Expression Changes And Clinical Significance Of Tight Junction Protein Occludin In Children With Acute Intestinal Obstruction Complicated Intestinal Necrosis

Objective:Observed the change of tight junction protein Occudin in children with acute intestinal obstruction complicated intestinal necrosis and investigated its possible mechanism and clinical significance.Methods:Selected 38 cases from December 2013 to December 2014,emergency call was admitted to hospital with acute intestinal obstruction underwent intestinal necrosis of intestinal resection in children as disease group.20 cases of digestive tract malformations (Meckel’s diverticulum, intestinal duplication without complications),underwent intestinal resection and anastomosis in children as control group.The expression of Occludin in intestinal epithelium was observed by immunohistochemistry,the average optical density was detected by IPP6.0;TUNEL wad used to detect the apoptosis index of intestinal epithelial cells;Western blotting was used to detect the content of p38MAPK and p-p38MAPK in intestinal cells;The concentration of TNF-a in serum of preoperative and postoperative 7 days were detected by ELIS A.Result:Compared with the normal control group, in the lesion group intestinal epithelial cell tight junctions of Occludin protein staining in the superficial, expression disorder interruption, OD value was lower than the control group, P< 0.01;In intestinal epithelial cell apoptosis index increased significantly, P< 0.01;In intestinal epithelial cells the content of p38MAPK is no significant difference P> 0.05, but the content of p-p38MAPK increased significantly, P< 0.01; The concentration of TNF-α in serum was significantly higher in the lesion group than in control group before operation, P< 0.05, after symptomatic treatment the concentration of TNF-a was gradually returned to normal.Person correlation analysis showed:the expression of Occludin value OD was negatived correlated with AI and TNF-α,P< 0.05.Conclusion:Acute intestinal obstruction complicated intestinal necrosis, in children, p38MAPK activated as p-p38MAPK that induced TNF-a produced and intestinal epithelial cell apoptosis, TNF-α activated could promoted cell apoptosis and decreased the expression of intestinal epithelial tight junction protein Occludin, caused intestinal mucosal barrier dysfunction. This may be the main cause of death of bacteria translocation in acute intestinal.