The Experimental Study About The Mechanism Of Correlation Expression Of Cerebullar Cox-2 With Brain Injury After Intestinal Firearm Wound

Object: In our experiment through the establishment of pig intestinal firearm wound model, observe the changes of cerebullar structure and function, and dynamic changes of plasma endotoxin, ,TNF-α,IL-6 levels ,cerebullar COX-2,PGE-2 expression and brain cell apoptosis after injury, investigate the relationships between cytokines, such as COX-2, and brain injury ,and their roles in the brain injury after intestinal firearm wound, to provide academic and experimental evidence of the prevention and treatment of subsequent brain 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 cerebullar tissue were observed under light microscope and electronmicroscope in all groups; The Plasma endotoxin levels were measured by chromogenic limulus amebocyte lysate test; cerebullar PGE2,plasma TNF-αand IL-6 levels were detected by ELISA; The brain cell apoptosis index were determianed by tunnel;cerebullar COX-2 expressions were measured with immunohistochemical staining and image analysis.Results: (1) The experimental group of 12h, 24h appeared gradually aggravated brain cells edema and degeneration under light microscope, there were no obviously change in the injury in the control group under light microscope.(2)Mitochondrial appeared gradually aggravated swelling and dissolved under EMS in 8h, 12h, 24h group,there were no obviously change in the injury in the control group under EMS.(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) The percentage of cerebullar apoptotic of the experimental group were significantly higher than that of control group (P<0.05), and it is positively correlated with impair time. (6) Cerebullar COX-2 expressions of the experimental group were significantly higher than that of control group (P<0.05), and it is positively correlated with impair time. (7)Cerebullar PGE2 expressions of the experimental group were significantly higher than that of control group (P<0.05), and it is positively correlated with impair time. (8) Correlation analysis shows that endotoxin were positively correlated with TNF-α, IL-6,COX-2,PGE2 and the percentage of cerebullar apoptotic (P<0.05).Conclusion: (1) Intestinal firearm wound induce cerebullar functional and morphological injury, which aggravates with prolongation of wound. (2) Endotoxemia after intestinal firearm wound could stimulus the production of TNF-α, IL-6,the percentage of cerebullar apoptotic and the expressions of cerebullar COX-2 and PGE2, and lead to brain injury through these cytokine. Complicated endotoxin-cytokine network played important roles in the occurrence and the development of subsequent brain injury after wound.