Objective To explore the method of laparoscopic splenectomy and pericardial devascularization . Methods Hand - assisted laparoscopic megalosplenic resection and portozygos disconnection (HLMRPD) was perfor medin 2 patients with portalhy pertension and hypersplenism from August 2 0 0 1to May 2 0 0 2 . Results Theoperation was completedsucces sfully in both patients.The intraoperative blood losswas 30 0ml and 35 0ml,respectively ,and the operation time ,2 35 min and 2 6 5 min ,respectively .Both patients recovered smoothly without posto perative complications . Conclusions HLMRPD is a safe ,minimally invasive and effective procedure.

Objective To study the sensitivity of radiotherapy on the cells in midsection and edge of glioma. Methods The glioma models were established in SD rats and exposed to X radiation. Proliferating cell nuclear antigen (PCNA), apoptosis rate and cell phase of the cells in the midsection and edge of glioma were detected by immunohistochemical assay, terminal transferase dUTP nick ending labeling (TUNEL) and flow cytometry. Results Immunohistochemical assay showed that PCNA-LI of the edge cells was significantly lower than that of midsection cells ((P

Naloxone is a synthetic pan-opioid receptor competitive antagonist of the opioid receptors inside and outside the cen-tral nervous system. After systemic administration, it reverses almost all opioid effects. Systemically administered naloxone is used to reverse the life-threatening opioid toxicity. A number of studies have analyzed the importance of oral naloxone as a peripheral opioid an-tagonist in cancer patients. Naloxone has shown satisfactory efficacy for opioid-induced constipation (OIC). Ultra-low dose of naloxone has been reported to enhance the anti-nociceptive effect of morphine and reduce morphine consumption. We summarize the results from current studies of naloxone administration in cancer pain management.

Objective: To analyze the clinical characteristics of opioid overdose in naloxone-antagonized advanced cancer pa-tients. Methods:Fifteen patients with moderate to severe cancer pain were diagnosed with opioid overdose. Five of the patients were treated with transdermal fentanyl, six with prolonged-release morphine sulfate tablets, and four with prolonged-release oxycodone hy-drochloride tablets. Naloxone was immediately administered upon discovery of opioid overdose. The reasons behind opioid overdose as well as the naloxone efficacy and patient prognosis were investigated. Results:In the patients of the group, the equivalent dosage of morphine, the treatment dosage is 10 mg/d to 640 mg/d, and the median dosage is 360 mg/d. The therapeutic dose of naloxone is 0.2 mg to 0.8 mg, and the median dosage is 0.4 mg. After naloxone use, the pupils of the patients were recovered in the first few min-utes, and respiratory depression improved within 10 min to 30 min. However, blood pressure recovery was slow for at least 1 hour. Two fever-afflicted patients were diagnosed with transdermal fentanyl overdose and impaired liver function, which exhibited rapid deteriora-tion immediately before the opioid overdose. Seven patients with poor pain control were diagnosed with opioid overdose during drug ti-tration. These patients were given poor prognosis, and their median overall survival time was 1.9 months. Conclusion: Opioid over-dose, which is shown to be common in advanced cancer patients, can be safely and effectively treated by naloxone. Early diagnosis and treatment of this condition would significantly improve the quality of pain control for the patient.

Objective:Evaluate the role of video-assisted thoracic surgery (VATS) in the treatment of bilateral synchronous multiple primary lung cancers.Methods and Results:Two paitents diagnosised as bilateral synchronous multiple primary lung cancers received one-stage treatment combined conventional thoracotomy with video-assisted thoracic surgery,performing open lobectomy to remove the larger tumor,performing wedge resection using thoracoscopy to excise the smaller one.The surgery time is short.Patients all recover smoothly without complications.To date,these two patients all alive without any sign of recurrence or metastasis of tumor,median follow-up time is 5 months (2 months+8 months).Conclusions:It is feasible to carry out one-stage treatment combined conventional thoracotomy with video-assisted thoracic surgery on patients with bilateral synchronous multiple prima-ry lung cancers,when one of the tumors of bilateral synchronous multiple primary lung cancers is classificated as T1N0M0.

0.05); while in nuclear positive group, the positive rate of p53 was significantly higher than that in nuclear negative one (P

Objective To study the protective effect of oxygen carrying liquid to brain tissue after hypertensive intracerebral hemorrhage in rats.Methods Collagenase and heparin were injected into the caudate nucleus of rats by stereotactic operation to induce a hemorrhage model,we observed the water content of brain,the morphology of the brain,the change of cerebral blood flow (CBF) and biochemical markers in each group.Results Group B without oxygen carrying liquid had more serious injury than group A with oxygen carrying liquid.Water content of brain tissue in group B (80.55?0.80%) was higher than group A (77.94?1 16%),group B had higher MBP levels(0.87?0.44 ng/ml) than group A (0.54?0.19 ng/ml), group B had higher NSE levels (1.74?0.68 ng/ml) than group A (1.19?0 49 ng/ml),There was remarkable difference in the two groups.Conclusion The oxygen carrying liquid had fine protective effect to the brain tissue around the hematoma after hypertensive intracerebral hemorrhage.

Objective To discuss the effect of microsurgery of intracranial arachnoid cyst. Methods 42 cases of intracranial arachnoid cyst treated with microsurgery were studied retrospectively.Results Total resection was performed in 23 cases and partial resection in 14 cases. 5 cases received partial resection and communication between cystic cavity and brain cistern. CT scans of 29 cases after operation showed completely obliteration or marked diminution in cystic size. The symptoms and signs of all the patients were improved significantly after a 1-year follow-up.Conclusion The effect of microsurgery of intracranial arachnoid cysts is satisfactory. It is important to communicate cystic cavity with subarachnoid space or brain cistern.

Objective To explore the way and effect of minimally invasive surgery of intracranial aneurysms.Methods 42 aneurysms from 40 patients were clipped under microscope, including 15 cases assisted with endoscope, 2 cases with neuronavigation and 2 cases with endovascular technique.Results 36 aneurysms were clipped, of which 2 were removed and 4 were wrapped. There were no parental arteries clipped incorrectly and no narrowing of the parental arterys under the helping of endoscope. Endovascular technique was applied in two large paraclinoid aneurysms, one was successfully clipped and the other was failed in procedure, but we dissected and clipped it at last by pressing the ICA. Two aneurysms were successfully located and removed under the help of neuronavigation.Conclusion Microneurosurgery combined with neuroendoscope, endovascularity and neuronavigation may reduce surgical injure and improve treatment effect.

Objective To evaluate the application of the flurescence-guided resection in gliomas surgery. The value and the advantages of this system for glioma resection was assessed, points for attention of application were discussed. Method 14 patients with gliomas in different region of the brain were performed flurescence-guided resection by using high-dose fluorescein sodium . Results Of our cases, according to the imaging data, total lesion removals were achieved in 11 patients (78.6%). The clinical status of all patients showed improvement without complication after surgery, the time of surgery and the days in hospital were both shortened than those of routine method of surgery. Conclusion The flurescence- guided resection is reliable and does accurate location in surgical treatment for gliomas. It increases rate of total lesion removal of glioma without injuring the adjacent functions.