Laparoscopic hepatectomy (LH) has been an incredible proliferation worldwide. many series have demonstrate that LH decreases intraoperative bleeding, postoperative compliceations and the duration of hospital stay. When compared with open hepatectomy(OP). Since the first LH was reported in 1992, near to 3000 cases have been reported,it's morbidity and mortality are 10. 5% and 0. 3% respectively. There are three terms should be used describe LH: pure laparoscopy, hand-assisted laparoscopy, and hybrid technique. In the beginning of LH, both resections were performed using the ultrasonic dissector and electrocautery,the operation included small wedge resection, liver cyst resection, and liver briopsy, however, while improvements in technology,as harmornic scalpel, endovasculer stapling devices, water jet, LigaSure, TissurLink, Habib etc. With increased experience, surgeons became holder and began to performe larger LH. But the keypoint of LH was use of portal inflow occlusion,and technique of paranchymal transection.

ObjectiveTo discuss the diagnosis method and management of Gallbladder polypoeid lesions (GPL).MethodA ten-year (2002-2011) retrospective reviews of all patients result underwent in ultrosenography (US) was conducted.ResultsTotal 591 peatients with GPL detected on US were identified,349 patients (59.1％) were women,the age ranges 20 to 93 years.395 patients had abdominal symtoms,of which 39.9％ patients had a single polyp and 9.8％ had gallstones.The specifisity of the diagnosis of GPL in US was 92.5 ％.Laparascopic cholecystectomy (LC) is the treatment of 136 chosen cases.In cases suspicious of malignancy,it is advisable to do cholecystectomy.ConclusionsMost small GPL are benign and remain static for years.Age more than 50 years old and size of polyp more than 10 mm are the two main important risk factors predicting malignancy in GPL.Other risk factors include concurrent gallstones,solitary polyp,and symptomatic polyp.LC is the treatment of unless since the suspicion of malignancy is high.

Objective To comparative analyze the CT enhanced scan and digital substraction angiography (DSA) in showing the residual and new lesions after treatment of transcatheter arterial chemoembolization (TACE).Methods 60 cases of patients with complete clinical information and imaging data from June 2010 to February 2013 were collected,these patients were diagnosed of primary hepatocelluar carcinoma and underwent TACE treatment.The sensitivity and specificity of CT and DSA to detect the residual and new lesions after TACE treatment were analyzed.By analysis of the main factors affecting the low detection rate to seek a method that can improve PHC residual new lesions detection rate after TACE.Results There were 86 lesions in 60 cases,CT enhanced scan clearly determined the diagnosis of 49 lesions (42 residues,7 new lesions).37 lesions did not prompted to tumor recurrence (residual and new lesions).DSA as the gold standard,the sensitivity of CT enhanced scan to check out the lesions was 84.5 ％ (49/58),specificity was 100.0 ％ (28/28),the false negative rate was 15.5 ％ (9/58),the accuracy was 89.5 ％ (77/86).Enhanced CT detection rate of tumor recurrence was 57.0 ％ (49/86),the DSA detection rate of tumor recurrence was 67.4 ％ (58/86).The difference of determining tumor recurrence between the CT enhanced scan and DSA was significant (x2 =7.11,P ＜ 0.05).Conclusions Three dynamic contrast-enhanced CT scan is the first choice for follow-up examination methods after TACE for hepatocellular carcinoma,but many factors will affect the detection rate of the residual and new lesions.Compared with CT examination,DSA examination has more advantages.DSA examination should be performed when the clinical suspicion of tumor recurrence is negative after enhanced CT scan.

Objective To investigate the clinical features,surgical treatment and prognosis of female breast cancer patients under 35 years.MethodsThe clinical data of 140 cases of female breast cancer patients in the young group ( ≤ 35 years) and 326 cases of female breast cancer patients in the control group ( 45 - 59years) undergoing surgical treatment from 2002 to 2009 in our hospital were analyzed retrospectively.All the data were analyzed with the statistical software of SPSS13.0.ResultsThe difference between the 2 groups had no statistical significance in tumor size or pathologic types( P ＞0.05).The axillary lymph node metastasis rate was obviously higher in the young group than in the control group ( P ＜ 0.05 ). Modified radical mastectomy and breast-conserving surgery were mainly performed.The proportion of patients in stage Ⅲ and Ⅳ in the young group was higher than that in the control group.The positive rate of ER and PR was lower while the positive rate of HER-2 was higher in the young group than those in the control group( P ＜ 0.05 ).ConclusionsBreast cancer in young women has the features of high clinical stage,high lymph node metastasis rate,low positive rate of ER and PR,high positive rate of HER-2,high recurrence rate and poor prognosis.The treatment principle of the diseaseis comprehensive therapies mainly based on surgical treatment.

