| Objective: As Small intestinal submucosa (SIS) can repair and reconstruct many sorts of tissue and organs ,the homogenating-injectable SIS exzudes to repair and reconstruct the different tissue and organs also. :It regenerated and repaired successfully the smooth muscle and the Achilles tendon rupture in the animal model ,so these experiments provided the primal foundation of experiment and theory for utilizing the SIS by minimal incision .but when the SIS was used to repair and reconstruct tissue ,the level of different concenteation wether impacted on the result of the process of repairing or reconstructing tissue .the relative protocol haven' t been found in the world by the time .so we would define the question by the experiment in the animal studies .the animal model of Achilles tendon rupture were copied with the healthy domestic goats ,approximately 1 to 2 years of age and weighing 33 and 40kg ,and then the different concentration of homogenting-injectable sterilizing SIS was injected in the location of Achilles tendon rupture analyzing the effect on repairing Achilles tendon in different interval .defining how concenteation influnce on repairing Achilles tendon rupturewith the homogenting-injectable SIS can provided the basement of experiment and theory for using in condation of minimal incison .Methods: (1) overview of experimental design.fority five healthy male domestic goats , approximately 1 to 2 years of age and weighing 33 and 40kg were divide randomly into three groups of 15 each according to three strength of 25%,50%,and 100% as A group B group and C group ,numbered each .the Achilles tendon of right hind leg of each goat was cut surgerically ,different homogenting-injectable SIS was injected in the spot of Achilles tendon rupture in each goat .before surgery and euthanasia,body weight measurement ,physical examination,radiographic analysis were performed on each animal.five animals from each group were sacrificed at each of the following points and the repairing Achilles tendon harvested for biomechanical test and histopathathologic examination^ weeks ,4 weeks ,6 weeks.all animals were subjected to clinical observation ,physical examination ,body weight and clinical pathologic evaluation throughout the study period and completed necropsy .(2)mortisal post-convex angle(MPCA) measuring .all animals were measured to MPCA of the behind-leg in condation of weightbearing before surgery ,measured once again before harvesting from 4 weeks.(3) Animal model : all animals were healthy and didn't have tuberculosis ,brucellosis,of encephalitis .goat was fixed on the operating table ,sterilizing as rutine ,incison localized alongmedial Achilles tendon ,2 to 3cm long .Achilles tendon was exposed to dissect in 3cm above the insertion like human Achilles tendon rupture. Then the homogenting-injectable SIS was injected in rupture point from lateral ,the formulation was 2mml,at last sutured skin.(4) Harvesting ,biomechanical testing and fixing: harvesting at the second week ,third week and sixth week for A group ,B group and C group each .every time for 5 goats in each group . biomechanical testing measured and repairing Achilles tendon sites were fixed at once with 10% formaldehyde after harvesting,and histological hematoxylin and eosin analysis.Result:(l) At 2 weeks the failure force of repairing Achilles tendon in A group was 179.4 + 48.15N , that of repairing Achilles tendon in B group was 161 ±45.55N , that of repairing Achilles tendon in C group was 356+40.83N .At 4 weeks he failure force of repairing Achilles tendon in A group was 682.6+69. IN , that of repairing Achilles tendon in B group was 584.6+ 57.9N , that of repairing Achilles tendon in C group was 983.6+ 66.7N . At 6 weeks the failure force of repairing Achilles tendon in A group wasl 121.2 + 253.3N , that of repairing Achilles tendon in B group was 1108 + 108.6N , that of repairing Achilles tendon in C group was 1726+121.7N .after 6 weeks the average failure force of repairing Achilles tendon in A group was 932.7 + 767.6 N, that of repairing Achilles tendon in B group was 897 + 795.3 N,that of repairing Achilles tendon in C group was 1105.2 + 692.2N(2)mortisal post-convex angle(MPCA) measuring:because casts were just removed at 2 weeks ,measurement beginning at 4 weeks . MPCA of left hind leg of A group was 149.99° ± 4.97° , that of right hind leg 149.96° ±4.98° before surgery, left hind leg of B group was 149.60° ±4.39° , that of right hind Iegl49.35° ±4.34.before surgery . left hind leg of C group was 149.51° ±3.89° , that of right hind leg 149.53° ± 3.91° before surgery .Post-opertive measurement of MPCA, left hind leg of A group was 149.94° ±4.76° , right hind Iegl48.67° ±5.43° , left hind leg of B group was 149.56° ± 4.41° ,right hind leg 147.63° ±5.12° , left hind leg 149.43 ° ±4.11° , right hind Iegl49.41° ±4.22° .after 2 weeks all samples'MPCA presented left hind leg 150.32° ±2.92° , preopertive right hind legl50.22° ±2.14° , postopertive right hind leg 148.77 ° ± 2.96 (4) statistic analysis. 1) biomechincal measurement .SNK-q test was used to analysis of variance for measurement at 2,4,6 weeks each. At 2 weeks , q 1=1.07 q2=6.71 q3=9.32(ql for A and B group, q2 for A and C group, q3 for B and C group). So pi >0.05, p2<0.01, p3< 0.01 .at 4 weeks ql=2.78 q2=5.97 q3=7.86.So pl>0.05, p2< 0.01, p3<0.01.at 6 weeks ql=2.13 q2=6.12 q3=7.89.So pl> 0.05, p2<0.01, p3<0.01.demonstrating from above count A and B haven't discrepancy,A and C or B and C have significant discrepancy in any time.SNK-q test was used to analyize the measurment of MPCA.the count of preoperative MPCA of left hind leg,preoperative MPCA of right hind leg andpostoperative MPCA of right hind leg were analyized.the result is ql'=0.67, q2'=0.78 ,q3'=0.96 (ql' for preoperative MPCA of left hind leg and preoperative MPCA of right hind leg , q2' for preoperative MPCA of right hind leg and postoperative MPCA of right hind leg ,q3' for postoperative MPCA of right hind leg and preoperative MPCA of left hind leg ) .so pl'>0.05, p2'>0.05, p3'>0.05. three groups haven't discrepancy (5) Exteral morphology and hematoxglin and eosin stained for histopathologic examination: At 4 weeks exteral morphology of repairing Achilles have no discrepancy with nomarl Achilles tendon at 2 weeks ,the dissected Achilles tendon from A and B group by a scattered inflammatory cell infiltrate within rupture portion, the cellular infiltrate consisted of mononuclear macrophages lymphocytes and plasma cells scattered irregularly throughout the test device and disdegradational SIS was much more than C group ,collagen' s diredtion worse than C group . the amount of new-producting collagen much less than C group .at 4 weeks ,the inflammatory cells infiltrates presented but much less common than those observed at 2 weeks from the A and B group ,and presented a large mount of fibroblast instead . the direction of collagen improved much more than that observed at 4 weeks the inflammatory cells infiltrates presented but much less common than those observed at 2 weeks from the A and B group ,and presented a large mount of fibroblast instead . the direction of collagen improved much more than that... |
PDF Full Text Request