Unlike the majority of other tissues,cartilage is low in cellularity and basically avascular in nature,therefore,chondral lesions due to injury commonly result in the development of osteoarthritis,eventually leading to progressive total joint destruction.Current clinical treatment strategies for cartilage defects include microfracture,osteochondral autografts and allografts.Although they are often used clinically,significant drawbacks and limitations still exist.To solve these problems,cartilage tissue engineering has been recommended to promote more effective treatments.In this review,we discuss current clinical approaches for repairing cartilage,as well as cartilage tissue engineering approaches which are currently developing.We also describe potential future directions in cartilage regeneration.

Objective：To observe the therapeutic effect of vertebroplasty balloon dilatation combined with acupuncture on patients with osteoporotic lumbar spine fracture who received PKP.Methods：Retrospective analysis was performed on 47 patients with osteoporotic lumbar spine fracture treated by PKP,and they were divided into acupuncture group(23 cases) and separate PKP group(24 cases) according to whether combined acupuncture treatment was available.After the PKP operation,the acupuncture group patients were given acupuncture therapy，Yaoshu point, Pishu point, Weizhong point and Ashi point were selected;Patients in the PKP group only received PKP treatment,and no acupuncture therapy was performed postoperatively.Visual analogue scale(VAS),functional impairment index(ODI),and kyphosis angle(KA) were used to evaluate the clinical efficacy.Results：All patients were successfully followed up for 1217 months,with an average followup time of(12.73±3.17) months.There was statistically significant differences in preoperative and postoperative KA angle between the two groups(P<0.05),KA angle was not significantly different between the two groups at each followup time point after operation(P>0.05).VAS and ODI were significantly different between the two groups after surgery and before surgery(P<0.05).Compared with VAS scores from 1 month to 6 months after surgery,the acupuncture group was significantly better than the PKP group alone(P<0.05).During the followup 6 months after surgery,there was no statistically significant difference in VAS scores between the two groups(P>0.05).ODI of the acupuncture group was significantly better than that of the PKP group alone(P<0.05).Conclusion：Acupuncture combined with PKP can achieve more satisfactory clinical efficacy than PKP alone in the treatment of lumbar osteoporosis fracture.

Objective：To investigate the effect of different administration routes of tranexamic acid on inflammatory factors and safety during total hip arthroplasty.Methods：The clinical data of 79 patients undergoing total hip arthroplasty in our hospital from February 2017 to July 2020 were retrospectively analyzed.Among them,41 cases were treated with tranexamic acid intra articular cavity local powder(group A),and 38 cases were treated with tranexamic acid intravenous drip(group B).The perioperative blood loss [intraoperative blood loss,postoperative drainage volume,total blood loss,hemoglobin(HB) and hematocrit(Hct) decreased value ] of the two groups were compared.The changes of fibrinolytic index and inflammatory index were compared between the two groups.The incidence of complications was compared between the two groups.Results：There was no significant difference in the amount of intraoperative blood loss between group A and group B(P>0.05).The postoperative drainage volume,total blood loss,Hb and HCT decreased value in group A were less than those in group B(P<0.05).Plasma fibrinogen(Fg),fibrinogen degradation product(FDP),and Ddimer(DD) levels after surgery in the two groups were higher than those before surgery(P＜0.05).There was no statistically significant difference in plasma Fg,FDP,DD before and after operation between the two groups(P>0.05).The levels of serum Creactive protein(CRP) and tumor necrosis factorα(TNFα) in the two groups were higher than those before operation(P＜0.05).There was no significant difference in serum CRP and TNFα levels before and after operation between the two groups(P>0.05).There was no significant difference in the incidence of deep vein thrombosis,incision infection and total incidence of complications between the two groups(P>0.05).Conclusion：The application of topical powder during total hip replacement surgery can reduce hidden blood loss compared with intravenous administration.The two methods of administration have the same effect on the level of inflammatory factors and their safety.

