Objective To explore the feasibitity of endoscopic thyroidectomy through armpit or breast approach. Methods 14 patients aged from 21 to 36 years.There were 11 cases of thyroid adenoma(9 cases of single side and 2 cases of double sides)and 3 cases of nodular goiter (1 case of single side and 2 cases of double sides).The mini-mcision was made at armpit or breast.A percutaneous chennel into thyroid gland was performed and the focus was removed with ultrasonic scalpel wnder endoscopy. Results All cases were operated on under endoscopy,in cluding 11 cases through armpit approach and 3 ones through breast approach.The mean operative time was 135(105～335)min.The average blood loss was 65ml through armpit approach and 135ml through breast approach respectively.There was no operative complications. Conclusions Thyroidectomy under endoscopy is a new secure method.

Objective To explore the feasibility of laparoscopic splenectomy and cholecysterctomy in the treatment of patients with congenital hemolytic anemia and cholecystolithiasis. Methods 8 patients with congenital hemolytic anemia and cholecystolithiasis were operated on by single-stage splenectomy and cholecysterctomy. Results The procedures were successfully accomplished in all patients. The average hospitalization was 7.5 days. No intraoperative and postoperative complications occurred in all of the 8 patients. Conclusions Single-stage laparoscopic splenectomy and cholecysterctomy is the therapy of choice for patients with congenital hemolytic anemia and cholecystolithiasis. The kind of operation is a minimally invasive approach and has the advantages of less injury and short hospital stay.

Objective To explore the feasibility of laparoscope combined with cholangioscope in the management of bile duct calculus. Methods 100 cases of extra- and/or intrahepatic bile duct underwent laparoscopic choledocholithotomy and T-tube drainage or intra- or postoperative cholangioscope was performed from July 1997 to December 2000. Results 42 out of 100 cases obtained intraoperative complete clearance of the bile duct calculus and other 58 cases achieved thorough clearance of calculus postoperatively once to six times. No residual calculus was found in 3 years of follow-up. Conclusions Laparoscopic and cholangioscopic surgery is an effective method for the treatment of bile duct calculus.

Objective To study the shape differences of upper epidermal cells in leaves of medicinal plants of Swertia L. and establish the new method for identifying them. Methods The epidermis were mounted in ordinary technique, and then scanned and binarized through HPIAS-1000 image analytic system. The waveness of the anticlinal walls (SFC) and the ratio of the Ferets diameter (SLF) of upper epidermal cells were detected. The leaf epidermal cells of 21 kinds of raw materials in 12 plants of Swertia L. from various regions were examined. Results The precision and reproducibility of software system were good, and the shape characters of the upper epidermal cells of the middle lamina in the third node arising from ground are the stablest inside the same species by the magnification 20?10 under microscope. The SFC and SLF of the upper epidermal cells of the same species of plants are relatively constant, conversely that of different species of plants are obviously different and distinguishable from each other. Conclusion The proposed method is a useful technique for identifying traditional Chinese medicinal materials originated from herbs and leaves of plants. HPIAS-1000 is simple, rapid, accurate, and practical for shape analysis of upper epidermal cells of plant leaf.

Objective To establish a method for content determination of swertiamarin in Lomatogoniopsis alpina. Methods HPLC method for determination was used. Chromatographic column: Alltimal C18 (250 mm?4.6 mm, 5 ?m). Mobile phase: methanol-water (including 0.05% H3PO4), and gradient elution. Flow rate:1 mL/min. Wavelength:234 nm. Column temperture:30 ℃. Results The calibration curve of swertiamarin was in good linearity over the range of 3.10～30.98 (r =0.999 1). The average recoveries were 98.0%, with RSD=2.66% (n =6). Conclusion It is a simple and sensitive method in controlling the quality of Lomatogoniopsis alpina.

Objective To explore the feasibility of laparoscopic subtotal colectomy on the basis of lesion identification with the combined use of laparoscopy and fibrocolonoscopy.Methods The operation was carried out under general anesthesia.The patients were maintained at a supine position.Four 10 mm trocars were introduced at the upper and lower borders of the umbilicus,and the left and right lower quadrants of the abdomen,respectively,and a 5 mm trocar was introduced at the right upper quadrant of the abdomen.The laparoscope was placed at the hypogastrium when performing right hemicolectomy,and at the left lower abdomen when left hemicolectomy.During the operation,a fibrocolonoscope was inserted by way of the severed end of the right colon for lesion identification.The colon was disconnected from the cecum to the sigmoid colon.Then the incision at the left lower abdomen was extended to 4 cm in length,and an extracorporeal ileosigmoidostomy was conducted. Results Pathologic changes of thickening and hardening intestinal walls were clearly observed under laparoscope.Fibrocolonoscopic examinations revealed that the false polyps and ulcers on the colonic mucosa had involved the descending colon and the part of the sigmoid colon.The operation time was 170 min and 190 min,respectively,and the intraoperative blood loss was 150 ml and 200 ml,respectively.Pathological examinations after the operation verified the presence of intestinal tuberculosis.No short-term complications occurred after the operation.The frequency of defecation was 5~6 times daily at short-term postoperative period and 1~2 times daily at 5~6 months after the operation.The patients' body weight increased by 2.5 kg and 4 kg,respectively. Conclusions Combined use of laparoscopy and fibrocolonoscopy can accurately evaluate the affected extent of the lesion.Laparoscopic subtotal colectomy is safe and feasible.

