Objective To explore the methods, safety and efficacy of laparoscopic splenectomy (LS) and pericardial devascularization. Methods Five patients underwent LS and pericardial devascularization from January to June 2003. Results All the operations were completed under laparoscope and no hand-assisted procedure was required. The operating time was 3.0～4.0 hours (mean, 3.5 hours) and the intraoperative blood loss was 250～450 ml (mean, 350 ml). No surgical complications occurred. Conclusions Laparoscopic splenectomy with pericardial devascularization is a feasible, effective, safe and minimally invasive procedure for patients with normal-sized to medium-enlarged spleen.

Objective To explore the application and efficacy of laparoscopic radical operation for rectal cancer after preoperative short-time radiotherapy.Methods The clinical data of 108 patients with Dukes B and C rectal cancer were analyzed retrospectively.Thirty-five patients underwent laparoscopic radical operation after preoperative short-time radiotherapy,meanwhile 30 patients underwent laparoscopic radical operation,and 43 patients underwent open operation,both later groups without preoperative radiotherapy.Results There were not significant differences in preoperative general condition,tumor size and stage,pathological type,site of operation,and mode of operation between the 3 groups.But there was a higher rate of radical resection and sphincter preservation in the laparoscopic operation plus radiotherapy group than in the other groups(P

Objective To study the inhibit effect of survivin short hairpin RNA on the survivin mRNA and protein expression of gallbladder carcinoma cells.Methods Human gallbladder carcinoma cells(GBC-SD) were transfected with recombinant plasmid.RT-PCR and Western blot were used to analyze the changes in(expression) levels of survivinmRNA and protein.Results The size of the PCR product was 350bp.DNA(sequencing) showed that the sequence of recombinant vector pshRNA-survivin was successfully constructed and suppressed the expression of(GBC-SD) survivinmRNA.Conclusions The recombinant plasmid constructed can inhibit the expression of survivinmRNA in transfected cells.This provides a new method and material for the biological therapy of cancer.

Objective To sum up our experiences for the diagnosis and treatment of visceral pseudoaneurysms. Methods This study included 14 patients admitted from 1990 to 2000, consisting of 6 hepatic, 5 splenic, 3 gastroduodenal aneurysms. Results Thirteen cases experienced a rupture. Five cases received emergent surgery, which was successful in 2, and fatal in one. Transcatheter embolization was used in 11 cases which was successful in all without complications and recurrence after an average follow up of 2 years. Conclusions Digital substraction angiography has diagnostic value for rupture of visceral pseudoaneurysms. Transcatheter embolization is an effective treatment for the majority of patients with visceral pseudoaneurysms.

Objective:To investigate the utilization and its influence factors of medical records in non-hospital staffs. Methods:Though the registration of the record copy and consult for non-hospital staffs from Sept.2002.to Aug.2006,the patients' personal information,case number,discharge date,utilization date,user persons,purpose and the copy contents,etc.were investigated.And the information was statistically analyzed by EXCEL.Results:51.55% of the utilization were for the medical insurance purpose.In which 54.61% of the total users were the patients themselves and 44.17% of which were the insurance organizations.Admission record was the most frequently copied item(22.79%) and record utilization was mostly occurred within one month after the discharge(35.08%).Conclusion:It should be emphasized that ①the medical staffs' legal consciousness be further wakened;②the management of medical records be strengthened;③the copy processes of the medical records be standardized;④the service be further improved.

Objective To evaluate the antitumor effect of SEB-scFv fusion Drotein on gastric cancer. Methods Typical changes of morphologic features and super-microstructure were observed when SEB-scFv fusion protein was used in SGC7901 cens;and the effects of SEB-scFv and its concentration on the cell growth were examined by methyltetrazolium(MTT)assay;DNA ladder and flow cytometry were employed respectively to detect the inhibition phenomenon or apoptosis.We produced a subcutaneous gastric tumor model in baby SD rats by implanting SGC7901 cells.The SEB and SEB-scFv were injeeted to the vena caudalis in the trial groups,and normal saline to the control group.The weight of the tumor and the survival were recorded after treatment. Results Cell inhibitory rate was increased along with increased concentration of SEB-scFv fusion protein.Electron microscopy revealed that the cell presented typical changes of apoptosis.FCM indicated that the apoptotic rate of SGC7901 cell lines significantly increased with increasing dose of SEB-scFv fusion protein,and agarose gel electrophoresis appeared marked DNA ladder.The average weight of tumor in the SEB-scFv group was lower than that in control groups(P＜0.05).The tumor inhibition rate was 61.3%,and the mean survival period of rats in SEB-scFv group was longer than that of other group(P＜0.05)with a survival prolongation rate of 54.6%. Conclusion The resuhs indicate that SEB-scFv fusion protein has an obvious antitumor effect on gastric cancer.

