Objective To find a new material for biomedical scaffold.Methods Composite films from poly-L-lactic acid(PLLA)and opal powder were fabricated.Osteoblasts seeded on the composite films and control ones were examined.Cell densities and morphologies on these films were studied by scanning electron microscopy(SEM).Cell growth and differential function were assessed by 3-(4,5-dimethyltyiazol-2-yl)-2,5-diphenyl tetrazolium bromide(MTT)test.Results SEM study showed that the addition of powder could improve the adhesion between osteoblasts and the composite films.MTT test proved that cell proliferation was improved when opal powder was added.This improvement came from the negative ion given off by the opal powder.The negative ions either accumulate at the cell membrane or enter into the cells.Accumulation of negative ions at the cell membrane leads to a change of electric potential difference across the cell membrane which should be in a proper range for the cells to perform their normal physiological function.If the negative ions enter the cells,they may take part in biochemical reactions whenever possible.In this way,the ions also affect the cell normal metabolism.Conclusion Osteoblasts grow well on opal/PLLA composites and the negative ion from opal powder is responsible for the enhancement of cell growth.This study provides a new material for biomedical scaffold.

Objective To compare the clinical efficacy of nasal intermittent positive pressure ventilation (NIPPV) and heated humidified high flow nasal cannula (HHHFNC) in the treatment of respiratory distress syndrome (RDS) among low-birth-weight premature infants.Method From May to December 2015,low-birth-weight premature infants with RDS who were born and treated in our hospital were randomly assigned into NIPPV group and HHHFNC group according to their initial ventilation mode.The incidence of initial treatment failure,the usage of pulmonary surfactant (PS),the parameters of respiratory support treatment and the incidence of complications were analyzed.Result A total of 70 cases with grade Ⅰ ～ llⅢ of RDS were included,including 33 males and 37 females.The birth weight ranged from 1 020 to 2 450 g,with a average of (1 845 ± 475) g.NIPPV and HHHFNC group each had 35 cases.No significant differences existed between the two group in the following items:the rate of mechanical intubation within 72 h (5.7％ vs.11.4％),use of PS (0％ vs.8.6％),incidence of severe apnea (11.4％ vs.14.3％),pneumonia (11.4％ vs.14.3％),the duration of invasive mechanical ventilation [76.3 (30.8,150.4) h vs.97.6 (56.2,142.6) h],non-invasive ventilation [65.0 (43.0,119.0) h vs.96.0 (65.0,134.0) h] and the duration of oxygen therapy [154.0 (47.0,340.0) h vs.148.0 (72.0,327.0) h,it was no (P ＞ 0.05).Also,no significant differences in the incidence of bronchopulmonary dysplasia,necrotizing enterocolitis,retinopathy of prematurity,patent ductus arteriosus,intra-ventricular hemorrhage,nose injury,pneumothorax between the two groups.Conclusion As an initial respiratory support for the treatment of low-birth-weight RDS preterm infants,HHHFNC has similar efficacy and safety with NIPPV,and further clinical research is needed.

