Objective To discuss the anxiety and panic disorder in the patients with cardiovascular diseases. Method To analyze the incidental rate, diagnostic criteria, clinical manifestations and treatment in the anxiety and panic disorders with cardiovascular diseases. Result The incidental rate of anxiety and panic attack in the patients with cardiovascular diseases is high. The common clinical manifestation including chest pain, hypertension, tachycardia, arrhythmia and symptoms similar with left heart failure. Conclusion Physicians ought to improve their ability in identifying the anxiety and panic disorders with cardiovascular diseases.

Objective The aim of this study was to discuss the technical details on laparoscopic total cyst excision with Roux Y hepatoenterostomy for the treatment of choledochal cyst in children.Methods Eight patients with type Ⅰ choledochal cyst (median age 3 6 years) underwent laparoscopic cyst excision with Roux Y hepatoenterostomy from July 2001 to April 2002.Under laparoscopic guidance, intraoperative cholangiogram was performed, the gallbladder and the dilated bile duct were completely excised. Roux en Y jejunojejunostomy was performed extracorporeally through umbilical incision (2 cm), and an end to side anastomosis was carried out intracorporeally.Results Median duration of operation was 4 8 hours (3 6 to 6 0 hours), intraoperative bleeding was between 10 to 50 ml. Hospital stay after the operation ranged from 3 to 8 days. There was no intra or postoperative complication.ConclusionLaparoscopic total cyst excision with Roux Y hepatoenterostomy was effective and safe procedure for children with choledochal cyst.

Objective To investigate the causes,treatments,and prevention of dysuria after transurethral resection of prostate (TURP). Methods The clinical data of 49 cases of dysuria post-TURP that were treated in our hospital from July 2004 to September 2008 were analyzed retrospectively. Results Among the cases,6 patients received silica catheterization again because of edema of the bladder neck and urethra; 9 underwent catheterization after bladder flush for delayed prostate bleeding; 20 underwent urethral dilatation or meatotomy due to meatal stenosis,5 received urethral dilatation for urethral stricture; urethral dilatation or direct vision internal urethrotomy were performed on 4 cases who had bladder neck fracture; TURP was carried out for a second time in 4 cases because of glandular residual; suprapubic cystostomy was made in 1 case of colonal carcinoma for long-term bed rest. All cases were cured after the treatment. Conclusions Meatal stenosis is the most common cause of dysuria post-TURP.Urethral dilatation is the first choice for the disease.

Objective To study the feasibility and efficacy of laparoscopic operation for choledochal cyst. Methods Under laparoscopy,intraoperative cholangiography was performed.The dilated commom bile duct and the gallbladder were excised,a Roux-en-Y cholangio-jejunostomy was constructed outside the abdominal cavity. Results 5 babies underwent the total cyst excision and hepato-cholangio-jejunostomy successfully and quickly recovered.Only a girl transferred to open operation because of previous operative history. Conclusions Laparoscopic treatment of choledochal cyst is feasible and satisfied outcome.

Objective To investigate the feasibility of laparoscopically assisted anorectal pull-through in the repair of high imperforate anus. Methods Four infants (3 boys and 1 girl, age range, 1 d～90 d) with high imperforate anus entered this study. During operations, the rectum was exposed via laparoscope down to the rectourethral fistula, which was ligated and dissected out laparoscopically; and then, by way of a passage through the center of pelvic floor musculature, the rectum was exteriorized to the perineum to perform anorectal anastomosis. Results Laparoscopically assisted anorectal pull-through was successfully performed in all the 4 cases as a primary procedure. The mean duration of the laparoscopy was 71 8 min (range, 45 min～90 min) and the mean blood loss 8 3 ml (range, 5 ml～20 ml), no blood transfusion required and no intraoperative complications occurred. All patients recovered uneventfully. In 3～12 months of follow-up, 1 patient was found anal stenosis at 1 month after the operation and was cured with secondary anorectoplasty. No postoperative complications were seen in the other 3 cases. By now, all the 4 patients have normal fecal continence. Conclusions Laparoscopically assisted anorectal pull-through is an effective technique in the repair of high imperforate anus. Experience has shown that this approach offers minimally invasive wounds, excellent visualization of the rectal fistula and accurate identification of the center of pelvic floor musculature.

