Objective To discuss key techniques of laparoscopic resection of hydatid liver cysts. MethodsLaparoscopic resection of hydatid cysts was performed in 56 patients with hepatic echinococcosis.Under laparoscopic visualization,wicks with 3% dioxide hydrogen were routinely used for avoiding the contamination of the peritoneal cavity related with the spillage.A specially-designed puncture-aspiration cannula was employed to irrigate and evacuate all the contents of the cysts.Then the cysts were sterilized by the injection of 20% hypertonic saline solution.Afterwards,the residual cystic cavity was explored.Results The laparoscopic operation was successfully completed in all the 56 patients,without conversions to open surgery.The operation time was 45~150 min(mean,60 min).The intraoperative blood loss was 10~120 ml(mean,70 ml).No complications occurred.Follow-up observations for 1~12 years(mean,2 years and 6 months) in the 56 patients found no recurrence of hepatic echinococcosis.Conclusions Application of 3% dioxide hydrogen wicks for preventing the contamination,specially-designed puncture-aspiration cannula for irrigation,injection of 20% hypertonic saline solution for sterilization,and residual cystic cavity exploration are crucial to good surgical outcomes.

Objective To promote the understanding and diagnostic acuity of Hirayama disease by studying the features of electromyogram (EMG) and nerve conduction. Methods EMG was performed in 33 patients with Hirayama disease. Surface electrode was applied to examine the median nerve, cubital nerve, musculospiral nerve and part of the popliteal nerve, and the motor nerve conduction velocity (MCV), distal motor latency (DML) and the amplitude of compound muscle action potential (CMAP) were recorded. The sensory nerve conduction velocity (SCV) was also examined in the median nerve, cubital nerve and part of the sural nerve. Results The neurogenic abnormalities were detected in extremity muscles, with exception of brachioradial muscle, of upper limbs. In all the 33 patients damage was found on the illness-side and 97.0% on the contralateral side. One patient was found to have neurogenic abnormality of brachioradial muscle and 4 of proximal muscles, including 1 in whom muscle of lower limbs was involved. EMG abnormality rate of distal muscles (89.9%) was significantly higher than that of the proximal muscles of upper limbs (6.7%) and also muscles of lower limbs (1.7%). EMG also showed that there was delayed distal motor latency (DML) and decreased wave amplitude of compound muscle action potential (CMAP) in the nerves of upper limbs. statistically significant difference was found between the CMAP amplitude of affected limb (2.52?1.83mV) and the contralateral upper limb (9.82?3.57mV) by the detection of ulnar nerve conduction, while no difference and no nerve block were found between the DML of affected limb (4.25?1.33ms) and the contralateral upper limb (3.28?0.36ms). Conclusions Electrophysiological changes may be detected in some patients with subclinical Hirayama disease, of which the electrophysiological test is valuable in establishing early diagnosis.

The canine model to study inhalaton injury established in our lab was employed,and neutrophil NADPH oxidase activity,blood gas analysis,lung water volume,chest radiographs,and pulmonary histopathological changes were observed in the dogs after they were exposed to smoke inhalaton.It was found that carbon monoxide poisoning,hypoxemia,metabolic aci-dosisi respiratory alkalosis and lung damage developed rapidly and early after smoke inhalation;white blood cells disappeared from the circulation 5 minutes after injury onward;the activity of neutrophil NADPH oxidase increased gradually from the 30th minute to the 6th hour after injury,then decreased and approached to its preinjury level in the 12th hour after injury.It is postulated on the basis of the above findings that neutrophils would accumulate in the lungs after smoke inhalation and experince a "respiratory burst" characterized by the activation of NADPH oxidase and the production of large amounts of oxygen and other active oxygen radicals,which would play a significant role in the pathogenesis of acute lung damage in the early stage of smoke inhalation injury.

Objective To investigate the changes of diamine oxidase(DAO) and endotoxin(ET) during the treatment of systemic inflammatory response syndrome with human growth hormone and the relationship between human growth hormone and intestinal mucosal barrier injury. Methods One hundred and forty six patients with systemic inflammatory response syndrome were randomly divided into operative group and non operative group, which were again randomly divided into the study group and control group.Plasma concentration of DAO and ET were determined before the treatment and 1 week after the treatment.Results Plasma concentration of DAO and ET in study group decreased after treatment with significant difference ( P

Objective To evaluate the feasibility and safety of laparoscopic surgery in the treatment of acute pyogenic cholecystitis. Methods From January 2005 to May 2008,laparoscopic surgery was performed on 156 cases with acute pyogenic cholecystitis in our hospital. The clinical data of the patients were retrospectively reviewed. Four trocars were used for cholecystotomy. Major resection of the gallbladder or cholecystostomy was carried out if the anatomy of the Calot triangle was complex. Results Among the 156 operations,laparoscopic cholecystectomy was succeeded in 139 cases (89.1%); cholecystostomy was performed on 6 cases (3.8%); and 11 patients (7.1%) received laparoscopic subtotal cholecystectomy (LSC). None of the patients were converted to open surgery. The operation time ranged from 35 to 180 minutes with a mean of 75. Thirteen patients showed increased level of direct bilirubin and/or stones in the common bile duct (revealed by cholangiography during the bile duct dilation),and were cured by removing the stones under laparoscope and T tube drainage. The T tube was withdrawn in 2 months after cholangiography. Follow-up was available in all of the patients for 3 to 6 months. No jaundice,abdominal pain,fever or other complications occurred during the period. Conclusion Laparoscopic surgery is feasible,effective,and safe for acute pyogenic cholecystitis.

