Objective To probe the change of the structure and function of the small bowel by injection of different drugs (verapamil, energy compounds or normal saline) via the superior mesenteric artery (SMA) injections.Methods The model of the small intestine ischemia/reperfusion (I/R) injury was made in grey rabbits. Free calcium concentration in mitochondria of the small intestine was determined, and the ultrastructural change was also observed by electron microscopy at the very time of occlusion, 60 minutes after occlusion and 30 minutes after reperfusion. Results The free calcium concentration in mitochondria was more declined in verapamil group (2.976±0.410 nmol/mg.prot) than in N.S. group (4.234±0.542 nmol/mg.prot), Ｐ＜0.01, at 60 minutes after occlusion. At 30 minutes after reperfusion, free calcium concentration in mitochondria was more decreased in energy compunds group (2.401±0.323 nmol/mg.prot) and verapamil group (3.847±0.610 nmol/mg.prot) than in the N.S. group (5.981±1.031 nmol/mg.prot). Conclusion Verapamil and energy compouds have protective effects on the functions and ultrastructures of the I/R of small intestine.
目的评价应用疝环充填式无张力疝修补术治疗腹股沟嵌顿疝并发小肠坏死的手术效果。方法对于我院2001年5月至2009年5月期间收治的21例腹股沟嵌顿疝并发小肠坏死患者应用疝环充填式无张力疝修补术给予一期修补，先行坏死肠管切除，后置入网塞。结果无手术死亡病例，1例患者发生切口感染，经换药后治愈。平均住院时间65 d。全部患者随访6个月至8年，平均51个月，未见复发。结论 疝环充填式无张力疝修补具有创伤小、安全及患者恢复快的优点，对于腹股沟嵌顿疝并发小肠坏死可以行一期修补，临床效果满意。
Objective To investigate the effect of porcine small intestinal submucosa extracellular matrix (PSISM) on the vitality and gene regulation of hepatocyte so as to lay the experimental foundation for the application of PSISM in liver tissue engineering. Methods The experiment was divided into two parts: ① BRL cells were cultured with 50, 100, and 200 μg/mL PSISM-medium which were prepared by adding PSISM into the H-DMEM-medium containing 10%FBS in groups A1, B1, and C1, and simple H-DMEM-medium served as a control (group D1); ② BRL cells were seeded on 1%, 2%, and 3% PSISM hydrogel which were prepared by dissolving PSISM in sterile PBS solution containing 0.1 mol/L NaOH in groups A2, B2, and C2, and collagen type I gel served as a control (group D2). At 1, 3, and 5 days after culture, the morphology and survival of liver cells were detected by the Live/Dead fluorescent staining. The cell vitality was tested by cell counting kit-8 (CCK-8) assay. And the relative expressions of albumin (ALB), cytokeratin 18 (CK18), and alpha-fetoprotein (AFP) in hepatocytes were determined by real-time fluorescent quantitative PCR (RT-qPCR). Results The Live/Dead fluorescent staining showed the cells survived well in all groups. CCK-8 results displayed that the absorbance (A) value of group C1 was significantly higher than that of group D1 at 5 days after culture with PSISM-medium, and there was no significant difference between groups at other time points (P>0.05). After cultured with PSISM hydrogels, theA values of groups A2, B2, and C2 were significantly higher than those of group D2 at 3 and 5 days (P<0.05), theA value of group A2 was significantly higher than that of groups B2 and C2 at 5 days (P<0.05), but there was no significant difference between groups at other time points (P>0.05). RT-qPCR showed that the relative expressions of ALB and CK18 mRNA significantly increased and the relative expression of AFP mRNA significantly decreased in groups A1, B1, and C1 when compared with group D1 (P<0.05). The relative expression of CK18 mRNA in group C1 was significantly lower than that in groups A1 and B1 (P<0.05). The relative expressions of ALB and CK18 mRNA were significantly higher and the relative expression of AFP mRNA was significantly lower in groups A2, B2, and C2 than group D2 (P<0.05); the relative expression of CK18 mRNA in group A2 was significantly higher than that in group B2 (P<0.05), and the relative expression of AFP mRNA in group A2 was significantly lower than that in group C2 (P<0.05), but no significant difference was found between other groups (P>0.05). Conclusion PSISM has good compatibility with hepatocyte and can promote the vitality and functional gene expression of hepatocyte. PSISM is expected to be used as culture medium supplement or cell carrier for liver tissue engineering.
