Objective To exzaminate its efficacy of appendectomy with small incision and sum up its virtues ,indications and technologies.Methods To analysize the clinical datas of 118 patients admissioned in Hangzhou first people’s hospital from July in 2001 to Dec.2006 retrospectively. Results 113 cases cured ,2 cases complicated with incision infectionh ,2 with fat fludify,1 with chronic diarrhea for bacterium maladjustment,1 with appendicity cancer proved by pathology. Conclusions Appendectomy with small incision compared with traditional operation has little complications ,no serious pain ,intestinal function recovery rapidly ,hospital stay shorter and incision close up well.simple appendicitis and most of suppurate appendicitis may be prefer to conside.

Objective To sum up and investigate the experience in diagnosis and therapeutic procedure for Hashimoto's disease(HD).Methods Clinical datas of 57 patients who were diagnosed clinically as HD admitted to First People's Hospital of Hangzhou from Jan 1996 to Dec 2006 were collected and analyzed.Results 50 females and 7 males,aged 12 to 68 years(average of 43.6 years).Rate of male to female is 1∶14,HD was coexistent with 10.5%(6/5 7)of thyoidgland malignant tumor 19.3%(11/57)of adenoma,14.0%(8/57)of hyperthyroidism,21.1%(11/57)of other systemtic autoimmunity disease and 8.8%(5/57)other rare disease 33.3%(19/57)of them were performed raical operation.The misdiagnosis rate was 21.1%(12/57)and missed diagnosis rate was 22.8%(13/57),The clinical feature of HD for diagnosis and surgical management procedure have been discussed.Conclusions It is emphasized that patients who suspected highly of having HD should be examinated by comprehensive methods,including B-us,lightly color on scintillation scintigraphy,elevation of antimicrosomiauxi and antithyoglobuline,FNAB,operative exploration and biopsy would be helpful.We suggest that the diagnosis of HD may be taken some routinely comprehensive procedure.To date,consecutive therapy and occationly some patients when the disease in coexistence,who ought to be operated correspondingly.

Objective To observe the clinical results of abdominal cavity chemotherapy by tube for the patients with stomach cancer ascities.Methods Fourteen patients with advanced stomach cancer ascities were treated by combination of abdominal chemotherapy and intervention chemotherapy from June in 2001 to June in 2006.Results Four patients alleviated completely,6 partly alleviated,2 mildly alleviated,1 stability,1 in progress.The total effective rate is 85.7%.Conclusions Abdominal chemotherapy is simple,the curative effect is accurate,but should choose suitable belly cavity detain tube,taking strict precautions against slip of chemotherapeutic drugs,the period is tight to observe.the poisonous reaction is also observed and should be handled in time,support therapy should be strengthened.

OBJECTIVE:To establish a rapid determination method for gentaminin active components.METHODS:Scan-TLC procedure was applied.A mixture of methanol-chloroform-28%ammonium hydroxide(1∶1∶1)was taken as developing reagent and ninhydrin in a mixtrue solvent as reveal reagent.The detecting wavelength was500nm.RESULTS:The amounts of three components in gentamincin per spot were linear in the range of2?g～12?g(r 1 =0.9993、r 2 =0.9996、r 1a =0.9991).CONCLUSION:This scan-TLC technique is recommendable for determination of gentamincin components.

OBJECTIVE: To observe the protective effect of Hugan granules on the acute liver injury model mice. METHODS: Acute liver injury model was induced by intraperitoneal injection of 0.12% chloroform-peanut oil solution. The histopathological changes of the liver tissues were observed under microscope. The activities of ALT, AST and SOD and the content of MDA in the liver tissues were determined and the liver indexes were calculated. RESULTS: Hugan granules at high, medium and low doses could significantly lower serum ALT and AST activities, enhance the activity of SOD, and lower both MDA content and the liver index. CONCLUSION: Hugan granules have a certain protective effect on the acute liver injury.

Objective To investigate the causes and measurement of the colonic fistulas after severe acute pancreatitis(SAP),so as to increase its cure rate.Method A retrospective study was made on 19 SAP cases complicated with colonic fistulas after drainage operation in order to find out the risk factors,the location and the time of complicated colonic fistulas,and to sum up the experiences of earlier diagnosis and comprehensive treatment.Results Most patients occurred colonic fistulas within 4~6 weeks postoperation.Seventeen patients recovered,the cure rate being 89.5%(17/19),and two case died of serious systemtic infection and multiple organ systemtic failure.Conclusions Colonic fistulas complicated by SAP is related to anatomic factors,the degree of local inflammation,the way of draingic tube putted away,and improper surgical therapy.Comprehensive therapy including taking double cannula to drainage in active,earlier jejunostomy nutrition support or colostomy,supplementing with recombinant human growth hormone can lead to better results.

