The clinical significance of pathological studies of congenital intestinal atresia

Objective

The purpose of this study was to explore the mechanisms of postoperative intestinal motility disorders in intestinal atresia patients by investigating the expression profiles of proteins, including calretinin (CR), glial-derived neurotrophic factor (GDNF), bone morphogenetic protein 2 (BMP-2), c-kit, α-smooth muscle actin (α-SMA), and S-100 protein; to decipher the correlation between the area of the pathological segment and the alteration of the above 6 proteins; and thereby to provide a clinical specific reference values to determine the removal length for intestinal tract resection.

Methods

Immunohistochemistry technique was applied to detect the CR, c-kit, GDNF, BMP-2, α-SMA, and S-100 protein in specimens of atretic, proximal, and distal intestine from 25 cases of intestinal atresia and samples of intestinal walls from 10 non-atresia control specimens. The alteration of the enteric nervous system, nerve growth and its regulatory factors, the interstitial cells of Cajal (ICCs), and the enteric muscle system were examined, with particular attention being paid to pathological changes and the lesion area.

Results

The expression of all of the abovementioned 6 proteins in the proximal side of the atresia was significantly lower than in control group. The expression of the abovementioned proteins tended to be higher farther away from the atresia site. The expressions of both GDNF and BMP-2 had returned to normal level at 10 cm proximal to the atresia site, whereas the expressions of CR, c-kit, α-SMA, and S-100 protein only returned to normal at 15 cm proximal to the atresia site. On the distal side, the expression of all 6 markers at 3 cm distal to the atresia site was normal.

Conclusion

Pathological deterioration of the myenteric ganglia, nerve growth factor, and ICCs are the causes of intestinal motility disorders after the surgical repair of intestinal atresia. Our data support resecting an intestinal segment extending from 15 cm proximal to 3 cm distal to the atretic segment. In proximal jejunal atresia, when it is not possible to resect 15 cm, we suggest resecting as much of the hypertrophic proximal intestine as possible. Based on our data, we believe this surgical practice could improve postoperative dysmotility in these patients.     

Allicin Ameliorates Cardiac Hypertrophy and Fibrosis through Enhancing of Nrf2 Antioxidant Signaling Pathways

Aim

To evaluate the protective effects of allicin on Ang II-induced cardiac hypertrophy.

Methods

Sprague?CDawley male rats were randomized into 3 groups:1)sham group (saline)(n?=?12), 2) Ang II group(n?=?9), 3) allicin group (Ang II + allicin)(n?=?9). They received infusions of either saline or Ang II (250?ng/kg body weight per min) through mini-osmotic pumps implanted subcutaneously for 2?weeks and given a diet containing 180?mg/kg/day of allicin for 8 consecutive weeks. Hemodynamic, morphological, histological, and biochemical changes were evaluated at corresponding time points.

Results

Ang II infusion increased blood pressure, heart rate and heart weight to body weight ratio, and resulted in anatomical and functional changes, such as increased LV mass, posterior wall thickness and LV end-diastolic diameter, and decreased fractional shortening and EF compared with sham rats. Nrf2 and HO-1 in the hearts of rats in the Ang II group were moderately elevated at both mRNA and protein levels compared to sham group mice, but NQO1 and??-GCS were significantly lower. GPx activities, levels of GSH and T-AOC in the hearts of the rats in the Ang II group were also significantly lower, and the levels of TBARS, reactive oxygen species and protein carbonyl were significant increased. Allicin attenuated LV mass, posterior wall thickness and LV end-diastolic diameter (1.10?±?0.04 vs. 1.37?±?0.05, 2.26?±?0.08 vs. 2.96?±?0.12, 7.27?±?0.36 vs. 8.56?±?0.41, respectively; all P?<?0.05), and increased fractional shortening and EF (28.30?±?3.21 vs. 25.40?±?2.57, 60.27?±?5.63 vs. 51.30?±?4.78, respectively; both P?<?0.05) in the Ang II-induced hypertrophic rats compared to the untreated Ang II rats. Furthermore, allicin treatment attenuated the accumulation of interstitial collagen and collagen I/III (P?<?0.01 vs. the untreated Ang II group), decreased the levels of reactive oxygen species, protein carbonyl and TBARS and increased GPx activities. Moreover, allicin significantly increased mRNA expression and protein levels of Nrf2, NQO1, and ??-GCS ( P?<?0.01, P?<?0.05 vs. the untreated Ang II group).

Conclusion

Allicin could prevent the development of cardiac remodeling and the progression of cardiac hypertrophy to cardiac dysfunction caused by enhancing the Nrf2 antioxidant signaling pathways.     

