Objective To study the feasibility of laparoscopic total mesorectal excision(TME) for low rectal cancer.Methods Laparoscopic total mesorectal excision was performed in 126 patients with low rectal cancer according to TME principle.Results The operation time was 95 - 180 min,with an average time of ( 117 ± 21 ) min,the amount of bleeding 50 - 200 ml,with an average amount of (90 ± 27 ) ml.2 - 3 days after surgery,gastrointestinal function was restored.Hospital stay was 6 - 14 days,with an average of (8 ± 2)days.Four cases converted to open surgery,the conversion rate for laparotomy was 3.2％.The proportion of sphincter-preserving operation was 95.24％ (120/126).No instant or delayed injury of ureters,large bleeding in front of sacrum and other operation-related severe complications happened intra-and after operation.Conclusion Laparoscopic surgery for low rectal cancer is safe and feasible.

The present study on 24 cases disclosed that the erythrocyte deformability(ED) of patients with acute myocardial infarction (AMI) was significantly lower than normal control. After incubate the patients' erythrocyte with Prop-lene Glycol Mannituse Sulfate(PGMS) and Pro-plene Glycol Alginate Sudium Sulfate (PSS ) , The ED was significantly higher than that of in-cubated without drug. PGMS was more effi-cious. The result indicated that PGMS and PSS may have high value in improving the microcir-culation of patient with AMI, increasing the blood flow of capilliaries in ischemic myocardium and reducing the area of infarction.

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 investigate the feasibility of total hip arthroplasty through a small anterolateral incision. Methods Total hip arthroplasty through a small anterolateral incision was performed in 53 cases (58 hip joints) from February 2003 to December 2003, including 5 cases of simultaneous replacement of bilateral joints, 6 cases of total hip revision, and 4 cases of hip joint rigidity. The surgical modification features were as follows: the patient was placed in recumbent position, with the involved buttock region slightly hanging over the side of the surgical bed and normally drooping; the involved leg was placed in 10? of adduction, which was helpful to the exposure of the greater trochanter; after the exposure of the neck of the femur and the greater trochanter, osteotomy was performed firstly, then the femoral head was dislocated and removed. Results The length of incision was 7~12 cm (mean, 8.5 cm). The operation time was 70~140 min (mean, 88 min). The blood loss was 250~660 ml (mean, 470 ml). No severe complications occurred. Postoperatively, weight-bearing and mobilization exercise were begun in 6~14 days. All the cases were followed for 4~40 weeks (mean, 28 weeks). The Harris hip scores showed excellent outcomes in 37 cases, good in 12, fair in 4, with a rate of excellent or good results of 92.5% (49/53). Conclusions Total hip arthroplasty through a small anterolateral incision is a feasible procedure that is characterized with minimal invasion, less blood loss and quick recovery. It can be applied in total hip replacement for artificial hip joint revision, hip joint rigidity, or congenital dislocation of hip joint.

Objective To explore the feasibility of endoscopic thyroidectomy through the approach of areola of breasts.Methods Endoscopic thyroidectomy via areola of breasts approach was carried out in 26 cases from March 2003 to September 2005.Thyroid nodules were right-sided in 13 cases,left-sided in 10 cases,bilateral in 1 case,and not palpable in 2 cases of hyperthyroidism(grade 1).There were 9 cases of solitary nodule and 15 cases of multiple nodules.The nodules were cystic in 5 cases,solid in 13 cases,and mixed in 6 cases,with 1~4 cm in diameter.Preoperative diagnoses included 9 cases of thyroid adenoma,15 cases of nodular goiter,and 2 cases of primary hyperthyroidism.Results The thyroidectomy was performed successfully under endoscope in 25 cases,with an operation time of 50~210 min(mean,112 min),including 4 cases of tumor enucleation,10 cases of unilateral partial thyroidectomy,8 cases of bilateral partial thyroidectomy,and 3 cases of bilateral subtotal thyroidectomy with isthmus resection.A conversion to open surgery was required in 1 case owing to thyroid carcinoma with trachea involvement.Pathological findings showed 4 cases of thyroid adenoma,18 cases of nodular goiter,2 cases of primary hyperthyroidism,and 2 cases of thyroid carcinoma.The drainage tubes were removed at 24~48 hours after operation.No nerve or parathyroid injuries occurred.The length of postoperative hospital stay was 3~6 d(mean,4.2 d).Follow-up observations in 25 cases for 3~33 months(mean,13 months) revealed no local recurrence.The patients were satisfied with cosmetic effects.The 2 cases of thyroid carcinoma were followed for 9 and 11 months,respectively,presenting no recurrence or metastasis.Conclusions Endoscopic thyroidectomy via areola of breasts approach is feasible and effective,offering satisfactory cosmetic outcomes.

Objective To evaluate effects of neoadjuvant chemotherapy on axillary lymph node status in patients with breast cancer.Methods A total of 45 patients with stage Ⅱ or Ⅲ breast cancer treated with neoadjuvant chemotherapy followed by surgery(Combination Group) were compared with 79 patients with breast cancer treated with initial surgery only(Surgery Group) in respect of axillary lymph node status,including the total number of the lymph nodes and the number of positive and negative lymph nodes,according to findings of physical examination,B-ultrasonography,and molybdenum target radiography.Results The total number of the lymph nodes and the number of positive lymph nodes were significantly less in the Combination Group(16.9?5.9 and 2.5?2.2) than in the Surgery Group(20.8?8.0 and 3.9?3.0)(t=-2.856,P=0.005;t=2.790,P=0.006),whereas the number of negative lymph nodes were 14.4?5.4 and 16.7?7.0 in the Combination Group and the Surgery Group,respectively,without statistical significance(t=-1.904,P=0.055).Four patients were found loco-regional relapse in each group during follow-up checkups for 6~19 months(mean,10 months) in 40 patients in the Combination Group and 7~21 months(mean,12 months) in 67 patients in the Surgery Group.Conclusions Total and positive axillary lymph nodes retrieved after axillary lymph node dissection decrease in number after neoadjuvant chemotherapy.

Objective To investigate the teaching effects for students of seven-year program.Method Symposiums were hold among 3 batches for seven-years program and questionnaire collected.Results We need to further modify the curriculum and improve clinical teaching skills,and students also need to have more research ideas.Conclusion We should modify current teaching content,curriculum,and skills.Clinical skills and humanization management should be highlighted.This is the key to ensure that teaching effects and teaching quality can be improved effectively.

Objective To study the relationship between serum fibronectin(Fn) and hyaluronic acid(HA) in patients with hepatocellular carcinoma(HCC) and their clinical value.Methods The serum Fn and HA levels in 50 cases of HCC 14 cases of benign hepatic disease and 100 healthy persons were determined by enzyme-labelled turbidimetry and radioimmuoassay.Results The serum Fn content (125.85?29.47)mg/L of the patients with HCC was significantly lower than those of both the benign hepatic disease(210.14?18.36)mg/L and healthy controls (219.96?26.26)mg/L,P