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Adult mammalian cardiomyocytes have minimal cell cycle capacity, which leads to poor regeneration after cardiac injury such as myocardial infarction. Many positive regulators of cardiomyocyte cell cycle and cardioprotective signals have been identified, but extracellular signals that suppress cardiomyocyte proliferation are poorly understood. We profiled receptors enriched in postnatal cardiomyocytes, and found that very-low-density-lipoprotein receptor (Vldlr) inhibits neonatal cardiomyocyte cell cycle. Paradoxically, Reelin, the well-known Vldlr ligand, expressed in cardiac Schwann cells and lymphatic endothelial cells, promotes neonatal cardiomyocyte proliferation. Thrombospondin1 (TSP-1), another ligand of Vldlr highly expressed in adult heart, was then found to inhibit cardiomyocyte proliferation through Vldlr, and may contribute to Vldlr's overall repression on proliferation. Mechanistically, Rac1 and subsequent Yap phosphorylation and nucleus translocation mediate the regulation of the cardiomyocyte cell cycle by TSP-1/Reelin-Vldlr signaling. Importantly, Reln mutant neonatal mice displayed impaired cardiomyocyte proliferation and cardiac regeneration after apical resection, while cardiac-specific Thbs1 deletion and cardiomyocyte-specific Vldlr deletion promote cardiomyocyte proliferation and are cardioprotective after myocardial infarction. Our results identified a novel role of Vldlr in consolidating extracellular signals to regulate cardiomyocyte cell cycle activity and survival, and the overall suppressive TSP-1-Vldlr signal may contribute to the poor cardiac repair capacity of adult mammals.
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Infarto del Miocardio , Trombospondina 1 , Animales , Ratones , Proliferación Celular , Células Endoteliales/metabolismo , Ligandos , Mamíferos , Ratones Noqueados , Infarto del Miocardio/metabolismo , Miocitos Cardíacos/metabolismo , Regeneración , Trombospondina 1/metabolismoRESUMEN
Adult mammalian cardiomyocytes have extremely limited capacity to regenerate, and it is believed that a strong intrinsic mechanism is prohibiting the cardiomyocytes from entering the cell cycle. microRNAs that promote proliferation in cardiomyocyte can be used as probes to identify novel genes suppressing cardiomyocytes proliferation, thus dissecting the mechanism(s) preventing cardiomyocytes from duplication. In particular, miR-199a-3p has been found as a potent activator of proliferation in rodent cardiomyocyte, although its molecular targets remain elusive. Here, we identified Cd151 as a direct target of miR-199a-3p, and its expression is greatly suppressed by miR-199a-3p. Cd151 gain-of-function reduced cardiomyocyte proliferation, conversely Cd151 loss-of-function increased cardiomyocytes proliferation. Overexpression of Cd151 blocks the activating effect of miR-199a-3p on cardiomyocyte proliferation, suggesting Cd151 is a functional target of miR-199a-3p in cardiomyocytes. Mechanistically, we found that Cd151 induces p38 expression, a known negative regulator of cardiomyocyte proliferation, and pharmacological inhibition of p38 rescued the inhibitory effect of Cd151 on proliferation. Together, this work proposes Cd151 as a novel suppressor of cardiomyocyte proliferation, which may provide a new molecular target for developing therapies to promote cardiac regeneration.
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MicroARNs/genética , Miocitos Cardíacos/citología , Tetraspanina 24/genética , Animales , Línea Celular , Proliferación Celular , Células Cultivadas , Regulación de la Expresión Génica , Humanos , Ratones , Miocitos Cardíacos/metabolismo , Ratas Sprague-DawleyRESUMEN
BACKGROUND: Concomitant incisional and parastomal hernias is a challenging condition. We used a hybrid technique of sublay and onlay to treat patients with this condition. MATERIAL AND METHODS: The clinical data of 32 consecutive patients treated from February 2008 to April 2014 for concomitant incisional and parastomal hernias were retrospectively reviewed. The mean diameter was 9 (range 4-13) cm of the incisional hernias, and 6 (range 4.5-8) cm of the parastomal hernias. RESULTS: The mean operative time was 247 (range 220-290) min. The mean hospital stay was 20 (range 14-27) days. All surgical wounds healed by primary intention. Seven patients had postoperative seroma and were well managed with puncture and compression. All 32 patients were followed up for a mean of 48 (range 5-68) months. Four patients recurred with parastomal hernias and were treated with secondary surgery. No further recurrence occurred until the last follow-up. CONCLUSIONS: This hybrid technique of sublay and onlay is only suitable for the repair of complex incisional and parastomal hernias.
