RESUMEN
Objective:To investigate the effects of of anti tumor necrosis factor-α (TNF-α) in adjuvant treatment of strangulated intestinal obstruction combined with ischemic intestinal necrosis.Methods:From February 2011 to August 2016 in Huadu District People′s Hospital Affiliated with Southern Medical University, 122 patients with strangulated intestinal obstruction combined with ischemic intestinal necrosis were selected and were equally divided into the experimental group and control group with 61 cases in each group according to the random draw envelope principle. Conventional surgical resection and anastomosis was used in control group, the postoperative anti TNF-α therapy was given for 2 weeks based on the treatment in control group.Results:All patients completed surgery and there were no serious complications during operation.The postoperative anal exhaust time and symptom remission time in experimental group were significantly lower than those in control group: (2.14 ± 0.41) d vs. (6.24 ± 1.28) d and (3.54 ± 0.77) d vs. (6.99 ± 0.91) d ( P<0.05). The incidence of postoperative 14 d complications such as anastomotic leakage, wound infection, anastomotic stenosis and pulmonary infection in the experimental group was 4.9%(3/61), and that of the control group was 18%(11/61), and the incidence of postoperative complications in the experimental group was significantly lower than that in the control group ( P<0.05). The postoperative 1d and 7 d serum TNF-α content in the experimental group was significantly lower than that in the control group ( P<0.05). The postoperative 14 d anal function in the experimental group was significantly better than that in the control group ( P<0.05). MRASP and MSP of postoperative 14 d in experimental group were all significantly higher than those in the control group: (80.24 ± 11.39) mmHg (1 mmHg=0.133 kPa) vs. (76.24 ± 12.11) mmHg, (231.98 ± 45.29) mmHg vs. (226.39 ± 41.87) mmHg ( P<0.05). Conclusions:The anti TNF-α in adjuvant treatment of strangulated intestinal obstruction combined with ischemic intestinal necrosis can promote the recovery of clinical symptoms and inhibit the release of TNF-α. It also can reduce the incidence of postoperative complications and improve gastrointestinal motility of patients.
RESUMEN
<p><b>OBJECTIVE</b>To compare the distribution and concentrations of matrix metalloproteinase (MMP)-1, 2, 3, 8, 9 in human coronal dentin.</p><p><b>METHODS</b>The localization of five types of MMP was performed using immunohistochemistry. Molars were demineralized and sectioned into 5 µm thick specimens. All specimens were randomly divided into five groups according to the antibodies. Each group contained two subgroups (n = 6). Immunoreactivity of each subgroup was visualized with 3, 3-diaminobenzidine solution or fluorescein isothiocyanate and observed under microscopy respectively. Molars were sectioned into slices. The slices were divided into two groups according to superficial or deep dentin and pulverized to fine powder. After dentin protein was extracted, the concentrations of MMP-1, 2, 3, 8, 9 were detected by using fluorescent microsphere immunoassay.</p><p><b>RESULTS</b>Immunohistochemical staining revealed that MMP-1, 2, 3, 8, 9 were highly concentrated in the deep dentin. However, intense immunoreactivities of MMP-2, 8, 9 were identified in a 6-10 µm wide zone adjacent to the dentino-enamel junction. The content of MMP-1 in superficial layer and deep layer of dentin were (0.037±0.025) and (0.433±0.089) ng/mg. The content of MMP-2 in superficial layer and deep layer of dentin were (0.445±0.115) and (2.730±0.712) ng/mg. The content of MMP-3 in superficial layer and deep layer of dentin were (0.071±0.069) and (0.460±0.108) ng/mg. The content of MMP-8 in superficial layer and deep layer of dentin were (0.586±0.246) and (6.159±0.948) ng/mg. The content of MMP-9 in superficial layer and deep layer of dentin were (0.384±0.185) and (1.460±0.251) ng/mg. The concentrations of all tested MMP were significantly higher in deep dentin than those in superficial dentin (P < 0.05).</p><p><b>CONCLUSIONS</b>There are five types of MMP contained in human coronal dentin, and the distribution of MMP shows a decreasing trend from the deep dentin to the superficial dentin.</p>