| Objective: Bacterial endotoxin is an species of compounds of lipopolysaccharide and small protein in cell wall of Gram-negative bacteria, it is a kind of endotoxin bioactive-phore released after bacterium,s death or resolution.It is mainly constructed by O-specificity catena,Core polysaccharide and Lipida. Lipida is the arch- group of many kind of bioactivity or toxic reaction of endotoxin.It is species-specificityless and has the resemblance toxic reaction as to cause calefy,alter of haemodynamics,coagulation and even induce shock. Its pathogenesis is mainly because of the strength of Bacterial endotoxin reach the point in organism ( > 0.005ng/ml),then will lure-facient end-source pyrogen, for instance the tumor necrosis factor(TNF),interleukin,β2—interferon,these agents irritat body temperature regulating cente induceorganism calefy, further Bacterial endotoxin may utend praeter propte overall organ and architecture straightly or indirectly , the pathological changes are pesky generally, lymph,lien,hepar,kid,bone marrow are all can be encroached, causes the architecture be involved in congestion,cutaneous dropsy and cell death, induce architecture and organ functional disturbance in fine. tumor necrosis factor(TNF)has two kinds of molecule forms in corpore one called TNF-αand the other is called TNF-β.TNF-αis cytogenic by monocaryon- macrophages which activated by bact lipopolysaccharide(LPS), it is also called cachectin; TNF-βis Lymphocyte production which irritanted by antigen or mitogen is also called lymphotoxin. They have many kinds of biology effectiveness in organism,such as anti- tumour,anti- virus,immunological regulation,induce Inflammatory reaction,excite release mediators of inflammation,effect bindweb etc.During to the donec research, Bacterial endotoxin is the fortist stimulating factor which causes TNF,released.This research to intend checkout whether there is a contrast of endotoxin in peripheral blood plasm between Preoperative and postop and that whether there is a contrast of endotoxin in peripheral blood plasm between Preoperative and postop through continuous monitoring to those patients who deligate or non- deligate the alimentary duct during the operation and whether the alimentary duct is the main path of the aversion of enter- endotoxin at the condition of postop and Fasting state, the dependablity of endotoxin and tumor necrosis factor, provid determinate numerical data for avoidance SIRS or MODS or MOF, abatement aeger–pathy decrease the course of treatment postop.Method: To select esophageal carcinoma aegers of connecting piece final diagnosised by cytology Preoperative 63 poues, 36 be male and 27 be female (male deligated 17, nulli-deligated 15, female deligated 13 and nulli-deligated 11), ages 50~65 years old, mean age is 58.2 years old(male<58.2 12 poues,>58.2 20 poues, female<58.2 11poues,>58.2 13 poues). T1 19 poues,T2 37 poues;N0 25 poues,N1 31 poues to the international Staging denom for esophago- prickle cell carcinoma(1997), random allocation enter the essay array and the compare array through the method of randomization(the essay array deligate the alimentary duct while the compare array not), perpou draw-off ulnar vein blood at the condition of rigour asepsis discern at Preoperative 1 day and postop 1,3,5 day, the collections centrifugalizate and recipe the supernatant,then determine the contents of endotoxin and tumor necrosis factor, through the method of amb-anti-sandwich euzymelinked immunosorbent assay, the dates are analysised through methods of amb-sample T-test, matched-T test, randomized blocks analysis of variance, Spearman correlation ranks analysis. P<0.05 was considered statistical significance. Then analyzed the contribution of the level of endotoxin and TNF in the blood plasm by deligate the alimentary duct, approached whether or not the alimentary duct is the main path of endotoxin dislocated.Results:1.Age and sex have no contribution to the level of endotoxin and TNF-αin blood plasm, an-significant difference(P=0.296,P>0.05), I.e the level of endotoxin and TNF-αin blood plasm is independence with Age and sex.2.The level of endotoxin and TNF-αin blood plasm either in deligated array or in nulli-deligated array, have significance diference(P=0.0000,P<0.01), postop manifly super-Preoper- ative. They step up since postop, chalk the crest value at dieb tert postop, after that they breakdown day by day, and down to the level of arch-day postop at fifth day postop, and has the tendency of down to the level ofproxima luce of Preoperative.3.There has highly significant difference between deligated array and nulli-deligated array at the level of endotoxin and TNF-αin blood plasm postop (P=0.0000,P<0.01),the deligated array lower than the nulli-deligated array manifly. Deligate alimentary duct block the main path of endotoxin dislocation.4.Alleosis-asis of the level of endotoxin and TNF-αin blood plasm at Preoperative and postop can be delineated by form of curvilinear. Cum time as X-axis and level of endotoxin and TNF-αin blood plasm as Y-axis, the alleosis tendency of the two arcuations has highly significant difference(P=0.0000,P<0.01). The saliens punctum of the two arcuations basi-coincidence, while the arcuation of nulli-deligated array ascensus fairly steep and rect than the deligated array ,furthermore, the crest value manif higher than the deligated array, the arcuation end point in nulli-deligated array still to remain higher than deligated array, however they have the tendency of coincidence.5.The level of TNF-αin blood plasm step up along with the step up of the level of endotoxin in blood plasm at dieb tert postop, the level of endotoxin chalk the crest value, level of TNF-αchalk the crest value too, after that they all breakdown day by day, at the fifth day postop down to the level of the first day postop, and has the tendency down to the level of preoperative, the alleosis of level of TNF-αaccompaniment the alleosis of level of endotoxin all along, the alleosis tendency are at equal pace. The level of endotoxin and TNF-αin blood plasm to offer the direct correlation, the coefficient correlation is 0.979(P =0.000,P<0.01).Conclusion:1.The level of endotoxin and TNF-αin blood plasm is independence with the age and sex.2.The level of endotoxin and TNF-αin blood plasm postop higher than preoperative manifly, operation wound cause the aversion of intestinal tract endotoxin.3.Obviate deligated the alimentary duct during the operation can cut down the level of endotoxin and TNF-αin blood plasm postop utilitily, the alimentary duct is the main path of the aversion of intestinal tract endotoxin.4.The level of TNF-αin blood plasm to offer the direct correlation with the level of endotoxin in blood plasm, furthermore, both of them chalk the crest value at dieb tert postop, not at 12 hours postop.5.Obviate deligated the alimentary duct during the operation ought to be the convention technique form of esophagus carcinoma. |
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