Objective To probe into the serum blood platelet and turn into the plain(TPO) dependence that the blood platelet of level, liver cell function and periphery counts in purpose. Methods Among 106 cases of virus hepatitis patients in hsopital measuring, serum TPO level was carried on with ELISA. According to having blood platelet to reduce and divide into: A, B,C,D,E,F, G.H, group I. Results Between group A and group B,group C and group D,group E and group F,group G and group H,serum TPO level had significant differences(P

Objective To study the effect of PGE_1 injection on hepatorenal syndrome.Methods 64 patients with hepatorenal syndrome were divided into two groups at random,33 cases in treatment group and 31 cases in control group.On the basis of complex treatment of the contrast group were added PGE_1 of 200?g,dissolved at 10% glucose liquid 100ml,ivgtt,qd,the course of treatment is 2 weeks.Results The improvement which treated the liver function of the group was superior to the contrast group(P

Objective To investigate the relationship between serum HBV.M.alanine transaminase(ALT) and hepatic tissue pathology in patients with chronic hepatitis B.Methods The serum HBV.M.liver function in 133 patients with chronic hepatitis B were measured,and these patients underwent percutaneous liver biopsy by colour Echo.All these patients were divided into eight groups according to HBeAg and HBV DNA positive or negative,ALT normal or not.Hepatic necrosis inflammation grade and hepatic fibrosis stage in the groups were compared.Results Hepatic histology of all these patients showed inflammation and necrosis and different degree fibrosis.In serum ALT normal patients,liver biopsy still showed different degrees inflammation and hepatic fibrosis degrees partly,even showed hepatocirrhosis.In serum ALT abnormal and HBeAg negative patients with chronic hepatitis B patients,hepatic tissue inflammation and fibrosis degrees were more serious,hepatic tissue pathology was out of proportion to the degree of serum HBV reproduction.Conclusion Judgment of disease activity doesn't only depend on the serum transaminases and the degree of serum HBV DNA replication.When clinical choosing indication of antiviral therapy,value of liver biopsy should not be substituted.Liver biopsy in chronic hepatitis B should be regarded as main basis of judgment the hepatitis activity.It also should be regarded as main basis if antiviral therapy is conducted.

Objective To explore the significance of blood coagulation disorder in acute pancreatitis(AP) of the elderly and its treatment with prostaglandin E_1.Methods Prothrombin time(PT),partially activated thromboplastin time(APTT) and fibrinogen(FIB) in cases of AP with ages over 60 were checked and compared with those in groups of AP with ages under 60 and normal control subjects.10 cases of AP of the elderly with elevated FIB were treated with prostaglandin E_1.Results Compared with groups of AP with ages under 60 and the normal subjects,FIB was significantly higher in cases of AP of the elderly with the highest in patients of SAP.8 out of 10 aged AP patients with elevated FIB was successfully treated with prostaglandin E_1.Conclusion Patients of AP may present with blood coagulation disorders especially in aged patients.Aged patients with elevated fibrinogen may predispose to SAP.Prostaglandin E_1 may be effective in this occasion.

Objective To evaluate the clinic efficacy of laparoscopic totally extraperitoneal technique in complex inguinal hernia repair. Methods Totally 42 patients with complex inguinal hernia were repaired by laparoscopic totally extraperitoneal technique in our hospital during July 2004 to June 2008. Among the cases,18 patients had bilateral indirect inguinal hernia,8 had unilateral indirect and direct inguinal hernia,5 suffered from indirect inguinal hernia at one side and direct inguinal hernia in the other side,4 patients showed bilateral direct inguinal,3 showed bilateral indirect inguinal hernia and unilateral direct inguinal hernia,2 had bilateral direct inguinal hernia and unilateral indirect inguinal hernia,1 patient showed indirect inguinal hernia complicated with femoral hernia at the same side,and 1 patient had indirect and direct inguinal hernia at the both sides.During the operation,a 10-mm incision was made at 15 mm below the umbilicus reaching the Hunter's line,to place the laparoscope and separate the extraperitoneal space.Afterwards,two 5-mm trocars were inserted and then extraperitoneal pneumorperitoneum was established involving the retropublic space extending up to the anterior superior spine,so that to return the complex hernias.A polypropylene patch was then used to cover the pubic foramen and Hesselbach triangle. Results TEP was successfully completed in all of the 42 patients with a mean operation time of 85-165 min (mean,107.3 min) and estimated intraoperative blood loss of 10-20 ml. Scrotum aerocele was detected in all of the cases during the operation. The patients received normal diet in 2 days postoperation. They were discharged from our hospital in 7 to 9 days (mean,7.6 days). Follow-up was achieved for 3 to 32 months (mean,15.3 months) in all of the patients,during the period,2 patients showed recurrent direct inguinal hernia,and 5 had mild paraesthesia in the lower abdominal wall. Conclusions TEP is safe and effective for complex inguinal hernia.

