Changes of intestinal hemodynamics in children with abdominal pain accompanied with or without mesenteric lymph node enlargement / 中国基层医药

Objective To analyze the changes of intestinal hemodynamics in children with abdominal pain accompanied with or without mesenteric lymph node enlargement.Methods From June 2016 to December 2017,in Yuncheng Central Hospital,48 children with abdominal pain and mesenteric lymph node enlargement were randomly selected as the study group,and 49 children with abdominal pain and no mesenteric lymph node swelling were selected as the control group.The end diastolic flow rate,peak systolic flow velocity and resistance index of the SMA were compared by color Doppler ultrasound.Results The end diastolic velocity[(16.46 ± 5.14)cm/s] and peak systolic velocity[(94.89 ±20.15)cm/s]of SMA in the study group were significantly lower than those in the control group [(20.23 ± 6.09) cm/s,(106.98 ± 19.32) cm/s] (t =3.2,3.00,both P ＜ 0.01).There was no statistically significant difference in the SMA resistance index between the two groups [(0.82 ± 0.05) vs.(0.81 ± 0.04)] (t =1.08,P ＞0.05).Conclusion The end diastolic flow rate and peak systolic flow velocity of SMA in children with abdominal pain and mesenteric lymphadenopathy are significantly lower than those with abdominal pain and no mesenteric lymph node enlargement.This shows that the end diastolic flow rate and peak systolic flow velocity of SMA can effectively reflect the changes in the intestinal flow mechanics of the children,which can be used to diagnose the mesenteric drenching in children.It provides a reliable basis for the enlargement of the knot.

Research progress on intestinal immunoregulation and mechanism of Sijunzi Decoction polysaccharide / 中草药

Sijunzi Decoction polysaccharide (SJZDP) is the active component contributing to the function of intestinal immunoregulation, which is the highest content in Sijunzi Decoction. SJZDP can activate immunological response in peyer’s patch, mesenteric lymph nodes, intestinal epithelial cells and intestinal intraepithelial lymphocytes, but the mechanism is unknown. The reported mechanisms of SJZDP’s intestinal immunoregulation activity are related to its regulation of intestinal flora and polyamine signaling pathway. This review is to give a comprehensive summary of information regarding the intestinal immunoregulation of SJZDP and mechanism to help us take the action for reasonable clinical utilization and further researches.

Effects of mesenteric lymph duct ligation on sepsis-induced lung and intestinal injuries in rats / 西安交通大学学报(医学版)

Objective To study the effect of mesenteric lymph duct ligation(MLDL)on sepsis-induced lung and intestinal injuries in rats.Methods Sepsis was induced by cecal ligation and puncture(CLP)in male rats.The rats were randomly divided into sham control group in which rats received sham operation,sepsis group(CLP group)in which rats received saline after CLP operation,and CLP+MLDL group in which rats received mesenteric lymph duct ligation(MLDL)after CLP operation.The rats were sacrificed at 24 h after CLP modeling. Bronchoalveolar lavage fluid,arterial blood,and intestine and lung tissues were collected to determine organ injuries.Results The lung tissue histopathology and blood gas analysis revealed that MLDL markedly alleviated the lung injury(ALI score:6.14 ± 0.51 vs.8.12 ± 0.63,P=0.029 9),improved oxygen partial pressure[(78.67 ± 4.51)mmHg vs.(64.83 ± 2.90)mmHg,P=0.0273],decreased lung W/D ratio(6.12 ± 0.25 vs.7.63 ± 0.49,P=0.021 2),decreased BALF cytokines levels[TNF-α:(828.17 ± 81.89)pg/mL vs.(1 118.17 ± 79.22)pg/mL,P=0.029 1;IL-6:(39.33 ± 5.50)ng/mL vs.(68.67 ± 5.24)ng/mL,P=0.003 4],alveolar permeability[protein levels:2.117 ± 0.289 2 vs.3.033 ± 0.164 7,P=0.020 3,and cell levels:(30.00 ± 3.587)×106/L vs.(43.83 ± 2.358)×106/L,P=0.009 1].However,according to the results of HE and biochemical detection,MLDL had no protective effect on sepsis-induced intestinal injury.Moreover,MLDL could significantly reduce the bacterial loads of the blood and lung,but do not change the bacterial level in the intestines.Conclusion MLDL has a significant protective effect on sepsis-induced lung injury mainly by decreasing bacterial translocation,but had no effect on intestinal injury.This difference may be related to that MLDL inhibits the bacteria spreading from abdominal cavity to other organs in sepsis but it causes their accumulation in the intestines.

