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标题：A self-powered implantable and bioresorbable electrostimulation device for biofeedback bone fracture healing
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作者：Guang Yao ; Lei Kang ; Cuicui Li 等
期刊名称：Proceedings of the National Academy of Sciences
印刷版ISSN：0027-8424
电子版ISSN：1091-6490
出版年度：2021
卷号：118
期号：28
DOI：10.1073/pnas.2100772118
语种：English
出版社：The National Academy of Sciences of the United States of America
摘要：Significance Bone fracture represents a significant problem in public health. State-of-the-art clinical study demonstrated that by correlating the stimulation amplitude and frequency directly to dynamic locomotion, biofeedback electrostimulation therapy is particularly effective compared to conventional continuous electrostimulation for postoperative therapy and rehabilitation after musculoskeletal injury. However, implementation of biofeedback still relies on complex electronics and sensing systems, which largely limits its accessibility to patients. Here we developed a self-powered implantable and bioresorbable device that directly applies biofeedback electrostimulations to the treatment of bone fracture. The electrostimulation signals are generated solely from relevant body motions, providing a closed-loop biofeedback therapy bringing rapid healing to fractures. This device is self-responsive, battery free, and requires no surgical removal after fulfilling the biomedical intervention. Electrostimulation has been recognized as a promising nonpharmacological treatment in orthopedics to promote bone fracture healing. However, clinical applications have been largely limited by the complexity of equipment operation and stimulation implementation. Here, we present a self-powered implantable and bioresorbable bone fracture electrostimulation device, which consists of a triboelectric nanogenerator for electricity generation and a pair of dressing electrodes for applying electrostimulations directly toward the fracture. The device can be attached to irregular tissue surfaces and provide biphasic electric pulses in response to nearby body movements. We demonstrated the operation of this device on rats and achieved effective bone fracture healing in as short as 6 wk versus the controls for more than 10 wk to reach the same healing result. The optimized electrical field could activate relevant growth factors to regulate bone microenvironment for promoting bone formation and bone remodeling to accelerate bone regeneration and maturation, with statistically significant 27% and 83% improvement over the control groups in mineral density and flexural strength, respectively. This work provided an effective implantable fracture therapy device that is self-responsive, battery free, and requires no surgical removal after fulfilling the biomedical intervention.
关键词：ennanogenerator;biofeedback therapeutics;closed-loop electrostimulation;bone fracture healing;bioresorbable electronics