Objective To study the efficacy and superiority of laparoscopy for the treatment of urachal fistula.Methods From January 2003 to March 2007,15 patients with urachal fistula received resection of the urachus in our hospital by laparoscopy with three trocar technique.The urachus was resected by clipping both the ends with Hem-o-lok and then cutting by ultrasonic scalpel.Frozen section examination of the resected tissues were carried out during the surgery.Results All the operations were completed under a laparoscope without conversions to open surgery.The operation time ranged from 25 to 50 minutes(mean,30 minutes).The intraoperative blood loss was 10 to 20 ml.The patients were discharged form hospital 2 to 4 days after the operation(mean,3 days).Among our cases,12 achieved a mean of 25.3 months follow-up(2 to 50 months),during this period none of them developed infections,recurrence,or carcinomatous changes.Conclusions Laparoscopy is feasible for urachal fistula.The method is simple and minimal invasive with good cosmetic outcomes and results in quick recovery.

Objective To evaluate the efficacy and priority of laparoscopy in the diagnosis and treatment of acute peritonitis. Methods Clinical data of 133 cases of acute peritonitis diagnosed and treated under laparoscope between April 2001 and October 2004 were retrospectively reviewed. Results Of the 133 cases, there were 60 cases of gastroduodenal perforation, 15 cases of acute cholecystitis, 8 cases of gallbladder perforation, 2 cases of sigmoid colon perforation, 35 cases of acute perforated appendicitis, 3 cases of jejunal diverticulum perforation, 1 case of foramen of Winslow hernia, 4 cases of acute pancreatitis, and 5 cases of primary peritonitis. The diagnostic accuracy was 100%. All the patients were treated laparoscopically without complications. Conclusions Laparoscopy gives a high diagnostic accuracy for acute peritonitis. The rationale for the use of it lies in the possibility of avoiding time- consuming preoperative B-ultrasonography or CT scans and performing minimally invasive surgical interventions directly.

Objective To investigate the clinical feas ib ility of endoscopic resection of benign mammary tumors. Methods A total of 22 cases were detected as benign mammary tumors by molybdenum targe t X-ray examinations from March 2002 to August 2003, including 15 cases of fibro ma and 7 cases of cystoid adenoma. The tumor was 2~4 cm in diameter (mean, 2.8 c m). A two-port transaxillary endoscopic resection using the electrotome and harm onic scalpel was carried out. Results The resection was comple ted endoscopically in all the 22 cases. The operation time was 28~68 min (mean, 42 min). A drainage tube was maintained for 1 day. Except for 1 case of subcutan eous effusion, no skin necrosis and other complications happened. The patients r ecovered uneventfully and stayed in hospital for 2~4 d (mean, 3 d) postoperative ly. There were no scars on the breast. Conclusions Transaxilla ry endoscopic resection of benign mammary tumors is safe and feasible and gives good cosmetic results.

Objective To explore the feasibility and surgical techniques of laparoscopic cholecystectomy(LC) in the treatment of incarcerated cystic duct stones associated with gallbladder empyema. Methods Laparoscopic cholecystectomy was performed in 76 cases of acute cholecystitis with incarcerated cystic duct stones and gallbladder empyema.During operation the cystic duct was found wide in 37 cases and was transected with overlapped clipping(11 cases),large-sized titanium clipping(9 cases),preformed knot ligation(3 cases),or Hem-o-lok ligation(14 cases),respectively.Cystic duct stones were removed during operation in 9 cases.Gallbladder bed hemorrhage occurred and was successfully stopped in 6 cases.Partial cholecystectomy was conducted in 6 cases. Results Laparoscopic cholecystectomy was successfully accomplished in all the 76 cases.The operation time was 50~125 min(mean,65.0?32.8 min).A drainage tube was placed in all the cases and was removed at 18~36 hours postoperatively,with a drainage volume of 40~90 ml/d (mean,55.0?10.4 ml/d).Biliary leakage happened in 2 cases and was cured with indwelling abdominal drainage.No patients were complicated with postoperative hemorrhage,visceral injuries,or bile duct injuries. Conclusions Laparoscopic cholecystectomy in the management of incarcerated cystic duct stones associated with gallbladder empyema is feasible.

Objective To explore the feasibility of mastoscopic resection of benign mammary gland tumors. Methods A total of 68 cases were diagnosed as having benign mammary gland tumors(42 cases of fibroma and 26 cases of cystic adenoma) by using molybdenum target X-ray examinations.The tumor was located at lower outer quadrant in 26 cases,upper inner quadrant in 16 cases,lower inner quadrant in 14 cases,and upper outer quadrant in 12 cases,respectively.The operation was conducted via a transaxillary approach.A specially-designed flap dissector was utilized to establish a tunnel underneath the breast skin,where the air was inflated to build a surgical space.Then the tumor was resected by using an electrotome or harmonic scalpel. Frozen-section examination was routinely carried out during operation. Results The operation was successfully completed in all the 68 cases,without intraoperative complications.The operation time was 28~45 min(mean,35 min).The drainage tube was indwelled for 1~2 d.Subcutaneous effusion occurred in 1 case.Postoperative recovery was uneventful without skin necrosis or other complications.The length of postoperative hospital stay was 2~5 d(3.0?1.5 d).Follow-up checkups in the 68 cases for 3~36 months(mean,12 months) revealed good cosmetic outcomes. Conclusions Transaxillary mastoscopic resection of benign mammary gland tumors is safe and feasible,with good cosmetic results.