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.
Objective To study the construction feasibility of a biodegradable artificial esophagus by the squamous epithelial cells and the myoblast cells seeded on the small intestinal submucosa(SIS) and to investigate the growth patternand angiogenesis of the co-cultured human embryonic squamous epithelial cells and the skeletal myoblasts in vivo. Methods The squamous epithelial cells and the myoblast cells were obtained from the 20-week aborted fetus. Both of their cellswere marked by 5-BrdU in vitro.The isolated cells were then seeded on the SIS and co-cultured in vitro for 24 hours, and then the compound of the cells and the SIS was transplanted into the subcutaneous tissue of the athymismus mice. The observation on the morphology and the cytokeratin AE3 and α-actin specified immunohistochemistry of the squamous epithelial cells and the myoblastcells was performed at each of the following time points: 3 days, 1 week, 2 weeks, and 3 weeks after transplantation. Results The morphological observation indicated that the cultured cells could penetrate into the small intestinal submucosa and form several-layered cell structures, and that the compound of the cells and the SIS could have angiogenesis within 2-3 weeks. The 5-BrdU specified immunohistochemical observation suggested that the cells growing in the small intestinal submucosa scaffold might be the cells transplanted.The cytokeratin AE3 specified and α-actin specified immunohistochemical studies demonstrated that the transplanted cells could differentiate in vivo. Conclusion It is possible to fabricate the framework of a biodegradable artificial esophagus with the epithelial cells and the myoblast cells seeded on the small intestinal submucosa.
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.
Objective To explore the possibility of small intestinal submucosa (SIS) for reconstruction of urethral defect. 〖WTHZ〗Methods Twenty-four male rabbits weredivided into 4 groups: group A (the tubulate SIS graft for urethral repair), group B (control group, urethral tubulate defect), group C (the SIS patch graft forurethral repairs), group D (control group, urethral part defect). Then the regenerative segment was studied with histological technique by hematoxylineosin straining and immunohistological straining for α-actin after 6 and 12 weeks postoperatively. The retrograde urethrography and urodynamics were used to evaluate the function of the regenerative urethra at 12 weeks after operation. Results In groups A and C, at 6 weeks after operation, the luminal surface of matrix was completely covered by urothelium, minimal SIS graft was observed in the extracellular matrix, new smooth-muscle cells was confirmed; however, more inflammatory cells were observed in the host-matrix anastomosis in group A than in group C. At 12 weeks postoperatively, the regenerative tissue was equivalent to the normal urethral tissue and SIS disappeared in group C, but some minimal SIS grafts were observed in group A. In groups B and D, urethral strictures and fibrous connective tissue were observed except ３ cases. The urethrography showed wide smooth urethral in group A and C, meawhile urodynamic evaluation didn’t demonstrat significant difference(P＞0.05) in the bladder volume and the maximum urethral pressure between preoperation and postoperation in group A or group C. Conclusion SIS can be a useful material for urethral repair in rabbits, the SIS patch graft is superior to the tubulate SIS graft in urethra reconstruction.
Objective To study the etiology， pathogenesis， and diagnosis of small bowel volvulus in adults. Method The clinical data of 43 cases of small bowel volvulus admitted to HassanⅡHospital of Settat from October 2009 to October 2012 were analyzed retrospectively. Results There were 11 cases of spontaneous small bowel volvulus.There were 32 cases of secondary small bowel volvulus， of which 19 cases due to postoperative abdominal adhesions. Clinical manifestation：early persistent severe abdominal pain was in 40 cases， frequent vomiting was in 29 cases， intestinalpattern or abdominal mass was in 28 cases. All 43 patients were received surgery， 22 （51.2%） cases were diagnosed by preoperative ultrasonography， small bowel necrosis was found in 16 cases during operation， 37 （86.0%） patients were cured and 6 （14.0%） patients died. Conclusions Secondary small bowel volvulus is main small bowel volvulus， post-operative abdominal adhesion is major causes of small bowel volvulus， the value of abdominal X-ray in diagnosing is limited. However， ultrasonography and CT are helpful in diagnosing these diseases. Small bowel volvulus and intestinal obstruction can reinforce each other. Early small bowel volvulus is characterized by clinical conditions such as severe abdominal pain， early vomiting signs， and signs not matching the symptoms. Acute onset and rapid progression are the features of small bowel volvulus， surgery should be intervened in early stage.
