Objective To probe into the serum blood platelet and turn into the plain(TPO) dependence that the blood platelet of level, liver cell function and periphery counts in purpose. Methods Among 106 cases of virus hepatitis patients in hsopital measuring, serum TPO level was carried on with ELISA. According to having blood platelet to reduce and divide into: A, B,C,D,E,F, G.H, group I. Results Between group A and group B,group C and group D,group E and group F,group G and group H,serum TPO level had significant differences(P

Objective To study the effect of PGE_1 injection on hepatorenal syndrome.Methods 64 patients with hepatorenal syndrome were divided into two groups at random,33 cases in treatment group and 31 cases in control group.On the basis of complex treatment of the contrast group were added PGE_1 of 200?g,dissolved at 10% glucose liquid 100ml,ivgtt,qd,the course of treatment is 2 weeks.Results The improvement which treated the liver function of the group was superior to the contrast group(P

Objective To investigate the relationship between serum HBV.M.alanine transaminase(ALT) and hepatic tissue pathology in patients with chronic hepatitis B.Methods The serum HBV.M.liver function in 133 patients with chronic hepatitis B were measured,and these patients underwent percutaneous liver biopsy by colour Echo.All these patients were divided into eight groups according to HBeAg and HBV DNA positive or negative,ALT normal or not.Hepatic necrosis inflammation grade and hepatic fibrosis stage in the groups were compared.Results Hepatic histology of all these patients showed inflammation and necrosis and different degree fibrosis.In serum ALT normal patients,liver biopsy still showed different degrees inflammation and hepatic fibrosis degrees partly,even showed hepatocirrhosis.In serum ALT abnormal and HBeAg negative patients with chronic hepatitis B patients,hepatic tissue inflammation and fibrosis degrees were more serious,hepatic tissue pathology was out of proportion to the degree of serum HBV reproduction.Conclusion Judgment of disease activity doesn't only depend on the serum transaminases and the degree of serum HBV DNA replication.When clinical choosing indication of antiviral therapy,value of liver biopsy should not be substituted.Liver biopsy in chronic hepatitis B should be regarded as main basis of judgment the hepatitis activity.It also should be regarded as main basis if antiviral therapy is conducted.

Objective To explore the significance of blood coagulation disorder in acute pancreatitis(AP) of the elderly and its treatment with prostaglandin E_1.Methods Prothrombin time(PT),partially activated thromboplastin time(APTT) and fibrinogen(FIB) in cases of AP with ages over 60 were checked and compared with those in groups of AP with ages under 60 and normal control subjects.10 cases of AP of the elderly with elevated FIB were treated with prostaglandin E_1.Results Compared with groups of AP with ages under 60 and the normal subjects,FIB was significantly higher in cases of AP of the elderly with the highest in patients of SAP.8 out of 10 aged AP patients with elevated FIB was successfully treated with prostaglandin E_1.Conclusion Patients of AP may present with blood coagulation disorders especially in aged patients.Aged patients with elevated fibrinogen may predispose to SAP.Prostaglandin E_1 may be effective in this occasion.

Objective To study the effect and value of the application of the median umbilical fold in laparoscopic treatment for indirect inguinal hernia in children.Methods A total of 105 cases of pediatric indirect inguinal hernia(including 32 cases of incarcerated hernia, 25 cases of bilateral hernia,and 6 cases of recurrent hernia after open surgery) was treated with laparoscopic high ligation of the hernia sac and repair with the median umbilical fold from January 2004 to August 2005.The operation was performed through two or three trocars.Under laparoscopic visualization,the internal ring was identified for a purse-string suture.Then the median umbilical fold was sutured on the internal ring to repair the defect.Results The operation was successfully performed under laparoscope in all the 105 cases.The operative time was 10~25 min(mean,15 min) for unilateral hernia and 20~35 min(mean,25 min) for bilateral hernia.The intraoperative blood loss was hardly seen.The length of hospital stay was 2~3 days.The postoperative recovery was uneventful,without intestinal adhesion,infection,or hematoma of the scrotum.Follow-up observations in the 105 cases for 5~24 months(mean,18 months) found no recurrence.Conclusions Laparoscopic high ligation of the hernia sac and repair with the median umbilical fold is safe and effect for pediatric indirect inguinal hernia,with advantages of mini-invasion,simple performance,short operation time,low complication rate,and quick recovery.

Objective To study the efficacy of laparoscopic pull through proctectomy for the treatment of rectal cancer. Methods There were 60 patients colonoscopically diagnosed as having rectal cancer (3~12 cm from the anal margin). Laparoscopic pull through proctectomy was performed. The distal tumor-free margin was about 2 cm. Results All the operations were performed successfully, without conversions to open surgery. The operating time was 89~179 min (120?25 min), the blood loss was 48~147 ml (75?26 ml), the length of hospital stay was 5~12 d (8.3?1.5 d), and the hospitalization expenditure was 8 680~15 800 yuan (9 900?750 yuan). Follow-up observations in the 60 patients for 12~25 months (mean, 22.3 months) showed no intraabdominal hemorrhage, anal stenosis, or intestinal leakage. Fecal incontinence was not seen at 2 postoperative month. One patient was found local recurrence after 12 months and underwent a second laparoscopic resection. Conclusions Laparoscopic pull through proctectomy for rectal cancer is safe, effective, and minimally invasive.

