Objective To summarize and review the heterogeneity of bone marrow derived stem cells (BMDSCs) and its formation mechanism and significance, and to analyze the possible roles and mechanisms in intestinal epithel ial reconstruction. Methods The related l iterature about BMDSCs heterogeneity and its role in intestinal epithel ial repair was reviewed and analyzed. Results The heterogeneity of BMDSCs provided better explanations for its multi-potency. The probable mechanisms of BMDSCs to repair intestinal epithel ium included direct implantation into intestinal epithel ium, fusion between BMDSCs and intestinal stem cells, and promotion of injury microcirculation reconstruction. Conclusion BMDSCs have a bright future in gastrointestinal injury caused by inflammatory bowl disease and regeneration.
【 Abstract 】 Objective To investigate the effects of 250 ml/m3 carbon monoxide (CO) inhalation or intraperitoneal infusion on lipopolysaccharide (LPS) induced rat intestinal tract injury, and to detect the roles of p38 mitogen-activated protein kinase (MAPK) pathway during CO administration. Methods After received 5 mg/kg LPS or an equal volume of normal saline by intravenous injection, 108 male SD rats were randomly divided into 6 groups: control group, CO inhalation (250 ml/m3) group, CO intraperitoneal infusion (250 ml/m3 at a rate of 2 L/min) group, LPS (5 mg/kg) group, LPS (5 mg/kg)+CO inhalation (250 ml/m3) group and LPS (5 mg/kg)+CO intraperitoneal infusion (250 ml/m3 at a rate of 2 L/min) group. The animals were differently sacrificed at 1, 3 and 6 h for the observation, and the ileum tissues were homogenized for determination the levels of platelet activator factor (PAF), intercellular adhesion molecule-1 (ICAM-1) and interlukin-10 (IL-10) with enzyme-lined immunosorbent assay, the content of maleic dialdehyde (MDA) with thiobarbitric acid, the activity of myeloperoxidase (MPO) with chemical method, the activity of superoxide dismutase (SOD) with hydroxylamine, the activity of phosphorylated p38 MAPK with Western blot, the pathology with light microscope, and the extents of cell apoptosis were showed by the ratio of the apoptotic cells which had less DNA to the total cells of a cell-suspension sample by using the flow cytometry after being stained with propidium iodide. Results Compared with both control, CO inhalation and intraperitoneal infusion group at the same time point, the levels of PAF, ICAM-1, MDA, MPO, cell apoptosis rate and the phosphorylated p38 MAPK protein in LPS group were increased, while IL-10 and SOD were decreased (P ＜ 0.05 or 0.01), and accompanied by severe intestinal tract injury. There were no statistics differences at the different time point in the same group. PAF, ICAM-1, MDA, MPO and cell apoptosis rate in both LPS+CO inhalation group and LPS+CO intraperitoneal infusion group were lower, while IL-10 and SOD were higher than the corresponding value in LPS group at the same time point (all P ＜ 0.05), with ameliorate injury too, but the expression of phosphorylated p38 MAPK was further up-regulated than that of LPS group (all P ＜ 0.05). However, there were no significant differences in these parameters between LPS+CO inhalation group and LPS+CO intraperitoneal infusion group. Conclusion 250 ml/m3 CO inhalation and intraperitoneal infusion exerts the similar protection against LPS induced rat intestinal tract injury via anti-oxidant, anti-inflammation, and anti-apoptosis. This may involve the p38 MAPK pathway.
Different types of bowel obstruction,including strangulated loop,mesenteric venous occlusions,mesenteric arterial occlusions and simple obstruction, were induced in rabbits.After induction of occlusion, imaging agent of 99mTc-pyrophosphate was injected intravenously.Thirty minutes later,abdominal plain image was successively taken with a single photon emission computed tomography (SPECT).At the same time,the uptake ratio of region of interest was determined.The results revealed that animals in strangulated loop group and mesenteric venous occlusion group had high radioactive concentration in the area of ischemic bowel. Uptake ratio of region of interest of imaging area in the two experimental group was higher than that in simple obstruction and control group.Whereas the mesenteric arterial occlusion group did not appearantly present the changes mentioned above.These showed that there was an accumulation of agent in strangulated ischemic bowel segment in strangulated loop group and mesenteric venous occlusion group.All results suggest that radionuclide visualization with SPECT could be a valuable method for early diagnosis of acute intestinal strangulation of strangulated loop type and mesenteric venous occlusion type.
Objective To investigate the surgical techniques for management of left colon carcinoma obstruction. MethodsThe techniques used in left colon carcinoma obstruction and the corresponding efficiencies reported in foreign literatures were reviewed. ResultsThe surgical techniques for management of left colon carcinoma obstruction involve palliative operation, staged operation and onestage operation. These methods had their own virtues as well as shortages. But on all accounts, onestage operation was favorable for both the patients and docters. ConclusionDifferent methods for management of left colon carcinoma obstruction have different adaptation index, first you must ensure safety, then you should try your best to do onestage operation.
