异丙酚对大鼠肠缺血再灌注时肠粘膜细胞凋亡的影响

目的评价异丙酚对大鼠肠缺血再灌注（I／R）时肠粘膜细胞凋亡的影响。方法24只SD大鼠随机分为3组（n=8），假手术组（S组）仅分离肠系膜上动脉（SMA）；肠缺血再灌注组（I／R组）阻断SMA1h；异丙酚组（P组）阻断SMA前30min腹腔注射异丙酚100mg／kg。于再灌注3h处死大鼠，取回肠末端组织，电镜及TUNEL法观察肠粘膜上皮细胞凋亡情况，并计算肠粘膜上皮细胞凋亡指数；测定肠粘膜超氧化物歧化酶（SOD）活性、丙二醛（MDA）及神经酰胺（CER）含量，RT-PCR法测定肠粘膜鞘磷脂酶（SMase）mRNA表达。结果与S组比较，I／R组肠粘膜SOD活性降低，MDA含量、CER含量、肠粘膜上皮细胞凋亡指数及SMasemRNA表达升高（P〈0．05或0．01）；与I／R组比较，P组MDA含量、CER含量、肠粘膜上皮细胞凋亡指数及SMasemRNA表达降低，S01）活性升高（P〈0．05或O．01）。I／R组肠粘膜SOD活性与CER含量呈负相关（r＝-0．775，P〈0．01），肠粘膜上皮细胞凋亡指数与CER含量呈正相关（r=0．852，P〈0．01）；P组肠粘膜上皮细胞凋亡指数与CER含量呈正相关（r=0．782，P〈0．01）。结论异丙酚可抑制大鼠肠缺血再灌注时肠粘膜上皮细胞凋亡，可能与清除氧自由基、下调SMasemRNA表达、减少CER生成有关。     

参芎注射液对肾缺血再灌注损伤大鼠的保护作用

目的观察参芎注射液对肾缺血再灌注损伤大鼠肾组织核因子-κB（NF-κB）、肿瘤坏死因子-α（TNF-α）、丙二醛（MDA）水平和超氧化物歧化酶（SOD）活性的影响,探讨其肾保护作用机制。方法将24只SD大鼠随机分为假手术对照组、缺血再灌注组、参芎预处理组,每组8只。免疫组织化学法检测各组大鼠肾组织NF-κB蛋白表达,酶联免疫吸附法检测肾组织TNF-α含量,用MDA和SOD试剂盒分别检测肾组织MDA含量和SOD活性。结果①与假手术对照组相比,缺血再灌注组大鼠肾组织NF-κB蛋白表达、TNF-α和MDA含量明显升高,差异均有统计学意义（P〈0．01）;而SOD的活性明显降低,差异有统计学意义（P〈0．01）。②与缺血再灌注组相比,参芎预处理组大鼠肾组织NF-κB蛋白表达、TNF-α和MDA含量降低,差异均有统计学意义（P〈0．05或P〈0．01）;而SOD的活性明显升高,差异有统计学意义（P〈0．01）。结论参芎注射液对肾缺血再灌注损伤有一定的保护作用,其机制可能与抗自由基氧化损伤以及抑制炎性细胞因子NF-κB和TNF-α的表达有关。     

参附注射液对大鼠胰腺移植受体小肠肠粘膜屏障的保护作用

目的探讨参附注射液（SF）对大鼠胰腺移植受体肠粘膜屏障的保护作用及机制。方法24只糖尿病大鼠随机分为缺血再灌注组（IR组。n=12），参附注射液预处理组（SF组．n=12），12只正常大鼠为对照组，IR组和SF组大鼠均接受胰腺移植，再灌注后5d检测小肠通透性和吸收功能，检测血清TNF-α、NO、SOD和淀粉酶活性，取受体空肠粘膜组织检测小肠粘膜粘膜湿重、微绒毛高度及宽度、MDA含量及MPO活性，同时取肠系膜静脉血、肠系膜淋巴结、肝及脾组织进行细菌培养，观察细菌易位情况。结果再灌注后SF组血清TNF—α含量（P〈0．01）、淀粉酶活性（P〈0．01）、MDA含量（P〈0．01）、MPO活性（P〈0．01）、小肠通透性（P〈0．01）、细菌易位率（P〈0．01）和小肠粘膜损伤程度均低于IR组；血清NO和SOD含量、小肠吸收功能均高于IR组（P〈0．01）。结论SF预处理可保护大鼠胰腺移植受体小肠肠粘膜屏障，降低细菌易位率，机制可能与降低胰酶活性、减少TNF—α生成、减轻PMNs粘附与聚集、增加NO和SOD含量有关。     