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Hernia Incisional/cirugía , Procedimientos Quirúrgicos Operativos/métodos , Estomas Quirúrgicos , Adulto , Anciano , Femenino , Humanos , Hernia Incisional/diagnóstico por imagen , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Mallas Quirúrgicas , Suturas , Tomografía Computarizada por Rayos XRESUMEN
BACKGROUND: Colorectal cancer (CRC) is a serious threat to human health and is drug-resistant. Circular RNA _0004585 (circ_0004585) has been shown to be expressed in CRC, but whether it plays a role in CRC with chemoresistance remains unknown. Therefore, this study aimed to investigate the potential role of circ_0004585 in CRC with 5-fluorouracil (5-FU) resistance. METHODS: The expression of related genes was detected by quantitative real-time polymerase chain reaction (qRT-PCR), and the protein expressions of cleaved caspase-3, cleaved caspase-9, and cyclin D1 (CCND1) were detected by western blot. Cell functions were identified using CCK-8, colony formation, flow cytometry, tube formation and transwell assays. The putative relationships between miR-874-3p and circ_0004585 or CCND1 were validated by dual-luciferase reporter assays. Animal experiments were conducted to verify the effect of circ_0004585 on 5-FU resistance in vivo. RESULTS: Circ_0004585 was highly expressed in CRC tissues and cells, particularly in 5-FU-resistant CRC tissues and cells. Circ_0004585 knockdown enhanced 5-FU sensitivity to further inhibit CRC cell viability, colony formation, cell migration and invasion, and accelerate cell apoptosis. MiR-874-3p was the target of circ_0004585, and miR-874-3p depletion partially recovered the malignant behaviors of 5-FU-resistant CRC cells that were blocked by silencing of circ_0004585. In addition, CCND1 was the target of miR-874-3p, and overexpression of CCND1 was able to restore the malignant effects of 5-FU-resistant CRC cells that were repressed by miR-874-3p enrichment. Animal experiments confirmed that circ_0004585 knockdown inhibited the growth of CRC tumors and enhanced 5-FU sensitivity in vivo. CONCLUSION: Circ_0004585 promotes the development of CRC and increases 5-FU resistance in CRC through the miR-874-3p/CCND1 axis. These results suggest that circ_0004585 may be a therapeutic target for 5-FU-ressitant CRC.
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Neoplasias Colorrectales , MicroARNs , Animales , Humanos , Ciclina D1/genética , ARN Circular/genética , Neoplasias Colorrectales/tratamiento farmacológico , Neoplasias Colorrectales/genética , Fluorouracilo/farmacología , MicroARNs/genética , Proliferación Celular , Línea Celular TumoralRESUMEN
AIMS: Post-natal maturation of mammalian cardiomyocytes proceeds rapidly after birth, with most of the myocytes exiting cell cycle, becoming binucleated, and adopting oxidative phosphorylation as the primary metabolic route. The triggers and transcriptional programmes regulating cardiomyocyte maturation have not been fully understood yet. We performed single-cell RNA-Seq in post-natal rat hearts in order to identify the important factors for this process. METHODS AND RESULTS: Single-cell RNA-Seq profiling was performed of post-natal Day 1 and Day 7 rat hearts, and we found that members of the activating protein 1 (AP-1) transcription factors showed a transient up-regulation in the maturing cardiomyocytes, suggesting their functional involvement in the process. Activating members of the AP-1 family by palmitate or adrenergic stimulation inhibited cardiomyocyte cytokinesis and promoted cardiomyocyte maturation. In contrast, knocking down AP-1 members Atf3 and Jun promoted cardiomyocyte cytokinesis, reduced polyploidy, and inhibited maturation. Mechanistically, RNA-Seq results and rescue experiments indicated that AP-1 members activate the expression of fatty acid metabolic genes to promote cardiomyocyte maturation. Finally, intraperitoneal injection of AP-1 inhibitor T-5224 in neonatal mice inhibits cardiomyocyte maturation in vivo. CONCLUSION: Our results are the first evidence implicating AP-1 transcription factors in post-natal cardiomyocyte maturation both in vitro and in vivo, which expand our understanding of the molecular mechanism of cardiomyocyte maturation, and may lead to novel therapies to treat congenital heart diseases.