Objective：To retrospectively analyze the efficacy and safety of anterior elbow neurovascular gap approach in the treatment of ulnar coronoid process fractures.Methods：From January 1,2016 to March 1,2019,13 cases of ulnar coronoid process fracture were included.All patients were treated by the anterior brachial arterymedian neurovascular internervation approach.Results：All patients were followed up for 850 months(mean 29.1 months).All the fractures healed smoothly.The average healing time was 4.2 months(36 months).The range of motion of elbow joint was 10 ° to 20 ° with an average of（12.5±3.3）° and flexion of 120 ° to 140 ° with an average of （134.3±5.5）°.There was no significant difference with regard to pronation and supination compared to the healthy limb.According to the MEPS score at the last followup,the patient's score was 7098,with an average of  （92.5±7.3）.The elbow function was excellent in 5 cases,good in 7 cases and fair in 1 case.One patient had mild heterotopic ossification of elbow,which had no significant effect on elbow function.One patient had mild pain during elbow movement after operation,which could be relieved by topical analgesic drugs.Conclusion：The anterior neurovascular gap approach of elbow can be used safely and efficiently for the treatment of the fracture of ulna coronoid process under direct vision.

Objective：To compare the early clinical effects of dissect Distal clavicle fracture(DCF) through Clavicular hook plate and Distal clavicle plate.Methods：To choose between August 2015 and January 2019 xiehe hospital affiliated to tongji medical college huazhong university of science and technology of clavicle admitted in orthopaedic clinical data of 114 patients with distal closed fracture were analyzed retrospectively,according to the surgery fixed in a different way,it can be divided into the anatomy of the collarbone steel group(52 cases,control group) with clavicular hook plate group(62 cases,the experimental group);with the control group of 32 cases.VAS scores were analyzed and compared between the two groups in terms of intraoperative operation time,bleeding volume,length of hospital stay,perioperative period and 1year postoperative followup.Results：The patients in both groups were followed up,and the followup time of the control group was 12~18 months [(14.5±2.4) months].Experimental followup time was 14~20 months [(16.5±3.8) months;generally have no obvious difference between two groups(P>0.05);perioperative VAS scores also had no statistical significance(P>0.05);the control group(9) [1] on the incidence of complications is slightly lower than the experimental group [4](6) incidence(P<0.05);the shoulder joint activity score group(85.7±12.6) is better than that of control group(80.1±10.2) score(P<0.05).Conclusion：Anatomical collarbone steel plate with clavicular hook plate distal clavicle fractures can get good healing rate,Although there was no significant difference between the two perioperative indexes,the clavicular hook plate had a certain advantage in recovering the range of motion of the shoulder compared with the anatomical clavicular plate.

Objective：To explore the clinical effects of different viscosity bone cements in percutaneous kyphoplasty(PKP) on senile osteoporotic vertebral compression fractures(OVCF).Method：A total of 60 OVCF patients admitted to the hospital from May 2018 to October 2020 were selected as the research objects.According to different treatment methods,they were divided into a control group(28 cases) and an experimental group(32 cases).Patients in the control group were injected with lowviscosity bone cement during PKP,and patients in the experimental group were injected with highviscosity bone cement during PKP.Calculate relevant indicators during the perioperative period and compare the bone cement leakage between the two groups.The anterior edge height of the vertebral body and the Cobb angle of kyphosis were compared between the two groups of patients before and after the operation,and the recovery rate of the vertebral body height and the rate of kyphosis correction were calculated.Followed up for 3 months,Compare visual analog pain score(VAS),Oswestry dysfunction index(ODI),health survey summary(SF36) score.Result：All 60 patients were successfully operated.The average operation time was(28.25±5.24) min,and the average amount of bone cement was(2.58±0.35) ml,the total leakage rate of bone cement in the experimental group was lower than that in the control group(P＜0.05),and all patients had no nerve damage during the operatio.The compression height of the anterior edge of the vertebral body and the Cobb angle of kyphosis were significantly lower than that of the preoperative 7 days and 3 months after the operation(P<0.05),and the experimental group was significantly lower than the control group(P<0.05) on the 7th day after the operation.There was no statistical difference between the two groups in March(P>0.05).The postoperative vertebral body height recovery rate and kyphosis correction rate in the experimental group were higher than those in the control group(P<0.05).The VAS and ODI scores of the two groups were lower than that of the preoperative 7 days after operation(P＜0.05).There was no significant difference in the VAS and ODI scores between the groups(P＞0.05),the SF36 scores of the two groups were higher than those before the operation at 3 months after operation(P＜0.05),and there was no statistical difference between the groups(P＞0.05).Conclusion：The used of highviscosity and lowviscosity bone cement during PKP surgery in elderly OVCF patients has significant effects,and the two have the same effect on pain and lumbar function improvement,the highviscosity bone cement can better restore and correct the vertebral structure,and the cement leakage rate was low.