Objective The article was to analyze the payment structure of hospitalized urban employees receiving basic medi -cal insurance and the factors affecting the payment structure , resulting in measures to control the in-hospital fee of Medicare patients . Methods Statistical analysis was done on hospitalization expenses , expense composition and payment structure of hospitalized Medi-care patients in a first-class comprehensive hospital from 2002 to 2012 .The analysis of multiple stepwise regression were done on possi-ble influencing factors of hospitalization expenses and payment structure . Results With the adjustment of health policy , the propor-tion of medical insurance fund payment in the hospitalization expenses increased year by year , while the individual payment-scale re-duced accordingly .The hospitalization expenses and payment structure of Medicare patients were correlated with Medicare payment pol -icy, social demographic characteristics and clinical disease features . Conclusion By rational control on controllable factors , empha-sis on health care education , adjustment on Medicare payment policy and promotion on two way referral system , it is hopeful to realize the effective utilization of health resources , to achieve reasonable control on medical costs , and to reduce patients'economic burden .

Objective To explore the effect and clinical significance of expression of nuclear factor-?B((NF-?B)),ICAM-1 and COX-2 on the occurrence and metastasis of gastric carcinoma.Methods The(expression) of NF-?B,ICAM-1 and COX-2 in 142 patients with gastric carcinoma was examined by(immunohistochemical) SP technique.The adjacent gastric tissue(30 cases) served as a control group.Results The expression of NF-?B was 62.0% in gastric carcinoma tissue,much higher than that of the control group(P

Objective To evaluate the feasibility,safety and short-term outcome of laparoscopic-assisted surgery for colorectal cancer.Methods From August 2001 to November 2004,laparoscopic resection of colorectal carcinoma were performed in 112 cases,including right hemicolectomy(n=23),left himicolectomy(n=7),radical resection of sigmoid cancer(n=15),Dixon procedure(n=49),and Miles procedure(n=18).Results One hundred and five patients underwent laparoscopic resection successfully,7 cases were converted to open surgery because of hemorrhage,obesity or adhesion with adjacent organ,6 of which were left colon or rectal cancer.The mean operating time was(161.2?48.6)min,and the mean operative blood loss was 78.5 mL.There were 8 cases occurred postoperative complications,and no mortality during perioperative period.The length of upper and lower segment of resection for colonic cancer was (14.5?3.2)cm and(11.0?2.6)cm respectively.The length of upper and lower segment of resection for rectal cancer was(15.3?2.7)cm and(2.8?1.6)cm,respectively.The mean number of lymph nodes dissected was(8.2?4.6),and lymph node metastases were found in 49 cases.One hundred and seven cases(95.5%) were followed up for 8-44 months,of which,7 cases had local recurrence and 6 cases had distant metastases.No case of trocar port tumor implantation was observed.Conclusions Laparoscopic surgery for colorectal cancer is feasible and safe,can result in the same outcome as open radical surgery,and has the advantages of mini-invasive procedure.

Objective To analyze the relationship between polymorphisms of EDNRB gene and Hubei provincial patients of Han ethnicity with sporadic Hirschsprung disease(sHD). Methods Peripheral blood samples from 104 patients with sHD and 84 parents of 42 patients, and 120 normal children(as controls) were collected. PCR-SSCP and direct DNA sequencing were used to detect mutations and polymorphisms of exon-4 in EDNRB gene. The differences of allele frequencies and genotype distribution in polymorphic sites were further analyzed between the three groups. Allele frequencies of SNPs in forty-two sHD trios were analyzed by transmission disequilibrium test(TDT), and the association between phenotype of HD and SNPs was analyzed. Results No mutant site was detected and one polymorphic site of c831 G→A(L277L) was observed in Hubei provincial patients of Han ethnicity with sHD. The allele frequency of A(68% vs 53%) and genotype frequency of AA(49% vs 30%) were significantly higher in sHD group than that in control group(P