与骨缺损区域骨组织再生相匹配的新型硅酸钙(基)支架的性能优化

背景:硅酸钙支架因为具有良好的生物相容性、骨诱导性、骨传导活性及具备一定的生物降解性而备受关注,但由于硅酸钙成骨效应不稳定、降解速率快以及力学性能差的原因,目前尚未应用于临床骨缺损修复中.目的:详细回顾近年来优化硅酸钙支架性能的研究进展,总结单相硅酸钙支架在骨缺损修复应用中的潜力和不足,探索其用于临床骨缺损修复的可能性...     

金属离子掺杂羟基磷灰石骨修复材料的特性及应用

背景：目前用于骨修复的自体骨和异体骨存在来源有限、供骨区并发症、潜在的疾病传播风险、免疫排斥反应及价格昂贵等问题,临床应用受到限制,人工骨修复材料作为骨移植替代材料得到了广泛研究。目的：总结金属离子掺杂改性羟基磷灰石用于骨组织修复的研究现状。方法：检索2000年1月至2022年5月Pub Med、Web of Science、中国知网及万方数据库收录的相关文献,中文检索词为“金属离子、羟基磷灰石、掺杂改性、骨修复”,英文检索词为“Metal ion,Hydroxyapatite,Doping modification,Bone repair”。最终纳入61篇文献进行综述分析。结果与结论：(1)离子掺杂羟基磷灰石具有良好的特性,锶可增强成骨细胞的骨生成过程,并抑制破骨细胞介导的骨吸收,锶掺杂羟基磷灰石在骨质疏松性骨缺损修复方面具有独特的优势。(2)铜、锌、银、镁、铁具有一定的抗菌活性,其中银、锌具有优异的抗菌性,掺杂改性羟基磷灰石对预防和治疗骨科感染具有重要意义。(3)铜可促进血管内皮细胞迁移,增加血管生成,掺铜羟基磷灰石可用于乏血管部位的骨组织修复。钡具有显影性,与羟基磷灰石等其他材料...     

聚乳酸-乙醇酸复合中药自然铜活性骨修复支架生物学评价

目的评价新型骨修复材料聚乳酸-乙醇酸复合中药自然铜活性骨修复支架的生物安全性。方法根据医疗器械生物学评价标准的要求,选取了溶血试验、细胞毒性试验、遗传毒性试验、刺激与致敏试验、全身毒性试验、植入试验等,全方位评价该新型材料的生物安全性。结果聚乳酸-乙醇酸复合中药自然铜活性骨修复支架的血液相容性良好,无全身毒性和细胞毒性,未发现短期遗传毒性,无皮肤刺激和致敏作用,材料植入骨后周围组织反应正常,骨修复情况良好。结论聚乳酸-乙醇酸复合中药自然铜活性骨修复支架是一种生物相容性好的骨修复材料,可安全应用于临床。     