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Miocitos Cardíacos , Factor de Transcripción AP-1 , Ratas , Ratones , Animales , Miocitos Cardíacos/metabolismo , Factor de Transcripción AP-1/genética , Factor de Transcripción AP-1/metabolismo , Proliferación Celular/genética , Citocinesis , Ciclo Celular , MamíferosRESUMEN
Background: Tafolecimab, a fully human proprotein convertase subtilisin/kexin type 9 (PCSK9) monoclonal antibody developed for the treatment of hypercholesterolemia, demonstrated robust lipid-lowering efficacy and favorable safety in previous short-term studies. We aimed to assess the long-term efficacy and safety of tafolecimab in Chinese non-familial hypercholesterolemia (non-FH) patients. Methods: Non-FH patients at high or very-high cardiovascular risk with screening low-density lipoprotein cholesterol (LDL-C) level ≥1.8 mmol/L or non-FH patients with screening LDL-C level ≥3.4 mmol/L and on stable lipid-lowering therapy for at least 4 weeks, were randomized in a 2:2:1:1 ratio to receive subcutaneous tafolecimab 450 mg Q4W, tafolecimab 600 mg Q6W, placebo 450 mg Q4W, or placebo 600 mg Q6W, respectively, in the 48-week double-blind treatment period. The primary endpoint was the percent change from baseline to week 48 in LDL-C levels. Findings: A total of 618 patients were randomized and 614 patients received at least one dose of tafolecimab (n = 411) or placebo (n = 203). At week 48, tafolecimab induced significant reductions in LDL-C levels (treatment differences versus placebo [on-treatment estimand]: -65.0% [97.5% CI: -70.2%, -59.9%] for 450 mg Q4W; -57.3% [97.5% CI: -64.0%, -50.7%] for 600 mg Q6W; both P < 0.0001). Significantly more patients treated with tafolecimab achieved ≥50% LDL-C reductions, LDL-C < 1.8 mmol/L, and LDL-C < 1.4 mmol/L than placebo group at both dose regimens (all P < 0.0001). Furthermore, tafolecimab significantly reduced non-HDL-C, apolipoprotein B, and lipoprotein(a) levels. The most commonly-reported treatment emergent adverse events in the tafolecimab groups included upper respiratory infection, urinary tract infection and hyperuricemia. Interpretation: Tafolecimab dosed at 450 mg Q4W and 600 mg Q6W was safe and showed superior lipid-lowering efficacy versus placebo, providing a novel treatment option for Chinese hypercholesterolemia patients. Funding: This study was sponsored by Innovent Biologics, Inc.
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Rcor2, the corepressor 2 of REST, a transcriptional repressor, is predominantly expressed in embryonic stem cells (ESCs) and plays a major role in regulating ESC pluripotency and neurogenesis. The function of Rcor2 in development of other germ layers is yet unclear. We utilized a Rcor2-/- mouse embryonic stem cell (mESC) line to investigate the role of Rcor2 in mESC differentiation. Rcor2-/- mESC shows reduced proliferation and severely compromised capacity to differentiate to all three germ layers. In contrast, Rcor2 knockout promotes primordial germ cells (PGCs) specific gene expression and possibly PGC formation. Mechanistically, we revealed that Rcor2 inhibits expression of genes required for PGC development, such as Dppa3 and Dazl, by associating to their promoters and enhancing local suppressive H3K9me3 modifications. Our results suggest that Rcor2 plays an important role in somatic cell fate determination by suppressing PGC differentiation through regulating epigenetic modifications of PGC specific genes.
