1.Research progress of bioactive scaffolds in repair and regeneration of osteoporotic bone defects.
Yuangang WU ; Kaibo SUN ; Yi ZENG ; Bin SHEN
Chinese Journal of Reparative and Reconstructive Surgery 2025;39(1):100-105
OBJECTIVE:
To summarize the research progress of bioactive scaffolds in the repair and regeneration of osteoporotic bone defects.
METHODS:
Recent literature on bioactive scaffolds for the repair of osteoporotic bone defects was reviewed to summarize various types of bioactive scaffolds and their associated repair methods.
RESULTS:
The application of bioactive scaffolds provides a new idea for the repair and regeneration of osteoporotic bone defects. For example, calcium phosphate ceramics scaffolds, hydrogel scaffolds, three-dimensional (3D)-printed biological scaffolds, metal scaffolds, as well as polymer material scaffolds and bone organoids, have all demonstrated good bone repair-promoting effects. However, in the pathological bone microenvironment of osteoporosis, the function of single-material scaffolds to promote bone regeneration is insufficient. Therefore, the design of bioactive scaffolds must consider multiple factors, including material biocompatibility, mechanical properties, bioactivity, bone conductivity, and osteogenic induction. Furthermore, physical and chemical surface modifications, along with advanced biotechnological approaches, can help to improve the osteogenic microenvironment and promote the differentiation of bone cells.
CONCLUSION
With advancements in technology, the synergistic application of 3D bioprinting, bone organoids technologies, and advanced biotechnologies holds promise for providing more efficient bioactive scaffolds for the repair and regeneration of osteoporotic bone defects.
Humans
;
Tissue Scaffolds/chemistry*
;
Bone Regeneration
;
Osteoporosis/therapy*
;
Tissue Engineering/methods*
;
Biocompatible Materials/chemistry*
;
Printing, Three-Dimensional
;
Calcium Phosphates/chemistry*
;
Osteogenesis
;
Ceramics
;
Cell Differentiation
;
Hydrogels
;
Bioprinting
;
Bone and Bones
2.Applications and prospects of graphene and its derivatives in bone repair.
Zhipo DU ; Yizhan MA ; Cunyang WANG ; Ruihong ZHANG ; Xiaoming LI
Chinese Journal of Reparative and Reconstructive Surgery 2025;39(1):106-117
OBJECTIVE:
To summarize the latest research progress of graphene and its derivatives (GDs) in bone repair.
METHODS:
The relevant research literature at home and abroad in recent years was extensively accessed. The properties of GDs in bone repair materials, including mechanical properties, electrical conductivity, and antibacterial properties, were systematically summarized, and the unique advantages of GDs in material preparation, functionalization, and application, as well as the contributions and challenges to bone tissue engineering, were discussed.
RESULTS:
The application of GDs in bone repair materials has broad prospects, and the functionalization and modification technology effectively improve the osteogenic activity and material properties of GDs. GDs can induce osteogenic differentiation of stem cells through specific signaling pathways and promote osteogenic activity through immunomodulatory mechanisms. In addition, the parameters of GDs have significant effects on the cytotoxicity and degradation behavior.
CONCLUSION
GDs has great potential in the field of bone repair because of its excellent physical and chemical properties and biological properties. However, the cytotoxicity, biodegradability, and functionalization strategies of GDs still need to be further studied in order to achieve a wider application in the field of bone tissue engineering.
Graphite/pharmacology*
;
Tissue Engineering/methods*
;
Humans
;
Osteogenesis/drug effects*
;
Biocompatible Materials/pharmacology*
;
Bone Regeneration
;
Tissue Scaffolds/chemistry*
;
Cell Differentiation
;
Bone and Bones
;
Bone Substitutes/chemistry*
;
Animals
3.Application and progress of intelligent responsive hydrogels in articular cartilage injury repair.
Qingyu XU ; Baojian ZHANG ; Hongri LI ; Chengri LIU ; Shuhao BI ; Zhixiang YANG ; Yanqun LIU
Chinese Journal of Reparative and Reconstructive Surgery 2025;39(2):250-256
OBJECTIVE:
To review clinical application and research progress of different types of intelligent responsive hydrogels in repairing articular cartilage injury.