Objective To explore the efficacy of laparoscopic hepatectomy in combination with radiofrequency ablation and Iodine-125 brachytherapy in the treatment of hepatic carcinoma.Methods The study included 26 cases of hepatic carcinoma(left-sided,12 cases;right-sided,11 cases,both-sided,3 cases).There were 34 tumor lesions,with a maximum diameter of 2.8～13.0 cm.All the patients underwent laparoscopic hepatectomy in combination with radiofrequency ablation and Iodine-125 brachytherapy.Results The combination operation was successfully completed in all the cases,without conversions to open surgery.During the operation,2 new tumor lesions were founded by laparoscopic ulstrasound.Among the 36 lesions,only harmonic scalpel vaporization and Iodine-125 seeds implantation was performed in 8 cases of posterior right lobe lesions,and laparoscopic hepatectomy in combination with radiofrequency ablation and Iodine-125 seeds implantation was conducted in 28 cases of margin lesions.Follow-up checkups for 12～25 months(mean,22.3 months)showed a 1-year survival rate of 92.3%(24/26).Local tumor recurrence was seen in 3 out of 36 lesions.No severe complications occurred.Conclusions Combination of laparoscopic hepatectomy,radiofrequency ablation,and Iodine-125 brachytherapy for treating hepatic carcinoma is safe and minimally invasive,with a rapid recovery and a high survival rate.

Objective To study the feasibility of laparoscopic high ligation and median umbilical fold onlay for the treatment of adult inguinal hernia.Methods Laparoscopic high ligation and median umbilical fold onlay was performed in 35 cases of adult inguinal hernia(including 5 cases of incarcerated hernia,12 cases of bilateral hernia,and 8 cases of recurrent hernia)from Janaury 2003 to August 2005.Surgical outcomes ad follow-up records were compared with those from another 30 cases of inguinal hernia treated by conventional surgery.Results The laparoscopic operation was successfully performed in all the 35 cases.As compared with conventional surgery,laparoscopic operation presented a shorter operation time(20.8?8.8 min vs 53.5?12.6 min;t=-12.262,P=0.000)and postoperative hospital stay(5.5?1.8 d vs 8.5?1.9 d;t=-6.529,P=0.000).Edema of scrotum was not found in laparoscopic cases but occurred in 11 out of 30 conventional cases(36.7%;?2=15.448,P=0.000).Follow-up examinations for 18.6?8.9 months found 2 cases of recurrence after conventional surgery and no recurrence after laparoscopic operation(?2=0.691,P=0.406).Conclusions Laparoscopic high ligation and median umbilical fold onlay is safe and feasible in the treatment of adult inguinal hernia.

Objective To evaluate the efficacy and priority of laparoscopy in the diagnosis and treatment of acute peritonitis. Methods Clinical data of 133 cases of acute peritonitis diagnosed and treated under laparoscope between April 2001 and October 2004 were retrospectively reviewed. Results Of the 133 cases, there were 60 cases of gastroduodenal perforation, 15 cases of acute cholecystitis, 8 cases of gallbladder perforation, 2 cases of sigmoid colon perforation, 35 cases of acute perforated appendicitis, 3 cases of jejunal diverticulum perforation, 1 case of foramen of Winslow hernia, 4 cases of acute pancreatitis, and 5 cases of primary peritonitis. The diagnostic accuracy was 100%. All the patients were treated laparoscopically without complications. Conclusions Laparoscopy gives a high diagnostic accuracy for acute peritonitis. The rationale for the use of it lies in the possibility of avoiding time- consuming preoperative B-ultrasonography or CT scans and performing minimally invasive surgical interventions directly.

Objective To investigate the clinical feas ib ility of endoscopic resection of benign mammary tumors. Methods A total of 22 cases were detected as benign mammary tumors by molybdenum targe t X-ray examinations from March 2002 to August 2003, including 15 cases of fibro ma and 7 cases of cystoid adenoma. The tumor was 2~4 cm in diameter (mean, 2.8 c m). A two-port transaxillary endoscopic resection using the electrotome and harm onic scalpel was carried out. Results The resection was comple ted endoscopically in all the 22 cases. The operation time was 28~68 min (mean, 42 min). A drainage tube was maintained for 1 day. Except for 1 case of subcutan eous effusion, no skin necrosis and other complications happened. The patients r ecovered uneventfully and stayed in hospital for 2~4 d (mean, 3 d) postoperative ly. There were no scars on the breast. Conclusions Transaxilla ry endoscopic resection of benign mammary tumors is safe and feasible and gives good cosmetic results.