 weight % Mg2SiO4; and composite C: 65 weight % PEEK, 30 weight % HA, 5 weight % Mg2SiO4. The materials were processed to obtain 3D printable filament. Biomechanical properties were analysed as per ASTM standards and biocompatibility of the novel material was evaluated using indirect and direct cell cytotoxicity tests. Cell viability of the novel material was compared to PEEK and PEEK-HA materials. The novel material was used to 3D print a standard spine cage. Furthermore, the CT and MR imaging compatibility of the novel material cage vs PEEK and PEEK-HA cages were evaluated using a phantom setup.

RESULTS

Composite A resulted in optimal material processing to obtain a 3D printable filament, while composite B and C resulted in non-optimal processing. Composite A enhanced cell viability up to ~ 20% compared to PEEK and PEEK-HA materials. Composite A cage generated minimal/no artefacts on CT and MR imaging and the images were comparable to that of PEEK and PEEK-HA cages.

CONCLUSION

Composite A demonstrated superior bioactivity vs PEEK and PEEK-HA materials and comparable imaging compatibility vs PEEK and PEEK-HA. Therefore, our material displays an excellent potential to manufacture spine implants with enhanced mechanical and bioactive property.

Surface functionalized nanoparticles: A boon to biomedical science

The rapid development of nanomedicine has increased the likelihood that manufactured nanoparticles will one day come into contact with people and the environment. A variety of academic fields, including engineering and the health sciences, have taken a keen interest in the development of nanotechnology. Any significant development in nanomaterial-based applications would depend on the production of functionalized nanoparticles, which are believed to have the potential to be used in fields like pharmaceutical and biomedical sciences. The functionalization of nanoparticles with particular recognition chemical moieties does result in multifunctional nanoparticles with greater efficacy while at the same time minimising adverse effects, according to early clinical studies. This is because of traits like aggressive cellular uptake and focused localization in tumours. To advance this field of inquiry, chemical procedures must be developed that reliably attach chemical moieties to nanoparticles. The structure-function relationship of these functionalized nanoparticles has been extensively studied as a result of the discovery of several chemical processes for the synthesis of functionalized nanoparticles specifically for drug delivery, cancer therapy, diagnostics, tissue engineering, and molecular biology. Because of the growing understanding of how to functionalize nanoparticles and the continued work of innovative scientists to expand this technology, it is anticipated that functionalized nanoparticles will play an important role in the aforementioned domains. As a result, the goal of this study is to familiarise readers with nanoparticles, to explain functionalization techniques that have already been developed, and to examine potential applications for nanoparticles in the biomedical sciences. This review's information is essential for the safe and broad use of functionalized nanoparticles, particularly in the biomedical sector.

Antimicrobial and Pro-Osteogenic Coaxially Electrospun Magnesium Oxide Nanoparticles-Polycaprolactone /Parathyroid Hormone-Polycaprolactone Composite Barrier Membrane for Guided Bone Regeneration

Introduction

An antibacterial and pro-osteogenic coaxially electrospun nanofiber guided bone regeneration (GBR) membrane was fabricated to satisfy the complicated and phased requirements of GBR process.

Methods

In this study, we synthesize dual-functional coaxially electrospun nanofiber GBR membranes by encapsulating parathyroid hormone (PTH) in the core layer and magnesium oxide nanoparticles (MgONPs) in the shell layer (MgONPs-PCL/PTH-PCL). Herein, the physicochemical characterization of MgONPs-PCL/PTH-PCL, the release rates of MgONPs and PTH, and antibacterial efficiency of the new membrane were evaluated. Furthermore, the pro-osteogenicity of the membranes was assessed both in-vitro and in-vivo.

Results

We successfully fabricated a coaxially electrospun nanofiber MgONPs-PCL/PTH-PCL membrane with the majority of nanofibers (>65%) ranged from 0.40~0.60μm in diameter. MgONPs-PCL/PTH-PCL showed outstanding antibacterial potential against Escherichia coli (E. coli) and Staphylococcus aureus (S. aureus) through the release of MgONPs. We also discovered that the incorporation of MgONPs significantly prolonged the release of PTH. Furthermore, both the in-vivo and in-vitro studies demonstrated that high dosage of PTH promoted pro-osteogenicity of the membrane to improve bone regeneration efficacy with the presence of MgONPs.

Conclusion

The new composite membrane is a promising approach to enhance bone regeneration in periodontitis or peri-implantitis patients with large-volume bone defects.