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OBJECTIVE: To compare the therapeutic effect between Fanzhen Jieci (warming acupuncture plus fast needling) combined with conventional acupuncture and simple conventional acupuncture on discogenic sciatica. METHODS: A total of 76 patients with discogenic sciatica were randomized into a Fanzhen Jieci group and a conventional acupuncture group, 38 cases in each one. Conventional acupuncture was applied at Shenshu (BL 23), Dachangshu (BL 25), L1-L5 Jiaji (EX-B 2) and Huantiao (GB 30) on the affected side, etc. in the conventional acupuncture group. On the basis of the treatment in the conventional acupuncture group, Fanzhen Jieci was applied at L1-L5 Jiaji (EX-B 2) and Huantiao (GB 30) on the affected side in the Fanzhen Jieci group, i.e. warming acupuncture was applied at L1-L5 Jiaji (EX-B 2), and fast needling was applied at Huantiao (GB 30) on the affected side for a depth of 40-60 mm, so as to introduce a sensation of electric shock transmitting to lower limb, and then the needle was immediately withdrawn. The treatment was given once every other day, 3 times a week for 3 weeks in both groups. The visual analogue scale (VAS) score of leg and low back pain, the Oswestry disability index (ODI) score and the 36-item short form health survey (SF-36) score before and after treatment were compared between the two groups. RESULTS: Compared before treatment, the VAS scores of leg and low back pain and the ODI scores after treatment were decreased in both groups (P<0.001), the changes of the VAS scores of leg and low back pain in the Fanzhen Jieci group were larger than those in the conventional acupuncture group (P<0.05). After treatment, except for the role emotional and health transition scores, the various scores of SF-36 were increased compared before treatment in the Fanzhen Jieci group (P<0.01); except for the role physical, role emotional and health transition scores, the various scores of SF-36 were increased compared before treatment in the conventional acupuncture group (P<0.01). After treatment, the physical functioning, role physical, bodily pain, mental health and general health scores of SF-36 in the Fanzhen Jieci group were higher than those in the conventional acupuncture group (P<0.05). CONCLUSION: Fanzhen Jieci combined with conventional acupuncture can effectively relieve the pain and improve the mental state in patients with discogenic sciatica, its therapeutic effect is superior to simple conventional acupuncture.
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Terapia por Acupuntura , Dolor de la Región Lumbar , Ciática , Puntos de Acupuntura , Humanos , Dolor de la Región Lumbar/terapia , Ciática/terapia , Resultado del TratamientoRESUMEN
Gastric cancer (GC) remains poor prognosis and survival issues due to the resistance of chemotherapies, such as cisplatin. The long non-coding RNA small nucleolar RNA host gene 7 (lncRNA-SNHG7) is known as an oncogenic molecule in diverse cancers. Here, we demonstrate that SNHG7 was significantly upregulated in gastric cancer and positively correlated with cisplatin resistance of gastric cancer cells that SNHG7 was significantly upregulated in cisplatin resistant cells. Silencing SNHG7 dramatically sensitized cisplatin resistant cells. In contrast, a negative correlation between lncRNA-SNHG7 and miR-34a was found that miR-34a was downregulated in gastric cancer patient tissues and significantly sensitized cisplatin resistant gastric cancer cells. Intriguingly, bioinformatical analysis indicated miR-34a has putative biding site for SNHG7 and such negative association between SNHG7 and miR-34a was verified in gastric cancer tissues. The cisplatin resistant cells displayed increased glycolysis rate and SNHG7 promoted cellular glycolysis rate of gastric cancer cells. Luciferase assay illustrated LDHA, a glycolysis enzyme, was the direct target of miR-34a. Importantly, inhibiting SNHG7 successfully suppressed LDHA expressions and sensitized cisplatin resistant cells and such inhibitory effects could be recovered by further anti-miR-34a. These findings suggest an important regulator mechanism for the SNHG7-mediated cisplatin resistance via miR-34a/LDHA-glycolysis axis.
