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目的:探讨全阴囊Ⅲ度烧伤不同方式重建阴囊对睾丸生精细胞凋亡及bcl-2蛋白表达的影响。方法:以2月龄贵州小型猪为实验动物,雄性40只,雌性24只。雄性随机分正常对照组(Ⅰ),自然愈合组(Ⅱ),植皮组(Ⅲ),皮瓣组(Ⅳ),每组10只。建模10月末雄性对照组及实验组每组6只与同期饲养的雌猪一一配对饲养,配对3周后雌猪继续喂养4个月观察生育情况,雄猪1年末取各组双侧睾丸标本,原位末端标记法(TUNEL)检测睾丸生精细胞凋亡指数(AI),免疫组化(SABC法)检测bcl-2蛋白表达。对数据行单因素方差分析。结果:细胞凋亡结果:Ⅰ、Ⅱ、Ⅲ、Ⅳ的AI值(x±s)%分别为:7.07±3.50、40.34±4.85、15.14±1.36、39.29±5.73,Ⅰ与Ⅱ、Ⅲ、Ⅳ相比差异均有显著性(P<0.05),Ⅱ与Ⅳ相比差异无显著性(P>0.05),Ⅲ与Ⅱ、Ⅳ相比差异均有显著性(P<0.05)。bcl-2蛋白表达结果:Ⅰ、Ⅱ、Ⅲ、Ⅳ的bcl-2蛋白表达(x±s)%分别为:75.07±3.74、54.93±4.03、66.85±3.06、53.33±5.22,Ⅰ与Ⅱ、Ⅲ、Ⅳ相比差异均有显著性(P<0.05),Ⅱ与Ⅳ相比差异无显著性(P>0.05),Ⅲ与Ⅱ、Ⅳ相比差异均有显著性(P<0.05)。配对喂养结果:Ⅱ、Ⅳ组配种没有成功,Ⅰ组全部配对成功,生育幼猪(10.0±1.18)头,Ⅲ组4头配种成功,生育(9.92±1.31)头,Ⅰ组与Ⅱ、Ⅲ、Ⅳ组相比差异均有显著性(P<0.05),Ⅲ组与Ⅱ、Ⅳ组相比差异均有显著性(P<0.05),Ⅱ与Ⅳ组相比差异无显著性(P>0.05)。结论:全阴囊Ⅲ度烧伤不同方式重建阴囊1年后对生精功能均有抑制作用,导致生精细胞凋亡增加,bcl-2蛋白表达降低,其中植皮重建阴囊对睾丸生精功能影响最小,建议阴囊Ⅲ度烧伤创面采用植皮修复。
OBJECTIVE: To investigate the effects of scrotal reconstruction on the apoptosis of spermatogenic cells and the expression of bcl-2 in scrotum with different ways of third degree burn with total scrotum. Methods: Two-month-old Guizhou mini-pigs were used as experimental animals, 40 males and 24 females. The male were randomly divided into normal control group (Ⅰ), natural healing group (Ⅱ), skin graft group (Ⅲ) and flap group (Ⅳ), with 10 in each group. At the end of October, 6 male rats in control group and experiment group were matched with the female piglets fed in the same period one by one. After 3 weeks, the female pigs were fed for 4 months to observe the fertility. At the end of 1 year, the male testis The apoptosis index (AI) of testes and the expression of bcl-2 protein were detected by immunohistochemistry (SABC method). One-way ANOVA was performed on the data. Results: The results of apoptosis showed that the AI (x ± s)% of Ⅰ, Ⅱ, Ⅲ and Ⅳ were 7.07 ± 3.50, 40.34 ± 4.85, 15.14 ± 1.36 and 39.29 ± 5.73, respectively (P <0.05). There was no significant difference between Ⅱ and Ⅳ (P> 0.05). The difference between Ⅲ and Ⅱ, Ⅳ was significant (P <0.05). Results of bcl-2 protein expression: The expression of bcl-2 protein of Ⅰ, Ⅱ, Ⅲ and Ⅳ were (75 ± 3) ± 3.74, 54.93 ± 4.03, 66.85 ± 3.06 and 53.33 ± 5.22, respectively , Ⅳ (P <0.05). There was no significant difference between Ⅱ and Ⅳ (P> 0.05). There was significant difference between Ⅲ and Ⅱ, Ⅳ (P <0.05). Paired feeding results: In the group Ⅱ and Ⅳ, the mating was unsuccessful. All the piglets in group Ⅰ were successfully paired. The first piglets were (10.0 ± 1.18) pigs and the third pigs were grouped successfully in the fourth pigs (9.92 ± 1.31) (P <0.05). There was significant difference between group Ⅲ and group Ⅱ, Ⅳ (P <0.05), but there was no significant difference between group Ⅱ and group Ⅳ (P> 0.05) . CONCLUSION: One year after scrotal reconstruction of scrotum by different ways of total scrotal sciosis, scrotum can inhibit the function of spermatogenesis, resulting in the increase of apoptosis of spermatogenic cells and the decrease of bcl-2 protein expression. The scrotal remodeling of scrotum has the least effect on spermatogenesis, Recommended scrotal third degree burn wounds with skin graft repair.