Effect Of Resuscitation After Selective Cerebral Ultra-deep Hypothermia Blood Flow Occlusion On Fas And P53: An Experimental Study On Monkeys

[Objective] To observe the expression of Fas and P53 in monkeys of resuscitationafter selective cerebral ultra-deep hypothermia and blood flow occlusion.[Method] Nine 4～10-year-old rhesus mulattas were divided randomly into twogroups: group A (bilateral internal carotid arterys would be occluded and 37℃Ringer'ssolution would be infused in operation) and group B (bilateral internal carotid arteryswould be occluded and 4℃Ringer's solution would be infused in operation). Exposedbilateral external jugular veins (EJVs), bilateral external carotid arterys (ECAs),bilateral internal carotid arterys (ICAs) and bilateral internal jugular veins (?Vs). RightIJV intubated to monitoring central venous pressure (CVP). A catheter was inserted intoright ICA to infuse cold Ringer's solution, two catheters were distally and proximallyinserted into ?Vs to extract the hypothermic diluted blood for ultrafiltration and thenperfuse the warm blood into the right venae cava inferior after rewarming. Total bodywas heparinizated before reduce the brain temperature. Both ICAs were clamped 10minutes. Then the both EJVs and the left IJV were clamped about 60 minutes. 4℃coldRinger's solution was immediately perfused into the right ICA to induce the braincooling less 16℃in group B, 37℃Ringer's solution was immediately perfused intothe right ICA in group A. After 60 minutes, perfusion was stopped and blood vesselswere recovered blood stream to cause brain physio-rewarming in group B, it didn'toccur in group A of course. During preoperative and postoperative course,MRI scanswere obtained and changes of hemodynamics were measured; the a functional scales ofneurology were done three days after operation.The monkeys' brain was immediatelyremoved 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 todetermine frontal cellular expression of Fas and P53 in respective group. Statistics wereanalyzed by ANOVA analyses with significance level at P<0．01．[ Results ] All monkeys of group A were not resuscitation after perfusion and died.The level of Fas and P53 protein expression was overly high in group A. All monkeys ofgroup B were succeeded in being built up the model. The hemodynamical parameterswere steady during the operation, and all of them lived up till they were executed. MRIscan was normal after operation and the function of neurological deficient scale wasnormal. The level of Fas and P53 protein expression were significantly lower in thegroup B than them in the group A (P<0．01) .[ Conclusion ] It is safety that monkeys resuscitate from selective cerebralultra-deep hypothermia and blood flow occlusion of bilateral internal carotid for 60minutes, and it is normal to the hemodynamical parameters and nervous function. Thelevel of Fas and P53 are significantly decreased after resuscitation after selectivecerebral ultra-deep hypothermia and blood flow occlusion. It is an endogenousself-protective mechanism for helping to maintain neuron survival and to recover neuralfunction. To most extent, mild cerebral ischemic lesion lead to neurocyte apoptosis andserious cerebral ischemic lesion lead to neurocyte necrosis.