BACKGROUND: It is a gold standard to repair and construct bladder via intestinal tract. However, intestinal tract existing in urinary system may cause metabolic disorder, infection, lithogenesis, or even a series of severe complications.OBJECTIVE: To summarize the performance of tissue engineering during reconstruction of urinary bladder, and to search a reasonable replacement of urinary bladder.METHODS: A computer-based online search was conducted with the key words of "tissue engineering, bladder, mesenchymal stem cells" in both Chinese and English from January 1993 to October 2009. Inclusion criteria: Articles about correlation among seed cells, tissue-engineered bladder, and bio-scaffold materials were included. Exclusion criteria: Duplicated researches or Meta analysis was excluded. Among 29 articles, the following five points were mainly analyzed: how to stably and rapidly obtain sufficient and viable cell source; how to choose bio-scaffold materials of bladder; how to repair and reconstruct bladder tissue; how to solve the ethics problem; how to accumulate vascularization of the in vitro constructed bladder tissue after transplantation. RESULTS AND CONCLUSION: Autoallergic bone marrow mesenchymal stem cells (BMSCs) which were chosen for bladder tissue engineering characterized by convenient collection and low immunogenicity; additionally, BMSCs could differentiate into transitional epithelial cells, smooth muscle cells, vascular endothelial cells, and neurocytes so as to improve blood supply and neural function of regenerated tissue. Furthermore, BMSCs could help grafts avoid from fibration-contracture; therefore, BMSCs have a perspective application. However, the efficacy of tissue-engineered bladder needs to be further evaluated for clinical application. For example, the healing, structure, functional reconstruction, and vascularization of tissue-engineered bladder and autoallergic bladder tissue, innervated establishment, and ethical difficulty will be further studied in the future.

Objective To explore the clinical effect of treating rheumatism arthritis with pure traditional Chinese medicine preparation of Tongluoshu Liquid.Methods The study of single-blind method was adopted.60 patients were recruited randomly into 2 groups,with 30 patients in each group.The patients in treatment group were administered with Tongluoshu Liquid,150ml each time,twice a day.Those in the control group were given diclofenac sodium sustained release tablets,one tablet each time,twice a day,and methotrexate,7.5 mg for each time,once a week.Results Compared with the control group,the symptoms of joint pain,joint swelling,joint tenderness,bend to stretch disadvantage and soreness and weakness of waist and knees were significantly improved( U=1.20、1.36、1.01、1.78、1.46,P＜0.05)in the treatment group.Conclusion Tongluoshu Liquid is a kind of economical,safe and effective medicine to treat rheumatism arthritis.

The reform of medical concepts,development of medical knowledge and innovation of medical techniques bring surgeons from the era of soldering iron to the digital era.In the 21st century,the demand for an excellent surgeon goes beyond by adding minimal invasiveness and optinal recovery of patients.With modern technology,we could obtain the information of external presentations as well as the internal relationship of organs by three dimensional reconstructions.With virtual technologies and robotic surgical systems,preoperative surgery planning and remote control of surgery could be realized currently.These changes are not only the reformation of minimally invasive surgcry,but also the trends of development of surgery in the 21st century.

Bile duct has great attraction to surgeons due to its special anatomical location,unique biological features and origin of complicate diseases. Minimally invasive surgery,represented by laparoscopic cholecystectomy and Davinci robotic surgical system,has brought technic revolutions to traditional biliary surgery.In order to understand the prospect and regression of biliary surgery in the new era,we need to upgrade the knowledge of the biliary system,and systemically investigate the anatomy and development of bile duct. The study of biliary system should follow the path of extrahepatic system to hilar and then to the intrahepatic system,and the intrahepatic biliary disease should be emphasised in this new era.

Hilar cholangiocarcinoma (HCCA) occurs at the confluence of the right and left hepatic bile ducts.Because of the unique anatomical position and the biological behaviour of HCCA,hepatic vessels,nerves,lymph nodes and adjacent tissues are easily invaded by HCCA.The operation for HCCA is difficult,and the prognosis of patients is poor.Extended hepatectomy guided by imaging techniques shed light on the management of HCCA,while controversies on extended hepatectomy exist at home and abroad,and a standard treatment is needed to be formulated.Therefore,the surgical management for HCCA should be standardized for improving the radical resection rate,reducing the incidence of complications and mortality.

General surgery has been the clinical foundation for all of the branches of the surgical specialties.The scientific principles developed in general surgery have spread through the specialties as well.This is the basis for surgical mastery.The rapid development of information sciences brings great opportunities for further developments in general surgery.General surgeons will be challenged to learn how to incorporate these advances into their practice.Integrating other disciplines such as digital imaging will be required for general surgeons in the 21st century.General surgeons should not only understand the essence of traditional general surgery,but also be proficient in the usage of advanced diagnostic and therapeutic tools which will lead to promoting further developments in general surgery.

