| OBJECTIVE:The purposes of this study are (1) to research the expression changes of dopaminereceptor on intestinal mucosa of rats with traumatic brain injury, and explore the roleof intestinal dopamine receptors in the intestinal mucosal barrier function；(2) tocompare the effection of adding different nutrients to enteral nutrition on intestinalmucosa of rats with traumatic brain injury and the relationship between the expressionof dopamine receptor and intestinal mucosal barrier function, and provide objectivetheoretical basis for nutritional support on the clinical critically ill patients.DESIGN:Using the improved Feeney free-fall brain injury unit, resulting in rat moderate braininjury to establishing the traumatic brain injury rat model. The rats were randomlydivided into normal control group, the TBI group, DA group and dopamine antagonistgroup, respectively in3,7days after traumatic brain injury of intestinal mucosal tissue,urine, viscera and tissue specimen. By measuring the weight of rats, using urinarylactulose and mannitol excretion rate ratio(L/M)determination of intestinal mucosalpermeability, with HE staining of rat intestinal mucosa morphology changes, withinternal organs in Escherichia coli colony number determination of bacterialtranslocation, using immunohistochemical method for the detection of intestinalmucosa of dopamine receptor expression, by PCR and Western-blotting method wereused to detect the intestinal mucosa of rats with dopamine receptor expression onmRNA and protein level, as observed in traumatic brain injury rat intestinal mucosalbarrier function and dopamine receptor expression changes. In the early researchfoundation, the traumatic brain injury in rats were randomly divided into controlgroup, enteral nutrition group, glutamine group, the probiotic group, united group, nutrition support. In traumatic brain injury in third,7days of taking samples, themethod of adding different nutrients on enteral nutrition on traumatic brain injury inrat intestinal mucosa barrier function and dopamine receptor expression in the rat.Data was collected, mainly uses the mean+SD, single factor analysis of variance,LSD-t test, SNK-q test and statistical analysis.RESULTS:1．traumatic brain injury of intestinal mucosa in rats with impaired barrier function:(1)at different time points in each group rats the urinary L/M ratio difference (F=67.155, P <0.01; F=564.713, P <0.01), traumatic brain injury group, dopamine andantagonists in rats of the L/M ratio was higher than that of control group (P <0.01);and the traumatic brain injury group, dopamine group with no differences (P>0.05),while the antagonist group compared with the reduced (P <0.01); and the third days,seventh days of the control group (t=1.152), traumatic brain injury group (t=0.878)and dopamine group (t=0.780) and L/M ratio no difference (P>0.05), the ratio ofantagonists of group decreased (t=2.84, P <0.05).(2) the HE staining showed that:compared to the control group in the rat intestinal mucosa morphology is basicallynormal, intestinal mucosal villous structure integrity, villous epithelial cells arrangedin rows, arranged in rows, interstitial edema and free; traumatic brain injury groupand dopamine in rats during traumatic brain injury for third days, intestinal villiintegrity is destroyed, intervillous interstitial hyperemia and edema, interstitialosteoporosis, intestinal villi are extremely irregular, villus epithelial necrosis andexfoliation, epithelium and lamina propria visible separation, lamina propria appearedvascular dilation, congestion and edema; seventh days after injury, intestinal mucosalepithelium appeared atrophic villi, shorter, wider spacing, interstitial still hyperemiaedema. But the antagonist rats villous changes more traumatic brain injury group anddopamine group for light, with only mild edema.(3) in traumatic brain injury rats gut,lung, liver, spleen, kidney and other organs are detected in the Escherichia colibacteria of the genus, the rats in the intestine, liver, spleen, kidney and other organs inEscherichia coli bacteria of the genus colony number compare differences (P <0.01).Compared with the control group, the TBI group and dopamine in rats in the intestine, liver, kidney and other organs in bacterial colony number (P <0.05), traumatic braininjury group and dopamine in rats in the gut, liver and other organs of bacterial colonycounts difference (P <0.05), while the antagonist group and control group nodifference (P>0.05).2. traumatic brain injury of intestinal mucosa in rats with dopamine receptorexpression levels up:(1) was observed under microscope control group DRD1isuniformly continuous distribution in intestinal epithelial cell edge, top along the villuscell membrane, under continuous distribution; traumatic brain injury rat intestinalepithelial structure destruction, there are a lot of Tan positive reaction, with the timeincreased, Tan positive reaction also increased; dopamine rats intestinal epithelialstructure largely intact, but there are a lot of Tan positive reaction; antagonist groupthird days in rat intestinal epithelial cells visible Large Tan positive reaction, butseventh days Brown positive reaction decreased.