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Cisplatino/farmacología , MicroARNs/metabolismo , ARN Largo no Codificante/metabolismo , Neoplasias Gástricas/tratamiento farmacológico , Antineoplásicos/farmacología , Resistencia a Antineoplásicos , HumanosRESUMEN
BACKGROUND: Curative medical treatment for patients with discogenic sciatica is limited. Acupuncture is an important non-pharmacological therapy reported to have positive therapeutic effects on discogenic sciatica. According to traditional Chinese acupuncture theory, discogenic sciatica is a channel tendon disease which can be treated by a special "Fan-zhen Jie-ci (FZJC)" method. Our recent preliminary clinical evidence indicated that the FZJC method had a positive treatment effect on the disease. This study will further evaluate the efficacy and safety of FZJC on patients with discogenic sciatica. METHODS: A single-blind randomized controlled clinical trial will be conducted, assigning 76 participants with discogenic sciatica to a randomly assigned FZJC group or a control group. Acupuncture treatment combined with the FZJC method will be applied in the FZJC group while routine acupuncture treatment only will be applied in the control group. Treatments will be administered three times a week for a total of 3 consecutive weeks. The primary outcome of this trial is change in the visual analogue scale of leg pain (VAS-LP), and the secondary outcomes are changes in the visual analogue scale of back pain (VAS-BP), the Brief Pain Inventory (BPI), the Oswestry Disability Index (ODI), the 36-Item Short Form Health Survey (SF-36), and serum concentrations of mitochondrial DNA (mtDNA) and high sensitivity C reactive protein (hsCRP). DISCUSSION: The results of this study will provide insight into the efficacy and safety of FZJC acupuncture as a treatment for discogenic sciatica. TRIAL REGISTRAION: The trial has been registered at the Chinese Clinical Trial Registry (ChiCTR1900026272) and the Acupuncture-Moxibustion Clinical Trial Registry (AMCTR-IOR-19000275).
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Terapia por Acupuntura , Ciática , Humanos , Ensayos Clínicos Controlados Aleatorios como Asunto , Ciática/terapia , Método Simple Ciego , Factores de Tiempo , Resultado del TratamientoRESUMEN
With the increasing incidence of colorectal cancer (CRC) and continued difficulty in treating it using immunotherapy, there is an urgent need to identify an effective immune-related biomarker associated with the survival and prognosis of patients with this disease. DNA methylation plays an essential role in maintaining cellular function, and changes in methylation patterns may contribute to the development of autoimmunity, aging, and cancer. In this study, we aimed to identify a novel immune-related methylated signature to aid in predicting the prognosis of patients with CRC. We investigated DNA methylation patterns in patients with stage II/III CRC using datasets from The cancer genome atlas (TCGA). Overall, 182 patients were randomly divided into training (n = 127) and test groups (n = 55). In the training group, five immune-related methylated CG sites (cg11621464, cg13565656, cg18976437, cg20505223, and cg20528583) were identified, and CG site-based risk scores were calculated using univariate Cox proportional hazards regression in patients with stage II/III CRC. Multivariate Cox regression analysis indicated that methylated signature was independent of other clinical parameters. The Kaplan-Meier analysis results showed that CG site-based risk scores could significantly help distinguish between high- and low-risk patients in both the training (P = 0.000296) and test groups (P = 0.022). The area under the receiver operating characteristic curve in the training and test groups were estimated to be 0.771 and 0.724, respectively, for prognosis prediction. Finally, stratified analysis results suggested the remarkable prognostic value of CG site-based risk scores in CRC subtypes. We identified five methylated CG sites that could be used as an efficient overall survival (OS)-related biomarker for stage II/III CRC patients.