Expression of Pref-1 and Related Chemokines during theDevelopment of Rat Mesenteric Lymph Nodes / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>The aim of this study was to investigate the ability of Pref-1+ adipocyte progenitor cells to mobilize into mesenteric lymph nodes (MLNs) and the dynamic expression of related chemokines during the development of rat MLNs.</p><p><b>METHODS</b>Immunohistochemical analyses were used to detect the expression of Pref-1 and related chemokines. Transmission electron microscopy (TEM) was used to observe the changes in ultrastructure of MLNs.</p><p><b>RESULTS</b>Cells containing lipid droplets were found in all rat MLNs at embryonic day (E) 18.5, 2 and 6 weeks (w) after birth, and they were similar to fibroblastic reticular cells (FRCs) or follicular dendritic cells (FDCs) under TEM. Pref-1+ adipocyte progenitor cells were found in all MLNs. The expression level of Pref-1 was significantly increased at 2 w after birth and decreased at 6 w after birth. The tendency of Cxcl12 expression was consistent with that of Pref-1 and was positively correlated with the expression of Pref-1 (P < 0.01; r = 0.897). At E18.5, Cxcl13, and Ccr7 were significantly expressed in the MLN anlage, but the expression level of Ccl21 was low. The expression level of Cxcl13, Ccr7, and Ccl21 in MLN were significantly increased at 2 w after birth (P < 0.05), while the expression of Ccr7 and Ccl21 were significantly decreased at 6 w after birth (P < 0.05).</p><p><b>CONCLUSION</b>Adipocyte progenitor cells are involved in the rat MLNs development through differentiation into FRC and FDC. The expression of the relevant chemokines during the development of MLNs is dynamic and may be related to the maintenance of lymph nodes self-balance state.</p>

Avaliação lectino-histoquímica de fígado e linfonodo mesentérico de búfalos mantidos em pastagens de Brachiaria spp / Lectin histochemistry evaluation of liver and mesenteric lymph node of buffaloes kept on Brachiaria spp. pastures

Animais que se alimentam em pastos de Brachiaria spp. comumente apresentam macrófagos espumosos isolados ou agrupados no fígado, além de cristais no interior de ductos biliares. A patogênese da formação e a natureza do material armazenado nestas células, contudo, ainda não são completamente conhecidas. Através da avaliação lectino-histoquímica, saponinas esteroidais (metabólitos glicosilados secundários) têm sido identificadas nos cristais e no citoplasma das células espumosas, e provavelmente são responsáveis por danificar o fígado e levar ao acúmulo de filoeritrina. Por meio deste trabalho, objetivou-se padronizar e caracterizar a utilização da lectino-histoquímica na detecção de metabólitos glicosilados nos tecidos de búfalos mantidos em diferentes pastos de Brachiaria spp. no Brasil. Fragmentos de fígado e linfonodo mesentérico de 40 animais foram analisados: 10 búfalos mantidos em pastagem predominante de B. decumbens por aproximadamente 12 meses; 10 búfalos mantidos em pastagem predominante de B. brizantha por aproximadamente 18 meses; 10 búfalos mantidos em pastagem de B. brizantha por aproximadamente quatro anos; e, como controle negativo, 10 búfalos mantidos em pastagem livre de Brachiaria spp. desde o nascimento. Quatorze lectinas foram testadas (Con-A, SBA, WGA, DBA, UEA, RCA, PNA, GSL-I, PSA, LCA, PHA-E, PHA-L, SJA e SWGA), em um total de 1120 fragmentos avaliados. Estudos anteriores demonstraram que a lectina PNA possui marcada reatividade para macrófagos espumosos de bovinos e ovinos. No presente estudo, a lectina SWGA apresentou acentuada reatividade e alta especificidade para macrófagos espumosos; WGA, GSL, PHA-E e PHA-L mostraram moderada a acentuada reatividade, mas baixa especificidade aos macrófagos espumosos; as outras lectinas não apresentaram reatividade ou especificidade relevantes. Além disso, não houve diferença relevante de marcação entre os fragmentos coletados de animais que se alimentaram de B. decumbens por 12 meses e B. brizantha por 18 meses. Porém, a diminuição da presença e marcação lectino-histoquímica dos macrófagos espumosos nos tecidos dos búfalos que ingeriram Brachiaria brizantha durante mais tempo indica que os animais podem passar por um processo de adaptação de acordo com o tempo de ingestão da planta. A avaliação lectino-histoquímica pode ser utilizada para caracterizar o material armazenado em macrófagos espumosos presentes no fígado e linfonodo mesentérico de búfalos que se alimentam em pastagens de Brachiaria spp. e ajuda na compreensão da patogênese de formação destas células.(AU)

