Tissue engineering has already become an important research direction of trachea substitute; the construction of the scaffold is one of the key factors for a tissue engineering trachea .With the development and the maturity of the technology of 3D-printing, the design and manufacture of the tissue engineered scaffold is widely broadened, various types of 3D-printed scaffold are researched constantly.This review aims to summarize and evaluates the latest progress of the experiments about 3D-printed tissue engineering scaffold.

Objective To explore the application value of the extra-glissonian pedicle transection approach guided by arantius' ligament in laparoscopic left hemihepatectomy.Methods The retrospective cohort study was conducted.The clinical data of 57 patients who underwent laparoscopic left hemihepatectomy in the First Affiliated Hospital of Fujian Medical University from January 2015 to January 2018 were collected.There were 18 males and 39 females,aged from 29 to 75 years,with an average age of 57 years.Of the 57 patients,22 undergoing the laparoscopic left hemihepatectomy with extra-glissonian pedicle transection approach guided by arantius' ligament and 35 undergoing laparoscopic left hemihepatectomy with regular intra-glissonian pedicle transection approach were allocated into the extra-glissonian transection group and intra-glissonian transection group,respectively.Observation indicators:(1) intraoperative situations and postoperative short-term outcomes;(2) postoperative complications;(3) follow-up.Patients were followed up by outpatient examination and telephone interview to investigate postoperative recurrence of diseases up to June 2018.Measurement data with normal distribution were represented as Mean±SD and comparison between groups was analyzed using the t test.Count data were described as absolute number or percentage and comparison between groups was analyzed using the chi-square test.Results (1) Intraoperative situations and postoperative short-term outcomes:the operation time,dissection time of left hepatic pedicle,volume of intraoperative blood loss were (123± 37) minutes,(14± 5) minutes,(337± 169) mL in the extra-glissonian transection group and (148± 27) minutes,(22± 3) minutes,(495±203) mL in the intra-glissonian transection group,respectively,showing statistically significant differences between the two groups (t =2.992,7.733,3.045,P＜0.05).Cases with intraoperative blood transfusion,time of gastrointestinal recovery,time for postoperative drainage-tube removal,duration of postoperative hospital stay were 1,(1.8±0.9)days,(3.2±0.9)days,(8.2± 1.7)days in the extra-glissonian transection group and 4,(2.0± 0.8)days,(3.6±0.8)days,(10.0±4.0)days in the intra-glissonian transection group,respectively,showing no statistically significant difference between the two groups (x2 =0.171,t=1.304,1.857,1.622,P＞0.05).There was no uncontrolled hemorrhage or air embolism in the two groups.(2) Postoperative complications:3 patients had complications of Clavien-Dindo classification Ⅰ in the extra-glissonian transection group including 1 of pulmonary infection,1 of abdominal infection,1 of incisional infection and 7 had complications in the intraglissonian transection group including 2 of pulmonary infection,2 of liver sectional effusion,1 of subphrenic abscess,1 of biliary leakage,1 of incisional infection,showing no statistically significant difference between the two groups (x2=0.066,P＞0.05).Patients with postoperative complications were cured and discharged after symptomatic treatment.There was no perioperative death in the two groups.(3) Follow-up:57 patients were followed up for 5-41 months,with a median time of 23 months.Two and 1 patients had tumor recurrence and hepatolithiasis recurrence in the intra-glissonian transection group,without recurrence of hepatic hemangioma or cholangiocarcinoma.Five patients had tumor recurrence in the intra-glissonian transection group,without recurrence of hepatic hemangioma,hepatolithiasis or cholangiocarcinoma.The disease recurrence rate was 13.6％ (3/22) and 14.3％(5/35) in the extra-glissonian transection group and intra-glissonian transection group,respectively,showing no statistically significant difference between the two groups (x2 =0.104,P＞0.05).Conclusions Extraglissonian pedicle transection approach guided by arantius' ligament in laparoscopic left hemihepatectomy is feasible and effective,which can control hepatic blood inflow of left liver,simplify the surgery procedure and shorten dissection time of left pedicle,in order to save operation time and reduce volume of intraoperative blood loss.

