Objective To explore the clinical value of laparoscopy combined with radionuclide imaging in the diagnosis and treatment of pediatric gastrointestinal hemorrhage, especially for Meckel’s diverticulum and double intestine. Methods ~ 99m Tc~-pertechnetate abdominal scintigraphy was performed in 22 children with a history of recurrent hemafecia or melena in this hospital from December 1998 to December 2005. All the children were given a laparoscopic exploration. Results Among the 22 patients, scintigraphy showed positive findings in 18 patients and negative, 4 patients. The positive patients were all confirmatively diagnosed by laparoscopic surgery and pathological examinations, including Meckel’s diverticulum in 14 patients and duplications of alimentary tract in 4 patients. In the other 4 patients with negative results, no organic pathologic changes was identified by laparoscopy in 3 patients and Meckel’s diverticulum was found after laparoscopic exploration in 1 patient. Conclusions Radionuclide imaging is an important method in the diagnosis of gastrointestinal tract hemorrhage in children and provides scientific basis for surgical intervention. The combination of laparoscopy and radionuclide imaging not only has values in the diagnosis and treatment of pediatric gastrointestinal hemorrhage, but also minimizes the blindness and trauma of exploratory laparotomy.

Objective To analyze the causes and preventions of the perioperative complications of micro-laparoscopic hernioplasty in infants and children with indirect inguinal hernia.Methods From January 1997 to January 2007,4500 infants or children with indirect inguinal hernia,including 702 cases who were complicated with hydrocele testis,were treated by micro-laparoscopic hernioplasty in our hospital.By laparoscopy,the endocycle was sutured circularly under the peritoneum using a self-designed needle.Then,only the peritoneum was ligated.Results No organ injury or complication occurred during the operation.The mean operation time was 9 min(5-13 min).Among the patients,4250 received a follow-up of 7-36 months(mean,25 months).Postoperative complications were found in 132 patients(3.1%),included scrotal gas in 10(0.24%),scrotal hydrocele in 16(0.38%),umbilical hernia in 27(0.64%),extraperitoneal emphysema in 20(0.47%),abdominal wall hematoma at the burr hole in 15(0.35%),foreign body sensation at the suture sites in 30(0.71%),scrotal hematoma in 8(0.19%),and iatrogenic cryptorchism in 6(0.14%).Thirty-five patients had recurrence(0.82%).Conclusions Micro-laparoscopic hernioplasty is a safe and reliable method for indirect inguinal hernia in infants and children.It is important to be familiar with the anatomy of the hernia under a laparoscope and to perform the operation carefully so that to avoid or decrease the perioperative complications.

Objective To evaluate the efficacy of mini-laparoscopic hernioplasty with Mesh strengthening in the treatment of hernia in adults. Methods We used mini-laparoscopic and self-decided needle-like instruments to perform 106 cases of Mesh replacement in addition to hernioplasty in treatment ot hernia in adults from January,1999 to Junuary,2001. Results Operation time ranged from 20min to 25min.Food-intake began in the operative day.No Complications occurred.The patient discharged 3d～4d after the operation.Following-up period lasting 5months to 2.5years showed no relapse occurred. Conclusions Mini-laparoscopic hernioplasty combined with Mesh strengthening is feasible in the treatment of hernia in adults.The method have the advantages ot mini-invasion,simple proccedures,shorter operation time and quicker recovery.

Objective To study a new operative procedure for hydrocele in children under mini-lapascope.Methods 103 children with hydrocele aged from 1 to 9 years old were performed by suture around internal rings under mini-laparoscope from November 2000 to March 2002. Results The operative time was (5～8) minutes and hospital stay (4～5) days. The incision didn't need suture and there was no obvious scar after operation. All cases were followed up at 1st month, 6th month and 1st year postoperatively. All cases recovered except for 2 cases recurred at 1st month postoperatively. Conclusions Suture around internal rings under mini-laparoscope is a minimally invasive and simple method for the treatment of hydrocele in children. It can find and deal with hidden patent internal rings.

Objective To evaluate the clinical significance of serum thrombospondin-1 (TSP-1) in systemic lupus erythematosus (SLE), and explore its possible involvement in SLE pathogenesis. Methods One hundred and thirty-eight patients diagnosed with SLE, including 124 cases of females and 14 males, as well as 60 healthy controls were recruited into this study. Enzyme-linked immunosorbent assay (ELISA) was used to determine serum TSP-1 expression level between the two groups. Spearman correlation analysis method was used to analyze the correlation between TSP-1 level of complement 3, complement 4, anti-double-stranded DNA, Rheumatoid factor and systemic lupus erythematosus disease activity index (SLEDAI). Results TSP-1 level in healthy control group was much higher than that in SLE patients. TSP-1 serum levels in SLE patients was positively correlated with complement 3 (r=0.386, P<0.01), complement 4 (r=0.301, P<0.01), and negatively correlated with anti-double-stranded DNA (r=-0.221, P=0.009), RF (r=-0.186, P=0.029) and SLEDAI (r=-0.273, P=0.001). Conclusion TSP-1 may play an immune-regulatory role in the development of SLE by inhibiting inflammation and autoantibody production. It could become a potential therapeutic target for the treatment of SLE.

Objective To evaluate the clinical value of Chinese Multi-Dimensional Health Assessment Questionnaire (MDHAQ-C) in patients with rheumatoid arthritis (RA). Methods From December 2015 to October 2016,four hundred and twelve RA patients were recruited in this study and completed the MDHAQ-C independently and routine assessment of patient index data 3 (RAPID3) was calculated. Then correlations were assessed by Spearman correlation coefficient of RAPID3 with indices of clinical relevance and disease activity to evaluate its clinical values. Results MDHAQ-C is moderately correlated with ESR (r=0.399), CRP (r=0.381), SJC (r=0.499), TJC (r=0.558) (P<0.01), but highly correlation with VAS of pain (r=0.836), VAS of global status (r=0.915) and overall assessment of physician (r=0.784)(P<0.01), and highly correlated with a Spearman's coefficient of 0.784 for DAS 28-ESR, 0.734 for CDAI and 0.682 for SDAI (P<0.001). Conclusion MDHAQ is a reliable, valid instrument for disease activity assessment and a feasible index for clinical settings in Chinese RA patients.