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.

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.

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.

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

Tension-free repair for inguinal hernias has been led into China since 1997 and being promoted quick development of hernia and abdominal wall surgery in China,meanwhile,there are still many problems in the recurrence,chronic pain and patch infection due to irregular operations.In order to solve these problems and improve the diagnosis,treatment and research levels of hernia and abdominal wall surgery,surgeons must pay attention to the basic and clinical technologies,quality control and so on.The studies on etiology of hernia will bring innovative therapy,registration system will contribute to summarize the clinical experiences,and establishment and implementation of quality control of hernia could ensure the effects of diagnosis and treatment.However,there is still a controversy about whether laparoscopic technology on inguinal hernias is minimally invasive surgery or not,though it is safe and effective.

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.

Objective: To observe the therapeutic efficacy of acupuncture combined with hyperbaric oxygenation for cervical spondylosis of nerve root type in acute phase.
Methods: One hundred cases with cervical spondylosis of nerve root type in acute phase were randomly divided into two groups, with 50 patients in each group. The patients in the treatment group were treated by acupuncture combined with hyperbaric oxygenation, and those in the control group only received the same acupuncture therapy as the treatment group. The therapeutic efficacy was evaluated after 2 courses of treatment.
Results: In the treatment group, 27cases were cured, 9 cases showed markedly effective, and 4 cases were invalid, and the recovery rate was 67.5%, the total effective rate was 90.0%; in the control group, 18 cases were cured, 17 cases showed markedly effective, 15 cases were invalid, and the recovery rate was 36.0%, the total effective rate was 70.0%. There were statistically significant differences between two groupsin the recovery rate and the total effective rate (bothP<0.05). The average cure time of the treatment group was (15.56±7.13) d, and that of the control group was (22.13±7.78) d, which also had significant difference between the two groups (P<0.05).
Conclusion: Acupuncture combined with hyperbaric oxygenationhas rapid and reliable effects for cervical spondylosis of nerve root type in acute phase.

We investigated the distribution of Chlamydia trachomatis genotypes in the outpatients visiting STD clinics in Fuzhou City ,China .Between 2013 and 2014 ,a total of 2 019 urethral or endocervical specimens from susceptible genital C .trachomatis infections were collected and detected by using real‐time PCR assay kit .The C .trachomatis‐positive specimens were subsequently amplified with nested PCR for Omp1 region and analyzed by sequencing .Genotyping was performed by BLAST similarity search and phylogenetic tree analysis .Eighty‐three of the 86 C . trachomatis‐positive specimens were suc‐cessfully sequenced .Only one specimen was identified as multiple infection .Eight different genotypes were identified .The most prevalent was F (36 .59% ) ,followed by E (24 .39% ) ,D (12 .20% ) ,G (9 .76% ) ,J (9 .76% ) ,H (3 .66% ) ,K (2 .44% ) and B (1 .22% ) .Synonymous mutation rate and non‐synonymous mutation rate among Omp1 genes of different geno‐types were calculated .All genotypes but G showed dN/dS values of<1 .Genotypes F and E were commonest .Synonymous sub‐stitution was the major pattern of variation in the process of Omp 1 gene evolution .

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.