Mid term results of fenestrated branch stent technique for the treatment of thoracoabdominal aortic aneurysms / 中华普通外科杂志

Objective:To evaluate the mid-term results of fenestrated/branched endovascular aortic repair (f/b EVAR) for the treatment of thoracoabdominal aortic aneurysms. M ethods The clinical data of 105 thoracoabdominal aortic aneurysm patients treated with f/b EVAR at the Department of Vascular Surgery of Nanjing Drum Tower Hospital from 2018 to 2019 were retrospectively analyzed. Results:There were 43 cases of thoracoabdominal aortic aneurysm and 62 cases of thoracoabdominal aortic aissection.A total of 336 branch arteries were reconstructed,and technical success rate was 94.3%. 100 cases (95.2%) were followed-up, 6 cases (5.7%) received reoperation interventions, and 11 cases (10.5%) died. During the follow-up period, 69 cases had complete imaging data. Based on the recent CT date of the thoracoabdominal aorta, 58 patients hael positive aortic remodeling and 11 patients hael negative and indeterminate remodeling; there were 31 cases (29.5%) of endoleaks, including 7 cases (6.7%) of type Ⅰb endoleaks, 8 cases (7.6%) of type Ⅱ, 1 case (0.95%) of type Ⅲa, 13 cases (12.4%) of type Ⅲc endoleaks and 2 cases (1.9%) of type Ⅳ. Conclusions:The mid-term follow-up results were satisfactory for TAAA treated with f/b EVAR. Internal leakage remains key point for f/b EVAR.

Efficacy and safety of lenvatinib combined with sintilimab as the second-line therapy for intrahepatic cholangiocarcinoma / 临床肝胆病杂志

Objective To investigate the efficacy and safety of lenvatinib combined with sintilimab as the second-line therapy for advanced intrahepatic cholangiocarcinoma (ICC). Methods A retrospective analysis was performed for the clinical data of the patients with advanced ICC who were admitted to Beijing Ditan Hospital from October 31, 2019 to October 31, 2021 and could not undergo surgery or experienced metastasis after surgery. All patients were treated with lenvatinib combined with sintilimab as the second-line therapy. The patients were followed up, and the RECIST1.1 criteria were used to assess treatment outcome. The primary endpoint was time to progression (TTP), and the secondary endpoints were tumor objective response rate (ORR), disease control rate (DCR), overall survival (OS) time, and safety. The Kaplan-Meier method was used to plot survival curves, and the log-rank test was used for comparison between groups. Results A total of 27 patients were enrolled, among whom there were15 male patients (55.6%) and 12 female patients (44.4%), with a median age of 58 years (range 33-73 years). The median TTP for these patients was 5.5 (95% confidence interval [ CI ]: 1.7-9.3) months, and 13 patients (48.1%) died of disease progression, with a median OS time of 11.2 (95% CI : 5.0-17.4) months. The overall ORR and DCR were 40.7% and 70.3%, respectively. Of all patients, 66.7% experienced varying degrees of adverse events, and among these patients, 44.4% had an increase in alanine aminotransferase, 44.4% had an increase in aspartate aminotransferase, 37.0% had hypertension, 29.6% had an increase in bilirubin, 29.6% experienced diarrhea, and 25.9% each experienced proteinuria, anorexia, and weakness. No treatment-related death was observed, and only 1 patient developed grade Ⅳ immune-related hepatotoxicity and was relieved without sequelae after corticosteroid therapy, resulting in permanent withdrawal of sintilimab. The patients with lymph node metastasis had a significantly shorter median TTP than those without lymph node metastasis (4.5 months vs 18.8 months, P =0.035), and the patients who achieved disease remission had a significantly longer median TTP [11.6 months (95% CI : 5.6-17.6) vs 2.8 months (95% CI : 1.8-3.8), P < 0.001]; the patients with lymph node metastasis had a shorter median OS time [9.6 months (95% CI: 7.9-11.3) vs 21.9 months (95% CI : 0-44.9), P =0.053], and the patients who achieved disease remission had a significantly longer median OS time [16.6 months (95% CI : 9.0-24.2) vs 6.9 months (95% CI : 3.6-10.2), P =0.011]. Conclusion Lenvatinib combined with sintilimab has a marked clinical effect and a low incidence rate of serious adverse events as the second-line therapy for advanced ICC, and therefore, it is a safe and effective treatment regimen.

