New strategies of laparoscopic cholecystectomy from left upper abdomen under massive adhesion of right upper abdomen / 中国内镜杂志

Objective Seen from the laparoscope, there is massive adhesion after the peritonitis, an operation with a large incision or radiation treatment in right upper abdomen. After failing to dissociate the adhesion and create e-nough space with the help of laparoscope, the laparoscopic cholecystectomy from the left upper abdomen is adopted depending on the specific situation to explore the possibility and practicability of creating instrument channel and operating space. Methods From May 2001 to May 2015, 13 patients (with a medical history of peritonitis, an opera-tion with a large incision, serious peritonitis or radiation treatment in right upper abdomen) were received operations of laparoscopic cholecystectomy, adhesion was serious near the trauma or otherwise. During the operation, massive adhesion was found in the right upper abdomen. The conventional LC did not work. Instrument channel and operat-ing space were created from the left upper abdomen through facies inferior hepatis and falciform ligament. LC cost 70 minutes to 155 minutes with an average of 117 minutes. Results LC of 13 patients (with a massive adhesion) from left upper abdomen was successful. In this way, it was easy to create instrument channel and operating space and avoid the massive adhesion. The operations took a longer time without injuring stomach intestines and bile vessel. Conclusion Acquired adhesion's peculiarity is negative correlation with distance, LC from the left upper abdomen through facies inferior hepatis and falciform ligament can be avoided the disassociation of massive adhesion and be created the instrument channel and operating space. The two ways are proved to be effective.

A Clinical Study onBushen Gujing Recipe in Treating Early Diabetic Nephropathy with Yin-Yang Deficiency Syndrome / 中国中医药信息杂志

Objective To investigate the effects ofBushen Gujing Recipe in treating early diabetic nephropathy (DN).Methods Sixty patients of early DN with Yin-Yang deficiency syndrome were randomly divided into treatment group and control group, 30 cases in each group. The control group was treated with conventional western medicine treatment, and the treatment group was treated withBushen Gujing Recipe combined with the conventional therapy. The treatment course was three months. The clinical efficacy, integral of TCM syndrome, and urinary albumin excretion rate (UAER) of the two groups were compared.Results After the treatment, the integral of TCM symdrome of the treatment group was lower than control group, showed a statistically significant difference (P<0.05). The total effective rates of clinical efficacy were 81.48% (22/27) in treatment group, and 64.00% (16/25) in control group. The therapeutic effect of treatment group was better than control group (P<0.05). UAER showed a statistically significant difference between two groups (P<0.05).Conclusion Based on the western medicine treatment,Bushen Gujing Recipe can improve the symptoms of patients, alleviate the injury of kidney, and has good efficacy on DN.