Hernia is a common and frequent disease.Theory of hernia and abdominal wall surgery has been quickly developing since 1970s, since then tension-free repair concept was originated.Continuous development of modern hernia surgery and abdominal wall surgery is based on this concept.New viewpoints include conduction of guideline of diagnosis and treatment for hernia and quality control standard, recognition of anatomy, definition of abdominal wall, concept of basic treatment principle, indication and contraindication for surgical treatment,development and choice of procedures, prevention and therapy of complications, evaluation of postoperative rehabilitation, improvement of quality of life, recurrence rate, appearance, longterm prognosis, etc.This paper describes the latest and important related issues in order to help surgeons to know new concepts, further standardize diagnosis and treatment and finally achieve satisfactory therapeutic efficacy.

Objective To observe the efficacy and safety of Hyzaar on hyperuricemia patients with essential hypertension.Methods 178 patients with essential hypertension and hyperuricemia were randomly divided into control group and observation group with each of 89 cases.Patients in the control group were treated with enalapril, 10 mg qd ,and hydrochlorothiazide, 12.5mg qd.Patients in the observation group were given 1 piece of Hyzaar tablet (5mg losartan and 12.5mg hydrochloride per tablet) per day for a course of 8 weeks.Blood pressure,serum uric acid level before and after the treatment were observed.Results Antihypertensive efficacy of the observation group and control group were 95.5% and 93.3% ,respectively( P > 0.05 ).Serum uric acid level of the observation group was significantly decreased than before treatment( P <0.01 ) ,while the serum uric acid of the control group showed no significant changes.The incidence of dry cough was higher in control group.Conclusion Hyzaar showed good efficacy in decreasing blood pressure and uric acid,and good safety in treating patients with primary hyperuricemia and hypertension.

This investigation determined the content of water,organic components and mineral of 80 skullparital bones from cadavers. Basing on semistatic test of anti-bending and anti-compressive mechanicsthe bone mineral contents were measured by quantitative computed tomogrophy. The relationship be-tween bone mineral contents and the mechanical properties was showed. The results suggested thatthere are positive interrelationship between anti-bending strength and skull spongiosa and betweenanti. compressive strength and skull compacta interna (r = O. 51 and O. 34, P

Objective To improve the resection rate of central type hepatoma. Method Under selective exclusion of hepatic blood flow and the use of caritational ultrasonic surgical aspiration (CUSA), hepatectomy of central hepatic segments was performed for liver tumors. Result There were 46 cases in this group. Preoperative hepatic function was Child A in 43 cases and Child B in 3 cases. Regional entire bloodstream was excluded ranging from 8 to 33 minutes in 39 cases, Intraoperative blood loss was 100 to 2400 ml,the average was 490 ml. Postoperative hepatic function recovery to Child A grade in 43 cases within one week, postoperative aacites developed in 3 cases, jaundice in 1 case, biliary fistula in 1 case, gastroplegia in 1 case. One patient died of myocardial infarction 3 days postoperatively. Thirty-five malignant cases were followed-up with a mean period of 9 months, one died of intraabdominal metastasis 10 months postoperatively, the other 34 cases was alive without recurrence. Conclusion Hepatic regional entire bloodstream exclusion is effective in the control of intraoperative blood loss ; Hypersound-emulsifying- attractor separates blood vessels and bile ducts in hepatic hilar region. The combination of these two techniques helps in the resection of central hepatic tumors.

Objective To explore the clinical effect of metoprolol combined with trimetazidine in coronary heart disease patients with heart failure and improvement of cardiac function.Methods 160 coronary heart disease patients with heart failure were selected,and they were randomly divided into research group and control group according to the digital table,80 cases in each group.The research group was treated with metoprolol combined with trimetazidine,and the control group was only treated with metoprolol therapy.The clinical curative effect,adverse reaction,heart rate(HR),plasma brain natriuretic peptide(BNP),left ventricular end-diastolic diameter(LVEDD),left ventricular end systolic diameter(LVESD) and left ventricular ejection fraction(LVEF) of the two groups were observed.Results The effective rate of the research group was 92.50%,which of the control group was 78.75%,the difference was statistically significant between the two groups(x2=6.14,P<0.05).The HR and BNP of the two groups before treatment were (95.24±5.71)beats/min,(291.42±16.34)pg/mL,(96.04±5.64)beats/min,(293.23±17.23)pg/mL respectively,the differences were not statistically significant between the two groups(t=0.89,0.68,all P>0.05),and after treatment,the HR and BNP were (72.53±4.24)beats/min,(221.42±11.42)pg/mL,(82.53±5.01)beats/min,(248.25±14.23)pg/mL respectively,the differences were statistically significant between the two groups(t=13.63,13.15,all P<0.05).The LVEDD,LVESD and LVEF of the two groups before treatment were (64.24±3.12)mm,(45.73±2.43)mm,(48.23±5.34)%,(64.67±3.22)mm,(45.64±2.47)mm,(48.29±5.38)% respectively,the differences were not statistically significant between the two groups(t=0.86,0.22,0.07,all P>0.05);After treatment,the LVEDD,LVESD and LVEF of the two groups were (51.94±3.01)mm,(34.93±2.53)mm,(60.23±4.53)%,(58.23±3.21)mm,(41.21±2.49)mm,(53.23±4.64)% respectively,the differences were statistically significant between the two groups(t=12.78,15.82,9.66,all P<0.05).The incidence rates of adverse reactions in the research group and the control group were 6.25%,11.25% respectively,the difference was not statistically significant between the two groups(x2=1.25,P>0.05).Conclusion The clinical effect of metoprolol combined with trimetazidine in the treatment of coronary heart disease patients with heart failure is obvious,and can improve heart function,it is worthy of clinical promotion.