Animals grazing Brachiaria spp. commonly present foamy macrophages isolated or grouped in the liver, and crystals within biliary ducts. The pathogenesis of formation and the nature of the material stored in these cells however are not completely known. Through lectin histochemistry evaluation, steroidal saponins (secondary glycosylated metabolites) have been identified in the crystals and within the cytoplasm of the foam cells, which are probably liable for damaging the liver, leading to accumulation of phylloerythrin. This study aims to standardize and characterize the use of lectin histochemistry to detect glycosylated metabolites in tissues of buffaloes kept on different Brachiaria spp. pastures in Brazil. Fragments of liver and mesenteric lymph node from 40 buffaloes were analyzed: 10 buffaloes that were kept in predominant pasture of B. decumbens for 12 months; 10 buffaloes that were kept in pasture with a predominance of B. brizantha for 18 months; 10 buffaloes that were kept on pasture of B. brizantha for about four years; and as a negative control, 10 buffaloes that were maintained on native pasture without Brachiaria spp. since birth. Fourteen lectins were tested (Con-A, SBA, WGA, DBA, UEA, RCA, PNA, GSL-I, PSA, LCA, PHA-E, PHA-L, SJA and SWGA), in a total of 1120 evaluated samples. Previous studies demonstrated that PNA showed great binding reactivity for foamy macrophages in cattle and sheep. In the present study, SWGA showed high specificity and marked binding reactivity for foamy macrophages; WGA, GSL, PHA-E and PHA-L showed moderate to marked reactivity, but low specificity for foamy macrophages. The other lectins had not relevant reactivity or specificity. Moreover there was no relevant reactivity difference between the collected samplesd from buffaloes that grazed B. decumbens for 12 months and Brachiaria brizantha for 18 months. However the decreased presence of foamy macrophages and its lectin histochemical binding in animals that fed on B. brizantha for a longer time, indicates that the buffaloes can pass through an adaptation process according to the plant intake time. Lectin histochemistry analysis can be used to characterize the material stored in foamy macrophages present in liver and mesenteric lymph node of buffaloes that graze on Brachiaria spp. pastures and helps to clarify the pathogenesis of these cells.(AU)

Effect of ligation of mesenteric lymph duct on coagulation function in rats with severe heat stroke / 解放军医学杂志

Objective To investigate the influences of mesenteric lymph duct ligation (LDL) on the coagulation function in rats with severe heat stroke (SHS). Methods Forty male Wistar rats were randomly and equally divided into control, heat stroke sham (HSS), HSS-LDL, severe heat stroke (SHS) and SHS+LDL groups. Mesenteric lymph ducts were ligated in HSC-LDL and SHS-LDL groups before reproduction of SHS model. SHS rat models were reproduced in a prewarmed incubator. Peripheral blood was drawn to determine the parameters pertaining to blood coagulability including prothrombin time (PT), activated partial thromboplastin time (APTT), D-dimmer and platelet count (PLT), and lung and kidney histopathology was observed after heat stroke. Results Compared with those in control group, no obvious changes were observed in the coagulation indices in HSS and HSS-LDL group. While PT and APTT significantly prolonged, PLT remarkably decreased, D-dimmer markedly increased in SHS group (P<0.05). The coagulation indices presented a recovery trend to certain extent in SHS-LDL group. Histopathological examination of the kidney and lung showed severe hemorrhagic and congestive lesions in SHS group. Mesenteric lymph duct ligation alleviated the coagulation disorders and histopathological lesions. Conclusion The entrance of toxic agents through lymphatic passage may be the pathogenetic factor in producing coagulopathy, and ligation of the mesenteric lymph ducts might prevent the entrance of toxic materials and alleviate the injury to the blood coagulation property and internal organs.

Hydrogen sulfide in posthemorrhagic shock mesenteric lymph drainage alleviates kidney injury in rats

Posthemorrhagic shock mesenteric lymph (PHSML) is a key factor in multiple organ injury following hemorrhagic shock. We investigated the role of hydrogen sulfide (H2S) in PHSML drainage in alleviating acute kidney injury (AKI) by administering D,L-propargylglycine (PPG) and sodium hydrosulfide hydrate (NaHS) to 12 specific pathogen-free male Wistar rats with PHSML drainage. A hemorrhagic shock model was established in 4 experimental groups: shock, shock+drainage, shock+drainage+PPG (45 mg/kg, 0.5 h prehemorrhage), and shock+drainage+NaHS (28 µmol/kg, 0.5 h prehemorrhage). Fluid resuscitation was performed after 1 h of hypotension, and PHMSL was drained in the last three groups for 3 h after resuscitation. Renal function and histomorphology were assessed along with levels of H2S, cystathionine-γ-lyase (CSE), Toll-like receptor 4 (TLR4), interleukin (IL)-10, IL-12, and tumor necrosis factor (TNF)-α in renal tissue. Hemorrhagic shock induced AKI with increased urea and creatinine levels in plasma and higher H2S, CSE, TLR4, IL-10, IL-12, and TNF-α levels in renal tissue. PHSML drainage significantly reduced urea, creatinine, H2S, CSE, and TNF-α but not TLR4, IL-10, or IL-12. PPG decreased creatinine, H2S, IL-10, and TNF-α levels, but this effect was reversed by NaHS administration. In conclusion, PHSML drainage alleviated AKI following hemorrhagic shock by preventing increases in H2S and H2S-mediated inflammation.