Efficacy and safety of lenvatinib in patients with unresectable hepatocellular carcinoma previously treated with tyrosine kinase inhibitor / 临床肝胆病杂志

Objective To investigate the efficacy and safety of lenvatinib in patients with unresectable hepatocellular carcinoma (HCC) previously treated with tyrosine kinase inhibitor (TKI). Methods A retrospective analysis was performed for the clinical data of 76 patients with unresectable HCC who were treated with lenvatinib in Beijing Ditan Hospital, Capital Medical University, from January 2019 to January 2020, and according to the treatment method, they were divided into TKI previously untreated group with 49 patients and TKI treatment-experienced group with 27 patients. The patients were observed till one year after enrollment, adjustment of treatment regimen, tumor progression, or death. The two groups were compared in terms of progression-free survival (PFS) time, objective response rate (ORR), disease control rate (DCR), and incidence rate of adverse events. The t -test or the Wilcoxon rank-sum test was used for comparison of continuous data between two groups, and the chi-square test or the Wilcoxon rank-sum test was used for comparison of categorical data between two groups; the Kaplan-Meier method was used for survival analysis, and the log-rank test was used for comparison between groups. Results There were no significant differences between the TKI previously untreated group and the TKI treatment-experienced group in median PFS time (115 days vs 72 days, P =0.148), ORR (36.7% vs 18.5%, P =0.098), DCR (65.3% vs 55.6%, P =0.402), and incidence rates of grade ≥3 adverse events (24.5% vs 18.5%, P =0.550). Conclusion Patients with unresectable HCC previously treated with TKI can benefit from lenvatinib and have good safety, with similar results to those treated with TKI for the first time.

Clinical effect of programmed cell death-1 inhibitor combined with lenvatinib in treatment of advanced primary liver cancer and related adverse events / 临床肝胆病杂志

ObjectiveTo investigate the clinical effect of domestic programmed cell death-1 (PD-1) inhibitor combined with lenvatinib in the treatment of advanced primary liver cancer and related adverse events. MethodsA retrospective analysis was performed for the clinical data of 24 patients with advanced primary liver cancer who were treated with domestic PD-1 inhibitor combined with lenvatinib in Beijing Ditan Hospital, Capital Medical University, from January 1, 2019 to April 2, 2020, with 15 patients in the Camrelizumab+lenvatinib group, 7 patients in the Sintilimab+lenvatinib group, and 2 patients in the Toripalimab+lenvatinib group. During follow-up, Modified Response Evaluation Criteria in Solid Tumors was used to evaluate the treatment outcome of intrahepatic lesions, and RECIST1.1 was used to evaluate extrahepatic metastatic lesions. The Kaplan-Meier method was used to evaluate survival time. ResultsAmong the 24 treatment-experienced patients, 11 achieved partial response, 7 achieved a stable disease, and 6 had disease progression, resulting in an objective response rate of 45.8% and a disease control rate of 75.0%. The median time to disease progression was 8.4 (95% confidence interval: 6.89-9.91) months. The incidence rate of adverse events was 54.17%, and the most common adverse events were fatigue (29.17%) and hypertension (25.00%). ConclusionPD-1 inhibitor combined with lenvatinib has a marked clinical effect in the treatment of advanced primary liver cancer, with a low incidence rate of serious adverse events, and thus it is a safe and effective treatment regimen.

genetic and chemical diversity in three original plants of licorice, Glycyrriza uralensis Fisch., Glycyrrhiza inflata Bat. and Glycyrrhiza glabra L.

Licorice is one of the most frequently used Chinese herbs, mainly containing triterpenoids and flavonoids. Three original plants, Glycyrrhiza glabra L., Glycyrrhiza uralensis Fisch., and Glycyrrhiza inflata Bat., are defined as licorice in Chinese pharmacopeia. In this study, 40 G. uralensis samples [Group A], 60 G. glabra samples [Group B, C and D] and 40 G. inflata samples [Group E and F], were used as plant materials, the genetic diversity of samples were determined by gene sequencing technology and the chemotypic diversity were detected by HPLC. The chemotypic diversity analysis showed that contents of triterpenoids in G. glabra [isoglycyrrhizin: 2.483 +/- 0.0671 mg·g-1, glycyrrhizin: 34.660 +/- 0.8591 mg·g-1] were obviously higher than that in G. uralensis and G. inflata. However, the contents of flavonoids [liquiritin: 21.996 +/- 0.6396 mg·g-1, isoliquiritin: 4.556 +/- 0.1252 mg.g-1, liquiritigenin: 0.623 +/- 0.0200 mg·g-1, isoliquiritigenin: 0.281 +/- 0.008 mg·g-1] in G. uralensis were higher than that in G. glabra and G. inflata. And contents of triterpenoids and flavonoids were both lowest in G. inflata. The genetic diversity analysis showed that the psbA-trnH intergenic regions on chloroplast DNA sequences were same in the same species, and significantly different between any two species. These findings will lay a solid foundation for the identification and quality control of licorice. Furthermore, recently the activity of isoglycyrrhizin has attracted more and more attentions and researches. The HPLC method established in this paper for the simultaneous assay of isoglycyrrhizin and glycyrrhizin will be helpful for the screening of superior quality licorice with a high content of isoglycyrrhizin

