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From April 2000 to June 2002, 512 cases of laparoscopical urologic operation have been performed through transperitoneal and retroperitoneal or extraperitoneal approach: 41 cases of nephrectomy, 36 cases of radical nephrectomy, 10 cases of nephroureterectomy with cystoscopic en bloc excision of the distal ureter and bladder cuff, 3 cases of partial nephrectomy, 78 cases of partial adrenalectomy or resection of adenomas, 71 cases of total adrenalectomy, 17 cases of ureterolithotomy, 122 cases of decortication of renal cyst, 1 case of Anderson-Hynes dismembered pyeloplasty, 7 cases of renal pedical lymphatics disconnection, 2 cases of relative living donor nephrectomy.

本课题通过对223例肾疾病、149例肾上腺疾病、17例输尿管结石病人进行腹腔镜及后腹腔镜手术,其中肾囊肿去顶术140例、单纯肾切除术41例、根治性肾切除术36例、肾输尿管全切及输尿管口膀胱袖套状切除术10例、后腹腔镜肾部分切除术3例、Anderson-Hynes肾盂成形术1例、肾蒂淋巴管离断术7例、腹腔镜和后腹腔镜活体亲属供肾切取术各1例、肾上腺部分或单纯肿瘤切除术78例、肾上腺全部切除术71例、输尿管切开取石术17例。记录手术时间、手术中失血量、肠道功能恢复时间及并发症,将结果与传统开放手术和国外学者的腹腔镜手术结果进行比较,对数据进行统计分析。

Methods: Between November 2003 and December 2005, 67 patients with renal cell carcinoma underwent retroperitoneal laparoscopic radical nephrectomy (34 patients, group A) and open radical nephrectomy (33 patients, group B). Operating time, blond loss, amount of postoperative drainage, time to ambulation, recovery of intestinal function after operation, the postoperative hospital stay, use of antalgesic and transfusion blood and plasma were compared between group A and group B, retrospectively. Results: In group A, the operations of 31 patients were successful and 3 cases failed, then conversed to open surgery. Firstly, one case were not decented the prerenal fascia and the other two cases occurred complications, one case was due to injurying genital gland vein, with blood loss of 500m1, another fatty renal capsula was too thick to explose the renal pedicle. The operations of group B were all successful, only one case was died of intracerebral hemorrhage after two monthes.

回顾性分析和比较后腹腔镜肾癌根治性切除术(Retroperitoneal laparoscopic radical nephrectomy, RLRN)34例与开放性肾癌根治性切除术(Open radical nephrectomy, ORN)33例,比较两种方法的手术时间、术中出血、术后引流、术后最早下床活动时间、肠功能恢复情况、术后住院时间、术后镇痛剂使用量、术中术后输血、血浆量、术后随访时间及手术效果结果:A组中1例因最初对解剖结构难于辨认,无法分离肾前筋膜至肾门而改行开放手术,1例因损伤精索静脉出血难以控制而改行开放手术,1例因肾周脂肪过多,无法将肾脏掀起显露肾蒂而行开放手术,31例手术成功。B组手术均获成功,1例术后2个月因大面积脑出血死亡,余均无瘤生存。

Results 155 patients had surgical site infections in total 1 589 patients undergoing general surgery and the infection rate was 9.75%. The infection rates were hightest in those undergoing celiotomy or colon surgery. 56 patients appeared with postdischarge surgical site infection, accounting for 36.13% in the whole infection public. Most postdischarge surgical site infection happened in class Ⅰ and class Ⅱ surgery. Albumin and hemoglobin abnormity, emergency surgery, bleeding, incision type and eduction were risk factors of surgical site infection by multivariate Logistic regression analysis.

结果 1 589例次手术患者中,155例次手术部位发生感染,感染率为9.75%;不同手术类别相同危险指数的手术以剖腹探查手术和结肠手术感染发生最高;有56例患者在出院后发生手术部位感染,随访感染占总感染例数的36.13%,随访感染以Ⅰ、Ⅱ类手术为主;经单因素及多因素Logistic回归分析得出,白蛋白及血红蛋白值异常、急诊手术、失血、切口类型、引流为手术部位感染的危险因素。

In the May issue of Harper's Bazaar, the quote-unquote singer, whose third album is coming out this fall, finally addresses the nose job and plastic surgery rumors, as well as the criticism that she's copping Jessica's style, and also dispenses advice for troubled stars like Britney Spears .

在五月的问题,哈珀的集市,报价-引文歌手,他们的第三张专辑,是走出来,今年秋天,终于解决了就业和鼻子整容手术的传言,以及作为的批评,她的柯平洁西卡的作风,和分配的意见,也为困扰的星级一样, Britney Spears的。

In the 6 years since the publication of the first volume of Recent Advances in Endourology by the Japanese Society of Endourology and ESWL, data on long-term oncological or functional outcomes have been collected in several related fields, and advances in surgical techniques and improved instrumentation have led to further development of such complex surgery as laparoscopic partial nephrectomy and radical prostatectomy.

泌尿生殖的癌(在Endourology方面的新近的发展)的Endourological 管理从Endourology 和ESWL的日本社会的在Endourology方面的新近的发展的第一个量的出版起在6 年,在长期的oncological或者功能的结果上的数据已经被在几个有关的领域收集,在外科技术内前进并且改进器械操作导致象腹腔镜检查部分的肾切除术和基本的prostatectomy这样的复杂手术的更进一步发展。

(1)Bullae of lung ruptured spontaneous pneumothorax is the best indication for VATS,which has the advantages of less trauma and ache,short operation time,quick recovery and small incision;(2)Recurrent unilateral spontaneous pneumothorax with contineous air leakage of 7 days after closed thoracic drainage,bilateral spontaneous pneumothorax should be treated by VATS;(3)Spontaneous pneumothorax with pleura adhesion can be treated by pneumonolysis and bullae of lung excision under thoracoscopy assisted small incision operation.

