In recent years,implantation medicine and alternative medicine have made great progress.As a resuh.clinical demands of substitutes for damaged organs and tissues have been greatly increased.The artificial organs.the tissue related engineering products,and biomaterials have saved thousands of patient's lives successfully.This article is to prospect for the development of artificial organs,tissue engineering and biomaterials in future vears.It mainlv includes the following aspects:The technical feature,the developing objection,the research direction,as well as a few questions which should be paid attention to in developing the related products.

The ever increasing use of the Single-use medical devices(SUD) in clinic has brought safety and convenience to people, while the management of SUD waste also put pressure on the environment. Reprocess and reuse of SUD has become the issue of social concerns. This paper will describe the management manner of FDA for reprocess and reuse of SUD, and then give some suggestion on China's management combining the national conditions of our country.

Objective Although chitosan has excellent biocompatibility and biodegradability, it is only soluble in acid solution that is not feasible for application in tissue engineering. The current study is aimed to prepare the carboxymethyl chitosan (CMC) for the purpose of improving the solubility of chitosan to meet the requirement of development of tissue engineering scaffolds. Methods The preparation methods and process conditions, such as the proportion of reactant, reaction temperature, reaction time and so on for three types of carboxymethyl chitosan were studied. Results The results indicated that optimal process conditions of three types of water soluble chitosan were obtained. Conclusion Water solubility of chitosan is greatly improved through carboxymethyl modification, which provides possibilities and foundation for further research.

Objective To investigate cell's viability and functions when human hepatocyte cell HepG2 and microcarriers were embedded in collagen gel and cultured in vitro.Methods Ultrasound concussion crushing method was used to get nanofiber microcarrier.HepG2 and microcarriers were embedded in collagen gel and cultured in 12 d.The albumin (ALB),urea and lactate dehydrogenase (LDH) levels in the nutrient solution were measured.Results The cells in nanofiber nanofiber microcarrier/collagen gel group were gathered around the microcarrier and formatted aggregates,the ALB and urea levels increased steadily and reached maximum in day 9,then decreased; In collagen gel without nanofiber microcarrier group cells uniformly distributed,the ALB and urea levels reached maximum in day 3,then decreased rapidly,and on day 6 majority of cells dead.Conclusion Gel entrapped nanofiber microcarriers and hepatoeytes is a high-density and longtime culture method which can possibly be used in the bioartificial liver system.

Nanotechnology is a newly rising subject.In order to reflect achievements and developments of nanotechnology,applications of nanotechnology to modern medicine are summarized,and its influences were analyzed dialectically.Nanotechnology will evoke a novel technical revolution,although there is still a long way to go before it is widely used.

Objective To study the feature of bone metabolism in different phase of elder type 2 diabetic nephropathy (DN) patients.Methods One hundred and fifty elder type 2 DN patients (non-microalbuminuria group,microalbuminuria group,clinic proteinuria group,DN renal inadequacy group and DN uremia group,each group was 30 cases),60 elder non-DN patients in chronic renal failure (CRF) (non-DN renal inadequacy group and non-DN uremia group,each group was 30 cases) ,and 30 elder healthy people (control group) were selected to observe the changes of osteocalcin (OT),β -crosslaps,parathyroid hormone ( iPTH),alkaline phosphatase (AKP),serum calcium (Ca),serum phosphorus (P) and Ca × P.Results In non-microalbuminuria group,microalbuminuria group and clinic proteinuria group,OT and β -crosslaps levels were lower than those in control group,and the lowest in microalbuminunia group (P＜0.01).In DN renal inadequacy group and DN uremia group,OT and β -crosslaps levels were higher than those in control group(P＜0.01).In the phase of CRF,OT,β -crosslaps and iPTH had no statistic difference between DN patients and non-DN patients,but had linear correlation.Serum P level was higher in DN renal inadequacy group and DN uremia group than that in control group(P＜0.01).Either DN or non-DN,serum P had more influence to Ca × P than serum Ca.Conclusions In the different phase of elder type 2 DNpatients,the effect of bone metabolism is different because of the different injury of renal function.Bone metabolism in the different phase has respective feature and mechanism,with low turnover in the first and high turnover in the end.

Objective To investigate the efficiency and safety as well as the effect of chronic intravenous iron supplementation on the improvement of anemia in the patients with maintain hemodialysis (MHD). Methods Fifty-six patients with MHD were involved in the six-month, controlled trail and randomly divided into two groups: intravenous iron group (IV group) and oral iron group (oral group). The patients of IV group (n=28) were intravenously pumped 100 mg iron dextran during each hemodialysis session for the total amount of 1000 mg,after that,100 mg iron dextrin each two weeks. Patients in the oral group took 525 mg ferrous sulfate a day during the first three months and received iron dextran on the above methods under stopping oral iron supplement during the second three months. The efficacy was assessed by determining the change of hemoglobin (Hb), hematocrit (Hct), serum ferritin (SF) and transferring saturation (TSAT). Results The levels of Hb, Hct, SF, TSAT were increasing in the IV group after trail and there were evidently difference in those markers in the first three months, compared to the oral group, P