Zn、Mg增强羟基磷灰石骨修复材料临床应用与机制：生物活性及成骨诱导的研究进展

文题释义： 骨缺损修复材料：目前临床上应用的骨修复材料主要有自体骨、同种异体骨和动物源性异种骨,但都存在一定的局限,应用受到限制。因此,研究开发对病损或缺失的骨组织进行有效修复和功能重建的人工骨修复材料具有广泛的临床需求和重要的意义,成为生物医用材料研究的热点。 骨组织工程：主要由3部分组成,分别是种子细胞、诱导因子及支架材料,通过培养的细胞在预制形态的三维支架上生长,之后植入骨缺损部位,在生物材料逐步降解的同时,种植的骨细胞不断增殖,从而达到修复骨组织缺损的目的。 背景：目前临床大量需求的自体骨存在来源不足、供骨区并发症等问题,而同种异体骨和异种骨存在免疫排斥、疾病传播等问题,应用受到限制,人工骨修复材料为骨缺损修复提供了重要解决途径。 目的：综合叙述锌、镁这2种二价阳离子掺杂羟基磷灰石的国内外最新基础研究进展及成骨诱导机制。 方法：检索PubMed数据库、万方数据知识服务平台及CNKI中国期刊全文数据库2006至2019年收录的有关Zn、Mg增强羟基磷灰石骨修复材料生物活性及成骨诱导相关研究的文章,检索词为“锌,镁,羟基磷灰石,体内,体外,成骨活性,骨修复,骨缺损;Zinc,magnesium, hydroxyapatite,in vivo,in vitro,osteogenic activity,bone repair,bone defect”。 结果与结论：尽管可降解活性元素Mg和Zn及其在羟基磷灰石基骨修复材料上的应用有较多研究,但研究目前仍然主要集中在金属或合金植入体方面,对于Mg-羟基磷灰石和Zn-羟基磷灰石复合材料的研究也大多制备成纳米颗粒、致密块体材料或作为生物医用金属材料的活性涂层来应用,关于将Mg和Zn元素与羟基磷灰石功能复合制备成仿骨结构多孔骨修复材料方面的研究还很少。同时金属离子材料仍面临许多挑战：首先,当特定金属从支架、植入物或其他释放装置中局部释放时,需要深入了解它们在健康和病变组织的细胞调控和细胞-细胞信号传导中的作用;其次,大量的体内实验证实金属离子可以从支架局部释放而不会产生全身毒性,但有致癌效应;此外还需要有更广泛的知识,了解将支架改善的生物学性能与金属离子释放效应联系起来的机制。 ORCID: 0000-0001-8645-7623(张亚楠) 中国组织工程研究杂志出版内容重点：生物材料;骨生物材料; 口腔生物材料; 纳米材料; 缓释材料; 材料相容性;组织工程     

骨填充材料修复骨肿瘤术后的骨缺损

背景：骨填充材料具有良好的生物活性、生物相容性、生物安全性和机械性能,可通过骨的传导及诱发新骨形成等作用实现骨的自身修复,是一种高效、安全、性价比较高的骨移植替代材料,可作为修复囊性破坏的良性骨肿瘤和瘤样病变术后缺损的修复材料进行更深入地研究及开发利用。 目的：总结近年有关骨填充材料修复骨肿瘤术后骨缺损的研究进展。 方法：由作者应用计算机检索维普数据库中与骨填充材料修复骨肿瘤术后骨缺损有关的文献,检索时限为1998-01/ 2009-10。检索关键词：骨填充材料,骨肿瘤,骨缺损。最终纳入22篇文献进入结果分析。 结果与结论：应用同种异体骨、自体骨复合物修复骨肿瘤瘤段切除后骨缺损是一种具有较高临床应用价值的有效方法。同种异体骨作为可被宿主生物学吸收重建的永久性植入材料,其相对于其他材料有很大优势。对于四肢良性肿瘤切除后骨缺损的修复,尤其是较大的骨缺损是一种具有较高临床应用价值的植入材料。     

纤维蛋白胶复合自体骨髓与人工骨促进脊柱融合的现状与展望

背景：如何利用纤维蛋白胶的黏合性在术中复合自体骨髓与人工骨来提高脊柱融合的成功率,值得进一步研究。 目的：综述纤维蛋白胶的研究背景、成分、作用原理及理化特性,纤维蛋白胶及自体骨髓复合人工骨在脊柱融合中应用的现状。 方法：由第一作者检索1994/2010 CNKI系列数据库及PubMed数据库有关纤维蛋白胶的研究背景、成分、作用原理及理化特性,纤维蛋白胶在构建组织工程骨及修复骨缺损中的应用,自体骨髓复合人工骨移植在修复骨缺损中的应用,脊柱融合中植骨方法应用等方面的文献。 结果与结论：自体骨髓复合人工骨移植修复骨缺损在临床取得了较好的疗效,因此在脊柱融合中利用自体骨髓复合人工骨来提高脊柱融合率应该是可行的方案,但以往自体骨髓混合人工骨的过程相对简单,又由于自体骨髓流动性大,注射后容易流失,明显降低了自体骨髓的成骨作用。因此设想在临床手术中,利用纤维蛋白胶的黏合特性将自体骨髓与人工骨黏合在一起,植入脊柱关节突、横突部位,充分发挥骨髓的最大成骨作用,这将是临床一个提高脊柱融合率的简易、快速、有效的方法,有待进一步的深入研究。     

