Objective To study the preoperative nursing care in excision of adrenal tumor by using laparoscope. Methods 72 patients with adrenal tumor have undergone the excision of adrenal tumor by using laparoscope in our hospital. Preoperative nursing included mental care, cardiac and pulmonary function assessement, pharmacotherapy, gastrointestinal and skin preparation. Postoperative monitoring the condition of all the patients, and given oxygen uptake to prevent hypercarbonemia. All the patients were encouraged to do functional recovery early and were guided to diet properly. Results All patients were successful obtained the excision of adrenal tumor by using laparoscope except two were reversed to open surgery. The patients could take food and leave bed in the first post-operative day. The mean post-operative stay was 6 days. Hydrothorax occurred in 2 cases and fat liquidation and wound infection occurred in 2 cases. There were no major complications such as hemorrhage and hypercarbonemia occurred. Conclusion The excision of adrenal tumor by using laparoscope is safe and reliable. Sufficient preoperative preparation, careful post-operative monitoring and timely using counter-measure are the key points in nursing care.

Objective To explore the regulating mechanism of bcl 2 gene in hepatocyte injury caused by obstructive jaundice in rats. Methods Normal rats' and bile duct ligated 7d,14d,21d rats' hepatocytes were isolated by in situ collagenase perfusion and primary culture. (1) bcl 2 mRNA was detected by RT PCR in all cells; (2) After normal rat and bile duct ligated 14d rat hepatocytes were added 100?M GCDC and kept for 24hrs, cells were evaluated by FCM and TUNEL. Results (1) Normal rat hepatocytes did not express bcl 2 by RT PCR technique. bcl 2 was expressed in 7-,14-,21-day BDL rats. (2) After adding 100?M GCDC and keeping for 24hrs, the apoptosis of bile duct ligated rat hepatocytes significantly decreased compared with that of normal rat hepatocytes. Conclusions (1) Bile duct ligated rat hepatocytes expressed bcl 2. (2) Hepatocellular expression of bcl 2 during obstructive jaundice is an adaptive phenomenon to resist apoptosis by bile salts.

Gallbladder cancer is the most common malignant neoplasm in biliary system,with a high degrade of malignancy,invasion and metastasis.The prognosis is heartbreaking.Radical surgery is the only possible way for curing.The current understanding of China's doctors at all levels on radical surgery of gallbladder cancer is chaotic.Based on the latest version eighth TNM staging of the American Joint Committee on Cancer(AJCC)of gallbladder cancer,making a review of the literature,combined with the author's personal experience,we have interpreted the reasonable selection of hepatectomy of gallbladder cancer,in order to improve the doctors at all levels to regulate the understanding of hepatectomy and the prognosis of gallbladder cancer.

Objective To investigate clinical value of the emergency endoscopic sclerotherapy and tissue adhesives embolization on patients with gastroesophageal varices bleeding. Methods A retrospective analysis of 52 cases of esophageal variceal bleeding in patients with clinical data was performed. Of which,22 patients were given conservative treatment alone and they were served as conservative treatment group. Another 30 patients were given the emergency endoscopic sclerotherapy and/ or tissue adhesive embolization besides the basis of conservative treatment,and they served as endoscopic treatment group. The data of hospitalization and mortality,rebleeding rates were recorded during hospitalized time and 1 year off hospitalization. Results The indices of hospitalized periods in endoscopic treatment group was( 16. 2 ± 1. 5)d,shorter than that in conservative treatment group((17. 6 ± 2. 1)d,P = 0. 53). The mortality and rebleeding rate in endoscopic treatment group in followed up periods were 3. 3% and 6. 6%,lower than those in conservative treatment group (9. 1%,13. 6%),and the comparison of relative risk RR of two groups of mortality and rebleeding rate were 2. 76 and 2. 06. Conclusion The therapy of emergency endoscopic sclerotherapy and tissue adhesives embolization of bleeding esophageal varices shows a good effect and it is worth recommending.

OBJECTIVE:To establish a method for simultaneous contents determination of schizandrin,schizandrin B and cin-namaldehyde in Xiaoqinglong granule. METHODS:HPLC was performed on the column of Wondasil-C18 with the mobile phase of acetonitrile-0.1% phosphoric acid solution(gradient elution)at the flow rate of 1.0 ml/min,the detection wavelength was 245 nm, temperature was 25 ℃ and volume was 20 μl. RESULTS:The linear range was 1.008-20.16 μg/ml(r=0.999 8) for schizandrin, 0.496-9.92μg/ml(r=0.999 7)for schizandrin B,and 1.012-20.24μg/ml(r=0.999 6)for cinnamaldehyde;RSDs of precision,sta-bility and reproducibility tests were no more than 1.33%;the average recoveries were respectively 98.9%(RSD=1.71%,n=6), 99.9%(RSD=1.50%,n=6) and 98.7%(RSD=2.10%,n=6). CONCLUSIONS:The method is simple,accurate and reproduc-ible,and can be used for the quality control of Xiaoqinglong granule.