Mantle cell lymphoma (MCL) is a rare subtype of non-Hodgkin lymphoma.The MCL is classified into two subtypes, some patients have a chronic/indolent course and the others have a more aggressive course and short survival.In recent years, some novel therapeutic target agents for MCL have reports.These target agents achieve efficacy comparable to conventional chemotherapy in relapsed/refractory MCL.Therapeutic targents for MCL include the surface antigens of B-cell lymphoma, B-cell receptor signaling, DNA damage response pathway and the cellular microenviroment.This review focused on the recent research progress of target agents in the treatment of MCL.

Objective To investigate pathogenic factors,prevention approaches and therapeutic methods of neurosurgical postoperative intracranial infection.Methods A total of 89 cases were selected as our subjects from 1432 cases ho had received neurosurgical operation in the First People's Hospital of Shangqiu from April 2009 to April 2012.The clinical data of 89 cases with intracranial infection were retrospectively analyzed.Chisquare test was selected to analyze the factors which might cause infection.Effect of decision criteria was chosen to evaluate the cure effect.Results The infection rate was related to the approach to the post fossa,operation periods above 4 h,ventricular drainage,long indwelling drainage and cerebrospinal fluid (CSF) leakage (P ＜0.05 or P ＜0.01).However,the infection rate was not related to age,sex and application of antibiotics before the operation (P ＞0.05).As to effects,73 cases (82.02％) were cured,and 7 cases (7.87％) were showed sort of effects,as well as 8 cases(8.99％) were improved a little and 1 case(1.12％) with invalid.Conclusion It is important to adopt appropriate operation method,by decreasing operation time,preventing drainage from pollution carefully in order to prevent and decrease the intracranial infection after craniotomy,prevention CSF leakage and proper treatment could effectively cure intracranial infection.

Objective To investigate the clinical effects of early cranioplasty and ventriculoperitoneal shunt in the treatment of traumatic brain injury.Methods 70 patients with traumatic brain injury were randomly divided into two groups.35 cases in the control group were treated with ventriculoperitoneal shunt,and received cranioplasty postoperative 3-6 months.35 patients in study group received early cranioplasty and ventriculoperitoneal shunt in 2-3 months after treatment.The therapeutic effects of the two groups were observed.Results After GCS,the excellent and good rate of study group was 71.4％,which was significantly higher than 57.2％ of the control group (x2 =7.47,P ＜ 0.05).The good rate of the study group was significantly higher than that of the control group (x2 =8.35,P ＜0.05).The moderate disability rate of the study group was significantly lower than that of the control group (x2 =7.33,P ＜0.05).The incidence rate of complications in the study group was 14.3％,which was significantly lower than 34.3％ in the control group (x2 =7.35,P ＜ 0.05).Conclusion Early cranioplasty and ventriculoperitoneal shunt therapy in the treatment of patients with traumatic brain injury can effectively improve clinical recovery of the patients,and reduce the postoperative complications.

Objective To compare the clinical effect of locking compression plate and anatomic plate fixation for Pilon fracture.Methods 68 patients with tibial Pilon fracture were selected and divided into two groups according to the random number table method,34 cases in each group,the observation group was given lock plus pressure plate fixation while the control group received anatomic plate for treatment,the clinically relevant indicators,treatment effect and occurrence of complications of the two groups were compared.Results The operation time of the observation group[(46.46 ±3.56)min],incision length[(5.25 ±0.75)cm],blood loss[(36.77 ±5.12)mL],plaster braking time[(13.23 ±1.77)d],fracture healing time [(12.42 ±1.43 )weeks],postoperative hospital stay [(9.89 ± 1.88)d]were less than or shorter than those of the control group [(68.76 ±4.45 )min,(12.78 ±1.54)cm, (84.75 ±8.65)mL,(20.30 ±2.43)d,(18.94 ±2.30)weeks,(15.67 ±2.64)d],the differences were statistically significant(t =6.834,9.455,7.488,6.591,7.033,8.210,all P <0.05).The excellent rate of the observation group was 94.12%,which was higher than 80.00% of the control group,the difference was statistically significant(χ2 =8.238,P <0.05).The postoperative complications occurred in the observation group was 5.88%,which was signifi-cantly increased to 17.65% in the control group,the difference was statistically significant(χ2 =7.657,P <0.05). Conclusion Compared with anatomical plate fixation,the locking compression fixation for Pilon fractures can shorten the healing time and reduce the incidence of complications,so it is safe and has significant advantages for the clinical application.