| Using ultrasound-guided sclerotherapy injection to cure cystic diseases, is more effective and with little trauma, has been widely used in clinic. Ethanol was commonly used as a hardening agent in the past, with the continuous improvement and sound medical treatment practice, the in vivo use of ethanol in human cystic diseases by percutaneous sclerotherapy has been restricted, while there is no available hardener for human in vivo therapy in market, makes ultrasound-guided sclerotherapy, which is a proven method in curing cystic diseases, limited in clinical application. This study aimed at seeking a therapeutic curing agent for human body, to make this approach continue to be used in clinical treatment.Part1Experimental Studies of the Curative effect for Lauromacrogol on Endometrial Cyst in SD Rat ModelObjective:This thesis is to study comparatively the sclerotherapy effect and the VEGF expression of lauromacrogol and dehydrated alcohol on endometriosis cyst in SD rat model. Therefore, this paper is going to explore whether lauromacrogol can become a better ideal curing agent in the sclerotherapy of endometrial cyst.Methods:The45SPF unfertilized female SD rats were taken endometrial transplantation in their own body to establish endometriosis cyst model. Then, the rats were randomly divided into lauromacrogol group, alcohol group and physiological saline group. The successful endometrial cysts was confirmed two weeks later by laparotomizing, the rats and the proper drugs were injected into every group to do sclerotherapy. After the rats were sewed up to keep one week, they were laparotomized again to observe the curing situation. The salerotherapy effect and VEGF expression of endometrial cyst in rat model were observed through staining HE and IHC.Results:First,40experimental rats were modeled successfully and66endometrial cysts were cultivated. There were13rats,22cysts in the saline group;14rats and24cystsl in the lauromacrogol group;13rats and20cysts in the dehydrated alcohol group. Therefore, the curing rate of lauromacrogol group was87.5%, dehydrated alcohol group was85%, and it was obviously to find that there were no significant differences between the two groups (P>0.05). Second, both lauromacrogol and dehydrated alcohol can make the glandular epithelium and gland of endometrial cyst inactivation under the microscope, and the glands of endometrial cyst were not obviously damaged in the saline group. Third, both VEGF expression of lauromacrogol group and dehydrated alcohol group were under the level of the saline group (P<0.017), while there was no obvious difference between lauromacrogol group and dehydrated alcohol group (P>0.017).Conclusion:Lauromacrogol can make the gland of animals’endometrial cyst inactivation and inhabit the expression of endometriosis, which has the similar sclerotherapy effect to dehydrated alcohol. Therefore, lauromacrogol will be accepted to become a better ideal curing agent in the sclerotherapy of endometrial cyst. Part2Experimental Studies of the behavioral changes and adverse onsequences after intraperitoneal injection of Lauromacrogol in SD RatsObjective:To simulate Lauromacrogol and absolute ethanol leaking into the abdominal cavity of rats, and compare the behavioral changes, adhesion, death and so on after the intraperitoneal injection of Lauromacrogol and ethanol, in order to lay the foundation of further evaluate of lauromacrogol’s adverse reactions when it’s used in human body for sclerotherapy.Methods:88female and mature rats were randomly divided into four groups:A, the lauromacrogol group of40; B, the absolute ethanol group of40; C, the physiology saline control group of8. A, B groups both set up five doses (0.1ml,0.2ml,0.4ml,0.8ml,1.6ml), each doses had eight rats, all of the rats were done intraperitoneal injection at the same position, the corresponding dose of hardener or physiology saline was injected at the left side of the abdominal wall,1.0cm away from the root of the left leg, the physiology saline group injection dose was1.6ml. Three minutes later, we observed and recorded the state of activities of rats. Their behavioral changes before and after injection were contrasted, pointed according to the following criteria:0points, unchanged;1point, abdominal muscle contractions and activity increased;2points, body arched up and activity reduced;3points, lethargy and unresponsive to stimuli. The behavior changes of three groups rats three minutes later after the injection were statistically analyzed. After a week sacrificed the surviving rats, and observed the rats’ situation of peritoneal adhesions laparotomy, then scored according to Nair evaluation systems; opened the abdominal cavity and observed abdominal injury of the rats died in a week, according to the chronological order of their deaths from the1～7days, then gave11-5points reversely.Results:After intraperitoneal injection, in A group, only1.6ml dose had two rats’ activity presenting inhibited state, behaving as activity reduced, faster heart rate slightly, the other dose groups had no significant change, except one or two rats’ activities slightly reinforced. F test was done between each dose in A group, P=0.658, it means there was no statistically significant difference between the groups;0.1ml,0.2ml dose in B group, injected3minutes later, most rats were mainly presenting excited, but the latter had greater integration than the former; in0.4ml dose group,3rats represented inhibition and five rats represented excitement; in0.8ml dose group,2rats behaved excitement and four rats behaved inhibition, two rats turned to flake out; in1.6ml dose group, two showed inhibition, the others all turned to flake out. Analysis of variance was done between each dose in B group, P=0.000, it’s means that there had a significant difference between groups, and represented dose-related; there only two rats were excited and the last didn’t change obviously in C group. There was no significant difference between group A and group C; There was no significant difference between0.1ml dose in group B and group C. Except above-mentioned, the other dose groups had significant differences. A week after the simulation of two hardeners leak into the abdominal cavity, the mainly adverse consequences of lauromacrogol were lead to different degrees of adhesion, the score of consequences and the dose had positive linear dose-related, there was no rats died in this group; the mainly adverse consequences of ethanol in surviving rats were intestinal adhesions, also had bowel and abdominal adhesions, one rat had dead in the first and fifth day in0.8ml dose group after the injection; On the next, sixth and seventh day, each day had a death rat in1.6ml dose group after injection, the main performance were extensive abdominal bowel necrosis after opening the abdominal cavity, the score of adverse consequences and the dose had positive linear dose-related. There were significant difference between two groups. Conclusion:the rats behavior changes in the lauromacrogol group were significantly lighter than the dehydrated alcohol group, it’s demonstrate that the negative stimulus in rats of lauromacrogol is much smaller than dehydrated ethanol. The lauromacrogol had not significant stimulation in rats in low dose injection, but it could inhibited the rats’activity in high doss injection, maybe it’s related to lauromacrogol’s mild narcotic effect; while dehydrated alcohol’s stimulation in rats is obviously, rats were obviously excited in low dose injection, maybe the pain caused by ethanol stimulation; rats activity were inhibited even been in lethargy at high dose, maybe it’s related to a large number of dehydrated alcohol quickly absorbed into the bloodstream through the peritoneal fluid and caused the toxic reactions. The experiment showed that Lauromacrogol leaked into the abdominal cavity did not cause bowel and abdominal cavity adhesions, and also did not cause bowel necrosis, the adverse consequences of Lauromacrogol was much lighter than dehydrated ethanol. |
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