The Dynamic Changes Of Different Women’s Menstrual Endometrium In The Abdominal Cavity Of Nude Mice And The Process Of Planting The Endometrium Into The Peritoneum

Objectives: Our current understanding of the cause and pathophysiology of endometriosis is limited. The most widely accepted theory was proposed by Sampson, hypothesis that endometriosis results from retrograde menstruation.However,nearly 90% of women may ecperience retrograde menstruation and only 10% of them suffered endometriosis.In recent years。Lang Jinghe and colleagues proposed hypotheses that eutopic endometrium intrinsic characteristics determine the "Destiny" of endometriumthat grow gradually forming ectopic lesion or death then cleared. Endometrium retograde in the abdominal cavity, Through 3A mode(Attachment-AEndometrium gression-Angiogenesis) in ectopic implantation survival and formation of ectopic lesions. The endometrial ectopic establishment of a new blood supply need 48 h-72 h, visibility in the early stage(72h) of endometrial into the abdominal activity tissue activity is one of the key determine its ability to survive. However, due to reasons of ethics, We can not have laparoscopic examination in short term on the same patient,counterflow endometrial early changes in the human abdominal cavity remains unclear. Endometriosis nude model can reveal the process of planting the endometrium into the peritoneum. Genetic background clear, stable, immune rejection does not occur, high copy rate, to maintain the inherent histological and biological characteristics of human endometrial implants, repetitive, loyal, is ideal animal model to build human endometriosis.The current EM nude model are mainly use normal non-menstrual women endometrium, endometriosis little attention to women’s menstrual period endometrial shedding planted in the abdominal cavity state.In this study, nude mice with T cell immune deficiencies BALB / C are used as experimental carrier. Endometrium are collected by different methods form women with and without endometriosis to implant into nude mice’s peritoneal cavity to establish the nude mice model of endometriosis. So that we can analyse The dynamic changes of different women’s menstrual endometrium and impacts on the establishment of nude mice model of endometriosis. This study will provide a theoretical basis for the establishment of an ideal animal models of Ems and further reveal the process of planting the endometrium into the peritoneum.Methods: Select twenty one patients in each group, who have surgical indications with and without endometriosis(who were confirmed as benign uterine lesions and endometrial normal by their Postoperative pathology). Endometrium that are shed naturally during the Menstrual period,scraped during the durmenstrual period and scraped during the operation are collected and divided into different groups. Experiments carried out in two stages:Stage one: The dynamic changes of different women’s menstrual endometrium in the abdominal cavity of nude mice.Collect the natural deciduous endometrium of menstrual period 2-3 days from normal women and women with endometriosis, 8 patients in each group, and then injected the endometrium into the enterocoelia of nude mice. Respectively, after 24h、48h、72h,take out endometrium to do HE staining and histological scores,and observe the hisological dynamic changes of endometrium in the peritoneal cavity.Stage two: Different women’s menstrual endometrium’s impacts of establishing nude mice model of endometriosis。The two groups all 13 patients are divided into six groups according to presence or absence of endometriosis and the endometrial collection methods: endometrium shed naturally in endometriosis women’s menstrual period(Endometriosis + shedding, EMsh), endometrium scraped in endometriosis women’s menstrual period(Endometriosis + scoraping, EMsc), endometrium scraped in endometriosis women’s proliferative stage(Endometriosis + proliferative stage, EMpr); endometrium shed naturally in normal women’s menstrual period(Normal + shedding, NOsh), endometrium scraped in normal women’s menstrual period(Normal + scoraping, NOsc), endometrium scraped in normal women’s proliferative stage(Normal + proliferative stage, EMpr). According to the corresponding source of endometrial all nude mice are divided into six groups: EMsh, EMsc, EMpr, NOsh, NOsc, NOpr. Mice in each group were sacrificed on the eighth day after injection of the endometrium.And then observe the endometrial implantation in nude mice’s abdominal cavity, the success rate of establishment of a nude mouse model of and lesion load within each group. Collect the ectopic lesion and analysis histologically.Results:Stage one: Compare the tissue activity of the two endometriosis groups before the intraperitoneal injection of the(0h), and afterinjection for 24 h, 48 h, 72 h. It can be found that both groups of menstrual period endometrium were damaged in varying degrees.In these groups glandular structures were partially damaged,stromal cells reduced and inflammatory cells immersed. However endometriosis endometrial groups were damaged relatively light, the normal groups were relatively heavy. By the analysis of thevariance it was found that menstrual endometrial in endometrial group had a higher histological score(HS) than the normal group(P <0.05). After injections of endometrial the histological scores gradually declined at different times, and the difference was significant(F = 236.0, P = 000).Stage two: Each group successfully established nude mice models of endometriosis but the success rate of nude mice models and lesion load were different. By comparing the corresponding endometriosis groups and normal groups, it can be found that EMsh group’ s modeling success rate was higher than Nosh group’s, and the difference was significant(p = 0.048).Conclusion: Compared with normal women,the endometriosis woman’s endometrium in menstrual period can remain viable for a long time in the abdominal cavity, and are easier to survive in the abdominal cavity implantation. Naturally shed menstrual endometrium from endometriosis women has a better ability of cultivation than normal women. Establishing the nude mice model by using naturally shed menstrual endometrium of endometriosis can reproduce this difference well, it is the ideal model for the study of endometriosis pathogenesis.