腹膜透析液添加尿激酶对腹透患者氧化应激及内皮功能的影响

目的探讨腹膜透析液添加尿激酶对腹透患者血清超氧化物歧化酶（SOD）、丙二醛（MDA）及血浆内皮素（endothelin,ET）、一氧化氮（nitricoxide,NO）的影响。方法将60例慢性肾脏病（CKD4期）患者随机分为治疗组（30例）和对照组（30例）,两组基础治疗相同,治疗组在腹膜透析液中添加尿激酶,治疗4周后观察两组患者SOD、MDA、ET、NO及临床症状的变化。用比色法测定健康对照组、对照组、治疗组血清MDA和SOD水平,用放射免疫法测定测定ET的变化,NO采用硝酸还原法测定。结果与健康对照组比较,对照组、治疗组血清SOD活性降低（P〈0．05）,NO升高（P〈0．05）,MDA含量升高（P〈0．05）,ET水平升高（P〈0．01）。对照组虽能够降低ET水平和NO,但未见SOD、MDA的变化,治疗组能够回升SOD活性,降低MDA含量,与健康对照组及对照组有明显差别（P〈0．05）,与对照组比较,治疗组在降低ET和NO方面疗效更为显著（P〈0．01）。结论腹膜透析液添加尿激酶可通过降低氧化应激反应,改善血管内皮功能,降低ET和NO水平,对CKD患者有治疗作用。     

卡巴胆碱预防术后腹腔粘连的实验研究

目的 观察拟胆碱药卡巴胆碱预防腹腔粘连的作用。方法 44只雄性Wistar大鼠按完全随机法分为假手术组（n=12）、手术对照组（n=16）及卡巴胆碱组（n=16，卡巴胆碱50ug／kg），后2组采用开腹后无菌干纱布摩擦大鼠盲肠蚓突部，钳夹和刮伤腹壁法制作大鼠腹腔粘连动物模型。各组于术后第7d和第14d各处死一半动物，参考Phillips 5级分类法并结合本模型特点进行大体粘连程度分级评分；取粘连组织切片行HE染色观察粘连组织病理变化，免疫组化法观察粘连组织Ⅰ型胶原含量变化，并进行图像分析。结果 卡巴胆碱组第7d与第14d大体粘连程度评分均明显低于手术对照组，差异有统计学意义（P〈0．01）；HE染色显示卡巴胆碱组比之手术对照组炎症反应轻，偶见增生纤维结缔组织；Ⅰ型胶原含量卡巴胆碱组第7d与第14d均明显低于手术对照组（P〈0．01）；各组内第7d与第14d比较，腹腔大体粘连程度评分和I型胶原含量差异无统计学意义（P〉0．05）。结论 拟胆碱药卡巴胆碱能显著预防大鼠腹腔粘连形成，降低粘连程度。     