Post-splenectomy infections in chronic schistosomiasis as a consequence of bacterial translocation

INTRODUCTION : Bacterial translocation is the invasion of indigenous intestinal bacteria through the gut mucosa to normally sterile tissues and internal organs. Schistosomiasis may cause alterations in the immune system and damage to the intestines, portal system and mesenteric lymph nodes. This study investigated bacterial translocation and alterations in the intestinal microbiota and mucosa in schistosomiasis and splenectomized mice. METHODS : Forty female 35-day-old Swiss Webster mice were divided into the following four groups with 10 animals each: schistosomotic (ESF), splenectomized schistosomotic (ESEF), splenectomized (EF) and control (CF). Infection was achieved by introduction of 50 Schistosoma mansoni (SLM) cercariae through the skin. At 125 days after birth, half of the parasitized and unparasitized mice were subjected to splenectomy. Body weights were recorded for one week after splenectomy; then, the mice were euthanized to study bacterial translocation, microbiota composition and intestinal morphometry. RESULTS : We observed significant reductions in the weight increases in the EF, ESF and ESEF groups. There were increases of at least 1,000 CFU of intestinal microbiota bacteria in these groups compared with the CF. The EF, ESF and ESEF mice showed decreases in the heights and areas of villi and the total villus areas (perimeter). We observed frequent co-infections with various bacterial genera. CONCLUSIONS : The ESEF mice showed a higher degree of sepsis. This finding may be associated with a reduction in the immune response associated with the absence of the spleen and a reduction in nutritional absorption strengthened by both of these factors (Schistosoma infection and splenectomy). .

A study on alleviation of acute lung injury in rats with bowel repletion pattern by mesenteric lymph drainage and its mechanism / 中国中西医结合急救杂志

Objective To observe the effects of mesenteric lymph drainage on acute lung injury and expression of p38 mitogen activated protein kinase (p38MAPK) signal pathway in rats with bowel repletion pattern. Methods Thirty male Wistar rats were randomly divided into three groups according to random number table method, namely sham operation group (sham group), bowel repletion model group (model group) and mesenteric lymph drainage group (drainage group), 10 rats in each group. The rat model of bowel repletion was established by ischemia/reperfusion (I/R) method, firstly 1 hour occlusion of superior mesenteric artery (SMA) to induce ischemia followed by reperfusion for 2 hours. In the rats of drainage group, the drainage of mesenteric lymph duct began at the end of model establishment and persisted for 3 hours. In the rats of sham group, the SMA and mesenteric lymph ducts were exposed with blunt dissection, and then they were immediately placed back into the abdominal cavity. After 3 hours of mesenteric lymph drainage, the lung and ileum tissues of rats in each group were harvested for evaluation of pathohistological changes and for the determination and comparison of myeloperoxidase (MPO) activity changes; the levels of tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) in bronchoalveolar lavage fluid (BALF) were detected by enzyme linked immunosorbent assay (ELISA), and the expressions of Toll-like receptor 4 (TLR4) mRNA and p38MAPK mRNA in the lung tissues were measured by fluorescence quantitative polymerase chain reaction (PCR).Results Under the light microscope, the pulmonary capillaries markedly dilated and congested, the interstitium width of lung increased with a large amount of inflammatory cells infiltration, the intestinal mucosal layer becoming thinner with detachment of intestinal villi and a large amount of inflammatory cells infiltration were detected in rats of model group. Compared with those in sham group, the levels of TNF-α and IL-6 in BALF, the MPO activity of lung and ileum tissues, and the expressions of TLR4 mRNA and p38MAPK mRNA in the lung tissues were significantly increased in model group.Compared with those in model group, the pathohistological damages in lung and ileum tissues were ameliorated, the levels of TNF-α and IL-6 in BALF, the MPO activity of lung and intestinal tissues and the expressions of TLR4 mRNA and p38MAPK mRNA in the lung tissues were lower in the rats of drainage group [TNF-α in BALF (ng/L): 858.55±27.16 vs. 1 680.58±105.62; IL-6 in BALF (ng/L): 0 vs. 484.71±5.43; MPO activity of lung (U/g): 0.95±0.13 vs. 1.36±0.11; MPO activity of ileum tissues (U/g): 0.75±0.13 vs. 1.30±0.16; TLR4 mRNA: 0.21±0.11 vs. 0.69±0.13, p38MAPK mRNA: 0.21±0.13 vs. 0.47±0.09; allP < 0.05].Conclusion Mesenteric lymph drainage can alleviate acute lung injury in rats with bowel repletion, and its mechanism may be related to the reduction of the expressions of TLR4 mRNA and p38MAPK mRNA and the release of TNF-α and IL-6 in lung tissues.

