ObjectiveTo summarize the methods to prevent pulmonary complications in patients underwent abdominal surgery during perioperative period and provide reference for the prevention of postoperative pulmonary complications.MethodLiteratures on the prevention of pulmonary complications after abdominal surgery were searched and reviewed.ResultsThe prevention of pulmonary complications after abdominal surgery included preoperative measures, intraoperative measures, and postoperative measures. Preoperative measures included preoperative education, patient risk assessment, smoking cessation, and so on. Intraoperative measures included anesthetic measures and surgical measures. Postoperative measures included atomization treatment, elimination of bad feelings, early postoperative activities, and so on. In view of the different basic conditions of patients underwent abdominal surgery, the selection and emphasis of preventive measures were also different.ConclusionThe prevention of postoperative pulmonary complications after general abdominal surgery should not only take preventive measures in perioperative period, but also should carry out individual management according to the patient’s condition and general conditions.
ObjectiveTo summarize research progress of non-coding RNAs (ncRNAs) in acute pancreatitis (AP), so as to provide new ideas for pathogenesis, diagnosis, and therapy of AP.MethodThe literatures on studies of ncRNAs in AP in recent years were read and reviewed.ResultsThe incidence of AP was currently increasing, but its etiology was diverse, and its pathogenesis was still fully unclear. In recent years, a large number of studies had confirmed that the ncRNA played an important role in the occurrence of many cellulars and diseases processes. Through continuous exploration for potential mechanisms of AP based on ncRNA (including long non-coding RNA and microRNA) function, it was found that the specificity and sensitivity of ncRNAs in the diagnosis of AP were better than of the traditional biomarkers. Meanwhile, ncRNAs were involved in the regulation of inflammatory response through a variety of ways.ConclusionsncRNAs are involved in altering gene expression (including up-regulation or down-regulation) in the key physiological functions of AP through a variety of ways, it might provide new ideas for understanding pathogenesis of AP and help to find new therapeutic targets. A variety of ncRNAs closely related to AP are expected to become biomarkers and molecular targets for early diagnosis and treatment of AP, so as to achieve early diagnosis and targeted treatment of AP.
OBJECTIVE: To explore an effective method to repair the abdominal wall defect. METHODS: From July 1996 to December 2000, 7 cases with abdominal wall defect were repaired by pedicle graft of intestine seromuscular layer and skin graft, among them, intestinal fistula caused by previous injury during operation in 4 cases, abdominal wall defect caused by infection after primary fistulization of colon tumor in 2 cases, abdominal wall invaded by intestinal tumor in 1 case. Exploratory laparotomy was performed under general anesthesia, the infective and edematous tissue around abdominal wall defect was gotten rid off, and the pathologic intestine was removed. A segment of intestine with mesentery was intercepted, and the intestine along the longitudinal axis offside mesentery was cutted, the mucous layer of intestine was scraped. The intestine seromuscular layer was sutured to the margin of abdominal wall defect, and grafted by intermediate split thickness skin. RESULTS: The abdominal wall wound in 6 cases were healed by first intention, but part of grafted skin was necrosed, and it was healed by second skin graft. No intestinal anastomotic leakage was observed in all cases. Followed up 1 to 2 years, there were no abdominal hernia or abdominal internal hernia. All the cases could normally defecate. The nutriture of all cases were improved remarkably. CONCLUSION: Pedicle graft of intestine seromuscular layer is a reliable method to repair abdominal wall defect with low regional tension, abundant blood supply and high successful rate.
目的 探讨腹主动脉瘤破裂的诊断和治疗方法。方法 我院从1999年10月至2004年1月期间经手术治疗腹主动脉瘤破裂6例。结果 1例患者因术后失血性休克而死亡； 5例患者随访4年，1例术后2年死于心肌梗死，余4例存活。结论 腹主动脉瘤应早期诊断、早期治疗，一旦破裂应迅速诊断、急诊手术，手术时应注意阻断腹主动脉的方法以及防止术后下肢缺血。
Objective To explore the effect of artemisinin on the apoptosis of pancreas acinar cells in acute pancreatitis (AP), and to study whether artemisinin can relieve the severity of AP. Methods ① In vivo experiment: twenty one Wistar rats were divided into the following 3 groups randomly: the normal control group, the AP group and the artemisinin group. The model of AP was established by injecting cerulein into the peritoneal cavity of rat. After establishment of AP in the artemisinin group, artemisinin was injected into the peritoneal cavity. Meanwhile normal saline was injected into the peritoneal cavity of rats of the normal control group and the AP group. The apoptosis of pancreas acinar cell was detected by terminal deoxynucleotidyl transferase mediated nick end labeling (TUNEL). The activity of myeloperoxidase was detected by absorption spectrometry. ② In vitro experiment: the pancreas acinar cells of normal rats were isolated through twostep enzyme digestion, and cultured. These acinar cells were divided into 3 groups: the normal control group, the AP group and the artemisinin group. Then, the cells of AP group were cocultured with cerulein, and those of the artemisinin group were cocultured with cerulein and artemisinin. The apoptosis of pancreas acinar cells were detected by AO dyeing and the measurement of the activity of caspase3. And the activity of LDH and AMS in the culture medium of each group were measured. Results ① In vivo: the apoptosis index of the artemisinin group was sigificantly increased and the activity of myeloperoxidase was obviously decreased compared with the AP group (P＜0.05). ② In vitro: the apoptosis index and the activity of caspase3 of the artemisinin group were significantly increased compared with the AP group (P＜0.05); the activities of LDH and AMS of the artemisinin group were more decreased than those of the AP group (P＜0.05). Conclusion Artemisinin could contribute to the apoptosis of rat pancreas acinar cells, decrease the releasing of trypsogen, alleviate the activation of neutrophil and relieve the severity of AP.