The volume of blood serum originally required for the estimation of alkaline phosphatase by Boclanaky's method has been reduced from 1.0 ml to 0.02 ml. The results obtained with this micro method were in close agreement with those obtained from the original macro procedure. Using this improved method the activity of the serum alkaline phosphatase of 144 apparently normal infants aged from 1-0 months were determined, giving an average value of .11.3 Bodansky units per 100 ml serum which is slightly higher than those found in the literature.

Objective:To study the effect of bone marrow stroma cell( BM SC) transplantation combined with multi-pore mineralization ossein(Bio-Oss) in the plerosis of mandibular defect.Methods:A round whole-layer defect in the diameter of 1.5 cm was created on each side of mandible in 16 whit e New Zealand rabbits.The rabbits were randomly divided into two groups.In group 1 BMSCs were collected and cultured with mineralization induce medium for 2 wee ks. Then cell suspension at the density of 5?10 7 /ml and gelatum were mixed a nd dripped into Bio-Oss bones, incubated in DMEM in 50 ml/L CO 2 incuba tor at 37 ℃ for 4-6 h.The BMSC-Bio-Oss was applied to make plerosis of the m andibular defects.In group 2 the defects were repaired with the Bio-Oss ossein only.Samples were collected after 8 and 12 weeks after opreation respectively an d observed with radiology and histology.Results:12 weeks after o peration, (1)in group 1 previous defects were basically consisted of new bone tissue;(2)in group 2 the previous defects were mainly consisted of fibrous tis sue. Conculsions:BMSC-Bio-Oss transplantation may effectively repair bone defect.

Objective To discuss the standard diagnosis and treatment for thyroid nodule.Methods 2 581 patients with thyroid nodule from 2005 to 2009 were studied.Common methods of examination and treatment were analyzed to avoid over-examination and over-treatment.Results 90%of the patients underwent ultrasound examination with a 92.9%sensitivity and 44.3%specificity when there were two or more risk characters.All patients underwent certain kinds of surgery according to their clinical conditions.The recurrence rate was 4%two and half years after lateral thyroid adenectomy or thyroid surgery without excision of thyroid isthmus.Conclusions There are many approaches to thyroid nodule examination and treatment,in which ultrasound is recommended for preoperative examination because of its higher sensitivity,specificity and lower cost,and surgery is still the most useful and effective treatment.Choosing the proper method for thyroid nodule diagnosis and treatment is the key point to avoid over-examination and over-treatment.

Objective To identify the effects of different release paths on public dose in the aftermath of a NPP accident.Methods RASCAL4.3 software was used to simulate the source terms of PWR NPPs and the characteristics of dose distribution in different release path scenarios of long term station blackout (LTSBO) accident.Results It had been shown that radioactivity was the highest in Scenario 2,which was the release path for releases of radionuclides into the environment due to steam generator tube rupture.Radioactivity was the lowest in Scenario 1,which was the release path for radionuclides to be released into the environment in the case of containment leakage or failure.TEDE dose was mainly distributed in the region within 40 km of the release point in different scearios.TEDE dose in the most sectors within 80 km was low than 10 mSv in Scenario 1,which was the release path via containment in containment leakage or failure and in Scenario 3,which was the release path by containment bypass.It was greater than 50 mSv in Scenario 2,which was the release path due to steam generator tube rupture.Conclusions For the environmental impact assessment,it should be paid more attention to the fact that the public health impact imposed by radionuclide release into the environment via the release path due to steam generator tube rupture in the aftermath of LTSBO accident at a NPP.

PurposeTo investigate the independent risk factors of refractory hypertension for effective screening and treatment.Materials and Methods 142 patients with refractory hypertension underwent renal angiography, morbidity of renal artery stenosis (RAS) and angiography results were analyzed using univariate and multivariate Logistic regression.Results Thirty-eight cases of RAS were identiifed with incidence of 26.8%. Univariate analysis indicated that diabetes, peripheral artery disease and coronary heart disease were the predictor for RAS (P<0.05 orP<0.01). Multivariate regression analysis demonstrated that peripheral artery disease (OR 5.011, 95%CI 2.17-8.93,P<0.001) was independent risk factors for RAS. Diabetes and coronary heart disease were not independent risk factors.Conclusion Peripheral artery disease is independent risk factor for RAS among patients with refractory hypertension, which can serve as a screening index of renal angiography or renal angioplasty and stenting for RAS.

OBJECTIVE To study multiple factors on bone graft healing of mandibular reconstruction. METHODS Patients were divided into two groups: healing group(31 cases) and healing delayed group(10 cases).By comparison between two groups,the factors on wound healing after bone grafting were studied. RESULTS In patient′s age and sex,bone graft type and size,and history of operation on bone graft done,there were no differences between two groups.Extraoral and intraoral passage was the important factor to two groups,P=0.000. CONCLUSIONS It is important for us to treat wound carefully while bone graft is carried with extraoral and intraoral passage.