Ultrasonic Detection of Mesenteric Lymph Nodes in Children with Intermittent Abdominal Pain / 华中科技大学学报(医学版)

Objective To examine the clinical application of ultrasonography to detection of mesenteric lymph nodes in chil‐dren with intermittent abdominal pain.Methods A total of 196 children who underwent abdominal ultrasonography for differ‐ent reasons were divided into the intermittent abdominal pain group and non‐abdominal pain group.The location ,size and num‐ber of mesenteric lymph nodes were recorded.Results Statistical difference in the long‐axis diameter(P=0.005)and ratio of short‐to‐long‐axis diameter was found among patients with different ages in non‐abdominal pain group(P= 0.015) ,while no significant difference was seen in short‐axis diameter(P=0.773).No significant difference was observed in the diameter of each axis between different genders in non‐abdominal pain group.There was a statistical difference between abdominal pain group and non‐abdominal pain group in the incidence of lymph nodes with short‐axis diameter of 6 mm and larger(P=0.002)and long‐axis diameter of 14 mm and larger(P=0.007).Conclusion Mesenteric lymph node with short‐axis diameter larger than 6 mm should be considered enlarged in children ,but should not be diagnosed with mesenteric lymphadenitis.It’s common to find en‐larged mesenteric lymph nodes in children without abdominal pain.Further investigations with a larger number of patients are required to confirm these findings .

Effects of the endogenous CRF on the biological phenotypes of mouse mesenteric lymph nodes den-dritic cells / 中华微生物学和免疫学杂志

Objective To investigate the expression of corticotropin-releasing factor (CRF) and its receptors including CRFR1 and CRFR2 on mouse mesenteric lymph nodes dendritic cells (MLNDC), and to analyze their effects on the biological phenotypes of intestinal dendritic cells .Methods The MLNDCs were isolated from C57BL/6 mice by using magnetic bead sorting .The purity of CD11c+DCs was identified by flow cytometry .The double-labeling immunofluorescence and the reverse transcriptase-polymerase chain reaction (RT-PCR) were performed to detect the expression of CRF , CRFR1 and CRFR2 on MLNDCs.The MLNDCs were exposed to CRF with or without the interference of CRFR 1 and CRFR2 antagonists .Flow cy-tometry was used to measure the changes of surface molecules ( MHCⅠ and MHCⅡ) and co-stimulatory molecules (CD80 and CD86).Results The CD11c+DCs accounted for (80.12±6.34)% of the isolate cells with a high cell viability of more than 90%.The expression of CRF , CRFR1 and CRFR2 at mRNA lev-el were detected in MLNDCs by RT-PCR.Results of the immunofluorescent staining assay indicated that both CRFR1 and CRFR2 were expressed on the surface of MLNDCs .The expression of CD86 on MLNDCs was inhibited by the treatment of MLNDCs with CRFR 1 antagonist , but enhanced by the treatment with CRFR2 antagonist .Conclusion Both CRF and CRFRs were detected in the MLNDCs isolated from the C57BL/6 mice.The CRF could alter the biological phenotypes of MLNDCs through binding to different CRFRs (CRFR1 and CRFR2), which affected the phenotypes of MLNDCs in opposite ways .

Effect of mesenteric lymphatic ligation on liver injury induced by severe acute pancreatitis in rats / 实用医学杂志

Objective To explore the effect of mesenteric lymphatic ligation on liver injury induced by severe acute pancreatitis. Methods 54 SD rats are randomly divided into sham-operation group (A), severe acute pancreatitis group (B) and severe acute pancreatitis and ligation group (C). Liver tissues were collected from each rat in 6, 12, and 24 h after ligation. Pathological changes in liver tissues were observed by haematoxylin and eosin staining. Levels of serum glutamic-pyruvic transaminase and glutamic oxalacetic transaminase were detected. Levels of TNF-α and IL-1 in liver homogenate were examined by enzyme linked immunosorbent assay. Results Under light microscopic examination, neutrophils and inflammatory exudate in hepatic lobule was increased as time prolonged in group B. Inflammation was reduced in group C as compared with group B.Levels of serum glutamic-pyruvic transaminase and glutamic oxalacetic transaminase were more significantly increased in groups B and C than in group A (P<0.05);while they were more significantly decreased in group C than in group B. Levels of TNF-αand IL-1 in liver homogenate were significantly increased in group B as compared with group A (P < 0.05); whereas they were more significantly decreased in group C than in group B at 24 h (P < 0.05). Conclusions Mesenteric lymphatic ligation can reduce liver injury in severe acute pancreatitis. Mesenteric lymphatic fluids may play an important role in severe acute pancreatitis.

