Chinese Journal of Tissue Engineering Research January 15, 2016 Vol.20, No.3

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20 3 20160115 Chinese Journal of Tissue Engineering Research January 15, 2016 Vol.20, No.3 1, 2 2 3 ( 1 100142 2 100022 3 130021). [J]. 201620(3):418-422. DOI:10.3969/j.issn.2095-4344.2016.03.021 ORCID: 0000-0002-6691-4492() β tpa upa 130021 :R318 :A :2095-4344 (2016)03-00418-05 2015-11-23 http://www.crter.org / β (tpa)(upa) 2006 2009 Ethical issues in animal experimentation β (2012s011). Wu Zhi-min 1, 2, Cui Hong-li 2, Liu Guo-hui 3 ( 1 Center for Gastrointestinal Cancer, Beijing Cancer Hospital, Beijing Institute for Cancer Research, Beijing 100142, China; 2 Department of General Surgery, Beijing Chuiyangliu Hospital, Beijing 100022, China; 418 P.O. Box 10002, Shenyang 110180

. 3 Department of Emergency Surgery, the First Hospital of Jilin University, Changchun 130021, Jilin Province, China) Wu Zhi-min, M.D., Associate chief physician, Center for Gastrointestinal Cancer, Beijing Cancer Hospital, Beijing Institute for Cancer Research, Beijing 100142, China Corresponding author: Liu Guo-hui, Department of Emergency Surgery, the First Hospital of Jilin University, Changchun 130021, Jilin Province, China Subject headings: Tissue Adhesions; Hyaluronic Acid; Carboxymethylcellulose Sodium; Tissue Engineering Funding: the Scientific Research Project of Jilin Provincial Health Department, No. 2012s011 Optimal dose and mechanism of sodium hyaluronate/carboxymethylcellulose for prevention of postoperative peritoneal adhesions: study protocol for a randomized controlled trial Abstract BACKGROUND: Local application of barriers is an effective way to prevent postoperative peritoneal adhesions. In previous experiments, a patented anti-adhesion material, sodium hyaluronate/carboxymethylcellulose, has been prepared. This glue-like polymer material has good biocompatibility, and because of its fluidity and compressibility, it can wriggle with the organs and diffuse in the entire abdominal cavity, and thereby play alubricant role to separate the intestine and peritoneum and reduce tissue adhesion. METHODS/DESIGN: A randomized controlled animal experiment has been designed. Animal models of peritoneal adhesion are made in New Zealand rabbits followed by injection of sodium hyaluronate/ carboxymethylcellulose at different concentrations and doses. The optimal concentration and dose of sodium hyaluronate/ carboxymethylcellulose is screened by comparing percentage of peritoneal adhesion between treatment and control groups. Anti-adhesion mechanism of sodium hyaluronate/carboxymethylcellulose is explored through the detection of fibroblast growth factor, endothelial cell growth factor, transforming growth factor β and serum tissue-type plasminogen activator, urokinase-type plasminogen activator and fibrinogen. DISCUSSION: This study will be powered to provide experimental evidence for sodium hyaluronate/carboxymethylcellulose in clincial prevention of postoperative peritoneal adhesion, as well as feasible ideas for exploring the anti-adhesion mechanism of sodium hyaluronate/carboxymethylcellulose. ETHICAL APPROVAL: This study was approved by the Ethics Committee of the First Hospital of Jilin University. The disposal of animals was in line with the Guideline for the Care and Use of Laboratory Animals formulated by the Ministry of Science and Technology, China in 2006 and the Ethical Issues in Animal Experimentation released in 2009. Cite this article: Wu ZM, Cui HL, Liu GH. Optimal dose and mechanism of sodium hyaluronate/carboxymethylcellulose for prevention of postoperative peritoneal adhesions: study protocol for a randomized controlled trial. Zhongguo Zuzhi Gongcheng Yanjiu. 2016;20(3):418-422. 1Experimental design 1.1 1.2 1.3 2Academic background and theoretical basis 2.1 [1] 90% 3.6% [2-3] 2.2 [4-5] Co-Tex [6-7] [8] PLGA PLGA [9] 2.3 20002002 [10] Al 3+ Fe 3+ Zn 2+ [11-13] 2009 [14] 02104173.3 2.4 ISSN 2095-4344 CN 21-1581/R CODEN: ZLKHAH 419

