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Bacterial infection and delayed osteointegration are two major challenges for orthopedic implants. Surface modification enables the implant have a time-sequenced biological function of effective antibacterial in the early stage and stable osteogenesis in the later stage, which is expected to achieve the purpose of preventing infection and prosthetic loosening after implant surgery. This study aims to construct a composite coating of carboxymethyl chitosan (CCS) grafted with an antibacterial (HHC36) and angiogenic (FP) fusion peptide (FP) on the surface of 3D-printed porous tantalum (Ta-CCS@FP) using alkaline treatment, electrostatic adsorption, and EDC/NHS reaction, to functionalize the surface coating while maintaining the original advantages of the material. The functionalized implants (Ta-CCS@FP) achieve sustained FP release in the initial stages, exhibiting potent antibacterial and anti-biofilm properties due to the synergistic action of the antimicrobial peptides (AMPs) HHC36 and CCS in disrupting bacterial membranes. Additionally, Ta-CCS@FP demonstrate robust osteogenic and angiogenic capabilities compared to Ta and Ta-CCS, attributed to QK and CCS. Notably, the conditioned medium intervention experiments of HUVECs and BMSCs showed that the implants had good angiogenic-osteogenic coupling properties. In vivoassays using infection bone defect models revealed that these bioactive implants effectively eradicated bacteria within 2 weeks and facilitated vascularized bone regeneration by 6 weeks. Thus, our study offers an integrated approach to address bacterial infection and enhance osseointegration for porous tantalum implants.

Infected bone defects (IBDs) remains a challenging problem for orthopedists. Clinically, routine management for IBDs has two stages: debridement and systematic antibiotics administration to control infection, and secondary grafting to repair bone defects. Whereas the efficacy is not satisfactory, because the overuse of antibiotics may lead to systemic toxicity, and the emergence of drug-resistant bacteria, as well as the secondary surgery would cause additional trauma and economic burden to the patients. Therefore, it is imperative to develop a novel scaffold for one-stage repair of IBDs. In this study, vancomycin (Van) was encapsulated into poly(lactic co-glycolic acid) (PLGA) microspheres through the double emulsion method, which were then loaded into the additively-manufactured porous tantalum (AM-Ta) through gelatin methacryloyl (GelMA) hydrogel to produce the composite Ta/GelMA hydrogel (Gel)/PLGA/vancomycin(Van) scaffolds for repairing IBDs. Physiochemical characterization of the newly-developed scaffold indicated that the releasing duration of Van was over 2 weeks. Biological experiments indicated good biocompatibility of the composite scaffold, as well as bacteriostasis and osteointegration properties, which showed great potential for clinical application. The construction of this novel scaffold would provide new sight into the development of orthopaedic implants, shedding a novel light on the treatment of IBDs.

Infected bone defects (IBDs) cause significant economic and psychological burdens, posing a huge challenge to clinical orthopedic surgeons. Traditional approaches for managing IBDs possess inevitable shortcomings; therefore, it is necessary to develop new functionalized scaffolds. Tantalum (Ta) has been widely used in load-bearing orthopedic implants due to its good biocompatibility and corrosion resistance. However, undecorated Ta could only structurally repair common bone defects, which failed to meet the clinical needs of bacteriostasis for IBDs. Researchers have made great efforts to functionalize Ta scaffolds to enhance their antibacterial activity through various methods, including surface coating, alloying, and micro- and nanostructure modifications. Additionally, several studies have successfully utilized Ta to modify orthopedic scaffolds for enhanced antibacterial function. These studies remarkably extended the application range of Ta. Therefore, this review systematically outlines the advances in the fundamental and clinical application of Ta in the treatment of IBDs, focusing on the antibacterial properties of Ta, its functionalization for bacteriostasis, and its applications in the modification of orthopedic scaffolds. This study provides researchers with an overview of the application of Ta in the treatment of IBDs.

