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Study on Bacterial Translocation in Acute Appendicitis in Children

Author: CuiZuo
Tutor: WangJianFeng
School: Shanxi Medical
Course: Pediatrics
Keywords: Acute appendicitis Bacterial translocation Nitric oxide synthase Nitric oxide Interleukin-10
CLC: R726.5
Type: Master's thesis
Year: 2009
Downloads: 29
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Abstract

Objective To investigate the children with acute bacterial translocation occurs appendicitis and appendectomy organization nitric oxide synthase enzyme (NOS), serum nitric oxide (NO), interleukin -10 (IL-10) and its clinical significance. Methods 30 cases of acute appendicitis in children admitted to hospital, seven days after blood, laparotomy lessons peritoneal fluid, take the the terminal ileum recent appendectomy at the lymph nodes one and remove the appendix, 10 cases of malrotation without appendicitis in children as a normal appendix control group, 10 cases of normal healthy children as normal blood samples control group. The polymerase chain reaction (PCR) qualitative detection of whole blood bacterial DNA (bacteria common 16SrRNA in E. coli BG); peritoneal fluid bacterial culture and mesenteric lymph nodes; immunohistochemical method for quantitative detection of the appendix of NOS expression; enzyme-linked immunosorbent assay assay (ELISA) quantitative detection of NO, IL-10 in the serum of different time. Simple appendicitis group preoperative appendicitis group was the control group and normal blood specimens 16SrRNA BG expression, the simple appendicitis intraperitoneal liquid and mesenteric lymph node bacterial cultures were negative; the a suppurative appendicitis group preoperative 16SrRNA-positive rate of 70 BG positive rate was 60%, and mesenteric lymph nodes of E. coli culture-positive rate was 50%, and peritoneal fluid positive rate was 40%, mesenteric lymph nodes bacterial culture of E. coli-positive at the same time BG also positive. Significant difference (P lt; 0.01); any between the two groups in the average gray value of the the appendicitis group organization NOS between the control group difference was statistically significant (P lt; 0.01). The appendicitis group preoperative NO, IL-10 concentration, body temperature and white blood cell (WBC) count values ??were different after, was statistically significant (P lt; 0.05); appendicitis preoperative control group were different, there are statistics significance (P lt; 0.01); prior to any surgery there are differences between the two groups was statistically significant (P lt; 0.01); postoperative and control groups had no statistical significance (P gt; 0.05). Immunohistochemistry of NOS BG positive, corresponding average gray value is significantly lower than the BG negative and statistically significant (P lt; 0.01); their corresponding serum NO, IL-10 levels and body temperature (T) white blood cell (WBC) count value is significantly higher than BG negative, the difference was statistically significant (P lt; 0.05). NO concentration and NOS mean gray value was a negative correlation, the correlation coefficient of -0.858 (P lt; 0.01); NO concentration of IL-10 concentration was positively correlated with a correlation coefficient of 0.698 (P lt; 0.01); NO concentration and white blood cell (WBC) count value was positively correlated with a correlation coefficient of 0.731 (P lt; 0.01). E. coli has occurred Conclusion Acute appendicitis intestinal bacterial translocation as appendectomy lesions aggravated bacterial translocation increased incidence of systemic inflammatory response syndrome incidence also increased. Children with acute appendicitis bacterial translocation and NO are closely related, it may be early mucosal barrier injury factor, is an important factor in causing bacterial translocation occurs. IL-10 is an anti-inflammatory factor to keep the balance of the immune inflammatory response capability, so as not to excessive systemic inflammatory response syndrome induced multiple organ dysfunction syndrome. Early diagnosis of clinically timely PCR detection of blood 16SrRNA, BG contribute to bacterial translocation of acute appendicitis; Serum IL-10, NO varying levels can be used as acute appendicitis bacteria shift prognosis.

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