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Aim Acupuncture, particularly electroacupuncture (EA), can improve the clinical outcomes of cardiopulmonary bypass (CPB) patients; however, the mechanisms remain unclear. This study aimed to examine the effects of EA pre-treatment on myocardial injury after CPB and investigate its potential mechanisms. MAIN METHODS: Male Sprague-Dawley rats were subjected to CPB and divided into Control (sham-operated), CPB, and EA (CPB + EA) groups. In the EA group, rats were treated with EA at the "PC6" acupoint for 30 min before being subjected to CPB. At 0.5, 1, and 2 h after CPB, the expression levels of plasma cardiac troponin I (cTnI) and lactate dehydrogenase (LDH), and myeloperoxidase (MPO) activity, TNFα, IL-1ß, reduced glutathione (GSH), oxidized glutathione (GSSH), and the ratio of GSH/GSSH in the myocardial tissue were measured. Apoptosis was detected by terminal deoxynucleotidyl transferase dUTP nick-end labelling (TUNEL) staining. The expression of cleaved caspase-3 was detected by immunofluorescence. The expression of apelin, APJ, AKT, p-Akt, ERK1/2, and p-ERK1/2 was determined using western blotting. KEY FINDINGS: Decreased myocardial injury marker levels, myocardial apoptosis, oxidative stress, and the inflammatory response were found in the EA group compared with the CPB group. The expression levels of apelin, APJ, and p-Akt/AKT were increased in the EA group, and the p-ERK1/2/ERK1/2 level was decreased. SIGNIFICANCE: This study showed that EA pre-treatment can protect the heart from damage following CPB, which might be mainly mediated by restoring the apelin/APJ signaling pathway.
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Receptores de Apelina/metabolismo , Apelina/metabolismo , Puente Cardiopulmonar , Electroacupuntura , Daño por Reperfusión Miocárdica/prevención & control , Transducción de Señal , Animales , Apelina/fisiología , Receptores de Apelina/fisiología , Apoptosis , Western Blotting , Puente Cardiopulmonar/efectos adversos , Puente Cardiopulmonar/métodos , Caspasa 1/metabolismo , Electroacupuntura/métodos , Glutatión/metabolismo , Interleucina-1beta/metabolismo , L-Lactato Deshidrogenasa/sangre , Masculino , Miocardio/metabolismo , Peroxidasa/metabolismo , Ratas , Ratas Sprague-Dawley , Troponina I/sangre , Factor de Necrosis Tumoral alfa/metabolismoRESUMEN
Breast cancer (BC) is the most common malignancy among women. We aimed to illuminate the molecular dysfunctional mechanisms of BC progression. The mRNA expression profile of BC GSE15852 was downloaded from Gene Expression Omnibus database, including 43 normal samples and 43 cancer samples. Differentially expressed genes (DEGs) in BC were screened using the t-test by Benjamin and Hochberg method. Kyoto Encyclopedia of Genes and Genomes (KEGG) pathways of the selected DEGs were enriched using Hypergeomeric distribution model. In addition, functional similarity network among the enriched pathways was constructed to further analyze the collaboration of these pathways. We found 848 down-regulated DEGs were associated with 16 significant dysfunctional pathways, including PPAR signaling fatty acid metabolism, and 1584 up-regulated DEGs were related to 6 significant dysfunctional pathways, like cell cycle, protein export, and antigen processing and presentation in BC samples. Crosstalk network analysis of pathways indicated that pyruvate metabolism, propanoate metabolism, and glycolysis gluconeogenesis were the pathways with closest connections with other pathways in BC. In addition, other antigen processing and presentation, including 19 DEGs; PPAR signaling pathway, including 18 DEGs; and pyruvate metabolism pathway, including 13 DEGs were further analyzed. Our results suggested that dysfunctional of significant pathways can greatly affect the progression of BC. Several significant disorder pathways were enriched in our comprehensive study. They may provide guidelines to explore the dysfunctional mechanism of BC progression.
