Objective To investigate the laparoscopic treatment for giant intraabdominal cysts with postoperative lower body edema. Methods Five cases of giant intraabdominal cysts were given an aspiration of 1 500 ~ 2 000 ml (mean, 1 800 ml) of fluid. The aspiration was performed percutaneously in 2 cases of hepatic cyst, and under direct vision through a 1.5~2.5 cm incision around the umbilics in 3 cases of lower intraabdominal cyst. After aspiration the cysts were excised (3 cases) or fenestrated (2 cases) laparoscopically. Postoperative lower body edema was treated with diuretics either orally (2 cases) or intravenously (3 cases). Results Symptoms completely disappeared after operation in 4 cases and were significantly improved in 1 case of polycystic liver. Follow-up for 3~12 months found no recurrence. The lower body edema subsided in 5~7 days after operation. Conclusions Aspiration of cystic fluid before laparoscopic operation and postoperative administration of diuretics could get good results for patients with giant intraabdominal cysts.

ObjectiveTo study the effect of prevention and treatment on osteoporosis in climacteric women by sport therapy. Methods 120 climacteric women were separated into rehabilitation group(n = 60)and control group(n = 60). Rehabilitation group accepted the oxygensport therapy, calcium, adjusted food. Control group was given calcium and adjusted food.The changs in densify of lumbar vertebradensify ofwere observed two yeats after treatment. ResultsDensify of lumbar vertebra in the rehabititation groupincreased( but there was no sta-tistical significance) and decreased remarkably in control group( P ＜ 0. 05) . Densify of lumbar vertebra lumbar in rehabititation group in-creased than that of the control group( P ＜ 0. 05) . Conclusion Exercise therapy was effective in preventing and treating osteoporosis in cli-macteric worrn.

Objective To measure circulating vascular endothelial growth factor-C(VEGF-C) levels in(patients) with colorectal carcinoma,and assess the clinical significance in diagnosis of lymph node metastasis.Methods Sixty-six patients with colorectal carcinoma and 30 healthy control patients were included in this study.Circulating VEGF-C and VEGF levels were assessed by enzyme-linked immunosorbent assay.Results Serum VEGF-C and VEGF concentration was higher in patients with colorectal carcinoma than in healthy control patients(P

Objective: To evaluate the therapeutic effects of Tuina and hyperbaric oxygen on prolapse of lumbar intervertebral disc. Methods: The included 160 cases of prolapse of lumbar intervertebral disc were allocated into a treatment group and a control group. The 100 cases in the treatment group were treated with tuina manipulation and hyperbaric oxygen. The 60 cases in the control group were treated with tuina manipulation. The total effect and scores of symptoms and signs were compared before and after treatment. Results: The total effective rate in the treatment group was 100.0%, and 83.0% in the control group. Conclusion: Tuina and hyperbaric oxygen had excellent effects on the prolapse of lumbar intervertebral disc, by improving the clinical symptoms and signs of ache and movement restriction of lower back and leg, and recovering the ability of work and daily life.

Objective To explore the leaves water extract on the liver human hepatocellular carcinoma xenografts and protein expression of Bcl-2 and HSP70 .Methods From cell morphology and DNA agarose gel electrophoresis the observation leaves water extract the characteristics of the material role in human hepatoma cells ,further use of immunocytochemistry agent Western blotting analysis method oncogene Bcl-2 and tumor suppressor genes HSP70expression .Results After the processing of the the 60 mg/mL leaves water extract of liver cancer cells after 12 h ,liver cells showed severe shrinkage ,pyknosis ,highlight the cell plasma mem-brane ,immunohistochemistry and Western blotting analysis showed that during the experiment along with the oncogene Bcl-2 ex-pression weakened(P<0 .05) ,while the expression of tumor suppressor genes HSP70 had no obvious change(P<0 .05) .Conclusion Water extract of the leaves can be induced in vitro human liver cancer cell apoptosis ,and the apoptotic process may be followed by the oncogene Bcl-2 ,tumor suppressor gene expression of HSP70 relationship .

Objective To study the application method and effect of perioperative enteral nutrition support in patients with gastrointestinal cancer.Methods 82 patients with gastrointestinal tumor were randomly divided into two groups.41 cases in the control group were given intravenous nutrition.41 patients in the study group were given enteral nutrition support 7d before operation,outage on the day of surgery,postoperation consistently given enteral nutrition support for 7d.The preoperative nutritional status,immune index,postoperative complications,the length of time and hospitalization expenses were compared between the two groups.Results Preoperative 1d,7d,the ALB,TRF,TP, PAB levels in the study group had no statistically significant differences compared with admission (all P >0.05).7d after operation,the TRF,PAB of the study group were (1.71 ±0.17)g/L,(174.67 ±22.81)mg/L,which of the con-trol group were (1.46 ±1.46)g/L,(142.73 ±27.32)mg/L,the differences were statistically significant (t =2.662, 2.917,all P <0.05).3d,7d after operation,the CRP,IL -6 and TNF - levels in the two groups increased signifi-cantly,compared with preoperation the differences were statistically significant (P <0.05).3d,7d after operation,the team CRP levels of the study group were (121.5 ±15.6)mg/L,(55.17 ±7.62)mg/L respectively,IL -6 levels were (81.42 ±13.56)pg/L,(56.14 ±9.73)pg/L and TNF -levels were (67.25 ±17.23)pg/L,(63.23 ±11.80)pg/L;In the control group,3d,7d after operation,CRP levels were (161.3 ±20.7)mg/L,(99.26 ±20.74)mg/L,IL -6 levels were (103.62 ±21.54)pg/L,(77.43 ±18.26)pg/L,the TNF -levels were (79.01 ±16.9)pg/L,(68.25 ± 12.48)pg/L,the differences between the two groups were statistically significant (P <0.05).The incidence rate of complications of the study group was 2.44%,which of the control group was 12.20% (χ2 =2.717,P <0.05 ). Conclusion Gastrointestinal tumor patients with malnutrition,perioperative enteral nutrition support can promote the synthesis of protein metabolism,relieve excessive postoperative systemic inflammatory reaction,reduce the risk of surgery.

