Effects Of Controlled Decompression On The Expression Of CCL2,IL6,TNFα And Neuronal Apoptosis In Brain Tissue Of Rabbits With Traumatic Brain Injury

Objective To compare the application of controlled decompression and rapid decompression in the treatment of acute intracranial hypertension caused by severe traumatic trauma in rabbits.The effects of two different surgical methods on rabbit behavior,release of inflammatory mediators and neuronal apoptosis.To explore the effectiveness and possible mechanism of controlled decompression technology in treating acute intracranial hypertension caused by severe head trauma in rabbits,provide laboratory evidence for the clinical application of controlled decompression surgery,and provide ideas for further basic research in the future.Methods126 New Zealand white rabbits were randomly divided into sham operation group(n=42),controlled decompression group(n=42)and rapid decompression group(n=42).After applying the balloon to create the intracranial hypertension model,take tissue samples at different time points(3 hours,6 hours,24 hours,3 days,7 days)after operation.The expression of CCL2,IL6 and TNF α and the changes of behavioral score,HE staining and neuron apoptosis in different groups were observed.ResultsThe behavioral score of the controlled decompression group was significantly lower than that of the rapid decompression group at each time point after operation.Compared with the sham operation group,IL6,TNF α and CCL2 in the controlled decompression group and rapid decompression group increased significantly at each time point after operation,suggesting that inflammatory reaction was involved in the pathophysiological changes after brain injury.Compared with the rapid decompression group,the expression of CCL2 in the controlled decompression group decreased significantly at 6hours,1 day,3 days and 7 days after operation(P<0.05).The expression of IL6 and TNF α in the rapid decompression group was also significantly higher than that in the controlled decompression group on the 3rd and 7th day after operation(P<0.05).Western Blotting results suggest that the expression levels of CCL2 and TNFα in the rapid decompression group and the controlled decompression group were significantly higher than those in the sham operation group,and the controlled decompression group was significantly lower than the rapid decompression group(CCL2:0.230±0.021<0.436±0.036;TNFα: 0.451±0.019<0.615±0.014,P<0.05).Compared with sham operation group,the expression of 6h CCL2 m RNA in controlled decompression group and rapid decompression group increased significantly after operation(9.72±0.553<25.497±0.532,P<0.05).Under light microscope,it can be seen that the microstructure of brain tissue is normal,the morphological structure of nerve cells is normal,the arrangement is regular,the cytoplasm is abundant and the nucleus can be seen clearly in the sham operation group.The microstructure of the rapid decompression group was disordered,which was characterized by reduced volume of nerve cells,nuclear atrophy and severe inflammatory cell infiltration.At the same time,compared with the rapid decompression group,the above morphological abnormalities in the control group were alleviated to a certain extent.The results of TUNEL staining showed that the number of nerve cells decreased significantly after brain injury,and the proportion of apoptotic cells between the rapid decompression group and the false group,and the proportion of apoptotic cells in the rapid decompression group was significantly lower than that in the rapid decompression group.These data demonstrate that controlled decompression is more effective than rapid decompression in protecting nerve cells and improving prognosis(52.500±3.082<96.167±6.940,P<0.05).ConclusionOur study found that controlled decompression can reduce the number of apoptotic neurons and improve neuroprognosis by reducing neuroinflammatory response.Generally speaking,whether from animal experiments or clinical trials,we can see that controlled decompression is an effective and better way of decompression surgery.However,the protective mechanism of controlled decompression on brain injury needs to be further studied.