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Neoplasias de la Mama/genética , Regulación Neoplásica de la Expresión Génica/genética , Redes Reguladoras de Genes/genética , Transducción de Señal/fisiología , Transcriptoma , Neoplasias de la Mama/metabolismo , Femenino , Perfilación de la Expresión Génica , Humanos , Análisis de Secuencia por Matrices de Oligonucleótidos , ARN Mensajero/análisisRESUMEN
OBJECTIVE: To investigate the value of CT 3D reconstruction in the diagnosis and treatment of incisional hernia and the related factor of abdominal cavity volume. METHODS: Abdominal wall defect and herniary volume were measured using 3D reconstruction based on plain CT scans in 17 patients with incisional hernias. RESULTS: The herniary diameter, area and volume could be measured in the 17 patients and the abdominal cavity volume was also measured in 10 patients using the 3D reconstruction technique. The correlation indices of the abdominal cavity volume with the patient's height, weight and body mass index (BMI) were all less than 0.01. CONCLUSION: Herniary area and volume and abdominal cavity volume can be accurately calculated through CT 3D reconstruction. The patch area should be more than 5 times as large as the defect area; combined with the perioperative overlap margin measurement method, this results in more scientific surgical management. The ratio of the herniary volume to the abdominal cavity volume may be conducive to preoperative assessment of the risk of abdominal compartment syndrome (ACS); however, the ratio that may lead to postoperative ACS remains to be determined. There are correlations of abdominal cavity volume with patient height, weight and BMI, especially with weight. We therefore propose that the abdominal cavity volume should be evaluated with internationally accepted indices.
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Cavidad Abdominal/diagnóstico por imagen , Hernia Abdominal/diagnóstico por imagen , Herniorrafia/métodos , Imagenología Tridimensional/métodos , Tomografía Computarizada por Rayos X/métodos , Cavidad Abdominal/cirugía , Anciano , Índice de Masa Corporal , Femenino , Estudios de Seguimiento , Hernia Abdominal/cirugía , Humanos , Masculino , Persona de Mediana Edad , Reproducibilidad de los Resultados , Estudios RetrospectivosRESUMEN
OBJECTIVE: Mesh infection may occur after incisional hernia repair using prosthetic mesh. Preparation of antibiotics-bonded meshes to prevent infection is one of the solutions. To evaluate the anti-infection effect of polypropylene mesh bonded norvancomycin slow-release microsphere by preparing the rat model of incisional hernia repair contaminated with Staphylococcus aureus. METHODS: The norvancomycin slow-release microspheres were prepared by emulsion and solvent evaporation method and they were bonded to polypropylene mesh (50 mg/mesh). The appearance of the microspheres was observed using scanning electronic microscope (SEM). The content of norvancomycin in microspheres and the release rate of the norvancomycin in norvancomycin-bonded polypropylene mesh were detected using high performance liquid chromatography method. The rat models of incisional hernia were developed in 40 healthy Sprague Dawley rats, aged 10-11 weeks and weighing 200-250 g. The rats were divided randomly into the experimental group (norvancomycin-bonded polypropylene mesh repair, n=20) and the control group (polypropylene mesh repair, n=20). And then the mesh was contaminated with Staphylococcus aureus. The wound healing was observed after operation. At 3 weeks after operation, the mesh and the tissue around the mesh were harvested to perform histological observation and to classify the inflammatory reaction degree. RESULTS: The norvancomycin microsphere had integrated appearance and smooth surface with uniform particle diameter, 64% of particle diameter at 60 to 100 microm, and the loading-capacity of norvancomycin was 19.79%. The norvancomycin-bonded polypropylene patch had well-distributed surface and the loading-capacity of norvancomycin was (7.90 +/- 0.85) mg/cm2. The release time of norvancomycin in vitro could last above 28 days and the accumulative release rate was 72.6%. The rats of 2 groups all survived to experiment completion. Wound infection occurred in 2 rats of the experimental group (10%) and 20 rats of the control group (100%), showing significant difference (chi2 = 32.727 3, P = 0.0000). The inflammatory reaction in experimental group was not obvious, grade I in 16 rats and grade II in 4 rats, and numerous inflammatory cell infiltration occurred in the control group, grade II in 3 rats and grade III in 17 rats, showing significant difference (chi2 = 32.314, P = 0.000). CONCLUSION: The polypropylene mesh bonded norvancomycin slow-release microsphere has definite anti-infection effect in rat model of incisional hernia repair contaminated by Staphylococcus aureus.