ObjectiveTo summarize the research advancement of peroxisome proliferator-activated receptor γ (PPARγ) agonists inhibiting transforming growth factor-β (TGF-β)-induced organ fibrosis. MethodsThe related literatures on PPARγ agonists inhibiting TGF-β-induced organ fibrosis were reviewed. ResultsTGF-β was a major fibrosispromoting cytokine, which could promote a variety of organ fibrosis. PPARγ agonists could effectively block TGFβ signal transduction, and then suppressed organ fibrosis well. ConclusionsThe main antifibrotic mechanism of PPARγ agonists is to inhibit TGF-β signal transduction. The studies on this mechanism will help promoting the clinical application of PPARγ agonists, and provide a new way of the treatment for organ fibrosis.
Objective To investigate the prevention and treatment strategy of bile duct injury (BDI) in laparoscopic cholecystectomy (LC). MethodsLatest progress was reviewed based on recent documents and the experience on BDI in LC in our department. ResultsWith the popularity of LC, BDI in LC is increasing. The reasons include illegibility and variability of local anatomy in gallbladder trigone,injury caused by galvanothermy, as well as operator’s overconfidence. In order to prevent BDI, we should apply more blunt dissection, not to use electrocogulation if possible and to study local anatomy and its variance clearly. The common bile duct and common hepatic duct should be clearly identified. Intraoperative cholangiography, laparoscopic ultrasonography and hepatobiliary scintigraphy are selections as necessary.The treatment of BDI depends on the type of BDI and its site and local condition.The treatment includes end to end anastomosis, repairing the defect, choledochoduodenostomy, RouxenY choledochojejunostomy and so on. T tube should be maintained in place for more than half a year after operation.Conclusion The key to improve the prognosis of BDI is prevention and treatment in proper time and in correct way.
【Abstract】Objective To analysis the clinical characteristics, pathogenesis, diagnosis and treatment of acute acalculous cholecystitis.Methods Seventy-nine cases of acute acalculous cholecystitis from January 1996 to January 2003 were retrospectively reviewed.Results Of those 79 cases, 13 cases were treated nonoperatively and 66 cases were treated operatively. Twentythree cases were suppurative, 43 cases were gangrenous with perforation in 18 cases，which were proved by postoperative pathology. Seventysix cases were cured and 3 cases were dead. Conclusion Keeping vigilant alert, observing dynamically as well as appropriate operative intervention are effective to improve the prognosis of acute acalculous cholecystitis.
目的 探索急性化脓性梗阻性胆管炎20世纪90年代后期与80年代以前的差异，探讨对本病治疗的方向。 方法 收集我院1996～2000年病例，并与我院1950～1981年资料进行比较。 结果 ①发病率显著降低，从46.08%降至15.62%； ②发病年龄延后10～20岁； ③入院时病情相对较轻，有休克者从51.39%降至22.80%； ④病死率明显下降，从25.78%降至3.50%； ⑤再手术患者显著增加，从12.12%增至55.20%。造成上述差异的原因与患者就诊早，及时的治疗，医务人员的水平提高，药品与医学的发展等有关。 结论 对急性梗阻性化脓性胆管炎患者，虽然发病率和死亡率已明显下降，仍需足够重视，因术后T管造影和B超检查发现肝内残石或胆管狭窄者，高达85.1%，复发再手术率达55.2%，远不能令人满意。为提高远期效果，应在急诊手术引流后，待患者病情平稳后，再进一步检查和彻底处理肝内病变。