The Effectiveness Of Adding Different Enteral Nutrition For The Rats After The Operation Of IPAA

Objective:To investigate the different enteral nutrition for the revovery of ileal pouch anal anastomosis in rats and the relationship with mucosal barrier of the pouch.To provide the experimental gists for the UC patients after IPAA.Methods:The weight of rats are ranging from 320-350 g which are male Sprague-Dawley(SD)rats were randomly divided into controlled group,Enteral Nutrition(EN)group,Enteral Nutrition with immune agents group,that is NI group,Enteral Nutrition with probiotics,that is NP group(n=8).Microsurgery was used to establish IPAA model.In the first two days after operation,all the rats supplied glucose and sodium chloride.Then in the third day after operation,the controlled group was given the rodent diet,the EN group was given the peptisorb,NI group was given the peptisorb with glutamine,NP group was given peptisorb and Lactobacillus acidophilus.Monitor the weight change,fecal score.Test the change of flora by the rapid smear method.In the 30 th day,pouch specimens were taken and pouch from all the group rats for histologic grading.Immunohistochemistry method was used to measure occludin protein.Saving blood to test the change of liver function including toatal Protein(TP),albumin(ALB),prealbumin(PA),transferrin(TF).Using spss19.0 software analysis result data,the measurement data is described by the mean or plus or minus standard deviation.When statistical analysis was performed,the analysis of the single factor variance between the normal distribution group was compared,and then the LSD method was adopted.Results:1.The general condition of the rat(1)mental state,activity and hair:the rats in controlled group,EN group,NI group and NP group were responsive,shiny hair.(2)First defecation time: there were no statistical differences among the 4 groups.(3)fecal score : EN,NI and NP group were higher than the controlled group(P<0.01).The score of EN,NI and NP group were no statistically difference(P<0.05).2.Nutrition status 1)weight: before the operation,there were no statistical differences among the 4 groups.;after the operation,the body weight of rats showed short-term decline,the differences of the time which the body weight of rats fell to the lowest level and descend range were statistically significant among the 4 groups(P<0.05).In EN group it was higher than that in NI group and NP group(P<0.05),the difference was not statistically significant between EN and NI group(P>0.05).At the 30 th day,the differences of body weight of rats were statistically significant among the 4 groups(P<0.05).In EN group it was less than that in NI group and NP group(P<0.05),the difference was not statistically significant between EN and NI group(P>0.05).(2)Blood test results showed: after the operation,there were statistical differences in the indicators of the four groups of rats(P<0.05).In NI group and NP group,it was better than that in EN group(P<0.01).The difference was not statistically significant between NI group and NP group(P>0.05).3.The intestinal barrier function of rats(1)fecal bacteria test results show that: the fecal bacterial count of rats in control group decreased,the number of gram positive bacilli increased,the number of gram negative bacteria reduced;the fecal bacterial count of rats in EN and NI group reduced,gram positive bacilli number increased slightly,the number of gram negative bacilli decreased slightly;the rats NI group MN normal distribution of fecal flora.Among the 4 groups,the fecal bacterial count of rats and the number of gram positive bacilli in NP group,EN group and NI group were higher than those in controlled group(P<0.01).They were higher in NP group than those in EN group and NI group(P<0.01).The difference was not statistically significant between NI group and NP group(P>0.05).The gram negative bacteria of EN,NI and NP groups were less than that in controlled group(P<0.01).It was less in NP group than that in EN group and NI group(P<0.01).The difference was not statistically significant between NI group and NP group(P>0.05).(2)the results of immunohistochemistry showed that the expression levels of Occludin protein in the EN group,NI group and NP group were significantly higher than those in the control group,the difference was statistically significant(P<0.05).4.Histopathology results showed that complete control of pouch mucosal villi in rats is damaged,villous,loose pouch villi irregular arrangement,villous epithelium appears necrotic,epithelium and lamina propria lamina propria edema;separation,EN group,NI group,NP group,the three groups of rats the pouch mucosa morphology was normal,the pouch mucosa villus integrity,villous epithelial cells arranged in neat,and no edema;EN group,NI group,NP group,pathological score were higher than the control group,but the difference was not statistically significant(P>0.05).Conclusions:1.EN,NI and NP can effectively improve the nutritional status of rats after IPAA,and accelerate the recovery of rats,the effects of NI and NP are better than EN.2.NP can effectively improve the distribution of bacteria in rat intestine and increase the expression of Occludin protein,so they can enhance pouch epithelial barrier protection.EN and NI can effectively increase the expression of Ocludin protein,and they can enhance pouch mucosa protective barrier.3.EN,NI and NP can effectively improve the revovery condition and pouch mucosa protective barrier of rats after IPAA,and this study provides basis experimental gists for the research of UC patients after IPAA.