MOLECULAR MECHANISM OF THE TRACHEAL LIGATION FOR HYPOPLASTIC FETAL LUNG

1. 胎儿气管结扎的微创技术发展胎儿气管结扎被认为是促进先天性膈疝肺发育不全的一种方式，但即使是胎儿镜下的方法对胎儿也不安全。本研究发展了单口入路，在USG的复杂引导下闭塞胎儿气管。在胎羊口腔内直接引入一个5mm的口，在USG引导下完成气管插管。引入一个精细的可拆卸的微球囊并吹气以封闭气管。胎儿在子宫内保存了5天，但是，所有胎儿都因子宫内胎儿死亡而流产。目前的技术似乎是可行的胎儿治疗，虽然更细致的护理处理胎儿和妊娠子宫应重新考虑。KGF、Bmp4表达的变化。根据我们之前的研究，KGF可能在硝芬诱导的胎儿肺发育不全中表达较少。原位杂交显示，硝芬处理后E14胎鼠肺组织中KGF mRNA的表达。到目前为止，KGF的表达在胎龄方面还没有明显的差异。Bmp4在两组E12中均有表达，在硝芬动物E16和对照组胎儿E18中均有一次低表达。提示妊娠晚期Bmp4可能参与了硝芬所致肺发育不全的形成。

1. Development of the fetal tracheal ligation by minimally invasive techniqueFetal tracheal ligation is considered to be a modality to promote lung development of the hypoplastic lung of congenital diaphragmatic hernia, however, even fetoscopic approach could not be safe to the fetus. The present investigation developed single port approach to occlude the fetal trachea with the sophisticated guidance by USG. A 5 mm port was introduced directly into the oral cavity of the fetal goat and the tracheal intubation was accomplished by USG guidance. A fine detachable micro-balloon was introduced and blown up to occlude the trachea. Fetuses were kept up to five days in uterus, however, all were lost by miscarriage due to intra-uterine fetal death. The present technique seems to be feasible for fetal treatment, although more meticulous care to handle fetuses and pregnant uterus should be reconsidered.1. Change of expression of KGF and Bmp4.Based on our previous study KGF may be less expressed in Nitrofen induced hypoplastic fetal lung. In situ hybridization revealed KGF mRNA expression in the lunf of E14 fetal rat treated by Nitrofen. So far, distinct difference of KGF expression has not been observed in terms of fetal age. Bmp4 is expressed in E12 in both group and once becomes low in E16 of Nitrofen animal and E18 of control fetus. The result may suggest that a possible role of Bmp4 in the late gestational age in the formation of lung hypoplasia induced by Nitrofen.