Objective To evaluate clinical effects of laparoscopic radical colectomy for colon carcinoma.Methods Laparoscopic radical colectomy were performed in 25 patients with carcinoma of colon,including 17 cases of laparoscopic-assisted radical colectomy,and 8 cases of laparoscopic radical colectomy.Results Operation time was 100-310 min,with an average of 195 min.The mean of intraoperative blood loss was 180 ml(range,100-350 ml).Time to first bowl movement was 1-4 days(mean,1.7 days).Postoperative pathological examination revealed no residual and infiltration of tumor cells in stump.Infection of incision wound occurred in 2 cases,with no bleeding,leakage and stenosis of anastomosis.The length of postoperative hospital stay was 6-10 days,with an average of 7.5 days.19 cases were followed up for 2-38 months(mean,13 months),which showed no tumor recurrence and port-site metastasis in 17 cases,2 cases died from extensive metastasis at 12 and 14 months postoperatively.Conclusions Laparoscopic radical colectomy has advantages of minimal invasion,safety,quicker recovery after operation,better radical curative results.

ObjectiveTo observe the protective effects of extract gingko biloba (EGb) on the myocardium mitochondria of diabetic rats.Methods40 Sprague-Dauley rats were divided randomly into the normal control group, diabetic group and EGb treatment group. The morphologic changes of myocardium mitochondria were studied by electron microscope, and the activities of succinate dehydrogenase (SDH), superoxide dismutase (SOD), nitric oxide synthase (NOS) and content of nitric oxide (NO), malondialdehyde (MDA) in the myocardium mitochondria were assayed by spectophotometer respectively.ResultsThe expansion of mitochondria, shorten of mitochondrial crest were observed under transmission electron microscope in diabetic rats. The activities of SOD and SDH decreased, but that of NOS and the content of NO increased in the diabetic group compared with control group. In EGb treatment group, the morphological change was slight, the activities of SOD and SDH were increased as well as NOS and the content of NO, MDA decreased compared with the diabetic group.ConclusionEGb can protect myocardium mitochondria of experimentally diabetic rats from lesion of free radical and excessive NO, and enhance the activity of SDH, protect myocardium of diabetic rat consequently.

Objective To study the protective effect of emodin on hepatic ischemia-reperfusion injury in the rat(liver). Methods Thirty Wistar rats were randomly devided into 3 groups:the sham-operatment group (Control group),the ischemia-reperfusion group (I/R group) and the emodin-treatment group (EMD group). By(clamping) the left and median lobes of the liver for 1 h and followed by 1 h of reperfusion,the(partial) (70%)(normothemic)(ischemia)-reperfusion injury model was established. The rats of emodin group received emodin [60mg/(kg?d)] by(oral) route for 3 days before ischemia. Blood and liver samples were obtained for(biochemical) and(histological) analysis 1 h after reperfusion. Some liver specimens were taken for flow cytometry(analysis) to assess the(mitochondrial)(membrane) potential (??m) . Rhodanmin123 and PI were used to label the cells.Results After reperfusion,(serum) levels of alanine transaminase(ALT) and liver contents of(malondialdehyde) (MDA) in the I/R group rats were increased significantly (P

Stage 4 of chronic kidney disease ( stage 4 CKD ) is induced by insufficiency of spleen and kidney , disorder of qi activity, poor circulation of blood and body fluid metabolic disorders. It is a disease due to the internal generation of dampness , turbid , stasis and toxin . Clinical observation has already demonstrated that in-sufficiency of spleen and kidney is the key pathogenesis and characteristics in stage 4 CKD . In this article , the necessity of regulating and nourishing spleen and kidney on stage 4 CKD was discussed from two aspects , which were the disease characteristics and the connotation of regulating and nourishing spleen and kidney . It provided brief and essential syndrome differentiation and treatment strategies in the clinical treatment of stage 4 CKD .

Chronic renal failure ( CRF ) , which is a progressive disease , is difficult to be reversed after the pathological damage was formed . Hence , a variety of integrated and complementary therapies should be used for the lifelong treatment and regulation . This article suggested that therapeutic methods should be given ac-cording to different stages of CRF in its development . Chinese medicine comprehensive therapy should be given to the early and middle stage chronic renal failure patients in order to delay the disease progression . In the uremia stage , replacement therapy should also be used as the basic treatment in order to reduce the general complications of dialysis or a kidney transplant , thereby improving the quality of life of patients . The integra-tion of Chinese medicine therapy on CRF are from three aspects , which are Chinese medicine decoction based on syndrome differentiation , Chinese medicine external therapy and Chinese medicine featured CRF management in order to receive better therapeutic effects .