Chronic wounds are characterized by long-term inflammation and persistent infection, which make them difficult to heal. Therefore, an urgent desire is to develop a multifunctional wound dressing that can prevent wound infection and promote wound healing by creating a favorable microenvironment. In this study, a curcumin-based metal–organic framework (QCSMOF-Van), loaded with vancomycin and coated with quaternary ammonium salt chitosan (QCS), was prepared. Multifunctional composite hydrogels were conveniently synthesized by combining methacrylic anhydride modified gelatin and methacrylic anhydride modified oxidized sodium alginate with QCSMOF-Van through radical polymerization and Schiff base reaction. It is important to note that the QCSMOF-Van could capture bacteria through the positive charges on the surface of QCS. In this process, due to the synergistic effect of broad-spectrum antibacterial Zn2+and vancomycin, the metabolism of bacteria was well inhibited, and the efficient capturing and rapid killing of bacteria were achieved. The QCSMOF-Van hydrogels could precisely regulate the balance of M1/M2 phenotypes of macrophages, thereby promoting the regeneration of nerves and blood vessels, which promotes the rapid healing of chronic wounds. This advanced cascade management strategy for tissue regeneration highlights the potential of multifunctional composite hydrogels in chronic wound dressings.

In non-high-risk individuals, risk-category-based atherosclerotic cardiovascular disease (ASCVD) screening strategies may be more cost-effective than one-size-fits-all approaches. However, current decisions are constrained by a lack of research evidence. We aimed to explore appropriate risk-category-based screening interval strategies for non-high-risk individuals in ASCVD primary prevention in the Chinese population.

Bone metastasis (BM) is a solid tumor confined to narrow bone marrow cavities with a relatively poor blood supply and hypoxic environment, making conventional anticancer treatments difficult. In our study, we fabricated nanoparticles (NPs) based on zeolitic imidazolate framework-8 (ZIF-8) loaded with indocyanine green (ICG, a photodynamic agent) and cytochrome c (Cyt c, an anticancer protein) with a surface modified by zoledronate (ZOL, a bone-targeting moiety) and a polyvinyl pyrrolidone (PVP) coating to increase their stability. The ICG/Cyt c@ZZF-8 NPs were expected to have synergistic antitumor therapy and bone protection efficiency. The in vitroand in vivoexperiments showed the bone-targeted and pH-sensitive ability of ICG/Cyt c@ZZF-8 NPs, which could be engulfed by tumor cells and release the cargos. Upon 780 nm laser irradiation, ICG produces cytotoxic reactive oxygen species (ROS, 1O2) that directly kill tumor cells, and Cyt c with catalase-like activity can induce programmed cell death and decompose H2O2to O2, thus enhancing the PDT efficiency. The ZOL can further inhibit bone resorption. The ICG/Cyt c@ZZF-8 NPs showed improved antitumor and bone protection efficiency in a mouse model of BM. This study demonstrated a potential mode for the synergetic therapy of orthopedic diseases.

Despite the widespread application of Ti6Al4V and tantalum (Ta) in orthopedics, bioinertia and high cost limit their further applicability, respectively, and tremendous efforts have been made on the Ti6Al4V-Ta alloy and Ta coating to address these drawbacks. However, the scaffolds obtained are unsatisfactory. In this study, novel high-interface-strength Ti6Al4V-based porous Ta scaffolds were successfully manufactured using Laser Powder Bed Fusion for the first time, in which porous Ta was directly manufactured on a solid Ti6Al4V substrate. Mechanical testing revealed that the novel scaffolds were biomechanically compatible, and the interfacial bonding strength was as high as 447.5 MPa. In vitro biocompatibility assay, using rat bone marrow mesenchymal stem cells (r-BMSCs), indicated that the novel scaffolds were biocompatible. Alkaline phosphatase and mineralized nodule determination demonstrated that the scaffolds favored the osteogenic differentiation of r-BMSCs. Moreover, scaffolds were implanted into rabbits with femur bone defects, and imaging and histological evaluation identified considerable new bone formation and bone ingrowth, suggesting that the scaffolds were well integrated with the host bone. Overall, these results demonstrated good mechanical compatibility, biocompatibility, and osteointegration performance of the novel Ti6Al4V-based porous Ta scaffold, which possesses great potential for orthopedic clinical applications.

ABSTRACTIntroductionTraditional therapy methods for treating tuberculous bone defects have several limitations. Furthermore, systemic toxicity and disease recurrence in tuberculosis (TB) have not been effectively addressed.Areas coveredThis review is based on references from September 1998 to September 2021 and summarizes the classification and drug-loading methods of anti-TB drugs. The application of different types of biological scaffolds loaded with anti-TB drugs as a novel drug delivery strategy for tuberculous bone defects has been deeply analyzed. Furthermore, the limitations of the existing studies are summarized.Expert opinionLoading anti-TB drugs into the scaffold through various drug-loading techniques can effectively improve the efficiency of anti-TB treatment and provide an effective means of treating tuberculous bone defects. This methodology also has good application prospects and provides directions for future research.

