The Effect Of Econutrition On Acute Gastric Mucosal Lesion In Rats With Severe Head Injury

Background:The prevention of acute gastric mucosal lesion(AGML) caused by severe head injuries(SHI) in the field of trauma research is an important topic.In addition to drug prevention of AGML,the role of Enteral nutrition(EN) has also drawn increasing attention.Research has been confirmed that general enteral nutrition formulations can restore and maintain gastrointestinal physiological functions,increase gastrointestinal blood supply,and to protect gastric,but traditional nutritional support improves less on patients' gastrointestinal barrier function.With the development of clinical nutrition and advanced research of regulation metabolism,econutrifion has been refered,that probiotics added enteral nutrition in order to maintain the human gastrointestinal micro-ecological balance, thereby enhancing the immunity of the body.Studies show that probiotics(such as bifidobacteria and lactobacilli) not only inhabit gastrointestinal tract and to maintain the ecological balance,but its biological characteristics(antioxidant effect,inhibiting the secretion of inflammatory mediators,inhibiting Helicobacter pylori) may play a role on stress-induced acute gastrointestinal mucosal damage control.Now the study of econutrition at home and abroad mainly concentrated on severe trauma and burn patients with intestinal function barrier,it has confirmed that they can strengthen the intestinal mucosal barrier and reduce bacterial translocation,lower infection rate of complications. However,we are not awared of any reported study about whether the Probiotics have beneficial effects on gastric mucosa in severe head injuried patients.Assuming its protective role is better than the ordinary enteral nutrition,which will choose better enteral nutrition substrate for Clinical severe brain injuricd patients providing new ideas and Theoretical basis.Objective:This study aims to investigate the effect of Econutritional on acute gastric mucosal lesion in Rats with severe head injury,and to verify whether econutrition can protect gastric mucosal in rat with severe head injury.Methods:The model of acute gastric mocusal lesion caused by server head injury was established by local impact injury.75 Sprague-Dawlay(SD) rats were randomly divided into 4 groups:normal control group(C group ),injury group(I group),enteral nutrition group(EN group ),EN adding probiotics group(EC group ).C group were not injured.the rats in the EC group were fed TRENSINE598.19kJ/(kg·d)+Bifid Triple Viable Capsules350mg/(kg·d) 4h after injury.EN group were fed TRENSINE which have the same nitrogen and calorie content 4h after injury.I Group 4h after injury fed with the same amount of Sodium Chloride Liquid.samples of all rats were collected on the 1rd day,the 3rd day and the 7th day after injury.Laser-Doppler Flowmeter measured gastric mucosal blood flow;Gastric mucosal injury were observed by Pathological hematoxylin - eosin staining;Serum and gastric malon dialdehyde content were measured with thio-barbituric acid and superoxide dismutase activity with xanthine oxidase method respectively;Serum Tumor Necrosis Factor-αcontent were measured by radioimmunoassay;Ulcer index were calculation.Results were expressed as mean±standard error of the mean.The differences between groups were analyzed by one-way ANOVA.Data analysis was performed using the SPSS11.0 software package.P＜0.05 was considered statistically significant.P＜0.01 for the difference is very significant.Result:1.The SHI model was established in rats by local impact injury.The mortality of model reached about 23%.Anatomically and pathologically,the injured rats were characterized by the contusion and laceration of brain,hemorrhage and subdural hematoma, etc.HE staining at 24h after injury showed marked hemorrhage in hippocampus area.1,3,5 days after injury were selected to dynamic observe change of gastric mucosal injury in rat. The incidence of AGML was 100%.HE staining show different degrees of capillary bleeding,exfoliated epithelial cell necrosis,gastric mucosa was the most notable change on the 5th days after injury.The above results indicate the animal model acute gastric mucosal lesion caused by severe brain injury meet.2.UI in the EN group were significantly lower than those in the I group on the 3rd and 5rd days after injury(P＜0.01).UI of EC group at different time point were obviously lower than I group(P＜0.01).There was no significant difference(P＞0.05) between EC group and EN group on post-injury 1th day and the remaining two time points were reduced (P＜0.05). 3.GMBF of I Group and EN Group were significantly lower than those of C group(P＜0.01).Comparing with I group,GMBF of EN group obviously increased on the 3th day and the 5th day(P＜0.01,P＜0.05).On each time point,GMBF in EC group were significantly higher than those in I group(P＜0.01).EC group were higher than EN group(P＜0.05).4.Comparing with C group,serum SOD activity in I group,EN group and EC group at different time point noticeably decreased(P＜0.01).The content of MDA of I group and EN group were obviously higher than those of C group(P＜0.01).The content of MDA in EC group on the lrd day after injury were significantly higher than C group(P＜0.01),but decreased at the remaining two point(P＞0.05).In EN group and EC group,the level of serum SOD were higher as compared with I group on the 3th day and the 5th day(P＜0.01,P＜0.05),but MDA content decresed nuch more sharply(P＜0.01).In EC Group, the level of serum SOD and MDA on the lth day were of no significance as compared with EN group,on other time points,SOD content increased(P＜0.05) and MDA activity decreased(P＜0.05).5.In EC group,compared with EN and I group,SOD activity in gastric mucosa increased(P＜0.01,P＜0.05),the content of MDA got lower than that in EN and I group(P＜0.01,P＜0.05).The amount of SOD in EC and EN group was higher than that in I group(P＜0.01,P＜0.05),the activity of MDA was significant decreased in EC and EN group(P＜0.01).6.the impact of Econutrition on serum TNF-αin rats with severe head injurythe level of TNF-αof I group,EN group and EC group apparently higher than those of C group(P＜0.01) on each time points after injury.The TNF-αcontents in EN group were of no significance as compared with those in I group(P＞0.05).In EC group,the level of TNF-αon the 3th day and 5th day significantly decreased those of I group (P＜0.01,P＜0.05),but comparing with EN group,which were of no sighnificance.(P＞0.05).Conclusion:1.Acute gastric mucosal damage can be observed on the 1th day after injury and to be the worst on 5th day. 2.Econutrition can promote rehabilitation of acute gastric mucosal injury of rats with severe head injury,which may be related to increased gastric mucosal blood flow,improve superoxide dismutase activity and to inhibite TNF-αproduction.3.Eonutrition can protect gastric mucosa in SHI rats,which better than enteral nutrition.4.Econutritional of 3 days or more had better curative effect.