title: Biliary tract external drainage protects against intestinal barrier injury in hemorrhagic shock rats.
abstract: OBJECTIVE
  To investigate the effects of biliary tract external drainage (BTED) on intestinal barrier injury in rats with hemorrhagic shock (HS).
  
  
  METHODS
  BTED was performed via cannula insertion into the bile duct of rats. HS was induced by drawing blood from the femoral artery at a rate of 1 mL/min until a mean arterial pressure (MAP) of 40 ± 5 mmHg was achieved. That MAP was maintained for 60 min. A total of 99 Sprague-Dawley rats were randomized into a sham group, an HS group and an HS + BTED group. Nine rats in the sham group were sacrificed 0.5 h after surgery. Nine rats in each of the HS and HS + BTED groups were sacrificed 0.5 h, 1 h, 2 h, 4 h and 6 h after resuscitation. Plasma tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), and lipopolysaccharide (LPS) levels were analyzed using enzyme-linked immunosorbent assay. Plasma D-lactate levels were analyzed using colorimetry. The expression levels of occludin and claudin-1 in the ileum were analyzed using Western blot and immunohistochemistry. Histology of the ileum was evaluated by hematoxylin and eosin staining.
  
  
  RESULTS
  Plasma TNF-α levels in the HS + BTED group decreased significantly compared with the HS group at 1 h and 6 h after resuscitation (P < 0.05). Plasma IL-6 levels in the HS + BTED group decreased significantly compared with the HS group at 0.5 h, 1 h and 2 h after resuscitation (P < 0.05). Plasma D-lactate and LPS levels in the HS + BTED group decreased significantly compared with the HS group at 6 h after resuscitation (P < 0.05). The expression levels of occludin in the HS + BTED group increased significantly compared with the HS group at 4 h and 6 h after resuscitation (P < 0.05). The expression levels of claudin-1 in the HS + BTED group increased significantly compared with the HS group at 6 h after resuscitation (P < 0.05). Phenomena of putrescence and desquamation of epithelial cells in the ileal mucosa were attenuated in the HS + BTED group. Ileal histopathologic scores in the HS + BTED group decreased significantly compared with the HS group at 2 h, 4 h and 6 h after resuscitation (P < 0.05).
  
  
  CONCLUSIONS
  BTED protects against intestinal barrier injury in HS rats.
authors.affiliation: Lu Wang, Bing Zhao, Ying Chen, Li Ma, Er-Zhen Chen, En-Qiang Mao, Department of Emergency Intensive Care Unit, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China.
authors.forename: Lu
authors.initials: L
authors.lastname: Wang
authors.affiliation: Lu Wang, Bing Zhao, Ying Chen, Li Ma, Er-Zhen Chen, En-Qiang Mao, Department of Emergency Intensive Care Unit, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China.
authors.forename: Bing
authors.initials: B
authors.lastname: Zhao
authors.affiliation: Lu Wang, Bing Zhao, Ying Chen, Li Ma, Er-Zhen Chen, En-Qiang Mao, Department of Emergency Intensive Care Unit, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China.
authors.forename: Ying
authors.initials: Y
authors.lastname: Chen
authors.affiliation: Lu Wang, Bing Zhao, Ying Chen, Li Ma, Er-Zhen Chen, En-Qiang Mao, Department of Emergency Intensive Care Unit, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China.
authors.forename: Li
authors.initials: L
authors.lastname: Ma
authors.affiliation: Lu Wang, Bing Zhao, Ying Chen, Li Ma, Er-Zhen Chen, En-Qiang Mao, Department of Emergency Intensive Care Unit, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China.
authors.forename: Er-Zhen
authors.initials: EZ
authors.lastname: Chen
authors.affiliation: Lu Wang, Bing Zhao, Ying Chen, Li Ma, Er-Zhen Chen, En-Qiang Mao, Department of Emergency Intensive Care Unit, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China.
authors.forename: En-Qiang
authors.initials: EQ
authors.lastname: Mao
mesh_terms: D000818:Animals; D001662:Biliary Tract Surgical Procedures / Q000379:methods*; D015415:Biomarkers / Q000097:blood; D015153:Blotting, Western; D062445:Claudin-1 / Q000378:metabolism; D004195:Disease Models, Animal; D004322:Drainage / Q000379:methods*; D007082:Ileum / Q000378:metabolism / Q000473:pathology*; D007150:Immunohistochemistry; D018836:Inflammation Mediators / Q000097:blood; D015850:Interleukin-6 / Q000097:blood; D019344:Lactic Acid / Q000097:blood; D008070:Lipopolysaccharides / Q000097:blood; D008297:Male; D062793:Occludin / Q000378:metabolism; D017207:Rats, Sprague-Dawley; D012771:Shock, Hemorrhagic / Q000097:blood / Q000473:pathology / Q000601:surgery*; D013997:Time Factors; D014409:Tumor Necrosis Factor-alpha / Q000097:blood
chemical_list: D015415:Biomarkers; D062445:Claudin-1; C568114:Cldn1 protein, rat; D018836:Inflammation Mediators; D015850:Interleukin-6; D008070:Lipopolysaccharides; D062793:Occludin; C568987:Ocln protein, rat; D014409:Tumor Necrosis Factor-alpha; D019344:Lactic Acid
keywords: Biliary tract external drainage; Claudin-1; D-lactate; Hemorrhagic shock; Occludin