| Object: In our experiment through the establishment of pig intestinal firearm wound model, observe the changes of hepatic structure and function, and dynamic changes of plasma endotoxin, TNF-α, IL-6 levels and hepatic COX-2 expression after injury, investigate the relationships between endotoxin and TNF-α, IL-6, COX-2, and their roles in the liver injury after intestinal firearm wound, to provide academic and experimental evidence of the prevention and treatment of subsequent liver injury after intestinal firearm wound.Methods: A total of 42 Chang-Bai piglets were randomized into 7 groups: control group and wounded 1 hour group, 2 hour group, 4 hour group, 8 hour group, 12 hour group, 24 hour group. To establish the pig intestinal firearm wound model, all of the piglets in experimental group were shot (at the location of hairless areas at inferior borde of the plica at the right side of the abdominal wall, 2 cm behind umbilicus) by military 54 gun after anesthesia at normal environment (Temperature 22℃-24℃,Relative Humidity 50%-60%). The piglets in control group were not shot, the remaining steps are the same. The blood and liver were collected at corresponding time in experimental group and after return to laboratory in control group. The changes of hepatic tissue were observed under light microscope in all groups, and the levels of serum ALT and AST were also detected at the same time; The Plasma endotoxin levels were measured by chromogenic limulus amebocyte lysate test; plasma TNF-αand IL-6 levels were detected by ELISA; Hepatic COX-2 expressions were measured with immunohistochemical staining and image analysis. Results: (1) Observing under light microscope, hepatocellular edema and degeneration was gradually aggravated from 1h group to 4h group, hepatocellular spot necrosis and piecemeal necrosis was observed in 8h group, and increasing from 8h group to 24h group. Liver morphology of control group is normal under light microscope. (2) Serum ALT and AST levels of the experimental group were significantly higher than that of control group (P<0.05), appeared two peaks in 2h group and 12h group (P<0.05), and the second peak exceeded the first one (P<0.05). (3) Plasma endotoxin levels of the experimental group were significantly higher than that of control group (P<0.05), 8 h after injury in the peak, 12 h after injury remained at peak levels. (4) Plasma TNF-αand IL-6 levels of the experimental group were significantly higher than that of control group (P<0.05), 12 h after injury in the peak. (5) Hepatic COX-2 expressions of the experimental group were significantly higher than that of control group (P<0.05), appeared two peaks in 2h group and 12h group (P<0.05), and the second peak exceeded the first one (P<0.05). (6) Correlation analysis shows that endotoxin were positively correlated with TNF-α, IL-6 and COX-2, (r=0.956~0.718, all P<0.05); TNF-α, IL-6 were positively correlated with COX-2, (r=0.854~0.778, all P<0.05).Conclusion: (1) Intestinal firearm wound induce hepatic functional and morphological injury, which aggravates with prolongation of wound. (2) After intestinal firearm wound plasma endotoxin increased significantly, intestinal firearm wound leaded to endotoxemia. (3) Endotoxemia after intestinal firearm wound could stimulus the production of TNF-α, IL-6 and the expressions of hepatic COX-2, and lead to liver injury through these cytokine. Complicated endotoxin-cytokine network played important roles in the occurrence and the development of subsequent liver injury after wound.
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