Effect of Monocyte Chemotactic Protein-1 on the Intraperitoneal Adhesion Formation

In order to study the role of monocyte chemotactic protein-1 (MCP-1) in the intra-peri- toneal adhesion formation, 23 infertile patients undergoing laparoscopic operation were divided into two groups: experimental group including 12 patients with intra-peritoneal adhesion and control group including 11 patients without intra-peritoneal adhesion. Peritoneal fluid (PF) and peritoneum were collected from these patients during laparoscopic examination. The expression levels of MCP-1 protein and MCP-1 mRNA were detected by using enzyme-linked immunosorbent assay (ELISA) and dot blot analysis method respectively. It was found that the levels of MCP-l protein in PF of the patients with peritoneal adhesion were significantly higher than in the control group (0.44±0. 11 ng/ ml vs 0. 19±0.09 ng/ml respectively, P<0. 01). The level of MCP-l mRNA in the peritoneum of the patients with peritoneal adhesion was significantly higher than in the control group (48. 61±3. 72 vs 19.87±2.54 respectively, P<0. 01). It was suggested that MCP-1 might play a role in the adhe- sion formation, and chemotactic cytokines expressing in the peritoneal mesothelial cells might be take part in the process.

Identification of candidate biomarkers correlated with pathogenesis of postoperative peritoneal adhesion by using microarray analysis

BACKGROUND Postoperative peritoneal adhesion(PPA),characterized by abdominal pain,female infertility,and even bowel obstruction after surgery,has always been a major concern.The occurrence and formation of adhesion are from complex biological processes.However,the molecular mechanisms underlying the basis of microarray data profile,followed by peritoneal adhesion formation,are largely unknown.AIM To reveal the underlying pathogenesis of PPA at the molecular level.METHODS The gene expression profile was retrieved from the Gene Expression Omnibus database for our analysis.We identified a panel of key genes and related pathways involved in adhesion formation using bioinformatics analysis methods.We performed quantitative PCR and western blotting in vivo to validate the results preliminarily.RESULTS In total,446 expressed genes were altered in peritoneal adhesion.We found that several hub genes(e.g.,tumor necrosis factor,interleukin 1 beta,interleukin 6,CX-C motif chemokine ligand 1,C-X-C motif chemokine ligand 2)were marked as significant biomarkers.Functional analysis suggested that these genes were enriched in the Toll-like receptor signaling pathway.According to the Kyoto Encyclopedia of Genes and Genomes pathway and published studies,TLR4,myeloid differentiation primary response protein 88(MyD88),and nuclear factor kappa B(NF-κB)played essential roles in Toll-like signaling transduction.Here,we obtained a regulatory evidence chain of TLR4/MyD88/NF-κB/inflammatory cytokines/peritoneal adhesion involved in the pathogenesis of postoperative adhesion.The results of the microarray analysis were verified by the animal experiments.These findings may extend our understanding of the molecular mechanisms of PPA.CONCLUSION The regulatory evidence chain of TLR4/MyD88/NF-κB/inflammatory cytokines/peritoneal adhesion may play key roles in the pathogenesis of PPA.Future studies are required to validate our findings.

Berberine prevents primary peritoneal adhesion and adhesion reformation by directly inhibiting TIMP-1

Peritoneal adhesions are fibrous tissues that tether organs to one another or to the peritoneal wall and represent the major cause of postsurgical morbidity.Enterolysis at repeat surgeries induces adhesion reformation that is more difficult to prevent than primary adhesion.Here we studied the preventive effects of different approaches of berberine treatment for primary adhesion,and its effects on adhesion reformation compared to Interceed.We found the primary adhesion was remarkably prevented by berberine through intraperitoneal injection 30 min before abrasive surgery(pre-berberine)or direct addition into injured cecum immediately after the surgery(inter-berberine).Rats with adhesion reformation had a more deteriorative collagen accumulation and tissue injury in abrasive sites than rats with primary adhesion.The dysregulated TIMP-1/MMP balance was observed in patients after surgery,as well as adhesion tissues from primary adhesion or adhesion reformation rats.Inter-berberine treatment had a better effect for adhesion reformation prevention than Interceed.Berberine promoted the activation of MMP-3 and MMP-8 by directly blocking TIMP-1 activation core,which was reversed by TIMP-1 overexpression in fibroblasts.In conclusion,this study suggests berberine as a reasonable approach for preventing primary adhesion formation and adhesion reformation.

Umbilical displacement: a mini review

Background:Umbilical displacement is a known disorder in folk medicine of different cultures.The various causes,clinical signs and symptoms are attributed to this disorder and different diagnostic and therapeutic methods are mentioned.Methods:To follow the aim of the study,Persian medicine literature,Google Scholar,Google,PubMed,Scopus and Web of Science were searched with no limit of the publication date and the article type(original papers and literature reviews).The searched terms were Navel,Umbilicus and other synonyms in Persian,Turkish,Russian,German,Chinese and Indian language,Dislocation,Sliding,Displacement,Deviation,Falling,Ptosis,Folk medicine and combination of these words.We also corresponded with several experts in traditional medicine via LinkedIn.All available descriptive evidence related to umbilical displacement was retrieved,and the contents were presented as categories including the disorder name,attributed signs and symptoms,and the diagnostic and therapeutic methods.Results:This disorder is called“Taharok-e-Sorre”in Persian medicine,“Nawikkatin”in Erbil(Iraq),“Dharan or Nabhi Sarakna”in Hindi,“Göbek düşmesi”in Turkish,Bēn tún in Chinese and“Cirro”in the people of Mayan community and Spanish,and“смещенпупок”in the folk medicine of the Kurgan Bashqir.Hard work,pregnancy,childbirth,fear,lifting heavy objects,rapid and sudden movements,trauma or fall and slipping of the foot are said to be causes of umbilical displacement.Umbilical displacement is associated with several symptoms such as diarrhea,constipation,abdominal pain,anorexia,anxiety,and depression.Conclusion:In this mini-review,umbilical displacement was expressed from the viewpoint of different cultures.New cases of umbilical displacement has been reported in new articles,and the pathology of umbilical displacement has been explained from the perspective of Persian medicine.

Conservative management of chronic gastric volvulus:44 cases over 5 years

AIM:To investigate clinical outcomes of patients with chronic gastric volvulus(GV)who were managed conservatively over a 5-year period.METHODS:A total of 44 consecutive patients with chronic GV,as diagnosed by barium study between October 2002 and July 2008 were investigated.All of these patients received conservative management initially without anatomical correction.Their clinical manifestations,diagnostic work-ups,and clinical outcomes were analyzed.We sought to identify independent risk factors for poor outcome by using the Cox proportional hazards model.RESULTS:The enrolled patients were predominantly male(n=37,84%)and of advanced age(median: 71 years old,interquartile range:57.5-78 years).Abdominal pain and fullness were the most common presentations.During the follow-up period(median:16 mo,up to 69 mo),there was no severe complication,but symptomatic recurrence was noted in 28 patients(64%).Only one patient turned to elective surgery for frequent symptoms.Peritoneal adhesion was the only independent risk factor associated with recurrence(hazard ratio:2.58,95%CI:1.08-6.13,P=0.033).CONCLUSION:Symptomatic recurrence of chronic GV is very common although serious complications infrequently occur with conservative management.Peritoneal adhesion is independently associated with recurrence.