Objective. To study the characteristics and pathogenesis of gut barrier damage following multiple firearm injuries in a porcine model. Methods. Twenty four small pigs were divided into 4 groups: control group (n=6, gr...Objective. To study the characteristics and pathogenesis of gut barrier damage following multiple firearm injuries in a porcine model. Methods. Twenty four small pigs were divided into 4 groups: control group (n=6, group C), group H (n=6, gunshot induced tangential fracture of parietal bone), group L (n=6, gunshot induced comminuted fracture of bilateral femora) and group M (n=6, combined group H+L). Gastric intramucosal pH (pHi), plasma endotoxin levels in portal vein, and plasma D lactate levels were measured and blood samples were cultured at different intervals after trauma. The animals were sacrificed at 72 h following trauma and intestinal tissues were harvested for pathological examination and diamine oxidase (DAO) activity measurement. Results. In group M at 72 h, pHi was significantly lower than that of group H and L (P< 0.01), and plasma endotoxin level was significantly higher than that of group H (P< 0.01) and group L (P< 0.05). Simultaneously, in groupM, D lactate level was markedly higher than that of group H (P< 0.01), and incidence of positive blood culture was much higher than that of group H and L (P<0.05). Necrosis and exfoliation were revealed at ileum villus top in all traumagroups, especially in group M, in which ileum DAO activity declined most significantly as well. Conclusion. Multiple trauma is prone to cause gastrointestinal ischemia even without hemorrhagic shock. The damage of gut barrier in multiple trauma appears to be more severe than that in one site trauma, thereby promoting gut derived endotoxemia and bacterial translocation and contributing to the development of endogenous infection.SURGICAL TREATMENT OF MALIGNANTESOPHAGEAL TUMORS IN PUMC HOSPITAL Guo Huiqin,Li Zejian ,Zhang Fan1 ,Zhang Zhiyong,Xu Letian ,Li Weidong2,Wang Xiuqin2and Wu Min2Department of Thoracic Surgery, PUMC Hospital, CAMS &PUMC, Beijing 100730Key words malignant esophageal tumors; early diagnosis; FHIT geneTo study how to prolong the postoperative survival time of the patientswith malignant esophageal tumors. The clinical data of 1098 patients with malignant esophageal tumors from 1961 to 1992 were retrospectively analyzed. The deletion of fragile histamine triplet (FHIT) gene (a tumor suppressor gene) in 30 fresh esophageal samples obtained in 1996 was detected with PCR and RT PCR method. The resectability was raised gradually and the operative morbidity and mortality decreased year by year, but there was no significant improvement on the postoperative 5 year survival rate. Delayed diagnosis and irradical resection influenced the long term survival. The deletion of cDNA of FHIT gene was 64.2%in esophageal cancer and 20%in the resected margin of the cancer. We believe that high grade atypical hyperplasia in esophageal epithelium and deletion of FHIT gene in esophageal cancer and its resected margin are pathological and molecular markers for early diagnosis of esophageal cancer respectively, and the latter may be one of the molecular markers for the resection. Early diagnosis and treatment, radical resection, and postoperative nutritional support are very important for the improvement of the postoperative survival time of the patients.展开更多
Ten outbred pigs were each operated on for three times. First, a 130 cm length of terminal ileum of each pig was isolated on its vascular pedicle as a Thiry-Vella loop. One week later, the solitary ileal segments were...Ten outbred pigs were each operated on for three times. First, a 130 cm length of terminal ileum of each pig was isolated on its vascular pedicle as a Thiry-Vella loop. One week later, the solitary ileal segments were transplanted heterotopically in two pigs. And after 28 days of heterotopic transplantation, the transplanted intestine was interposed into continuity of host intestine as orthotopic transplant. During the experiment, tests were made on 6th day after the first operation (period 1), the 14th (II), 28th (III) day after heterotopic transplantation, and 3 weeks after interposition (IV) respectively for the levels of glucose, palmitate and leucine. Additionally, at period I, III, and IV, a 3 cm length of intestinal mucosa was excised for morphologic observation and determination of DNA, RNA and protein contents. After heterotopic transplantation, the absorptive function of transplanted intestine was severely impaired for two weeks. The absorption of glucose! and palmitate was partially recovered by period III, at which time leucine level had return to normal. At period IV, the absorptive function of glucose and leucine had surpassed normal levels, while palmitate had risen to the level of pretransplantation. After transplantation, at period III, DNA, RNA and protein contents were well below normal. Three weeks after orthotopic transplantation, RNA and protein had risen to normal level, while DNA content remained below normal, The morphologic changes during the experiment were correlated with the changes of contents in RNA, protein and DNA. The area, height, width of villi and the area, depth, width:of crypt were below normal at III and recovered by 3 weeks after orthotopic transplantation (period IV), but were still lower than the levels at pretransplantation. Crypt depths were deeper than those of pretransplantation.展开更多
