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ObjectiveTo investigate the effects of splenectomy on the intestine mucosa barrier in rats with obstructive jaundice. Methods50 Wistar rats were divided randomly into the obstructive jaundice group (OJ), in which the animals underwent operation to ligate common bile duct, and the obstructive jaundice + splenectomy group (OJ+ S). Seven days post-operation, plasma endotoxin levels were detected. Intestinal mucosa permeability was measured by the ratios of lactulose and mannitol (L/M). Immunohistochemistry and Western blot were used to examine the expression of tight junction proteins (ZO-1 and occludin) in the distal ileum mucosa. Western blots images were analyzed quantitatively. ResultsAverage ratios of L/M and plasma endotoxin were decreased obviously in the OJ+S group compared to those in the OJ group (all P=0. 001). Compared with the OJ group, the average intestinal villus height and mucosa thickness were upgraded somewhat in the OJ + S group (P = 0.019, 0. 001 ). By immunohistochemistry staining seven days post-operation, same comment as above the amounts of strong positive expression of ZO-1 were significantly decreased in the OJ group (6/18, P-0. 021). There wewas no difference between the OJ+S group(8/17) and the OJ group.The amount of strong positive expression of occludin was higher in the OJ + S group than that of the OJ group(10/17 vs 4/18, P= 0. 026). The same outcomes were obtained by quantitative Western blot images. Conclusion The intestinal epithelial permeability was increased in rats with obstructive jaundice,and intestinal barrier was damaged. After excising spleen, the amount and distribution of tight junction proteins were changed and the impairment of intestinal barrier was abated.
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Objective To investigate the correlation of insulin resistance (IR) and benign prostate hyperplasia (BPH). Methods The 200 health examination men were divided into three groups according to the prostate volume (PV). There were 100 healthy subjects as control group (PV≤20 ml), 50 cases in BPH1 group (20 ml＜PV＜50 ml) and 50 cases in BPH2 group (PV≥50 ml).The fasting blood glucose (FBG) and fasting serum insulin (FSI) were determined using hexokinase method and radioimmunoassy, respectively. The IR index (IRI) and body mass index (BMI) were calculated according to the formula in HOMA model. Results There were no statistical differences between BPHl group and healthy control group in IRI (1.10±0. 18 vs. 1.18±0.21) and BMI (22. 0±3.0vs. 21.8±2.7) (t=0.74, 0.18, both P＞0. 05), but the IRI (1.31±0.19) and BMI (24. 8±3.29) increased in BPH2 group (P=0. 01, 0.03). The percentage of hyperglycosemia was higher in BPH patients than in normal controls (25% vs. 5%, P = 0. 00). Of them, the percentage of hyperglycosemia was the highest in BPH2 group (36%, P = 0. 01 ), their IRI ( 1.47 ± 0.21 ) was higher than in euglycemia patients (t=3.92, P=0.00), but the BM1 was unchanged compared with the control group ( 25.8 ± 4.3 vs. 24.3 ± 2.71, P = 0. 95 ). Conclusions There is a positive correlation of IR and hyperglycosemia with severe BPH, and the IR in severe BPH is independent of BMI.
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Objective To investigate the effects and mechanisms of bile on small intestine mucosal barrier.Methods Fifty Wistar rats were assinged into 3 groups randomly: obstructive jaundice(OJ) group(n=20),biliary external drainage group(n=20) and control group(n=10).Ten days after operation,the plasma endotoxin level was determinated,the terminal ileum mucosas was obtained to be morphologically measured by light microscope,and immunohistochemistry and Western blot were uesd to examine the expressions of tight junction proteins zona occludens-1(ZO-1) and occludin in the mucosas.Results Atrophy significantly appeared in the distal ileum mucosas in OJ group.Compared with control group,the intestinal villus height,mucosa thickness and crypt depth in OJ group were obviously decreased 27.8%,21.7%,and 25.4%(P=0.001,0.001,0.040).There were no differences between external drainage group and control group(P=0.050,0.070,0.080);While the values of external drainage group were significantly higher than those in OJ group(all P=0.001).The level of plasma endotoxin was up to(1.49?0.27) EU/ml in OJ group compared with control group((0.27?0.09) EU/ml),P=0.001.In external drainage group,the value was(0.91?0.25) EU/ml,which was obviously higher than that in control group and lower than that in OJ group(all P=0.001).Immunohistochemical study showed strong positive expression of ZO-1 dropped from 7/10 in the control group to 6/20 in OJ group(P=0.040),occludin expression was 8/10 in control group and 7/20 in OJ Group(P=0.020);expressions of them in external drainage group(8/20(P=0.100,0.210) and 9/20(P=0.060,0.200)) displayed no significant differences compared with the other twogroups.Quantitative testing of Western blot showed the expressions of ZO-1 and occludin in OJ group were significantly lower than those in control group(P=0.001,0.010),the values in external drainage group were higher than those in OJ group(P=0.005,0.014).The expression of ZO-1 was lower in external drainage group than that in control group(P=0.001),and there was no significant difference of occludin between the two groups(P=0.062).Conclusion Lack of intestinal bile will undermine the intestinal tight junction protein composition,and make intestinal mucosal barrier impaired.The intestinal barrier more severely injured when biliary tract obstructs because of multiple factors.Bile plays an important role in the maintenance of intestinal mucosal barrier.