The Dual Effect of 3D-Printed Biological Scaffolds Composed of Diverse Biomaterials in the Treatment of Bone Tumors

Bone tumors, including primary bone tumors, invasive bone tumors, metastatic bone tumors, and others, are one of the most clinical difficulties in orthopedics. Once these tumors have grown and developed in the bone system, they will interact with osteocytes and other environmental cells in the bone system's microenvironment, leading to the eventual damage of the bone's physical structure. Surgical procedures for bone tumors may result in permanent defects. The dual-efficacy of tissue regeneration and tumor treatment has made biomaterial scaffolds frequently used in treating bone tumors. 3D printing technology, also known as additive manufacturing or rapid printing prototype, is the transformation of 3D computer models into physical models through deposition, curing, and material fusion of successive layers. Adjustable shape, porosity/pore size, and other mechanical properties are an advantage of 3D-printed objects, unlike natural and synthetic material with fixed qualities. Researchers have demonstrated the significant role of diverse 3D-printed biological scaffolds in the treatment for bone tumors and the regeneration of bone tissue, and that they enhanced various performance of the products. Based on the characteristics of bone tumors, this review synthesized the findings of current researchers on the application of various 3D-printed biological scaffolds including bioceramic scaffold, metal alloy scaffold and nano-scaffold, in bone tumors and discussed the advantages, disadvantages, and future application prospects of various types of 3D-printed biological scaffolds. Finally, the future development trend of 3D-printed biological scaffolds in bone tumor is summarized, providing a theoretical foundation and a larger outlook for the use of biological scaffolds in the treatment of patients with bone tumors.

Corrosion and wear behavior of Ti-5Cu-xNb biomedical alloy in simulated body fluid for dental implant applications

The present study examined the corrosion and tribological behavior of novel Ti-5Cu-xNb alloy synthesized via powder metallurgy as a new biomedical material in a simulated bodily fluid (SBF) solution. The electrochemical impedance spectroscopy (EIS) study reveals the formation of two protective layers on the surface of alloys during the test. The alloys spontaneously produce a passivating oxide coating on their surfaces, and the breakdown potential (1.14-1.17 V) and re-passivation current density (2.07-3.04 μAcm^-2) were observed during the potentiodynamic polarization test. The highest corrosion resistance was observed for the alloy Ti-5Cu-10Nb (i_corr = 21.44 nA-cm^-2). The SEM and XPS analysis of the corroded surface showed the formation of oxide on the surfaces of the alloys. The samples were tested at 10 N, 15 N, and 20 N loads against the zirconia counterpart to investigate the effect of loading on friction and wear. The lowest coefficient of friction was obtained for Ti-5Cu-5Nb (0.25-0.41) at 20 N loading, while the maximum for Ti-5Cu-10Nb at 15 N load falls in the range of (0.71-0.25). Additionally, they present the wear rate in the range of (5.3 × 10^-8-1.45 × 10^-6 mm³/mm), in accordance with the change in microstructure and mechanical properties. However, the wear rate increases with the addition of niobium and reaches the maximum for Ti-5Cu-15Nb at 20 N loading condition, but it is relatively deficient compared to commonly used implant material. Therefore, it is suggested that this β-type Ti-5Cu-xNb alloy is a promising candidate, more suitable than the commercially used Ti and Ti-6Al-4V for dental applications.

Progress in partially degradable titanium-magnesium composites used as biomedical implants

Titanium-magnesium composites have gained increasing attention as a partially degradable biomaterial recently. The titanium-magnesium composite combines the bioactivity of magnesium and the good mechanical properties of titanium. Here, we discuss the limitations of conventional mechanically alloyed titanium-magnesium alloys for bioimplants, in addition we summarize three suitable methods for the preparation of titanium-magnesium composites for bioimplants by melt: infiltration casting, powder metallurgy and hot rotary swaging, with a description of the advantages and disadvantages of all three methods. The titanium-magnesium composites were comprehensively evaluated in terms of mechanical properties and degradation behavior. The feasibility of titanium-magnesium composites as bio-implants was reviewed. In addition, the possible future development of titanium-magnesium composites was discussed. Thus, this review aims to build a conceptual and practical toolkit for the design of titanium-magnesium composites capable of local biodegradation.

