Dealing with bone defects is a significant challenge to global health. Electrospinning in bone tissue engineering has emerged as a solution to this problem. In this study, we designed a PVDF-b-PTFE block copolymer by incorporating TFE, which induced a phase shift in PVDF fromαtoβ, thereby enhancing the piezoelectric effect. Utilizing the electrospinning process, we not only converted the material into a film with a significant surface area and high porosity but also intensified the piezoelectric effect. Then we used polydopamine to immobilize BMP-2 onto PVDF-b-PTFE electrospun nanofibrous membranes, achieving a controlled release of BMP-2. The scaffold's characters were examined using SEM and XRD. To assess its osteogenic effectsin vitro, we monitored the proliferation of MC3T3-E1 cells on the fibers, conducted ARS staining, and measured the expression of osteogenic genes.In vivo, bone regeneration effects were analyzed through micro-CT scanning and HE staining. ELISA assays confirmed that the sustained release of BMP-2 can be maintained for at least 28 d. SEM images and CCK-8 results demonstrated enhanced cell viability and improved adhesion in the experimental group. Furthermore, the experimental group exhibited more calcium nodules and higher expression levels of osteogenic genes, including COL-I, OCN, and RUNX2. HE staining and micro-CT scans revealed enhanced bone tissue regeneration in the defective area of the PDB group. Through extensive experimentation, we evaluated the scaffold's effectiveness in augmenting osteoblast proliferation and differentiation. This study emphasized the potential of piezoelectric PVDF-b-PTFE nanofibrous membranes with controlled BMP-2 release as a promising approach for bone tissue engineering, providing a viable solution for addressing bone defects.

Tendon-bone insertion injuries (TBI), such as anterior cruciate ligament (ACL) and rotator cuff injuries, are common degenerative or traumatic pathologies with a negative impact on the patient's daily life, and they cause huge economic losses every year. The healing process after an injury is complex and is dependent on the surrounding environment. Macrophages accumulate during the entire process of tendon and bone healing and their phenotypes progressively transform as they regenerate. As the “sensor and switch of the immune system”, mesenchymal stem cells (MSCs) respond to the inflammatory environment and exert immunomodulatory effects during the tendon-bone healing process. When exposed to appropriate stimuli, they can differentiate into different tissues, including chondrocytes, osteocytes, and epithelial cells, promoting reconstruction of the complex transitional structure of the enthesis. It is well known that MSCs and macrophages communicate with each other during tissue repair. In this review, we discuss the roles of macrophages and MSCs in TBI injury and healing. Reciprocal interactions between MSCs and macrophages and some biological processes utilizing their mutual relations in tendon-bone healing are also described. Additionally, we discuss the limitations in our understanding of tendon-bone healing and propose feasible ways to exploit MSC-macrophage interplay to develop an effective therapeutic strategy for TBI injuries. The Translational potential of this article: This paper reviewed the important functions of macrophages and mesenchymal stem cells in tendon-bone healing and described the reciprocal interactions between them during the healing process. By managing macrophage phenotypes, mesenchymal stem cells and the interactions between them, some possible novel therapies for tendon-bone injury may be proposed to promote tendon-bone healing after restoration surgery.

Osteosarcoma (OS) is a highly fatal bone tumor characterized by high degree of malignancy and early lung metastasis. Traditional chemotherapy fails in improving the efficacy and survival rate of patients with OS. Butyrate (NaBu) has been reported as a new antitumor drug for inhibiting proliferation and inducing apoptosis in various cancer cells. However, the effect of NaBu on the ferroptosis of OS is still unknown. This study aimed to investigate whether NaBu promotes erastin-induced ferroptosis in OS cells and to uncover the underlying mechanism. Here, we found that NaBu significantly enhanced erastin-induced ferroptosis in vitro and in vivo. Compared with the group that erastin used alonely, pre-treating with NaBu exacerbated erastin-meditated GSH depletion, lipid peroxidation, and mitochondrial morphologic changes in OS cells. In a subcutaneous OS model, NaBu combined with erastin significantly reduced tumor growth and increased the levels of 4-HNE. Mechanistically, NaBu downregulated SLC7A11 transcription via regulating ATF3 expression. Overexpression of ATF3 facilitated erastin to induce ferroptosis, while ATF3 knockdown attenuated NaBu-induced ferroptosis sensitivity. In conclusion, our findings revealed a previously unidentified role of NaBu in erastin-induced ferroptosis by regulating SLC7A11, suggesting that NaBu may be a potential therapeutic agent for OS treatment.