Objective Our aim is to compare the safety and benefits of laparoscopic versus open incision hernia repair.Methods Forty-seven patients in our hospital were analyzed with prospective randomized double-blind study following either laparoscopic or open hernia repair.And others prospective randomized studies(PRS)were analyzed.Results Overall complication rate was similar in both groups(8.5% versus 9.2% in the laparoscopic and open groups respectively),but some early complications in the laparoscopic group maybe require a reoperation.Operating time was similar in the laparoscopic group.There was shorter length of stay and higher expense in the laparoscopic group and there was significant difference in the pain scores and medications,resumption of diet,or activity scores.At 2 weeks,there was no difference in the activity or pain scores,but physical function and physical health scores on the short-form 36(SF36)quality of life assessment forms were little in the laparoscopic group.Regardless of the technique(P=0.158).The result of PRS meta-analyses is that operating time was simila in the laparoscopic group.There was longer length of stay in the Laparoscopic group.And the rate of wound infection is significantly higher in the open groups.Conclusion Unlike other minimally invasive procedures,Laparoscopic hernia repair did not offer an advantage over open hernia repair in all studied parameters except pain,activities and quality of life scores at 2 weeks.It also took similar to perform.The choice of the procedure should be based on surgeon or patient preference.

Objective To explore the preoperative misdiagnosis in the breast cancer and the methods to improve the diagnostic accordance rate. Methods The preoperative diagnosis and results of 358 cases with breast cancer has been analysized retrospectively in the recent ten years. Results Total Cases with present diagnostic technique diagnosed befor operation was 176 only;the accordance rate was less than 50%.With aspiration biopsy and molybdenum palladium roentgenograph,the rate was 25%(79 cases).The actual preoperative accordance rate was less than 10%(32 cases).It is said approximately 90% cases were postoperatively diagnosed. Conclusion The present excision biopsy not only has made many patients lost the chance of chemotherapy preoperation, but also interferenced the application of new therapic methods in the clinical practice.Infrared spectroscopy and ultrasonography have been commonly used in the clinical practice.With the low diagnostic accordance rate,they were applied only for screening.With simplity and high diagnostic accor dance rate,aspiration biopsy and molybdenum pall adium roentgenograph should be enrolled extensively in the clinical practice. The puncture and specimen fixing technique also should be improved.

Objective To find an effective operational approach that can mostly reduce heat and other injury to Calot's triangle when separating and anatomizing it at LC operation.Method We abandoned traditional hot separating method by electric coagulation hook which can cause hot injury easily and cold separating method simply by elastic separating plier which can cause errhysis and illegibility of operational field.We applied sucting and scraping cold separating method mainly by suction apparatus which can keep operational field clear and avoid hot injury.Result 52 cases with different cholecyst disease (including cholecystolithiasis,cholecyst polyp,acute cholecystitis with edema and acute cholecystitis with partly gangrene) were adopted by this method and achieved satisfacted effect.Conclusion Sucting and scraping cold separating method are easily operated and can mostly keep separated tube skeletonized.It can avoid hot and other injury in operation,keep operational field clear by less errhysis.To acute cholecystitis with edema it has more advantage and are worth to adopting.

The evaluation on clinical efficacy of traditional Tibetan medicine (TTM) is an important scientific subject during the development of TTM. Firstly, the authors introduced the current situations and problems in evaluation on clinical efficacy of traditional Tibetan medicine both at home and abroad in this study. Secondly, they compared the similarities and differences between TTM and traditional Chinese medicine (TCM) in evaluation on clinical efficacy, define their differences in details but not in nature, and proposed that TTM could selectively learn TCM's experiences in clinical research and build a specific methodology system for evaluation on clinical efficacy according to its own characteristics. Thirdly, they discussed the methodological challenges in evaluation on clinical efficacy of TTM, including the pending clinical research guidelines and disease diagnosis standards according to its own characteristics. Finally, they propound some suggestions for promoting the evaluation on clinical efficacy of TTM, including the comprehensive application of multiple research methods, overall research-based evaluation on efficacy of TTM complex intervention and selection of accepted and objective outcome indexes for efficacy evaluation.
Biomedical Research ; Clinical Trials as Topic ; Drug Evaluation ; methods ; standards ; Drugs, Chinese Herbal ; therapeutic use ; Humans ; Medicine, Tibetan Traditional ; Treatment Outcome