Objective To investigate disorders in calcium and phosphorus metabolism and abnormity in parathyroid function and their related factors in maintenance hemodialysis(MHD)patients.Methods We collected serum Hb,SCr,BUN,calcium,phosphorus,iPTH,high sensitivity C-reactive protein(hs-CRP),albumin and calculated albumin-corrected Ca and Kt/V from 198 patients with MHD in Jing'an District Central Hospital,Shanghai from Jan.2009 to Dec.2010.The calcium and phosphorus metabolism and parathyroid function were evaluated according to the guidelines of bone metabolism and controlling of bone disease in Kidney Disease Outcome Quality Initiative(KDOQI)recommended by National Kidney Foundation of the United States.198 patients were classified into the standard group(150-300 ng/L),lower than the standard group(＜150 ng/L)and higher than the standard group(＞ 300 ng/L)according to serum iPTH levels.Results In the 198 cases,110 cases were normal in serum Ac-Ca(55.6％); 118 cases were normal in serum phosphorus (59.6％); 143 cases were normal in Ca × P(72.3％); 39 cases were normal in iPTH(19.7％).All four items up to the standard were 28 cases(14.1％)among 198 cases.However,132(66.7％)patients showed lower than 150 ng/L in serum iPTH.The average serum iPTH gradually decreased with age.The senior patients demonstrated the highest average serum Hs-CRP,the lowest average serum phosphorus and the lowest albumin.There were no statistical significance in sex,hemodialysis duration,diabetes,blood pressure,Hb,Bun,SCr,Ac-Ca and Kt/V among three groups.Conclusion The disorders in calcium and phosphorus metabolism and abnormity in parathyroid function is common in the MHD patients.We should pay attention to hypofunction of parathyroid gland in the patients with MHD,which may be related to aging,malnutrition and potential infection.These findings need further investigation.

Objective To study the short-term clinical efficacy and its possible mechanism of refractory hypertension(RH) treated by continuous veno-venous hemofiltration (CVVH) in maintenance hemodialysis (MHD) patients. Methods Thirty-four MHD patients with RH treated with CVVH enrolled in the treatment group,all these patients were treatment of 2 -3 times,each time 8 - 10 hours. Thirty MHD patients with wellcontroled blood pressure were recruited as control. Changes of blood pressure, dry weight, plasma levels of parathyroid hormone (PTH), renin ( RA), angiotensin Ⅰ , Ⅱ ( AT Ⅰ , AT Ⅱ ), aldosterone ( Ald ) were observed before and after hemodialysis. Results In the treatment group,compared with pre-treatment, the blood pressure decreased significantly with an effective rate of 64.7% and efficient rate of 100. 0%. Before treatment, plasma RA was ([1.10 ±0.25] μg/(L · h)and [0:78 ±0.26] μg/(L · h),AT Ⅰ was [0.89 ±0.21] μg/L and [ 0. 52 ± 0. 14 ] μg/L, AT Ⅱ was [ 177.68 ± 89.46 ] ng/L and [ 89. 25 ± 12. 84 ] ng/L, Ald was [72. 06 ± 11.47 ]ng/L and [ 48.92 ± 8. 65 ] ng/L, PTH was [ 306. 81 ± 69. 37 ] ng/L and [ 248.76 ± 134. 62 ] ng/L in the treatment and control group respectively. All the measurements in the treatment group were significantly higher than those in the control group (P ＜ 0. 05 ). In the treatment group, compared to pre-treatment, plasma RA significantly decreased ( [ 1.10 ± 0. 25 ]μg/ ( L · h) vs [ 0. 76 ± 0. 17 ] μg/( L · h ), as well as AT Ⅰ ( [ 0. 89 ±0.21]μg/L vs [0.50 ±0.12] μg/L),ATⅡ([177.68±89.46]ng/L vs [ 87.13±14.22] ng/L),Ald ([72.06±11.47]ng/Lvs [ 46. 01± 9. 86 ] ng/L ) and PTH ( [ 306. 81 ±69.37]ng/L vs [ 186.53 ±32.93 ] ng/L) ( P ＜ 0. 05 ). However, there was no significant changes in the above mentioned measurements between before and after hemodialysis in the control group (P ＞ 0. 05). Conclusion CVVH may be an effective methods in the treatment of MHD patients with RH, and its antihypertensive mechanisms may be that CVVH can effectively remove the excess water in the body, and reduce plasma RA, AT Ⅰ , AT Ⅱ ,Ald and PTH levels.

Objective: To investigate the trend of hepatitis B incidence among children under 10 years in Zhejiang Province from 2004 to 2020 with age, period and birth cohort, so as to provide the basis for evaluating the implementation of hepatitis B prevention and control measures for children in Zhejiang Province. Methods: Data of hepatitis B incidence among children under 10 years in Zhejiang Province from 2004 to 2020 were collected through the Infectious Disease Reporting Information System of Chinese Disease Prevention and Control Information System. The trend in hepatitis B incidence was analyzed using an age-period-cohort model. Results: The incidence of hepatitis B among children under 10 years in Zhejiang Province decreased from 12.91/105 in 2004 to 0.61/105 in 2020, with a reduction of 95.24%. The incidence showed an decreasing trend with the increase of age. Compared with 2012, the risk of hepatitis B incidence among children under 10 years appeared a tendency towards a decline with time, with the period rate ratio decreased from 4.546 (95%CI: 3.322-6.220) in 2004 to 0.277 (95%CI: 0.161-0.478) in 2020. Compared with the 2008 cohort, the risk of hepatitis B incidence appeared a tendency towards a decline with cohort, with the cohort rate ratio decreased from 25.535 (95%CI: 15.105-43.166) in 1995 to 0.135 (95%CI: 0.038-0.475) in 2020. Conclusions The incidence of hepatitis B among children aged under 10 years in Zhejiang Province from 2004 to 2020 showed a downward trend. The risk of hepatitis B incidence decreased with increasing age and advancing birth cohort.