Biodegradability and Cytocompatibility of 3D-Printed Mg-Ti Interpenetrating Phase Composites

Orthopedic hybrid implants combining both titanium (Ti) and magnesium (Mg) have gained wide attraction nowadays. However, it still remains a huge challenge in the fabrication of Mg-Ti composites because of the different temperatures of Ti melting point and pure Mg volatilization point. In this study, we successfully fabricated a new Mg-Ti composite with bi-continuous interpenetrating phase architecture by infiltrating Mg melt into Ti scaffolds, which were prepared by 3D printing and subsequent acid treatment. We attempted to understand the 7-day degradation process of the Mg-Ti composite and examine the different Mg2+ concentration composite impacts on the MC3T3-E1 cells, including toxicity, morphology, apoptosis, and osteogenic activity. CCK-8 results indicated cytotoxicity and absence of the Mg-Ti composite during 7-day degradation. Moreover, the composite significantly improved the morphology, reduced the apoptosis rate, and enhanced the osteogenic activity of MC3T3-E1 cells. The favorable impacts might be attributed to the appropriate Mg2+ concentration of the extracts. The results on varying Mg2+ concentration tests indicated that Mg2+ showed no cell adverse effect under 10-mM concentration. The 8-mM group exhibited the best cell morphology, minimum apoptosis rate, and maximum osteogenic activity. This work may open a new perspective on the development and biomedical applications for Mg-Ti composites.

A biomechanical evaluation on Cubic, Octet, and TPMS gyroid Ti6Al4V lattice structures fabricated by selective laser melting and the effects of their debris on human osteoblast-like cells

Lattice structures are widely used in orthopedic implants due to their unique features, such as high strength-to-weight ratios and adjustable biomechanical properties. Based on the type of unit cell geometry, lattice structures may be classified into two types: strut-based structures and sheet-based structures. In this study, strut-based structures (Cubic & Octet) and sheet-based structure (triply periodic minimal surface (TPMS) gyroid) were investigated. The biomechanical properties of the three different Ti6Al4V lattice structures fabricated by selective laser melting (SLM) were investigated using room temperature compression testing. Scanning electron microscopy (SEM) and energy dispersive X-ray spectroscopy (EDX) were used to check the 3D printing quality with regards to defects and quantitative compositional information of 3D printed parts. Experimental results indicated that TPMS gyroid has superior biomechanical properties when compared to Cubic and Octet. Also, TPMS gyroid was found to be less affected by the variations in relative density. The biocompatibility of Ti6Al4V lattice structures was validated through the cytotoxicity test with human osteoblast-like SAOS2 cells. The debris generated during the degradation process in the form of particles and ions is among the primary causes of implant failure over time. In this study, Ti6Al4V particles with spherical and irregular shapes having average particle sizes of 36.5 μm and 28.8 μm, respectively, were used to mimic the actual Ti6Al4V particles to understand their harmful effects better. Also, the effects and amount of Ti6Al4V ions released after immersion within the cell culture media were investigated using the indirect cytotoxicity test and ion release test.

A general fruit acid chelation route for eco-friendly and ambient 3D printing of metals

Recent advances in metal additive manufacturing (AM) have provided new opportunities for prompt designs of prototypes and facile personalization of products befitting the fourth industrial revolution. In this regard, its feasibility of becoming a green technology, which is not an inherent aspect of AM, is gaining more interests. A particular interest in adapting and understanding of eco-friendly ingredients can set its important groundworks. Here, we demonstrate a water-based solid-phase binding agent suitable for binder jetting 3D printing of metals. Sodium salts of common fruit acid chelators form stable metal-chelate bridges between metal particles, enabling elaborate 3D printing of metals with improved strengths. Even further reductions in the porosity between the metal particles are possible through post-treatments. A compatibility of this chelation chemistry with variety of metals is also demonstrated. The proposed mechanism for metal 3D printing can open up new avenues for consumer-level personalized 3D printing of metals.

Biofunctional magnesium-coated Ti6Al4V scaffolds promote autophagy-dependent apoptosis in osteosarcoma by activating the AMPK/mTOR/ULK1 signaling pathway

The recurrence of osteosarcoma (OS) after reconstruction using Ti6Al4V prostheses remains a major problem in the surgical treatment of OS. Modification of the surfaces of Ti6Al4V prostheses with antitumor functions is an important strategy for improving therapeutic outcomes. Magnesium (Mg) coating has been shown to be multifunctional: it exhibits osteogenic and angiogenic properties and the potential to inhibit OS. In this study, we determined the proper concentration of released Mg²⁺ with respect to OS inhibition and biosafety and evaluated the anti-OS effects of Mg-coated Ti6Al4V scaffolds. We found that the release of Mg²⁺ during short-term and long-term degradation could significantly inhibit the proliferation and migration of HOS and 143B cells. Increased cell apoptosis and excessive autophagy were also observed, and further evidence of AMPK/mTOR/ULK1 signaling pathway activation was obtained both in vitro and in vivo, which suggested that the biofunctional scaffolds induce OS inhibition. Our study demonstrates the ability of an Mg coating to inhibit OS and may contribute to the further application of Mg-coated Ti6Al4V prostheses.

