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局部地塞米松可改善鸡胚腹裂的肠道病变。

Local dexamethasone improves the intestinal lesions of gastroschisis in chick embryos.

作者信息

Yu Jiakang, Gonzalez-Reyes Salome, Diez-Pardo Juan A, Tovar Juan A

机构信息

Research Laboratory, Hospital Infantil Universitario La Paz, P. de la Castellana 261, 28046 Madrid, Spain.

出版信息

Pediatr Surg Int. 2004 Jan;19(12):780-4. doi: 10.1007/s00383-003-0958-9. Epub 2004 Jan 30.

Abstract

BACKGROUND AND AIMS

Eviscerated bowel in gastroschisis (Gx) undergoes changes that lead to dysfunctions and create management difficulties. This study tests the hypothesis that exposure of the eviscerated bowel of chick embryos with Gx to dexamethasone might have beneficial effects on the parietal lesions.

METHODS

Gx was created in chick embryos on incubation day 15 and either dexamethasone (0.047 mg in 0.24 ml) or 0.075% saline were instilled into the amnio-allantoic chamber on day 17. The chicks were recovered near hatching (day 19) and eviscerated and non-eviscerated portions of the intestines were recovered, weighed and processed for HE and synaptophysin staining or for total DNA and protein measurements. Total mural and serosal layer thickness were determined and intramural ganglia were counted. ANOVA was used for comparison among groups with significance level set at p<0.05.

RESULTS

Chicks with Gx and Gx + saline controls had reduced body weight and tibial length in comparison with controls. The eviscerated bowel was heavier with marked wall thickening at the expense of all layers but particularly of the serosa. They had decreased total intestinal DNA with normal protein and decreased intramural ganglion density. In contrast, chicks from the Gx + dexamethasone group had normal body weight and tibial length, near-normal intestinal wall thickness with slightly increased serosal width, near-normal intestinal DNA content and normal density of intramural ganglia.

CONCLUSION

Local dexamethasone had beneficial effects on the eviscerated bowel of chicks with Gx as judged by decreased wall thickening, normalization of total intestinal DNA and richer neural population. Late gestational exposure to steroids could represent another alternative for preventing intestinal lesions in Gx.

摘要

背景与目的

腹裂(Gx)患儿的脱出肠管会发生变化,导致功能障碍并造成管理困难。本研究检验了以下假设:将患有Gx的鸡胚脱出肠管暴露于地塞米松可能对壁层病变有有益影响。

方法

在孵化第15天给鸡胚造成Gx,在第17天向羊膜 - 尿囊腔注入地塞米松(0.24 ml中含0.047 mg)或0.075%盐水。在接近孵化时(第19天)回收雏鸡,取出肠管,回收脱出和未脱出部分的肠管,称重并进行苏木精 - 伊红(HE)和突触素染色,或进行总DNA和蛋白质测量。测定肠壁全层和浆膜层厚度并计数壁内神经节。采用方差分析进行组间比较,显著性水平设定为p<0.05。

结果

与对照组相比,患有Gx和Gx +盐水对照组的雏鸡体重和胫骨长度降低。脱出肠管较重,壁明显增厚,所有层均受累,但浆膜层尤其明显。它们的肠总DNA减少,蛋白质正常,壁内神经节密度降低。相比之下,Gx +地塞米松组的雏鸡体重和胫骨长度正常,肠壁厚度接近正常,浆膜宽度略有增加,肠DNA含量接近正常,壁内神经节密度正常。

结论

从壁增厚减轻、肠总DNA正常化和神经细胞增多来看,局部应用地塞米松对患有Gx的雏鸡脱出肠管有有益影响。妊娠晚期接触类固醇可能是预防Gx肠损伤的另一种选择。

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