Objective To investigate the technical skill of hand-assisted gasless laparoscopic nephroureterectomy for patients with transitional cell carcinoma in renal pelvis. Methods 4 patients underwent hand-assisted gasless laparoscopic nephroureterectomy for transitional cell carcinoma in renal pelvis with homemade gasless laparoscopic device from July to November 2001. Results The average operative time was 170 minutes, and the average blood lose was 195 ml. No analgesic was prescribed postoperatively. The interval to resume normal oral intake 2 8 days. All patients had been followed up for 1 to 4 months, there was no tumor recurrence in bladder. Conclusions Hand-assisted gasless laparoscopic nephroureterectomy has the advantages of easy to learn, safer and faster to operate, less blood loss, less interference to cardiopulmonary system, as well as quicker postoperative recovery.

To furtherly reduce the subxiphoid port site pain,improve the cosmetic result and patient satisfaction,and increase the safety for patients underwent laparoscopic cholecystectomy by advanced laparoscopic knotting skill.Methods:Among our 1500 patients underwent laparoscopic cholecystectomy since 1991,120 cases of modified laparoscopic cholecystectomy (MLC) were performed with three 5-mm ports and one 10-mm port(for laparoscope and sepcien withdrawn).There were 25 male and 95 female patients with an average age of 55 years (24～77years).The indications for MLC included polypoid lesions of gallbladder (21),simple cholecystitis(3),cholecystolithiasisi with chronic cholecystitis(84),with acute suppurative cholecystitis(7),with atrophic cholecystitis(5).Results:There were 5 patients underwent combined laparoscopic appendectomy(3),fenestration of hepatic cyst(1),and drainge for liver abscess(1).The average operative time for MLC was 55 minutes(30～150min),blood loss was 10ml(3～50ml),and postoperative stay was 3 days(1～5days).There were no conversion from MLC to either LC or open surgery,without mortality.Complications were limited to two patients(1.7%).One was retained common bile duct stone and another was port site bleeding after operation.They were treated by transduodenal endoscopic stone retrieval and simple suture ligation,respecrtively.Conclusions:The advantages of MLC conducted mainly by advanced laparoscopic knotting techniques were no more laparoscope (either 2-mm or 5-mm)needed,no sacrifice of good illumination and laproscopic image.Most of all,its costeffective and operative safety were all improved furtherly.

Objective To observe the effect of clapping acupoint on hyperosteogeny of lumbar vertebra. Methods Ninety-eight cases were randomly divided into 65 cases treated by clapping Ashi point in treatment group and 33cases treated by simple acupuncture in control group.Results Among 65 cases in treatment group, 52 cases were cured and 13 cases were not cured; of 33 cases in control group, 19 cases were cured and 14 cases were not cured, and there had significant difference in cure rate between the two groups, x2 =5.51, P ＜0.05. Conclusion Treatment of hyperosteogeny by clapping acupoint was better than simple acupuncture therapy.

Objective To research the clinical safety and feasibility of self-made devices in gasless laparoscopic surgery. Methods A total of 5 generations of gasless laparoscopic devices (8 models) were designed and manufactured by ourselves from April 1993 to September 2004. After animal experiments, 15 types of different gasless laparoscopic operations were carried out in 87 patients. Results Out of the 87 cases, conversions to open surgery were required in 7 cases (conversion rate, 8.0%). The other 80 cases of gasless laparoscopic operations were successfully performed, involving cholecystectomy, colorectal resection, partial cecectomy, subtotal gastrectomy, inguinal herniorrhaphy, abdominal wall contraction, radical resection for carcinoma of renal pelvis, haital herniorrhaphy with Toupet’s fundoplication and total hysterectomy. Conclusions Our self-made gasless laparoscopic devices may be applied safely and effectively in clinical cases. Gasless laparoscopic surgery has been reflecting the complementary advantages of modern laparoscopic surgery and traditional open surgery. It is of supplementary significance in patients contraindicated to pneumoperitoneum and of distinctive importance for laparoscopic gastrointestinal surgery requiring abdominal fistulization or prolonged incision, as well as hand-assisted hepatobiliary or pancreatic laparoscopic surgery.

Objective To summarize the clinical experience of laparoscopic radical resection of colorectal carcinoma.Methods Clinical data of 13 cases of colorectal carcinoma treated by laparoscopic radical resection from November 2002 to April 2006 in this department were retrospectively analyzed.There were 10 cases of colon cancer(Duke's A,4 cases;Duke's B,6 cases) and 3 cases of rectal cancer(all Duke's A).Results According to the size of the tumor,the 13 patients were treated with either laparoscopic-assisted operation(10 cases) or hand-assisted laparoscopic surgery(3 cases).All the operations were performed successfully.No conversions to open surgery were needed and no mortality occurred.Follow-up checkups for 1~36 months(mean,17 months) showed no recurrence.Conclusions In patients with colorectal carcinoma,the selection of laparoscopic-assisted procedure or hand-assisted laparoscopic surgery can not only provide the operative safety and effectiveness,but also enable the operation minimally invasive.