The combination of percutaneous iohexol-ethanol injection with radiofrequency ablation for the treatment of primary liver cancer in high-risk locations / 中华肿瘤杂志

Objective@#To investigate the safety and efficacy of radiofrequency ablation (RFA) with percutaneous iohexol-ethanol injection (PIEI), compared with RFA plus transcatheter arterial chemoembolization (TACE) for patients with primary liver cancer(PLC)in high-risk locations.@*Methods@#From January 2012 to December 2014, 54 patients with PLC in high-risk locations were enrolled. They were divided into Group A (RFA combined with PIEI) and Group B (RFA plus TACE). The efficacy and adverse events were assessed.@*Results@#54 patients had 74 lesions in high-risk locations. There were 26 cases with 40 lesions in Group A, and 28 cases with 34 lesions in Group B. The complete ablation rate of Group A was significantly higher than that of Group B (92.5% vs 70.6%, P=0.014). The two-year local tumor progressionrateand two-year overall survival rate were similar between these two groups (Group A 20.0% vs Group B 38.2%, P=0.083; 90.3% vs 84.3%, P=0.523). Furthermore, the surgery-related severe adverse events of Group A (7.1%, one case of liver abscess and one case ofhematobilia) were more common than that of Group B (0%, P=0.491). No significant differences were found in common adverse events including fever, pain, elevation of aminotransferase and bilirubin.@*Conclusions@#Compared with RFA plus TACE, RFA plus PIEI resulted inbetter complete ablation rate in patients with primary liver cancer in high risk locations. Prospective, randomized, controlled trials are warranted for further evaluation.

Content Determination of the Main Active Components in Citrus chachiensis with Different Storage Time by HPLC / 中国药房

OBJECTIVE:To establish a method for the main active components in Citrus chacheiensis with different storage time (1-19 years). METHODS:HPLC was conducted to determine the content of hesperidin:the column was Diamonsil C18 with mobile phase of methanol-acetic acid-water(35∶4∶61,V/V/V)at a flow rate of 1.0 ml/min,detection wavelength was 283 nm,col-umn temperature was 25 ℃,and the injection volume was 5 μl;the contents of nobiletin and tangeretin:the column was Diamon-sil C18 with mobile phase of water-methanol(gradient elution)at a flow rate of 1.0 ml/min,detection wavelength was 326 nm,col-umn temperature was 25 ℃,and the injection volume was 10 μl;and the content of synephrine:the column was Diamonsil C18 with mobile phase of methanol-potassium dihydrogen phosphate solution(taking 0.6 g potassium dihydrogen phosphate,1.0 g sodi-um dodecyl sulfate,1 ml glacial acetic acid dissolved to 1 000 ml)(65∶35,V/V)at a flow rate of 1.0 ml/min,detection wavelength was 275 nm,column temperature was 25 ℃,and the injection volume 20 μl. RESULTS:The linear range was 500-4 500 ng for hesperidin(r=0.999 8),38.816-388.16 ng for nobiletin(r=0.999 6),19.936-199.36 ng for tangeretin(r=0.999 5)and 640-2 560 ng for synephrine(r=0.999 9);RSDs of precision,stability and reproducibility tests were lower than 3%;recoveries were 96.42%-102.75%(RSD=2.54%,n=6),97.42%-99.95%(RSD=2.46%,n=6),99.26%-106.19%(RSD=2.31%,n=6) and 97.47%-99.76%(RSD=1.95%,n=6),respectively. CONCLUSIONS:The method is simple and stable with good reproducibility, and can be used for the contents determination of main active components in C. chacheiensis with different storage time. Pericarpi-um citri“the older the better”may be irrelevant to the change of the contents of the above-mentioned 4 active components,and it is speculated related to the release of volatile oil content to ease dryness.

