| Objective: To establish the model of tracheal stenosis after airway injury in rabbits,and through the comparison of tracheal stenosis rate,pathological changes,the expression of TGF-beta 1 mRNA,Col-I,Col-III,preliminary study on combined application of erythromycin,penicillin and budesonide in the prevention of rabbit tracheal injury effect of tracheal stenosis and its possible mechanismMethods: 36 New Zealand white rabbits(male and female),weighing about2.5kg-3.0kg.Were randomly divided into negative control group,model control group,penicillin group,budesonide group,erythromycin group,erythromycin and penicillin plus budesonide group(combination group),a group of 6,each group were done in general anesthesia,the negative control group after tracheotomy trachea suture directly(not treated with tracheal brush),rest each group underwent tracheotomy,with hard nylon evenly brush back and forth 20 times to wipe the wall brush scraping endobronchial tracheal mucosa after tracheal suture.Erythromycin was administered by gavage,13.6mg/kg,2 times aday;penicillin was administered by intramuscular injection,with a dose of 4.35 units of /kg,daily for 2 times;budesonide was administered by inhalation,0.05mg/kg daily for 2 times.All patients were administered 7 days before operation to the postoperative day 10.The rabbits were sacrificed 10 days after operation,collect tracheal tissue after HE staining under optical microscope,the pathological changes of tracheal stenosis rate measurement and tracheal tissue examination;the relative expression of TGF-beta 1 qRT-PCR were tracheal tissue and the amount of mRNA;expression were detected by immunohistochemical in tracheal tissue Col-I,Col-III.Results: The stenosis rate in combination group for the stenosis rate(28.17+ 3.38)%,significantly lower than that of model group(53.95 + 7.09)%,penicillin group(44.78 + 4.03)%,budesonide group(49.90 + 5.47)%,erythromycin group(35.11 + 4.50)%,(T were 9.29,5.98,7.83 and 2.50,all P <0.05).The histopathologic comparison: negative control group the mucosa,submucosa and the outer layer is clearly visible,submucosal connective tissue loose,small lymphocytes,fibroblasts,and no vascular proliferation;model control group showed inflammatory cell infiltration,fibroblast proliferation and angiogenesis;combination group.The number of inflammatory cells there was no obvious infiltration into small vascular fibroblasts,proliferation.The relative expression of TGF-beta 1 mRNA combination group TGF-beta 1 mRNA relative expression was significantly lower than the model control group,penicillin group,budesonide group,erythromycin group,the differences were statistically significant(P < 0.05);the relative expression of budesonide group TGF-beta 1 mRNA and model group comparison,difference no statisticalsignificance(P > 0.05).The determination of the Col-I value,average optical density of Col-III: Col-I,Col-III is mainly expressed in the submucosa extracellular matrix;combination group Col-I,the average optical density values of Col-III were significantly lower than the model control group,penicillin group,budesonide group,erythromycin group,the differences were statistically significant(P < 0.05);budesonide group Col-I,Col-III the average optical density value compared with the model group,the difference was not statistically significant(P > 0.05)Conclusions: The use of inhaled budesonide alone does not prevent tracheal stenosis after rabbit tracheal injury.The combined application of erythromycin,penicillin and budesonide by anti-inflammatory,anti infection,down-regulation of TGF-beta 1,Col-I and Col-III can effectively alleviate the tracheobronchial injury of rabbit stenosis,can be considered for the prevention and treatment of benign tracheal stenosis. |
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