聚氨酯材料在骨质疏松性骨缺损修复中的应用

背景:聚氨酯支架材料作为骨组织工程的基本框架并具有良好的生物相容性、降解性、可塑性和骨传导性,是治疗骨质疏松骨缺损的一种有效方法.目的:全面综述了聚氨酯体系对骨缺损的疗效,并探讨了聚氨酯与具成骨活性成分的结合,以促进骨质疏松性骨缺损修复的研究思路.方法:以"osteoporosis,bone defect,polyur...     

β-TCP材料改性研究进展及在骨缺损修复中的应用*

大段骨缺损再生修复是临床骨科面临的难题之一,利用组织工程材料修复大段骨缺损是最具前景的治疗方式。β-TCP材料由于具有与自体骨相似的无机成分,良好的生物相容性、可吸收降解以及骨传导等性能被广泛应用于骨科临床治疗。虽然β-TCP材料是一种最具潜力的骨替代材料,但是还存在诸如降解速率与新骨再生速率不匹配、脆性大力学强度不够、骨诱导能力差等缺陷,从而阻碍其临床应用。采用其他材料对β-TCP材料改性提高降解、力学及骨诱导等性能是目前研究热点。本文就β-TCP材料改性研究及在骨缺损再生修复中的应用作一综述。     

骨修复替代材料修复骨缺损的选择与应用

背景：在骨缺损治疗方面,近几年集中在骨修复替代材料领域出现了一系列重大科研突破,催生了很多全新的骨修复替代材料。目前临床上可供选择的骨修复替代材料种类繁多,各种材料的特性不同,各有优势和缺点。如何正确选择与应用是创伤骨科医师面临的实际问题,值得讨论和推敲。 目的：通过对自体骨、同种异体骨和人工骨材料在应用中的相关文献分析,评价3种骨修复替代材料的生物性能,有利于骨科医师更好的理解几种骨修复替代材料的理化、生物性能,进一步提高诊断和治疗水平。 方法：人工骨材料在骨缺损修复中起到不可取代的作用,并且也获得良好的临床效果,但近期临床效果并非是与传统材料的最终比较结果。人工骨材料安全性和稳定性的验证尚缺乏足够的实验依据,确切疗效尚须长期的临床观察。寻找具有良好生物特性的人工骨材料抑制是骨科的研究热点。分别对自体骨、同种异体骨、人工骨材料3种骨修复替代材料治疗骨缺损的理化、生物性能,安全性综合比较进行实验数据分析。 结果与结论：①在骨缺损修复过程中,从修复质量、免疫排斥和疾病传播等多方面来衡量,自体骨都是最佳的选择,成为骨移植的金标准。但来源有限且取骨区可能产生并发症,取骨又造成第二术区的创伤,因而它的临床应用受到了很大的限制。②同种异体骨的来源比自体骨多,但与宿主间的免疫排斥反应,并有感染疾病如肝炎病毒的可能。③人工骨材料成型迅速,在计算机辅助设计和辅助制作的帮助下,能更好的合成与缺损骨形态接近的骨修复替代材料,人工骨材料的骨诱导性和仿生物性骨结构方面还不能令人满意。④现有的骨修复替代材料均存在各自不同某些缺陷,不能完全满足临床质量的需要。未来能代替天然骨骼,解决骨缺损修复的材料应当是优势的组合,是骨修复替代材料的发展趋势。     