Pathogens and risk factors of peritoneal dialysis-related peritonitis / 中国感染控制杂志

Objective To investigate the bacterial spectrum and antimicrobial resistance of peritoneal dialysis (PD)-related peritonitis,and provide evidence for rational antimicrobial use.Methods Clinical data of 120 patients with PD-related peritonitis in a hospital from January 2013 to December 2014 were retrospectively analyzed. Results 91 cases (75.83%)showed positive result in bacterial culture,93 pathogenic strains were cultured,inclu-ding 73 (78.49%)gram-positive and 13 (13.98%)gram-negative bacterial strains,the most common gram-positive bacteria was Staphylococcus epidermidis (n=38,40.86%),and the main gram-negative bacteria was Escherichia coli (n =3,3.23%).Gram-positive strains had high resistance rates to penicillin,erythromycin,and oxacillin (93.65%,69.57%,and 64.41 % respectively),while resistance rates to vancomycin and linezolid were both low (2.90% and 1 .47% respectively),and were sensitive to teicoplanin,tigecycline,and nitrofurantoin.Gram-negative bacteria had high resistance rates to cefazolin,cefuroxime,and ampicillin(50.00%,37.50%,and 37.50% respec-tively),but were sensitive to imipenem,tobramycin,and piperacillin.Resistance rates of gram-positive and gram-negative bacteria to gentamicin and levofloxacin were both low.Non-standard operation during dialysate exchange was the most common cause of peritonitis (56.67%),most peritonitis were gram-positive bacterial infection (79.41 %);while gram-negative bacteria were the main pathogens of diarrhea-induced peritonitis (52.63%).The cure rates of gram-positive bacteria, gram-negative bacteria,and negative-cultured peritonitis were 92.96%, 76.92%,and 86.21% respectively,difference was not statistically significant(χ2 =3.39,P =0.18).Conclusion Gram-positive bacteria are major pathogens in PD-related peritonitis,and are usually caused by the bacteria through dialy-sis catheter due to non-standard operation during dialysate exchange.First-generation cephalosporins are not recom-mended as empirical therapy against gram-positive bacteria,while vancomycin is still the best choice.Third-genera-tion cephalosporins and aminoglycosides are recommended as empirical therapy against gram-negative bacteria. Gentamicin and levofloxacin can be used alone as empirical therapy in special circumstances.

Risk factors leading to pulmonary embolism in patients of lower extremity deep vein thrombosis with iliac vein compression / 中华普通外科杂志

Objective To evaluate risks of symptomatic pulmonary embolism (PE) in deep vein thrombosis (DVT) patients complicating iliac vein compression syndrome (IVCS).Methods Between January 2010 and January 2015,patients diagnosed with lower extremity DVT and IVCS at our institution were included.The odds of symptomatic PE versus lower extremity DVT complicated with IVCS were assessed using Logistic regression models.Its association with age,gender,thrombophilic risk factors,degree of stenosis,filter implantation and symptomatic PE were assessed.Results Of 759 patients,410 patients had inferior vena cava (IVC) filters implanted and 349 had not.In filter placement group,3 patients suffered from symptomatic PE among 32 with thrombi intercepted in IVC filters.In the group with no IVC filters placement,39 cases suffered from symptomatic PE.Symptomatic PE was in positive correlation to respiratory disease and right lower extremity DVT,and negative correlation to IVC filter implantation.Conclusions In lower extremity DVT patients complicated with IVCS,the right lower extrenity DVT and respiratory disease are risk factors of symptomatic PE.IVC filter implantation prevents symptomatic PE from happening in most patients.

Enhancing production of ergosterol in Pichia pastoris GS115 by over-expression of 3-hydroxy-3-methylglutaryl CoA reductase from Glycyrrhiza uralensis

The rate-limiting enzyme in the mevalonic acid (MVA) pathway which can lead to triterpenoid saponin glycyrrhizic acid (GA) is 3-hydroxy-3-methylglutaryl-CoA reductase (HMGR). In order to reveal the effect of copy number variation in the HMGR gene on the MVA pathway, the HMGR gene from Glycyrrhiza uralensis Fisch. (GuHMGR) was cloned and over-expressed in Pichia pastoris GS115. Six recombinant P. pastoris strains containing different copy numbers of the GuHMGR gene were obtained and the content of ergosterol was analyzed by HPLC. The results showed that all the recombinant P. pastoris strains contained more ergosterol than the negative control and the strains with 8 and 44 copies contained significantly more ergosterol than the other strains. However, as the copy number increased, the content of ergosterol showed an increasing-decreasing-increasing pattern. This study provides a rationale for increasing the content of GA through over-expressing the GuHMGR gene in cultivars of G. uralensis.

