Polylactic acid (PLA) and its copolymer are biodegradable polymer materials which are widely used in the medical field because of their excellent mechanical properties, chemical stability, good biocompatibility, and biodegradability. In this paper, research advances in the study on polylactic acid and its application in vascular stent are discussed.

Mechanical vascular anastomosis is a technique that uses special vascular anastomotic devices to entirely or partly substitute vascular anastomotic suturing . With the development of manufacture and the emergence of new biomaterials, this technique gained great progress and a large number of research both on preclinical and clinical has been carried out since the 50～60s of last century. The present paper reviewed the development of mechanical vascular anastomosis, analysed their advantages and deficiencies, and pointed out the research trend on these techniques.

Objective To study the main infectious bacteria and their drug-resistance after liver tra nsplantation. Methods K-B method was used to detect the susceptibility of agents of the main bacteria after liver transplantation. ESBLs and AmpC ?-lactamase among the main negati ve bacillus were detected by three-dimensional tests. ?-lactamase and Van gen e among Enterococcus were dectected by standard agar dilution susceptibility tes ts and Nitrocefin respectively. Results Among the main Gram-negative bacteria in 55 cases of infection following liver transplantation, the ratio of resistance to 4 or more antibiotic were all beyond 40% . The detectable rate of ESBLs and AmpC ?-lactamases in Enterobacter cloacae and Escherichia coli was 32.4% and 36.8% , and 33.8% and 10.5% re spectively. Moreover, the detectable rate of both ESBLs and AmpC ?-lactamases in Enterobacter cloacae and Escherich ia coli was 24.3% and 7.0% repectively. 8.8% and 11.1% produced ?-lactamases in Enterococcus faec alis and Enterococcusfaecium, with the ratio of resistance to Vancomycin being 11.2% and 18.5% respectively. Conclusions The primary pathogens have the high and multiple resistance to antimicrobial aft er liver transplantation. ESBLs and AmpC ?-lactamases were the main two factor s of drug-resistance among Gram-negative bacillus. we should pay much attentio n to the high detectble rate of Enterococcus which are resistant to Vancomycin a fter liver transplantation.

The incidence of obesity increases worldwide every year,positioned as an important disease by WHO,and it has become an important public health problem.National survey shows that overweight and obesity rates were 22.8％ and 7.1％ respectively in Chinese adults in 2002,affecting 270 million people.At present,bariatric surgery is a safe and effective treatment for severe obese patients.In July 2011,a patient with Ⅲ degree obesity (weight 148 kg and BMI 51 kg/m2) complicated with type 2 diabetes mellitus was admitted to the Third Xiangya Hospital of Central South University.The treatment plan was made after diagnosis and treatment of muhidisciplinary team and the patient underwent laparoscopic sleeve gastrectomy.The patient was followed up to September 2012 and recovered well without severe surgical complications,and the weight and BMI were decreased to 75 kg and 25 kg/m2 respectively.

Type 2 diabetes mellitus (T2DM) usually becomes complicated and unmanageable when combing with metabolic syndromes of obesity,hypertension and hyperlipidemia.Medical treatment generally adopts non-surgical management,such as diet control,exercise and oral medications; surgical treatment can improve the condition of patients with T2DM and the metabolic syndromes.In this article,the multi-disciplinary treatment of a patient with T2DM and obesity in the Third Xiangya Hospital of Central South University was analyzed,so as to provide a new way for the treatment of this disease.

The incidence of obesity is increasing in the world yearly, obesity and its complications pose a serious threat to the health of people at the same time. In recent years with the progress of economy, the development of science and technology and the change of concept, surgical robots are increasingly used in metabolic and bariatric surgery. In this review, the application and development trend of minimally invasive surgical robot in metabolic and bariatric surgery are reviewed, the advantages of surgical robot in metabolic and bariatric surgery are discussed, and the future development are prospected.

Jaundice occurs in 19%-40% of the hepatocellular carcinoma (HCC) patients. HCC associated jaundice may be divided into hepatocellular and icteric types in terms of its underlying pathophysiology. The jaundice of icteric type is caused by obstruction of the bile duct through cancer embolus, blood clot, biliary sludge, tumor compression or infiltration. Jaundice and epigastric discomforts are the main clinical manifestations. In the present case, severe acute pancreatitis and acute cholangitis presenting as initial complaints of icteric type HCC were quite rare. A tumor located at the central lobe of the liver and a cancer embolus at the lower part of the common bile duct (CBD) were detected by CT scan. Curative resection of HCC with CBD exploration eradicated both the tumor and the embolus, and no recurrence was found after a 36 month follow-up.

Additive manufacturing (AM) is a collection of technologies based on the layer-by-layer manufacturing. Characterized by its direct manufacturing and rapidity, it has been regarded by the Economist Journal as one of the key techniques which will trigger the third industry reformation. The present article, beginning with a brief introduction of the history of AM and the process of its major technologies, focuses on the advantages and disadvantages and medical applications of the technique.
Medicine ; Printing, Three-Dimensional

The interaction between medical instrument and target tissue during the surgery occurs in instrument-tissue interface. The reliability research on the interface is directly related to the safety and effectiveness of medical instrument in the clinical application. This paper illustrates the necessity of reliability research on instrument-tissue interface. Two main contents are synthetically reviewed the present paper: (1) reliability research on medical instruments; (2) biological tissue properties and its mechanical response.
Humans ; Reproducibility of Results ; Surgical Instruments ; Surgical Procedures, Operative

Vitamin D plays an important role in cellular differentiation and Calcium phosphate metabolism.At the same time,the role of Vitamin D in glycolipid metabolism had attracted a lot of attention.Bariatric surgery is an effective treatment to achieve therapeutic endpoints for comorbidities associated with obesity,but vitamin D status is always insufficient before and after surgery.In this review,the author aim to (1) discuss the deficiency of vitamin D in bariatric patients,(2) to summarize the impact of vitamin D on glycolipid metabolism and the outcome of bariatric surgery,(3) to discuss the supplementation for the deficiency of vitamin D.