骨诱导活性材料修复牙槽突裂骨缺损的可行与可靠性

背景：临床可以采取植骨方式治疗牙槽骨缺损,其中所选用的植骨材料对最终植骨效果会产生一定的影响。 目的：探讨骨诱导活性材料修复牙槽突裂骨缺损的可行性和可靠性。 方法：纳入63例牙槽突裂骨缺损患者,其中男33例,女30例,年龄8-15岁,均实施骨移植治疗,按照所选用植骨材料的不同分为自体骨组(n=32)和骨诱导活性材料组(n=31)。治疗结束后随访12个月,观察两组植骨效果、骨密度、未萌尖牙情况及不良反应发生情况。 结果与结论：①治疗总有效率：两组间比较差异无显著性意义(P > 0.05)。②未萌尖牙情况：自体骨组7颗未萌尖牙中,2颗萌出,4颗向植骨区移动,1颗未出现明显改变;骨诱导活性材料组6颗未萌尖牙中,2颗萌出,2颗未出现明显改变,2颗向植骨区移动。③牙槽骨密度：两组修复后的骨密度均较治疗前显著增加(P < 0.05),修复后两组间比较差异无显著性意义。④不良反应：两组患者均未出现感染、排异及植骨材料脱落等不良事件。表明利用骨诱导活性材料修复牙槽突裂骨缺损可以获得与自体骨移植相似的效果,具有一定的临床应用可行性和可靠性。 中国组织工程研究杂志出版内容重点：生物材料;骨生物材料; 口腔生物材料; 纳米材料; 缓释材料; 材料相容性;组织工程     

纳米TCP颗粒在骨修复用复合材料中分散性的研究进展

运用骨组织工程技术修复骨缺损是近年来研究的热点,其中对骨组织工程技术中关键要素之一的骨修复材料的研究最为深入。纳米TCP(nano-TCP)/可吸收高聚物复合材料因其优良的骨传导性、骨生成性及骨诱导性而备受关注,但由于nano-TCP颗粒团聚而引起的复合材料性能的恶化仍然是当下研究的难点。本文从nanoTCP颗粒分散性的研究意义、团聚原理以及改善分散性的方法 3个方面进行文献综述与讨论,期望为进一步改善nano-TCP/可吸收高聚物复合材料的应用性能提供参考。     

Enhanced regeneration of critical bone defects using a biodegradable gelatin sponge and beta-tricalcium phosphate with bone morphogenetic protein-2

We examine the osteogenicity of a sponge biomaterial consisting of a biodegradable mixture of gelatin and beta-tricalcium phosphate (betaTCP) that bound bone morphogenetic protein 2 (BMP-2) in critical-sized bone defects in rats. Gelatin-betaTCP sponges containing either phosphate buffered saline or incorporating BMP-2 are implanted into 5 mm diameter bone defects created in rat mandibles. We assess the defects biweekly for 8 weeks following implantation. There is significantly higher osteoinductive activity and significantly more Gla-osteocalcin content at bone-defect healing sites treated with gelatin-betaTCP sponges incorporating BMP-2 than there is in those treated with sponges that did not contain BMP-2. Histologically, new bone that contains bone marrow and that is connected to the original bone almost entirely replaces the regenerated bone. These results show that biodegradable gelatin-betaTCP incorporating BMP-2 is osteogenic enough to promote healing in large bone defects.     

HA/β-TCP支架材料的研究进展

随着骨修复材料需求的增多,HA/β-TCP复合支架作为一种兼具良好的生物相容性、生物降解性、骨传导性以及骨诱导性的生物材料受到了人们的广泛关注。本文关注于web of science上的相关文献,主要论述以下几个方面内容:HA/β-TCP组成比例对复合支架的性能影响;HA/β-TCP复合支架与其他主流材料的复合;新制作工艺的出现与结构改进。在技术推进和研究深入的背景下,对作为骨修复工程中较为理想的生物材料HA/β-TCP复合支架的发展现状进行介绍。     

表面改性在医用镁及镁合金材料研究中的应用

镁及镁合金材料作为可降解生物材料,其密度与人骨密度相当,具有较高的比强度和比刚度以及相对于非金属材料的更好的塑韧性和可加工性。因此,镁及镁合金有望用于承力部位的骨组织修复。本文综述了医用镁及镁合金作为生物医用材料的表面改性技术的研究现状。     

