Studies On Protective Effects Of Biliary Tract External Drainage On Multiple Organ Function And The Related Mechanism In Hemorrhagic Shock

Objectives: To test the change of intestinal barrier function after biliary tract external drainage(BTED)in hemorrhagic shock,the change of heme oxygenase-1(HO-1)expression in liver after BTED,the relationship between improvement of multiple organ functions after BTED in hemorrhagic shock and HO-1.Methods: To study the change of multiple organ functions from the angle of function,morphology and molecular biology using enzyme-linked immuno sorbent assay(ELISA),real-time reverse transcription-polymerase chain reaction(RT-PCR),western blotting,immunohistochemistry and histopathological grade.First of all,studying the changes of intestinal barrier function after BTED using rats model of hemorrhagic shock.The hemorrhagic shock rats model was established by drawing blood from femoral vein.The BTED model was established by drawing bile from common bile duct.Second,we studied the change of HO-1 expression in liver after BTED using the BTED rat model.Finally,we studied the relationship between HO-1 and the improvements of multiple organ functions after BTED in hemorrhagic shock via the inhibition of HO-1.In this part,rats were given zinc protoporphyrin(a specific HO-1 inhibitor)(30 mg/kg)via intraperitoneal injection 24 hours before experiments.Results: In hemorrhagic shock rats,plasma D-lactate and lipopolysaccharide(LPS)levels decreased significantly 6 hours after BTED(P < 0.05);the expression levels of occludin increased significantly 4 hours and 6 hours after BTED(P < 0.05);the expression levels of claudin-1 increased significantly 6 hours after BTED(P < 0.05);phenomena of putrescence and desquamation of epithelial cells in ileum mucosa were attenuated after BTED;the ileum histopathologic scores decreased significantly 2 hours,4 hours and 6 hours after BTED(P < 0.05).The expression levels of HO-1 in liver increased significantly 1 hour and 6 hours after BTED(P < 0.05).In hemorrhagic shock rats,tumor necrosis factor ?(TNF-?)mRNA levels in the jejunum decreased significantly after BTED(P < 0.05);the expression levels of occludin and aquaporin-1(AQP-1)in the jejunum and ileum increased significantly after BTED(P < 0.05);the dry/wet ratio of the lung and kidney increased significantly after BTED(P < 0.05);myeloperoxidase(MPO)levels in the lung and kidney decreased significantly after BTED(P < 0.05);TNF-? mRNA levels in the lung and kidney decreased significantly after BTED(P < 0.05);the expression levels of AQP-1 in the lung and kidney increased significantly after BTED(P < 0.05).Under the condition that HO-1 was inhibited by zinc protoporphyrin,all these effects induced by BTED disappeared in the jejunum,ileum,lung and kidney(P < 0.05).Conclusions: BTED reduced the intestinal barrier injury in hemorrhagic shock,increased the expression of HO-1 in the liver.BTED reduced the multiple organ injury in hemorrhagic shock through the induction of HO-1.