METHODS:
The animal experiments and clinical studies of different types of intelligent responsive hydrogels for repairing articular cartilage injury were summarized by reviewing relevant literature at home and abroad.
RESULTS:
The intrinsic regenerative capacity of articular cartilage following injury is limited. Intelligent responsive hydrogels, including those that are temperature-sensitive, light-sensitive, enzyme-responsive, pH-sensitive, and other stimuli-responsive hydrogels, can undergo phase transitions in response to specific stimuli, thereby achieving optimal functionality. These hydrogels can fill the injured cartilage area, promote the proliferation and differentiation of chondrocytes, and expedite the repair of the damaged site. With advancements in cartilage tissue engineering materials research, intelligent responsive hydrogels offer a novel approach and promising potential for the treatment of cartilage injuries.
CONCLUSION
Intelligent responsive hydrogel is a kind of flexible, controllable, efficient, and stable polymer, which has similar structure and functional properties to articular cartilage, and has become one of the important biomaterials for cartilage repair. However, there is still a lack of unified treatment standards and simple and efficient preparation technology.
Hydrogels/therapeutic use*
;
Cartilage, Articular/injuries*
;
Tissue Engineering/methods*
;
Humans
;
Animals
;
Chondrocytes/cytology*
;
Biocompatible Materials/chemistry*
;
Tissue Scaffolds/chemistry*
4.Research progress on strontium modified β-tricalcium phosphate composite biomaterials with immune regulatory properties.
Huanxi LI ; Xingyu SHAN ; Hongda WANG ; Zhimin TIAN ; Chunnuo HE ; Haoqiang ZHANG
Chinese Journal of Reparative and Reconstructive Surgery 2025;39(4):511-517
OBJECTIVE:
To review the research progress of strontium (Sr) modified β-tricalcium phosphate composite biomaterials (SrTCP) promoting osteogenesis through immune regulation, and provides reference and theoretical support for the further development and research of SrTCP bone repair materials in bone tissue engineering in the future.
METHODS:
The literature about SrTCP promoting osteogenesis through immune regulation at home and abroad in recent years was extensively reviewed, and the preparation methods, immune mechanism and application of promoting osteogenesis were summarized and analyzed.
RESULTS:
The preparation methods of SrTCP include solid-state reaction sintering method, solution combustion quenching method, direct doping method, ion substitution method, etc. SrTCP has immune regulatory effects, which can play an immune regulatory role in inducing macrophage polarization, inducing angiogenesis and anti oxidative stress to promote osteogenesis.
CONCLUSION
At present, studies have shown that SrTCP can promote bone defect repair through immune regulation. Subsequent studies can start from the control of the optimal repair concentration and release rate of Sr, and further clarify the specific mechanism of SrTCP in promoting angiogenesis and anti oxidative stress, which is helpful to develop new materials for bone defect repair.
Calcium Phosphates/pharmacology*
;
Strontium/pharmacology*
;
Biocompatible Materials/pharmacology*
;
Humans
;
Osteogenesis/drug effects*
;
Tissue Engineering/methods*
;
Bone Substitutes/pharmacology*
;
Bone Regeneration/drug effects*
;
Animals
;
Tissue Scaffolds/chemistry*
;
Neovascularization, Physiologic/drug effects*
;
Macrophages/immunology*
5.Research progress on silk fibroin-nerve guidance conduits for peripheral nerve injury repair.
Fan DONG ; Yining WANG ; Zixiang WU ; Quanchang TAN
Chinese Journal of Reparative and Reconstructive Surgery 2025;39(6):777-782
OBJECTIVE:
To review the research progress on silk fibroin (SF)-nerve guidance conduits (NGCs) for peripheral nerve injury (PNI) repair.
METHODS:
To review the recent literature on PNI and SF-NGCs, expound the concepts and treatment strategies of PNI, and summarize the construction of SF-NGCs and its application in PNI repair.
RESULTS:
Autologous nerve transplantation remains the "gold standard" for treating severe PNI. However, it's clinical applications are constrained by the limitations of limited donors and donor area damage. Natural SF exhibits good biocompatibility, low immunogenicity, and excellent physicochemical properties, making it an ideal candidate for the construction of NGCs. SF-NGCs constructed using different technologies have been found to have better biocompatibility and bioactivity. Their configurations can facilitate nerve regeneration by enhancing regenerative guidance and axonal extension. Besides, the adhesion, proliferation and differentiation of neurons and Schwann cells related to PNI repair can be effectively promote by NGCs. This accelerates the speed of nerve regeneration and improves the efficiency of repair. In addition, SF-NGCs can be used as regenerative scaffolds to provide biological templates for nerve repair.