Objective: To explored the bio-compatibility and cartilage regeneration of the rabbits genipin cross-linked decellularized scaffold, to provide experimental and theoretical support for the clinical application of genipin cross-linked decellularized scaffold. Methods: Detergent-enzyme method was used to prepare decellularized tracheal scaffolds. Cellular content of native trachea and decellularized trachea were compared by 4′, 6-diamidino-2-phenylindole(DAPI) staining. Masson trichrome staining was used to compare the histological structure of the progenitor tube, decellularized trachea, and genipin cross-linked decellularized trachea. Nine adult New Zealand white rabbits were randomly divided into autologous tracheal transplantation group (negative control group), allogeneic tracheal transplantation group (positive control group), and genipin cross-linked decellularized tracheal transplantation group (experimental group). Autologous bone marrow mesenchymal stem cells were implanted on the surface of trachea in each group. The blood cells and type II collagen were detected to compare the inflammatory response and chondrocyte regeneration after tracheal orthotopic transplantation in the three groups. Results: After DAPI staining and light microscope observation (×200), the cell content of the acellular 7-cycle trachea [(143.0 ± 71.1) cells/field] was significantly lower than that of the native trachea [(853.5 ± 149.6) cells/field], and the difference was statistically significant (P<0.001). Masson′s trichrome staining showed that the tissue structure of genipin cross-linked decellularized trachea was more complete. Blood cell analysis and type II collagen test results showed that genipin cross-linked decellularized trachea transplanted with bone marrow mesenchymal stem cells after transplantation in situ has little rejection and can be converted into chondrocytes by the action of related growth factors in vivo. Conclusions Genipin cross-linked decellularized tracheal scaffold combined with stem cell transplantation can successfully construct a tracheal in situ replacement model. This study provides a strong support for the research of tissue engineering trachea.

Lung cancer is one of the most common cancers in the world,which seriously affects people's physical and mental health.About 85％ of them are non-small cell lung cancers.In recent years,with the rapid development of low-dose computed tomography,Da Vinci robotic surgery and targeted therapy,the therapeutic effect of lung cancer has been greatly improved.However,due to the lack of early diagnosis of biomarkers,therapeutic targets and signs of prognosis,most patients have metastases when they are at the time of treatment.Lung cancer remains the leading cause of cancer-related death.CircRNA is a special endogenous non coding RNA,which is formed by the reverse splicing of the 3'splice donor site and the 5'splice acceptor site to form a covalent closed loop.It is highly conservative and stable.The expression level of circRNA in non-small cell lung cancer is obviously abnormal,which is closely related to the occurrence,development and metastasis of non-small cell lung cancer.It is expected to become an ideal biomarker,which is used for early diagnosis of non-small cell lung cancer,and provides new therapeutic targets and prognostic markers.

This paper rounded up the resources and advantages leveraged by the hospital′s burn and plastic surgery department as a national key discipline. The department practiced medical services for chronic wounds in the regional hierarchical medical system for chronic wounds to promote the development medical alliances. IT development of the hierarchical medical network has achieved disease information sharing, namely centralized patients screening, patients referral confirmation, mutual recognition of test results, online consultation and treatment follow-up. Other achievements include standardization of medical criteria for chronic wounds by means of effective integration of resources imbalance within the network and improvement of internal medical regulations; elevation of primary level innovation capacity and services by means of high-caliber specialists working at primary institutions and mutual exchanges in between; effective medical cost control via guarantee system building, thus enhancing the public benefit nature of public hospitals. The paper also probed into problems and solutions expected in the way of promoting the chronic wound hierarchical medical system.