Value of deep vein ascending venography in the diagnosis of iliac vein compression syndrome / 中华普通外科杂志

Objective To evaluate ascending venography in the diagnosis of iliac vein compression syndrome.Methods From April 2011 to April 2013,we have had 556 patients with varicose veins suspected of Cockett syndrome.The degree of varicose veins by the International Union of Venous Clinical Classification (CEAP classification) was as following[1]:shallow varicose veins of lower limb (C2) in 190;varicose veins with limb swelling (C3) in 149 cases ; with body skin changes,such as pigmentation,eczema or lipid hard skin disease (C4) in 130; with healed ulcers (C5) in 17; with active ulcer(C6) in 70.Deep vein anterograde contrast and femoral venous cannula angiography were performed on 760 times.Results Iliac vein compression syndrome (Cockett) was detected by ascending venography in 154 patients,the diagnosis was established by following femoral venous cannula angiography.In the other 48 patients in whom Cockett syndrome was suspected by ascending venography,final diagnosis was reached by femoral venous cannula angiography.Altogether there were 202 iliac vein compression syndrome cases,with a positive rate 38.19％ (202/529).The narrowness was larger than 50％ in 173 cases.In 145 cases there were visible collateral vessels.Conclusions Deep vein ascending angiography is a useful screening method in the diagnosis and treatment of Cockett syndrome.

Effect of Qingrequzhuo capsule on blood pressure of patients with type 2 diabetes metabolism syndrome / 国际中医中药杂志

Objective To observe the effect of Qingrequzhuo capsule on blood pressure of patients with type 2 diabetes metabolism syndrome. Methods 72 cases with type 2 diabetes and metabolic syndrome were randomly recruited into a control group and a treatment group. Based on the conventional treatment, the treatment group was treated with Qingrequzhuo capsule, 5 tablets/time, 3 times/d; While the control group was treated with ramipril tablets 2.5 mg, 1 times/d, respectively. After 3 months, the value of blood pressure and blood lipids were observed. Results After treatment, the blood pressure and blood lipid were significantly improved in both groups(P<0.05), but no significant difference between the two groups (P>0.05). Conclusion Besides improving blood lipids, Qingrequzhuo capsule can also reduce high blood pressure and improve a variety of risk factors to cardiovascular disease.

Analysis on laws of tradition Chinese medicine treating diabetic retinopathy / 国际中医中药杂志

Objective To investigate the laws of the treatment of diabetic retinopathy with traditional Chinese medicine.Methods By searching domestic literature of treating DR with traditional Chinese medicine in CNKI from 2000 to 2010, made primary summary and analyzed. Results 85 eligible published documents were found involving 147 medicinal herbs. Herbs with the functions of tonifying, activating blood circulation and eliminating stasis and heat were mostly seen.Cases reported in literature were mainly non-proliferative lesions,occupying a ratio of 58.82%;drug observation time was mainly 12 weeks, occupying a ratio of 44.17%. Conclusion Asthenia,statis and heat were pathological factors existing throughout the whole process of DR. Invigorating, romoting blood circulation, and,cooling blood should be the basic therapeutic methods.

Influence of Rhubarb on Renal Expression of Intercellular Adhesion Molecule-1 and Vascular Cell Adhesion Molecule-1 in Diabetes Mellitus Rats / 国际中医中药杂志

Objective To explore the influence of DaHuang on renal expression of intercellular adhesion molecule-1 (ICAM-1) and vascular cell adhesion molecule-1 (VCAM-1) in diabetes mellitus rats. Methods After the DM rat model was made, 24 DM rats were selected randomly and divided into a model group (12 DM rats) and a Rhubarb group group were given pure water in equal amount every day. 8 weeks later, kidney was cut to make pathological slice and method of SP immunohistochemistry was adopted for staining. Observed the expression of ICAM-1 and VCAM-1. Result The renal expression of ICAM-1 and VCAM-1 in the rhubarb group and the model group were obviously increased compared with the normal group (P<0.05). The renal expression of ICAM-1 and VCAM-1 in the rhubarb group was obviously weaker than the normal group(P<0.05). Conclusion Rhubarb could obviously inhibit the renal expression of ICAM-1 and VCAM-1 in diabetes mellitus rats and protect kidney of diabetes mellitus rats.

