Objective To compare the effect of laparoscopic appendectomy and laparotomy surgery in the treatment of chronic appendicitis .Methods According to the different operation mode , 148 patients with chronic appendicitis were divided into the laparoscopic operation group (62 cases) and abdominal operation group (86 cases). The operation time ,bleeding volume ,the first time of anal exhaust ,hospitalization time and postoperative complications were observed.The patients were followed up for 6 months to 2 years,the postoperative abdominal adhesion and pain were observed .Results The bleeding volume ,the first time of anal exhaust ,hospital stay and hospitalization expenses in the laparoscopic operation group were significantly less than those in the abdominal operation group ( t=3.307, 2.682,2.703,2.830,all P<0.05).The operation time of the two groups had no statistical difference (t=0.506,P>0.05).After surgery,the number of patients with abdominal abscess ,intestinal obstruction,infection of incision had no statistically significant differences between the two groups (χ2 =1.132,1.305,1.287,all P>0.05).The number of patients with chronic pain in laparoscopic operation group was 6 (10.2%),which was significantly less than that in the control group (19 cases,22.6%) (χ2 =3.956,P<0.05).Conclusion The laparoscopic appendectomy has small trauma,quick recovery,that can be widely explored during resection of abdominal adhesion ,with low incidence rate of postoperative chronic pain ,better therapeutic effect .

Objective To investigate production of interleukine 6 (IL 6) and interleukine 8 (IL 8) by retinal pigment epithelial (RPE) cells and its inhibition by interleukine 1 receptor antigonist(IL 1ra). Methods Cultured human RPE cells was treated with interleukine 1 ? (IL 1?, 10 ng/ml) and/or IL 1ra ( IL 1ra, 1、10、100 ng/ml). IL 6 and IL 8 mRNA and protein expression were detected by ELISA, immunohistochemistry and in situ hybridization (ISH) assay. Results IL 6 and IL 8 in conditioned media of RPE cells in controls was 2 000 pg/ml and 5 000 pg/ml respectively after stimulation of IL 1? for 8 h. IL 1ra (100 ng/ml) significantly inhibited IL 6 (300 pg/ml, t=8.011, P

ObjectiveTo study the risk factors of renal artery pseudoaneurysm (RAP) following partial nephrectomy.MethodsOpen partial nephrectomy was performed on a total of 464 cases of renal cell cancer from July 2003 to May 2010. Five patients ( 1.1％ ) had postoperative hemorrhage from RAP.The surgery technique of the open partial nephrectomy, the clinical presentation, imaging findings and treatment of RAP were reviewed. The anatomical characteristics of these five renal tumors on enhanced CT were quantified using the R.E.N.A.L. Nephrometry Score System.ResultsAll five cases were male, two had tumors on the left side and three on the right side. Median tumor size was 3.6 cm ( range from 2.5 to 5 cm; Radius score 1 - 2). Four tumors were exophytic of these, three had a major endophytic component (≥50％) deep in the parenchyma (Exophytic/endophytic score 2 ), one was entirely endophytic (score 3 ). The distance of all the tumors to the collecting system was ≤4 mm ( Nearness score 3 ). Four of the five tumors were across the polar line and/or renal axial midline ( Location score 3 ). The other tumor was located under the lower pole ( Location score 1 ) but close to the renal hilar. All patients presented with delayed gross haematuria and decreasing hemoglobin occurred on mean postoperative day 12 (3 -23 day). Four patients complained of flank pain, two of which had signs of hypovolemia requiring blood transfusion. The diagnosis was confirmed by the contrast medium-enhanced CT and selective angiography, and RAP was found most commonly arising from the segmental branch of renal artery. Superselective microcoil angioembolization was successfully performed in four cases, once in three cases and twice in the remaining case. The procedure failed in one patient and a nephrectomy was done. At a mean follow-up of 21 months (12 -30) , all patients had normal renal function without evidence of recurrence.ConclusionsRAP should be considered in all patients who had delayed hematuria after partial nephrectomy. A central, deep tumor and its relationship to the segmental branch of renal artery could be an important risk factor for this complication. Choosing the case properly for partial nephrectomy and suturing the transected vessels and the defect of parenchymal correctly could reduce occurrence of this serious complication. Early use of selective angioembolization could be a primary choice of treatment.