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Multifunctional Mg coating is considerable surface modification for Ti6Al4V prostheses.

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Mg²⁺ releasing by the scaffolds could significantly inhibit the proliferation and migration of OS cells.

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The biofunctional scaffolds could inhibit OS by activating autophagy-dependent apoptosis.

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The AMPK/mTOR/ULK-1 pathway was involved in autophagy-depended apoptosis induced by the scaffolds.

Biomedical Applications of Metal 3D Printing

Additive manufacturing's attributes include print customization, low per-unit cost for small- to mid-batch production, seamless interfacing with mainstream medical 3D imaging techniques, and feasibility to create free-form objects in materials that are biocompatible and biodegradable. Consequently, additive manufacturing is apposite for a wide range of biomedical applications including custom biocompatible implants that mimic the mechanical response of bone, biodegradable scaffolds with engineered degradation rate, medical surgical tools, and biomedical instrumentation. This review surveys the materials, 3D printing methods and technologies, and biomedical applications of metal 3D printing, providing a historical perspective while focusing on the state of the art. It then identifies a number of exciting directions of future growth: (a) the improvement of mainstream additive manufacturing methods and associated feedstock; (b) the exploration of mature, less utilized metal 3D printing techniques; (c) the optimization of additively manufactured load-bearing structures via artificial intelligence; and (d) the creation of monolithic, multimaterial, finely featured, multifunctional implants.

Enhancing the Capillary Force of Binder-Jetting Printing Ti6Al4V and Mechanical Properties under High Temperature Sintering by Mixing Fine Powder

Binder jet 3D printing (BJ3DP) is an additive manufacturing technology that selectively deposits binder on powder to form a three-dimensional green body followed by sintering process. The low strength of green body and metallurgical issues limit the manufacture of Ti6Al4V parts with high-performance and that are lightweight. In this study, thermal-bubble inkjet technology was used to print Ti6Al4V parts via jetting low-concentration in-situ polymer binders. In addition, a method for mixing fine powder was used to enhance the capillary force of the powder bed and mechanical properties of the parts. The results show that the capillary force was enhanced from 8.35 kPa for pure powder to 16.27 kPa for mixed powder by mixing fine powder. The compression strength of green body was enhanced from 1.5 MPa to 3.21 MPa. After sintering, the sample with mixed powder sintered at 1420 °C for 2 h had achieved a maximum density of 95.2%, microhardness of 316 HV, and yield stress of 589 MPa. The relative density of 95.2% of Ti6Al4V parts fabricated by BJ3DP technology in our study is significantly higher than the value reported in the existing literature. Finally, the porous structure with a size of 550 μm was fabricated. Results presented demonstrate that BJ3DP can produce Ti6Al4V parts with excellent properties.

Binder Jetting Additive Manufacturing of High Porosity 316L Stainless Steel Metal Foams

High porosity (40% to 60%) 316L stainless steel containing well-interconnected open-cell porous structures with pore openness index of 0.87 to 1 were successfully fabricated by binder jetting and subsequent sintering processes coupled with a powder space holder technique. Mono-sized (30 µm) and 30% (by volume) spherically shaped poly(methyl methacrylate) (PMMA) powder was used as the space holder material. The effects of processing conditions such as: (1) binder saturation rates (55%, 100% and 150%), and (2) isothermal sintering temperatures (1000 ^○C to 1200 ^○C) on the porosity of 316L stainless steel parts were studied. By varying the processing conditions, porosity of 40% to 45% were achieved. To further increase the porosity values of 316L stainless steel parts, 30 vol. % (or 6 wt. %) of PMMA space holder particles were added to the 3D printing feedstock and porosity values of 57% to 61% were achieved. Mercury porosimetry results indicated pore sizes less than 40 µm for all the binder jetting processed 316L stainless steel parts. Anisotropy in linear shrinkage after the sintering process was observed for the SS316L parts with the largest linear shrinkage in the Z direction. The Young's modulus and compression properties of 316L stainless steel parts decreased with increasing porosity and low Young's modulus values in the range of 2 GPa to 29 GPa were able to be achieved. The parts fabricated by using pure 316L stainless steel feedstock sintered at 1200 ^○C with porosity of ~40% exhibited the maximum overall compressive properties with 0.2% compressive yield strength of 52.7 MPa, ultimate compressive strength of 520 MPa, fracture strain of 36.4%, and energy absorption of 116.7 MJ/m³, respectively. The Young's modulus and compression properties of the binder jetting processed 316L stainless steel parts were found to be on par with that of the conventionally processed porous 316L stainless steel parts and even surpassed those having similar porosities, and matched to that of the cancellous bone types.