Osteosarcoma has a relatively high incidence rate among primary malignant tumors, and the survival rate is low. Clinically, surgical resection and chemotherapy are mainly used, which are difficult to utilize to treat metastatic or recurrent osteosarcoma. The combination of chemotherapy and immuno-therapy can achieve a better tumor treatment effect. M1 macrophages (M1 Mo) can kill tumor cells and have tumor-targeting and phagocytosis ability, which are an ideal tool for tumor-targeted drug delivery. However, as carriers, living cells have the disadvantages of uncontrollable size, poor tissue permeability, and poor stability. In this study, the M1 macrophage membrane (M1M) was used as the carrier and loaded with MMP-2 (matrix metalloproteinase-2)-sensitive drug-loaded liposomes (GL) to prepare a complex nanovesicle drug delivery system M1M (GL/DOX/TPI-1), with a tumor active targeting function, for combined chemical and immune therapy from doxorubicin (DOX) and tyrosine phosphatase inhibitor 1 (TPI-1). The complex nanovesicles not only retain the tumor-targeting ability from the M1 macrophage membrane but also have the advantages of controllable size, responsive drug release, and high stability. The results of in vivo efficacy test show that the drug delivery system realizes active targeted enrichment in osteosarcoma tissue. Under the response of MMP-2, the internally encapsulated antitumor drugs DOX and TPI-1 from the system are released. This drug delivery system combined with chemical and immune treatment can effectively achieve the aim of the treatment of osteosarcoma.

Titanium dioxide (TiO2), as one of the titanium (Ti)-based implants, holds a promise for a variety of anti-bacterial application in medical research. In the current study, a functional molybdenum disulfide (MoS2)/polydopamine (PDA)-LL-37 coating on titanium dioxide (TiO2) implant was prepared. Anodic oxidation and hydrothermal treatment was given to prepare TiO2 nanotubes-MoS2/PDA-LL-37 (T-M/P-L). The in vitro osteogenic effect of T-M/P-L was evaluated by measuring mesenchymal stem cell (MSC) adhesion, proliferation, alkaline phosphatase (ALP) activity, extracellular matrix (ECM) mineralization, collagen secretion and osteoblast-specific messenger RNAs (mRNAs) expression. The determination on the anti-bacterial ability of T-M/P-L was followed. Furthermore, the ability of T-M/P-L to promote bone formation in vivo was evaluated. Near-infrared (NIR) laser irradiation exposure enabled the T-M/P-L coating-endowed Ti substrates to hold effective anti-bacterial ability. T-M/P-L promoted the adhesion and proliferation of MSCs. In addition, an increase was witnessed regarding the ALP activity, collagen secretion and ECM mineralization, along with the expression of runt-related transcription factor 2, ALP and osteocalcin in the presence of T-M/P-L. Additionally, T-M/P-L could stimulate endothelial cells to secrete vascular endothelial growth factor (VEGF) and promote capillary-like tubule formation. Upon NIR laser irradiation exposure, T-M/P-L not only exhibited efficient in vivo anti-bacterial activity but also facilitated new bone formation. Collectively, T-M/P-L had enhanced anti-bacterial and osteogenic activity under NIR laser irradiation.