疗效满意。结论:(1)肺大泡破裂自发性气胸是胸腔镜手术最佳的适应证,与传统开胸手术相比,胸腔镜手术具有患者创伤小,手术时间短,术后疼痛轻,康复快,符合美容要求等特点;(2)反复发作的单侧自发性气胸,行胸腔闭式引流术后持续漏气7d,双侧自发性气胸,不论是否同时发作都可考虑胸腔镜手术治疗;(3)自发性气胸并胸膜粘连可用胸腔镜辅助小切口行粘连松解肺大泡切除术;(4)为减少一次性材料的消耗,降低手术成本,可辅助小切口使用常规胸科手术器械完成手术;(5)为减少术后复发率需行胸膜固定术。

It can prevent growth of fibroblast and formation of fibrin bundles. So it can prevent postsurgical adhesions effectively.

本品可用于多种手术中,防止或减少术后组织粘连的形成,如妇产科手术、普通外科手术、骨科手术、神经外科手术、肿瘤手术、各种腹腔镜手术等。

"The issue of whether access to interventional facilities affects clinical outcomes in patients admitted with acute coronary syndrome is under scrutiny," write Frans Van de Werf, from University Hospital Gasthuisberg in Leuven, Belgium, and colleagues, from the Global Registry of Acute Coronary Events Investigators."A positive association between the availability of a catheterisation laboratory and improved outcomes would argue for a change in the routing of patients with acute coronary syndrome from the nearest community hospital to a regional specialised tertiary care hospital with immediate access to a catheterisation laboratory (similar to the handling of acute trauma cases)."

比利时鲁汶Gasthuisberg大学医院Frans Van de Werf医师,与其来自全球急性冠状动脉疾病注册试验试验的同事们表示,有关于介入性机构的取得,是否会影响因急性冠状动脉疾病住院病患的后果,一直以来都是个密切观察的课题;心导管设施的可获得性与改善病患后果之间的关系,将对是否应该将急性冠状动脉疾病病患从最近的社区医院,转到具有可以立即进入心导管室进行手术的区域三级照护医院(类似处理急性创伤的情况)的改变引发争议。

"The issue of whether access to interventional facilities affects clinical outcomes in patients admitted with acute coronary syndrome is under scrutiny," write Frans Van de Werf, from University Hospital Gasthuisberg in Leuven, Belgium, and colleagues, from the Global Registry of Acute Coronary Events Investigators."A positive association between the availability of a catheterisation laboratory and improved outcomes would argue for a change in the routing of patients with acute coronary syndrome from the nearest community hospital to a regional specialised tertiary care hospital with immediate access to a catheterisation laboratory (similar to the handling of acute trauma cases)."

比利时鲁汶Gasthuisberg大学医院Frans Van de Werf医师,与其来自全球急性冠状动脉疾病注册试验试验的同事们表示,有关於介入性机构的取得,是否会影响因急性冠状动脉疾病住院病患的后果,一直以来都是个密切观察的课题;心导管设施的可获得性与改善病患后果之间的关系,将对是否应该将急性冠状动脉疾病病患从最近的社区医院,转到具有可以立即进入心导管室进行手术的区域三级照护医院(类似处理急性创伤的情况)的改变引发争议。

It seems to me that once eyesight goes under weaponry's scalpel It can see through human flesh Seems to me that desire pushes the world from behind It never misses a beat Seems to me the word "thrill" gets lashed by a storm Before it reaches climax Seems to me that to a starving person The world is divided into edibles and non-edibles Seems to me our life-force gets dominated by smooth breathing And coughing is definitely an insurrection Seems to me the wealth accumulated by old men Is a frozen lake for springtimes to skate on Seems to me the thriftiest folks end up treating others to envy Seems to me once you make the mirror's acquaintance, it has you dressing up for a lifetime Seems to me the person furthest ahead is not there to enjoy the view He would rather turn and watch the scene behind Seems to me two rows of teeth are nature's way of proving collective strength Which is why individuals lean toward organizations Seems to me it would take nothing more than a power blackout To unseat the 21st Century from history's stage It seems to me Peace is the minimal quest of our animal nature But the spiritual realm is filled with traps of ideals And so It seems to me the speed of bullets is most persuasive In this world, no other kind of civilization works quicker

我以为被军火做过手术的视力能把血肉看穿我以为欲望在后面不停地推动世界一次也不会落空我以为快感这个词甚至能让我在被风暴的强暴中达到高潮我以为对饥饿者来讲世界只有食品与非食品之分我以为生命一直被平顺的呼吸垄断咳嗽绝对是一种反动我以为只要老男人积累了厚厚的财富就为春天们提供了可以滑冰的湖面我以为再节省的人也免不了使用嫉妒请客我以为一旦认识了镜子就要为其打扮终身我以为最前面的人不是观赏前面的景点而是为了回头欣赏后面的风光我以为天生的两排牙证明了集体的强悍这就是个人要靠拢组织的理由我以为一旦停电就马上能让二十一世纪下台我还以为和平是动物性的人类最起码的追求精神世界则充满了更多理想的陷阱所以我以为子弹的速度最有说服力这世界还没有比它更快的文明

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