The surgical intervention and criteria of severe acute pancreatitis has significantly changed in the last several years with the advent of enhanced imaging techniques and minimally invasive surgery.Many kinds of minimally invasive technologies which take laparoscopy as a representative are constantly applied to the treatment of severe acute pancreatitis and make its mortality and postoperative complication rate decrease obviously.However,there are many different ways using laparoscopic techniques to treat severe acute pancreatitis.In this review,the author will discuss the current status of the different approaches.

External therapy of traditional Chinese medicine(TCM) is a common method in clinic of TCM.External therapy for internal disease is one of the characteristics of TCM treatment.Both traditional medicine and modern research had discovered that the aromatics produced an obvious effectiveness in external therapy.Percutaneous absorption is also a characteristic of Chinese medicine,the aromatic herb can promote the percutaneous absorption,and there are many methods of using aromatic herb in treating internal disease with external theropy.This article was a review on the theoretical basis and the clinical practice of aromatic herb.

10.3969/j.issn.2095-4344.2013.26.015

Objective To summarize the experience of laparoscopic appendectomy(LA).Methods A retrospective analysis was carried out on clinical data of 162 cases of laparoscopic appendectomy in this hospital from August 2002 to April 2005.Results Laparoscopic operation was completed in all the cases but 1 case of intestinal tuberculosis.The operative time was 30~90 min(mean,42 min) and the intraoperative blood loss was 5~10 ml.No complications were noted.Conclusions Laparoscopic appendectomy has advantages of little invasion,less blood loss,rapid recovery,and fewer complications,being a safe and ideal surgical alternative.

[Objective]To explore the feasibility and safety of percutaneous kyphoplasty(PKP) and percutaneous vertebroplasty(PVP) treating osteolytic lesions of high thoracic vertebra with metastasis by one side extrapedicular approach,and to assess the clinical result of minimally invasive technique. [Methods]In March 2008,one patient(male,59 years old) with T1~3 vertebral metastases of lung cancer diagnozed 8 months ago was selected.The symptoms included extremely severe pain in upper thoracic spine and left should.The analgesic effect was limited for more than 6 months.There was no operative option.Domestic PKP and PVP tool systems were used in local anaesthesia.Under fluoroscopic guidance,T2 and T3 vertebral augmentation were separately completed by single side extrapedicular approach PKP and PVP.Clinical results were followed up and observed.[Results]The procedure was performed smoothly.T3 and T2 vertebrae were differently treated by PKP and PVP.T1 received no treatment because of patient`s intolerance.The operative time of T3 vertebral PKP was 57 minutes.The volume of injected bone cement was 1.9ml.The operative time of T2 vertebral PVP was 49 minutes.The volume of injected bone cement was 1.5ml.Extravertebral leakage of the polymethylmethacrylate(PMMA) into the paravertebral itssue was found without clinical symptom,because osteolysis occurred in the left pedicle of T2 vertebra.There was no other complication.The patient was discharged 5 days after operation.The preoperative,2 days and 3 months postoperative follow-up VAS scores were 10,3 and 6.The patient's markedly pain could be controlled by analgesia.[Conclusion]One side approach percutaneous kyphoplasty is a safe and effective technique for treatment of high thoracic vertebral metastasis with markedly relief of pain.

Objective To explore a method for rapid bedside temporary pacing by the right internal jugular vein approach.Method The right internal jugular veni puncture was taken by Jernigan technique and self made J tipped introducer was introduced to get to the high right atrium by the vein approach,then the J curvature of the introducer at the distal end is turned and directed at the tricusped valve outside the body,the lead attached to external pacemaker was inserted and advanced through the introducer until continuous ventricular captures appeared on the fluoroscopy.Results 30 patients in total were paced rapidly and successfully at bedside without Roentgenography.Continuous right ventricular pacing was got within 1～3 (median 2) minutes from vein puncture and within 6～30(median 13) seconds after the placement of the introducer had been completed,respectively.Conclusions The rapid bedside temporary pacing can be performed safely and rapidly through the J tipped introducer by the right internal jugular vein approach without Roentgenography.

Objective To study the relation between the quantity of DNA extracted by Chelex-100 method and multiplex STRs analysis.Methods DNA extracted from a variety of common forensic casework specimens were quantified by using Real-time PCR,and then amplified with AmpFLSTR IdentifilerTM PCR Amplification kit.ResultsAccording to the results of quantification,the quantities of DNA extracted from 113 samples by Chelex-100 method were adjusted to 0.5~3ng for establishing 8?l amplification system,and in this condition,most of 113 forensic casework specimens could be successfully genotyped.Conclusion When the quantity of DNA extracted by Chelex-100 method ranged from 0.5ng to 3ng,most results of multiplex STRs analysis were satisfying.Moreover,the amplification effect of 1?l DNA template was better than 3?l DNA template when the concentrations of extracted DNA were more than 0.5ng/?l.

To detect STR genotypes of degraded DNA from decomposed tissues. The PCR apmlified products of 40 degraded DNA samples, which were purified from decomposed muscles after death for 1～6 weeks, were separated by denaturing polyacrylamide. The genotypes were analyzed by 377 DNA sequencer and 2 fluorescence-based multiplex amplification systems which contain 12 STR loci and lsex locus. The specific PCR products of 12 STR loci and 1 sex locus of the 40 samples were typed precisely and rapidly. The method described here is very useful in forensic case works, especially for the seriously degraded DNA samples.

Objective To evaluate the polymorphism and forensic applicability of Y - DNA STR locus DYS391. Method 111 unrelated male samples from Guangzhou Han population were investigated.DYS391 primer was labeled with FAM. PCR products were detected using denatured PAGE with GenScan Software on the ABI Prism 377 DNA sequencer.Results Frequency data of 3 different DYS391 alleles were obtained. Conclusion The results demonstrated that the DYS391 locus is of high human specificity. No mutation was found.

Objective To investigate the effects of ropivavaine on gamma -aminobutyric acid(GABA)-activated membrane cur-rents in isolated dorsal root ganglion(DRG) neurons of the rats with ischiadic nerve chronic constriction injury (CCI) and to discuss the possible analgesia mechanism of ropivacaine .Methods The whole-cell patch clamp technique was used to record and compare the changes of GABA receptor activation currents of acute isolated DRG neurons after 30 s of ropivacaine preperfusion in the oper-ating side and the operative opposite side of the CCI model rats and the sham-operation group .Results (1)Compared with the oper-ative opposite side ,the sham-operation group and the control group ,the thermal withdrawal latency in the operative side group of the CCI model rats was notablely shortened(P<0 .05);(2)the amplitude of GABA-activated currents with different concentration GABA(0 .1-1 000μmol/L) in the operative opposite side group of the CCI operation was significantly greater than that of the op-erative side group and the sham-opeartion group ;(3)DRG neurons after ropivacaine preperfusion (0 .1-1 000μmol /L) showed va-rying degrees of enhancement effect on the 100 μmol/L GABA-activated currents ,the enhancement amplitude in the CCI operative opposite side group was significantly greater than that in the operative side group and the sham-operation group ;(4)The dose-re-sponse curve of DRG neurons GABA (0 .1-1 000μmol/L) activated current in the operative side group of the CCI rats after ropiva-caine pre-perfusion (100 μmol/L) was shifted to the left ,the difference between two EC50 had no statistical significance (P>0 .05) .Conclusion Ropivacaine has the enhancement effect on GABA activated currents in the DRG neurons of the CCI model rats , which could be one of reasons for ropivacaine producing the anesthetic and analgesic effect .