Hospitals in China are classified into tiers (1, 2 or 3), with the largest (tier 3) having more equipment and specialist staff. Differential health insurance cost-sharing by hospital tier (lower deductibles and higher reimbursement rates in lower tiers) was introduced to reduce overcrowding in higher tier hospitals, promote use of lower tier hospitals, and limit escalating healthcare costs. However, little is known about the effects of differential cost-sharing in health insurance schemes on choice of hospital tiers.

ABSTRACTIntroductionThe treatment of hard tissue defects, especially those of bone and cartilage, induced by infections or tumors remains challenging. Traditional methods, including debridement with systematic chemotherapy, have shortcomings owing to their inability to eliminate infections and high systematic toxicity.Area coveredThis review comprehensively summarizes and discusses the current applications of 3D-printed porous tantalum (3D-P-p-Ta), a novel drug delivery strategy, in drug delivery systems to repair hard tissue defects, as well as the limitations of existing data and potential future research directions.Expert opinionDrug delivery systems have advanced medical treatments, with the advantages of high local drug concentration, long drug-release period, and minimal systematic toxicity. Due to its excellent biocompatibility, ideal mechanical property, and anti-corrosion ability, porous tantalum is one of the most preferable loading scaffolds. 3D printing allows for freedom of design and facilitates the production of regular porous implants with high repeatability. There are several reports on the application of 3D-P-p-Ta in drug delivery systems for the management of infection- or tumor-associated bone defects, yet, to the best of our knowledge, no reviews have summarized the current research progress.

Tantalum has unique advantages as a biomaterial for repairing bone defects due to its outstanding bioactivity, excellent corrosion resistance, and mechanical properties. Ideal implants for bone repair should be of good biocompatibility and bioactivity, as well as ability to simulate the microstructure and mechanical environment of human bone tissues. Additive manufacturing can facilitate freedom of design for the macrostructure/microstructure of bone implants with controlled mechanical properties; thus, this method has great potential. Additively manufactured tantalum implants provide a novel alternative for bone repair and are gaining increasing attention. This systematic review aims to comprehensively summarize the subsistent evidence from physicochemical, cellular, animal, and clinical studies on additively manufactured tantalum implants in repairing bone defects, for the first time. This work may provide researchers an essential grasp on the advances of additively manufactured tantalum implants.Impact statementTantalum has unique advantages as a biomaterial. Additive manufacturing facilitates design freedom and additively manufactured tantalum is a novel alternative for bone repair. Studies on additively manufactured tantalum progress greatly, while no review summarizing the progresses was published.

Tantalum (Ta) implants fabricated by current processing techniques inevitably contain more or less oxygen impurities due to the extremely high melting point and high affinity of oxygen for Ta. Therefore, in this study we investigated whether oxygen impurities cause any effects on the bioactivity of Ta. EDS analysis demonstrated the surface oxygen content difference among different fabricated Ta samples, and the surface water contact angle (WCA) of Ta with high oxygen content (HO-Ta) was significantly higher than that of Ta with medium (MO-Ta) and low (LO-Ta) oxygen content. The in vitrocellular experiments showed that MC3T3-E1 cells on Ta with lower oxygen content exhibited better adhesion, growth, morphological development and in vitroosteogenic ability. Similarly, the in vivoanimal experiments indicated the better bone regeneration and ingrowth performances of Ta with lower oxygen content. In addition, the highest ROS production was detected in the HO-Ta group, while the lowest in the LO-Ta group. This study suggests that the oxygen content within Ta, which occurs unavoidably due to technical limitations, negatively affects the bioactivity of Ta in a dose-dependent manner, indicating the need to develop techniques to produce orthopedic all-Ta implants.

Previous observational studies established a positive relationship between snoring and stroke. We aimed to investigate the causal effect of snoring on stroke.

