Objective To evaluate the feasibility and effect of the treatment of hematopathy by laparoscopy plus small incision splenectomy. Methods Dissection and separation of the ligaments of the spleen with laparoscopy first. And then made a small abdominal incision to ligate and divid the pedicle of spleen to finish splenectomy. Sixteen cases of idiopathic thrombocytopenic purpura(ITP) and 4 cases of heriditary spherocytosis(HS), who were treated by medication but no effect or recurrence, were treated by this procedure. Results All the patients recovered smoothly without infection of the wound ,without fluid collection in the spleen fossa,and without great intraoperative blood loss.The operating time was 1.5～2.5h(average 2.2h), intraoperative blood loss was 30～85ml(average 65ml).Hospital stay was 4～7d( average 6d). No recurrence was found during the follow-up for 0.5 to 2.5 years in this series. Conclusions Laparoscopy plus small incision splenectomy in the treatment of some hematopathy has many advantages,such as less trauma, safety, effective and quick recovery.

Objective To study the outcome of lost gallstones in peritoneal cavity. Methods Gallstones and bile collected from 51 patients undergoing laparoscopic cholecystectomy were analysed and cultured.One to three gallstones from each patient were placed into the peritoneal cavity of a corresponding Wistar rat on sterile condition. Results 8 rats died of peritoneal infection, intestinal fistula and ileus within one month. Abdominal wall abscess occured to one rat. All survival rats were sacrificed three months later. Pathologic results showed that the nidus of abscess appeared in tissue around the stone. Conclusions Lost gallstone is harmful to body. We should avoid gallstone lost in peritoneal cavity.

ObjectiveTo evaluate the feasibility of endoscopic thyroid adenoma excision. Methods Dogs were used to practice endoscopic thyroid surgery under anesthesia. On the basis of animal experiment, endoscopic technique was introduced into dissection of follicular nodule of the thyroid lobe. One male and 11 females, aging between 23～52, underwent endoscopic enucleation of thyroid tumors from March 2002 to October 2002. Results The procedure was successful in 11 cases with 1 case converted to open surgery. The average time of operation was 70*!min, and intraoperative blood loss was 5～20*!ml. The patients had minimal pain. The cosmetic result was excellent. The incisions were completely hidden even with open necked skirt. Conclusions The cosmetic result of endoscopic thyroidectomy is satisfactory.

ObjectiveTo evaluate the influence of laparoscopic operation on pH value, phagocytic function of neutrophil, immunoadhesion activity of RBC CR 1 (complement receptor typeⅠ) in abdominal cavity. Methods Determination of the pH value, phagocytic function of neutrophil, immunoadhesion of RBC CR 1 in abdominal exudatives during laparoscopic procedures was undertaken and results were compared with the relative indexes detected in peripheral vein blood. Results The average pH value was 7.41, the percentage of the phagocyte was 74.6%, phagocytic index 55.7, and immunoadhesion activity of RBC CR 1 was 58% in blood during laparoscopic operation. While the average pH value was 7.14, the percentage of the phagocyte 65.6%, phagocytic index 47.6,and immunoadhesion activity of RBC CR 1 50% in the abdominal exudatives. Conclusion Compared with the peripheral vein blood indexes, the intraabdominal pH value, phagocytic function of neutrophil and immunoadhesion activity of RBC CR 1 decreased significantly during laparoscopic operation. The intraabdominal inflammation may diffuse with the effect of CO 2 pneumoperitoneum when patients with serious inflammation receive laparoscopic operation.

Objective To evaluate the safety and feasibility of laparoscopic cholecystectomy(LC) in patients with cirrhosis,and compare the value of model for end-stage liver disease (MELD) score and Child-Pugh classification in predicting prognosis.Methods We reviewed the records of 55 laparoscopic cholecystectomies in cirrhotic patients in our department in the recent 11 years.Indications included symptomatic gallbladder disease,cholecystitis,cystic polyps and cystic adenoma.MELD score and Child-Pugh class were preoperatively calculated and associated with postoperative results.Data regarding patients and surgical outcome were retrospectively analyzed.Results No perioperative death occurred.Total cholecystectomy was employed in 53 patients and subtotal cholecystectomy in 2 patients.Median operative time was(77?5.1)min.Median intraoperative blood loss was(51.0?3.33)mL.Median hospital stay was(5.0?1.3)days.Postoperative complications occurred in 9.09% of the patients,including hemorrhage,intra-abdominal collections and wound complications,which were all controlled conservatively.The incidence of postoperative complications in Child A patients was 7.27%,in Child B was 10.0%;in MELD score below 14 was 2.44%,and in MELD score above 14 was 28.57%.The difference between rates of postoperative complications in patients with preoperative MELD score above 14 and below 14 was significant(P0.05).Conclusions Laparoscopic cholecystectomy is a safe procedure for selected cirrhotic patients,and with controllable complications.MELD score appears to predict morbidity more accurately than Child-Pugh classification system.

Objective: To investigate the shortterm efficiency of overflow fecal incontinence treated by biofeedback and electrical stimulating therapy. Methods: Twenty children with overflow fecal incontinence were given combined therapy, biofeedback and electricalstimulating therapy,for four weeks. Every therapy cost 20 to 30 minutes. The grading of clinical incontinence degree ,measurement of pressure of the anus and rectum, electromyogram of muscles of solum plevis were done before and after the therapy. Results: Followup was done for a mean of 4.5 years (range 3 to 5), the subjective scores, maximum contractive pressure of anus, last contractive time, rectal volume at sensory threshold, contraction amplitude of external anal sphincter and pudenda neural latency were significantly different from the ones before treatment (P

To study the changes of metabolites in rat urine after treatment of Aristolochia fangchi decoction by metabonomic method.