Objective To evaluate the effect of hepatocyte growth factor(HGF) on intestinal permeability and bacterial translocation after small bowel transplantation in rats. Methods Twenty Wistar rats were as recptors and twenty SD rats as donors. After heterotopic intestinal grafting, cyclosporine A was administered at 6mg/kg·day intramuscularly for inhibiting rejection. The SD rats were divided into 2 groups(n=10). HGF was administered at 150 μg/kg·day (HGF group) and normal saline was administered at 150 μg/kg·day (controlgroup). Intestinal permeability and bacterial translocation to the mesenteric lymph nodes and portal vein were assessed at the 8th postoperative day. Results The lactulose and lactulose/ mannitol of control group (0.0931%±0.008 5% and 0.132± 0.021) were higher than those of normal reference value (0.015 0%±0.002 0% and 0.020±0.005)（Plt;0.05）. The lactulose and lactulose/ mannitol of HGF group (0.039 6%±0.009 0% and 0.056±0.013) were also higher than those of normal reference value（Plt;0.05）.The bacterial culture positive proportion of lymphaden in HGF group and control group were 10% and 60%, showing statistically significant difference（Plt;0.05）. The bacterial culture positive proportion of portal vein in HGF group and control group were 10% and 20% respectively（P＞0.05）. Conclusion HGF can decrease intestinal permeability and bacterial translocation from the lumen of the graft to the mesenteric lymph nodes,thus improve gut barrier function, may be of help to reduce the incidence of septic complications after intestinal grafting.
【Abstract】ObjectiveTo study the application of ultrasonically activated scalpel in laparoscopic intestinal adhesion release.MethodsIntestinal adhesion release with ultrasonically activated scalpel under laparoscope was performed in 29 patients suffered from intestinal adhesive obstruction after gynecological operation. ResultsAll operations were successfully performed, and none of them converted into open surgery. Intestinal disruption occurred durring operation in 2 patients with extensive intestinal denseadhesion which were mended successfully under laparoscope. The operative duration was 30-150 min (mean 45 min). Postoperative complications such as bowel leakage, bleeding, abdominal infection were not experienced. Postoperative hospital stay was 3-7 days (mean 4 days). No case had relapse symptom such as abdominal distention or pain after 1-24 months of followup. ConclusionCompared with electric scalpel, ultrasonically activated scalpel can improve the operative safety, lessen tissue damage, shorten operative time, and reduce the chance of relapse in laparoscopic operation in gynecology.
ObjectiveTo determine the effects of different volume fluid resuscitation on intestinal injury and the permeability of intestine in hemorrhagic shock rats. MethodsSprague-Dawley male rats(n=72) were randomly equally divided into 4 groups after the model establishment of blood pressure-controlled hemorrhage, 45, 30, and 15 mL/(kg·h) of fluid resuscitation were performed in high dosage of resuscitation(HLR), moderate dosage of resuscitation(MLR), and low dosage of resuscitation(LLR) group respectively, but rats of Sham group didn't accept fluid resuscitation. After resuscitation, ten centimeters ileum was harvested for testing intestinal permeability. Then 6 rats of each group were sacrificed at 24, 48, and 72 hours after fluid resuscitation respectively. Over the specified time interval, blood was collected for testing levels of lactic acid and plasma tumor necrosis factor-α(TNF-α). The ileums of 3 resuscitation groups were obtained for testing the ratio of wet weight to dry weight and observing the histological changes. ResultsAfter resuscitation, the intestinal permeability was higher in HLR group(P<0.05). At 3-8 hours after resuscitation, rats of Sham group were all died, and the other rats of 3 groups were all alive. The level of plasma lactic acid was lower in LLR group than those of other 2 groups at 24 hours(P<0.05). The levels of TNF-α were higher in HLR group than those of other 2 groups at 24, 48, and 72 hours(P<0.05), and at 48 hours, level of TNF-α in LLR group was lower than MLR group(P<0.05). At 24 hours after resuscitation, ratio of intestinal wet weight to dry weight in LLR group was the lowest, and HLR group was the highest(P<0.05). According to the histopathology, intestinal injuries of the 3 groups were tend to be remission with the time, and at 48 and 72 hours after resuscitation, intestinal villus of LLR group appeared to be normal. ConclusionLimited fluid resuscitation of 15 mL/(kg·h) could not only decrease the levels of lactic acid and TNF-α, but also moderate the intestinal permeability and the intestinal injury in early stage after shock and surgery.
