Correlative Analysis Of Lung NKA Activity And Arterial Blood Gas In PE-SWD Of Rabbits And Intervention Study By Medicine

The World Health Organization reported 409.272 drowning deaths worldwide in the year 2000, making this the second leading cause of unintentional injury death globally, after road traffic accidents. According to what was reported the main reason for death of sea-water drowning was pulmonary edema of sea water drowning. Hypoxemia, hypercapnia and metabolic acidosis were the common pathophysiology trait. The NKA plays essential roles in active alveolar epithelial fluid cleaning. The decrease in NKA activity was not only the direct consequence of the factors which caused the PE-SWD, but also the secondary cause that leads the PE-SWD to continue developing. Many basic and clinical studies have proved that anisodamine can produce significant effect on relieving noncardiogenic edema. It was generally recognized as the mechanical of therapeutically effect caused by kinetics. This study aimed to analyze the correlation of variation between lung NKA activity and arterial blood gas; and to investigate the effect and mechanism of NKA in the PE-SWD by PE-SWD models. Observe the effects of anisodamine on lung NKA activity in PE-SWD and investigate its possible mechanism of PE-SWD treatment.Objectives Through establishing the PE-SWD of rabbits models to observe the variation pathophysiology of lung tissue which is seawater instilled,and it is expected to analyze the correlation of lung NKA activity and arterial blood gas, investigate the effect and mechanism of NKA in the PE-SWD. Analyze the possible mechanism and with the 654-2 treatment on the PE-SWD lung edema by intervention of 654-2,investigate the preventive and therapeutic effects of anisodamine (654-2) on PE-SWD.Methods According to methods provided in the literature. The PE-SWD models were established. The animals presented the following symptoms: visible embarrassment in breathing, oral lip cyanochroia, respiratory frequency increasing, and two lungs covered with crackles. There are pink foam liquid flowed from tracheal intubations. Arterial blood gas showed PaO2< 50mmHg, SaO2< 80%, PaO2/ FiO2 < 300mmHg, the models are reckoned to have been successfully established, and then we timed. 2,Experiment grouping. According to the design of experiment, groups are randomized as following: normal control; drowning group; 654-2 treatment the drowning group the drowning group. 3,Arterial blood gas detecting. As the time of experiment group one ml arterial blood got by the right arterial femur irrigate in anticoagulation test tube for the arterial blood gas determined, we analyzed the variation of arterial gas at different times. 4,Activity of NKA detecting. At these time points, rabbits were heparineized and then sacrificed with bloodletting respectively. The thorax was opened rapidly, and the lung was processed as the following description. 1g specimens from the left lower lung for preparation lung tissue homogenate, 2000/min for ten minutes, took the supernatant for NKA activity with chromatometry. 5,To determine the lung dry /wet weight ratio, and the right upper /middle lung was removed and dried to a constant weight(48℃for 72h). The dried lung was weighed and the lung dry/wet radio was then calculated. 6,Histopathology. Partial left lower lung tissue were fixed in10% formalin, processed and stained with haematoxylin and cosine for pathological examination, and fixed in 2.5% glutaral for transmission electron microscope examination.Results 1,Variation of arterial gas. PaO2 and SaO2 decreased notably, showed severe hypoxemia, and the oxygen partial pressure reached the lowest in one hour, then increased slowly, but manifested more degraded than normal. PaCO2 rose in a shot time, then declined afterwards. So did pH, actual bicarbonate. Acidosis continually existed, mainly appeared as metabolic acidosis. 2,The NKA activity of lung homogenate of drowning groups were apparently lowed after PE-SWD . There is no statistics significance in ten minutes between normal and drowning groups. After 1 h NKA activity reached the lowest, as the drowning time prolonged, it was elevated but lower than before drowning. 3,Gross appearance of lung tissue. Compared with the normal control showed pink, uniformity in the face of lung, it is showed kermesinus lamellar and (or) hemorrhage, are mainly located at the lower lung, we can extrude many pink edema from ross-section. And its color greatly faded, but the areas and volumes enlarged. 4,Pathology. 1): Common light microscope. Drowning group lung tissue section hematoxylin and eosin stain presented alveolus at different degree and interstitial edema. There were well-distributed red-stained in alveolar space. Alveolar septum, interlobular septum broken, and we can see scatter hemorrhage. Blood capillary of alveolar wall engorgement and pulmonary hyaline membrane are formed, and the infiltration of inflammatory cells in alveolar spaces. In the treatment group, these changes were less obvious, and the amplitude decreased. 2): lung tissue transmission electron microscope: Severe cellular damage occurred in the drowning group, and it presented mitochondria swollen, vacuolization, crista mitochondriales broken, typeⅠ,Ⅱepithelium cell body swollen, we could see typeⅡepithelium cell escaped from alveolar space. Pulmonary capillary endotheliocyte membrane damaged, cell body swelled, lamellar body destroyed. Interalveolar septum broken; collagen fibers of interalveolar septum increased; red blood cell desquamated; hemorrhaged in lumens. Macrophage infiltrated in alveolar space. There was not any change in normal control. And in treatment group there was no the above changes, especially the degree of injury of pulmonary capillary endothelial cell desquamate less than drowning group, and macrophage infiltrated had not detected.Conclusions 1,Decrease in NKA activity was not only the direct consequence of the factors which caused the PE-SWD, but also the important factor which promoted the PE-SWD to continue developing. Correlation between NKA activity and arterial blood gas variation was demonstrated, and illustrated the fact that NKA plays an essential role in the edema clearance of drowned lung, and it had significance to the development and recovering of PE-SWD. 2,Using up-regulated medicine of NKA activity to treat PE-SWD had important effect. 3,NKA activity raised up in treatment group, and oxygen partial pressure, oxygen saturation are improved, acidosis lessen possessed statistical significance. We proved anisodamine could treat PE-SWD by up-regulated NKA activity.