Surgical resection offers hilar cholangiocarcinoma patients the only chance for cure and long-term survival.Hepatectomy,extrahepatic bile duct resection,regional lymphadenectomy and hepatojejunostomy are the current treatment of choice for most patients with hilar cholangiocarcinoma.Because of the aggressive nature of hilar cholangiocarcinoma and the absence of effective adjuvant therapy,surgical therapy still remains a challenge to hepatopancreatobiliary surgeons even in the precise surgery era.Controversies exist over preoperative assessment and staging,the use of preoperative biliary drainage,preoperative portal vein embolization,the range of hepatic resection,portal vein resection and construction,hepatic arteriectomy and the range of lymphadenectomy.This article reviews the surgical management of hilar cholangiocarcinoma with a focus on these controversies.

BACKGROUND:Intercondylar eminence fractures of the tibia are often treated by arthroscopic surgery, but the fixation methods are controversial.
OBJECTIVE:To compare curative effect of hol ow screw and suture fixation in treatment of tibial intercondylar eminence fractures under arthroscopy.
METHODS:A total of 46 patients with tibial intercondylar eminence fractures were recruited from the Third People’s Hospital of Yancheng, China from June 2010 to January 2013. According to the patient’s wil ing and physician’s suggestions, the involved patients were divided into hol ow screw group (n=25) and suture fixation group (n=21), undergoing hol ow screw and suture fixation under arthroscopy, respectively.
RESULTS AND CONCLUSION:According to Ikeuchi grade, the excellent and good rate after fixation showed no significant differences between the two groups (P>0.05), but the functional training time in hol ow screw group was significantly shorter than that in suture fixation group (P<0.05). Hol ow screw treatment under the arthroscopy is better than suture fixation in treatment of intercondylar eminence fractures of the tibia.

Objective To introduce technique and specific operation of a psychotherapy that suited to the Chinese cultural background and psychological characteristics of Chinese people, which can rich modem clinical treatment. Methods Introduce a specific operation of systemic TCM psychotherapy on the basis of treatment experience. Results Imagine therapy in the static state of Qigong is a specific technology of systemic TCM psychotherapy (SPT), which has been gradually standardized and matured with more than two decades of innovation and accumulated experience. Conclusion Imagine therapy in the static state of Qigong has great clinical value.

Objective To introduce a sleep-regulating technique in the static state of Qigong and a way of manipulation which meets to Chinese cultural background and psychological characteristics of Chinese people for the purpose of enriching modem clinical psychotherapies. Methods Based on previous therapeutic experience, we introduce one specific technique of the Systematic Psychotherapy of TCM (SPT) . Results Sleep-regulating technique in the static state of Qigong is a specific and practical technique of SPT, which has been gradually standardized and consummated with more than two decades of innovation and accumulation. Conclusion Sleep-regulating technique in the static state of Qigong has great clinical value.

Objective To introduce a Chinese medical psychological treatment which is suitable for the psychological characteristic of Chinese people under the Chinese culture background and its concrete skill; To enrich the modern clinical psychological therapy. Methods The article introduced the concrete applied skills of systemic psychological treatment (SPT). Results The emotional intervention in the state of Qigong calmness was one of the concrete applied skill of SPT, which has been gradually standardized after its innovation and experience accumulation over the past twenty years. Conclusion The emotional intervention in the state of Qigong calmness has high value for clinical application.

Objective To study the effects of mild hypothermia on secondary cerebral vasospasm and levels of endothelin (ET),calcitonin gene related peptide (CGRP) in cerebrospinal fluid (CSF)and plasma in patients with severe brain injury(SBI).Methods Sixty-five patients with SBI were randomly divided into mild hypothermia group(30 cases)and control group(35 cases).Based on the routine treating method,the patients of mild hypothermia group were treated with local mild hypothennia.The levels of ET,CGRP in CSF and plasma were detected before and after treatment.And the incidence rates of secondary cerebral vasospasm cases were compared between the two groups.Results (1)At 7,14 day after treatment,ET levels in CSF and plasma in mild hypothermia group were significantly lower than these in control group (P＜0.05or＜0.01).The CGRP levels in CSF and plasma were the lowest at 7 day,then gradually increased in two groups.However,the CGRP levels in mild hypothermia group at 7,14 day were higher than those in control group (P＜0.05 or＜0.01).(2) The rate of secondary cerebral vasospasm in mild hypothermia group was 6.67% which significantly less than that in control group (22.86%) (P＜0.05).Conclusion Mild hypothermia can prevent the increasing of ET and the decreasing of CGRP in CSF and plasma,and decrease the incidence rate of secondary cerebral vasespasm in patients with SBI.

The paper covered the implementation and social outcomes of the medical relief policy benefiting urban and rural residents in Anhui province. Based on analysis of problems identified, it proposed such recommendations: Enhance government financial support; improve the "safety net"mechanism of community hospitals; build a dynamic management system for those in need of medical relief; and tighten the linkage with social medical insurance.

Objective To study the value of procalationin (PCT) in neonatal infection disease diagnosis. Methods PCT was measured in 118 neonates in neonatal department of our hospital, then compared with C-reactive protein (CRP). According to the results, the 118 neonates were divided into three groups; severe infection group (n=51) , local infection (n=37) and non- infection group (n=30). Results PCT positive rate in the severe infection group (86. 27%) was higher than the other two (37. 84%, 16. 67%) (P

Objective:To study the value of clinical application of 16-slice spiral CT in the diagnosis of acute chest pain.Methods:53 cases who presented with acute chest pain were included in the study.All of the patients underwent CTA examination to evaluate the coronary arteries,pulmonary arteries,thoracic and abdomen aorta.Coronary arteries angiography and interventional therapy was performed in 6 of the 53 cases.Multi-planar reconstruction(MPR),maximum intensity projection(MIP),curved-planar reconstruction(CPR)and volume rendering(VR)were used to display coronary arteries,pulmonary arteries,thoracic and abdomen aorta.The image quality was then evaluated according to whether the examinations can fulfill the clinical demand for the differential diagnosis of acute chest pain.Results:In the 53 cases,there were 33 cases with coronary arteries disease,9 cases with aortic dissection or dissecting aneurysm,2 cases with pulmonary arteries embolism,2 cases with spontaneous rupture of esophagus,2 cases with pneumothorax.Conclusion:CTA examination with 16-slice spiral CT can display the coronary arteries,pulmonary arteries,thoracic aorta in 11～13s with good image quality.It is of great value of clinical application in the etiological diagnosis for the patients with acute chest pain.

AIM:To compare the attention ability characteristics between the elite young female soccer players and ordinary female middle-school students,and analyze attention characteristics of the elite young female soccer players at different positions,so as to establish the distinction model for them.METHODS:The experiment was carried out in Soccer School of Shandong Province in October 2005 and Jining Institute Attached Middle School in March 2006.Sixty-four second-level or above outstanding young female soccer athletes were selected including 18 forward,20 halfback and 26 back persons.Meanwhile,80 ordinary female middle-school students served as controls.Using the Athletics Psychology Ability and Condition Diagnosis Test Software and WT-attention test software(1.0 version) developed by the Sports Research Institute of National Sports Bureau,the detection on the attention stability,attention assignment,attention shift,attention span and attention was carried out.The data were analyzed by normal distribution,T-test,and distinction analysis to establish the distinction equation for the attention characteristics of outstanding young female soccer athletes.RESULTS:144 subjects were all involved in the result analysis.①The attention ability of outstanding young female soccer athletes was significantly superior to that of the ordinary female middle-school student(P