Tissue distribution of Aconitum alkaloids extracted from Radix aconiti preparata after oral administration to rats / 药学学报

Aim To develop an HPLC method for the determination of Aconitum alkaloids extracted from Radix aconiti preparata in rats. Methods Waters 2690@996 PAD system was used. The analytical column was a Halsil 100 C18 column (250 mm×4.6 mm ID, 5 μm). The mobile phase was water, methanol and diethyl amine at the ratio of 75∶ 25∶ 0.1. The flow rate was 0.9 mL·min -1. The wavelength of the detector was 240 nm. Results The linear ranges of aconitine in the heart, spleen, lung and kidney were 0.4-100 μg·mL -1, the correlation coefficients were 0.997 2, 0.998 6, 0.999 3 and 0.999 4, respectively. The linear range of aconitine in liver was 2-200 μg·mL -1 and the correlation coefficient was 0.999 0. The linear ranges of hypaconitine in heart, liver, spleen, lung, kidney, brain and spinal cord were 5-100 μg·mL -1, the correlation coefficients were 0.999 4, 0.999 7, 0.999 8, 0.998 4, 0.999 8, 0.999 8 and 0.999 7, respectively. Detection limits (S/N=3) of aconitine and hypaconitine were 0.4 μg·mL -1. The recoveries of aconitine and hypaconitine ranged from 88.7% to 102.2% and 86.5% to 101.3%, respectively, and the RSD of precision of aconitine and hypaconitine was 10%. Conclusion It appears to be an accurate and effective method that can offer reference basis for in toxication of Radix aconiti preparata clinically.

Diagnosis and treatment of traumatic diaphragma rupture / 中国普通外科杂志

Objective To explore the early diagnosis and optimum operative approach of traumatic diaphragma rupture (TDR) . Methods The clinical dada of 23 patients with TDR admitted to our hospital in recent 10 years were retrospectively analyzed. Results The diagnosis of TDR was made before operation in 12 cases1 (52.2%), and intraoperation in 8 (34.8), and misdiagnosed in 3 cases (13.1%). All the 23 patients underwent operation. Of the 23 patients, the operation was performed via thorax approach in 12 patients , via abdominal approach in 8, and via thorax-abdominal approach in 3. Hernation of the abdominal viscera into the thorax was observed in 18 cases, and single TDR in 5 cases.Empyema occurred after operation in 2 patients. 3 cases(13.1%) dead of hypovolemic shock and multiple organs failure. Conclusions The diagnosis of TDR may be difficult. The key of the diagnosis of TDR is to think of it. Once the diagnosis is made or suspected, the operation should be taken as early as possible. The choice of operative approach should be according to the injury mechanism and location; the choice of the operative procedure should be according to the intraoperative findings.

The evaluation for local resection of carcinoma of the ampulla of Vater / 中国普通外科杂志

Objective To study the feasibility of local resection for the tumor of the ampulla of Vater. Methods The result of 14 cases with carcinoma of the ampulla of Vater treated by local resection and 18 cases undergoing Whipple procedure in this hospital between 1988.5～1999.5 was analyzed. Results The postoperative morbidity for local resection was 7% and 39% for Whipple procedure respectively, P 0 05,and 5 year survival rate was 30% and 62% respectively, P

Nonoperative management of adult blunt hepatic injury / 中国普通外科杂志

ObjectiveTo evaluate nonoperative management of adult blunt hepatic injury. MethodThe outcome of 132 cases with adult blunt hepatic trauma admitted in this hospital between Oct 1982 and Oct 2002 was analyzed. Thirty-four cases (25.8%) were treated by nonoperative management. Before 1995, only a portion of patients underwent CT scan and after 1995, diagnosis of liver injury was established by CT scan in all cases. ResultThe nonoperative management rate before 1995 was 16.7% (14/84) and after 1995, it was 41.7% (20/48)(P0.05). ConclusionWith the progress of image monitoring and life support system, some patients of blunt hepatic injury could be managed by conservation therapy.