| Chapter 1.A study on establishment of the rabbit intrauterine adhesions model by electrothermal injuryObjective:Intrauterine adhesions(IUAs)are caused by damage to the basal layer of the endometrium,resulting in formation of adhesion tissues that partially or completely obliterate the uterine cavity.IUA is associated with secondary amenorrhea,infertility,and recurrent pregnancy loss.Pathogenesis and therapy of IUA remain unsolved,which highlights the need for stable and effective experimental animal models.Methods:In the present study,according to two different methods to establish the model,forty-two female New Zealand White rabbits were randomized into two groups:mechanical injury group(n =21)and electrothermal injury group(n =21).Each rabbit served as its own control,supported by the presence of two completely separate uterine horns.In the mechanical injury group,one uterine horn of the rabbit was the injury group(M-A group),which was given a mechanical injury,and the contralateral uterine horn was the control group(M-B group),received no treatment.In the electrothermal injury group,one uterine horn of the rabbit was the injury group(E-A group),which was given a electrothermal injury,and the contralateral uterine horn was the control group(E-B group),received no treatment.Then each 5 rabbits of mechanical injury group and electrothermal injury group were sacrificed at various times(day 7,14 and 28)after the surgery to analyze the differences on endometrial morphology,number of endometrial glands and the area of endometrial fibrosis between two uterine horns;six rabbits of each group were mated on day 7 and sacrificed during pregnancy to quantify the number of implanted fetus.Results:No synechia have been observed in all groups.In the M-A group,the number of endometrial glands on Day 7 were reduced than M-B group(P<0.05),but other examinations on Day 7,14 and 28 demonstrated no significant difference between M-A and M-B group;In the E-A group,although an almost complete regeneration of endometrium was observed on day 28,the number of endometrial glands on Day 7,14 and the number of implanted fetus on Day 7 were significantly reduced than E-B group(P<0.05,P<0.01),with the ratio of the area with endometrial stromal fibrosis to total endometrial area on Day 7 significantly increased(P<0.01).Conclusions:Taken together,even if no intrauterine adhesion were observed,these results suggest that the method of electrothermal injury is effective for the establishment of a rabbit IUA model within 7-14 days after the surgery with negative impact on implantation.Chapter 2.Research on the safety limit of cold extracorporeal perfusion and ischaemic storage of human uterusObjective:To investigate the safety limit of cold extracorporeal perfusion with histidine-tryptophane-ketoglutarate(HTK)and ischaemic storage of human uterus.Methods:A total of 7 uteri were obtained from patients undergoing extensive hysterectomy for cervical carcinoma.Three of them were perfused with cold HTK solution through each artery to detect the safe height of perfusion and to establish the mathematical model showing the relation between perfusion height and pressure.The other four uteri were perused at proper height,and then endometrium and myometrial tissues were collected and stored in HTK or normal saline(NS).The samples were then divided into Oh group,HTK3h group,HTK6h group,HTK24h group,NS3h group,NS6h group and NS24h group.The cellular morphology and contractility of each group was detected,and the tolerability of human uterine tissue to cold ischaemic after short-time perfusion was determined.Results:The corresponding perfusion height of 90?140mmHg perfusion pressure was 62?122cm.Compared with Oh group,the HTK3h and HTK6h groups did not exhibit any major changes,while the HTK24h group and NS groups displayed degenerative changes such as hydropic changes,loss of intercellular contacts,hydropic mitochondria and coarse chromatin.No apparent difference in contractility was observed in specimens in HTK3h,HTK6h and HTK24h groups(P=0.772),but the contractility weakened significantly in the NS groups compared with the HTK groups(P<0.05).Conclusions:The safe height is 62?122cm for extracorporeal perfusion of human uterus by cold HTK solution;human uterine myometrial tissue can tolerate cold ischaemia for at least 6h when stored in HTK solution after short-time extracorporeal perfusion. |
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