文摘Objective. To study the characteristics and pathogenesis of gut barrier damage following multiple firearm injuries in a porcine model. Methods. Twenty four small pigs were divided into 4 groups: control group (n=6, group C), group H (n=6, gunshot induced tangential fracture of parietal bone), group L (n=6, gunshot induced comminuted fracture of bilateral femora) and group M (n=6, combined group H+L). Gastric intramucosal pH (pHi), plasma endotoxin levels in portal vein, and plasma D lactate levels were measured and blood samples were cultured at different intervals after trauma. The animals were sacrificed at 72 h following trauma and intestinal tissues were harvested for pathological examination and diamine oxidase (DAO) activity measurement. Results. In group M at 72 h, pHi was significantly lower than that of group H and L (P< 0.01), and plasma endotoxin level was significantly higher than that of group H (P< 0.01) and group L (P< 0.05). Simultaneously, in groupM, D lactate level was markedly higher than that of group H (P< 0.01), and incidence of positive blood culture was much higher than that of group H and L (P<0.05). Necrosis and exfoliation were revealed at ileum villus top in all traumagroups, especially in group M, in which ileum DAO activity declined most significantly as well. Conclusion. Multiple trauma is prone to cause gastrointestinal ischemia even without hemorrhagic shock. The damage of gut barrier in multiple trauma appears to be more severe than that in one site trauma, thereby promoting gut derived endotoxemia and bacterial translocation and contributing to the development of endogenous infection.SURGICAL TREATMENT OF MALIGNANTESOPHAGEAL TUMORS IN PUMC HOSPITAL Guo Huiqin,Li Zejian ,Zhang Fan1 ,Zhang Zhiyong,Xu Letian ,Li Weidong2,Wang Xiuqin2and Wu Min2Department of Thoracic Surgery, PUMC Hospital, CAMS &PUMC, Beijing 100730Key words malignant esophageal tumors; early diagnosis; FHIT geneTo study how to prolong the postoperative survival time of the patientswith malignant esophageal tumors. The clinical data of 1098 patients with malignant esophageal tumors from 1961 to 1992 were retrospectively analyzed. The deletion of fragile histamine triplet (FHIT) gene (a tumor suppressor gene) in 30 fresh esophageal samples obtained in 1996 was detected with PCR and RT PCR method. The resectability was raised gradually and the operative morbidity and mortality decreased year by year, but there was no significant improvement on the postoperative 5 year survival rate. Delayed diagnosis and irradical resection influenced the long term survival. The deletion of cDNA of FHIT gene was 64.2%in esophageal cancer and 20%in the resected margin of the cancer. We believe that high grade atypical hyperplasia in esophageal epithelium and deletion of FHIT gene in esophageal cancer and its resected margin are pathological and molecular markers for early diagnosis of esophageal cancer respectively, and the latter may be one of the molecular markers for the resection. Early diagnosis and treatment, radical resection, and postoperative nutritional support are very important for the improvement of the postoperative survival time of the patients.
文摘Ten outbred pigs were each operated on for three times. First, a 130 cm length of terminal ileum of each pig was isolated on its vascular pedicle as a Thiry-Vella loop. One week later, the solitary ileal segments were transplanted heterotopically in two pigs. And after 28 days of heterotopic transplantation, the transplanted intestine was interposed into continuity of host intestine as orthotopic transplant. During the experiment, tests were made on 6th day after the first operation (period 1), the 14th (II), 28th (III) day after heterotopic transplantation, and 3 weeks after interposition (IV) respectively for the levels of glucose, palmitate and leucine. Additionally, at period I, III, and IV, a 3 cm length of intestinal mucosa was excised for morphologic observation and determination of DNA, RNA and protein contents. After heterotopic transplantation, the absorptive function of transplanted intestine was severely impaired for two weeks. The absorption of glucose! and palmitate was partially recovered by period III, at which time leucine level had return to normal. At period IV, the absorptive function of glucose and leucine had surpassed normal levels, while palmitate had risen to the level of pretransplantation. After transplantation, at period III, DNA, RNA and protein contents were well below normal. Three weeks after orthotopic transplantation, RNA and protein had risen to normal level, while DNA content remained below normal, The morphologic changes during the experiment were correlated with the changes of contents in RNA, protein and DNA. The area, height, width of villi and the area, depth, width:of crypt were below normal at III and recovered by 3 weeks after orthotopic transplantation (period IV), but were still lower than the levels at pretransplantation. Crypt depths were deeper than those of pretransplantation.
