The objectives of this work were to develop an antibiotic coating on the surface of a titanium plate to determine its antibacterial properties in vitro and in vivo. To prepare vancomycin-coated titanium implants, we adopted the electrospinning nanotechnique. The surface structure of the coating implants was observed using a scanning electron microscope. An elution method and a high-pressure liquid chromatography assay were used to characterize the release behavior of vancomycin from the coating. The antibacterial efficacy and the cytotoxicity of the coated titanium implants on osteoblasts were investigated in vitro. In addition, X-ray, white blood cell count, C-reactive protein, erythrocyte sedimentation rate, and pathological examination were performed to validate its antimicrobial efficacy in vivo. The antibiotic coating released 82.7% (approximately 528.2 μg) of total vancomycin loading in the coating in vitro. The release behavior of vancomycin from nanofiber coatings exhibited a biphasic release pattern with an initial burst on day 1, followed by a slow and controlled release over 28 days. There was no cytotoxicity observed in vitro for the vancomycin-loaded coating. The vancomycin-coated titanium implants were active in treating implant-associated infection in vivo. Thus, vancomycin-coated titanium implants may be a promising approach to prevent and treat implant-associated infections.

1. The present study investigated the therapeutic effects of both single and combination treatment with Yunke (technetium-99 conjugated with methylene diphosphonate; (99)Tc-MDP) and colloidal chromic phosphate (32)P (phosphonium-32) in rats with adjuvant arthritis (AA). 2. Rats were randomly allocated to one of five groups: (i) normal control group (sham operated and treated with normal saline); (ii) AA control group (arthritis induced with adjuvant and treated with normal saline); (iii) (32)P colloid group (arthritis induced with adjuvant and treated with a single intra-articular injection of colloidal chromic phosphate phosphonium-32 (0.02 mCi) and i.p. injections of normal saline every other day); (iv) Yunke group (arthritis induced with adjuvant and treated with i.p. Yunke (2.5 x 10(-3) microg/kg) every other day and single intra-articular injection of normal saline); and (v) combination group (arthritis induced with adjuvant and treated with a combination of both therapies). 3. The left-to-right diameter (LRD) of the left hind ankle, serum levels of tumour necrosis factor (TNF) and interleukin (IL)-1b and histological sections of the ankle joints were examined at different time points. 4. The LRD of the left hind ankle was smaller for the combination group compared with (32)P colloid alone at Week 4 (7.11 +/- 0.28 vs 7.57 +/- 0.24 mm, respectively; P < 0.001). The combination treatment was more effective than (32)P colloid alone in decreasing serum TNF (1.614 +/- 0.368 vs 1.977 +/- 0.255 ng/mL, respectively; P = 0.002 for Week 4) and IL-1b (0.271 +/- 0.027 vs 0.308 +/- 0.020 ng/mL, respectively for Week 4; 0.209 +/- 0.023 vs 0.255 +/- 0.016 ng/mL, respectively for Week 6; both P = 0.001). Histologically, the combination group exhibited less synovium proliferation compared with Yunke treatment alone and decreased inflammatory cell infiltration compared with (32)P colloid alone. 5. In conclusion, the combination of Yunke and (32)P colloid is more effective in the treatment of AA in rats compared with Yunke or (32)P colloid alone.

Various biomaterials have been investigated in attempts to improve the mechanical stability of marrow clots derived from microfracture to obtain repaired tissue closely resembling hyaline cartilage. The goal of this study was to investigate the retention, adhesion, proliferation, and cartilage extracellular matrix (ECM) production of marrow clot-derived cells within a bone marrow mesenchymal stem cell-derived (BMSC-d) ECM/marrow clot composite scaffold. We fabricated BMSC-dECM/marrow clot composite scaffolds and kept them in chondrogenic medium in vitro for 1, 3, or 6 weeks. Unmodified marrow clots were used as a control. The BMSC-dECM/marrow clot composite scaffold exhibited a porous structure suitable for cell attachment and growth and further maintained cell viability. The DNA content measurements revealed that more cells proliferated in the BMSC-dECM/marrow clot composite scaffolds over time than in the marrow clots. Furthermore, the histologic, immunohistochemical, and western blot results demonstrated that the BMSC-dECM/marrow clot composite scaffold produced more hyaline-like cartilage and less fibrocartilage than the marrow clot in culture. Taken together, these findings indicate that the porous BMSC-dECM/marrow clot composite scaffold promotes the retention, attachment, and proliferation of cells from the marrow clot, and thus can stabilize the marrow clot to support chondrogenesis.

The purpose of this study was to introduce a modified surgical approach for the treatment of posterior column tibial plateau fractures. Fifteen patients with posterior column fractures with or without other column fractures were included and treated with this approach between July 2015 and June 2016. The patients were followed up for 18 to 24 months (20.9 ± 1.8 months). Outcomes included neural or vascular injuries, wound complications, nonunion, plate loosening or breakage, and Hospital for Special Surgery (HSS) scores. Bone union was observed in all cases, and the average time for bone union was 13.5 ± 1.4 weeks (11–16 weeks). No neurovascular injuries, malunion, nonunions, or plate loosening or breakages were observed. The average HSS score was 94.7 ± 4.1 (range: 84–100). The modified direct posterior midline approach can provide excellent exposure and facilitate reduction and internal fixation of posterior column fractures of the tibial plateau, including split and depressed fractures. We expect that this approach can be used as a new effective method for managing complex posterior tibial fractures.

Traumatic spinal cord injury (SCI) is a catastrophic damage that causes changes in its motor function permanently. Reactive astrocytes is a pathological feature of spinal cord injury (SCI). Exosomes take part in the transportation of miRNAs and play an a novel platform for intercellular communication in the central nervous system (CNS). However, the effect of miRNAs in Neuronal stem cells (NSCs) derived exosomes in SCI was unknown. in vivo SCI model and in vitro experiments were performed to investigate the effects and mechanisms of exosomes. NSCs-derived exosomes promoted motor function recovery by shifting astrocytes from the A1 to A2 phenotype. microarray analysis of miRNA showed that miR-31-5p was the most enriched in NSCs-derived exosomes. Bioinformatics, RIP, and luciferase activity predicted IL34 was the target downstream gene of miR-31-5p. Western bloting examined IL34/STAT3 signaling pathway involved in modulating atrocities by the exosomal miR-31-5p. Rescue experiments evaluate that exosomal miR-31-5p shifting astrocytes A1 to A2 phenotype by inhibiting IL34/STAT3 signaling cascades, and promoted motor function recovery in mice after SCI.