Clinical analysis of 64 cases of closed abdominal trauma / 中国基层医药

Objective To investigate the clinical diagnosis and treatment of blunt abdominal trauma(BAT).Methods The clinical data of 64 patients with BAT were retrospectively analyzed.Results 49 patients treated by surgery were cured and 12 cases treated by non-surgery were cured.3 patients died,two of them died for multi-organ dysfunction and one of them died for brain trauma.Conclusion Because the BAT is severe and complicate,so it shoald be diagnosed and treated as soon so possible.

A combination of laparoscopy and choledochoscopy in the management of choledocholithiasis / 中华普通外科杂志

Objective To evaluate the clinical applications and surgical methods of combined laparoscopic common bile duct (CBD) exploration with choledochoscopy. Methods From 2006 to 2009,clinical data of 42 patients with choledocholithiasis undergoing laparoscopic common bile duct exploration were retrospectively analyzed. We applied a step-by-step electric coagulating incision technique on the CBD,the step-by-step suturing technique, and the step-by-step clamping technique with alligator forceps, and soft tube irrigating technique with suctioning by selecting the proper exploration route, improving the common bile duct incision technique and calculus removing techniques. Results Procedures were successful in all the cases. There was no conversions to open surgery, no postoperative bleeding and no operative mortality. The mean operating time was 120 minutes (ranging, 90 to 150 minutes) with minimal intraoperative blood loss ( ranging, 20 to 40 ml). Ductal stone clearance was successful in 41 out of 42 patients ( 93% ). The largest number of the common bile duct stones was 16. With the diameter of stones larger than 15 mm in 18 cases in which the biggest was 30 mm. Bile leak developed in 1 patient, retained stones found in 3 patients,including intrahepatic cholelithiasis in one case. As a result, 38 out of 42 patients underwent common bile duct exploration. 35 patients were placed on T-tubes. Four patients underwent cystic duct exploration in which 3 had primary suture of the cystic duct and 1 had drainage. There was no infection and stenosis of biliary tract in the 42 followed-up cases. Conclusions Laparoscopic common bile duct exploration with stone extraction can be performed with high efficiency, minimal morbidity and without mortality. Improving the way of operation and selecting suitable exploration can result in better clinical outcomes.

The Value of Trunk Retraining Hemiplegia / 中国康复理论与实践

@#The motor function of the trunk in 10 hemiplegic patlents was evaluated with Biodex Sys- tem Ⅱisokinetic testing aparatus. The result shows that the strength of flexors and extensors of the trunk,especially the flexors,becomes weaker(The ratio of flexors to extensors is less than 1).The patients weretreated with a series of the trunk retraining methods. The motor function of the trunk was improved aftertreatment(P<0.01 ).The total motor function(Fugl-Meyer Assessing Scale)also makes significant progress(P<0.01).The study proposes that the retraining and regaining of the trunk motor function in hemiplegiais quite important not only to the trunk but also to total motor function.