Objective: Hypoxic tumors contribute to local failure and distant metastases. Nevertheless, the molecular hallmarks of hypoxia remain ill-defined in osteosarcoma. Here, we developed a hypoxic gene signature in osteosarcoma prognoses.Methods: With the random survival forest algorithm, a prognostic hypoxia-related gene signature was constructed for osteosarcoma in the TARGET cohort. Overall survival (OS) analysis, receiver operating characteristic (ROC) curve, multivariate cox regression analysis, and subgroup analysis were utilized for assessing the predictive efficacy of this signature. Also, external validation was presented in the GSE21257 cohort. GSEA was applied for signaling pathways involved in the high- and low-risk samples. Correlation analyses between risk score and immune cells, stromal/immune score, immune checkpoints, and sensitivity of chemotherapy drugs were performed in osteosarcoma. Then, a nomogram was built by integrating risk score, age, and gender.Results: A five-hypoxic gene signature was developed for predicting survival outcomes of osteosarcoma patients. ROC curves confirmed that this signature possessed the well predictive performance on osteosarcoma prognosis. Furthermore, it could be independently predictive of prognosis. Metabolism of xenobiotics by cytochrome P450 and nitrogen metabolism were activated in the high-risk samples while cell adhesion molecules cams and intestinal immune network for IgA production were enriched in the low-risk samples. The low-risk samples were characterized by elevated immune cell infiltrations, stromal/immune scores, TNFRSF4 expression, and sensitivity to cisplatin. The nomogram accurately predicted 1-, 3-, and 5-years survival duration.Conclusion: These findings might offer an insight into the optimization of prognosis risk stratification and individualized therapy for osteosarcoma patients.

骨关节炎(osteoarthritis,OA)是常见的关节退行性病变,常表现为关节疼痛及活动受限.不可逆的软骨退变与软骨下骨骨质破坏是其最主要的病理改变.OA早期诊断困难,大多数晚期患者因此接受关节置换.环状RNA(circRNAs)是一类特殊的非编码RNAs,由碱基组成闭环结构,广泛存在真核生物中.作为调节细胞代谢的重要分子,circRNAs近年来被发现在骨关节炎中异常表达,参与软骨破坏及关节无菌性炎症等生物学行为.同时,circRNAs的环状结构使其能在血液中稳定存在,具有骨关节炎早期诊断、疗效评估及治疗的潜力.现就circRNAs及其在骨关节炎调控的研究进展展开论述.

Background The anatomic and biomechanical aspects of the L5-S1 level present unique operative challenges compared with the L4-L5 level. We aim to explore the clinical outcomes and radiographic measurements of L4-L5 patients compared with L5-S1 patients after undergoing Percutaneous Endoscopic Transforaminal Discectomy with Foraminoplasty (PETDF). Methods A total of 84 patients who underwent PETDF for LDH treatment between January 2017 and June 2020 were included in this study. Preoperative, perioperative, demographic data, clinical and radiographic outcomes were compared between patients with L4-L5 involvement and patients with L5-S1 involvement. Results There were no significant differences between the two groups in terms of Age, Gender, Follow-up time, the postoperative questionnaire results (Visual Analog Scale [leg], VAS [lower back], and Oswestry Disability Index) or the Excellence and Good Rate and Recurrence Rate. There was no significant difference in the mean preoperative to postoperative change in Intervertebral Space Height (ISH), Intervertebral Space Angle (ISA), Lumbar Lordosis, Foraminal Area (FA) of Operating Side and FA of Contralateral Side between the 2 groups. The mean VAS of Leg Pain, VAS of Lower Back Pain and ODI postoperative scores were significantly improved over the preoperative scores in each of the two groups and the ISH, ISA, FA of Operating Side and FA of Contralateral Side postoperative were significant difference form preoperative Conclusion PETDF is an effective and safe treatment approach for lumbar disc herniation in both L4/L5 and L5/S1 level. Although it may increase lumbar ISA and result in low CFA (contralateral foraminal area) and ISH.