Objective：To observe the effect of systemic functional exercise combined with Jianghuang Huoxue Zhitong plaster on the functional recovery in the postoperative patients undergoing lumbar fusion.Methods：100 patients undergoing lumbar fusion were randomly divided into treatment group(50 cases) and control group(50 cases).The treatment group was treated with systematic function exercise combined with Jianghuang Huoxue Zhitong plaster, while the control group was treated with systematic function exercise.Before and 1,7,14 and 30 days after operation,visual analog score(VAS) and JOA were used to evaluate the clinical effect.Result：The patients in both groups were followed up successfully.On the first day after treatment,there was no significant difference in VAS and JOA scores between the treatment group and the control group(P>0.05).After 7 days,14 days and 30 days,the JOA score of the treatment group was significantly higher than that of the control group,and the neurological recovery of the patients was significantly improved,the difference was statistically significant(P<0.05).VAS score was significantly lower than that of the control group,and the pain degree of the patients was significantly reduced.The difference was statistically significant(P<0.05).Conclusion：The combination of systemic functional exercise and Jianghuang Huoxue Zhitong plaster can significantly promote the recovery of nerve function and the improvement of pain in the postoperative patients undergoing lumbar fusion,and can improve the quality of life of the patients.

Objective：Discusses the curative effect of application of modified SmithPeterson(SP) approach assist percutaneous cannulated screws treatment Pipkin Ⅰ type fractures.Methods：The clinical data(Duration of surgery,intraoperative bleeding,and length of hospital stay)from 10 cases of application of modified SmithPeterson(SP) approach assist percutaneous cannulated screws treatment Pipkin Ⅰ type fractures from May 2014September 2019were analyzed retrospectively,and the incidence of related complications was recorded,periodically review Xray and bone 3D CT to understand fracture healing,Followup records of the hip joint Harris score and ThompsonEpstein score to evaluate the efficacy.Results：The operation time was 70130min[(90.5±4.6)min] ,the intraoperative blood loss was 90210ml[(125.6±12.4) ml],and the hospitalization period was 1533d[(23.6±3.7) d].Intraoperative reduction and fixation were smooth,and all fractures reached anatomical reduction;All 10 patients were followed up after the operation.The followup time was 12～36 months[(23±2.1) months].No complications occurred,and all fractures were bony healing.The Harris score of hip joint 12 months after operation was(85.6±4.3),which was significantly improved compared with that before operation(27.3±3.4),and the difference was statistically significant(t=9.52,P<0.05).ThompsonEpstein clinical evaluation criteria at the last followup:7 cases were excellent,2 cases were good,1 case was fair,and the excellent and good rate was 90.0%.Conclusion：Application of modified SmithPeterson(SP) approach auxiliary percutaneous cannulated screws treatment Pipkin Ⅰ type fractures can fully expose and firmly fix the femoral head fracture with the vertical fracture line.It has good exposure effect,less trauma,less bleeding,short operation time,and helps early recovery of hip function after surgery.It is worthy of clinical application.

Objective：To compare the midterm therapeutic effect of dynamic cervical implant(DCI) and Prestige LP artificial cervical replacement for the treatment of cervical disc herniation.Methods：49 patients were included for cervical disc herniation and underwent surgery in our hospital.They were divided into DCI group(Group A) and Prestige LP group(Group B).The VAS,JOA,SF36 and Range of motion(ROM) were compared of the two groups.Results：There were 22 patients in Group A,with a mean followup time of 24.5 months.27 patients were included in Group B,with a mean followup time of 25.8 months.The VAS,JOA and SF36 of the two groups were no significant difference between the two groups(P＞0.05).The ROM of C27 of the two groups showed no significant difference(P＞0.05).The ROM of operated level was greater at last follow up than preoperation in Group B(P<0.05),and the ROM of operated level was greater in Group B than Group A at last follow up significantly(P<0.05).Conclusions：The clinical results in DCI were similar as Prestige LP artificial cervical replacement in earlymedium period.The semiconstrained feature of DCI may take protection for the facet joint of operated level to some extent and the indications was larger than cervical disc implantation.