Objective:To investigate the feasibility and efficacy of transcystic injection of indocyanine green during laparoscopic cholecystectomy (LC) surgery in the treatment of patients with gallbladder stones combined with liver cirrhosis.Methods:The clinical data of 96 patients with cirrhosis who underwent LC for gallbladder stones with cholecystitis attacks in the Department of Hepatobiliary and Pancreatic Surgery of the Second People′s Hospital of Changzhou City from January 2018 to May 2022 were retrospectively analyzed. All patients were diagnosed by clinical history and auxiliary examination before surgery and underwent cholecystectomy according to their groups, which were divided into fluorescence group ( n=49) and white light group ( n=47) according to whether ICG was used or not, where the fluorescence group underwent LC in fluorescence mode after direct intraoperative injection of ICG via gallbladder. The two groups were compared in terms of identification time of the three tubes, operation time, intraoperative bleeding, intraoperative injury, intraoperative open abdomen and blood transfusion, postoperative drainage time, postoperative hospitalization time, postoperative complications and changes in infection and liver function indexes before and after surgery. The measurement data obeying normal distribution were expressed as mean±standard deviation( ± s), and independent sample t-test was used for comparison between groups. The measurement data obeying the skewed distribution were expressed by M( Q1, Q3), and the Mann-Whitney U test was used for comparison between groups. Count data were expressed as rates (%), and the chi-square test or Fisher′s exact probability method was used for comparison between groups. Results:The procedure was successfully performed in both groups, and the identification of triple-tube time, operative time, intraoperative bleeding, postoperative drainage time, postoperative hospital stay, postoperative ALT, postoperative GGT, and postoperative TBIL in the fluorescent group were (14.96±1.49) min, (52.14±7.36) min, 5(5, 10) mL, (1.61±0.61) d, (2.37±0.49) d, 31.5(22.0, 44.8) U/L, 38.0(21.0, 91.5) U/L, 18.0(11.5, 22.8) μmol/L, and (29.87±3.37) min, (84.36±13.25) min, 10(10, 20) mL, (2.70±0.69) d, (3.15±0.42) d, 45.0(28.0, 64.8) U/L, 73.0(32.0, 132.0) U/L, 23.0(16.1, 29.3) μmol/L in the white light group and the differences were statistically significant compared with the two groups( P<0.05). In the fluorescence group, there was no intraoperative injury and no cases of intraoperative opening, and there were 2 cases of postoperative complications, while in the white light group, there were 2 cases of intraoperative injury, 1 case of intraoperative opening, and 5 cases of postoperative complications, and there were no cases of blood transfusion in both groups. There was no statistically significant difference between the fluorescence group and the white light group when comparing the preoperative laboratory indexes of both groups ( P>0.05). When comparing the first postoperative white blood cell count, C-reactive protein, aspartate aminotransferase, and alkaline phosphatase indexes in the fluorescence group and the white light group, there was no statistically significant difference between the two groups ( P>0.05). Conclusion:When LC is performed in patients with symptomatic gallbladder stones combined with cirrhosis, intraoperative injection of indocyanine green via the gallbladder to visualize the gallbladder and bile duct structures is simple and easy to perform, and the safe and efficient dissection of extrahepatic bile ducts and gallbladder bed speeds up the procedure while reducing postoperative trauma.

Objective:To investigate the feasibility and potential of fluorescent cholecystic bile duct visualization with direct intravenous injection of indocyanine green(ICG) in obese patients undergoing laparoscopic cholecystectomy(LC).Methods:The clinical data of 132 patients with LC combined with obesity admitted to the Department of Hepatobiliary and Pancreatic Surgery of the Second People′s Hospital of Changzhou City, affiliated to Nanjing Medical University, from January 2023 to July 2023 were retrospectively analyzed. They were divided into fluorescence group( n=65) and control group( n=67) according to whether indocyanine green fluorescence navigation was used or not. There were 50 males and 82 females, and all the enrolled patients body mass index≥28 kg/m 2. Two groups identify the time of the three tubes, intraoperative bleeding, operation time, postoperative hospitalization time, white blood cell count(WBC), C-reactive protein(CRP), alanine aminotransferase(ALT), gamma-glutamyl transferase(GGT), and postoperative follow-up in the fluorescent and control groups were counted respectively. Measurement data with skewed distribution were expressed as M( Q1, Q3), and intergroup comparisons were performed using the Mann-Whitney U test; counting data were described by frequency(rate), and intergroup comparisons were made by applying the chi-square test, Fisher′s exact probability method, and chi-square corrected test according to the difference in the minimum frequency. Results:Surgery was successfully completed in both groups. Preoperative inflammatory indicators and liver function levels were also not statistically significant( P>0.05). The time to identify the three tubes, operation time, intraoperative bleeding, and postoperative hospitalization in the fluorescence group were 18.00(13.50, 20.00) min, 40.00(30.00, 50.00) min, 5.00(5.00, 10.00) mL, and 2.00(1.50, 3.00) d, and in the control group were 32.00(25.00, 45.00) min, 65.00(50.00, 85.00) min, 41.00(41.00, 46.00) mL, and 4.00(3.00, 5.00) d. The differences between the two groups were statistically significant( P<0.05). The postoperative leukocyte count, postoperative CRP, and postoperative GGT were 9.15(7.10, 11.75)×10 9/L, 7.19(3.22, 20.00) mg/L, and 34.0(20.0, 49.0) U/L in the fluorescence group, and 13.05(11.02, 15.59)×10 9/L, and 18.78(12.90, 32.95) mg/L in the control group, respectively, 82.5(68.5, 114.5) U/L, and the differences between the two groups were statistically significant ( P<0.05). None of the patients showed abdominal pain, abnormal liver function and hepatobiliary ultrasound in the follow-up findings within 2 months after surgery. Conclusion:The effect of obesity, a factor that interferes with ICG fluorescence, is extremely limited, and ICG fluorescence cholangiography is a useful technique in the obese population that not only improves the efficiency of the procedure, but also increases intraoperative safety, with results superior to those of conventional laparoscopic cholecystectomy.