Effect Of Carbon Dioxide Pneumoperitoneum On The Sever Acute Pancreatitis On Pericranium Tissue,the Expression Of Pericranium NF-?B And Cerebrospinal Fluid S-100B Protein

Objective SPF healthy male SD rats were used to establish a severe acute pancreatitis?SAP?experimental model in Xining,Qinghai Province?at an altitude of2260,belonging to intermediate altitude?.The objective of the present research was to explore the potential impacts of CO₂ pneumoperitoneum on SAP-induced rat brain pathology,brain NF-?B and cerebrospinal fluid S-100 B protein and provide guidance and basis for the application of endoscope technique in the clinical surgical treatment of SAP.Methods 30 rats?SPF healthy male SD rats;age: 10-12w;weight: 310±20g?were randomly divided into three groups:?1?Control group: After disinfection and laparotomy,duodenum and pancreas were gently turned over before closing the abdomen;?2?SAP group?10 rats?: a SAP model was established before closing the abdomen,without filling with CO₂ gas;?3?SAP+CO₂ pneumoperitoneum group:after disinfection and laparotomy,a SAP model was established before closing the abdomen,and the abdominal cavity was filled with CO₂ gas with an automatic insufflator for laparoscopy to maintain the pressure at 8mmHg for 120 min.10 rats were divided into each group,and different interventions were given to each group respectively.All experimental rats?rats died during the experimental process were excluded?were anesthetized heavily for 8 hours,and then the rat head was fixed to extract cerebrospinal fluid?S-100 B protein was determined by ELISA?;the rats whose cerebrospinal fluid was extracted were sacrificed,the abdomen was opened again after disinfection,blood was drawn from abdominal aorta?blood amylase was determined by automatic biochemical analyzer?;pancreatic tissue was removed for histopathological examination;brain tissue was removed after opening the skull for histopathological examination and IHC test;data were obtained for statistical analysis.Results?1?Pancreatic pathology: Both SAP group and SAP+CO₂pneumoperitoneum group had changes in pancreatic pathology.Common lightmicroscope indicated that there were obvious calcified plaques in the necrotic pancreatic tissue of rats,and inflammatory cell infiltration was obvious in the surrounding tissue and the necrotic region.The necrotic lesions were focal or flaky,with inflammatory bleeding in local tissue.The final pancreatic pathology score obtained was high;the pancreatic tissue of the rats in the control group was generally normal,with no obviously degenerative and necrotic cells,with no obvious inflammatory cell infiltration in the surrounding tissue.The rat pancreatic pathology scores of SAP group?9.00±1.98?and SAP+CO₂ pneumoperitoneum group?1.15±0.85?showed significantly differences compared with the control group?P < 0.05?,while there was no significant difference between SAP group and SAP+CO₂pneumoperitoneum group?P >0.05?.?2?Brain pathology: Both SAP group and SAP+CO₂ pneumoperitoneum group had changes in rat brain tissue.Ordinary light microscope indicated that there were obvious congestion and edema in the rat brain tissue,extravasated blood could be seen within small vessels and capillaries,the tissues and white matter and grey matter around small vessels were enlarged,and inflammatory cell infiltration occurred.TEM showed that neurocyte body swelling can be noted in the cerebral cortex,nissl bodies in neurocyte bodies,cell nuclei were translocated and most of them were in irregular shape,chromosome condensation occurred,etc.;mitochondria and endoplasmic reticulum enlargement was noted;myelin sheath separation and rupture were seen.The rat brain tissue pathology scores of SAP group and SAP+CO₂ pneumoperitoneum group were?1.0 ± 0.50?and?1.1 ±0.64?respectively,showing statistically significant difference compared with the control group?0.3 ± 048??P<0.05?;there was no significant difference between SAP group and SAP+CO₂ pneumoperitoneum group?P=0.638?.?3?AMY: The AMY content in rat arterial blood of SAP group and SAP+CO₂ pneumoperitoneum group were?2734 ± 414?and?3043 ± 457?respectively,showing statistically significant differences compared with the control group?334 ± 76??P<0.05?;there was no significant difference between SAP group and SAP+CO₂ pneumoperitoneum group?4?NF-?B positive expression index in brain tissue: The NF-?B positive expression indexes in brain tissue of SAP group and SAP+CO₂ pneumoperitoneum group were?0.529±0.139?and?0.468±0.113?,showing statistically significant differencescompared with the control group?0.178±0.051??P<0.05?;there was no significant difference between SAP group and SAP+CO₂ pneumoperitoneum group?P=0.243?.?5?Cerebrospinal fluid S-100 B protein: The S-100 B protein contents in rat brain cerebrospinal fluid of SAP group and SAP+CO₂ pneumoperitoneum group were?23.10±1.97?and?24.14±3.12?,showing statistically significant differences compared with the control group?0.45±0.04??P < 0.05?;there was no significant difference between SAP group and SAP+CO₂ pneumoperitoneum group?P>0.05?.Conclusions CO₂ pneumoperitoneum has no obvious impacts on the brain tissue pathology,NF-?B expression in brain and S-100 B protein content in cerebrospinal fluid of SPF healthy male SD rats with severe acute pancreatitis in middle elevation area.