Objective To study a new operative procedure for hydrocele in children under mini-lapascope.Methods 103 children with hydrocele aged from 1 to 9 years old were performed by suture around internal rings under mini-laparoscope from November 2000 to March 2002. Results The operative time was (5～8) minutes and hospital stay (4～5) days. The incision didn't need suture and there was no obvious scar after operation. All cases were followed up at 1st month, 6th month and 1st year postoperatively. All cases recovered except for 2 cases recurred at 1st month postoperatively. Conclusions Suture around internal rings under mini-laparoscope is a minimally invasive and simple method for the treatment of hydrocele in children. It can find and deal with hidden patent internal rings.

Objective To explore the clinical effects of laparoscopic hernioplasty in patient over 70 years old. Methods We utilized the modified laparoscopic intraperitoneal onlay mesh (IPOM) to treat the inguinal hernia in 69 elderly patients. Results The laparoscopic operations were completed in all the 69 patients. The operative time was 20～30 min (mean, 25 min). No operative complications took place and the intraoperative blood loss was hardly seen. The duration of hospitalization was 5～7 days. The patients recovered smoothly, without wound infection or scrotum hematoma. Follow-up observations for 6～24 months in the 69 patients found no recurrence. Conclusions Modified laparoscopic IPOM treating inguinal hernia in elderly patients is feasible, on the premise of proper perioperative management.

Objective To explore the feasibility of B-ultrasound guided ureteroscopic holmium laser nephrolithotomy via percutaneous nephrostomy for the treatment of complex renal calculi. Methods A total of 32 cases of complex renal calculi was included in the study. Under local anaesthesia and B-ultrasound guidance, a percutaneous nephrostomy was performed untill a F_ 16 catheter could be introduced, with the sheath indwelling in the tract. Then under a F_ 8/9.8 ureteroscopy, holmium laser nephrolithotomy was conducted for 1~3 fractions with an interval of 3~5 d. Results The renal puncture was successfully accomplished in all the cases. The stone-free rate was 75% (24/32) at 4 weeks, and 94% (30/32) at 12 weeks after procedure. No serious hemorrhage or infection happened. No conversion to open surgery was required. Conclusions Under local anaesthesia and B-ultrasound guidance, ureteroscopic holmium laser nephrolithotomy via percutaneous nephrostomy for the treatment of complex renal calculi is safe, effective, and feasible.

Objective To explore the clinical value of laparoscopy combined with radionuclide imaging in the diagnosis and treatment of pediatric gastrointestinal hemorrhage, especially for Meckel’s diverticulum and double intestine. Methods ~ 99m Tc~-pertechnetate abdominal scintigraphy was performed in 22 children with a history of recurrent hemafecia or melena in this hospital from December 1998 to December 2005. All the children were given a laparoscopic exploration. Results Among the 22 patients, scintigraphy showed positive findings in 18 patients and negative, 4 patients. The positive patients were all confirmatively diagnosed by laparoscopic surgery and pathological examinations, including Meckel’s diverticulum in 14 patients and duplications of alimentary tract in 4 patients. In the other 4 patients with negative results, no organic pathologic changes was identified by laparoscopy in 3 patients and Meckel’s diverticulum was found after laparoscopic exploration in 1 patient. Conclusions Radionuclide imaging is an important method in the diagnosis of gastrointestinal tract hemorrhage in children and provides scientific basis for surgical intervention. The combination of laparoscopy and radionuclide imaging not only has values in the diagnosis and treatment of pediatric gastrointestinal hemorrhage, but also minimizes the blindness and trauma of exploratory laparotomy.

Follow-up is the key link for the continued rehabilitation of stroke patients after discharge. It is conducive to the dynamic assessment of the disease and the recovery of dysfunction, to improving the medication compliance of patients, and to reducing the risk of complications and stroke recurrence. With the development of society, the contents and forms of follow-up for stroke patients are becoming more and more abundant; however, the problems such as incomprehensive and not unified contents, a lack of standardization, and high rate of lost still exist. This paper reviews the necessity of follow-up and its application in the rehabilitation of stroke patients after discharge, so as to provide the reference for perfecting the management of follow-up in community rehabilitation for stroke patients.

The etiological factor, diagnosis, as well as therapeutic results of 23 cases with urinary fistula following renal transplantation, at the Chengdu Military General Hospital, from December 1998 to December 2008, were analyzed retrospectively, including 21 cases with a renal transplantation, 2 cases with retransplantation; 9 cases adopt renal artery, renal veins to external lilac artery, external lilac vein anastomosis, 14 cases with renal artery to internal lilac artery, renal veins to external lilac vein anastomosis. 23 cases were followed-up for 6-12 months, 17 cases suffered urinary fistula at days 3-7 after transplantation, 6 cases occurred at days 7-10; there were 17 stoma fistulae, 4 distal end necrosis of ureter, 2 ureteral fistulae. 11 cases were received conservative treatment, and 12 cases with operation. Among the surgery patients, 9 cases received conventional operation and 1 of them returned with urinary fistula and then was cured by second operations; 3 patients received pedicled omentum transplantation and no recurrence or hydronephrosis happened with normal renal function. The one-time success rate was 92% (11/12), of which the repair success rate using pedicled omental was 100%. The results demonstrated that prevention plays an important role in urinary fistula, and ureter should be protected during the surgery. Meanwhile, stoma fistula should be avoided. Promptly treatment following urinary fistula is also necessary to reduce the damage of urinary fistula to the renal function.