Silk-based biomaterials

Silk from the silkworm, Bombyx mori, has been used as biomedical suture material for centuries. The unique mechanical properties of these fibers provided important clinical repair options for many applications. During the past 20 years, some biocompatibility problems have been reported for silkworm silk; however, contamination from residual sericin (glue-like proteins) was the likely cause. More recent studies with well-defined silkworm silk fibers and films suggest that the core silk fibroin fibers exhibit comparable biocompatibility in vitro and in vivo with other commonly used biomaterials such as polylactic acid and collagen. Furthermore, the unique mechanical properties of the silk fibers, the diversity of side chain chemistries for 'decoration' with growth and adhesion factors, and the ability to genetically tailor the protein provide additional rationale for the exploration of this family of fibrous proteins for biomaterial applications. For example, in designing scaffolds for tissue engineering these properties are particularly relevant and recent results with bone and ligament formation in vitro support the potential role for this biomaterial in future applications. To date, studies with silks to address biomaterial and matrix scaffold needs have focused on silkworm silk. With the diversity of silk-like fibrous proteins from spiders and insects, a range of native or bioengineered variants can be expected for application to a diverse set of clinical needs.     

骨修复材料在骨折及骨缺损治疗中的价值

背景：人工骨材料作为骨移植替代物修复骨缺损,是医学和生物材料学领域内的一项重要研究课题。 目的：总结近年有关骨修复材料在骨折及骨缺损中的应用现状。 方法：由作者应用计算机检索维普数据库中与骨修复材料治疗骨折、骨缺损有关的文献,检索时限为1998-01/2009-10。检索关键词为“骨折,骨修复,假体置换,材料”。纳入标准：①选取针对性强,相关度高的文献。②排除一些重复性研究。对资料进行初审,并查看每篇文献后的引文。最终纳入26篇文献进入结果分析。 结果与结论：目前研究较多的骨修复材料有纳米羟基磷灰石/聚酰胺66,脱钙骨基质,硫酸钙颗粒,纳米晶羟基磷灰石/胶原复合材料等。纳米级组织工程骨材料则是利用纳米技术在纳米结构单元或纳米数量级(1~100 nm)下生产的新型材料,研制成的纳米羟基磷灰石/胶原骨经动物实验研究证实,比普通羟基磷灰石有更为优越的生物相容性和生物活性,无细胞毒性,能促进和加快骨创的愈合。     

丝素蛋白复合骨髓间充质干细胞构建组织工程化骨修复节段性骨缺损的实验研究

目的 探讨丝素蛋白材料复合骨髓间充质干细胞构建组织工程化骨组织修复兔桡骨的节段性骨缺损的可行性.方法 分离培养兔骨髓间充质干细胞,与丝素蛋白膜材料复合培养,扫描电镜观察细胞在材料上的生长情况.将24只新西兰大白兔制成桡骨中段1.5cm长的骨缺损模型,随机分为3组:实验组(植入细胞材料复合物)、对照组(单纯植入丝素蛋白材料)、空白组(不植入修复材料).术后2,4,8,12周分别行大体观察、组织学观察和X线观察,比较3组骨缺损修复的情况.结果 骨髓间充质干细胞在丝素蛋白膜材料上生长情况良好.术后2,4,8,12周放射学检查新骨生成以及组织学检查新骨生成情况,实验组均优于对照组,空白组各时点均无新骨形成.结论 丝素蛋白材料与骨髓间充质干细胞体外复合培养构建的组织工程化骨能够修复兔桡骨缺损,可以作为组织工程骨的支架材料的全新来源. Abstract： Objective To investigate the possibility of adopting the silk fibroin biomaterial as the scaf-fold for bone marrow mesechymal stem cells(BMSCs) in the repair of rabbit radial defects. Methods BMSCs were isolated and co-cultured with the silk fibroin biomaterial in vitro. The growth condition of these cells on the scaffold was observed under electronic microscope. Bone defect models were made by removing 15 mm length of midshaft radial bone in 24 New Zealand rabbits. Animals were randomly devided into the experimental group in which the BMSCs seeded silk fibroin scaffold were transplanted, control group in which simple silk fibroin bioma-terial scaffold was adopted and blank group in which rabbits were left untreated. The repair of the defects was observed at 2, 4, 8, 12 weeks after operation, respectively. Results The rabbits BMSCs grew well on the material and the animals treated with grafts exhibited new bone formation. Result from experimental group was apparently superior to that of the control group at 2, 4, 8, 12 we     