Functions and applications of metallic and metallic oxide nanoparticles in orthopedic implants and scaffolds

Bone defects and diseases are devastating, and can lead to severe functional deficits or even permanent disability. Nevertheless, orthopedic implants and scaffolds can facilitate the growth of incipient bone and help us to treat bone defects and diseases. Currently, a wide range of biomaterials with distinct biocompatibility, biodegradability, porosity, and mechanical strength is used in bone-related research. However, most orthopedic implants and scaffolds have certain limitations and diverse complications, such as limited corrosion resistance, low cell proliferation, and bacterial adhesion. With recent advancements in materials science and nanotechnology, metallic and metallic oxide nanoparticles have become the subject of significant interest as they offer an ample variety of options to resolve the existing problems in the orthopedic industry. More importantly, these nanoparticles possess unique physicochemical and mechanical properties not found in conventional materials, and can be incorporated into orthopedic implants and scaffolds to enhance their antimicrobial ability, bioactive molecular delivery, mechanical strength, osteointegration, and cell labeling and imaging. However, many metallic and metallic oxide nanoparticles can also be toxic to nearby cells and tissues. This review article will discuss the applications and functions of metallic and metallic oxide nanoparticles in orthopedic implants and bone tissue engineering.

Recent Developments of Biomaterials for Additive Manufacturing of Bone Scaffolds

Recent years have witnessed surging demand for bone repair/regeneration implants due to the increasing number of bone defects caused by trauma, cancer, infection, and arthritis worldwide. In addition to bone autografts and allografts, biomaterial substitutes have been widely used in clinical practice. Personalized implants with precise and personalized control of shape, porosity, composition, surface chemistry, and mechanical properties will greatly facilitate the regeneration of bone tissue and satiate the clinical needs. Additive manufacturing (AM) techniques, also known as 3D printing, are drawing fast growing attention in the fabrication of implants or scaffolding materials due to their capability of manufacturing complex and irregularly shaped scaffolds in repairing bone defects in clinical practice. This review aims to provide a comprehensive overview of recent progress in the development of materials and techniques used in the additive manufacturing of bone scaffolds. In addition, clinical application, pre-clinical trials and future prospects of AM based bone implants are also summarized and discussed.

A study of Titanium and Magnesium particle-induced oxidative stress and toxicity to human osteoblasts

Hybrid implants combine both Titanium (Ti) and Magnesium (Mg) are prevalent nowadays. The long-term implications of Ti and Mg implants within the human body are not yet fully understood. Many implant failure cases due to inflammation, allergic responses, and aspect loosening have been reported frequently. Particles generated through daily wear and tear of implants may worsen the situation by causing acute complications. An in-depth understanding of the behavior of metal particles with human osteoblasts is necessary. In this study, a novel and systematic attempt was made to understand the effects of different concentrations of Ti and Mg particles to the osteoblastic SAOS2 cell: toxicity, alterations to mitochondria, and changes to the specific gene and protein expression. Ti particles were found toxic to SAOS2 cells at different dosages, while Mg particles at lower concentrations could improve cell viability. To understand this phenomenon better, we have measured cellular reactive oxygen species (ROS) production and cell apoptosis & necrosis percentage. We also have checked the mitochondrial structure with transmission electron microscope (TEM), and mitochondrial function using Tetramethyl rhodamine, ethyl ester staining (TMRE). NDUFB6, SDHC, and ATP5F1 were the essential mitochondrial genes involved in the ROS production and ATP production. Immunocytochemistry (ICC) and real-time polymerase chain reaction (qPCR) were implemented to check the regulations of these related genes.