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.

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 evaluate the use of ultrasonography befor and after inguinal hernioplasty.Methods In 30 patients, 32 inguinal hernias were submitted to tension-free inguinal hernioplasty,ultrasonography was applied before the surgery and after one mother. Ultrasonography revealed the character of the hernia before the surgery and observed the situation of the mesh after the surgery.Results Diagnostic ultrasound detected 20 inguinal hernias,4 direct hernias, and 3 femoral hernias which were consistent with intraoperative findings. We identified 2 seromas, 1 recurrence of hernia and 1 folding mesh after hernia repair. Conclusion Ultrasonography is a useful examination in preoperative assessing inguinal hernia and demonstrating postoperative complications associated with mesh.

Acute cholecystitis and acute cholangitis are common acute abdomen in biliary surgery. The morbidity of acute cholecystitis is high, and abdominal ultrasound has become the first choice for imaging examination. Disease assessment and severity grading are used to guide the formulation of treatment plan. Early laparoscopic cholecystectomy is the first choice for mild acute cholecystitis. Supportive treatment should be used in patients with severe acute cholecystitis to improve symptoms for elective cholecystectomy. For patients with severe cholecystitis who can not tolerate the risk of surgery and have no effect on conservative treatment, gallbladder drainage should be performed in time. Acute cholangitis is an acute disease with high mortality. Magnetic resonance cholangiopancreatography is an important imaging examination. The treatment principle of acute cholangitis is early biliary decompression, antibiotic application and general supportive treatment. The common methods of biliary decompression include percutaneous transhepatic cholangiography drainage, endoscopic duodenal papillary bile duct drainage, endoscopic ultrasound-guided biliary drainage, and surgical placement of T-tube drainage.

Groin incarcerated hernia and groin strangulated hernia in adults are common acute abdominal disease,usually with aging,male-dominated inguinal direct and indirect hernia and female dominated femoral hernia,high mortality.Groin hernia medical history,hernia specialist checkup and imaging examination are quick and accurate diagnosis of adult groin incarcerated and strangulated hernia necessary prerequisites.Traditional hernia surgery,tension-free repair,laparoscopy tension-free repair are commonly used in emergency surgery of groin incarcerated hernia and strangulated hernia in adults.The aim of this article is to summarize the timing of surgery and surgical methods of groin incarcerated and strangulated hernia in adults.

Some aspects of hernia and abdominal wall surgery in China have come up to an international advanced level,such as number and quality of operation.The latest issue of The Lancet gave a high score of 99 points on diagnosis and treatment of inguinal hernia in China,which has far outstripped the other developed countries of the world,with China in fourth place globally.The journal commented that,considering the treatment of inguinal hernia rely mainly on surgery,the reason Chinese surgeon performed well recalled for the great number of patients,surgery of huge quantity and the strong operation ability of the doctors in China.But there is still a wide gap on comprehensive strength between Chinese and international levels,and quality control standard is one of major aspects.If hernia and abdominal wall surgery wants to develop further,perfect quality control system is a crucial step.

Objective To explore the relationship between music preferences and mental health in medical students and to propose countermeasures.Methods Music Preferences Questionnaire and Chinese college students mental health scale(CCSMHS) were used to test 538 randomly selected medical students and the data was analyzed by descriptive statistics,T test and variance analysis with SPSS 20.0 and the inspection level was α=0.05.Results ①Statistically significant (P＜0.05) differences were found on somatization,anxiety,depression,inferiority,paranoid,force,social withdrawal,reliance,impulse and psychotic tendencies in medical students with different preference of music style; ②Statistically significant (P＜0.05) differences were found on anxiety and inferiority in medical students with different preference of music type; ③Statistically significant (P＜0.05) differences were found on anxiety,depression,paranoid,force,social withdrawal and reliance in medical students with different participating ways of music; ④Statistically significant (P＜0.05) differences were found on somatization,anxiety,inferiority and paranoid in medical students with different attitude about participating music activities; ⑤Medical students with different preferences of music activities preferences did not have significant difference on factor of mental health(P＞0.05).Conclusion The relationship between medical students' mental health and music preferences is very close.By training and guiding music preferences of medical students in mental health education,we can improve their mental health effectively.

Objective To evaluate acellular tissue matrix mesh in inguinal hernioplasty in young male patients.Methods Clinical outcome and sexual function were evaluated on 12 young male inguinal hernia patients undergoing inguinal hernioplasty by ACTM mesh.Results The mean operation time was 62 minutes.Postoperative analgesics were needed for an average of 1.45 days (range,0 -4 days).The average postoperative hospital stay was 3.9 days,and patients were able to return to normal activity,after a mean 11.8 days.All patients were followed-up for a mean duration of 9.54 months(range,6 - 16 months).Two patients complained pain one month after surgery and the pain disappeared later without any medical treatment.There was no hernia recurrence and foreign body feelings,nor sexual and reproductive problems.Conclusions The ACTM mesh is a safe and effective material for inguinal hernioplasty,especially in young male patients.

ObjectiveTo discuss the diagnosis and treatment of rupture of spleen in a base-level hospital with limited conditions. MethodsThe clinical data, diagnosis of bleeding by ultrasound, and results of (nonoperative) and operative treatment of 317 patients with rupture of spleen in Vila Central Hospital of the (Republic) of Vanuatu were retrospectively analyzed. ResultsUltrasound diagnosed 30 patients with (subcapsular) hemorrhage and 287 patients with true rupture of spleen. Based on ultrasound results, (conservative) treatment was used for 29 patients and 288 patients underwent operation. Conclusions(Ultrasonography) had a high positive diagnostic rate for rupture of spleen, and the diagnosis of bleeding volume was consistent with the findings at operation. The findings on ultrasonography can be considered in selection of cases with appropriate indications for splenectomy. Ultrasonography is an effective method for use in the (treatment) of rupture of spleen.

Objective To evaluate the accuracy of multi-detector-row CT (MDCT) in the diagnosis and preoperative evaluation of breast cancer. Methods From January 2004 to December 2007,the clinical data of 54 cases wih pathologically proved breast cancer undergoing preoperative MDCT scan (31 cases also underwent MRI scan) were retrospectively analyzed at our hospital. Surgical planning was based on MDCT assessment. The extent and location of tumor depicted by MDCT,MRI and pathology were compared. Results Breast carcinoma was diagnosed by MDCT in all the cases. In these 54 patients,MDCT achived an accuracy of 87% in evaluating the extent of tumor. Based on MDCT,39 cases underwent BCT surgery with a 8% margin positive rate. MDCT and MRI had no significant difference in accuracy of evaluation on the extent of tumor ( x2 = 0. 5, P ＞ 0. 05 ). Conclusions MDCT accurately assesses the extent and location of breast cancer, proving its value in preoperative evaluation of breast cancer.