目的：探讨急性胆源性胰腺炎(ABP)手术时机和术式的选择。方法：回顾性分析247例急性胆源性胰腺炎的临床资料。 结果：非手术治疗10例，死亡4例；12例急诊手术后发生并发症5例，死亡2例；169 例延期手术术后发生并发症1例，治愈；56例择期手术无并发症发生。结论：以胆道梗阻为主的ABP应急诊手术解除胆道梗阻；胆道无梗阻先采用非手术治疗，胰腺炎控制后，再处理胆道病变。
目的:探讨胆总管结石致急性梗阻性黄疸手术治疗的效果。方法:回顾分析72例手术治疗胆总管结石致急性梗阻性黄疸患者的临床资料。结果:术后死亡3例。随访3~6年,效果优良者62例。3例胆总管T管引流术后3年复发肝胆管结石。结论:对该病的治疗术前应尽量做全面辅助检查,明确结石的部位及大小,胆管的形态及位置。根据病情确定手术时机和方式,对保证患者安全,减少术后并发症,提高治愈率有重要意义。
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.