Objective To investigate the value of laparoscopy in the diagnosis and treatment of unexplained chronic abdominal pain.Methods From January 2014 to February 2016, clinical data of 56 unexplained chronic abdominal pain undergoing laparoscopic surgery were analyzed retrospectively.Laparoscopic exploration was performed firstly and then the corresponding abnormalities were diagnosed and dealt with accordingly.Results The disease causes were explicit in 48 cases (85.7%), including 25 cases of abdominal adhesions, 8 cases of chronic appendicitis, 2 cases of small intestinal diverticulum, 2 cases of intestinal tuberculosis, 2 cases of lymphoma, 5 cases of endometriosis, 2 cases of tubal adhesions, 1 case of peritoneal metastasis of gastric cancer after surgery, and 1 case of appendiceal mucinous adenocarcinoma.Surgical treatment was performed in 43 cases, 3 of whom were converted to laparotomy.There were no postoperative complications in the 56 cases.The follow-up rate was 92.9% (52/56), and lost of follow-up was in 4 cases.The follow-up duration was from 3 months to 3 years (median, 19.4 months).There was 1 death case (peritoneal carcinomatosis).There were 35 cases (62.5%) of complete relief of abdominal pain (no recurrence of preoperative abdominal pain symptoms) and 12 cases (21.4%) of pain relief (preoperative pain decreased or interval extended).The total effective rate was 83.9% (47/56).Conclusion Laparoscopy is of high value in the diagnosis and treatment of unexplained chronic abdominal pain.

This study was aimed to explore the nonlinear relationship between syndromes and prescriptions by using the artificial neural network (ANN) algorithm. The clauses composed of syndromes and prescriptions in Shanghan Lun (Treatise on Cold Damage and Miscellaneous Diseases) were sorted out. A total of 245 clauses were trained with ANN to establish the knowledge base model of syndromes and prescriptions. After that, 100 clauses were tested. And then, the symptoms of Gui-Zhi-Tang (GZT) syndrome, Ma-Huang-Tang (MHT) syndrome, Xiao-Chai-Hu-Tang (XCHT) syndrome and Bai-Hu-Tang (BHT) syndrome were input into the model to predict the Chinese herbs. The results showed that the test accuracy of the model was 79%. For the herbs to GZT and MHT syndrome, the test error was less than 0.1. For the main herbs to XCHT and BHT syndrome, the test error was less than 0.1. While for other herbs, the test error was less than 0.3. It was concluded that the ANN algorithm can simulate the nonlinear relationship between syndromes and prescriptions, which can be applied to study the syndrome differentiation, in order to contribute to the syndromes and prescriptions standardization and the traditional Chinese medicine (TCM) information.

Objective To study the clinical feasibility and effect of totally endoscopic resection of axillary accessory breast.Methods Totally endoscopic resection of axillary accessory breast was performed in 48 cases(59 sites).On the basis of liposuction,a camera port and two 5-mm working trocars were made.By using forceps,dissecting scissors,or harmonic knife,were inserted.The cobweb-like fibropartition around the accessory breast was dissected.Results Postoperatively,there were 1 case of subcutaneous liquid accumulation and 2 cases of subcutaneous petechia,and no hematoma or infection developed.All wounds healed by first intention.Follow-up observations for 2～58 months(mean,23.6 months) showed good appearance and satisfactory effects.Conclusions Totally endoscopic resection of axillary accessory breast is safe,offering good cosmetic effects and being worthy of recommendation.

Objective To explore the diagnosis and treatment of abdominal cocoon. Methods This article retrospectively summarized clinical data of 6 cases of abdominal cocoon. Results All the 6 cases of abdominal cocoon were misdiagnosed preoperatively: 5 cases were diagnosed as having intestinal obstruction and 1 case,abdominal mass.Partial or total capsule resection was adopted in all the 6 cases,1 of which simultaneously underwent intestinal arrangement. Conclusions Abdominal cocoon is not specific,which is difficult to diagnose preoperatively.Upper digestive tract radiography,B-ultrasonography and CT scanning help to make the diagnosis.Partial or total capsule resection,intestinal arrangement,intestinal resection and release for intestinal adhesion are usually adopted as the treatment.

Objective To probe the effect of transareolar or mastoscopy assisted breast-conserving surgery combined with open axillary lymph node dissection in the treatment of breast cancer. Methods Nineteen patients, with breast cancer of a diameter cm from the nipple, were treated by transareolar or mastoscopy assisted breast-conserving surgery from August 2001 to November 2003.After the lipolysis and suction of axillary fat,open axillary lymph node dissection was performed. Results Intraoperative frozen pathological examination had showed positive margin in 1 case, in which an enlarged excision was required to obtain a negative result. Postoperative subcutaneous edema underlying the operated site occurred in 2 cases and was cured by needle aspiration and pressure dressing. Excellent cosmetic outcomes were obtained with symmetrical breast development and all the patients were satisfied with the treatment. Postoperative follow-up for 2～19 months (mean, 10.6 months) found no recurrence in the breast or the axillary fossa. Conclusions Breast-conserving surgery can be expediently carried out by means of transareolar incision or with the help of mastoscopy. The combination with open axillary lymph node dissection may give favorable effect.

