ABSTRACT
Objective: To evaluate the anti-adhesion properties of xyloglucan (mXG) hydrogel in the L929 mouse fibroblasts, to establish the animal model of recurrent adhesion in the rats after adhesionlysis, and to investigate the prevention effect of mXG hydrogel in recurrent adhesion and its influence in the expressions of transforming growth factor-β1 (TGF-β1) and connective tissue growth factor (CTGF). Methods: After seeding on the surface of mXG gel, the adhesion property of L929 mouse fibroblasts was detected with fluorescence staining. The rat models of recurrent adhesion were established after adhesionlysis. Fourty-eight SD rats were randomly divided into 3 groups respectively (n=16). In adhesion group, 1 mL saline was injected into the abdominal wall and cecum of the rats; in commercial membrane group, the 2 cm × 3 cm chitosan anti-adhesion membrane was used to cover the wound of abdominal wall of the rats; in mXG hydrogel group, 1 mL 4% mXG hydrogel was injected into the abdominal wall and cecal wound of the rats, and abdominal surgery was ended after the complete formation of the hydrogel (3 min). Eight rats were killed in each group 7 and 14 d after the second operation, and the degrees of adhesion were evaluated and the histological changes were observed. Immunohistochemical staining was used to observe the expression levels of CTGF and TGF-β1. Results: A large number of L929 mouse fibroblasts proliferated well and exhibited a spherical morphology in control group; but in mXG hydrogel group, only very little L929 mouse fibroblasts were globular, showing the mXG hydrogel had good resistance to the adhesion of L929 mouse fibroblasts. Blunt separate adhesion surface formed in all of the rats after operation. 7 d after the second operation, 4-5 score adhesion with fibrous connective tissue hyperplasia formed in adhesion group; moderate adhesion formed in commercial membrane group with more connective tissue; most cecum and abdominal wall began to heal in mXG hydrogel group with less connective tissue. 14 d after the second operation, more severe peritoneal adhesions presented in adhesion group with proliferated fiber connetive tissue and collegan; severe adhesions also presented in commercial membrane group; mild adhesion was found in two rats mXG group, the other rats had no adhesion, and the defects were almost completely recovered. On days 7 and 14 after the second operation, the mean adhesion score of the rats in mXG group was significantly lower than those in adhesion group and commercial membrane group (P<0.05). The expression levels of TGF-βl and CTGF were increased with the increase of peritoneal adhesion scores and collagen deposition; the expression levels of TGF-βl and CTGF were the highest in adgesion group and the lowest in mXG group. Conclusion: mXG hydrogels have good resistance to fibroblast adhesion, and mXG hydrogel is effective in reducing the formation of recurrent adhesion in the rats after adhesionlysis and can decrease the expression levels of adhesion-related factors TGF-βl and CTGF.
ABSTRACT
Objective:To evaluate the anti-adhesion properties of xyloglucan(mXG)hydrogel in the L929 mouse fibroblasts,to establish the animal model of recurrent adhesion in the rats after adhesionlysis,and to investigate the prevention effect of mXG hydrogel in recurrent adhesion and its influence in the expressions of transforming growth factor-β1(TGF-β1)and connective tissue growth factor(CTGF).Methods:After seeding on the surface of mXG gel,the adhesion property of L929 mouse fibroblasts was detected with fluorescence staining.The rat models of recurrent adhesion were established after adhesionlysis.Fourty-eight SD rats were randomly divided into 3 groups respectively(n=16).In adhesion group,1 mL saline was injected into the abdominal wall and cecum of the rats;in commercial membrane group,the 2 cm×3 cm chitosan anti-adhesion membrane was used to cover the wound of abdominal wall of the rats;in mXG hydrogel group,1 mL 4% mXG hydrogel was injected into the abdominal wall and cecal wound of the rats,and abdominal surgery was ended after the complete formation of the hydrogel(3 min).Eight rats were killed in each group 7 and 14 d after the second operation,and the degrees of adhesion were evaluated and the histological changes were observed. Immunohistochemical staining was used to observe the expression levels of CTGF and TGF-β1.Results:A large number of L929 mouse fibroblasts proliferated well and exhibited a spherical morphology in control group;but in mXG hydrogel group,only very little L929 mouse fibroblasts were globular,showing the mXG hydrogel had good resistance to the adhesion of L929 mouse fibroblasts.Blunt separate adhesion surface formed in all of the rats after operation.7 d after the second operation,4-5 score adhesion with fibrous connective tissue hyperplasia formed in adhesion group;moderate adhesion formed in commercial membrane group with more connective tissue;most cecum and abdominal wall began to heal in mXG hydrogel group with less connective tissue.14 d after the second operation,more severe peritoneal adhesions presented in adhesion group with proliferated fiber connetive tissue and collegan;severe adhesions also presented in commercial membrane group;mild adhesion was found in two rats mXG group,the other rats had no adhesion,and the defects were almost completely recovered.On days 7 and 14 after the second operation,the mean adhesion score of the rats in mXG group was significantly lower than those in adhesion group and commercial membrane group(P<0.05).The expression levels of TGF-β1 and CTGF were increased with the increase of peritoneal adhesion scores and collagen deposition;the expression levels of TGF-β1 and CTGF were the highest in adgesion group and the lowest in mXG group.Conclusion:mXG hydrogels have good resistance to fibroblast adhesion,and mXG hydrogel is effective in reducing the formation of recurrent adhesion in the rats after adhesionlysis and can decrease the expression levels of adhesion-related factors TGF-β1 and CTGF.
ABSTRACT
Objective To investigate the clinical pregnancy outcomes of laparoscopic treatment for different degrees of tubal adhesion and tubal distal occlusion.Methods Clinical information of 41 infertile patients from April 2001 to December 2005 was reviewed.According to the extent of tubal and pelvic lesion,the patients were classified as stage Ⅰ in 10 patients,stage Ⅱ in 10,stage Ⅲ in 17,and stage Ⅳ in 6.After a diagnosis was made by hysterosalpinggography(HSG),all the patients received a salpingostomy and adhesionlysis under laparoscope.Results No abnormal findings were detected by hysteroscopy and bilateral tubes were patent after operation in all the 41 patients.The 10 patients at stage Ⅰ were followed up for 12~21 months.Four of them got pregnant in six months and 1 got pregnant in 1 year because of intermittent separation,all the 5 patients being intrauterine pregnancy.The 8 patients at stage Ⅱ were followed up for 12~26 months.Three patients got pregnant,including intrauterine pregnancy in 1 and ectopic pregnancy in 2.The pregnancy occurred at 15,16,and 26 months after operation,respectively.The 17 patients at stage Ⅲ were followed up for 3~48 months.Four had pregnancy,at 3,4,12,and 14 months after operation,respectively,including intrauterine pregnancy in 1 and ectopic pregnancy in 3.The 6 patients at stage Ⅳ were followed up for 12~36 months and no pregnancy was observed.Among the 12 patients with pregnancy,8 got pregnant within 12 months and 3 at 13~18 months after operation,the pregnancy rate within 18 months being 91.7%(11/12). Conclusions Clinical pregnancy outcomes are related with the degree of tubal lesion and adnexal adhesion.Patients at stage Ⅰ~Ⅱ have better pregnancy outcomes than patients at stage Ⅲ~Ⅳ.