A correction to this paper has been published: https://doi.org/10.1007/s00264-021-05055-9

人工智能技术在医疗卫生领域中展现着广泛的应用前景和发展空间,已成为影响医疗健康发展的重要科技手段.文章结合近5年来我国出台的医疗人工智能相关政策文件,深入探讨人工智能技术在我国各医疗领域的发展现状,充分分析人工智能技术在医疗领域的应用价值,总结讨论目前人工智能技术在各医疗领域应用中存在的问题.给未来人工智能技术在我国医疗卫生领域的应用发展方向提供参考,为该技术在我国医疗行业进一步拓展、融合和深化提供理论基础.

A correction to this paper has been published: https://doi.org/10.1007/s00264-021-05055-9

Osteolytic disorders are characterized by impaired bone volume and trabecular structure that leads to severe fragility fractures. Studies have shown that excessive osteoclast activity causes impaired bone microstructure, a sign of osteolytic diseases such as osteoporosis. Approaches of inhibiting osteoclastogenesis and bone resorption specifically could prevent osteoporosis and other osteolytic disorders. Acacetin is a potent molecule extracted from plants with anti-cancer and anti-inflammatory bioactivities. Here, we demonstrated, for the first time, that acacetin repressed osteoclastogenesis, formation of F-actin rings, bone resorption activity, and osteoclast-related gene expression in vitro through modulating ERK, P38, and NF-κB signaling pathways and preventing expression of NFATc1. Micro-CT and H & E staining results indicated that acacetin alleviated LPS-induced osteolysis in vivo. Overall, our findings suggested that acacetin could help to prevent osteoporosis and other osteoclast-related osteolytic disorders.

Graphene oxide (GO), a kind of polymer, is often selected as a controlled released agent, whereas titanium dioxide (TiO₂) nanotubes are commonly used as a drug-coated carrier. This study was conducted to develop methods for manufacturing the GO/TiO₂/HHC-36 composite coating and exploring its bacteriostat and osteogenesis properties. The GO/TiO₂ nanotubes were prepared by electrochemical methods and HHC-36 was then adsorbed to GO/TiO₂to obtain GO/TiO₂/HHC-36. Sustained release of HHC-36 was analyzed and the antibacterial effect was examined by the inhibition zone test. The biocompatibility and osteogenesis in vitro of GO/TiO₂/HHC-36 were explored. Finally, the osteogenesic property of the composite coating was investigated in a rat femoral defect model in vivo. GO/TiO₂/HHC-36 was successfully prepared and had good controlled released performance in vitro. The inhibit zone size of S. aureus was 2.1 mm and that of E. coli was 3.0 mm. GO/TiO₂/HHC-36 showed good biocompatibility with mesenchymal stem cells (MSCs) and promoted their adhesion, migration, and differentiation. In addition, the secretion of alkaline phosphatase, collagen, mineralized matrix and osteoblast-related nutrient factors of MSCs was increased after treatment with GO/TiO₂/HHC-36. Furthermore, GO/TiO₂/HHC-36 also stimulated endotheliocytes to secrete VEGF, leading to angiogenesis. Finally, implantation of GO/TiO₂/HHC-36 in the rat femur defect model resulted in MSC migration and increased expression of osteoblast related proteins. The composite coating with controlled released of HHC-36 showed distinct antibacterial properties and promoted osteogenesis in vitro and in vivo.