氯胺酮对大鼠脊髓背角星形胶质细胞的保护机制

目的 探讨氯胺酮对N-甲基-D天冬氨酸（NMDA）诱导的大鼠脊髓背角星形胶质细胞损伤的保护机制。方法 取新生2～3dWistar大鼠40只T12～L5脊髓背角星形胶质细胞,原代纯化培养3周。将细胞随机分六组：NMDA组（N组）,氯胺酮组（K组）、NMDA加不同浓度氯胺酮组（标记为NK1～NK3组）,对照组（C组）。加药后培养30min或24h取各组细胞检测超氧化物岐化酶（SOD）活性和丙二醛（MDA）含量,免疫细胞化学观察Bcl-2／Bax表达,流式细胞仪检测星形胶质细胞凋亡率和胞内游离钙浓度（[Ca^2＋]i）。结果 与C组比较,N组细胞发生大量凋亡（P〈0．01）,Bax强阳性表达,Bcl-2阴性表达,SOD活性显著降低（P〈0．01）,MDA含量明显增加（P〈0．01）,[Ca^2＋]i显著升高（P〈0．01）。与N组比较,NK2、NK3组细胞凋亡明显减少（P〈0．05或P〈0．01）,Bcl-2阳性表达,Bax阴性表达,[Ca^2＋]i低（P〈0．05或P〈0．01）,SOD活性增加（P〈0．01）,MDA含量低（P〈0．01）。结论 氯胺酮抑制激活的背角星形胶质细胞内Ca^2＋超载,增强Bcl-2蛋白表达,抑制NMDA诱导的细胞凋亡,并增强抗氧化酶活性,抑制脂质过氧化反应引起的细胞损伤。     

氧自由基损伤在压疮形成中的作用机制实验研究

目的探讨氧自由基在压疮形成中的作用机制。方法将24只雄性SD大鼠随机均分为对照组（C组）、不完全性缺血组（I组）及不完全性缺血再灌注组（IR组），均仰卧于简易加压装置中，C组未受压2h后处死，I组承受70mmHg压力2h后处死，IR组承受70mmHg压力2h并于解压2h后处死。结果I组和IR组皮肤肉眼观察均出现紫红色，皮肤、肌肉光镜下观察均出现炎性细胞浸润、水肿．并且IR组更明显；I组与C组比较，超氧化物歧化酶（SOD）活性和丙二醛（MDA）含量差异无显著性意义（均P〉0．05），IR组与C组、I组比较，SOD活性显著下降（P〈0．01，P〈0．05），MDA含量显著增加（均P〈0．01）。结论压疮的形成过程中不完全性缺血再灌注加重组织细胞损伤，其中氧自由基起着重要的作用。     

雌激素抗氧化作用与绝经后骨质疏松症的关系

目的探讨活性氧与雌激素的相关性，以进一步阐明活性氧与骨质疏松症的内在联系。方法本研究选择符合纳入标准的绝经后妇女，测定其骨密度（BMD），根据骨密度分为骨质疏松组、骨量减少组及正常组各30例。检测各组研究对象的血清丙二醛（MDA）、超氧化物歧化酶（SOD）及雌二醇（E2），比较各组之间的MDA、SOD及E2的不同并分析MDA、SOD与E2的相关性。结果MDA与E2呈显著负相关（r=-0．458，P〈0．01），SOD与E2呈显著正相关（r=0．527，P〈0．01）；骨质疏松组的MDA较骨量减少组及正常组升高而SOD含量降低（P〈0．01）。骨质疏松组的E2较骨量减少组及正常组降低（P〈0．01）。结论绝经后妇女体内活性氧水平与雌激素的变化密切相关，雌激素具有抗氧化作用，雌激素水平降低引起的绝经后骨质疏松症，可能包含了活性氧的参与和介导。     

BEMF对卵巢切除骨质疏松大鼠治疗作用的骨形态计量学研究

目的观察BEMF对OVX—OP大鼠骨形态计量学指标的影响，探讨BEMF对卵巢切除致骨质疏松大鼠的治疗作用及机制。方法6个月龄雌性未孕Wistar大鼠40只，按体质量随机分为卵巢切除组（OVX）、假手术组（Sham）、仿生电磁场治疗组（EM）、雌激素治疗组（E）。术后8周，E组苯甲酸雌二醇肌肉注射，0．5mg／kg，1次，2周。EM组大鼠暴露于仿生电磁场治疗，1h·次^-1·d^-1，OVX、Sham组不予以任何处理，作为对照组。治疗10周后处死各组大鼠，取左侧胫骨进行骨形态计量学测定。结果治疗10周后，EM组大鼠％Tb．Ar、Tb．Th、Tb．N较OVX组显著增加（P〈0．01），Tb．sp显著降低（P〈0．01），与E组变化相似。E组、EM组大鼠成骨细胞数（％L．Pm）低于OVX组（P〈0．01）；EM组、E组仍高于Sham组（P〈0．01）；EM组高于E组（P〈0．01）。E组、EM组破骨细胞数（N．Oc）低于OVX组（P〈0．01）；EM组、E组仍高于Sham组，（P〈0．01）；EM组高于E组，差异非常显著（P〈0．01）。结论BEMF具有增加骨量、改善骨结构的作用；与雌激素的治疗作用存在不同机制。     