Effect of microRNA-7 onαβT lymphocytes of mouse mesenteric lymph nodes / 中国免疫学杂志

Objective:To detect the change of proportions of αβT lymphocytes in mesenteric lymph nodes of miR-7 knockdown (miR-7KD)mice,and preliminarily explore its importance.Methods: The volume,weight index and total cells number of mesenteric lymph node in miR-7KD mice were measured.The pathologic morphology change of mesenteric lymph nodes was observed by HE stai -ning.And the changes on proportion of αβT lymphocytes in mesenteric lymph nodes of miR-7KD mice were analyzed by Flow cytometry.Results:Compared with those of WT (wild type) mice,the volume,weight index,and the total cells number of mesenteric lymph node were significantly increased ( P<0.05 ).Moreover ,the pathologic morphology was significantly changed.The proportion and numbers of T lymphocyte were significantly increased;however,the proportion of B lymphocyte were significantly decreased (P<0.05). Notably,the proportion and number of CD4+T cells and CD8+T cells were significantly increased (P<0.05).Meanwhile,CD62L+T cell proportion were vigorously reduced and CD 69+T cell and IFN-γ+T cell proportion were notably up-regulated,which belong to CD4+and CD8+T cell(P<0.05).Conclusion:There was significant influence in the proportion of αβT lymphocytes in mesenteric lymph nodes of miR-7KD mice,suggesting that miR-7 might play an important role in the composition and function of lymphocytes in mesenteric lymph nodes.

Mesenteric lymph reperfusion exacerbates spleen injury caused by superior mesenteric artery occlusion shock

The intestinal lymph pathway plays an important role in the pathogenesis of organ injury following superior mesenteric artery occlusion (SMAO) shock. We hypothesized that mesenteric lymph reperfusion (MLR) is a major cause of spleen injury after SMAO shock. To test this hypothesis, SMAO shock was induced in Wistar rats by clamping the superior mesenteric artery (SMA) for 1 h, followed by reperfusion for 2 h. Similarly, MLR was performed by clamping the mesenteric lymph duct (MLD) for 1 h, followed by reperfusion for 2 h. In the MLR+SMAO group rats, both the SMA and MLD were clamped and then released for reperfusion for 2 h. SMAO shock alone elicited: 1) splenic structure injury, 2) increased levels of malondialdehyde, nitric oxide (NO), intercellular adhesion molecule-1, endotoxin, lipopolysaccharide receptor (CD14), lipopolysaccharide-binding protein, and tumor necrosis factor-α, 3) enhanced activities of NO synthase and myeloperoxidase, and 4) decreased activities of superoxide dismutase and ATPase. MLR following SMAO shock further aggravated these deleterious effects. We conclude that MLR exacerbates spleen injury caused by SMAO shock, which itself is associated with oxidative stress, excessive release of NO, recruitment of polymorphonuclear neutrophils, endotoxin translocation, and enhanced inflammatory responses.

Role of post-hemorrhagic shock mesenteric lymph in enhancement of vas-cular permeability / 中国病理生理杂志

AIM: To investigate the role of post-hemorrhagic shock mesenteric lymph (PHSML) in the enhancementof vascular permeability .METHODS: Eighteen Wistar rats were randomized into sham group , shock group,and shock plus mesenteric lymph drainage (shock +drainage) group.The rats in shock group and shock +drainagegroup were routinely subjected to hemorrhagic shock and hypotension [(40 ±2) mmHg] was maintained for 90 min, andthen the fluid resuscitation was performed.Mesenteric lymph was drained in the rats in shock +drainage group from resuscitationfinished to 6 h, for the observation of PHSML drainage on the vascular permeability in multiple tissues of hemorrhagicshock rats.Afterwards, human umbilical vein endothelial cells (HUVECs) were incubated with the PHSML in vitro to observethe effects of PHSML on the morphology and permeability of HUVECs .RESULTS: The degree of blue color and concentrationsof Evens blue in the lung, myocardium, kidney, liver, spleen and small intestine were significantly increased inthe shocked rats than that in sham group, while the ratios of the dry weight to the wet weight were decreased .The mesentericlymph drainage reversed these changes .Meanwhile, 4% and 10% of PHSML at 0 ~3 h and 3 ~6 h after resuscitation,and lipopolysaccharide (10 mg/L) all caused the damage of HUVECs, decreased the viability and trans-endothelial electricalresistance of HUVECs, and increased the permeability of HUVECs to fluorescein isothiocyanate -labeled albumin. CONCLUSION: PHSML is a vital factor in the enhancement of vascular permeability .