Carbon Nanotube–Poly(lactide-co-glycolide) Composite Scaffolds for Bone Tissue Engineering Applications

Despite their indisputable clinical value, current tissue engineering strategies face major challenges in recapitulating the natural nano-structural and morphological features of native bone. The aim of this study is to take a step forward by developing a porous scaffold with appropriate mechanical strength and controllable surface roughness for bone repair. This was accomplished by homogenous dispersion of carbon nanotubes (CNTs) in a poly(lactide-co-glycolide) (PLGA) solution followed by a solvent casting/particulate leaching scaffold fabrication. Our results demonstrated that CNT/PLGA composite scaffolds possessed a significantly higher mechanical strength as compared to PLGA scaffolds. The incorporation of CNTs led to an enhanced surface roughness and resulted in an increase in the attachment and proliferation of MC3T3-E1 osteoblasts. Most interestingly, the in vitro osteogenesis studies demonstrated a significantly higher rate of differentiation on CNT/PLGA scaffolds compared to the control PLGA group. These results all together demonstrate the potential of CNT/PLGA scaffolds for bone tissue engineering as they possess the combined effects of mechanical strength and osteogenicity.     

Repair of an intercalated long bone defect with a synthetic biodegradable bone-inducing implant

Recombinant human bone morphogenetic protein (rhBMP)-2 in a block copolymer composed of poly-D,L-lactic acid with randomly inserted p-dioxanone and polyethylene glycol (PLA-DX-PEG) as a carrier and porous beta-tricalcium phosphate (beta-TCP) blocks were used to generate a new fully absorbable osteogenic biomaterial. The bone regenerability of the rhBMP-2/PLA-DX-PEG/beta-TCP composite was studied in a critical-sized rabbit bone defect model. In an initial study, a composite of PLA-DX-PEG (250 mg) and beta-TCP (300 mg) loaded with or without rhBMP2 (50 microg) was implanted into a 1.5 cm intercalated bone defect created in a rabbit femur. Defects were assessed by biweekly radiography until 8 weeks postoperatively. The bony union of the defect was recognized only in the BMP-loaded group. To obtain further data on biomechanical and remodeling properties, another BMP-loaded composites group was made and observed up to 24 weeks. All defects were completely repaired without residual traces of implants. Anatomical and mechanical properties of the repaired bone examined by histology, 3-dimensional CT (3D-CT) and mechanical testing were essentially equivalent to the nonoperated-on femur at 24 weeks. These experimental results indicate that fully absorbable rhBMP-2/PLA-DX-PEG/beta-TCP is a promising composite having osteogenicity efficient enough for repairing large bone defects.     

The Transplantation of hBM-MSCs Increases Bone Neo-Formation and Preserves Hearing Function in the Treatment of Temporal Bone Defects – on the Experience of Two Month Follow Up

Temporal bone reconstruction is a persisting problem following middle ear cholesteatoma surgery. Seeking to advance the clinical transfer of stem cell therapy we attempted the reconstruction of temporal bone using a composite bioartificial graft based on a hydroxyapatite bone scaffold combined with human bone marrow-derived mesenchymal stromal cells (hBM-MSCs). The aim of this study was to evaluate the effect of the combined biomaterial on the healing of postoperative temporal bone defects and the preservation of physiological hearing functions in a guinea pig model. The treatment’s effect could be observed at 1 and 2 months after implantation of the biomaterial, as opposed to the control group. The clinical evaluation of our results included animal survival, clinical signs of an inflammatory response, and exploration of the tympanic bulla. Osteogenesis, angiogenesis, and inflammation were evaluated by histopathological analyses, whereas hBM-MSCs survival was evaluated by immunofluorescence assays. Hearing capacity was evaluated by objective audiometric methods, i.e. auditory brainstem responses and otoacoustic emission. Our study shows that hBM-MSCs, in combination with hydroxyapatite scaffolds, improves the repair of bone defects providing a safe and effective alternative in their treatment following middle ear surgery due to cholesteatoma.