丙酮酸乙酯调节脓毒症小鼠肝细胞HSP70表达的研究

目的研究丙酮酸乙酯（EP）对脓毒症小鼠肝细胞热休克蛋白70（HSPT0）的调节作用。方法制作小鼠盲肠结扎穿孔模型（CLP），应用丙酮酸乙酯林格氏液（REPS）与乳酸钠林格氏液（RLS）对小鼠进行液体复苏，60只小鼠分3组，各20只：假手术组、CLP模型＋REPS复苏组、CLP模型＋RLS复苏组，检测肝组织丙二醛（MDA）及肝细胞HSP70的表达。结果脓毒症小鼠较假手术组MDA浓度增高，P〈0．01。EP显著提高脓毒症小鼠肝组织的抗氧化能力，REPS组肝组织MDA浓度低于RLS组【（48．18±598）μmol／g．prot vs（78．34±11．16）μmol／gprot，P〈0．01]；REPS组小鼠肝细胞HSPT0表达较RLS组增高[（28．76±5．69）vs（20．04±4．93），P〈0．051。HSP70表达与MDA值呈负相关（r=-0．733，P〈0．01）。结论EP具有的抗氧化作用能提高脓毒症小鼠肝细胞的HSPT0表达。     

Methylene blue prevents surgery-induced peritoneal adhesions but impairs the early phase of anastomotic wound healing.

OBJECTIVES: Adhesion formation continues to be an important problem in gastrointestinal surgery. In recent years, methylene blue (MB) has been reported to be an effective agent for preventing peritoneal adhesions. However, its effects on the wound healing process are unknown. In the present study, we investigated the effects of MB on the early and late phases of anastomotic wound healing and on adhesion formation. METHODS: We randomly categorized 92 rats into 2 groups in bursting pressure measurements and 50 rats into 3 groups in the adhesion model. We divided the animals into saline-treated (n = 46) or MB-treated (n = 46) groups. Bursting pressures of the anastomoses were measured on postoperative days 3 and 7. In biochemical studies, tissue hydroxyproline levels, total nitrite/nitrate levels and nitric oxide synthase activity were measured on postoperative days 3 and 7. In the adhesion model, we randomly categorized rats into sham (n = 10), saline-treated (n = 20) and MB-treated (n = 20) groups, and the formation of intraperitoneal adhesions was scored on postoperative day 14. We compared the measurement of bursting pressure and biochemical measurements of tissue hydroxyproline levels, total nitrite/nitrate levels and nitric oxide synthase activity. Histopathological findings of specimens were presented. RESULTS: During the early phase of wound healing (postoperative day 3), bursting pressures, tissue hydroxyproline, total nitrite/nitrate levels and nitric oxide synthase activity in the MB-treated group were significantly lower than those of the saline-treated group. On postoperative day 7, there was no significant difference in these parameters between MB and saline-treated groups. In the adhesion model, MB caused a significant reduction in the formation of peritoneal adhesions. CONCLUSION: MB prevents peritoneal adhesions but causes a significant impairment of anastomotic bursting pressure during the early phase of the wound healing process by its transient inhibitory effect on the nitric oxide pathway.     

