Objective To explore the early diagnosis,surgical treatment and clinical effect of acute superior mesenteric artery embolism.Methods Base on the retrospectively study of the clinical data of 10 patients with acute superior mesenteric artery embolism,all the patients were treated with routine blood test,D -dimer,abdominal ultrasound,abdominal CT examination.At the same time,partial selective superior mesenteric artery angiography was performed.Patients with definite or highly suspected of mesenteric artery embolism,such as no absolute surgical procedure, were treated by immediate surgical fixation.Superior mesenteric artery embolism was confirmed in the surgery.Then Operation was decided according to intestinal necrosis.Fogaty catheter removal was applied to the main trunk of the superior mesenteric artery.At the same time,such as the discovery of branches of vascular embolism,the therapy using direct injection of urokinase in local embolism was performed because of difficulty in embolectomy for narrow vessels. Then anticoagulation therapy was performed after surgery.Results Among them,1 case gave up treatment from the hospital,2 cases died of multiple organ failure after operation,and 7 cases recovered well after operation.Conclusion Early diagnosis of acute superior mesenteric artery embolization combined with early surgical treatment is the key to the treatment of acute superior mesenteric artery embolism.The cure rate can be significantly improved and the mortality rate can be reduced.Fogaty catheter was applied to treat acute superior mesenteric artery embolism with the therapy using direct injection of urokinase in local embolism has the characteristics of quick effect and curative effect.

Objective To observe the change of 18F-Fluorodeoxyglucose positron emission tomography-computed tomography (18F-FDG PET-CT) imaging on lung tumors after treatment of Argon-Helium (Ar-He) cryoablation,and to search the measure for evaluating the short-term curative effect after treatment of Ar-He cryoablation.Methods 19 focuses of 15 patients had completed the treatment of Ar-He cryoablation.All of patients imaged with 18F-FDG PET-CT in six months after Ar-He cryoablation.7 patients of all imaged with 18F-FDG PET-CT pre- and after Ar-He cryoablation.The others only imaged with 18F-FDG PET-CT after cryoablation,but these focuses could compare with tissues near the focus or other tumors in themselves.Results 18F-FDG PET-CT imaging found that there was no accumulation of radionuclide in 13 of 19 focuses after cryoablation and there was no new tumor in follow-up.Two target region of cryoablation,which grew up in mediastinum,were found radiation defect with distinct boundary and expanding outward during 4 months.The other 4 focuses recurred during 6 months in which there was accumulation of radionuclide after cryoablation.There was significant change about SUVmax of focuses after cryoablation by qualitative and quantitative analysis (t =3.784,P ＜0.05).But the changes of SUVmax had no significant difference in different time,between cryoablation and PET-CT imaging (F =0.106,P ＞0.05).Conclusion 18F-FDG PET-CT imaging really reveals the range and effect of Ar-He cryoablation.It is an optimal measure for evaluating the short term curative effect after Ar-He cryoablation.

Objective The effects of laparoscopic management of indirect ingunal hernia in adults were studied. Methods 17 patients with indirect inguinal hernia underwent laparoscopic high ligation of hernial sac and 12 patients with indirect inguinal hernia underwent traditional hernial repair between November 2000 to February 2002.The outcomes of two groups were compared retrospectively. Results Comparison between laparoscopic and open group showed that the operating time was (89 9?25 8)min vs(63 5?22 4)min( t =2 8612, P