Objective: To investigate the efficacy and safety of the new investigational drug pegylated interferon α-2b (Peg-IFN-α-2b) (Y shape, 40 kD) injection (180 µg/week) combined with ribavirin in the treatment of patients with genotype 1/6 chronic hepatitis C (CHC), with standard-dose Peg-IFN-α-2a combined with ribavirin as a positive control. Methods: A multicenter, randomized, open-label, and positive-controlled phase III clinical trial was performed. Eligible patients with genotype 1/6 CHC were screened out and randomly divided into Peg-IFN-α-2b(Y shape, 40kD) group and Peg-IFN-α-2a group at a ratio of 2:1. The patients in both groups were given oral ribavirin for 48 weeks in addition and then followed up for 24 weeks after drug withdrawal. Abbott Real Time HCV Genotype II was used to determine HCV genotype, and Cobas TaqMan quantitative real-time PCR was used to measure HCV RNA level at 0, 4, 12, 24, 48, and 72 weeks. Adverse events were recorded in detail. The primary efficacy endpoint was sustained virological response (SVR), and a non-inferiority test was also performed. Results: A total of 561 patients with genotype 1/6 CHC were enrolled, among whom 529 received treatment; 90.9% of these patients had genotype 1 CHC. The data of the full analysis set showed that SVR rate was 69.80% (95% CI 65.00%-74.60%) in the trial group and 74.16% (95% CI 67.73%-80.59%) in the control group (P = 0.297 0). The data of the per protocol set (PPS) showed that SVR rate was 80.63% (95% CI 76.04%-85.23%) in the trial group and 81.33% (95% CI 75.10%-87.57%) in the control group (P = 0.849 8), and the 95% CI of rate difference conformed to the non-inferiority standard. The analysis of the PPS population showed that of all subjects, 47.9% achieved rapid virologic response, with a positive predictive value of 93.8%. The incidence rate of adverse events was 96.30% in the trial group and 94.94% in the control group, and the incidence rate of serious adverse events was 5.13% in the trail group and 5.06% in the control group. Conclusion In the regimen of Peg-IFN-α combined with ribavirin for the treatment of genotype 1/6 CHC, the new investigational drug Peg-IFN-α-2b(Y shape, 40 kD) has comparable clinical effect and safety to the control drug Peg-IFN-α-2a.

Objective To evaluate the safety and effectiveness of partial cystectomy combined with chemotherapy in treating localized muscle invasive bladder cancer.Methods The patients admitted to localized muscle invasive bladder cancer from October 2011 to December 2015 were screened according to the strict inclusion criteria,and the final 53 patients were enrolled in the study,37 males and 16 females,aged 36 to 85 (63.72 ± 13.31)years.Tumor diameter 1.5-4.0 (2.52 ±0.56)cm,the number of≤ 3 and the edge of the tumor from the ureteral opening ＞ 2 cm.All pathological types are urothelial carcinoma.All patients were examined by MRI clinical stage T2a-T2b period.A total of 53 patients with muscle invasive bladder cancer who refuse or older,merge the heavier medical disease,difficult to tolerate radical cystectomy.Using partial cystectomy,intraoperative electrosurgical excision to deep muscle,parallel to the tumor bed frozen to confirm negative margins,postoperatively systemic chemotherapy of gemcitabine combined cisplatin and bladder perfusion chemotherapy of hydroxycamptothecin.Results Patients were successfully opcrated,and no margin positive or incision planting cases.The operating time is 55-110 min and average (79.11 ± 17.25)min.There was no serious complication in operation and postoperative,pathological diagnosis was invasive epithelial cell carcinoma of the urinary tract,pathology classification:low level 41 cases,and high level 12 cases.Follow up of 12 to 62 months,an average of (27.11 ± 12.22)months,21 cases of recurrence,12 patients had superficial recurrence in the bladder who was treated successfully by transurethral resection of bladder tumor,5 cases of multiple myometrial invasion who was treated by radical cystectomy (3 cases died of bladder cancer after the surgery in 8,12,and 18 months later),4 cases of myometrial invasion with recurrence of pelvic lymph node metastasis or even distant metastasis to give up treatment (all died within six months of bladder cancer).The first tumor recurrence time 3-18 months,11 months and the median time.Conclusions Our data indicate that partial cystectomy combined with chemotherapy is a safe and effective in treating localized muscle invasive bladder cancer,with less trauma,shorter operative time and higher safety,so as to provide an alternative treatment for patients with advanced age,high risk or who can not be implemented transurethral resection of bladder tumor or who refused to undergo radical cystectomy.