几丁糖对大鼠术后腹腔粘连的预防作用

目的　探讨几丁糖对术后腹腔粘连的预防作用。方法　将 45只大鼠随机分为对照组 (A组 ) ,右旋糖酐组 (B组 ) ,几丁糖组 (C组 ) ,于腹腔内浆膜损伤部位分别注入 1%乳酸液 ,3 2 %右旋糖酐 -70液 ,2 %几丁糖乳酸液各 2ml ,术后 14d处死动物 ,观察各组腹腔粘连状况并送病理检查。结果　 3组粘连分级有显著性差异 (P <0 .0 1) ;C组粘连发生率较另 2组为低 ,有显著性差异 (P <0 .0 5 )。光镜下C组炎症反应轻微 ,纤维增生不明显 ;电镜下C组纤维细胞分泌胶原能力弱 ,间皮细胞增生活跃。结论　几丁糖可有效地降低大鼠术后腹腔粘连的发生和粘连程度 ,其作用优于右旋糖酐 -70 ,且不影响切口的愈合。     

Effect of nitric oxide on postoperative adhesion formation

Peritoneal adhesions continue to be a significant cause of postoperative complications. The purpose of the present study was to investigate the effect of nitric oxide in preventing postoperative adhesion formation in rats. Three randomized groups of Sprague-Dawley rats were subjected to a standardized lesion by cecal abrasion and parietal peritoneal defect. 0.9% NaCl (control, group 1), L-arginine (300 mg/kg, group 2) and Nomega-nitro arginine methyl ester (L-NAME; 25 mg/kg, group 3) were administered intraperitoneally before abdominal closure and during 3 consecutive days after surgery. Two weeks after surgery, a relaparotomy was performed and the extent of adhesion formation was determined. In groups 1 and 3 heavy adhesions were detected. In the L-arginine group, adhesion formation was significantly less than in the other groups (p < 0.05). This study showed that L-arginine reduced adhesion formation.     

聚-己内酯隔离膜防止大鼠术后腹腔粘连作用的研究

目的 探索高分子生物降解材料在预防腹腔粘连中的作用。方法 120只大鼠按编号法随机均分为对照组、乳胶隔离膜组和聚-己内酯（polycaprolactone，PCL）隔离膜组。对照组手术建立腹腔粘连动物模型，乳胶隔离膜组和PCL隔离膜组在该手术基础上，分别将两膜固定在腹膜创面上。3组动物分别于术后1、3、7及30d不同时点各取10只大鼠开腹观察腹腔粘连情况。结果对照组全部发生腹腔粘连，乳胶隔离膜组及PCL隔离膜组粘连率明显减低，以后者更显著。结论PCL膜能被假单胞杆菌脂肪酶降解，避免异物刺激产生新的粘连，故此膜为首选。     

Prevention of Postoperative Peritoneal Adhesions by Administration of Estrogen

Aim: Postoperative abdominal adhesions represent one of the most common causes of intestinal obstruction in surgical patients. In this study, the effects of intraperitoneal administration of estrogen on the development of postoperative intraabdominal adhesions and peritoneal leucocytes in a rat adhesion model were investigated. Methods: Sixty Wistar albino rats were divided into three groups. Group 1 (control group) had their abdomen closed after surgery without administration of any material or drug. Group 2 (saline group) received 2 ml of 0.9% NaCl, and group 3 (estrogen group) animals received a single intraperitoneal dose of 2 cc (1 mg) estrogen (Estradiol propionate, 50.000U, Akrofilline®, Biofarma, Turkey). All the groups were exposed to the same adhesion-creating procedure (Swolin K. Experimental studies on the prevention of intra-abdominal adhesions. Studies on rats with an emulsion of lipid and prednisolone. Acta Obstet Gynecol Scand. 1966;45:473–498.). After 7–42 days, all animals were sacrificed. Adhesions were scored and peritoneal leucocytes were counted. Results: The adhesion formation and peritoneal leucocyte count of the estrogen group were significantly less than the control and saline groups and a statistically significant difference was determined in comparison of those groups (p <. 05). Conclusion: We concluded that intraperitoneal estrogen decreases the incidence of postoperative intraabdominal adhesion formation in rat adhesion model.     

