Objective To explore the effects of ulinastatin (UTI) on renal apoptosis and expression of bcl-2 in rats with severe acute pancreatitis (SAP). Methods Sixty rats weighing 250-300 g were randomized divided into 3 groups: pseudo-operation group (SO group, n=20), SAP group (n=20) and UTI treated group (UTI group, n=20). The model of SAP was established by retrograde injection of 5% sodium taurocholate solution into the biliopancreatic duct in the rats. Serum Cr and BUN were determined. The left kidneys were resected for light and electronic microscopic study. Renal cell apoptosis was determined by TUNEL. Expression of bcl-2 was detected by immunohistochemical staining of SABC. Results Serum Cr, BUN, renal cell apoptotic index and bcl-2 expression were markedly increased in SAP group compared with SO group （P＜0.05， P＜0.01）, Renal tissue injuries were aggravated in SAP group under light and electronic microscopic study as well. In UTI group, serum Cr, BUN and renal cell apoptotic index were decreased significantly while the expression of bcl-2 increased remarkably and renal tissue injuries relieved compared with SAP group （P＜0.05）. Positive correlations were found between the renal cell apoptotic index and BUN as well as Cr (r=0.807, P＜0.05; r=0.812, P＜0.05). Conclusion The protective effect of UTI on SAP renal injury is probably through increasing bcl-2 expression and decreasing apoptosis.
目的探讨阑尾切除术后腹腔引流放置与否对切口感染的影响。方法回顾性分析1 719例阑尾手术的引流情况和切口感染情况。结果引流组切口感染率为50.93%，未引流组为3.17%(Plt;0.005)。其中单纯性阑尾炎引流组感染率为33.33%，未引流组为1.66%； 化脓性阑尾炎引流组感染率为46.43%，未引流组为3.12%； 坏疽性阑尾炎引流组感染率为56.25%，未引流组为20.00%； 穿孔性阑尾炎引流组感染率为54.95%，未引流组为23.08%。结论无论何种类型阑尾炎，术后放置腹腔内引流均可能增加切口感染。
目的 探讨腹腔镜胆囊切除术(LC)术中中转开腹的原因，评估LC术前难易的程度及如何减少LC手术并发症。 方法 回顾性分析广州市解放军第421医院1998年10月至2008年6月期间实施1 200例LC中38例中转开腹患者的临床资料。结果 LC术中中转开腹发生率为3.16%，其原因包括胆囊周围严重粘连，近期急性发作，Calot三角严重充血水肿，解剖不清，术中无法控制出血，胆总管损伤。 结论 胆囊周围粘连严重，近期急性发作，应慎重选择LC。掌握好中转开腹的时机及处理方法，是降低LC手术并发症的有效措施。