Objective To explore the feasibility of repairing and strengthening the posterior wall of the inguinal canal with laparoscopic hernioplasty using autologous anterior abdominal wall tissues.Methods From January 2001 to September 2007,173 adult patients with inguinal hernia(141 cases of indirect hernia,28 cases of direct hernia,3 cases of femoral hernia,and 1 case of obturator hernia)were treated by laparoscopic hernioplasty with autologous tissues obtained from the median,internal,and lateral umbilical folds,and the U-shape fold.Three trocars were used to perform the laparoscopy by one surgeon,who completed the intracavity suturing using two hands.Results All the 173 operations were completed without converting to open surgery.Among the 152 cases of unilateral hernia,the mean operation time was 25 min(10-40 min),while in the 21 cases of bilateral hernia,the mean operation time was 40 min(20-60 min).Postoperative complications included retroperitoneal hematoma(1 case),scrotal swelling(3),testicular hydrocele(1),subcutaneous hemorrhage at the inguinal area(2),and scrotitis(1).The patients were followed up for 1-84 months(mean 35 months),during which 3 patients had recurrence.Conclusions Laparoscopic hernioplasty with autologous tissues is feasible and safe for adult patients with inquinal hernia with advantages of short hospitalization,minimal surgical trauma,quick recovery,and low rate of recurrence.

Objective To explore the effect of ω-3 fish oil on nutrition improvement and inflammatory reaction of patients with gastrointestinal tumor after operation.Methods 60 cases with gastrointestinal tumor were divided into control group(30 cases) and study group (30 cases),both groups were provided with parenteral nutrition treatment[ 104.6 kJ · kg-1 · d-1 ].Fish-oil fatty emulsion was given to the study group.The postoperative for the first day received half of the total energy and the total energy The remaining four days.Blood samples were gained on the morning of day 1,on the morning of day 3 and day 6 after operation respectively to measure albumin ( ALB),prealbumin (PA),total protein(TP),transferrin(TRF),the neutrophilic granulocyte count,lymphocyte count (TLC),serum C-reactive protein(CRP).Results Both groups of patients was comparable(all P ＜ 0.05 ).Both groups of patients was treated after five days of postoperative and ALB,TP,TRF were not significantly different.PA in both groups on day 6 was significantly increased,and the study group was higher than control group.there were statistical differences between them ( all P ＜ 0.05 ).The neutrophilic granulocyte count and CRP of both groups were significant reduced,and the study group was lower than control group.There were statistical differences between them( all P ＜0.05 ).Conclusion ω-3 fish oil on nutrition could improve nutritional quality and modulate inflammatory reaction of patients with gastrointestinal tumor after operation.

Objective To evaluate the dissection and hemostasis effects of harmonic scalpel in laparoscopic surgery. Methods The effect in patients underwent laparoscopic surgery with harmonic scalpel or with high frequency electricity scalpel was compared. Results All the operations were done by laparoscopy.No complications or massive blood loss occurred during and after operation.The average operation time ,blood loss of operation with harmonic scalpel were less than that with high frequency electricity scalpel. Conclusions Harmonic scalpel has precise cutting , controlled coagulation, and less tissue injury,it can increase the safety and microsurgery techinque of laparoscopic surgery.It is a very important equipmeat and useful for laparoscopic surgery .

Purpose To assess the feasibility of measuring maximal density of a region of interest (ROI) with contrast-enhanced CT in quantifying degrees of intestinal ischemia in patients with intestinal obstruction.Materials and Methods Abdominal CT images and reports of 160 patients with intestinal obstruction were retrospectively studied.All the data were reviewed by CT visual evaluation method and measuring maximal density of ROI respectively.The CT visual evaluation took the way of accumulated points,and divided the degrees of intestinal ischemia into five categories.The measuring maximal density of ROI quantified the degrees of bowel enhancement with a bar histogram on CT workstation.The results were compared with the pathological examination.The sensitivity,specificity,positive and negative predictive values and accuracy of the two methods were calculated respectively,and compared.Results The sensitivity,specificity,positive and negative predictive values and accuracy of CT visual evaluation method were 96.7％,72.9％,82.1％,94.4％ and 86.2％,respectively.The sensitivity,specificity,positive and negative predictive values and accuracy of the measuring maximal density of ROI were 68.8％,100.0％,100.0％,71.4％,82.5％,respectively.By measuring the area under the ROC curve,the ROI method (0.995) was more accurate than CT visual evaluation method (0.908) in the diagnosis of bowel ischemia.Conclusion Measuring the maximal density of ROI can quantize bowel wall enhancement.It is a reliable and useful method in the diagnosis of intestinal ischemia,and in accordance with pathological results.