目的 总结对粪石性小肠梗阻患者的诊治经验。方法 对我院2000～2012年期间收治的45例成人粪石性小肠梗阻患者的病史、X射线表现、CT表现、治疗情况等进行回顾性分析。结果 本组有22例患者发病前曾进食柿子、山楂或黑枣，7例有胃部手术史，9例患有糖尿病。39例行腹部CT，其中35例可见小肠扩张与萎陷肠管移行区椭圆形斑点状团块。22例经非手术治疗缓解，随访2～3个月无肠梗阻复发；23例行剖腹探查，其中1例于术后21 d死于急性呼吸窘迫综合征，其余均治愈。结论 进食富含鞣酸食物史、胃部手术史、糖尿病史、典型螺旋CT表现是诊断的关键因素，部分患者可经保守治疗缓解，若保守治疗无效，则行手术探查，手术应先试行手法碎石，并全程探查胃肠道以避免多发粪石残留。
ObjectivesTo systematically review the risk factors for intestinal injury induced by non-steroidal anti-inflammatory drugs(NSAIDs).MethodsWe comprehensively searched WanFang Data, CNKI, Web of Science, EBSCO, PubMed and The Cochrane Library databases to collect studies on risk factors of NSAIDs-induced intestinal injury. Two reviewers independently screened literature, extracted data and assessed risk of bias, and then, meta-analysis was performed by using RevMan 5.2 and STATA 12.0 software.ResultsA total of 6 case-control studies were included, in which 265 patients were in the case group and 301 patients in the control group. The results of meta-analysis showed that PPI was an independent risk factor for NSAIDs-induced intestinal injury (OR=1.59, 95%CI 1.07 to 2.35, P=0.02). In addition, patients with osteoarthritis (OR=2.44, 95% CI 1.11 to 5.36, P=0.03) or rheumatoid arthritis (OR=3.04, 95% CI 1.31 to 7.03, P=0.01) was associated with intestinal mucosal injury induced by NSAIDs. Gender, age, smoking history, drinking history, H2RA and rebamipide medication history, cardiovascular disease and cerebrovascular disease were not associated with intestinal injury.ConclusionsPPI is an independent risk factor for NSAIDs-induced intestinal injury. However, studies with high-quality, larger sample size are required to further verify that PPI increases the prevalence of intestinal injury.
Objective To compare the effect of small intestinal submucosa(SIS)and polypropylene mesh(PPM) on repairing abdominal wall defects in rats, and toprobe into the feasibility of using SIS to repair the abdominal wall defects. Methods 100 SD rats(50 males and 50 females)were randomly divided into 2 groups(n=50). Their weight ranged from 200 to 250 g.Full thickness abdominal wall defects (2 cm×2 cm) were created by surgery and were repaired with SIS and PPM respectively. At different postoperative time (1st, 2nd, 4th, 8th and 12th week), animals were sacrificed to make histological observation. The tensile strengthand the development of adhesions were measured and observed. Results 95 animals survived and were healthy after surgery. No inflammatory response and obvious immunoreaction were observed in both groups. One week after operation, the tensile strengthof abdominal wall in SIS group (204.30±5.13 mmHg) was lower than that in PPMgroup(240.0±10.0 mmHg) at 1st week(P＜0.05),and there were no difference at 4th, 8th, 12th week. Adhesions were more marked in PPM group thanthat in SIS group(P＜0.05). Conclusion Both SIS and PPM are histologically compatible when used in rats and can maintain sufficient tensile strength. SIS is superior to PPM in regards to tissue compatibility and adhesion formation.
