Hepatic resection is the treatment of first choice for patients with primary or secondary hepatic tumours.Although liver resection techniques have improved considerably in the past 10 years,liver failure is still the most scared complication,particularly in patients with cirrhosis.In recent years,surgeons constantly attempt to overcome the limits of anatomy and the volume of tumor to increase resection rates.Therefore,accurate evaluation of the hepatic functional reserve is very important in the development of hepatobiliary surgery.

Objective To evaluate the clinical efficacy of coroflex (BRAUN, Germany) intracoronary stent. Methods To retrospectively analyze the immediate angiographic and clinical follow-up outcomes of 81 patients (pts) receiving coroflex intracoronary stenting. Results 88 coroflex intracoronary stents were implanted in 81 pts. According to ACC/AHA classification, 38 lesions were type A-B 1, 50 lesions were type B 2-C. 52 lesions were de novo, 22 were suboptimal results after PTCA and 14 lesions were bailout for dissections. Stent deployment was successful in 82/88 (93.2%). High-pressure (16-18 atm) balloon was used for stent deployment in 3 lesions with severe calcification. Dissection was occurred at distal of stent in 2 lesions but no inducing flow reduction. Angiography showed TIMI 2 grade after intracoronary stenting in 1 diffused lesion. There were no adverse events occurred during hospital stay. Clinical follow-up of in 75 pts were conducted for 7.5?3.0 (3-13) months, there were no cardiac death or myocardial infarction reported. Complain of angina (CCS class Ⅰ) occurred in 17 pts (22.7%). Repeat angiography was performed in 7 pts, there were 2 in-stent restenosis with successful revascularization. Conclusion Coroflex intracoronary stenting appears to be safe and effective in the treatment of coronary lesions with favorable outcomes.

Objective To explore the clinical effects of laparoscopic hernioplasty in patient over 70 years old. Methods We utilized the modified laparoscopic intraperitoneal onlay mesh (IPOM) to treat the inguinal hernia in 69 elderly patients. Results The laparoscopic operations were completed in all the 69 patients. The operative time was 20～30 min (mean, 25 min). No operative complications took place and the intraoperative blood loss was hardly seen. The duration of hospitalization was 5～7 days. The patients recovered smoothly, without wound infection or scrotum hematoma. Follow-up observations for 6～24 months in the 69 patients found no recurrence. Conclusions Modified laparoscopic IPOM treating inguinal hernia in elderly patients is feasible, on the premise of proper perioperative management.

Objective To summarize the experience in diagnosis and treatment of primary splenic neoplasm (PSN). Methods The clinical data of 31 patients with PSN treated in our hospital were retrospectively analyzed. Results Amongst the patients, 25 were diagnosed as PSN postoperatively. Fifteen out of the 19 patients with benignancy were treated with splenectomy, and the others underwent partial splenectomy or tumor excision. Eleven out of the 12 patients with malignancy received splenectomy (including two by excision of pancreatic body and tail), and the other one underwent biopsy alone. The pathological types were as follows: varieties of cyst in 11, angiocavemoma in 4, inflammatory pseudotumor in 2, cavernous lymphangioma in 1, cystic degeratin of liomyoma in 1, malignant lymphoma and lymphsarcoma in 6, hemangiosarcoma in 3, fibrosarcoma in 1, liomyosarcoma in 1 and malignant fibrous histiocytoma in 1. Three patients with malignancy survived for 5 years. The reason was that they received radical splenectomy in combination with chemotherapy or radiotherapy and immunotherapy. Conclusions PSN should be diagnosed mainly according to clinical manifestations and image examination. The differentiation between benignancy and malignancy depends on CT, hemangiography and determination of seros AKP and ? GT levels. Early diagnosis, radical operation and comprehensive treatment are important for improving the prognosis of PSN.

The development and application of assessment tools for chronic obstructive pulmonary disease (COPD) have been a hot spot both at home and abroad. More and more scales and questionnaires for COPD assessment have emerged. The comparison on characteristics of different scales / questionnaires, and the selection of appropriate as-sessment tool have become a key issue which requires to be solved. This article analyzed characteristics of commonly used assessment tools both at home and abroad. Related thoughts had been put forward for the providing of evidences in the improvement of COPD efficacy evaluation index system.

Comorbidity, which can affect the treatment and prognosis of its disease, has gradually caught attention from both at home and abroad. Although chronic obstructive pulmonary disease (COPD) mainly involved lung tissues, it may also cause the systemic (or extra-pulmonary) adverse effects. Many types of comorbidities existed in COPD. This article summarized the prevalence, risk factors and pathogenesis of comorbidities such as cardiovascular disease, osteoporosis, anxiety and depression, lung cancer, infection, metabolic syndrome and diabetes mellitus. It also con-ducted related studies on the diagnosis and treatment status and current problems of COPD comorbidities, which may provide evidences for COPD outcome evaluation.