CONCLUSION
The biodegradable natural SF has been extensively studied and demonstrated promising application prospects in the field of NGCs. It might be an effective and viable alternative to the "gold standard" for PNI treatment.
Fibroins/chemistry*
;
Peripheral Nerve Injuries/therapy*
;
Nerve Regeneration
;
Tissue Scaffolds/chemistry*
;
Humans
;
Guided Tissue Regeneration/methods*
;
Biocompatible Materials
;
Animals
;
Tissue Engineering/methods*
;
Schwann Cells/cytology*
;
Peripheral Nerves
;
Neurons/cytology*
6.Preparation of calcium phosphate nanoflowers and evaluation of their antioxidant and osteogenic induction capabilities in vitro.
Mingyu JIA ; Zhihong CHEN ; Huajian ZHOU ; Yukang ZHANG ; Min WU
Chinese Journal of Reparative and Reconstructive Surgery 2025;39(9):1203-1211
OBJECTIVE:
To investigate the antioxidant and osteogenic induction capabilities of calcium phosphate nanoflowers (hereinafter referred to as nanoflowers) in vitro at different concentrations.
METHODS:
Nanoflowers were prepared using gelatin, tripolyphosphate, and calcium chloride. Their morphology, microstructure, elemental composition and distribution, diameter, and molecular constitution were characterized using scanning electron microscopy, transmission electron microscopy, Fourier transform infrared spectroscopy, and energy-dispersive spectroscopy. Femurs and tibias were harvested from twelve 4-week-old Sprague Dawley rats, and bone marrow mesenchymal stem cells (BMSCs) were isolated and cultured using the whole bone marrow adherent method, followed by passaging. The third passage cells were identified as stem cells by flow cytometry and then co-cultured with nanoflowers at concentrations of 0, 0.4, 0.8, 1.2, 1.6, 2.0, 2.4, 2.8, 3.2, and 3.6 mg/mL. Cell counting kit 8 (CCK-8) assay was performed to screen for the optimal concentration that demonstrated the best cell viability, which was subsequently used as the experimental concentration for further studies. After co-culturing BMSCs with the screened concentration of nanoflowers, the biocompatibility of the nanoflowers was verified through live/dead cell staining, scratch assay, and cytoskeleton staining. The antioxidant capacity was assessed by using reactive oxygen species (ROS) fluorescence staining. The in vitro osteoinductive ability was evaluated via alkaline phosphatase (ALP) staining, alizarin red staining, and immunofluorescence staining of osteocalcin (OCN) and Runt-related transcription factor 2 (RUNX2). All the above indicators were compared with the control group of normally cultured BMSCs without the addition of nanoflowers.
RESULTS:
Scanning electron microscopy revealed that the prepared nanoflowers exhibited a flower-like structure; transmission electron microscopy scans discovered that the nanoflowers possessed a multi-layered structure, and high-magnification images displayed continuous atomic arrangements, with the nanoflower diameter measuring (2.00±0.25) μm; energy-dispersive spectroscopy indicated that the nanoflowers contained elements such as C, N, O, P, and Ca, which were uniformly distributed across the flower region; Fourier transform infrared spectroscopy analyzed the absorption peaks of each component, demonstrating the successful preparation of the nanoflowers. Through CCK-8 screening, the concentrations of 0.8, 1.2, and 1.6 mg/mL were selected for subsequent experiments. The live/dead cell staining showed that nanoflowers at different concentrations exhibited good cell compatibility, with the 1.2 mg/mL concentration being the best (P<0.05). The scratch assay results indicated that the cell migration ability in the 1.2 mg/mL group was superior to the other groups (P<0.05). The cytoskeleton staining revealed that the cell morphology was well-extended in all concentration groups, with no significant difference compared to the control group. The ROS fluorescence staining demonstrated that the ROS fluorescence in all concentration groups decreased compared to the control group after lipopolysaccharide induction (P<0.05), with the 1.2 mg/mL group showing the weakest fluorescence. The ALP staining showed blue-purple nodular deposits around the cells in all groups, with the 1.2 mg/mL group being significantly more prominent. The alizarin red staining displayed orange-red mineralized nodules around the cells in all groups, with the 1.2 mg/mL group having more and denser nodules. The immunofluorescence staining revealed that the expressions of RUNX2 and OCN proteins in all concentration groups increased compared to the control group, with the 1.2 mg/mL group showing the strongest protein expression (P<0.05).