OBJECTIVECombined the blood biochemical markers, the renal histopathological changes and the metabonomics profile were investigated to study the toxicity differences between Aristolochia fangchi and Stephania tetrandra.

METHODTen rats were randomly selected from 70 male Wistar rats as blank control group. The remaining 60 rats were divided into three groups. The two treated groups were orally administrated by 8.1 g x kg(-1) of A. fangchi and S. tetrandra respectively and the control group by equal volume of distilled water for 4weeks. Before the administrated and every 2 weeks, urine and plasma were collected and their 1H-NMR spectra were acquired, and then subjected to data process and PCA. Blood biochemical analysis and histopathological examination were carried out.

RESULTOn the 2nd weekend, the BUN of the two treated groups, the AST of A. fangchi group were all markedly higher than that of the control group (P < 0.05). Compared with the A. fangchi group, the SCr higher in the S. tetrandra group (P < 0.05). The kidney pathological changes were apparently in the two treated groups and the pathological changes in the liver apparently in the S. tetrandra group. Along with the lasting of administration to the 4th week, the BUN, ALT and AST of the two treated groups, the SCr of A. fangchi group were all significantly higher than that of the control group (P < 0.01). The renal and liver injuries in the two treated groups were all become more seriously. Comparing the A. fangchi group, the BUN, SCr and AST were all higher in the S. tetrandra group (P < 0.05). Compared with control group, the urinary concentrations of citrate, 2-oxo-glutarate, taurine, hippurate, TMAO, creatine and the plasma concentrations of 3-D-hydroxybutyrate, acetone, NAC, OAC, creatinine were all changed.

CONCLUSIONThe A. fangchi and S. tetrandra all can induce the renal and liver lesion and its seriousness is correspondent to the lasting of administration. The liver and kidney toxicity of S. tetrandra are all more serious than the A. fangchi.

Animals ; Aristolochia ; chemistry ; Blood Chemical Analysis ; Drug-Related Side Effects and Adverse Reactions ; Drugs, Chinese Herbal ; administration & dosage ; adverse effects ; metabolism ; Kidney ; chemistry ; drug effects ; metabolism ; pathology ; Liver ; chemistry ; drug effects ; metabolism ; pathology ; Male ; Metabolomics ; Random Allocation ; Rats ; Rats, Wistar ; Stephania tetrandra ; chemistry ; Urine ; chemistry

Objective To explore the feasibility of hybrid procedure of percutaneous puncture for residual shunt after ventricular septal defect(VSD) repair.Methods From March 2015,we did percutaneous punctured transcatheter device closure of residual shunt after VSD repair for four patients.The patients included 2 males and 2 females with age from 4 years 9 months to 11 years 7 months and weight from 18 kg to44 kg.Four patients are diagnosed for4 years after VSD repair,3 years after tetralogy of Fallot (TOF),3 years after coarctation of aorta(CoA) combined with VSD,and 1 year after VSD repair,respectively.The withsize of residual shunt from 4.8 mm to 6.8 mm.Residual shunt are perimembranous,conoventricular and intracristal.Punctured directly through the right ventricular surface into the right ventricle in the 4-th or 5th intercostal space of the left sternal border.Next,extracted the guide wire after inserting a conveyor tube.Subsequently,7-10 mm VSD closure device were delivered via the conveyor tube.Results All the four operations were succeeded.A total of four closure devices were placed.Two of them are equilateral devices,and two are decentered devices,with size from 7mm to 9mm.Echocardiographyexamination revealed no significant pericardial effusion.Post-operative ultrasonic cardiogram showed the VSD closure device on site,with no pericardia1 effusion and no obvious morphological abnormalities of the valve.For one-year follow-up,the cardiac functionsof all patients were well.Conclusion Percutaneous punctured transcatheter device closure is a new,efficient and reliable method of treatment for children withresidual shunt after VSD repair.This method also can extend and offer a new avenue for valvular prosthesis and Perimembranous VSD.

Objective To explore the feasibility of percutaneous puncture for ventricular septal defect(VSD).Methods From March 2015,we did percutaneous punctured transcatheter device closure of VSD for 22 patients.The patients included 15 males and 7 females with age from 2 years 6 months to 11 years 7 months, weight from 13.5 kg to 44.0 kg.Among 22 pa-tients,6 were diagnosed with residual shunt after VSD repair, with size of residual shunt from 4.8 mm to 7.0 mm.Residual shunts are perimembranous, conoventricular and intracristal.The other 16 patients were diagnosed with isolated VSD,with de-fect size from 3.5 to 5.1 mm.For all patients,we punctured directly through the right ventricular surface into the right ventri-cle in the 3th or 4th intercostal space of the left sternal border.Next, we succeeded to extract the guide wire after inserting a conveyor tube for 21 patients.Subsequently,7-10 mm VSD closure device were delivered via the conveyor tube.Only one patient was changed to perform occlusion of VSD through chest small incision due to improper selection of punctured position. Results A total of 21 closure devices were placed for 21 patients.18 of them are equilateral device,and 3 are decentered de-vice,with size from 5 mm to 10 mm.There were small amount of pericardial effusion in 4 patients using TEE examination,and no future treat was performed after observation.For one-year follow-up, all patients have recovered very well.Conclusion Percutaneous punctured transcatheter device closure fits for treatment for children with residual shunt after VSD repair and isola-ted VSD.It has a good recent result.