Macrophages play a very fundamental role in bone regeneration. Changing the physicochemical properties of biomaterials to regulate the genes and protein expressions of Macrophages in vivois of great significance to promote osteogenesis and angiogenesis in bone tissue engineering. Herein, we investigated the interaction of biomimetic hydroxyapatite coatings with macrophages and the subsequent impact on osteogenesis and angiogenesis. In this study, we found that biomimetic hydroxyapatite coating could inhibit the expression of inflammatory factors (tumor necrosis factor-α, TNF-α) while promoting bone morphogenetic protein-2 (BMP-2) and vascular endothelial growth factor (VEGF), thereby promoting angiogenesis of vascular endothelial cells and osteogenic differentiation of mesenchymal stem cells. This study demonstrated that biomimetic hydroxyapatite coating modified polycaprolactone (PCL) possessed an excellent osteoimmunomodulatory property and was a promising coating material for the application.

Background: While transcription factor (TF) regulation is known to play an important role in osteoblast development, differentiation, and bone metabolism, the molecular features of TFs in human osteoblasts at the single-cell resolution level have not yet been characterized. Here, we identified modules (regulons) of co-regulated genes by applying single-cell regulatory network inference and clustering to the single-cell RNA sequencing profiles of human osteoblasts. We also performed cell-specific network (CSN) analysis, reconstructed regulon activity-based osteoblast development trajectories, and validated the functions of important regulons both in vivo and in vitro. Results: We identified four cell clusters: preosteoblast-S1, preosteoblast-S2, intermediate osteoblasts, and mature osteoblasts. CSN analysis results and regulon activity-based osteoblast development trajectories revealed cell development and functional state changes of osteoblasts. CREMand FOSL2regulons were mainly active in preosteoblast-S1, FOXC2regulons were mainly active in intermediate osteoblast, and RUNX2and CREB3L1regulons were most active in mature osteoblasts. Conclusions: This is the first study to describe the unique features of human osteoblasts in vivo based on cellular regulon active landscapes. Functional state changes of CREM, FOSL2, FOXC2, RUNX2, and CREB3L1regulons regarding immunity, cell proliferation, and differentiation identified the important cell stages or subtypes that may be predominantly affected by bone metabolism disorders. These findings may lead to a deeper understanding of the mechanisms underlying bone metabolism and associated diseases.

Background: To explore the clinical effects of 3D printing techniques on the correction of complex malformation. Method: A computed tomography (CT) scan was used to collect data on malformations of patients and the orthopedic plan was made by virtual manipulation of the reality before surgery. The results of the virtual orthopedics were compared with the expected results. A guide plate for osteotomy was also utilized when necessary. The actual operation was carried out according to the plan. Results: The average age of the 11 patients was 19.09 years (19.09?±?6.93 years) and the average follow-up was 16 months (16?±?15.11 months). The symptoms were obviously improved. The preoperative World Health Organization Disability Assessment Schedule (WHODAS 2.0) score, modified Barthel index and Functional Independence Measure (FIM) score in patients were 70.45?±?15.75, 96.55?±?3.78 and 121.36?±?4.15, respectively and correspondingly 53?±?12.75, 98.82?±?1.66 and 123.82?±?4.60 after surgery, respectively. There were significant differences before and after surgery (P?<?0.05). Conclusion: The use of 3D printing technology can provide intuitive and accurate help for the correction of complex limb malformations and greatly facilitates the communication between doctors and patients. The FIM score is suitable for the evaluation of the curative effect before and after the treatment of patients with complex malformations.

Osteochondral defect (OCD) regeneration remains challenging because of the hierarchy of the native tissue including both the articular cartilage and the subchondral bone. Constructing an osteochondral scaffold with biomimetic composition, structure, and biological functionality is the key to achieve its high‐quality repair. In the present study, an injectable and 3D printable bilayered osteochondral hydrogel based on compositional gradient of methacrylated sodium alginate, gelatin methacryloyl, and β‐tricalcium phosphate (β‐TCP), as well as the biochemical gradient of kartogenin (KGN) in the two well‐integrated zones of chondral layer hydrogel (CLH) and osseous layer hydrogel (OLH) is developed. In vitro and subcutaneous in vivo evaluations reveal that apart from the chondrogenesis of the embedded bone mesenchymal stem cells induced by CLH with a high concentration of KGN, a low concentration of KGN with β‐TCP in the OLH synergistically achieves superior osteogenic differentiation by endochondral ossification, instead of the intramembranous ossification using OLH with only β‐TCP. The biomimetic construct leveraging KGN as the only biochemical inducer can facilitate cartilage and subchondral bone restoration in the in vivo osteochondral defect. This one‐stone‐two‐birds strategy opens up a new facile approach for OCD regeneration by exploiting the biological functions of the bioactive drug molecule KGN. An injectable biomimetic scaffold is constructed for osteochondral defect regeneration. Kartogenin (KGN) is used as the only bioactive drug molecule to achieve the "one‐stone‐two‐birds" strategy. A high concentration of KGN in the chondral layer hydrogel can induce the chondrogenesis of bone marrow mesenchymal stem cells (BMSCs), while a low concentration of KGN with β‐tricalcium phosphate (β‐TCP) can realize superior osteogenic differentiation of BMSCs by endochondral ossification.