To elucidate the mechanism of renal injury following intestinal ischemia/reperfusion, reactive oxygen metabolites in kidney and plasma were examined in 20 rats following intestinal ischemia/reperfusion by measurement of lipid proxidation (LP).The plasma lipid peroxide concentration after reperfusion was higher than that of the contol group (Ｐ＜0.01),the LP in kidney homogenate was also significantly higher (Ｐ＜0.01) following intestinal ischemia/reperfusion.Our study suggests that reactive oxygen metabolites after intestinal ischemia/reperfusion plays an important role in kidney 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 diagnosis and treatment of primary small intestinal tumor (PSIT). MethodsEighty-eight cases of PSIT were analyzed in our hospital retrospectively. Results Thirty-six cases were diagnosed before operation, 52 cases were misdiagnosed and the percentage amounted to 59.1%. The major clinical manifestations of PSIT were abdominal pain (66 cases, 75.0%), obstruction (56 cases, 63.6%), abdominal mass (51 cases, 58.0%) and stool with blood (48 cases, 54.5%).The major pathological types of PSIT were adenocarcinoma (55.7%), sarcoma of smooth muscle (25.0%), lymphoma (13.6%), fatty sarcoma (5.7%). The tumors of 36 cases located in jejunum (40.9%), 34 cases in ileum (38.6%) and 18 cases in duodenum (20.5%).Conclusion It is difficult to diagnose PSIT before operation. The following advice could help to get a correct diagnosis: ① Surgeons should be alert when meeting a patient with the above symptoms, and then collect and analyze the clinical data comprehensively. ②Patients over 40 years with complaints of inexplicable abdominal pain, weight loss, anemia, dyspepsia and abdominal mass should be examined appropriately by gastrointestinal X-ray, gastrointestinal endoscopy, ultrasonography, CT and angiography of superior mesenteric artery. ③When the diagnosis can’t be confirmed, an exploratory operation should be performed immediately to avoid the delay of treatment. ④The treatment of PSIT includes radical resection of small intestine and chemotherapy according to the pathological results of tumor.
目的:探讨原发性小肠肿瘤的临床特点、诊断及治疗方法, 提高对原发性小肠肿瘤的诊断水平及鉴别能力,降低误诊率。方法:对我院 1993~2008 年收治的 59 例原发性小肠肿瘤的临床资料进行回顾分析。结果:小肠肿瘤起病隐匿,缺乏特异症状,临床表现有腹痛、贫血、消瘦、便血、肠梗阻及发热等,术前经行内窥镜、X 线、B 超及 CT 等检查,术前确诊仅有 11 例,误诊率达 81.36 %。十二指肠 18 例(30.51 %),空肠 13 例(22.03 %),回肠 29 例(49.15 %)。59 例均经手术证实诊断,其中良性肿瘤 14 例(23.73 %),恶性肿瘤 45 例(76.27 %), 腺癌发病率最高 22 例(37.29 %)。良性肿瘤行了局部肠壁或肠段切除,恶性肿瘤 19 例进行根治性切除,其他行姑息切除或改道。本组病例中无围手术期死亡病例。45 例恶性肿瘤病例中, 25 例患者术后进行了2~6 次不等的辅助化疗并获得随访 6 个月至 5 年,39 例死亡,存活 5 年以上 6 例。结论:原发性小肠肿瘤恶性率高,临床上往往缺乏特征性表现,目前临床上没有有效的诊断手段和方法,误诊率较高,预后差。因此,临床医师对本病的警惕性是诊断此病的关键所在。对反复腹痛、消瘦、腹部包块、肠梗阻、不明原因消化道出血等临床表现患者应高度怀疑小肠肿瘤,及早剖腹探查,改善预后。
Objective We sought a good understanding of the current role of computed tomography (CT) in the diagnosis of small bowel obstruction (SBO).Methods We looked for the best evidence on computed tomography for diagnosing small bowel obstruction by searching MEDLINE/PubMed (1978-April, 2006), SUMsearch (1978-April, 2006), CNKI (1978-April, 2006) and critically appraised the evidence. Results There was powerful evidence supporting the efficacy of computed tomography in the diagnosis of small bowel obstruction. Given the current evidence together with our clinical experience and considering the patient and his family members, values and preferences, computed tomography was done. We confirmed the diagnosis of strangulating small bowel obstruction, which needed immediate operation. Conclusions Computed tomography is a very useful tool for the diagnosis of small bowel obstruction with high sensibility and specificity.