BACKGROUND:Although the renal transplantation technology has been quite mature, vascular complications during and after transplantation inevitably occur.
OBJECTIVE: To investigate the diagnosis and management of vascular complications during and after renal transplantation.
METHODS: A retrospective analysis was performed in 11 patients suffering from vascular complications during and after renal transplantation. During the transplantation, there were two cases of arterial anastomotic stenosis, one case of renal vain transverse, three cases of atherosclerosis plaque of the external iliac artery blocking the transplant renal artery, one case of twisted renal vein. After transplantation, there were two cases of extra renal pseudoaneurysm, one case of arterial anastomotic stenosis, and one case of renal artery obstruction.
RESULTS AND CONCLUSION: Two cases of arterial anastomotic stenosis during operation had good recovery, and renal alograft dysfunction occurred after 6 and 11 years, respectively. In the case of renal vain transverse, the renal alograft functioned for 12 years. Among the three cases of atherosclerosis plaque of external iliac artery blocking the transplant renal artery, 1 case presented with renal alograft dysfunction immediately, the other two patients,renal function recovered wel during the folow-up of 6 and 2 years respectively. In the case of twisted renal vein, delayed graft function occurred, and the patient died of severe pulmonary infection 1 month later. The renal alograft dysfunction occurred in the two cases of post-transplantation extra renal pseudoaneurysm. The case of post-transplantation arterial anastomotic stenosis was treated by baloon angioplasty and metalic stent placement via femoralartery, and the renal function became normal during 18 months of folow-up. The case of post-transplantation renal artery obstruction appeared to have delayed graft function, and died of severe pulmonary infection 3 weeks later. These findings indicate that patients with vascular complications during and after renal transplantation can obtain satisfactory outcomes if receiving accurate diagnosis and timely treatment.

Objective To investigate the short-term outcome of vascularized supraclavicular lymph nodes flap transplantation to treat the lower extremity lymphedema.Methods From June,2014 to June,2016,6 cases of stage Ⅱ-Ⅲ lower extremity lymphedema received vascularized supraclavicular lymph nodes flap transplantation in this study.Flap size ranged from 2.5 cm×8.0 cm to 3.5 cm×10.0 cm.The anterior tibial artery and accompanying vein were detached for anastomosis.Results One case suffered flap necrosis and then received lymphatic-venous anastomosis instead;2 cases suffered vascular crisis and partial flap necrosis,but transplanted lymph node survived and the wound were closed with skin graft.The other 3 flaps survived without any complication.Follow-up time ranged from 0.5 to 2.0 years.The affected limb circumference and the incidence of lymphangitis decreased significandy,with no complications observed in donor site.Conclusion Using vascularized supraclavicular lymph nodes flap transplantation to treat lower limb lymphedema,it has satisfactory short-term outcome and no obvious complications.It is a promising treatment choice for patients with lower extremity lymphedema in the early and mid stage.

Objective To investigate the apply value of the Visual FoxPro database management system in statistic analysis of blood lipid .Methods The blood lipid detection data of 2397 cases undergoing physical examination in the Chongqing Tumor Insti-tute were selected .The Visual FoxPro 6 .0 database management system was adopted to conduct the statistical analysis on total cho-lesterol(TC) ,triglyceride(TG) ,low density lipoprotein cholesterol(LDL) and high density lipoprotein cholesterol(HDL) in various age groups .The blood lipid situation in various ages periods was analyzed .Results The overall dyslipidemia rate in the research subjects was 45 .44% ,in which 57 .62% for male and 33 .80% for female .Serum TC ,TG ,HDL-C and LDL-C mean levels were (4 .94 ± 0 .96) ,(1 .05 ± 2 .35) ,(2 .83 ± 0 .79)and(1 .17 ± 0 .27)mmol/L in male cases ,and(4 .86 ± 0 .91) ,(0 .83 ± 1 .57) ,(2 .64 ± 0 .80) and (1 .35 ± 0 .29)mmol/L in female cases respectively .Conclusion The Visual FoxPro 6 .0 database management system can be very convenient to screen and statistically analyze the blood lipid levels in different age groups and has the advantages of high efficiency ,rapidness and simpleness .

Report a case sustained Gustilo type III C open fracture of the left humerus with brachial artery injury who has limb ischemia and wound infection after operation in June, 2014. To salvage the limb, performed cross limb vessel transfer to restore blood supply at one-stage. After multiple debridement, Flow-through flap transfer was performed for definitive reconstruction of the arterial injury and repair the wound in secondary stage. In the 3rd stage, cutting the pedicle of transposition vessels. Follow-up at 1 year after surgery, the patient's left upper limb had survived with limited movement and confirmed Flow-through the vessel reconstruction using CTA.