In this paper we report a “steel–concrete” inspired layered hybrid spine cage combining a titanium mesh and a bioceramic scaffold, which were welded together through a bioglass bonding layer using a novel multistep manufacturing methodology including three-dimensional slip deposition, gel casting, freeze-drying, and cosintering. The interfacial welding strength achieved 27 ± 0.7 MPa, indicating an excellent structural integrity of the hybrid cage construct. The biocramic scaffold layer consisting of wollastonite and hydroxyapatite had an interconnected, highly porous structure with a pore size of 100–500 μm and a porosity of >85%, well fufilling the structural requirements of bone regeneration. Simulated body fluid immersion assay showed that the hybrid cage exhibited excellent biodegradability to facilitate rapid bone-like apatite formation. In vitro studies demonstrated that the bioceramic scaffold on the hybrid cage supported attachment, spreading, growth, and migration of bone/vessel-forming cells and triggered osteogenic differentiation of human mesenchymal stem cells. In vivo studies further suggested that the bioceramic scaffold on the hybrid cage could actively promote fast generation of new bone tissues within 12 weeks of implantation in a rabbit femoral condyle model. This study has provided a new design and fabrication methodology of hybrid cages by integrating strong mechanical properties with excellent biological activities including osteoinductivity and bone regeneration ability, for spine fusion and segmental bone reconstruction.

Our aim in this study was to identify the associations between growth differentiation factor 15 (GDF15) and type 2 diabetes mellitus (T2DM) complications in a community-based population in China.

A comprehensive depiction of long-term health impacts of marital status is lacking.

This study explored the surgical method and short-term clinical effect of a greater trochanter osteotomy along with cementless artificial total hip arthroplasty in the treatment of Crowe type IV developmental dysplasia of the hip. The authors conducted a retrospective analysis of 18 patients (22 hips) with Crowe type IV dysplasia who were seen between June 2008 and August 2010. After undergoing cementless artificial total hip arthroplasty using a posterolateral approach, a greater trochanter osteotomy was used to adjust the tension of the gluteal muscle, and an acetabular cup was placed.Average preoperative length shortening of the affected limb was 4.5 cm (range, 3.4–6 cm), and average postoperative length increase was 4.0 cm (range, 3.2–4.8 cm). Average postoperative Harris Hip Score was 87 (range, 79–91), which was higher than the average preoperative score of 38 (range, 32–51). Intraoperatively, 3 hips (3 patients) sustained a proximal femur fracture. Due to the stability of the femoral prosthesis, either no treatment or wire fixation only was given; by 2 months postoperatively, radiographs indicated that all fractures had healed. One patient had symptoms of sciatic nerve paralysis that resolved 3 months postoperatively.Performing a greater trochanter osteotomy after cementless artificial total hip arthroplasty is effective for the treatment of Crowe type IV dysplasia and can rebuild the complex biology and biomechanics of hip dysplasia without increasing the complication risk.

The higher failure rate of total hip arthroplasty (THA) in young, active patients remains a challenge for surgeons. Recently, larger-diameter femoral heads combined with an alumina matrix composite ceramic (BIOLOX Delta; CeramTec AG, Plochingen, Germany) articulation was developed to improve implant longevity and meet patients’ activity demands while reducing the risk of component-related complications. The purpose of this study was to determine whether this new device may provide advantages for young, active patients. A prospective, randomized, controlled trial was conducted on 93 patients (113 THAs) with more than 3 years of follow-up. Patients were randomly divided into a study group (51 THAs) with a 36-mm Delta ceramic-on-ceramic (COC) articulation and a control group (62 THAs) with a common-sized alumina ceramic head on polyethylene liner (COP) articulation. Clinical and radiographic results were collected to compare the outcomes and complications, including implant-related failures, osteolysis, and noises. The large-diameter Delta COC articulation provided greater range of motion improvement (6.1° more), similar Harris Hip Scores, and similar complication rates compared with the alumina COP articulation. This study suggests that in the short term, the large-diameter Delta COC articulation results in better range of motion with no higher complication rates; however, mid-term (8–10 years) or longer follow-up is necessary to determine its superiority in young, active patients.