Objective To evaluate the curative effect and indications of medical ozone for the treatment of lumbar disc herniation.Methods 10~20 ml(35~45 ug/ml) medical ozone was injected into the lumbar disc percutaneously each case. The patients were followed up for 6~12 months. Results 60 cases (66 lumbar discs) with lumbar disc herniation were treated with the injection of medical ozone. The total effective rate was 96.67% , excellent and good rate was 76%.The efficacy in herniation to be 30% of vertebral canal diameter and lumbardisc bulging group. Conclusion The treatment of lumbar disc herniation with medical ozone is simple,effective and no complications.

Objective To evaluate the role of intravasc ular ultrasound (IVUS) in determining strategy for coronary artery stenosis of intermediate severity.Methods The study population consisted of 75 patients who had de novo coronary lesions of intermediate severity (40% to 70% diameter stenosis) in coronary angiography. IVUS examination was performed in all patients using standard methodology. Minimal lumen cross-sectional area (MLA) ≤ 4.0- mm 2 or percent area stenosis≥60% were identified as an IVUS index of functionally severe coronary stenosis, and used as an indication of coronary stenting. Major adverse cardiac events (cardiac death, acute myocardial infarction and recurrent angina) and the use of nitrates were recorded during follow-up. Results There were 44 patients (59%) with functional coronary artery stenosis, and all underwent successful coronary stenting. Acute coronary syndromes, soft plaque and positive coronary arterial remodeling were more common compared with the remaining 31 patients (41%) only treated medically. During a mean of (14?7) months of follow-up, there was no cardiac death and acute myocardial infarction. Readmission occurred in 5 patients (11%) due to in-stent restenosis in patients with interventional therapy and 4 patients (13%) due to exacerbation of coronary artery stenosis in patients with medical therapy. The use of nitrates was discontinued in 18(41%) and 14(45%) patients treated with interventional therapy and medical therapy, respectively. Conclusions It is valuable to perform IVUS examination in clinical decision making for intermediate coronary artery stenosis. IVUS criteria of MLA≤ 4.0- mm 2 or area stenosis≥60% may be a reliable index of functional coronary stenosis, determining the therapeutic strategy in patients with intermediate coronary artery stenosis.

Objective To know the problems of reference factors,and then provide evidences for scientific and specific identifying index system for students from poor families.Methods Questionnaires were used among 719 students from poor families.Results There were 86.0％ families whose earnings were lower than 410 RMB per month.57.2％ families depended on agriculture.70.1％ students were from the rural areas.Family member number was 4～6 for the majority ( 70.7％ ).91.2％ ( 94.5％ ) fathers'( mothers' ) education levels were under high middle school.64.0％ ( 67.3％ )fathers ( mothers ) were farmers.The proportion of students having computers was 76.1％.61.2％ students' life was not frugal.There were 80.9％ students who thought campus cards shouldn't be monitored.Conclusion Family economic situation should be the key indicator.Most of the basic family information could be reference factors.Basic situation of students at school was inappropriate to be reference factors.

Objective The aims of this study were to assess the efficacy of video-assisted thoracoscopic extended thymectomy(VATET) as a treatment for non-thymomatous myasthenia gravis (NTMG) and to identify prognostic factors for thymectomy.Methods Retrospectively analyzed clinical datas of 112 patients received VATET for the treatment of NTMG.Clinical efficacy and variables influencing outcome were evaluated by Kaplan-Meier method and Cox proportional hazards regression analysis.Results At 3.2 years averaged (1.5-6.2 years) of follow-up,none of these patients were lost to follow up.According to the MGFA post-intervention status,54 patients(48.2％) obtained complete stable remission during follow-up,21 patients(18.8％) obtained pharmacologic remission,10 patients (8.9％) obtained minimal manifestations,7 patients (6.3％) improved,20 patients(17.8％) unchanged,and none of these patients were worse or died of MG.By multivariate analysis,the chance of complete stable remission was significantly increased when age ＜ 40 years (P ＜ 0.01,OR =3.468),symptom duration ＜ 12 months(P ＜ 0.01,OR =3.203) and the presence of thymic hyperplasia (P ＜ 0.01,OR =3.064).Conclusion Video-assisted thoracoscopic extended thymectomy achieved satisfactory long-term results in patients with nonthymomatous myasthenia gravis,while age,symptom duration,the presence of thymic hyperplasia correlated with response to operation.