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Due to the complexity and risk of liver anatomy and operation, laparoscopic hepatectomy is still a challengeable procedure. In order to acquire the optimal treatment effect, we need to comprehensively analyze the general condition, hepatic reserve function of patients, and the pathway selection before this surgery. Compared with open hepatectomy, the advantage of laparoscopic hepatectomy for hepatocellular carcinoma has been widely recognized. Anatomical hepatectomy, regional resection technology, and precise hepatectomy promote the all-round development of minimal invasive liver surgery. With the navigation of indocyanine green and laparoscopic ultrasound, and the support of associating liver partition and portal vein ligation for staged hepatectomy, controlled low central venous pressure and other technologic revolution, laparoscopic hepatectomy is believed to bring new breakthrough in treatment of HCC. Although the number of HCC patients who underwent laparoscopic resection of is increasing, there are still numbers of problems, referred to technology applied and promoted, at home and abroad. This article aims to discuss the pathway selection, surgical indications and contraindications, transformation of concepts, technology annotation, and the control of complications in HCC treatment.
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Objective To analyze the feature and cause of stumps of amputees after Wenchuan earthquake,and study the effects of rehabilitation treatment for stumps.Methods Fifty-two cases with stump limbs post-amputation were evaluated,including stump skin status,stump shape,stump length,stump swelling,range of motion (ROM)of joint and strength of stump,and were treated with physical therapy,stump moulding and kinesiotherapy.Results The incidences of stump ulcer,stump swelling,conical stump,short stump and limitation of ROM of joint in all 52 cases were 76%,73%,34%,40%and 42%respectively.After rehabilitation treatment stump ulcers healed,stump swelling eliminated;stump shape,ROM of joint and muscle strength improved obviously.All poor stumps could be fit with the prosthetic limb and get good function.Conclusion The incidences of poor stump limb post·amputation after earthquake were high.Rehabilitation treatment can improve the stump condition.Early comprehensive rehabilitative intervention after amputation is important for fitting the prosthetic limb tO the stump.
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The article summarized the practice teaching experience of traumatology: strengthening the learning education of medical ethics and the knowledge of psychology,understanding the specificity and complexity in traumatology,following the rule of evidence-based medicine and establishing clinic thoughts,strengthening the training of basic skill,basic knowledge and basic theory and helping the interns transit to clinical clerkship.