Objective：To explore a method for measuring patella height in the condition of knee joint effusion.Methods：The imaging data of 50 patients admitted to our hospital from June 2017 to June 2019 were retrospectively analyzed.The conventional Patellar Index and the Modified Patellar Index (MPI) were measured and compared in each patient with or without knee joint effusion.Results：The correlation between MPI and the traditional patella index were evaluated,and the results showed that MPI had a good correlation with the three traditional patella indexes(P<0.05).Assessment of changes in each patella index before and after knee effusion showed that the traditional patella index had significant changes before and after knee joint effusion(P<0.05),while MPI had no significant difference(P＞0.05).Conclusion：The traditional patella index has a significant difference before and after knee joint effusion,while MPI has a good correlation with the traditional patella index.There is no significant change before and after knee joint effusion,so it can be considered to evaluate the patella height under the condition of knee joint effusion.

Objective：To investigate the clinical characteristics of aneurysmal subarachnoid hemorrhage(aSAH) in elderly patients under different treatments.Methods：A total of 48 cases of aged aSAH patients over 70 years old treated in Department III of Neurology,Renmin Hospital of Wuhan University from September 2018 to November 2020 were collected as the elderly group,and 288 cases of aSAH patients under 70 years old admitted during the same period were collected as the nonelderly group for retrospective analysis.The gender composition,admission condition,aneurysm characteristics,prognosis of the two groups were compared under different treatment options.Results：There were no significant differences in the aspect of gender composition,aneurysm neck widths,aspect ratios,aneurysm rupture and rebleeding between the two groups(P>0.05).There were statistically significant differences in the aspect of aneurysm locations(mainly internal carotid artery and posterior communicating aneurysms),histories of hypertension,HuntHess grades,Fisher grades,prognosis,cerebral infarctions and hydrocephalus(P<0.05).Conclusion：There are many prognostic factors affecting aSAH in elderly patients,and it is necessary to make a comprehensive analysis of the condition and the surgical plan for elderly patients.After evaluation,endovascular embolization is preferred.For patients with surgical clipping,hematoma should be removed as soon as possible to reduce the occurrence of infarction,which can improve the surgical treatment effect of elderly patients with aSAH.

Objective：To investigate the correlation between delayed cerebral infarction with intracranial aortic and small arterial spasm in subarachnoid hemorrhage.Methods：170 SAH patients admitted to the Department of Neurological Surgery of our hospital from January 2014 to October 2019 were analyzed.DCI was divided into DCI group and DCIfree group according to whether DCI occurred during hospitalization.General data,CT perfusion imaging(CTP) parameters,CT angiography(CTA) and Transcranial Doppler(TCD) were compared between the two groups,multivariate Logistic regression was used to analyze the relationship between intracranial artery spasm in different regions and DCI after SAH.Results：Of the 154 patients included in the study,61 had DCI,with a DCI incidence of 39.61%.The incidence of cerebral blood volume (CBV), cerebral blood volume (cerebral blood volume，CBV) and intracranial artery spasm in DCI group were higher than those in DCIfree group(P<0.05).Fewer patients underwent lumbar puncture CSF replacement in the DCI group than in the DCIfree group(P<0.05).The cerebral blood flow (CBF) in DCI group was lower than that in DCIfree group(P<0.05).Multivariate Logistic regression analysis showed that,Fisher's grade CBV and macrovasosm were independent risk factors for DCI after SAH,CBF was a protective factor affecting DCI of patients after SAH.Conclusion：Intracranial arterial spasm is an independent risk factor for patients with DCI after SAH,while spasm of small arterial has no significant correlation with DCI after SAH.

