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.

Objective To investigate the effect of narrow-band UVB combined with tacrolimus ointment in the treatment of vitiligo,and its influence on IL-17 and IL-22 in peripheral blood.Methods 100 patients with vitiligo were selected as study subjects,and they were divided into the control group and observation group according to the random number table method,50 cases in each group.The control group was given 0.1% tacrolimus ointment,the observation group was treated with narrow-band UVB combined with 0.1% tacrolimus ointment.After 6 months of treatment,the clinical treatment effect of the two groups was observed.The levels of serum IL-17 and IL-22 were detected by ELISA,the differences between before and after treatment were compared between the two groups.Results The cure rate,effective rate of the observation group were 74.0%,96.0%,respectively,which were significantly higher than 62.0%,84.0% of the control group,the differences were statistically significant(x2=3.125,2.897,all P<0.05).The levels of IL-17 and IL-22 in the two groups before treatment had no statistically significant differences(all P>0.05).After treatment,the levels of IL-17 and IL-22 in the two groups significantly decreased(t=3.454,3.032,all P<0.05),which in the observation group were lower thanthose in the control group(t=3.867,2.665,all P<0.05).Conclusion Narrow-spectrum UVB combined with tacrolimus ointment has good clinical effect on vitiligo,which can effectively improve the local immune response.

Objective To analyze the condition, distribution, constituent ratio, main symptoms, laboratory examination and other clinical features of juvenile rheumatic disease (JRD) in order to enhance theunderstanding of it. Methods Five hundred and sixty-one cases of JRD treated in the Department of Pediatrics of Henan Provincial People′s Hospital were analyzed retrospectively from January 1990 to August 2003. Results Henoch-Schonlein purpura (HSP), juvenile idiopathic arthritis(JIA), rheumatic fever (RF), systemic lupus erythematosus (SLE) occurred more in rural area than in urban. Mucocutaneous lymphnode syndrome (MCLS) occurred more in urban than in rural area.The initial symptoms of JRD were arthralgia, skin rashes and fever. The frequently involved organs were kidney, lymphnode, heart and liver. White blood cell count and erythrocyte sedimentation rate raised in 43.1% and 61.6% patients with JRD respectively. Rheumatoid factor was mostly positive in JIA. Three patients died. Conclusion 2.9% patients with JRD have been admitted to Department of Pediatrics. The most common diseases are HSP, JIA, MCLS, RF, SLE. The morbidity of HSP shows an increasing tendency and RF shows decreasing tendency. It is suggested to enhance the understanding of JRD. Improve the diagnostic and treatment level is the key to control disease and reduce complications.

Objective:To explore the characteristic of percutaneous transpedicular basilar part puncture on dimensional images and its safe procedure under image guidance.Methods:12 human spines(T_4～L_5)were gathered from preservative cadavers.Com- puterized Tomography(CT)was used for scanning.In the transverse section of the pedicle,the angles and the width of the pedicle basilar part were measured and the statistical analyses were made.Results:The angles of the pedicle basilar part diminished from T_4 to T_8 and enlarged from T_9 to L_5.The width of the pedicle basilar part enlarged from T_4～L_5.There was no significant difference in these parameters between male and female groups or between left and right sides.Conclusion:Transpedicular basi- lar part approach could be used in T_4 to T_8 but transpedicular basilar part and trans-pedicular approach can be chosen in T_9 to L_3 and transpedicular could be used in L_4～L_5 when percutaneous vertrbroplasty is done in T_4 to L_5.

Objective:To observe the clinical effect of Xihuang Pill in treatingadvanced primary liver caner. Methods: 23 cases of advanced primary liver caner were enrolled in the research. Two courses of Xihuang Pill were given orally (21d per course). The patients' quality of life (QOL) and clinical manifestations were recorded before and after the treatment. Results: QOL was improved in patients after the treatment. Clinical symptoms, such as abdominal distention, poor appetite and cancer pain, were also relieved. The above changes were statistically significant (P

Objective To evaluate the effect of total mesorectal excision with single stapling technique for low positioned rectal cancer.Methods Based on total mesorectal excision,56 cases of low positioned rectal cancer underwent anal preserving operation with single stapling technique and purse-string forceps.The 2 years follow-up result was retrospectively analyzed on radical resection effect,defecating function,complication rate and recurrent rate.Results All the resection margins were clear and had no intraoperative death,anastomotic leakage or occurrence of incontinence.Anastomotic stricture rate was 4%(2/56) and local recurrent rate was 5%(3/56).The patients were satisfied with anal function.Conclusion Based on total mesorectal excision,anal preserving operation for low positioned rectal cancers using single stapling technique and purse-string forceps can improve the postoperative quality of life,that is safe,feasible,practical and economical.