To study the effect of vascular proliferation and reconstruction in chronic hepatitis B (CHB), immunohistochemical staining and in situ hybridization were used. The expression of transforming growth factor (TGF-?1) and smooth muscle actin (?-SMA) in livers of CHB were observed. The results showed that TGF-?1 and ?-SMA were related with degeneration of hepatocytes, intrahepatic vascular fibrosis and hepatic sinusoidal capillarization. The expression degree and range of TGF-?1 and ?-SMA increased with the exacerbation of liver lesion. These results suggest that vascular proliferation and reconstruction may play important roles during the process of CHB.

OBJECTIVE:To investigate the clinical efficacy and safety of cilostazol combined with alprostadil in the treatment of peripheral arterial disease(PAD). METHODS:A total of 68 PAD patients in our hospital from Jan. 2015 to Jan. 2016 were di-vided into observation group(34 cases)and control group(34 cases)according to random number table. Control group was given basical treatment,and Alprostadil injection 2 mL+0.9% Sodium chloride injection 100 mL,ivgtt,qd. Observation group was addi-tionally given Cilostazol tablets 100 mg,po,bid,on the basis of control group. Both groups were treated for 30 days. Clinical effi-cacies of 2 groups were observed. The hemorheology indexes(hematocrit,whole blood high-shearing viscosity,erythrocyte aggre-gation index,erythrocyte deformation index,plasma viscosity),inflammatory factor indexes(TNF-α,IL-6,IL-8, hs-CRP),oxida-tion stress indexes(GSH-Px,SOD,T-Aoc,MDA),arteriosclerosis indexes(ABI,TBI,dorsalis pedis artery blood flow)were de-termined before and after treatment. The occurrence of ADR was recorded. RESULTS:Total response rate of observation group (91.18%)was significantly higher than that of control group(79.41%),with statistical significance(P<0.05). Before treatment, there was no statistical significance in hemorheology indexes,inflammatory factors indexes,oxidant stress indexes or arteriosclero-sis indexes between 2 groups(P>0.05). After treatment,hematocrit,whole blood high-shearing viscosity,erythrocyte aggregation index,erythrocyte deformation index,plasma viscosity,the levels of TNF-α,IL-6,IL-8,hs-CRP and MDA in 2 groups were de-creased significantly;while the levels of GSH-Px,SOD,T-Aoc,ABI,TBI and dorsalis pedis artery blood flow were increased sig-nificantly;the improvement of above indexes in observation group was significantly better than control group,with statistical signif-icance(P<0.05). There was no statistical significance in the incidence of ADR between observation group(14.71%)and control group(11.76%)(P>0.05). CONCLUSIONS:For PAD,cilostazol combined with alprostadil can effectively improve hemorheolo-gy indexes,inflammatory factor indexes,oxidation stress indexes and arteriosclerosis indexes with good safety.

Objective To study the relationship between vascular obstruction,inflammation and the pseudolobuli formation in liver tissues with chronic hepatitis B.Methods The liver biopsies from 1256 patients with chronic hepatitis B was observated by HE,histochemical,immunohistochemical and the electricity mirror techniqe.Results (1)The intrahepatic vascular inflammation and obstruction was a histopathological characteristics of liver cirrhosis of chronic hepatitis B;(2)The lesions of vascular inflammation caused the vascular obstruction and induced the proliferations of venous and fiber;(3)The blood vessel of hyperplasia revolved round the liver cell into the irregular cell circular(tiny node).The tiny node settled the composition base in the interest of pseudolobuli formation;(4)The blood vessel of hyperplasia once more inflammation,blocking,fiber deposit constituted the fiber brings,pseudolobuli formation.Conclusion The vascular obstruction,inflammation has a closely relationship with the pseudolobuli formation in liver tissues with chronic hepatitis.

Objective To evaluate the feasibility of endoscopic thyroidectomy via an incision under the armpit. Methods A skin incision was made under the armpit and a channel was established to thyroid gland and endoscopic thyroidectomy was performed in 32 cases suffering from unilateral thyroid lesion including 24 cases of solitary adenoma, 5 cases of multiple adenoma, 3 cases of cystic goiter. Results The average operative time was 125 min and the average blood loss was 55 ml. There were not any postoperative complications. Conclusion Endoscopic thyroidectomy is a mini-invasive surgery. The operative field was clear and ultrasonic scalpel is capable of dealing with blood vessels during the procedure.