Objective：To evaluate the advantage of negative pressure suction followed by thin thoracic tube after thoracoscope operation.Method：During January 2019 to December 2020, we performed 87 thoracoscope operations, and they were randomly divided into experimental group(47 cases) and control group(40 cases).the experimental group use negative pressure suction followed by thin thoracic tube after thoracoscope operation，otherwise，the control group use routine medium caliber thoracic tube to drainage pleural hydrocele，analyze the differences between two groups by statistical treated data on  the extubation time after operaton，the gross of pleural effusion after operaton，the levels of lactate dehydrogenase(LDH) at 24 hours after surgery.Result：The extubation time was significantly shortened in the experimental group(P＜0.05).The gross of pleural effusion after operaton and the levels of lactate dehydrogenase(LDH) the moment ofafter surgery showed no significant between two groups(P＞0.05).Conclusion：The experimental group can shorted time of bearing drainage tubes after thoracoscope operation;the negative pressure suction followed by thin thoracic tube can not cause additional damage to thoracic cavity,and facilitate enhanced recovery after surgery.

Objective：To analyze the efficacy and quality of life of ultrasoundguided radiofrequency ablation of pleural metastases in the treatment of nonsmall cell lung cancer associated malignant pleural effusion.Method：The 101 patients with nonsmall cell lung cancer complicated with malignant pleural effusion were collected from April 2018 to April 2020.According to the doubleblind random number grouping method,the patients were divided into combined treatment group(ultrasound guided radiofrequency ablation combined with targeted thoracic perfusion,n=36),thoracic perfusion treatment group(n=30) and radiofrequency ablation group(n=35).In the radiofrequency ablation group,ultrasoundguided radiofrequency therapy was used;in the thoracic perfusion treatment group,targeted perfusion of bevacizumab into pleural cavity was used;and in the combined treatment group,ultrasoundguided radiofrequency therapy combined with local targeted pleural perfusion was used.The changes of tumor indexes(CEA,CA125,vascular endothelial growth factor expression),progression free survival time,pain score and quality of life score of patients with malignant pleural effusion before and after treatment were compared and analyzed.Result：The tumor markers CEA and CA125 of three groups of patientswere significantly decreased after treatment,the difference was statistically significant(P<0.05).The vascular endothelial growth factor decreased significantly in the combined treatment group and the thoracic perfusion treatment group after treatment,the difference was statistically significant(P<0.05).The progression free survival time of the combined treatment group was longer than that of the thoracic perfusion treatment group and the radiofrequency ablation group(P<0.05).After treatment,the VAS pain score and quality of life score improved significantly in the combined treatment group and the radiofrequency ablation group(P<0.05).There were no grade 3/4 serious side effects in the three groups after treatment.Conclusion：The ultrasound guided radiofrequency ablation combined with targeted thoracic perfusion therapy can improve the progression free survival time,down regulate the expression of vascular endothelial growth factor,and improve the quality of life of patients.

Objection：To observe the effect on naked mice，sliver hyperplasia and hepatocellular carcinoma growth after liver arterial ligation combined with partial portal ligation.Methods：To take healthy 4weekold naked mice,establish hepatocellular carcinoma models,divide 120 naked mice into 4 groups randomly:control group(Sham n=30);partial portal vein ligation group,(pPVL n=30),hepatic artery ligation group(HAL n=30)，HAL combined with pPVL group(HAL+pPVL n=30).After corresponding treatment, serum biochemical indexes, preserved liver regeneration rate, tumor size and surrounding microvascular invasion were observed at different time points.Result：One naked mouse dead in pPVL+HAL group in 72h,also one naked mouse in pPVL group dead in 24h.The ALT and AST levels of pPVL group and HAL+pPVL group was significantly different from that of Sham group at 24h and 72h after operation(P<0.05).The preserved side liver quality of PVL group and HAL+pPVL group was significantly different from that of Sham group and HAL group at 72h,1W,2W,3W after operation(P<0.05).The tumor volume of HAL group and HAL+pPVL group was significantly different from that of PVL group and Sham group at 1W,2W and 3W after operation(P<0.05).The Sham group and PVL group were combined as the control group,and the HAL group and HAL+pPVL group were combined as the experimental group,The positive rate of MVI in the experimental group was significantly different from the control group at 3W after operation(P<0.05),and also that was significant difference between 2W and 3W after operation in the experimental group(P<0.05).Conclusion：HAL+pPVL could promote the growth of preservated liver hyperplasia and inhibit the growth of tumor in a short period of time,which provides a new treatment for some patients with advanced hepatocellular carcinoma.