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<p><b>OBJECTIVE</b>To evaluate the long-term effects of retrograde liberated highly selective vagotomy (RLHSV) in the treatment of duodenal ulcer.</p><p><b>METHODS</b>Seventy patients with duodenal ulcers complicated by stenosis, bleeding, or perforation were operated on by retrograde liberated highly selective vagotomy. Among these patients, 61 had perforated duodenal ulcers, 6 bleeding and 3 stenosis.</p><p><b>RESULTS</b>Followed up for 30 to 120 months in 65 patients showed a recurrence rate 7.69% and no hemorrhage occurs. According to the modified Visick grading system, 56 patients (86.2%) were of Visick I, 4 (6.1%) of Visick II, 2 (3.0%) Visick III, 3 (4.6%) Visick IV, and (92.3%) Visick I or II.</p><p><b>CONCLUSIONS</b>This modified procedure is rapid, easy and radical operation with excellent long-term results. It can be considered an effective alternative for the treatment of duodenal ulcer with complication.</p>
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Adult , Aged , Female , Humans , Male , Middle Aged , Duodenal Ulcer , General Surgery , Follow-Up Studies , Gastric Emptying , Gastroscopy , Recurrence , Vagotomy , MethodsABSTRACT
Objective To summary the experience in diagnosis and surgical treatment of differentiated thyroid carcinoma (DTC). Methods The clinical data and follow-up results of 167 cases of DTC were retrospectively analysed. Results (1) The accurate rate of preoperative cytology diagnosis was 76.9%(97/126). (2)121 patients were diagnosed as thyroid carcinoma before or during operation. Histologic examination after primary operation revealed that the carcinoma spread to the isthmus and the opposite lobe in 5 cases. 57 cases were followed up with only 2 cases recurred 2 and 3 years after the operation, and 3 died 6 to 10 months after operation. (3)87.5%(42/48)cases of the reoperation were due to misdiagnosis as benign lesions in primary operation. Histologic examination revealed that residual tumor in the remnant thyroid tissue was found in 45.2%(19/42)cases, and residual tumor in the lymph nodes of the suffered side in 19.0%(8/42)cases. 30 cases were followed up without any recurrence. Conclusions (1) Cytological diagnosis must be paid great attention to preoperatively; (2) Excision of the suffered lobe, isthmus and greater partial of the opposite lobe, along with clearing the enlarged lymphnodes of the isolateral side are generally performed for the DTC; (3) Reoperation due to misdiagnosis as benign lesions in primary operation must remove the remnant tissue of thyroid and the isolateral lymphnodes. The cases should also be followed up even if enough excising is performed in primary operation.
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Objective To explore the effects of glucagon-like peptide-2(GLP-2) on intestinal mucosa epithelium myosin light chain kinase(MLCK)of the rat with obstructive jaundice.Methods The obstructive jaundice models of rats were set up.At postoperative 10 d,the control group rats were subcutaneously injected with 0.5 mL PBS;experiment group A with 250g/(kg?d) GLP-2 (0.5 mL),and experiment group B with 125 g/(kg?d) GLP-2 (0.5 mL),b.i.d?7 d,then all the rats were killed The villus height,mucosa thickness and crypt depth of the terminal ileum mucosa were detected.Immunohistochemistry and Western-blot were used to examine the distribution and expression of MLCK.Image analytical system and statistics software were used to analyze the results quantitately.Results The intestinal villi of the distal ileum mucosa were short and sparse in control group.Compared with control group,the average intestinal villus height,mucosa thickness and crypt depth were increased 27.8%,21.7% and 25.4%(all P0.05).The same outcomes were obtained by quantitative analysing Western blot images.The degression of intestinal villus height and absorbance of MLCK images presented direct correlation.Conclusions The intestinal mucous membrane shows obvious atrophy in obstructive jaundice.Exogenous supplemented GLP-2 can enhance the quantity and distribution of MLCK in intestinal mucosa in obstructive jaurdice,and can restore the morphology of intestinal mucosa epithelium.
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Objective To elucidate the mechanisms of disruption of intestinal mucosa barrier in obstructive jaundice.Methods The obstructive jaundice model of rats was set up.At 10 d and 20 d after operation,immunohistochemistry and Western-blot techniques were used to examine the distribution and expression of tight junction proteins(ZO-1,Occludin) and myosin light chain kinase(MLCK)in intestinal mucosa.Results In normal control groups,the staining of ZO-1 and occludin was predominantly localized to the margins of the epithelial cells and the apex of the cell membrane,and displayed a continuous and uniform distribution along the under surface of the villae.MLCK was distributed mainly in cytoplasm.In obstructive jaundice groups,ZO-1 and occludin staining appeared discontinuous and vague,with rough edges and spiculate processes.The staining of MLCK was also discontinuous and scanty.The strong positive express ratio of ZO-1,Occludin and MLCK were obviously lower in two experiment group than those in the control group all P