白藜芦醇对高脂饮食大鼠骨骼肌不同线粒体亚群氧化、抗氧化水平和胰岛素敏感性的影响

目的 观察白藜芦醇对高脂饮食大鼠骨骼肌不同线粒体亚群氧化、抗氧化水平及胰岛素敏感性的影响.方法 8周龄雄性SD大鼠分为普通饮食组(NC组)、高脂饮食组(HF组)及白藜芦醇干预高脂饮食组(HFR组);干预8周后检测各组大鼠骨骼肌肌膜下(SS)及肌纤维间(IMF)线粒体氧化应激及抗氧化水平,并观察各组大鼠整体及骨骼肌胰岛素敏感性的变化.结果 与NC组相比,HF组大鼠胰岛素敏感性明显下降(P＜0.05),SS及IMF线粒体活性氧簇(ROS)和丙二醛的水平明显增加,SS线粒体抗氧化酶活性均下降,而IMF线粒体抗氧化酶活性均增高(均P＜0.05).与HF组相比,HFR组胰岛素敏感性明显改善,SS及IMF线粒体的抗氧化酶活性均明显增高,ROS和丙二醛的含量明显下降到NC组水平(均P＜0.05).结论 白藜芦醇对高脂饮食大鼠骨骼肌不同线粒体亚群氧化应激水平均有明显的改善作用,并且显著增加其胰岛素敏感性.     

不同低氧方式对大鼠血清和组织局部肾素血管紧张素系统的影响

目的 研究慢性间歇低氧(CIH)与持续低氧(CH)对大鼠血清及组织器官局部的肾素血管紧张素(RAS)系统的影响,以探讨CIH相关性高血压及低氧性肺动脉高压的发生机制.方法 18只SD雄性大鼠按随机数字表法分为CIH组、CH组和对照组共3组,每组6只.CIH组大鼠循环给予氮气和压缩空气(每循环180 s,舱内最低氧浓度达6％～8％,维持20～25 s,然后恢复至21％,7 h/d),CH组持续给予氮气(舱内氧浓度保持8％～12％,7 h/d),对照组大鼠常规饲养.结果 第6周时CIH大鼠收缩压(SBP)显著高于CH组、对照组(P＜0.05)和实验前水平(P＜0.01).CIH分别与CH和对照组比较:肾小动脉和肺小动脉中ACE及ACE2水平差异有统计学意义(P＜0.05);血清和肾组织中AngⅡ显著增高(P＜0.05),Ang-(1-7)则明显降低(P＜0.05).CH组肺组织AngⅡ较CIH及对照组增高(P＜0.05),Ang-(1-7)降低(P ＜0.05);SBP与血清及肾AngⅡ水平呈正相关;与Ans-( 1-7)水平呈负相关.CIH组肾小动脉及CH组肺小动脉管壁厚度、壁厚度占外径或内径的百分比(WT％)及管壁面积占血管壁总面积的百分比(WA％)分别与其他两组比较均有明显差异(P＜0.05).肺及肾的小动脉管壁厚度与其相应组织局部的AngⅡ呈正相关(r=0.386、0.414,均P＜0.05),与Ang-( 1-7)呈负相关(r=-0.401,-0.394,均P＜0.05).结论 CIH与CH两种低氧方式对大鼠血清及各组织局部的RAS系统影响程度及结果存在差异性,CIH主要影响大鼠肾组织及肾小动脉及体循环RAS系统,与血压增高密切相关;CH主要影响肺组织及肺小动脉RAS系统,可能与肺动脉重塑及肺动脉高压有关.     

经导管主动脉瓣置换术的新进展

近年来,经导管主动脉瓣置换(TAVI)术发展迅猛。对于外科手术风险很高的严重主动脉瓣狭窄患者,TAVI术已成为一种替代治疗。随着器械的不断改进和临床经验的积累,一些新的技术开始应用于TAVI领域,如非传统的支架输送途径、新材料的带瓣膜支架、局部麻醉下的TAVI术、经导管"瓣中瓣"技术等等。本文将TAVI领域近年来出现的一些新技术作一介绍。     

DAPI联合PKH26标记骨髓干细胞在急性肝脏损伤模型小鼠肝内迁移的示踪作用

目的探讨PKH26和DAPI联合标记骨髓干细胞在肝脏组织内迁移过程中的示踪作用。方法用PKH26和DAPI联合标记从Balb/c小鼠骨髓中分离出骨髓干细胞,用CCl4腹腔注射的方法制备小鼠急性肝脏损伤模型后,将标记的BMMC经尾静脉移植入急性肝脏损伤模型小鼠体内,对照组经尾静脉注入磷酸盐缓冲液(PBS)。移植2周后取肝脏组织,通过激光共聚焦荧光显微镜观察骨髓干细胞向肝脏内迁移的情况。结果接受骨髓干细胞移植组小鼠肝脏组织内可发现DAPI和PKH26双重标记的骨髓干细胞。结论 PKH26和DAPI可以联合标记向急性肝损伤模型肝组织迁移的骨髓干细胞,为体内示踪骨髓干细胞脑内迁移提供更加准确的实验方法。