| Background:With the development of modern surgery technology as well as anesthesiology,more and more aged patients underwent some sorts of modem and complex surgery over their old age life.The fact is that some surgeries involved a mass of blood loses and subsequent blood transfusion,while hypertension as an important combine disease before operation is common.However,how to treat hemorrhagic shock precisely in Patients with hypertension when they underwent major surgery with a mass of blood loses is not known well.Although rough HB concentration 7-10 g/dl is well known,the anesthetists are lack of moderate guideline to deal with complex onset when aged patients with hypertension suffered from mass blood loses.Hemorrhagic shock has been well studied all over the world,which refers to restored circulation volume rapidly is the first and most important step of all and improvement of microcirculation in order to maintain moderate tissue perfusion in heart,brain,kidney is the next important step.Frustratingly,the brain microvascular changes in long and untreated hypertension subjects are hardly evaluated,which means the scientists focus on brain injury has little reliable evidence to guide how to deal hemorrhagic shock in these subject or how many units blood are must transfer to such patients.The reason was that we are lack of evidence about not only the relationship between brain injury and the hemorrhagic shock patients who has been restored circulation volume by rapid fluid resuscitation but the exactly desire HB threshed value of irreversible brain tissue low oxygen.It is well known that the aged group suffered major surgery were susceptible to POCD,while multiple necessary measures and participants involved multiple disciplines have not given clearly solutions,one of which includes what is perfect HB concentration in aged patients older than 65years old whose BP were uncontrolled hypertension for several years.The SHR is a perfect animal model in research TBI,POCD and acute hemorrhagic anemia.Objective:To establish an ideal rat model(SHR or Wistar rat)to study the relationship between POCD,TBI and acute hemorrhagic anemia.To study the impacts of acute hemorrhagic anemia on cognitive function and protein biomarkers from injured brain tissue.Material and methods:60 adult SHR(10-month-old)were randomly divided into 3 groups,A(0%),B(20%),C(40%),which means the rats will suffer corresponding blood loses according to the group.Before surgery and blood loses,all the rats will be trained how to find a platform merged into opacity’s water for 4 succession days signs following 1day non-signs training in MWM system.All rats will undergo bilateral groin surgery following intubation into femoral arterial and femoral vein respectively,by which the researcher can withdraw corresponding blood loses and infuse designed volume of lactated ringer’s solution from femoral vein and measure MAP by a catheter connecting femoral arterial and transducer.6 rats were randomly selected in each group before euthanasia.Among them,3 rats’ brain cortex and hippocampus were taken on an wax experiment board placed in an ice box and stored in-80℃ for hypoxia biomarkers research and another 3 rats’ whole brain were taken out on the same methods and embedding in the wax according to experiment protocol.The remainder 14 rats were tested spatial memory on the 4th day after surgery,and they completed subsequent 6 days’ test on working memory as well as learning capability.The data was recorded by computer in WMS automatically and Statistics was executed by researcher using SPSS 20.0.Result:The changes in MAP and HB among 3 groups were accordance with our experimental design(the HB gradients among 3group were significance,p<0.000),though MAP in C group has much higher changes than A&B group(p<0.05).EL has no significance among groups at base line as well as test day.But when compared EL before and after surgery,EL of rats in C group has much changes than the other 2groups(p<0.05).Although the result of probe test and working memory has no difference among groups,the trials needed to find underwater platform at first day of working memory experiment in rats of C group was much more than that of A&B group.HIF-α,n-NOS in cortex and hippocampus of rats in C group showed significant upper regulation than A group(p<0.05).IHC results showed that GFAP in brain of C&B group had much more expression than that of A group.IHC results of IBA1 and NF had shown some a little change in C group than A&B group.The App and Nissl body showed no-significance among 3 groups.Conclusion:Acute hemorrhage anemia would impact the brain injury biomarkers in adult SHR when they suffered 40%or more blood loses.The corresponding ethology related to blood loses has shown somewhat trend but without significant difference,which should more numbers of sample.Acute mild hemorrhage anemia(20%)has shown some extent brain injury biomarkers expression compared to severity blood loses,which should be identify in further research. |
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