. (tpa)(upa) β(tgf-β) (FGF) 1 1 tpa upa TGF-β FGF EGF 1 2 3 4 1 2 3 4 tpaupatgf-β βfgfegf [15-16] [17-19] 3 Study purpose 3.1 3.2 4 Animal selection 4.1 (1) (2)(2.4±0.3) kg (3) (4) 4.2 (1) (2) (3) 5 Interventions 5.1 420 P.O. Box 10002, Shenyang 110180

. 12 h3%(1 ml/kg) 5 cm 20 cm 0.8 cm 5.2 12 d 5.3 2 (3% 3 ml/240 g)12 d 5.4 6 Study protocol 6.1 6.2 1 6.3 2 β (tpa)(upa) 6.4 (1)( ) (2) (3) (4) (5)( tpaupaβ ) 6.5 6.6 1 7 Outcome measurement 7.1 (tpa) (upa) β(tgf-β)(fgf) 7.2 [20] 05 0 7.3 () 7.4 1 8 Statistical analysis 8.1 P < 0.05 8.2 10 8.3 SAS 9.0 () (%) (tpaupa )x _ ±s t 8.4 9 Administration 9.1 9.2 2 10 Terms and conditions 10.1 10.2 10.3 2006 ISSN 2095-4344 CN 21-1581/R CODEN: ZLKHAH 421

. 2009Ethical issues in animal experimentation 10.4 10.5 10.6 11 References [1] Zeng Q, Yu Z, You J, et al.efficacy and safety of Seprafilm for preventing postoperative abdominal adhesion: systematic review and meta-analysis.world J Surg. 2007; 31(11): 2125-2131 [2] Fazio VW, Cohen Z, Fleshman JW,et al.reduction in adhesive small-bowel obstruction by Seprafilm adhesion barrier after intestinal resection.dis Colon Rectum. 2006; 49(1):1-11. [3] Ten Broek RP, Issa Y, van Santbrink EJ,et al.burden of adhesions in abdominal and pelvic surgery: systematic review and met-analysis.bmj. 2013; 347:f5588. [4] DeCherney AH, dizerega GS.Clinical problem of intraperitoneal postsurgical adhesion formation following general surgery and the use of adhesion prevention barriers.surg Clin North Am. 1997;77(3):671-688. [5] Lim R, Morrill JM, Lynch RC, et al.practical limitations of bioresorbable membranes in the prevention of intra-abdominal adhesions.j Gastrointest Surg. 2009; 13(1):35-41. discussion 41-42. [6] Gago LA, Saed GM, Chauhan S,et al.seprafilm (modified hyaluronic acid and carboxymethylcellulose) acts as a physical barrier.fertil Steril. 2003;80(3):612-616. [7] Jiang S, Wang W, Yan H, et al.prevention of intra-abdominal adhesion by bi-layer electrospun membrane.int J Mol Sci. 2013; 14(6):11861-11870. [8].PLGA[D]. :.2012. [9],,,. [J]., 2009,17(10): 1025-1029. [10],,. [J].(), 2002,28(2):163-164. [11],,,. Zn 2+ [J].,2012,29(3):427-428. [12],,.Al3+ [J].,2002,22(3):167-167. [13],,,.Fe3+ [J].,2004,12(2):79-80. [14],,,. [J]., 2010, 13 (11): 855-856. [15] Urman B, Gomel V, Jetha N.Effect of hyaluronic acid on postoperative intraperitoneal adhesion formation in the rat model.fertil Steril. 1991;56(3):563-567. [16] Zhou J, Elson C, Lee TD.Reduction in postoperative adhesion formation and re-formation after an abdominal operation with the use of N, O - carboxymethyl chitosan.surgery. 2004; 135(3):307-312. [17] Gago LA, Saed GM, Chauhan S, et al.seprafilm(modified hyaluronic acid and carboxymethylcellulose) acts as a physical barrier.fertil Steril. 2003;80(3):612-616. [18] Eggleston RB, Mueller PO, Parviainen AK, et al.effect of carboxymethylcellulose and hyaluronate solutions on jejunal healing in horses.am J Vet Res. 2004;65(5):637-643. [19] Du XH, Liu JQ, Xin K,et al.dexamethasone and sodium carboxymethyl cellulose prevent postoperative intraperitoneal adhesions in rats.braz J Med Biol Res. 2015; 48(4):344-348. [20],.- [J]., 1997.4(1):40. 12 Supplementary 2006 2009 Ethical issues in animal experimentation CNKI 3 () 422 P.O. Box 10002, Shenyang 110180