Analysis of components of mesenteric lymph in rats with severe intraperitoneal infection / 中华危重病急救医学

Objective To investigate the components of mesenteric lymph of the rats with severe intraperitoneal infection,and inquire into the effect of intestinal lymphatic pathway in severe intraperitoneal infection.Methods Twenty-four male Wistar rats were randomly divided into two groups according to random number table method,namely model group and sham group with 12 rats in each group.The rat model of severe intraperitoneal infection was reproduced by injecting artificial gastric juice and E.coli intraperitoneally.Mesenteric lymph in both groups was collected 4 hours after the reproduction of the model,and white blood cells were counted and classified.The levels of endotoxin,alkaline phosphatase (AKP),lactate dehydrogenase (LDH),creatine kinase (CK),glutamine transferase (GST),protein and cytokines of mesenteric lymph were determined.Results Compared with the sham group,there was an increase in the neutrophil ratio in mesenteric lymph (0.167 ± 0.004 vs.0.610 ± 0.006,t=33.520,P＜0.001),however the percentage of both macrophages (0.009 ± 0.001 vs.0.020 ± 0.004,t=-6.677,P＜0.001) and lymphocytes (0.824 ± 0.005 vs.0.921 ± 0.004,t=-31.471,P＜0.001) was decreased in model group.Compared with sham group,the levels ofendotoxin (kEU/L:0.346 ±0.022 vs.0.186 ±0.001,t=18.103,P＜0.001),AKP [U (king unit):13.97 ± 5.55 vs.3.76 ± 0.18,t=4.503,P=0.006],LDH (U/L:2 827.45 ± 1 940.32 vs.712.68 ± 14.09,t=2.670,P=0.044),CK (kU/L:2.19 ± 1.21 vs.0.70 ± 0.01,t=3.035,P=0.029),GST (kU/L:12.33 ± 6.53 vs.1.36 ± 0.39,t=4.105,P=0.009) were all significantly elevated.The concentration of protein (g/L:4.40 ± 0.48 vs.2.84 ± 0.16,t=6.882,P=0.001),tumor necrosis factor-α [TNF-α (ng/L):499.39 ±76.36 vs.180.90 ± 70.98,t=7.483,P＜0.001],interleukin-6 [IL-6 (μg/L):13.74 ± 0.78 vs.-0.07 ± 0.07,t=52.972,P＜0.001],intercellular adhesion molecule-1 [ICAM-1 (ng/L):2 754.19 ±221.48 vs.1 362.85 ±393.43,t=6.891,P＜0.001] and monocyte chemo-attractant protein-1 [MCP-1 (μg/L):28.23 ± 1.77 vs.24.87 ± 1.15,t=3.561,P=0.007] and high mobility group protein-1 [HMGB-1 (ng/L):1 392.78 ± 572.42 vs.564.17 ± 21.32,t=3.543,P=0.016] in mesenteric lymph in model group were significantly higher than those in sham group.Conclusion Intestinal lymphatic pathway maybe the early pathway for the production of remote organ injury caused by severe intraperitoneal infection.

Association of EB virus-induced pharyngitis with mesenteric lymphadenitis in children / 实用医学杂志

Objective To analyze the clinical correlation between EB virus-induced pharyngitis with gastrointestinal symptoms and mesenteric lymphadenitis in children , and to explore the value of EBV-VCA-IgM dectection and color Doppler ultrasound in the diagnosis of EB virus-induced mesenteric lymphadenitis. Methods 356 children with pharyngitis complicated by gastrointestinal symptoms were prospectively analyzed. 162 patients who had a postive result of EBV-VCA-IgM detection by ELISA were assigned to a study group , while another 194 patients who had a negative result were assigned to a control group. The size , number and blood flow of mesenteric lymph nodes were determined by color Doppler ultrasound in both groups. The data were counted , compared and analyzed. Results 43 children had mesenteric lymphadenitis in the study group , so had 11 in the control group. There was a significant difference between the two groups (P < 0.01). Conclusions Children with pharyngitis complicated by gastrointestinal symptoms may suffer from mesenteric lymphadenitis. ELISA for EBV-VCA-IgM detection and color Doppler ultrasound have certain clinical value in the diagnosis of mesenteric lymphadenitis indcued by EB virus infection.

