Effect Of Resuscitation After Selective Cerebral Ultra-deep Hypothermia Blood Flow Occlusion On Nuclear Factor Kappa B(NF-κB) And MMP-2: An Experimental Study On Monkeys

【Objective】To observe the expression of NF-κB and MMP-2 in monkeys of resuscitation after selective cerebral ultra-deep hypothermia and blood flow occlusion.【Method】Eight 4～10-year-old rhesus mulattas were divided randomly into two groups: group A (bilateral internal carotid arterys would be occluded and 37℃Ringer's solution would be infused in operation) and group B (bilateral internal carotid arterys would be occluded and 4℃Ringer's solution would be infused in operation). Exposed bilateral external jugular veins (EJVs), bilateral external carotid arterys (ECAs), bilateral internal carotid arterys (ICAs) and bilateral internal jugular veins (IJVs), Right IJV intubated to monitoring central venous pressure (CVP). A catheter was inserted into right ICA to infuse cold Ringer's solution, two catheters were distally and proximally inserted into IJVs to extract the hypothermic diluted blood for ultrafiltration and then perfuse the warm blood into the right venae cava inferior after rewarming. Total body was heparinizated before reduce the brain temperature. Both ICAs were clamped 10 minutes. Then the both EJVs and the left IJV were clamped about 60 minutes. 4℃cold Ringer's solution was immediately perfused into the right ICA to induce the brain cooling less 16℃in group B, 37℃Ringer's solution was immediately perfused into the right ICA in group A. After 60 minutes, perfusion was stoped and blood vessels were recovered blood stream to cause brain physio-rewarming in group B, it needed not in group A of course. Preoperative and postoperative monkeys were examinated MRI. Operation changes of hemodynamics were measured; the dysfunctional scales of neurology were done three days after operation, then it was done every week. The monkeys' brain was immediately removed soon after death of group A in operation, and so did it in group B after we executed the monkeys 12 weeks after operation, followed by fixation, dehydration, embedding with paraffin and section. Immunohistochemical technique was used to determine the gray scale of the frontal cellular expression of NF-κB and MMP-2 in respective group. Statistics were analyzed by analyses with significance level at P＜0. 05.【Results】All monkeys of group A were not resuscitation after perfusion and died. All monkeys of group B were succeeded in being built up the model. The hemodynamical parameters were steady during the operation, and all of them lived up for ever. MRI was normal after operation and the function of neurological deficient scale was normal. The levels of NF-κB and MMP-2 protein expression were significantly higher in the group A than those in the group B (P＜0. 05).【Conclusion】It is safety that monkeys resuscitate from selective cerebral ultra-deep hypothermia and blood flow occlusion of bilateral internal carotid for 60 minutes, and it is normal to the hemodynamical parameters and nervous function. The levels of nuclear factor kappa B and MMP-2 expression are significantly decreased after monkeys of resuscitation after selective cerebral ultra-deep hypothermia and blood flow occlusion. These are activated by cerebral ischemia and involves in ischemic cerebral injury by promoting the transcription of cytokines, adhesion factors and inflammatory enzymes, inducing the apoptosis of neurons, regulating the activity of astrocytes, inducing injury of free radicals.