| Background and objectiveInguinal hernia is one of the most common surgery diseases, whose incidence rate is about 3‰～5%‰.Many scientists had been making attempt to explain the pathogenesis of inguinal hernia in the past hundred years from anatomical basis, the closure of processus vaginalis to spermatic cord lipoma, but no one was able to find the root cause of inguinal hernia. In recent years, foreign scholars thought that collagen metabolic disorders may be an important reason for inguinal hernia. The doctrine put forward a view that in the connective tissue of patients with inguinal hernia, the contents of typeⅠcollagen reduced, but typeⅢrelatively increased in patients with inguinal hernia, and eventually leading to the reduce in proportion of the two collagen metabolic and the discorders of Collagen metabolism, causing the occurrence of inguinal hernia. Collagen metabolic disorder doctrine had recently been more approved by domestic and foreign scholars.In clinical, with age increasing, the account of patients with inguinal hernia increases, especially male patients who is more than 60. At present, researchs on the relationship between collagen metabolism and the age of patients with inguinal hernia are rare at home and abroad. The subject is to determine the expression of type I and type III collagen contents and its proportion in different age segments in the anterior rectus sheath in patients with inguinal hernia by the immunohistochemical method, analyse the expression level of the two collagen and explore the relationship between age and collagen metabolism of type I and type III. It can provide a theoretical basis for clinical treatment and further study of the inguinal hernia. The study is the first case at home and abroad.Materials and methods1. Experimental designExperimental group:60 cases with primary inguinal hernia, according to different age segments, the experimental group was divided into three groups. Experimental group 120 cases(from age 50 to 59), Experimental group 220 cases(from age 60 to 69), Experimental group 320 cases(≥age 70).Control group:20 cases with non-hernia(from age 50 to 80).Both groups were obtained from the First Affiliated Hospital of Zhengzhou University from May 2011 to August 2011 at the same time. All patients are male, the organization was obtained from the anterior rectus sheath of the lower abdomen and was fixed in the 10% formaldehyde liquid. The area of the organization was about 10mm* 5mm.Exclusion criteria:experimental and control groups were excluded from undergoing hormone or other immunosuppressive therapy patients, chemotherapy patients, patients with diabetes, patients with hypoproteinemia, the history of local inflammation, connective tissue disease.2. Experimental methodsMethod:Immunohistochemical SP method. Collagen contents were indicated by the relative quantitative of integrated optical density.Reagent sources:Rabbit ant-human type I collagen polyclonal antibody (SANTA CRUZ biological company in the United States), Rabbit anti-human type III collagen polyclonal antibody (USA SANTA CRUZ biological agents company), SP9000 kit (Beijing Zhongshan biotechnology company), DAB kit (Beijing Zhongshan biological Engineering company).3. Statistrical analysisThe results were recorded as (x±s). SPSS17.0 statistical software package was used for statistical analysis. For two groups of quantitative data, differences were analyzed by t-test. The single faetor analysis of variance was used to compare during many groups. The P value which was less than 0.05 was considered statistically significant.Results1. TypeⅠcollagen protein expression:Control group wsa 156.02±11.37.Experiment group 1 was 135.04±2.57, compared with the control group, it was significantly lower, the difference was statistically significant (P=0.005<0.05).Experiment group 2 was 128.77±1.85, compared with the control group, it was significantly lower, the difference was statistically significant (P=0.001<0.05).Experiment group 3 was 112.46±7.23, compared with the control group, it was significantly lower, the difference was statistically significant (P=0.001<0.05).Experiment group 1>Experiment group 2>Experiment group 3. Compared any one among the experimental groups with another, the difference was statistically significant (P<0.05).Compared Experiment group (60 cases) with Control group, the difference was statistically significant (P=0.001<0.05).2. TypeⅢcollagen protein expression:Control group wsa 116.21±7.80.Experiment group 1 was 128.97±3.46, compared with the control group, it was significantly higher, the difference was statistically significant (P=0.032<0.05). Experiment group 2 was 132.58±2.41, compared with the control group, it was significantly higher, the difference was statistically significant (P=0.001<0.05).Experiment group 3 was 149.97±6.39, compared with the control group, it was significantly higher, the difference was statistically significant (P=0.016<0.05).Experiment group 1<Experiment group 2<Experiment group 3. Compared any one among the experimental groups with another, the difference was statistically significant (P<0.05).Compared Experiment group (60 cases) with Control group, the difference was statistically significant (P=0.023<0.05).3. The ratio of TypeⅠand TypeⅢcollagen:Control group wsa 1.35±0.12.Experiment group 1 was 1.05±0.02, compared with the control group, it was significantly lower, the difference was statistically significant (P=0.021<0.05).Experiment group 2 was 0.97±0.02, compared with the control group, it was significantly lower, the difference was statistically significant (P=0.025<0.05).Experiment group 3 was 0.75±0.06, compared with the control group, it was significantly lower, the difference was statistically significant (P=0.001<0.05).Experiment group 1>Experiment group 2>Experiment group 3. Compared any one among the experimental groups with another, the difference was statistically significant (P<0.05).Compared Experiment group (60 cases) with Control group, the difference was statistically significant (P=0.018<0.05).Conclusion1. With age, the contents of typeⅠcollagen gradually decrease, typeⅢcollagen gradually increase, the ratio of the two collagens decrease in the connective tissue of patients with inguinal hernia. It is probably one of the reasons that the older the elder is, the higher the incidence of inguinal hernia is.2. The research reveals that patients with inguinal hernia have appear collagen metabolism disorders. It is speculated that traditional hernia repair is not an ideal surgical method, but tension-free repair is an more ideal surgical approach. |
PDF Full Text Request