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 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] 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 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 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 expression levels of nuclear factor kappa B, Bcl-2 associated K and TNF-αproteins to discuss the effects of NF-κB and Bak proteins in the pathogenesis of UC.Methods:Eighty clean grade of adult Sprague-Dawley( SD) rats were used,male and female in half and then rando mly selected sixty as the model group,another twenty as the control group.SD rats model were manufactured by a compound method:Trinitrobenzene sulfonic acid ( TNBS )+ethanol.We observed and assessed colonic mucosa by the general morphology and histological changes.To applicated immunohistochemistry and RT-PCR methods to detected the protein and mRNA expression levels of NF-κB,Bak and TNF-αin the model groups and the control group and to analysed their relationships.Results:The successful rate of making model was 97%.The number of inflammatory cells in the model groups more than the control(P<0.01).Group immunohistochemical and RT-PCR,NF-κB and TNF-αproteins and mRNA in UC colon epithelium cells and inflammatory cells were higher than the control(P<0.01).Bak protein in inflammatory cells were lower than the control(P<0.01),but there was no statistical significance in epithelial cells(P>0.05).The expression levels of NF-κB,TNF-αincreased as the histological grade increased(P<0.05),however,the expression level of Bak decreased(P<0.05).NF-κB in colonic mucosa of rats with UC had a significantly positive correlation with that of TNF-α(r=0.892,P<0.01),and negatively correlated with that of Bak(r=-0.793,P<0.01).Conclusion:The levels of NF-κB and Bak may be related to the occurrence and development of UC.

Objective To study the connection between MRI characteristics of spinal cavernous hemangioma(SCH)and its clinical and pathological features.Methods 20 cases of SCH confirmed by pathology were retrospectively analysed.The characteristics of MRI signal intensity were analysed in comparison with the clinical manifestations and pathology.Results Among the 20 cases,5 lesions located in the cervical segment of spinal cord,12 lesions in the thoracic segment,2 in the lumbar segment and 1 in the thoracic-lumbar segement.SCH could be devided into four patterns:intramedullary lesion,epidural lesion,intradural-extramedulary lesion and vertebral lesion.The typical MRI characteristics of SCH were mixed signal intersity on T_1 or T_2 weighted images,low signal intensity ring could be seen around the lesions and more pronounced on T_2 images.Spinal cord compression syndrome was the main clinical manifestation.Cavernous hemangiomas were red or purple mulberg-like lesions which were composed of dilated,thin-walled vessel with a simple endothelial lining and a variably thin fibrous adventitia under the microscope.Conclusion MRI is the most reliable method in diagnosing SCH,MRI characteristics of signal intensity of SCH are correspond with their clinical and pathological features.

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

Objective To investigate the clinical value of the probe melting curve analysis‐based PCR assay for the detection of three types of αT .Methods A total of 149 blood and prenatal archival DNA samples (6 of which were amniotic fluid samples)with three knownαT genes ,which included 63 carriers with Hb CS ,22 cases with Hb QS ,43 individuals with Hb WS and 1 double heter‐ozygote with Hb CS and Hb WS) as well as 20 samples with normalα‐globin gene sequence that had been confirmed by RBD com‐bined with DNA sequencing were selected to test the specificity of probe melting curve analysis by blind analysis .Results The probe melting curve analysis accurately detected 100 of the DNA samples previously characterized by S RBD combined with DNA sequencing .Conclusion Probe melting curve analysis‐based PCR assay for the detection ofαT is featured with rapidity and accuracy and can be applied to clinical and prenatal diagnosis .