In order to study the effects of biliary high pressure on splanchnic major nerve and the its significance during sever type acute cholangitis(ACST), using a self-made catheter with a blind cyst at the biliary tract, an observation was completed on biliary compression of 150mmHg (20kPa) in big ear white rabbits, nervous impulse frequercy of splanchnie major nerve and blood pressure was measured at the same time. The results showed that a significant decrease in blood pressure(P0.05), the authors believe that activity of splanchnic major nerve is related to the decrease of blood pressure in earlier stage of ACST.

In order to study the effect of acute biliary hypertension on cardiovascu-lar activity, an experiment has been done on Japanese big ear white rabbits, using a self-made catheter with an inflatable rubber bag fixed to its anterior end. It was insertedinto the extrahepatic biliary tract via the duodenum, biliary high pressure of 8-20 kPawas created and maintained for 2 h by inflating the bag with water. A significant decreaseof cardiac output (CO) and fall of the arterial blood pressure were found during theexperiment (P0.05). These results indicated that the increase ofthe biliary pressure without infection could also make CO decrease, so it was a direct rea-son for falling of blood pressure, it was also an important factor causing the decline ofblood pressure in the ealier stage of severe acute cholangitis (ACST).

Because of the particularity of the interventional therapy,that is,the interventional management covers a large scope in clinical application and involves the diagnosis and treatment of various diseases of multiple systems and organs,the clinical interventional practice has really brought an unprecedented challenge for the administration of the nursing care in the intervention ward.In our hospital,independent nursing group for the intervention ward was established two years ago.For the past two years,we have constantly groped and summarized the reasonable and effect administration of interventional nursing care.Pertinent administrative measures,such as nurse training,strengthening of communication with physicians and focusing on key links in nursing care and promptly finding out the weak points in clinical work,have effectively improved the quality of clinical nursing,in this way the clinical nursing practice has been integrated into the interventional therapy and the safe and high-quality nursing service has been provided to the patients.

Objective To investigate the role of CT in the diagnois of superior vena cava syndrome secondary to pulmonary carcinoma. Method Fifty patients with pulmonary carcinoma resulting in SVCS were confirmed by pathological examinations. Relationship between anatomical distribution and gross type of pulmonary carcinoma and modes of pulmonary carcinoma resulting in SVCS were analyzed retrospectively and statistically. Correlation among obstructive degree of SVC, opening of collateral pathway and swelling of chest wall was analyzed retrospectively and statistically. Results For modes of pulmonary carcinoma resulting in SVCS, direct invasion of pulmonary carcinoma was 7 patients, metastasis of lymph node was 16 patients and both of the two was 27 patients.Modes of pulmonary carcinoma resulting in SVCS were different for different gross types of pulmonary carcinoma in different pulmonary lobes ( x2 = 30.012,P ＜ 0.05). On CT appearances of secondary lesions, cases of simple constitution and opening of collateral pathway, simple swelling of chest wall, both of the two and neither of the two were 14 patients, 12 cases, 15 patients and 9 patients in order on CT. With SVC obstruction at different extent,constitution and opening of collateral pathway and swelling of chest wall were different ( x2= 12.881, P ＜ 0.05).Conclusions SVCS resulted from pulmonary carcinoma can be diagnosed by contrast enhanced CT.

Objective To study a new method for internal drainage and primary suture after laparoscopic choledocholithotomy (LCH). Methods Twenty-five patients with chronic cholecystitis combined with cholecystolithiasis and choledocholithiasis were performed laparoscopic cholecystectomy and choledocholithotomy and extraction of stones with choledoscopy. Results One case of Mirizzi' syndrome converted into laporotomy and 24 cases were successfully performed. Excluding neither internal nor external drainage was carried out with primary closure of common bile duct (CBD) in 1 case and T-tube were placed in 4 cases, the made-self 3mm～5mm diameter silica tubes with one-way hook were placed into the common bile duct for internally drainage in 19 cases. The time of operation was from 90 to 420 minutes with a mean of 145 minutes. 1～5 calculus were removed from CBD. A mean of hospitalized days stay was 7.5 day. Conclusions The operation of internal-tube drainage of LCH frees either the inevitably risk of hyper pressure of biliary duct because of the spasm of Oddi's sphincter or disadvantage of T-tube for drainage after LCH, which is new method both safety and practicality, both simpleness and easiness, and accords with the physiological needs of the human body.

Objective To study the possibility and safty of laparoscopic partial cholecystectomy in difficult cholecystectomy. Methods The operative procedures,efficaey and complications of 26 laparoscopic partial cholecystectomy between 1999 and 2001 were reviewed retrospectively.The operative indications were empyema cholecystitis, Mirris syndromeⅠtype,frozen Calot's triangle,shrunken gallbladder. Results operative time was (51?16 5) minutes;The time to recovey activity was (11?4 3) hours;food-intake began (22?8 5) hours after operation; The hospital stay was (4 5?1 5) days;bile leakage after operation was found in 2 cases and recovered after conservative management.Following-up period lasting 6 to 25 months showed no complecations occurred. Conclusions Laparoscopic subtotal cholecystectomy may simplify the operation and decrease the risk in difficult cholecystectomy,and can get the therapeutic result of cholecystomy combined with standard cholecystectomy.

Objective The effects of laparoscopic management of indirect ingunal hernia in adults were studied. Methods 17 patients with indirect inguinal hernia underwent laparoscopic high ligation of hernial sac and 12 patients with indirect inguinal hernia underwent traditional hernial repair between November 2000 to February 2002.The outcomes of two groups were compared retrospectively. Results Comparison between laparoscopic and open group showed that the operating time was (89 9?25 8)min vs(63 5?22 4)min( t =2 8612, P

Objective To assess the feasibility of combined laparoscopic multi-organ surgery in clinical appliation. Methods 48 combined laparoscopic multi-organ surgeries performed from August 2000 to November 2001 were analyzed. Results All laparoscopic procedures were successfully completed.No one needed to be converted to laparotomy and had postoperative complications.Postoperative stay was similar to that of patients under laparoscopic mono-organ surgery in the same time. Conclusions Combined laparoscopic multi-organ surgery can be performed conveniently.It offers significant benefits to patients such as decreased postoperative pain,reduced trauma to the abdominal wall and cost-saving.

Objective To explore a simple and convenient surgical method for maxillary sinus cyst by endoscopic surgery. Methods Rudolf 4.5mm cannula paracentetic needle was used.The cyst was cut throuqh inferior nasal meatus and sampled. Results 30 cases were followed up for half a year to 3 years.No relapse was found either through X-ray or through CT scanning. Conclusions Exicision of maxillary sinus cyst by endoscopic surgery through inferior canal is one of minimally invasive operations,and the effect is positive.

Objective To investigate the feasibility and procedures of semi-open establishment of pneumoperitoneum(SOEPP) for laparoscopic surgery in patients with a history of abdominal surgery. Methods 117,patients,with a history of abdominal surgery received SOEPP and were retrospectively reviewed from October 1994 to January 2002. Results Out of 117 patients,pneumoperitoneum was established successfully in 115 cases by SOEPP.The successful rate of SOEPP was 98 3%(115/117). Conclusions SOEPP is a safe and feasible method in most patients with abdominal operative history.