Objective：To investigate the sexual function of patients with nonmuscle invasive bladder cancer during intravesical treatment,and analyze possible influencing factors.Method：A total of 198 patients with nonmuscle invasive bladder cancer were enrolled.After transurethral resection of bladder tumors,patients who underwent intravesical treatment.The European Organisation for Research and Treatment of CancerNonMuscleInvasiv Bladder Cancer Quality of Life Questionnaire(EORTC QLQNMIBC24),the Female Sexual Function Index(FSFI) for female,the national Sexual Function Index(IIEF5) for male,Evaluation Scale for Communication with Spouse about cancerrelated concerns was used to obtained data to analyze the status of sexual function in patients with nonmuscle invasive bladder cancer during intravesical treatment.Result：84 patients stopped sexual activity during intravesical treatment,114 patients with sexual life have a lower frequency of sexual life than before intravesical treatment.86.51% of men and 88.00% of women have different degrees of sexual dysfunction.During intravesical treatment,the patients had different degrees of lower urinary tract symptoms(21.27±9.67).Patients who stop sex life have severe lower urinary tract symptoms.47% of patients worry that sexual activity will “contaminating” each other.Regarding sex life,7.5% of patients received medical staff guidance during intravesical treatment.Compared with patients with sexual life,patients who stopped sexual life had lower scores for sexual function and sexual communication with their spouses(0.69±0.55 vs 1.75±1.08).Conclusion：The sexual function of patients with nonmuscle invasive bladder cancer is negatively affected during intravesical treatment, Clinical staff should inform patients about the impact of related treatment on sexual function before intravesical treatment,,eliminate the “contamination” of sexual life and affect disease rehabilitation Misunderstanding,encourage couples to communicate about sexual life issues in order to improve the quality of sexual life of patients.

Objective：To investigate the impact of sex on sepsis after ureteroscopy (URS).Method：We retrospectively enrolled 759 proximal ureteral stone patients in our hospital.The ogistic regression analysis was used to evaluate the influence of sex on postoperative sepsis.Results：In univariate analysis, female patients were more likely to develop sepsis （OR=3.498，P<0.05）.However, sex had no statistical relationship with sepsis after adjustment of urine culture.For the adjustment of other factors，the odds ratio of sex ranged from 3.010 to 3.768 （P<0.05）.Multivariate analysis showed that sex was not significantly related to postoperative sepsis while positive urine culture was significantly associated with increased sepsis rate（OR=12.042，P<0.05）.Conclusion：Female patients are more likely to develop sepsis after URS.It may be due to the high bacteriuria prevalence in female group.Therefore, a detailed urinary evaluation is needed for female patients before surgery to optimize surgical strategy to reduce the occurrence of sepsis.

Objective：To explore the effect of enhanced recovery after surgery(ERAS) in perioperative period of elderly patients with locally advanced renal cell carcinoma(RCC).Methods：100 patients with locally advanced renal carcinoma admitted from June 2015 to June 2020 were randomly divided into control group(n=50) and ERAS group(n=50).The patients in the control group were given routine nursing during the perioperative period,and ERAS group was given measures related to ERAS on the basis of routine nursing.Postoperative first exhaust time,first defecation time,length of hospital stay,incidence of complications,readmission rate(within 30 days after discharge),nursing satisfaction,as well as pain degree and Creactive protein(CRP) level at 5 days after surgery were monitored in the two groups.Results：There were no statistically significant differences between the two groups in general conditions,operation time and intraoperative blood loss(P>0.05).ERAS group had significantly shorter postoperative exhaust time,first defecation time and hospital stay time than the control group(P＜0.01).There were no significant differences between the control group and ERAS group(P>0.05) in postoperative VAS score,CRP level and readmission rate 30 days after surgery.The complication rate of patients in the control group was significantly higher than that of ERAS group(P＜0.05),and the nursing satisfaction of patients in ERAS group was significantly higher than that of the control group(P＜0.05).Conclusion：ERAS in the perioperative period of elderly patients with locally advanced RCC can effectively promote postoperative rehabilitation of patients,reduce the incidence of complications and improve patient satisfaction.

