目的：探討急性膽源性胰腺炎(ABP)手術時機和術式的選擇。方法：回顧性分析247例急性膽源性胰腺炎的臨床資料。 結果：非手術治療10例，死亡4例；12例急診手術后發生并發癥5例，死亡2例；169 例延期手術術后發生并發癥1例，治愈；56例擇期手術無并發癥發生。結論：以膽道梗阻為主的ABP應急診手術解除膽道梗阻；膽道無梗阻先采用非手術治療，胰腺炎控制后，再處理膽道病變。
目的:探討膽總管結石致急性梗阻性黃疸手術治療的效果。方法:回顧分析72例手術治療膽總管結石致急性梗阻性黃疸患者的臨床資料。結果:術后死亡3例。隨訪3~6年,效果優良者62例。3例膽總管T管引流術后3年復發肝膽管結石。結論:對該病的治療術前應盡量做全面輔助檢查,明確結石的部位及大小,膽管的形態及位置。根據病情確定手術時機和方式,對保證患者安全,減少術后并發癥,提高治愈率有重要意義。
Objective To investigate the role of AKT/FOXOs /atrogin-1/MuRF1 signaling pathway in skeletal muscle atrophy in rats with chronic obstructive pulmonary diseases( COPD) .Methods Passive cigarette smoking was used to establish COPD model. The protein expression of atrogin-1, MuRF1, FOXO-1, phosohorylated-AKT and total AKT were measured by Western blot. The mRNA expression of atrogin-1, MuRF1 and FOXO-1 were measured by reverse transcription-polymerase chain reaction( RT-PCR) . Results Compared with the control group, the mRNA expressions of atrogin-1, MuRF1 and FOXO-1 significantly increased in extensor digitorum longus ( EDL) of the COPD group (Plt;0.05 ) . Meanwhile the protein expression of atrogin-1 and MuRF1 significantly increased in the COPD group(Plt;0.05) , while the protein expression of FOXO-1 was not significantly different between two groups(Pgt;0.05) . In addition, , the protein expression of phosohorylated-AKTand the ratio of phosohorylated-AKT to total AKT significantly increased in EDL of the COPD group(Plt;0.05) . Conclusion The mRNA and protein expression of AKT/FOXOs/ atrogin-1 /MuRF1 in skeletal muscle are significantly increased in COPD rats, suggesting that AKT/FOXOs/ atrogin-1 /MuRF1 signalling pathway plays a crucial role in skeletal muscle atrophy of COPD.