[Objective] To discuss the cure effect of conjunctiva valve combined with tarsorrhaphy and standardized medication on refractory keratohelcosis. [Method] Choose 37 cases with 37 eyes of the disease above, divide them into control group, n=17, and observation group, n=20; the control one take conjunctiva valve combined with tarsorrhaphy and routine medicine intervention; other group, standardized drug intervention instead of routine medicine. Observe the therapeutic effect after 6m. [Result] In observation group, 18 cases were cured(90%), 2 better(10%); for other group, they were 9(52.9%) and 4(23.5%) respectively, and 4 cases had no effect(23.5%). Comparing both cure effects, the difference had statistical meaning. [Conclusion] The conjunctiva valve combined with tarsorrhaphy could markedly improve the cure effect if intervened with standardized drug.

Objective To investigate the relationship between body mass index (BMI),total body fat (TBF),body fat distribution,and dyslipidemia in the elderly.Methods A total of 395 healthy elderly people who had annual examination at Peking Union Medical College Hospital were consecutively enrolled from October 2013 to March 2014.Body weight (BW),TBF,abdominal fat (AF),visceral fat (VF),visceral fat area (VFA) and waist-to-hip ratio (WHR) were measured with multi-frequency bioelectric impedance analysis.Serum triglyceride (TG),total cholesterol (TC),high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C) were measured at the same time.The relationship between BMI,TBF,body fat distribution,and dyslipidemia were analyzed.Results The incidences of obesity (17.8％ vs.9.6％,P=0.036),overweight (49.6％ vs.30.4％,P=0.000) and dyslipidemia (67.0％ vs.44.8％,P =0.000) in male were significantly higher than those in female;while female showed a significantly higher percentage of TBF (60.0％ vs.41.1％,P =0.001).TC was positively correlated with TBF (P =0.020),AF (P =0.018),VF (P =0.015) and VFA (P =0.017);TG was positively correlated with BMI (P =0.000),TBF (P=0.000),WHR (P=0.000),AF (P=0.000),VF (P=0.000) and VFA (P=0.000);LDL-C was positively correlated with BMI (P =0.049),TBF (P =0.005),AF (P =0.004),VF (P =0.003) and VFA (P =0.004);while HDL-C was negatively correlated with BMI (P =0.000),TBF (P=0.020),WHR (P=0.000),AF (P=0.021),VF (P=0.024) and VFA (P=0.022).Receiver operating characteristic curve analysis showed that the predictive curves of BMI,TBF,WHR,AF,VF and VFA were above the reference line.TBF (P =0.000),WHR (P =0.000),AF (P =0.000),VF (P =0.000),VFA (P =0.000),TG (P =0.000) and LDL-C (female:P =0.021) in obesity/overweight group were significantly higher than those in normal weight group.Conclusion Obesity/overweight,high TBF and large WHR may increase the risk of dyslipidemia in the elderly.

Objective To investigate the clinical thoracic images of SARS. Methods Thoracic images of SARS were analyzed in 175 patients with 1 060 chest plain films and 20 CT scans. Results The typical signs of SARS were multifocal air-space consolidations and progress over a day from small shadow to generalized findings. Conclusion It is necessary to make the diagnosis of SARS with thoracic plain film, and CT could detect the early pulmonary abnormality of SARS.

Objective: To summarize surgery experience and efficiency of laparoscopic excision of choledochal cyst and reconstruction of biliary tract and to analyze the treatments administered during intra and post-operation of the biliary reconstruction. Methods: We enrolled 48 cases of video-guided laparoscopic intraoperative cholangiography, cholecystectomy, choledochocele resection, Roux-en-Y hepaticojejunostomy with an anti-reflux valve from August, 2001 to October, 2003.Their operative procedures and aims were retrospectively analyzed. Results: Forty-four out of 48 patients successfully underwent laparoscopy and recovered soon. Only 4 cases were transformed to open operation. The post-operation complications were found in 4 cases. Conclusion: Video-guided laparoscopic excision of choledochal cyst, biliary tract reconstruction and Roux-en-Y hepaticojejunostomy are an effective method of treatment with advantages of minimal injury, less bleeding, and sooner recovery.

Objective To explore a new therapy for Hirschsprung's disease ( HD). Methods From Jul 2001 to Aug 2003,72 cases underwent transanal pull-through plus partial myoctomy of internal sphincter. Rectoanal manometry was done for 27 patients perioperatively. Forty-eight patients were followed-up and evaluated according Reding standard. Results Pre-and post-operative rest pressure was (38 ?8) mm Hg and (22?6 ) mm Hg respectively (P