Objective：To explore the value of ultrasonic debridement combined with moist therapy in the treatment of diabetic foot ulcer.Methods：68 patients with diabetic foot ulcer in our hospital from January 2019 to January 2020 were randomly divided into two groups:the observation group and the control group，there were 34 cases in each group.Ultrasound debridement combined with moist therapy was the observation group,and traditional debridement combined with moist therapy was the control group,34 cases in each group.The wound healing,local tissue perfusion,wound healing time and dressing change times of diabetic foot ulcer in the two groups were recorded and analyzed statistically.Results：The wound healing of the observation group was better than that of the control group on the 7th and 14th day after the first treatment(33.13±3.05 vs.35.19±3.82,P<0.05;21.58±3.63 vs.28.22±4.75,P<0.05).On the 14th day after the first treatment,the local blood perfusion in the observation group was significantly better than that in the control group[(1.21±0.19 )PU vs.(0.83±0.15）PU,P<0.05].The number of dressing changes and healing time in the observation group were significantly shorter than those in the control group[12.61±1.44 vs.20.44±2.40,P<0.05;(21.29±2.84)d vs.(30.88±3.28)d,P<0.05].Conclusion：Ultrasonic debridement combined with moist therapy has obvious advantages over traditional debridement combined with moist therapy in the treatment of diabetic foot ulcer wounds.

Objective：To investigate the management of immunosuppression in kidney transplant recipients with COVID19.Methods：Retrospective,five cases of kidney transplant recipients with confirmed COVID19;all the medical history,clinical features and the management of immunosuppression were recorded and analyzed.Results：The immunosuppression regimen was not adjusted in 1 common type patient.4 cases were severe/critical，while the mycophenolate mofetil was discontinued for (19.8±3.6)d in the other 4 severe/critical cases;tacrolimus was taken at half dosage for (8.3±4.1)d and complete discontinuation for (9.0±3.1)d due to uncontrolled symptoms.At the same time, 20~40mg/d methylprednisolone was given intravenously for (11.8±4.2)d.All the 5 patients had negative nucleic acid and normal renal function, and were discharged from hospital.The mean time from onset to discharge was (37.6±8.3) d.Conclusion：For kidney transplant patients with COVID19,especially those with severe pneumonia,reducing or withdrawal of immunosuppressive agents,as well as early lowdose and shortterm use of corticosteroids,are essential for good outcomes.

Articular cartilage is a major tissue distributed at the joint surface;it plays a role in loadbearing and lubricating.The articular cartilage of the joints in the extremities mainly consists of hyaline cartilage composed of collagen II.Fibrocartilage formation is easily observed when the cartilage is injured or degenerated,which has abundant type I collagen.In this study,a new viewpoint and concept,focusing on the modification of fibrocartilage in situ approach and regeneration of hyaline cartilage,namely “fibrocartilage hyalinization”,was proposed as a practical clinical strategy.We conducted preliminary discussions and prospects on the feasibility and potential mechanisms of fibrocartilage hyalinization.It is hoped that the strategy will be helpful to the development and clinical transformation of cartilage regeneration research.

The bonetendon interface is an anchoring structure between the tendon and the bone.Due to its special physiological structure,the damaged bonetendon interface often forms a scar to heal.The biomechanical strength is significantly lower than the normal bonetendon interface.With the development of tissue engineering technology,more and more experts and scholars have applied tissue engineering technology to the repair of bone and tendon interfaces.This article reviews bionic design of bonetendon interface scaffold materials,  optimization of steam cell and controlled of cytokines in bonetendon interface repair.

Extrahepatic cholangiolithiasis is a common disease in hepatobiliary surgery.With the development and maturity of laparoscopy,the concept of minimally invasive technique for the treatment of Extrahepatic cholangiolithiasis has been widely accepted.At present,the combination of laparoscopy,choledochoscopy and duodenoscopy has diversified the strategies of minimally invasive laparoscopic therapy,but there is still some controversy over the clinical selection and application.In this paper,the application status and progress of laparoscopy in the treatment of extrahepatic cholangiolithiasis were reviewed,and the application experience of minimally invasive technique was summarized.