(2) groups of intestinal mucosa ofrats with DRD1and DRD2expression in mRNA level of PCR testing found that,compared with the control group, the TBI group, dopamine and antagonists of groupDRD1and DRD2expression of mRNA water was increased (P <0.01), and traumaticbrain injury group, dopamine receptor expression level of mRNA group nodifferences, antagonist group than the other two groups decreased. WB detects theresult shows, each receptor expression than those in the control group raised, wherein,traumatic brain injury and expression of DRD1and DRD2dopamine group bandbrightness difference, antagonists of group band brightness are different.3. add different nutrition enteral nutrition can help improve brain trauma in the ratintestinal mucosal barrier function:(1) after traumatic brain injury in rats body weightwere significantly reduced (P <0.05), but the group rats body weight differences (F=6.30, P <0.01), and the control group comparison, adding different nutrition enteralnutrition group rats body weight was increased (P <0.01), no differences between thenutrition group.(2) Traumatic brain injury seventh days, groups of intestinal mucosaof rats with L/M ratio difference (F=432.472, P <0.01), add different nutritionenteral nutrition group of intestinal mucosa in rats with L/M ratio was lower than thecontrol group, the difference was statistically significant (P <0.01). One of the probiotic group rat L/M ratio is lower than the other nutrition group (P <0.05).(3)the HE staining showed that, add different nutrients in rats with traumatic brain injurygroup of pathological damage in varying degrees of loss.(4) of traumatic brain injuryon day seventh rats in each group, lung, liver, spleen, intestine, kidney and otherorgans are detected in the Escherichia coli bacteria of the genus, in the gut, lung,spleen, kidney and other organs, groups of Escherichia coli bacteria of the genuscolony number compare differences, were lower than the control group (P <0.05),the probiotic group and combination group detected in the intestinal colony numberless than enteral nutrition group and glutamine group (P <0.01).4. add different nutrition enteral nutrition mode can make the intestinal mucosa ofdopamine receptor expression levels by:(1) after traumatic brain injury in ratsintestinal tissue were visible Brown positive reaction. Compared with the controlgroup, brain trauma seventh days, the nutrition group of rat intestinal tissue Brownpositive reaction decreased.(2) groups of intestinal mucosa of rats with DRD1andDRD2expression in mRNA level of PCR testing found that, compared with thecontrol group, the nutrition group DRD1and DRD2expression of mRNA water dropson average (P <0.01); the nutrition group DRD1expression level of mRNA had nosignificant difference; the probiotic group and combination group of rat intestinalmucosal DRD2expression of mRNA levels than the enteral nutrition group andglutamine group decreased (P <0.01). WB detects the result shows, each receptordownregulation of expression than those in the control group, DRD1and DRD2bandbrightness difference.CONCLUSION:(1) traumatic brain injury can lead to intestinal mucosa permeability in rats wassignificantly elevated, the epithelial cells of intestinal mucosa injury, intercellulartight junctions wider tissue morphological changes, and the occurrence of organ tissuebacterial translocation and other phenomena, suggests that traumatic brain injury ofintestinal mucosa in rats with impaired barrier function.(2) in traumatic brain injury rat intestinal dopamine receptor expression levelsincreased, that traumatic brain injury of intestinal mucosa in rats with impaired barrier function may be associated with intestinal dopamine receptor expression levels relatedto the up-regulation of.(3) adding different nutrition enteral nutrition can slow brain trauma in the rat bodyweight decreased, prevent traumatic brain injury in the rat intestinal mucosapermeability increase, reduce brain injury in the rat intestinal mucosa tissuemorphology of injury, on intestinal mucosal barrier of rats with traumatic brain injuryhas a protective effect, helps to reduce bacterial translocation the occurrence of.Adding different nutrition enteral nutrition in slow brain trauma in the rat weightdecreased and the maintenance of gut barrier function have their respectiveadvantages, which may be associated with different nutrients on intestinal mucosalbarrier function by different mechanisms related to.(4) adding different nutrition enteral nutrition can down-regulate intestinal dopaminereceptor expression levels, through the reduction of dopamine and its receptor binding,thereby on intestinal mucosal barrier function plays a role in protection, it may beadded with different nutrition enteral nutrition improvement in traumatic brain injuryrat intestinal mucosal barrier function is one of the mechanisms, critically ill patientswith clinical nutritional support and nursing care provided academic basis.
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