Objectives: The aim of this study was to define whether growth hormone therapy would reduce the course of postoperative fatigue (POF) in aged patients (60～80 years old) with nutritional support. Methods: Forty aged patients who underwent partial gastrectomy or other operations were randomized into two groups. All patients were treated with the same nutritional support formula.A group of patients was treated with rhGH for 7 day from the third day after operation, and control group treated with placebo.The score of POF, nitrogen balance, transferrin level and body weight were monitored. Results: Score of POF in rhGH group on day 7 and 14 after operation was lower than that in control group(P0.05). Conclusions: Aged patients with rhGH after major operation can recover more rapidly from POF.

Objective: To assay the content and stability of vitamin C(VC) in serum by a simple, specific method. Methods: Serum samples were extracted by metaphosphoric acid, and analyzed on a column C 18 of HPLC with DAD detector at 234 nm. Mobile phase was 100 mmol/L KH 2PO 4, pH3.00. The flow rate was 1 ml/min. Results: Under this condition, the retention time of VC was 5.76 min. The within run and between run reproducibilities tests were 0.42% and 2.11% respectively, and the recovery rate ranged from 82% to 88.5%. Stored at -70 ℃ and compared to that of its metaphosphoric acid extract, serum VC content was stable only for two days, and then decreased rapidly, whereas it did not decrease in metaphosphoric acid extract until the fifth day. Conclusion: A simple, sensitive and reliable method of HPLC with DAD detector is established for measuring VC in either serum or fruit, such as orange juice. VC should be determined immediately or should be extracted with metaphosphoric acid as soon as possible, then the extracts are kept at -70 ℃, and analysed within 5 d.

Objective To summarize the experience of clinical diagnosis and treatment for recurrence and progress of relieved myastbenia gravis after thymectomy. Methods 22 recurrent and progressive after relieved pa-tients with myasthenia gravis who underwent thymectomy were retrospectively analyzed. The remission therapy was conducted with combined glucocorticoid and anticholinesterase and its effectiveness was estimated. Results It was 1,17,4 as better Osserman scale Ⅰ , Ⅱ , Ⅲ respectively before operation but 15,6,1 as better Osserman scale Ⅱ , Ⅲ, Ⅳ respectively in recurrence and progress of relieved myasthenia gravis after thymectomy besides 6 with myas-thenic crisis. Complete remission and partial remission were gained in 9 patients and 12 patients respectively. There was 1 hospital-death. Conclusions Recurrence and progress can occur in any patient of relieved myasthenia gravis after thymectomy. Bulbar myasthenia gravis is usually presented as dysphagia. Reasonable administration of glucocor-tieoid could improve majority of recurrence and progress of relieved myasthenia gravis after thymectomy but responses poorly to the anticholinesterases.

AIM: To explore the possible changes in cell adhesion molecules and composition of complement activation in patients with acute myocardial infarction (AMI). METHODS: The expression of leukocyte CD18, soluble intercellular adhesion molecule-1 (sICAM-1), soluble vascular-cell adhesion molecule-1 (sVCAM-1) and composition of complement activation (sC5b-9) concentrations of patients with AMI (67 cases), old myocardial infarction (OMI, 42 cases) and 38 healthy volunteers were measured using enzyme-linked immunosorbent assay(ELISA). RESULTS: The expression of leukocyte CD18, sICAM-1,sVCAM -1 and sC5b-9 were significantly higher in AMI patients than that in normal controls and OMI patients(P

Objective To study the protein fingerprinting of carbapenems resistant and susceptible Acinetobacter baumannii (Ab) strains ,investigate the clinical value of affinity distance in carbapenems resistant strains .Methods A total of 22 carbapenems resistant Ab strains and 18 carbapenems susceptible Ab strains were collected ,and bacterial protein fingerprinting was detected by surface-enhanced laser desorption ionization time of flight mass spectrometry (SELDI-TOF-MS) ,differentially expressed proteins was analyzed by Biomarker Wizard 3 .1 .Cluster analysis of differential expressed proteins was conducted on SPSS 19 .0 .Results The protein expression pattern of carbapenems resistant and sensitive Ab strains had significant difference (P< 0 .05) .Cluster anal-ysis showed carbapenems resistance Ab was given priority to with type A ,followed by type B .Conclusion The results of cluster a-nalysis carbapenems resistance of Ab protein fingerprinting could determine the distance of affinity relationship of Ab .It could pro-vide a theoretical basis for the infection and clinical epidemiology of Ab .