Titanium (Ti)-based alloys are widely used in tissue regeneration with advantages of improved biocompatibility, high mechanical strength, corrosion resistance, and cell attachment. To obtain bioactive bone–implant interfaces with enhanced osteogenic capacity, various methods have been developed to modify the surface physicochemical properties of bio-inert Ti and Ti alloys. Nano-structured hydroxyapatite (HA) formed by micro-arc oxidation (MAO) is a synthetic material, which could facilitate osteoconductivity, osteoinductivity, and angiogenesis on the Ti surface. In this paper, we applied MAO and steam–hydrothermal treatment (SHT) to produce HA-coated Ti, hereafter called Ti–M–H. The surface morphology of Ti–M–H1 was observed by scanning electron microscopy (SEM), and the element composition and the roughness of Ti–M–H1 were analyzed by energy-dispersive X-ray analysis, an X-ray diffractometer (XRD), and Bruker stylus profiler, demonstrating the deposition of nano-HA particles on Ti surfaces that were composed of Ca, P, Ti, and O. Then, the role of Ti–M–H in osteogenesis and angiogenesis in vitro was evaluated. The data illustrated that Ti–M–H1 showed a good compatibility with osteoblasts (OBs), which promoted adhesion, spreading, and proliferation. Additionally, the secretion of ALP, Col-1, and extracellular matrix mineralization was increased by OBs treated with Ti–M–H1. Ti–M–H1 could stimulate endothelial cells to secrete vascular endothelial growth factor and promote the formation of capillary-like networks. Next, it was revealed that Ti–M–H1 also suppressed inflammation by activating macrophages, while releasing multiple active factors to mediate osteogenesis and angiogenesis. Finally, in vivo results uncovered that Ti–M–H1 facilitated a higher bone-to-implant interface and was more attractive for the dendrites, which promoted osseointegration. In summary, MAO and SHT-treated Ti–M–H1 not only promotes in vitro osteogenesis and angiogenesis but also induces M2 macrophages to regulate the immune environment, which enhances the crosstalk between osteogenesis and angiogenesis and ultimately accelerates the process of osseointegration in vivo.

Purpose: Subacromial impingement syndrome (SIS) and its related rotator cuff tears are the most important cause of shoulder joint pain, which has recently received greater attention. Arthroscopy is a safe, effective, and minimally invasive procedure for the treatment of stage Ⅱ or Ⅲ SIS. Previous studies have reported that little blood loss usually occurs during this procedure. However, significant perioperative hidden blood loss (HBL) is often overlooked. In this respect, we herein aimed to investigate the amount of HBL and identify its possible risk factors. Methods: We enrolled 59 patients with SIS who received shoulder arthroscopy between December 2019 and June 2020 in this study. The clinical data recorded included the height of patients, weight pre- and postoperative hematocrit (Hct), which were used to calculate HBL using Gross’s formula. We analyzed the risk factors, including sex, age, BMI (body mass index), stage of SIS, diabetes, hypertension, and operative time using multivariate linear regression analysis. Results: Our results revealed that the mean of HBL was 341.4 ± 214.9 mL, while that of the postoperative Hb loss was 13.3 ± 8.0 g/L. The incidence of postoperative anemia was significantly associated with HBL (χ2 = 14.496, P < 0.001). Furthermore, multivariate linear regression analysis demonstrated that all seven factors, including gender (P = 0.698), age (P = 0.553), BMI (P = 0.854), stage of SIS (P = 0.906), diabetes (P = 0.984), hypertension (P = 0.532), and operative time (P = 0.645), were not significantly associated with HBL. Conclusion: Findings from this study show that postoperative HBL following shoulder arthroscopy was significant, which can aggravate anemia or lead to secondary anemia, thus should not be neglected.

Background. To the best of our knowledge, no published English literatures has provided detailed parameters about the normal epidural fat and other contents in lumbar spinal canal. Our objective was to quantify reference data of epidural fat and the contents of lumbar spinal canal to guide the diagnosis of lumbar epidural lipomatosis.Methods. 178 content lumbar MRI cases were analysis on Picture Archiving and Communication Systems (PACS).Results. the mean anteroposterior ( AP ) diameters ± standard deviation(SD) of lumbar vertebral body ( V )、dural sac ( DS )、epidural fat ( EF ) each measured lever on the mid-sagittal MRI and the mean cross-sectional area ± SD of lumbar spinal canal ( SC )、DS of each measured lever on the axial MRI were showed. The mean AP diameters of V and DS are showed obvious significant difference between men and women ( P ＜0.05). The mean AP diameters of EF is showed no significant difference between men and women (P ＞0.05). Also The mean area of lumbar SC (male 316.7 mm2, female 306.4 mm2 ) and DS (male 198.6 mm2, female 189.2 mm2) are showed obvious significant difference between men and women ( P ＜0.05). The growth trend of the thickness of epidural fat in lumbar spinal canal is showed.Conclusion. Our investigation provides insight into the anatomy of epidural fat and gives the relevant parameters of lumbar spinal canal and its contents on MRI. MRI is the most sensitive imaging test to diagnose lumbar epidural lipomatosis