Effect of normal mesenteric lymph on multiple organ injury in mice with endotoxic shock / 中国病理生理杂志

AIM:To observe the effects of normal mesenteric lymph (NML) on the lung, heart and liver inju-ries and the phosphorylation levels of p 38 mitogen-activated protein kinase ( MAPK) , extracellular signal-regulated kinase (ERK) 1/2 and c-Jun N-terminal kinase (JNK) in the mice with endotoxic shock (ES).METHODS: The NML was drained form health male BALB/c mice for the intervention of ES after the removal of cellular constituent .Lipopolysaccha-ride (LPS, 35 mg/kg) was intraperitoneally injected into the mice for the establishment of ES model .After 60 min of LPS injection, the administration of NML (1/15 of whole blood volume) was performed through the femoral artery in NML +ES group.Meanwhile, the mean arterial pressure (MAP) was monitored during the experiment .At 6 h after intraperitoneal in-jection of LPS or the corresponding time point , blood samples were harvested from the heart through apical centesis for de-termination of the biochemical indexes to reflect myocardial and hepatocyte injuries .Simultaneously , the lung , heart and liver tissue specimens from a fixed location were harvested for the observation of histomorphology and the measurement of phosphorylation levels of p38 MAPK, ERK1/2 and JNK.RESULTS:Compared with sham shock (SS) group, MAP in ES group and NML+ES group remarkably decreased at multiple time points after intraperitoneal injection of LPS .However, MAP in NML+ES group at 80 min, 90 min, 190 min, 210 min, 240 min, 250 min, 340 min, 350 min, and 360 min were significantly increased compared with ES group .There were normal structures in the lung , liver and myocardium of the mice in SS group, while the morphological damages of these tissues appeared in ES group .Meanwhile, the damages were attenuated in the mice of NML +ES group.The activities of AST , ALT and CK-MB in the plasma in ES group were remark-ably higher than those in SS group .The CK-MB activity in NML+ES group was also increased compared with SS group , and the activities of AST and LDH-1 were lower than those in ES group .At 6 h after LPS injection , the phosphorylation levels of p38 MAPK, ERK1/2 and JNK in the lung tissues were remarkably increased .Meanwhile , no statistical difference of these indexes between the myocardial and hepatic tissues was observed .NML intervention decreased the phosphorylation levels of p38 MAPK in the lung tissues , and p38 MAPK, ERK1/2 and JNK in the myocardial tissues .CONCLUSION:The NML administration alleviates multi-organ injuries and reduces the phosphorylation level of p 38 MAPK in the lung tis-sues in the mice subjected to ES .

Myosin light chain kinase is necessary for post-shock mesenteric lymph drainage enhancement of vascular reactivity and calcium sensitivity in hemorrhagic-shocked rats

Vascular hyporeactivity is an important factor in irreversible shock, and post-shock mesenteric lymph (PSML) blockade improves vascular reactivity after hemorrhagic shock. This study explored the possible involvement of myosin light chain kinase (MLCK) in PSML-mediated vascular hyporeactivity and calcium desensitization. Rats were divided into sham (n=12), shock (n=18), and shock+drainage (n=18) groups. A hemorrhagic shock model (40±2 mmHg, 3 h) was established in the shock and shock+drainage groups. PSML drainage was performed from 1 to 3 h from start of hypotension in shock+drainage rats. Levels of phospho-MLCK (p-MLCK) were determined in superior mesenteric artery (SMA) tissue, and the vascular reactivity to norepinephrine (NE) and sensitivity to Ca2+ were observed in SMA rings in an isolated organ perfusion system. p-MLCK was significantly decreased in the shock group compared with the sham group, but increased in the shock+drainage group compared with the shock group. Substance P (1 nM), an agonist of MLCK, significantly elevated the decreased contractile response of SMA rings to both NE and Ca2+ at various concentrations. Maximum contractility (Emax) in the shock group increased with NE (from 0.179±0.038 to 0.440±0.177 g/mg, P<0.05) and Ca2+ (from 0.515±0.043 to 0.646±0.096 g/mg, P<0.05). ML-7 (0.1 nM), an inhibitor of MLCK, reduced the increased vascular response to NE and Ca2+ at various concentrations in the shock+drainage group (from 0.744±0.187 to 0.570±0.143 g/mg in Emax for NE and from 0.729±0.037 to 0.645±0.056 g/mg in Emax for Ca2+, P<0.05). We conclude that MLCK is an important contributor to PSML drainage, enhancing vascular reactivity and calcium sensitivity in rats with hemorrhagic shock.

An Unusual Clinical Presentation of Kimura's Disease Occurring in the Mesenteric Lymph Nodes.

Kimura's disease is a rare inflammatory disorder of unknown aetiology primarily seen in young Asian males. The disease is characterized by a triad of painless subcutaneous masses in the head and neck region, blood and tissue eosinophilia, and markedly elevated serum immunoglobulin E (Ig E) levels. Clinically the subcutaneous nodules occur predominantly in the head and neck region of young males. However, we report the case of a 60 year old male presenting with mesenteric lymphadenopathy diagnosed with Kimura's disease.