Objective To evaluate initial experience with shape memory alloy stent as an alterative to colostomy in patients with intestinal obstruction of rectal cancer. Methods Twenty-one patients with acute and chronic rectal obstructions from malignant causes underwent stent placement. After rectal stent was slenderized in ice water, it was inserted into the strictured rectum by hand or sigmoidoscope. Nitinol mesh stent were deployed in hot water. Results Eighteen patients who had underwent rectal stent placement achieved clinical decompression within 5 hours. Colostomy underwent in 3 patients due to stent failure. Eighteen patients with stent were followed-up, 14 cases died in 56-720 days and 4 other cases were still alive without intestinal obstruction in 2-15 months. Conclusion Nitinol mesh stent may be useful in the management of terminal or high-risk surgical patients for palliative purposes shuning colostomy. Palliation of stent combined with chemotherapy and immunotherapy can be performed to improve survival.
Objective To investigate the effects of N-acetylcysteine （NAC） on the intestinal barrier in rats with severe acute pancreatitis （SAP） and its possible mechanism. Methods Eighty Wistar rats were randomly （random number method） divided into normal control group （CON group， n=8）， sham operation group （SO group， n=24）， SAP group （n=24）， and NAC group （n=24）， then the rats of latter 3 groups were sub-divided into 6， 12， and 24 hours group， each time point group enrolled 8 rats， respectively. Rats of CON group didn’t receive any treatment. SAP rat models were established by injecting 5.0% sodium taurocholate into the biliary-pancreatic duct for SAP group and NAC group， while rats of SO group were injected normal saline instead of sodium taurocholate. The rats of NAC group were given an intraperitoneal injection of NAC at 1 hour before operation， and the rats of SO group and SAP group were given an intraperitoneal injection of normal saline instead at the same time. Rats of CON group were sacrificed to get ileum （about 5cm） and blood from right ventricular （5mL） for further test， and rats of the other 3 groups were sacrificed at 6， 12， and 24hours after operation. Then the levels of amylase （AMY）， C-reactive protein （CRP）， endotoxin， D-lactic acid， and diamine oxidase （DAO） in plasma， the levels of superoxide dismutase （T-SOD）， myeloperoxidase （MPO）， and malondialdehyde （MDA） in ileum tissues were tested. Apoptosis of mucosal cells in ileum tissues was determined by terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling （TUNEL）. Pathological changes in ileum tissues were observed and scored. Expression levels of bax and bcl-2mRNA in ileum tissues were determined by real-timefluorescence quantitative PCR （real-time PCR）， and related proteins were tested by Western blot method， respectively. Results Compared with SAP group at the same time point， the levels of CRP in NAC group were lower at all the 3 time points （P＜0.05） and AMY were lower at 12 and 24 hours （P＜0.05）， levels of DAO， endotoxin， and D-lactic acid were lower at 12 and 24 hours （P＜0.05）， but level of DAO was higher than SAP group at 6 hours （P＜0.05）. Compared with SAP group at the same time point， the levels of MPO and MDA in ileum tissues were lower in NAC group at all the 3 time points （P＜0.05）， but levels of T-SOD increased significantly at 12 and 24 hours （P＜0.05）. Compared with SAP group at the same time point， the apoptosis indexes were lower in NAC group at all the 3 time points （P＜0.01）， and pathologic scores of ileum tissues were lower at 12 and 24 hours （P＜0.05）. The pathological changes under a light microscope were observed better in NAC group than that of SAP group at each time point. Moreover， compared with SAP group at the same time point， the expression levels of bax mRNA and protein were lower in NAC group at all the 3 time points （P＜0.05）， while higher in bcl-2 mRNA and protein （P＜0.05）. Conclusions NAC can protect the function of small intestinal barrier， and can alleviate SAP-induced injury of the intestinal mucosa. In addition to antioxidant effects， the underlying mechanisms also may include the anti-apoptotic effects.
Objective To review the development of researches on the stem cells and the tissue engineering technique used in the intestines. Methods We comprehensively reviewed the literature related to the stem cells and the tissue engineering technique used in the intestines, and summarized the conclusions made by the researches concerned. Results The researches on the stem cells and the tissue engineering technique used in the intestines were attractive topics in the recent years and obtained some developments, especially in the field dealing with the characteristics, proliferation and differentiation of the intestinal stem cells as well as the tissue engineering framework of the small intestinal submucosa in vivo. However, the markers for the differentiation of the intestinal stem cells were still a critical problem, which had not been solved yet, and besides, the researches on the intestinal tissue engineering were still in the initial stage. Conclusion There is a broad prospective application of the intestinal stem cells and the tissue engineering technique to the intestinal problem solution. Substantial achievements can be obtained in the treatment of the inflammatory bowel disease, inan exploration on the oncogenesis mechanism, and in the clinical application ofthe intestinal tissue engineering.