Icodextrin reduces postoperative adhesion formation in rats without affecting peritoneal metastasis

BACKGROUND: Peroperative peritoneal trauma activates a cascade of peritoneal defense mechanisms responsible for postoperative adhesion formation. The same cascade seems to play a role in the process of intra-abdominal tumor recurrence. Icodextrin is a glucose polymer solution that is absorbed slowly from the peritoneal cavity, allowing prolonged "hydroflotation" of the viscera, thereby decreasing adhesion formation. This study evaluated the adhesion-preventing properties of icodextrin and its effect on peritoneal metastasis. METHODS: Reproducible rat models of peritoneal trauma were used, allowing semiquantitative scoring of adhesion formation or tumor load. In one experiment, peritoneal trauma was inflicted; one group was treated by peroperative intra-abdominal instillation of 7.5% icodextrin, one by instillation of RPMI (placebo), and one had no instillate (controls). In another experiment involving a different model of peritoneal trauma, the coloncarcinoma cell line CC531 was injected intraperitoneally to induce tumor load, again using these three groups. RESULTS: Treatment of peritoneally traumatized rats with icodextrin caused a 51% reduction in postoperative adhesion formation ( P < .001). However, peroperative intra-abdominal treatment with icodextrin did not affect intraperitoneal tumor cell adhesion and growth of free intra-abdominal tumor cells in rats with this model of severe peritoneal trauma. CONCLUSION: A 7.5% icodextrin solution is effective in reducing postoperative adhesions without promoting tumor recurrence and therefore may prove useful and safe in oncologic surgery.     

羧氨基萄聚多糖钠间断腹腔内注射预防术后腹腔粘连

目的探讨羧氨基萄聚多糖钠（术尔泰）间断腹腔注射预防术后腹腔粘连。方法32只雌性SD大鼠完全随机法均分为四组：A组为假手术组、B组为术尔泰一次性腹腔灌注组、C组为术尔泰问断腹腔注射组、D组为生理盐水处理组。A组行开关腹手术,B、C、D三组制作腹腔粘连模型,10d后处死动物,行BellucoC粘连评分;行HE和Masson染色,sP法观察粘连组织转化生长因子-β1（TGF-β1）的表达。结果①A组粘连最轻,C组粘连评分明显低于D组和B组。②HE、Masoon染色示A组无明显炎症反应,C组较B、D两组的炎症反应明显减轻。③A组与C组TGF-β1的表达无明显差异,但两组TGF-β1的表达要明显轻于D组和B组,差异有统计学意义（P〈0．01）。结论术后腹腔间断注入羧氨基萄聚多糖钠可以显著抑制TGF-β1表达,其防粘连作用明显优于一次性腹腔灌注。     

Effect of a matrix metalloproteinase activity and TNF-alpha converting enzyme inhibitor on intra-abdominal adhesions

BACKGROUND: Formation of intra-abdominal adhesions depends, in part, on the activity of serine proteinases. Matrix metalloproteinases (MMP) are required for epithelialization of skin wounds but their involvement in mesothelialization of peritoneal wounds and in adhesion pathogenesis is not known. Early tumor necrosis factor-alpha (TNF-alpha) levels have been proposed to reflect propensity to adhesion formation. OBJECTIVE: The impact of MMP activity and secreted TNF-alpha on peritoneal adhesion formation and healing was investigated through systemic administration of the synthetic broad-spectrum MMP and TNF-alpha-converting enzyme (TACE) inhibitor GM 6001. METHODS: Female Sprague-Dawley rats of 4-6 weeks of age were injected subcutaneously daily with GM 6001 100 mg/kg (n = 12) or vehicle (n = 10) starting two days before surgery. In each rat, two standardized peritoneal wounds, 20 mm x 5 mm, were made. One peritoneal wound was sutured whereas the contralateral wound healed by secondary intention. Adhesion formation and peritoneal healing, cell proliferation, and hydroxyproline concentrations were evaluated on postoperative day 7. RESULTS: Total serum TNF-alpha levels increased in vehicle-treated rats (p = 0.019) while GM 6001 treatment effectively prevented the rise in the postoperative phase (p < 0.001). No significant differences were observed in the extent of adhesion formation (p = 0.67) between control (65.0%) and GM 6001-treated (61.5%) animals, or peritoneal wound healing or cell proliferation. Hydroxyproline levels increased in the wounds (p = 0.014) but were not different between the two groups (p = 0.14). CONCLUSIONS: Lack of a striking effect of the MMP and TACE antagonist GM 6001 on postoperative adhesions suggests that MMP activity and TNF-alpha might not be major adhesiogenic factors.     