CONCLUSION
The study successfully prepares nanoflowers, among which the 1.2 mg/mL nanoflowers exhibits excellent cell compatibility, antioxidant properties, and osteogenic induction capability, demonstrating their potential as an artificial bone substitute material.
Animals
;
Osteogenesis/drug effects*
;
Mesenchymal Stem Cells/drug effects*
;
Calcium Phosphates/pharmacology*
;
Rats, Sprague-Dawley
;
Rats
;
Antioxidants/chemistry*
;
Cells, Cultured
;
Cell Differentiation/drug effects*
;
Nanostructures/chemistry*
;
Tissue Engineering/methods*
;
Bone Marrow Cells/cytology*
;
Coculture Techniques
;
Tissue Scaffolds/chemistry*
;
Male
;
Biocompatible Materials/chemistry*
;
Cell Survival
;
Core Binding Factor Alpha 1 Subunit/metabolism*
;
Cell Proliferation
7.Progress and challenges of poly (L-lactic acid) membrane in preventing tendon adhesion.
Jiayu ZHANG ; Xiaobei HU ; Jiayan SHEN ; Yuanji HUANG ; Shen LIU
Chinese Journal of Reparative and Reconstructive Surgery 2025;39(9):1212-1218
OBJECTIVE:
To review the research progress and challenges of poly (L-lactic acid) (PLLA) membrane in preventing tendon adhesion.
METHODS:
The relevant literature at home and abroad in recent years was extensively searched, covering the mechanism of tendon adhesion formation, the adaptation challenge and balancing strategy of PLLA, the physicochemical modification of PLLA anti-adhesion membrane and its application in tendon anti-adhesion. In this paper, the research progress and modification strategies of PLLA membranes were systematically reviewed from the three dimensions of tissue adaptation, mechanical adaptation, and degradation adaptation.
RESULTS:
The three-dimensional adaptation of PLLA membrane is optimized by combining materials (such as hydroxyapatite, polycaprolactone), structural design (multilayer/gradient membrane), and drug loading (anti-inflammatory drug). The balance between anti-adhesion and pro-healing is achieved, the mechanical adaptation significantly improve, and degradation is achieved (targeting the degradation cycle to 2-4 weeks to cover the tendon repair period).
CONCLUSION
In the future, it is necessary to identify the optimal balance point of three-dimensional fitness, unify the evaluation criteria and solve the degradation side effects through the co-design of physicochemical modification and drug loading system to break through the bottleneck of clinical translation.
Tissue Adhesions/prevention & control*
;
Polyesters/chemistry*
;
Humans
;
Biocompatible Materials/chemistry*
;
Tendons/surgery*
;
Membranes, Artificial
;
Tendon Injuries/surgery*
;
Wound Healing
;
Animals
;
Durapatite/chemistry*
8.Research progress of hydrogel-based growth factors for treatment of intervertebral disc degeneration.
Chinese Journal of Reparative and Reconstructive Surgery 2025;39(11):1491-1497
OBJECTIVE:
To summarize recent research progress in hydrogel-based growth factors for treatment of intervertebral disc degeneration (IDD).
METHODS:
The relevant literature on hydrogel-based growth factors for IDD treatment at home and abroad was extensively reviewed, and their advantages and therapeutic effects in repairing IDD were analyzed and summarized.
RESULTS:
Hydrogels exhibit high hydration, biocompatibility, and biodegradability, enabling targeted delivery and sustained release of growth factors such as growth differentiation factors and transforming growth factors. This facilitates enhanced efficacy in promoting cell proliferation, extracellular matrix synthesis, and reducing inflammatory responses. Consequently, hydrogels demonstrate broad application prospects in the repair of IDD.