Mean blood pressure varies moderately with outdoor air temperature in many western populations. Substantial uncertainty exists, however, about the strength of the relationship in other populations and its relevance to age, adiposity, medical treatment, climate and housing conditions.

3D-printed porous tantalum scaffold has been increasingly used in arthroplasty due to its bone-matching elastic modulus and good osteoinductive ability. However, the lack of antibacterial ability makes it difficult for tantalum to prevent the occurrence and development of periprosthetic joint infection. The difficulty and high cost of curing periprosthetic joint infection (PJI) and revision surgery limit the further clinical application of tantalum. Therefore, we fabricated vancomycin-loaded porous tantalum scaffolds by combining the chemical grafting of (3-aminopropyl)triethoxysilane (APTES) and the electrostatic assembly of carboxymethyl chitosan and vancomycin for the first time. Our in vitroexperiments show that the scaffold achieves rapid killing of initially adherent bacteria and effectively prevents biofilm formation. In addition, our modification preserves the original excellent structure and biocompatibility of porous tantalum and promotes the generation of mineralized matrix and osteogenesis-related gene expression by mesenchymal stem cells on the surface of scaffolds. Through a rat subcutaneous infection model, the composite bioscaffold shows efficient bacterial clearance and inflammation control in soft tissue and creates an immune microenvironment suitable for tissue repair at an early stage. Combined with the economic friendliness and practicality of its preparation, this scaffold has great clinical application potential in the treatment of periprosthetic joint infection.

Motor recovery after severe spinal cord injury (SCI) is limited due to the disruption of direct descending commands. Despite the absence of brain-derived descending inputs, sensory afferents below injury sites remain intact. Among them, proprioception acts as an important sensory source to modulate local spinal circuits and determine motor outputs. Yet, it remains unclear whether enhancing proprioceptive inputs promotes motor recovery after severe SCI. Here, we first established a viral system to selectively target lumbar proprioceptive neurons and then introduced the excitatory Gq-coupled Designer Receptors Exclusively Activated by Designer Drugs (DREADD) virus into proprioceptors to achieve specific activation of lumbar proprioceptive neurons upon CNO administration. We demonstrated that chronic activation of lumbar proprioceptive neurons promoted the recovery of hindlimb stepping ability in a bilateral hemisection SCI mouse model. We further revealed that chemogenetic proprioceptive stimulation led to coordinated activation of proprioception-receptive spinal interneurons and facilitated transmission of supraspinal commands to lumbar motor neurons, without affecting the regrowth of proprioceptive afferents or brain-derived descending axons. Moreover, application of 4-aminopyridine-3-methanol (4-AP-MeOH) that enhances nerve conductance further improved the transmission of supraspinal inputs and motor recovery in proprioception-stimulated mice. Our study demonstrates that proprioception-based combinatorial modality may be a promising strategy to restore the motor function after severe SCI.

The periosteum is rich in vascular networks, osteoprogenitor cells, and stem cells and plays an important role in bone defect repair. However, existing artificial periosteum materials still have difficulty in meeting clinical requirements, such as good mechanical properties and bionic structure construction, osteogenic differentiation, and vascularization capabilities. Here, a poly-ε-caprolactone (PCL)/whitlockite (WH, 5, 10, 15 wt %) artificial periosteum with different doping amounts was prepared by electrospinning technology. According to the results of in vitromineralization experiments, the rapid ion release from WH promotes the deposition of mineralized hydroxyapatite. Inductively coupled plasma-optical emission spectroscopy, in vitroangiogenesis, and cell migration experiments showed that the bionic periosteum of the 15% WH group had the best release rate of Mg2+and the best ability to promote the human umbilical vein endothelial cell angiogenesis and migration. In addition, this group promoted collagen formation and calcium deposition. Finally, the subcutaneous implantation model was used to verify the biocompatibility and angiogenesis ability of the proposed membrane in vivo. Overall, this biomimetic PCL/WH nanofiber membrane combines the positive osteogenic differentiation ability and angiogenic ability of calcium phosphate materials and thus has good application prospects in the field of periosteal repair in the future.