Effects of Peritoneal Lavage with Scolicidal Agents on Survival and Adhesion Formation in Rats

Intraoperative irrigation of the peritoneal cavity with scolicidal agents is frequently recommended when dealing with traumatic or spontaneous rupture of hydatid cysts. The present experimental study was designed to examine the influence of various scolicidal agents on adhesion formation and survival. A total of 149 rats were randomly allocated to nine groups. Peritoneal lavage through a median laparotomy was performed with the following scolicidal agents. Group 1 (0.9% saline: controls), group 2 (20% hypertonic saline), group 3 (0.04% chlorhexidine gluconate), group 4 (3% hydrogen peroxide), group 5 (0.5% silver nitrate), group 6 (1% polyvinylpyrrolidone-iodine, or PVP-I ), group 7 (5% PVP-I), group 8 (0.5% cetrimide/0.05% chlorhexidine), and group 9 (10% PVP-I). The surviving animals were sacrificed on postoperative day 15. Adhesion formation was macroscopically graded by the Nair criteria. The severity of adhesion formation was evaluated microscopically using the fibrosing scoring criteria and the strain test. Group 9 (10% PVP-I) was excluded from the adhesion evaluation because all of the rats died in this group. The mortality rate was significantly higher in groups 5 and 7 than in groups 1, 2, 3, 4, 6, and 8. Adhesion scores were significantly lower in groups 1, 2, 3, and 4 than in groups 5, 6, 7, and 8. The lowest adhesion score was found in group 3 and the highest in the group 7. These results indicate that 0.04% chlorhexidine gluconate, the most potent scolicidal agent in vitro and in vivo, was associated with the lowest adhesion formation and mortality among various scolicidal agents in this experimental study.     

A novel approach to reducing postoperative intraperitoneal adhesions through the inhibition of insulinlike growth factor I activity

HYPOTHESIS: Interference with insulinlike growth factor I (IGF-I) activity, both systemically and intraperitoneally, reduces postoperative intraperitoneal adhesion severity. SETTING: Experimental animal model. DESIGN, INTERVENTIONS, AND MAIN OUTCOME MEASURES: Adult female rats were subjected to hypophysectomy, sham hypophysectomy (control), IGF binding protein 4 (IGFBP-4) treatment, or albumin treatment (control). All rats underwent laparotomy and uterine horn abrasion with adjacent parietal peritoneal trauma for the purpose of creating postoperative intraperitoneal adhesions. Glucocorticoids and thyroid hormone were replaced in the hypophysectomy group. On postoperative day 10, rats were weighed, subjected to phlebotomy, and killed. Postmortem laparotomies were performed and blinded observers scored uterine-peritoneal adhesions on a 0 to 3 scoring system. Plasma IGFBP-4 levels and organ weights were measured in the IGFBP-4 and albumin treatment groups. Blood samples in all rats were analyzed for IGF-I levels. RESULTS: Rats with low IGF-I levels (hypophysectomy) and inhibited IGF-I activity (IGFBP-4 treatment) formed significantly less severe adhesions than their control counterparts. As expected, rats in the hypophysectomy group displayed greater weight loss and lower plasma IGF-I levels than sham-treated rats. Rats treated with IGFBP-4 and those treated with albumin demonstrated no differences in body weight, organ weights, IGF-I levels, and IGFBP-4 levels. CONCLUSIONS: Both the reduction of systemic IGF-I levels via hypophysectomy and the inhibition of local intraperitoneal IGF-I activity via IGFBP-4 treatment resulted in diminished postoperative adhesion severity. Treatment with IGFBP-4 may play a role in postoperative adhesion prophylaxis in the future.