CONCLUSION
Research on hydrogel-based growth factors for treating IDD demonstrates advantages such as avoiding disc damage caused by repeated injections and controlling growth factor release concentrations. However, drawbacks include the limited variety of loaded growth factors and the need to verify the long-term stability and biocompatibility of hydrogels. Therefore, further research is required on aspects such as the types of loaded growth factors and the long-term stability and biocompatibility of hydrogels to establish an experimental foundation for their clinical application.
Intervertebral Disc Degeneration/therapy*
;
Hydrogels/chemistry*
;
Humans
;
Intercellular Signaling Peptides and Proteins/administration & dosage*
;
Biocompatible Materials/chemistry*
;
Animals
;
Tissue Engineering/methods*
;
Cell Proliferation/drug effects*
;
Drug Delivery Systems
9.Key role of biomechanical properties and material selection in rotator cuff repair.
Chinese Journal of Reparative and Reconstructive Surgery 2025;39(12):1606-1614
OBJECTIVE:
To summarize the biomechanical research progress of biomaterials in rotator cuff injury repair and to explore how biomaterials can restore the native histological and mechanical properties of the rotator cuff.
METHODS:
The relevant literature at home and abroad was widely reviewed to analyze the biomechanical properties of synthetic biomaterials, naturally derived biomaterials, and tissue grafts in the repair of rotator cuff injuries.
RESULTS:
Synthetic biomaterials [such as poly (lactic-co-glycolic acid) and polycaprolactone] can provide initial stable mechanical support due to their adjustable mechanical properties and degradation characteristics, while naturally derived biomaterials (such as collagen and hyaluronic acid) can promote cell adhesion and tissue integration due to their biocompatibility and bioactivity. Tissue grafts exhibit significant clinical utility by providing immediate mechanical stability and promoting tendon-to-bone healing. Three-dimensional bioprinting technology provides new possibilities for personalized repair of rotator cuff injuries by precisely controlling the spatial distribution and mechanical properties of biomaterials.
CONCLUSION
Future studies should further optimize the design of bioprinting materials, cell sources, and scaffolds to achieve better mechanical properties and clinical efficacy of biomaterials in the repair of rotator cuff injuries.
Humans
;
Rotator Cuff Injuries
;
Biocompatible Materials/chemistry*
;
Biomechanical Phenomena
;
Tissue Scaffolds
;
Rotator Cuff/surgery*
;
Tissue Engineering/methods*
;
Polyesters
;
Polyglycolic Acid/chemistry*
;
Hyaluronic Acid/chemistry*
;
Collagen/chemistry*
;
Lactic Acid/chemistry*
;
Polylactic Acid-Polyglycolic Acid Copolymer
;
Bioprinting
;
Wound Healing
;
Printing, Three-Dimensional
;
Tendon Injuries/surgery*
10.Biomaterials of different sizes for enhanced adoptive cell transfer therapy in solid tumors.
Jiaxin CHEN ; Rui LIU ; Yingqi TANG ; Chenggen QIAN
Journal of Zhejiang University. Medical sciences 2025;54(4):469-478
Adoptive cell transfer (ACT) shows significant efficacy against hema-tological malignancies but is limited in solid tumors due to poor homing, immunosuppre-ssion, and potential toxicity. Biomaterials spanning from nano- to macroscales-including nanoparticles, microspheres/micropatches, and hydrogels-offer unique advantages for ex vivo cell engineering, in vivo delivery, and modulation of the tumor microenvironment. Specifically, nanoparticles enable gene delivery, artificial antigen-presenting cell engi-neering, and immune microenvironment remodeling. Microspheres/micropatches improve immune cell expansion, targeted activation, and localized retention. Hydrogels enhance ACT via in situ genetic engineering, 3D culture support, and cytokine co-delivery. This review summarizes advances in biomaterial-enhanced ACT, highlighting their potential to improve delivery efficiency, amplify antitumor responses, and reduce toxicity. These insights may accelerate the clinical translation of ACT for solid tumors.
Humans
;
Neoplasms/therapy*
;
Biocompatible Materials/chemistry*
;
Immunotherapy, Adoptive/methods*
;
Nanoparticles
;
Hydrogels
;
Adoptive Transfer/methods*
;
Animals

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