title: [Vancomycin cationic liposome combined with nano-hydroxyapatite/chitosan/konjac glucomannan scaffold for treatment of infected bone defects in rabbits].
abstract: OBJECTIVE
  To investigate the anti-infection and bone repair effects of cationic liposome-encapsulated vancomycin combined with the nano-hydroxyapatite/chitosan/konjac glucomannan (n-HA/CS/KGM) composite scaffold in vivo.
  
  
  METHODS
  Fifty-one 6-month-old New Zealand white rabbits, weighing 1.5-3.0 kg, were selected to prepare chronic infectious tibia bone defect model by using Staphylococcus aureus. After 4 weeks, 48 survival rabbits were randomly divided into 4 groups (n=12). After debridement, defect was treated with nothing in group A, with n-HA/CS/KGM composite scaffold in group B, with vancomycin and n-HA/CS/KGM composite scaffold in group C, and with cationic liposome-encapsulated vancomycin and n-HA/CS/KGM composite scaffold in group D. After 8 weeks of treatment, general observation, X-ray, HE staining, the bacterial culture, and the measurement of the longest diameter of bone defect were done.
  
  
  RESULTS
  At 4 weeks after modeling, 48 rabbits were diagnosed as having osteomyelitis, including periosteal new bone formation, destruction of bone, and soft tissue swelling. The Norden score was 3.83 +/- 0.52. At 8 weeks after treatment, sinus healed in groups C and D, but sinus was observed in groups A and B; the gross bone pathological scores of group D were significantly better than those of groups A and B (P < 0.05). Bone defects were repaired completely in group D, the results of the longest diameter of bone defects in group D was significantly better than those in the other 3 groups (P < 0.05). New bone formation was observed in groups C and D, but periosteal reaction and marrow low-density shadow were observed in groups A and B; Norden score in group D was significantly better than those in groups A, B, and C (P < 0.05). HE staining showed that there were a large number of trabecular bone formation and fibrosis, with no obvious signs of infection in groups C and D, but neutrophil accumulation was observed in groups A and B; Smeltzer scores in groups C and D were significantly better than those in groups A and B (P < 0.05). Bacteriological results showed higher negative rate in groups C and D than in groups A and B (P < 0.05).
  
  
  CONCLUSIONS
  Cationic liposome-encapsulated vancomycin and n-HA/CS/KGM composite scaffold can be a good treatment for infectious bone defects in rabbits, providing a new strategy for the therapy of bone defects in chronic infection.
authors.affiliation: Orthopedic Center, Kunming General Hospital of Chengdu Military Command, Kunming Yunnan, 650032, PR China.
authors.forename: Jinliang
authors.initials: J
authors.lastname: Huang
authors.forename: Tao
authors.initials: T
authors.lastname: Ma
authors.forename: Hui
authors.initials: H
authors.lastname: Tang
authors.forename: Xinyu
authors.initials: X
authors.lastname: Fan
authors.forename: Yongqing
authors.initials: Y
authors.lastname: Xu
mesh_terms: D000818:Animals; D001847:Bone Diseases / Q000382:microbiology / Q000628:therapy*; D001861:Bone Regeneration; D048271:Chitosan / Q000627:therapeutic use*; D002908:Chronic Disease; D017886:Durapatite / Q000627:therapeutic use*; D008081:Liposomes; D008351:Mannans / Q000627:therapeutic use*; D049329:Nanostructures; D010019:Osteomyelitis / Q000628:therapy; D011817:Rabbits; D013203:Staphylococcal Infections / Q000628:therapy*; D054457:Tissue Scaffolds; D014640:Vancomycin / Q000627:therapeutic use*
chemical_list: D008081:Liposomes; D008351:Mannans; C022901:(1-6)-alpha-glucomannan; D014640:Vancomycin; D048271:Chitosan; D017886:Durapatite