The surface modification of titanium is effective in promoting osseointegration and is widely used in the treatment of bone diseases. Epimedii Folium (EF) plays an important role in the treatment of metabolic bone diseases. However, few studies have so far been reported on their combined use in such treatments. In the present study, EF water extract was coated onto the surface of TiO₂ nanotubes (TNT) by electrochemical anodization to obtain EF-TNT. Through analysis of surface morphology characteristics, it was demonstrated that EF was successfully coated on the surface of TiO₂ nanotubes. In vitro drug release data suggested that the quantity of EF water extract released was a significant quantity over 4 days, reaching a total of 80%, the release continuing in total for approximately 2 weeks. By using scanning electron microscopy and immunofluorescent staining, it was found that, EF-TNT more strongly promoted adhesion, proliferation, and differentiation of MC3T3-E1 osteoblasts compared with Ti and TNT. Quantitative reverse transcript polymerase chain reaction (qRT-PCR) analysis indicated that the expression of key genes for proliferation and differentiation of osteoblasts, such as COL1a1, ALP, OPN, and Runx2, were up-regulated by EF-TNT. Network pharmacology analysis suggested that EF water extract not only regulated the proliferation and differentiation of osteoblasts but also caused a regulatory effect on osteoclasts via multiple signaling pathways, such as RANKL-RANK-induced signaling and TGF-β signaling. These findings indicate that the EF-TNT promotes differentiation and proliferation of osteoblasts, and represents considerable potential for use in clinical applications.

Artificial joint replacement is an effective surgical method for treating end-stage degenerative joint diseases, but peripheral bacterial infection of prosthesis can compromise the effect of the surgery. Herein, antibacterial effects of titanium dioxide nanotubes (TNTs) coated with polyhexamethylene guanidine (PHMG) were examined via in vitro and in vivo experiments. TNTs with a pore diameter 46.4 ± 5.9 nm and length of 300–500 nm for the slice and 650–800 nm for the rod were fabricated by anodization. Then, 3.46 ± 0.40 mg and 1.27 ± 0.28 mg of PHMG were coated onto the TNT slice and rod, respectively. In vitro studies of the release of PHMG showed that the antibacterial agent was released in two stages: initial burst release and relatively slow release. In vitro and in vivo antibacterial studies showed that the PHMG-loaded TNTs (PHMG-TNTs) had excellent antibacterial abilities to prevent bacterial infections. Clinical pathological analysis of rabbit femurs indicated that the implanted PHMG-TNTs had no apparent pathological changes. Real-time quantitative reverse transcription polymerase chain reaction analysis of the femur tissues around the implants showed that the expression of osteogenic-related genes, including runt-related transcription factor 2, osteocalcin, alkaline phosphatase, bone sialoprotein, bone morphogenetic protein 2 and vascular endothelial growth factor A, was significantly upregulated in the PHMG-TNT implanted group as compared to the other groups. Overall, these findings provide a promising approach for the fabrication of antibacterial and bone biocompatible titanium-based implants in orthopedics.