Objective To investigate the value of laparoscopy combined with esophagogastroscopy in the treatment of achalasia of the cardia. Methods Twenty-five patients with achalasia of the cardia between October 2003 and April 2006 in this department underwent the HellerDor operation under laparoscopy combined with esophagogastroscopy.Results A1l the operations were successfully accomplished.The operating time was 60~240 min(mean,107 min) and the intraoperative blood loss,5~60 ml(mean,22 ml).Intraoperative mucosal perforation was encountered in 4 patients.All the patients got out of bed for activities at 8 hours after operation,with first passage of flatus,removal of the gastric tube,and liquid diet intake at 1~3 days after operation(mean,1.5 days).The esophageal manometry showed the lower esophageal sphincter(LES) pressure had decreased to normal levels at 7 days after operation.The 24-hour ambulatory pH studies showed a high reflex index in 3 patients,but without symptoms.Upper gastrointestinal barium swallow showed the dilated esophagus had a 8~26 mm(mean,18 mm) decrease in diameter at 8 days after operation.The length of postoperative hospitalization was 8~11 days(mean,8.5 days).Follow-up for 1~30 months(mean,5.4 months) in all the patients showed 23 patients were asymptomatic and 2 had intermittent dysphagia.Conclusions Heller-Dor operation under laparoscopy combined with esophagogastroscopy has advantages of precise positioning,little invasion,less pain,and good effects,increasing the quality of operation as well as decreasing the incidence of complications.

Objective To explore the clinical value of domestic harmonic scalpel in laparoscopic cholecystectomy. Methods Modified laparoscopic cholecystectomy (LC) was performed in 36 cases under general anesthesia. The operation was completed by using domestic USI harmonic scalpel in 21 cases (USI Group) and by using imported harmonic scalpel in 15 cases (GEN Group). Results The operation was laparoscopically accomplished in both of the groups, without conversions to open surgery. Of the USI Group, the operating time was 42.6?7.5 min, the postoperative drainage was 34.3?14.0 ml, the length of postoperative hospitalization was 4.9?0.9 d, the speed for cutting cystic duct was 335.1?180.3 ?m/s, the speed for cutting cystic artery was 524.2?127.8 ?m/s, and the denaturalization width of cystic duct was 2 047.6?376.3 ?m. Of the GEN Group, the operating time was 47.0?9.0 min, the postoperative drainage was 38.0?3.9 ml, the length of postoperative hospitalization was 4.3?0.9 d, the speed for cutting cystic duct was 403.5?120.1 ?m/s, the speed for cutting cystic artery was 513.5?125.9 ?m/s, and the denaturalization width of cystic duct was 2 266.7?306.3 ?m. There was no differences in these parameters between the two groups ( P

Based on the theory of topological structure within the syndrome of tradition Chinese medicine (TCM), the high order multiple dimensions and nonlinear structure of syndrome can be cracked. And the panorama of complex and changeable syndrome can be showed. The dynamic evolving law of sub-sets of syndromes and the changing rule of the main signs and symptoms with the secondary signs and symptoms can be interpreted. Therefore, the evolving law of sub-sets of syndromes and the accurate corresponding law of prescriptions and medicines can be realized. And the scientific connotation of dynamic evolving rule of syndrome can be revealed. Studying on the occurrence regularity of syndrome, the structure characterization of TCM syndrome can be carried out. And the mathematical structure-physical structure-biological structure can be revealed. Along with the mass new specific forms of syn-dromes to be cracked, the simulation data platform of therapeutic methods with prescriptions and medicines of syn-dromes can be built through the simulation technology of computer. Using the clinical data, through the literature of carding and contrast, the scientific connotation of judgment and diagnostic standard of syndromes can be interpreted. The distracting law of syndromes of diseases can also be revealed through the clinical data of syndrome-groups. And the theoretical basis for the formulation of judgments and diagnostic standard of syndromes of diseases which con-forming to the dynamic evolving law of syndromes can be provided. Evaluation on TCM efficacy can be carried, in order to make clear the curative effect evaluation index system of TCM syndrome in multiple dimensions and multi-ple levels for the promotion of the substantially improvement of syndrome differentiation level.

AIM:To design a signal collecting system of urethral internal pressure based on embedded microprocessor(ARM).METHODS:Based on ARM,the signal collecting module of urethral internal pressure and signal amplifier circuit were designed with sensor technology.The A/D transition circuit was improved by signal feedback theory to increase measurement accuracy.The software of sensor temperature drift was rectified by second linear interpolation so to enhance the accuracy of data collection.RESULTS:In simulated static urethral internal pressure collection,the signals of urethral internal pressure that sensor collected were corresponded with the location completely and send them into RAM of ARM for following analysis.CONCLUSION:The ARM-based signal collecting system of urethral internal pressure has simple circuit,reliability,lower power consumption,high precision and strong spot data analysis.

Objective To investigate the effects of radiofrequency thermocoagulation in relieving refractory pain of knee osteoarthritis in older patients.Methods A total of 18 patients with refractory pain of knee osteoarthritis were under treatment of radiofrequency thermocoagulation to denervation and compared to 20 patients with refractory pain of knee osteoarthritis which were under treatment of arthroscopy combined with compound betamethasone (control group).The Oxford knee score and visual analogue scale were used to evaluate the clinical effects before operation,at 1 week,4 weeks and 12 weeks after operation.Results There were significant decreases in both groups after operation than before operation(Foxford ＝4.12,3.98,FVAS ＝3.98,4.11,both P＜0.05),but there were no statistics differences between radiofrequency thermocoagulation group and control group at 1 week,4 weeks and 12 weeks after operation(toxford ＝ 1.215,1.426; tVAS＝1.319,1.123,0.867,P＞0.05).Conclusions The treatment of radiofrequency thermocoagulation is a minimally invasive method,which can relieve refractory pain of knee osteoarthritis in middle and older patients and recover knee function effectively.