| Objectives:Various causes of tracheal trauma or disease,leading to cartilage injury,mucous membrane rupture or hematoma formation,followed by fibrous connective tissue and scar tissue repair,and ultimately the formation of tracheal stenosis.Tracheal stenosis treatment is still very difficult,surgical treatment of tracheal scar mature area of significant effect,and drug treatment in the early prevention of tracheal stenosis has a positive effect.Carboxymethyl Chitosan is a water-soluble polysaccharide,which is derived from chitosan by carboxymethylation,with better biodegradability and histocompatibility,hemostasis,pain and inhibition of the growth of microorganisms.In addition,it can promote the growth of epithelial cells,inhibition of fibroblast proliferation and migration,to inhibit the formation of scar tissue,thereby accelerating wound healing.In this study,rabbits with tracheal stenosis were established by spherical electrocoagulation method,and Carboxymethyl Chitosan was inhaled on the basis of tracheal stenosis model.Through the study of pathomorphology,and to compare the study of carnitine chitosan inhalation on the inhibition of tracheal fibrosis to provide the basis.Methods:1.Part ?: Twenty-two adult New Zealand white rabbits were divided into experimental group(n = 12)and control group(n = 10).10-12 rings of trachea in the experimental group were longitudinal incised,and animals were assigned to either sham control(tracheotomy only)or injured(tracheotomy and spherical coagulation)groups using various spherical coagulation(20 W)for 5s.Formation of cicatrix of tracheal were observed by endoscopy on day 7?14 and 28.Animals were killed at 28 d.The larynx and the upper trachea tissue was harvested for observation and histologic evaluation(HE and Masson staining).2.Part ?: 20 New Zealand white rabbits were randomly divided into inhalation drug group(n = 10)and inhalation saline group(n = 10).After the establishment of the two groups of tracheal stenosis model,inhalation drug group was inhaled carboxymethyl chitosan and inhalation saline group was inhaled into saline.The tracheal scar formation was observed on the 14 th and 28 th day.The effect of inhalation of carboxymethyl chitosan on aerosol trauma in tracheal.Tracheal mucosa were observed by scanning electron microscopy,HE staining of heart,liver,spleen,lung and kidney were observed.3.Part ?: The expression of TGF-?1 and protein expression levels of TGF-?1 in the trachea were detected by immunofluorescence staining and ELISA.Results:1.Part ?: Endoscopic examination,the first 14 d after tracheal burning visible granulation tissue and scar hyperplasia,tracheotomy suture smooth,no granulation tissue and scar increased.On the 28 th day after operation,the scar contracture and cartilage malformations were observed in the trachea burning.The stenosis was observed.The degree of tracheal stenosis was 44%-62% and the median was 55%.T0 o surgery 28 d,the experimental group of tracheal stenosis with time gradually increased,the first 28 d stenosis higher than 7d after burning,the difference was statistically significant(P <0.05).HE staining and MASSON trichrome staining results can be seen on the 28 th day under mild inflammation of the submucosal reaction,and no columnar epithelial regeneration.Granulation tissue is replaced by dense collagen fibers,damaged cartilage is contracted by collagen fibers.2.Part ?: Endoscopic examination,to 28 d after surgery,the inhalation drug group of tracheal stenosis with time gradually increased;after the first 28 d in the inhalation saline group stenosis higher than the inhalation drug group,the difference was statistically significant(P <O.05).CT showed that the tracheal transverse diameter of the inhalation drug group was longer than that of the inhalation saline group rabbits in the same plane,and there was significant difference(P <0.05).HE staining and MASSON trichrome staining results can be seen a small amount of collagen fibers,loose connective tissue visible on the surface,the damaged cartilage morphology intact,no obvious damage and pulling King spasm in inhalation drug group.The content of hydroxyproline in the inhalation drug group was lower than that in the inhalation saline group(P <0.05).HE staining showed no abnormalities in rabbit heart,liver,spleen,lung and kidney tissues and tracheal scanning electron microscopy.3.Part ?:Compared with Inhalation carboxymethyl chitosan group,the expression of TGF-?1 positive cells in the inhalation saline group was significantly higher(P <0.05).Compared with Inhalation saline group,the expression of TGF-?1 protein in the inhalation drug group was decreased.Conclusion:1.Spherical electrocoagulation can lead to tracheal stenosis,spherical electrocoagulation can be used to establish tracheal stenosis,the method is simple.2.Suggesting that aerosolized carnitine chitosan has an inhibitory effect on tracheal fibrosis.3.Inhalation carboxymethyl chitosan in the tracheal traumatic fibrosis may be related to TGF-?1. |
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