The function of miR-9 in osteosarcoma is not well-investigated and controversial. Therefore, we conducted meta-analysis to explore the role of miR-9 in osteosarcoma, and collected relevant TCGA data to further testify the result. In addition, bioinformatics analysis was conducted to investigate the mechanism and related pathways of miR-9-3p in osteosarcoma. Literature search was operated on databases up to February 19, 2020, including PubMed, Web of Science, Science Direct, Cochrane Central Register of Controlled Trials, and Wiley Online Library, China National Knowledge Infrastructure, China Biology Medicine disc, Chongqing VIP, and Wan Fang Data. The relation of miR-9 expression with survival outcome was estimated by hazard ratio (HRs) and 95% CIs. Meta-analysis was conducted on the Stata 12.0 (Stata Corporation, TX). To further assess the function of miR-9 in osteosarcoma, relevant data from the TCGA database was collected. Three databases, miRDB, miRPathDB 2.0, and Targetscan 7.2, were used for prediction of target genes. Genes present in these 3 databases were considered as predicted target genes of miR-9-3p. Venny 2.1 were used for intersection analysis. Subsequently, GO, KEGG, and PPI network analysis were conducted based on the overlapping target genes of miR-9-3p to explore the possible molecular mechanism in osteosarcoma. Meta-analysis shown that overexpression of miR-9 was associated with worse overall survival (OS) (HR = 4.180, 95% CI: 2.880-6.066,P < .001, I-2 = 23.5%). Based on TCGA data, osteosarcoma patients with overexpression of miR-9-3p (HR = 1.603, 95% CI: 1.028-2.499,P = .037) and miR-9-5p (HR = 1.698, 95% CI: 1.133-2.545,P = .01) also suffered poor OS. In bioinformatics analysis, 2 significant and important pathways were enriched: Wnt signaling pathway from gene ontology analysis (gene ontology:0016055,P-adjust = .008); hippo signaling pathway from Kyoto Encyclopedia of Genes and Genomes analysis (P-adjust = .007). Moreover, network analysis relevant protein-protein interaction was visualized, revealing 117 nodes and 161 edges. High miR-9 expression was associated with poor prognosis. Based on bioinformatics analysis, this study enhanced the understanding of the mechanism and related pathways of miR-9 in osteosarcoma.

目的 在人工关节置换钛假体材料表面原位合成负载抗菌剂聚六亚甲基胍(polyhexamethylene guanidine,PHMG)的二氧化钛(TiO2)纳米管,通过体外、体内实验研究负载PHMG的TiO2纳米管的抗菌性能,为具有良好抗菌性能人工关节假体材料的开发提供新的思路.方法 采用阳极氧化法制备TiO2纳米管,并于其表面负载抗菌剂PHMG.体外实验时分别将纯金属钛箔、TiO2纳米管钛箔和负载PHMG的TiO2纳米管钛箔与金黄色葡萄球菌ATCC 29213悬液共培养研究其抑菌性能.体内实验时将24只新西兰大白兔股骨扩髓并注入0.1 ml 108 CFU/ml的金黄色葡萄球菌悬液制备感染模型后,分别将纯金属钛棒、TiO2纳米管钛棒和负载PHMG的TiO2纳米管钛棒植入新西兰大白兔右侧股骨髓腔,研究体内的抑菌性能.结果 通过阳极氧化制备的TiO2纳米管孔径为(46.4±5.9)nm,钛箔TiO2纳米管长度为300～500 nm,钛棒TiO2纳米管长度为500～1000 nm,于其表面分别负载(3.46±0.40) mg与(1.27±0.28) mg PHMG.体外PHMG释放实验表明,该药物的释放分为两个阶段:初始突释释放阶段和相对缓慢释放阶段,为早期抑制细菌入侵和后期持续抑菌提供保障.体外和体内抑菌实验表明,载有PHMG的TiO2纳米管能够抑制细菌黏附与定植,减少感染.结合临床病理分析表明PHMG-TiO2纳米管植入组无明显病理变化,骨髓腔内可见大量有核细胞和网状结缔组织,并且在髓腔内可见正常的骨髓组织.结论 负载PHMG的TiO2纳米管对金黄色葡萄球菌有良好的抗菌性能,作为一种人工关节假体材料具有极大的研究意义和开发价值.