The Protection Effect Experimental Study Of Poloxamer 188 On Nerve Cell

The mortality rate is 100～150/100 000 among severely craniocerebral injured patient. Intracranial hematoma and brain edema are main causes of intracranial hypertension. Although craniotomy with bone flap,dehydrant agents,mild hypothermia are important to reduce brain edema, we still find out that brain edema happen on some patients after operation.It is a priority to improve the effect of the treatment on severely craniocerebral injured patient, while it is a key step to seek a better method of nerve protection in order to prevent secondary brain injury. Poloxamer 188 is one of the rare surface active agents which can be used on IV injection. Its protection effects on cells are: it can prevent the combinations between molecular protein and cell-membrane receptor;it can reduce nerve cell edema ,and reduce the toxicity of tissue inflammation as well. The NF-κB is a very important cell factor on infection, immune reaction, controlling cell differentiation and cell apoptosis, which is also an important signal transduction molecular in secondary neuraxitis. Some scholars discover that NF-KB activation is the same as the development law of traumatic occlusion cerebral edema through the analogue experiment of rats'brain injury. Therefore, the early suppress on NF-κB is the primary factor on treating craniocerebral injury, which will be a new treatment. Currently, scholars from home and abroad mainly have researches on P188's protection effect through vitro experiment,but the studies and thesis about the protection effect through the study on intravenous-drug-using are rarely seen either in China or outside China. The experiment used rats of acute subdural hematoma, and they were divided into groups to take ICP and water content of brain tissue,while the means of RT-PCR was applied to study the changing laws of NF-KB gene among various groups. The experiment focus on exploring the relationship among intracranial pressure after injury, water content and NF-κB. The experiment aims to prove that P188 can protect brain tissue of brain injured rats,which also provides experimental evidence for further study on P188 and clinical application.MethodsALL rats were randomly assigned into five groups: Model group,Control group, Large craniotomy group, P188 treat group, Large craniotomy + P188 treat group. Monitor ICP and determine water content at 30min, 2h,6h,12h. RT-PCR determines NF-κB mRNA at 12h. Finally, make the contrast of statistics differences among all the groups through the method of statistics, and provide analysis and discussion on the results.Results1. Establish the acute subduaral hematoma rat as the model.Dissect: hematoma locates under the subduaral.The sizes and the positions of hematoma are a little different. The thickness of typical hematoma is 0.5～1.5 mm, and the size is 8～10 mm,which distribute on the surface of brain.2. Monitoring ICP(intracranial pressure)Injection with 0.8ml blood every time. The ICP goes up rapidly in each injection and shapes the peak, then the ICP falls, from the beginning of the injection until the end of it the ICP shapes a sawtooth peak, the average height is 6.52±0.31mmHg,2 hours after the injection the ICP falls rapidly and it falls to 4.59±0.32 mmHg,then it gradually increases. There is statistics meaning for the comparisons of 30min, 2h and 6h inside the Model group(P < 0.05), and it is statistically meaningless to compare with 12h.The comparisons between 30 min of Large craniotomy group with the other times are statistically meaningful (P < 0.05). 12h of p188 group is statistically meaningful when comparing with 12h of model group(P < 0.05. Large craniotomy group + P188 group is similar to Large craniotomy group,mean is too low, it is statistically meaningless.3. The Measure of the water quantity in brain tissueWater content of control group is not time-varying. Other groups show that the water content change with the time changing and it is direct ratio. Model group at 12h is statistically meaningful when compare with other groups(P < 0.05).P188 group at 12h is with less water content comparing with Large craniotomy group. It is meaningsful to compare Large craniotomy +P188 group and Large craniotomy group at 12h(P < 0.05).4. the comparison of brain tissue's NF-κB mRNA gene among various groupsIt is statistically meaningful to compare control group with other groups and P< 0.05, P< 0.05 when Large craniotomy group compared with P188 group, P< 0.05 when P188 group is compared with P188+ Large craniotomy group.Conclusions1. At the early period of craniocerebral injury,ICP and water content, NF-κB is direct ratio. 2. Iv P188 can reduce water content,bring down ICP,reduce NF-κB in the acute subduaral hematoma rat as the model .This result points out P188 can across blood brain barrier.