BACKGROUND: Practice has proved that organic material and inorganic materials used alone are not ideal scaffold materials. Polylactic acid (PLA) possessing excellent biocompatibility, degradability and absorbability, PLAs composites will be one of the most important biocomposite in the 21~(st) century. OBJECTIVE: To observe the effects of PLA-chitosan fiber (CF)/hydrexyapatite-calcium silicate (HA-CS) on adhesion, proliferation and differentiation of osteoblasts. METHODS: The rat osteoblasts were obtained from the cranium of newborn Wistar rats within 24 hours, and primarily cultured using modified collagenase digestion. The cells were generated and their biological characteristic was examined by inverted phase-contrast microscope, hematoxylin-eosin staining, alkaline phosphatase (ALP) staining and mineralized nodules staining. Then the cells at passage 3 were co-cultured with PLA-CF, PLA-CF/CS and PLA-CF/HA-CS in vitro. At 3, 6 and 9 days of the culture, cell morphology was observed by inverted phase contrast microscopy. In addition, MTT assay and ALP activity test were used to observe the effects of three kinds of materials on cell differentiation and proliferation. RESULTS AND CONCLUSION: Osteoblasts attached on all three scaffold materials can adhere, grow, differentiate and proliferate. The effect of three materials on cell activity was PLA-CF/HA-CS>PLA-CF/CS>PLA-CF. The composite scaffold PLA-CF/HA-CS has a good compatibility, indicating that the material has a great potential for application in bone tissue engineering.

Objective: To observe the biocompatibility of acellular nerve scaffold (ANS) via three sterilization methods, to provide experimental data for tissue engineering industrialization. Methods: Pig sciatic nerves were cut and treated using the NaOH maceration method. ANSs were sterilized by ethylene oxide, ~(60)Co-irradiation and peracetic acid. Evaluated the biocompatibility by MTT, cellular compatibility test, collagenase susceptibility test in vitro and local implantation test. Results: ANS retained the integrity of structure and major components of the basement membrane. The result of MTT test showed that the ANSs via different sterilization methods had statistical differences. There were no overall significant differences in Collagenase susceptibility test. Scanning electron microscope results showed the skin fibroblasts could attach, proliferate and grow well on the surface and holes of ANS with sterilization of PAA and Co~(60),a small quantity of cells adhered on ANS with sterilization of ETO. Tests for local effects after implantation show that different sterilization methods don't effect the ability of ANS to resist the enzyme degradation. In ETO group, rats showed an acute inflammatory response followed by chronic inflammation. In PAA and ~(60)Co group rats showed an acute inflammatory response that diminished such that the graft ultimately became indistinguishable from native tissue, observations that were consistent with graft acceptance. Conclusion: Peracetic acid sterilization offers a convenient alternative protocol for ANS processing. ANS sterilized with PAA shows good compatibility and biologic safety. It is an ideal sterilization method for ANS.

BACKGROUNDLung wedge resections and biopsies are frequently needed to diagnose and treat benign or malignant lung lesions. This study aims to compare thoracoscopy with thoracotomy for lung biopsy and wedge resection in solitary pulmonary nodule (SPN).

METHODSA controlled retrospective study was performed in this hospital. Patients with clinical diagnosis of SPN were undergone thoracoscopy or thoracotomy. Data of operation time, hours of stay in recover room, duration and volume of chest tube drainage, accuracy of biopsies, days of hospitalization and the whole cost of hospitalization were evaluated.

RESULTSAll patients were received lung biopsies and wedge resections (thoracoscopy 26,thoracotomy 47), and they were diagnosed pathologically. The days of hospitalization were similar in the two groups. The minutes of operation had no significant difference (thoracoscopy: 103.9±29.4 minutes, thoracotomy: 94.7±33.9 minutes). Both groups had equivalent duration of chest tube drainage (thoracoscopy: 60.3±25.0 hours, thoracotomy: 62.5±20.1 hours, P =0.687) . The total volume of chest tube drainage showed no difference in both groups. The hours of stay in recover room (thoracoscopy: 75.4±21.6 hours, thoracotomy: 80.4±17.7 hours, P =0.287) and days of hospitalization after operation (thoracoscopy: 11.3±3.4 days, thoracotomy: 10.6±2.4 days, P = 0.304 ) were not different significantly. The whole cost of thoracoscopy was 17 800.2±6 038.9 CNY and thoracotomy was 17 677.4±6 327.8 CNY ( P = 0.936 ).

CONCLUSIONSThere is no significant difference in outcomes for thoracoscopy and thoracotomy approaches. Both thoracoscopy and thoracotomy are acceptable procedures for lung biopsy and wedge resection in solitary pulmonary nodules.

【Objective】 To compare the outcomes of robot-assisted laparoscopic transperitoneal and retroperitoneal operation for huge (>6 cm) adrenal tumors. 【Methods】 The clinical data of 45 patients with huge adrenal tumors who underwent robotic surgery during Jan.2017 and Dec.2021 were retrospectively analyzed, including 28 cases via the transperitoneal approach and 17 cases via the retroperitoneal approach. 【Results】 No patients were converted to open operations. There were no significant differences in postoperative drainage time (2.24±0.44 vs. 2.36±0.49) d, operation time (130.88±5.96 vs. 136.61±8.39) min, blood loss (189.41±13.91 vs. 192.5±12.36) mL and postoperative hospital stay (7.06±0.56 vs. 7.46±0.69) d between the retroperitoneal and transperitoneal approaches. Retroperitoneal approach was better than transperitoneal approach in early postoperative feeding [(38.82±6.75 vs. 74.14±6.57) h, P<0.01] . 【Conclusion】 Robotic surgery is safe and effective in the treatment of large adrenal tumors. The choice of surgical approach should be based on patients’ condition, tumor volume and location.