【Abstract】Objective To investigate the value of laparoscopy in the diagnosis and treatment of small bowel diseases.Methods Data of thirtythree cases of small bowel diseases receiving laparoscopy in this hospital from May 2000 to February 2004 were analyzed retrospectively. Results All cases underwent laparoscopy successfully and no complication was observed. The mean operative time was 65 min.The mean intraoperative blood loss was 30 ml. Postoperative pain was mild. Flatus and feces were passed about 32 hours after treatment and the mean postoperative hospital stay was 7 days. The pathologic examination showed: 18 benign and 6 lowgrade malignant stromal tumors, 5 Meckel’s diverticula and 4 NonHodgkin’s lymphomas. No recurrence occurred in 33 cases during the followup for 10 to 36 months.Conclusion Laparoscopy is a very useful and minimally invasive technique in the diagnosis and treatment of small bowel diseases. It is simple, safe, effective and worthy of be clinically applied.
Objective To investigate the effect and mechanism of growth factors on intestinal compensation after massive intestinal resection， and understand the progress of growth factors in nutrition support treatment for short bowel syndrome （SBS）. Method The related literatures about the application and effect of growth factors in the patients with SBS were reviewed. Results Different kinds of growth factors had different effects on intestinal adaptation after massive intestinal resection. The application of growth factors according to the specific circumstances of the patients with SBS could shorten the residual small intestine compensatory time and improve the nutrition status of the patient with SBS. Conclusions Growth factors play important role in promoting the intestinal adaptation after resection. Different kinds of growth factors have their effects and it’s helpful for getting rid of the total parenteral nutrition early. However， much work still remains to be done.
目的 探讨小肠扭转的CT影像学表现及多层螺旋CT的诊断价值。 方法 回顾性分析2006年2月－2011年8月14例经手术证实肠扭转患者的临床及影像资料。 结果 14例小肠扭转患者中有9例出现“U形征”，13例有肠管和血管的“漩涡征”，4例有“鸟喙征”，2例可见“靶环征”，1例可见空回肠“转位征”。 结论 肠管及血管的“漩涡征”是诊断小肠扭转的特异性征象，“鸟喙征”、“靶环征”等其他CT征象为小肠扭转的正确诊断提供可靠依据。多层螺旋CT扫描及三维重组对小肠扭转的诊断具有重要价值。
Objective To explore the possibilityof constructing tissue engineering muscles by combining allogeneic myoblasts with small instestinal submucosa(SIS) in rabbits.Methods A large number of purified myoblasts were obtained with multiprocedure digestion and repeated attachment method from skeletal muscles taken from extremities of immature rabbits which were born 7 days ago. The myoblasts were labeled with BrdU, and then combined with SIS to construct tissue engineering muscles. This kind of tissue engineering muscles were grafted into the gastrocnemius muscle defect (1.5 cm in length, 1.0 cmin width) of fifteen rabbits as the experimental group. The SIS was grafted into the same position in the control group. The rabbits were sacrificed 4, 6, 8 weeks after operation. The tissue engineering muscles were evaluated by macroscopic、histological and immunohistochemical observations, and by quantitative analysis of local immunocyte in the grafting site. Results Allogeneic myoblasts with SIS were combined perfectly in vitro. The SIS was connected tightly to surrounding skeletal muscles and inflammation response was obvious 4 weeks after grafting.The SIS began to break down and inflammation response became slight 6 and 8 weeks after operation. Compared with that of 8th week, the quantitative analysis oflocal immunocyte in 4th and 6th week in both experimental and control group hassignificance(Plt;0.05). Newly formed muscle tissues were found around SIS in the experimental group in 4th, 6th, and 8th week. Expression of BrdU and myosin immunohistochemical staining were positive in the experimental group and negative inthe control group.Conclusion Tissue engineering muscles of rabbits which are constructed by combining allogeneic myoblasts with SIS can survive and proliferate.