BACKGROUND: Some studies have demonstrated that the degradation of extracellular matrix (ECM), which matrix metalloproteinases (MMPs) participates in, plays a key step in the corneal neovascularization (CNV). Tissue factor pathway inhibitor 2 (TFPI-2), a new type serine proteinase inhibitor found recently, can effectively inhibit the activity of MMPs. Whether TFPI-2 gene transfection can influence CNV is unclear.OBJECTIVE: To investigate the effect of TFPI-2 gene transfection on CNV.DESIGN: Randomized controlled experiment.SETTING: Laboratory for Department of Surgery, Wuhan Union Hospital; Central Laboratory, the Affiliated Third Hospital of Sun Yat-sen University.MATERIALS: This study was carried out in the laboratory for Department of Surgery of Wuhan Union Hospital and State Central Laboratory of the Third Hospital Affiliated to Sun Yat-sen University between June 2004 and March 2006. Sixty healthy purebred adult New Zealand rabbits of either gender, weighing 2.5 to 3.0 kg, were involved. Preoperatively, no obvious anterior segment ocular lesion was found by slit-lamp examination. pBos-Cite-neo/TFPl-2 was kindly gifted by Dr. Zhong Ren (Department of Hematology, Union Hospital). Peroxydase blocking agent, nonimmune goat serum,mouse anti-human MMP-1, 2 and 3 monoclonal antibodies, biotin labeled goat-anti-mouse IgG second antibody (Santa cruz Company) were used in this study.METHODS: Experimental intervention: Experimental rabbit models of CNV were created in each group by silver nitrate cautery. Then, the rabbit models were randomized into 3 groups and 20 rabbits for each group. Different reagents were subconjunctivally injected via many points in each group: saline in the group Ⅰ, empty vector in the group Ⅱ, plasmid encoding TFPI-2 in the group Ⅲ. Experimental evaluation: CNV growth was observed under the slit-lamp biomicroscope.The expression of TFPI-2 in each rabbit model was detected by reverse transcription-polymerase chain reaction (RT-PCR) method 2 weeks after modeling; the expression of MMPs in corneal tissue was detected by immunohistochemical method at 3,5,7,9 and 14 days after modeling.TFPI-2 gene expression was significantly higher in the group Ⅲ than in the group Ⅱ and group Ⅰ (P ＜ 0.01); The MMP-1, 2, 3 expressions in the corneal tissue were significantly lower in the group Ⅲ than in the group Ⅱ and group Ⅰ,respectively, especially MMP-1, 3.

Objective To identify Mallotus panicutus (lam) Muell.Arg and explore the acute toxicity.Methods Pharmacognostic identification and chemical reaction methods were adopted to the identification.The maximum concentration and maximum volume of ethanol extracts of M.panicutus (lam) Muell.Arg were given via intragastric administration in mice to observe the toxic and side effects after 14 days.Results The chemical reaction showed M.panicutus(lam) Muell.Arg concluded the constituents such as flavone and saponin and there was no acute toxicity in mice.After 14 days,the growth rate of mice weight of blank group and drug group were 73.5% and 62.9% (P ＞ 0.05).Conclusion The results could be taken as the reference for analyzing the quality of this drug and guiding the clinical medication.

Extracellular signal-regulated kinase/mitogen-activated protein kinase(ERK/MAPK) signaling pathway plays an important role in gastrointestinal tumorigenesis and development.ERK/MAPK signal transduction pathway has three important molecular targets: the small G protein Ras,Raf kinase and MEK1/2 and ERK1/2.At present,there are three kinds of approach which can inhibit ERK / MAPK signal transduction pathway:⑴ destroying the structure and(or) function of the target protein,⑵adopting the deficit strategy,⑶damaging the interaction between proteins.These approaches can provide new ideas for the treatment of gastrointestinal cancer.

Objective To compare the outcomes of operative with non-operative treatment for thoracolumbar burst fracture without neurological deficit using Meta-analysis.Methods Electronic database were searched from inception to February 2014 by two independent reviewers,including Pubmed Medline,Excerpta Medica Database (Embase),Cochrane Central Register of Controlled Trials,Chinese Biology Medicine (CBM),Chinese Wanfang Database,and China National Knowledge Infrastructure (CNKI).Inclusion and exclusion criteria were applied to select the studies.Quality appraisal and data extraction were based on Cochrane Collaboration guidelines.Results Two randomized controlled trials (RCTs),which reported outcomes for 79 patients (41 with operative treatment and 38 with nonoperative treatment) at a follow-up of two years or more were included.Between-study heterogeneity was found to be significant,for one reported better results in surgery group concerning pain relief,function recovery and returning to work.However,opposite results were found in another trial.Meta-analysis showed surgery led to higher complication rates (RR =2.85,95％ CI 0.83-9.75),including subsequent surgery (RR =8.39,95％ CI 1.12-62.87).Conclusion Operative and nonoperative managements produce similar results with respect to pain relief,function regain,and returning to work when performed for thoracolumbar burst fractures without neurologic deficit,but operation is often associated with more complications.

Hepatic failure following partial liver resection is a major complication and a cause of perioperative mortality for patients with primary liver cancer. Today, many different tests have been established for liver function evaluation. These tests contain conventional tests and quantitative tests.Furthermore, we should combine them to precisely evaluate hepatic functional reserve.