This paper introduces a method for PET data backup and recovery by PC.

Objective To investigate the possibility of rolipram for treatment of spinal cord injury (SCI) in rats. Methods 30 adult female Sprague-Dawley rats were divided into sham-operation group (sham group, n=10), spinal cord injury group (SCI group, n=10) and rolipram treatment group (R group, n=10). The rats in SCI group and R group were modeled as spinal cord transection injury, and R group was administrated with rolipram subcutaneouly after SCI. They were assessed with Basso Beattie and Bresnahan (BBB) score 2, 4, 6, and 8 weeks after SCI, and the expressions of growth associated protein 43 (GAP-43) and glial fibrillary acidic protein (GFAP) were detected with immunohistochemistry 2 weeks after SCI. Results There were significant difference in the BBB scores between SCI and R groups 6 and 8 weeks after SCI (P<0.05). The expression of GAP-43 was more and GFAP was less in R group than in SCI group (P<0.05). Conclusion Rolipram can increase the expression of GAP-43 and inhibit the expression of GFAP, while improves the the motor function in rats after spinal cord transsection injury.

Objective To evaluate the role of P2X7 receptor in the ventrolateral periaqueductal gray (vlPAG) in tramadol-induced reduction of neuropathic pain (NP) in rats.Methods Fifty-four male clean-grade healthy Sprague-Dawley rats,aged 7 days,weighing 190-230 g,were studied.NP was induced by chronic constrictive injury (CCI) to sciatic nerve.Experiment Ⅰ Thirty-six rats were divided into 3 groups (n =12 each) using a random number table method:sham operation group (group S),group NP1 and NP plus tramadol group (group NP1 +T).Tramadol 15 mg/kg was intraperitoneally injected once a day from day 7 to day 14 after CCI in group NP1+T.The mechanical and thermal pain thresholds of the nerve-injured hindlimb were measured before CCI and on 1,5,7,10,12 and 14 days after CCI.Rats were sacrificed after measurement of pain threshold on day 14 after CCI,and the expression of P2X7 receptor in vlPAG was detected by immunohistochemistry and Western blot assay.Experiment Ⅱ Eighteen rats were divided into 3 groups (n =6 each) using a random number table method:group NP2,NP plus tramadol group (group NP2+T) and NP plus tramadol plus a specific P2X7 receptor antagonist A-438079 group (group NP2+T+A).In NP2+T+A group,a catheter was implanted in vlPAG,and the NP model was established on 5th day after successful catheterization.Tramadol 15 mg/kg was intraperitoneally injected once a day from day 7 to day 14 after CCI in group NP2+T.In group NP2+T+A,tramadol 15 mg/kg was intraperitoneally injected once a day from day 7 to day 14 after CCI,followed by a microinjection of A-438079 100 pmol (0.3 μl) via vlPAG before giving tramadol on day 14.The mechanical and thermal pain thresholds were measured at the end of the last tramadol administration and within 1 h after the end of the last tramadol administration.Results Experiment Ⅰ Compared with group S,the mechanical and thermal pain thresholds were significantly decreased at each time point after CCI,the number of P2X7 receptor positive cells was increased,and the expression of P2X7 receptor was up-regulated in the other two groups (P＜0.01).Compared with group NP1,the mechanical and thermal pain thresholds were significantly increased at days 7-14 after CCI,the number of P2X7 receptor positive cells was increased,and the expression of P2X7 receptor was up-regulated in group NP1 +T (P＜0.01).Experiment Ⅱ Compared with group NP2,the mechanical and thermal pain threshold were significantly increased at each time point after CCI in NP2+T and NP2 +T+A groups (P＜0.01).Compared with group NP2 +T,the mechanical and thermal pain thresholds were significantly decreased at each time point after CCI in group NP2+T+A (P＜ 0.01).Conclusion The mechanism by which tramadol mitigates NP is partially related to enhanced function of P2X7 receptors in vlPAG of rats.