| Pelvic organ prolapse(POP) is also called perineal hernia.It is a worldwide health problem, higher incidence in older women, with the development of society and economy, the severity of the aging population, its incidence has increased year by year. Although it is not a fatal disease, but seriously affect the health and quality of life. In the United States, aged 50-79 years old, about 40 percent of women suffer from varying degrees of POP. POP causes are many, but its mechanism is not clear. occurred. Recent studies have found weak pelvic tissues elastic fibers, or one of the pathological basis POP damage occurred.Elastic fibers is an important component of connective tissue, tissue elastic fibers can be given good scalability and reversible deformation, which can maintain normal tissue structure and function. Elastin(Elastin) is the most important and most resilient fiber core protein, Fibrillin-1(Fibrillin-1) is a stent formed of elastin, its formation of elastin plays a vital role. Some researchers have found that patients with inguinal hernia transverse fascia sparse elastic fibers, separation, Fibrillin-1 was significantly reduced, and the distribution of abnormalities, is the cause of inguinal hernia patients transverse fascia resistance weakened. Elastic fibers in the female pelvic floor tissues rich in content, in POP patients, Elastin, Fibrillin-1 is also involved in the occurrence and development of POP domestic and overseas foreign literature has not reported. Therefore, the present study attempts to study patients with non-POP, II ° prolapse patients, III ° prolapse in Elastin patient organizations, Fibrillin 1-in protein and gene expression levels, explore their roles in the formation and development of POP and relationships, thus the reason for the occurrence and development of POP provide new ideas.ObjectiveBy studying patients with non-POP, II ° prolapse patients, III ° prolapse in Elastin patient organizations, Fibrillin 1-in protein and gene expression levels, explore their roles in the formation and development of POP and relationships, thus the reason for the occurrence and development of POP provide new ideas.Materials and Methods 1. Materials: Collected in our hospital in July 2013- February 2014 with pelvic organ Third Affiliated Hospital of Zhengzhou University, gynecology prolapse treated 60 patients(all post-menopausal women), Which by the POP-Q scores II ° prolapse 30 cases, with an average(59.93 ± 1.98) years old, III ° prolapse in 30 cases, with an average(60.16 ± 1.43) years old, intraoperative 12:00 whichever position were full thickness of the vaginal wall, size of about 1.0cm * 1.0cm as the study group. Choose period to period due to cervical Ia1 Ib1 patients of the anterior vaginal wall 12 o’clock position size of about 1.0cm *1.0cm 30 cases of full-thickness tissue samples as a control group, average(59.83± 1.62) years. All specimens conventional subjects, after in vitro immediately divided into two, an in vitro for 30 minutes stored at-80 refrigerator,℃ Another part immediately after in vitro in 10% formaldehyde solution, fixed, embedded in paraffin. All patients had no estrogen-related diseases and cirrhosis, rheumatoid arthritis and other collagen and elastin metabolism disorders, were not used corticosteroids and hormone drugs within the past six months. Each group of patients in group ANOVA age, parity, gravidity, body mass index analysis and comparison of various factors between groups, the difference was not statistically significant. Preoperative patients signed an informed consent. Postoperative pathology experts confirmed the diagnosis clear. 2. Methods: Respectively by immunohistochemical SP method and RT-PCR(reverse transcription-polymerase chain reaction) method, in strict accordance with the kit instructions, detection Group 3 vaginal wall tissue Elastin, Fibrillin-1 protein levels and gene expression levels. 3. Statistic method: Using SPSS17.0 statistical software for data analysis. Count data using the mean plus or minus standard deviation, quantitative data between groups using one-way ANOVA, chi square test components using qualitative data,between variables using correlation analysis, Each test method for testing are a =0.05 level.Results 1. Elastin protein is mainly expressed in the cytoplasm. Elastin protein in patients with non-POP vaginal wall, II ° vaginal wall prolapse patients, III ° prolapsed vaginal wall tissue of patients were expressed, As the severity of prolapse, the degree of cell staining faded, the proportion of positive staining cells decreased,.Three groups of samples positive expression rates were 73.3%,46.67%, 20.00%, The difference was statistically significant(P﹤0.05). 2. Fibrillin-1 protein is mainly expressed in the cytoplasm. Fibrillin-1 protein in patients with non-POP vaginal wall, II ° vaginal wall prolapse patients, and patients with vaginal wall prolapse III ° tissues were expressed, As the severity of prolapse, the degree of cell staining faded, the proportion of positive staining cells decreased, Three groups of samples positive expression rates were 83.33%, 33.33%, 10.00%,the difference was statistically significant,(P﹤0.05). 3. According to association analysis, vaginal wall tissue Elastin, Fibrillin-1 protein expression was positively correlated(r=0.957,p<0.01). 4. Agarose gel electrophoresis showed that 1560 bp for Fibrillin-1 target band,203bp for Elastin target band and 564 bp for internal control beta-actin stripe.The results of its semi-quantitative determination of the display that Elastin m RNA and Fibrillin-1 m RNA expression was positive in the three groups, Elastin m RNA displayed in the results semi-quantitative determination of electrophoretic that the control group expression levels(0.247±0.0039), II ° prolapse group expression levels(0.184±0.0035), III ° prolapse group expression levels (0.095±0.0031), Each two groups were statistically significant differences (p<0.01). The results Fibrillin-1 m RNA in the semi-quantitative determination of the electrophoretic display that the control group expression levels(0.158±0.0021), II ° prolapse group expression levels(0.085±0.0023), III ° prolapse group expression levels(0.048±0.0024), Each two groups were statistically significant differences(p<0.01).Conclusion 1. Elastin and Fibrillin-1 protein in patients with non-POP anterior vaginal wall, II °in patients with anterior vaginal wall prolapse, III ° in patients with anterior vaginal wall prolapse tissue were expressed, however, with the severity of prolapse, reduced expression level, which plays an important role in the process of formation of pelvic organ prolapse. 2. In the anterior vaginal wall prolapse tissue Elastin, Fibrillin-1 protein expression was positively correlated, they have a catalytic role in the development of pelvic organ prolapse in. |
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