Objective To investigate the prophylactic effects of pancreatic duct stenting (PDS) combined with non-storied anti-inflammatory drug (NSAID) on post endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis (PEP) in difficult bile duct cannulation .Methods One hundred and eight patients who experienced difficult bile duct cannulation during hospitalization from January 2012 to November 2016 in the Department of Gastroenterology of the hospital were enrolled for the study .The patients were ran-domly divided into 4 groups:i.e.Group A that underwent simple PDS , Group B that received NSAID , Group C that were treated with PDS combined with NSAID and Group D that had routine ERCP without preventive measures for PEP .The levels of serum amylase be-fore surgery, 4 and 24 hours after ERCP were observed closely .The scores of abdominal pain were evaluated by VAS method , and the levels of serum amylase , the rate of post ERCP and scores of abdominal pain after ERCP were compared between the 4 groups.Results Four hours after ERCP, serum amylase levels of group B and group C were all significantly lower that those of group D (P<0.05). Serum amylase levels of group A, B and C 24 hours after ERCP were all significantly lower that those of group D (P<0.05).The rate of PEP 24 hours after ERCP for group A and C was 0%, which was obviously lower than that of group D (7.4%)(P<0.05).The VAS scores of various groups 4 and 24 hours after ERCP were significantly higher than that before ERCP (P<0.05).The VAS scores of groups B and C 4 and 24 hours after ERCP were all significantly higher than that of group D (P<0.05), and the VAS scores of group B 4 and 24 hours after ERCP was obviously lower than that of group A (P<0.05).Only at hour 24 after ERCP, the VAS pain scores of group A were higher than that of group D (P<0.05).Conclusion After ERCP, pancreatic duct stenting combined with non-storied anti-inflammatory drug could reduce the rates of hyperamylasemia and PEP , as well as the scores of abdominal pain scores after ERCP, and also could effectively prevent the incidence of pancreatitis after PEP .

Objective To investigate the incidence of non-infectious diseases at different stages of a prolonged escort missiononboard the frigate.Methods The constituent ratio of non-infectious diseases occurred at different stages of a prolonged escort missionby a certain frigate was calculated,and the incidence of various non-infectious diseases at different stages was compared accordingly.Results For non-infectious diseases occurred during the whole course of the mission,the top 3 non-infectious diseases were lumbarmuscle strain,insomnia and motion sickness.Then came dermatitis,dental ulcer,xerophthalmia,trauma and cardiovascular diseases.The onset stages (early,middle and late stages)of various non-infectious diseases were different from one another.The incidence oflumbar muscle strain,insomnia,dermatitis,dental ulcer and xerophthalmia at late stage of the mission was significantly higher than thatat the early stage(P <0.01),and the incidence of motion sickness at the early stage was significantly higher than that at late stage(P <0.01).Conclusion With the extension of the escort mission,the incidence of lumbar muscle strain,insomnia,dermatitis,dentalulcer and xerophthalmia increased,while the incidence of motion sickness decreased.

Objective To explore clinical application of neotype controllability artificial nephrohydrosis in percutaneous nephrolithoto-my. Methods 400 patients with renal lithiasis or superior segment ureter lithiasis in our hospital were divided into group A and group B. 200 cases of group A received neotype controllability artifiicial nephrohydrosis;200 cases of group B received conventional artificial nephro-hydrosis. The puncture duration, amount of bleeding and times of puncture of the two groups were compared. Results 195 cases in Group A were developed renal tract for PCNL effectively,157 cases were developed renal tract for PCNL effectively in Group B. The puncture duration, amount of bleeding and times of puncture of group A and group B were respectively (1. 8 ± 0. 7) vs. (2. 5 ± 1. 2) min,(112. 7 ± 51. 0) vs. (270. 2 ± 89. 3) mL,(1. 1 ± 0. 2) vs. (1. 8 ± 0. 7) times. The differences were significant. Conclusion Neotype controllability artificial nephrohydrosis can develop renal tract for PCNL effectively.