Objective To report our experience of nephron sparing surgery (NSS) with mini-incision approach.Methods Sixty-one mini-incision NSS were analyzed retrospectively from 2005 to 2011 in our department.Demographic and clinical data,complications,histologic and oncologic data were analyzed.There were 35 males and 26 females with average age of 41 years.B ultrasound and CT scan were performed in all cases and MR was performed in 23 cases.CT angiography was performed in 10 cases.Renal cell cancer was diagnosed in 38 cases,angiomyolipoma in 14 cases,complicated renal cyst or duplicated kidney in 6 cases and no definite diagnosis in 3 cases.All the lesions were single with 21 in the right side and 40 in the left side.The average diameter of the lesions was 3.2 (2.3-8.8) cm.The mini-flank supra-12th rib incision was performed in all cases.The renal artery was clamped with bulldog clamp,all transected blood vessels on the renal incisal surface were sutured with 3-0 Vicryl sutures,and collecting system was closed with continuous' 3-0 Vicryl suture.Results The average length of incision was 8.1 (6.5-11.0) cm.The average operative time was 93 (70-140) min.The average warm ischemia time was 19 (12-32) min.The average blood loss was 72 (20-300) ml and the average hospital stay was 6 (5-15) d.The delayed hemorrhage was occurred in 1 patient who was treated with conservative treatment.Clear cell carcinoma was found in 28 cases,chromophobe carcinoma was found in 6 cases,papillary carcinoma was found in 5 cases,angiomyolipoma was found in 16 cases,complicated cyst was found in 3 cases and renal duplication was found in 3 cases.Fortyfive patients were followed up from 28 to 82 months with no delayed complication and no recurrence or metastasis in 35 malignant cases.Conclusions The approach of mini-incision NSS can duplicate the procedure of traditional open NSS.This approach can also couple the benefits of both laparoscopic and open NSS techniques with a smaller incision which can be used to remove the specimen.

Objective To assess the clinical efficacy of patient controlled intravenous analgesia (PCIA) with mixture of fentanyl and droperidol for post-prostatectomy pain. Methods 104 patients undergone prostatectomy were randomly divided into two groups. In group A, the patients received PCIA.In group B, they received routine analgesia.The pain scores of visual analogue pain scale (VAS) and control of bladder spasm were recorded at various time postoperatively, and the time of continuous infusion of bladder, the time of indwelling catheter and the mean hospitalization time were also recorded. Results Compared with those of group B,the VAS,continuous time and ratio of bladder spasm decreased markedly in group A ( P

Objective To compare oligoneucleotide arrays with sequence specific primer polymerase chain reaction (PCR-SSP) for HLA-DR genotyping in order to develop a new technique of genotyping for donors and recipients in kidney transplantation. Methods Sixty DNA samples of donors and recipients were subjected to HLA-DR typing by oligoneucleotide arrays and PCR-SSP simultaneously. The results of the two typing techniques were analyzed.Results Of 60 samples using the two above-mentioned typing techniques, the results in 56 samples were identical with the accordance rate being 93 %, and in the remaining 4 unidentified samples verified by the other laboratory, oligoneucleotide arrays made 1 allele miss typing for 2 samples , 1 allele mistaking for 1 and PCR-SSP made 1 allele miss typing for 1 sample. Among the total, 20 samples retyping was made and its reproduction rate was 96 %. Conclusion The oligoneucleotide arrays technique for HLA genotyping has advantage of high sensitivity, high efficiency, high level standard and it is incomparable.

Objective To evaluate the effects of continuous pulmonary artery Perfusion with hypothermic oxygenated blood on lung function in children with congenital heart defects (CHD) and pulmonary hypertension(PH). Methods 20 patients diagnosed with CHD and PH were divided into group 1( perfused with oxygenated blood) and group 2 (conventional CPB). A canula was inserted into the main pulmonary artery for the perfusion with a rate of 15～30 ml?kg -1 ?min -1 . CPB was established as usual. The data of two groups including the oxygen concentration, airway pressure, blood gas analysis were recorded. At fixed times, blood sample was taken out for the measurement of the sICAM-1 and MDA. Results The concentration of sICAM-1 and MDA in group 1 was much lower than that in group 2 on 12 and 24 hours after surgery. Issues of the lung function including OI?A-aDOa_2 and airway pressure was significantly different between the two groups. Conclusion The study showed that the continuous pulmonary perfusion with oxygenated blood could preserve lung function in patients with CHD and PH.

Objective To establish a method of HPLC gradient elution method determination of Notoginsenoside R1, Ginsenoside Rg1 and Rb1 in Naodesheng Capsules. Methods Kromasil C18 column was used with a mobile phase of acetonitrile-water gradient elution, column temperature at 25 ℃. Results Notoginsenoside R1, Ginsenoside Rb1 and Ginsenoside Rg1 showed good linear relationship at the range of 0.495～1.782 ?g (r =0.9999), 2.65～9.54 ?g (r =0.9995), 1.85～6.66 ?g (r =0.9999), respectively. The average recovery:Notoginsenoside R1 was 100.60% (RSD=1.99%), Ginsenoside Rb1 was 100.86% (RSD=2.19%) and Ginsenoside Rg1 was 98.83% (RSD=1.95%), respectively. Conclusion The methods is simple, accurate, highly sensitive and reproducible. It can be used for the quantitative determination of Notoginsenoside R1, Ginsenoside Rg1 and Rb1 in Naodesheng Capsules.