At present,there are some problems about teaching acupuncture and massage elective course in colleges of western medicine,which are caused by student's specialty,thinking mode and the teaching material of elective course.To improve the quality of the teaching in acupuncture and massage,it is necessary to reorientate the teaching intention,adjust the course plan.

Objective To investigate the treatment of common bile duct or common hepatic duct transverse injures(CBDTI) in cholecystectomy.Methods From January 1993 to March 2008,3362 patients received cholecystectomy in our hospital,among them 5 developed CBDTI.We reviewed the clinic feature,management,and outcomes of these patients. Results Of the 5 patients,2 had common hepatic duct transverse injuries and 3 showed common bile transverse injuries.One of the five received postenterobiliary drainage and the other four underwent choledoch end-to-end anastomosis.No biliary leakage was found after the operation.One patient developed biliary stenosis and cholangitis after the end-to-end anastomosis and thus received postenterobiliary drainage.This case was followed up for 15 years,during which no abdominal pain,fever or jaundice occurred.The patient who underwent postenterobiliary drainage showed symptoms of cholangitis for 3 times whithin 2 months after the treatment;therefore,conservative therapy was carried out.Afterwards,the patient was cured and showed no abdominal pain,fever or jaundice during a 5-year follow-up.The other 3 patients who received end-to-end anastomosis were followed up for 1,2,or 4 years,no complications were noticed during the period.Conclusions Based on personal experience and the type of injury,surgeons may chose choledoch end-to-end anastomosis or postenterobiliary drainage to treat CBDTI.

Objective To observe the influence of spine kyphotic deformity on postmenopausal osteoporosis patients' pulmonary function and physical activity,and then provide a guide for the rehabilitation training of patients with osteoporosis and a kyphotic spine.Methods Sixty postmenopausal women with osteoporosis were recruited from the osteoporosis outpatients of the Third Hospital of Peking University.Half of them suffered from spine kyphosis (the spine kyphosis group) and the other half did not (the non-spine kyphosis group).There was no significant difference in the average ages and body mass indexes of the two groups.The research applied Cobb's angle and wall-occiput distance (WOD) to assess kyphosis severity,a visual analogue scale (VAS) to evaluate the patient's pain level,plus pulmonary function assessments and thoracic expansion assessments in both groups simultaneously,and the 6-minute walking test (6-MWT) to assess the patients' physical activity.Results The spine kyphosis group said they experienced significantly more pain than the non-kyphosis group,and they had worse pulmonary function and poorer physical activity.These differences were statistically significant.Pulmonary function was significantly correlated with the severity of spine kyphosis,back ache,thoracic expansion as well as physical activity.Conclusion Spine kyphosis deformity can aggravate back ache among postmenopausal osteoporosis patients,and affect their pulmonary function and physical activity.When planning clinical exercise training for such patients,physicians should pay attention to respiratory function training so as to improve the patients' pulmonary function,physical activity and endurance as much as possible,and thus improve their quality of life.

Objective To investigate laparoscopic treatment of hepatic cysts in the right posterior lobe.Methods A four-port laparoscopic fenestration and drainage was performed in 35 patients with symptomatic hepatic cysts in the right posterior lobe(the lesion was located at the segment Ⅳ in 21 patients and at the segment Ⅶ in 14 patients) from January 1998 to December 2005.For cysts located at the superior segment of the right posterior lobe,the operation was performed through the suprahepatic approach. The liver was pressed along the anterior and inferior direction by using a pair of traction tongs for the exposure of hepatic cysts.Then the cyst was fenestrated and filled with pedicled greater omentum.For cysts located at the inferior segment of the right posterior lobe,the operation was conducted through the infrahepatic approach.The hepatocolic ligament,right triangular ligament,and connective tissues between the liver and the kidney were opened by using a harmonic scalpel.The liver was lifted with the traction tongs,and the cyst was fenestrated and filled with greater omentum.Results Laparoscopic fenestration and drainage was accomplished in all the 35 patients,without conversions to open surgery.The suprahepatic approach was adopted in 15 patients and the infrahepatic approach,in 20 patients.The operation time was 30～95 min(mean,46 min).No surgery related complications occurred.Pathological examinations in the 35 patients showed congenital cysts of liver.After operation,patients' symptoms all disappeared.The postoperative hospitalization time was 2～5 days (mean,3.8 days).All the 35 patients were followed for 6～36 months(mean,34 months).The cyst did not completely disappeared but significantly subsided in 2 patients(suprahepatic approach),without remarkable symptoms.The cysts were not obviously enlarged within 6 months.Conclusions Laparoscopic fenestration and drainage via suprahepatic or infrahepatic approach is an effective treatment for hepatic cysts in the right posterior lobe.