Effects And Mechanisms Of Electro-acupuncture On The Brain Injury After Cardiopulmonary Resuscitation

1.Objectives 1)To explore the protective effect of Electro-acupuncture(EA)on cardiopulmonary resuscitation in rats and the influence on the survival rate of rats after resuscitation 72 hours;2)to investigate the relationship between the protective effect of rat brain injury after cardiopulmonary resuscitation EA and reduce the inflammatory cell in hippocampus CA1 region of EA;3)to study the possible mechanism of protective effect of EA,to investigate the influence of cholinergic anti-inflammatory pathway in the effect.2.Method The animal model of cardiac arrest was established by transcutaneous electrical stimulation of the epicardium.The rats were divided into five groups randomly:(1)sham group: anesthesia and operation,did not induce cardiac arrest;(2)CPR group: to establish a rat model of cardiac arrest and routine resuscitation;(3)EA group: rats were given electro acupuncture pretreatment treated at "Baihui" "Neiguan" and "Zusanli" acupoint 3 days before induce cardiac arrest for 30 minutes,once a day for three consecutive days,then the same with the CPR group;4)BGT group: in 30 minutes before the induce of cardiac arrest,intraperitoneal injection of 1.0 ug/kg alpha bungarotoxin in the rats,then the same with the EA group;5)GTS group: in 30 minutes before the induce of cardiac arrest,intraperitoneal injection of 5 mg/kg GTS-21 in the rats,then the same with the CPR group.NDS score and survival time were observed;inflammatory cells infiltration of the rats brain tissue were observed by HE-staining;the TNF-? and IL-6 level were detected by ELISA method;the expression of NF-?B in rat hippocampus was detected with Western blot.3.Result 1)EA reduced the times of adrenaline injection and defibrillation,shorten the time of recovery significantly(P<0.05);the effect of EA group and GTS group were similar.2)EA increased the survival rate,and the difference between CPR group and EA group was statistically significant(P<0.05).The difference between EA group and BGT group was statistically significant(P<0.05).3)in EA group,NDS decreased at 24 hours,48 hours and 72 hours after resuscitation,and the difference was statistically significant compared with group CPR(P<0.05).4)the infiltration of inflammatory cells in hippocampus CA1 area of EA group was reduced significantly compared with group CPR(P<0.05).There was a significant difference between EA group and BGT group(P<0.05);EA group had similar effect with GTS group.5)the concentration of TNF-? and IL-6 in the serum in the rats in EA group were decreased significantly at 1 hours,4 hours and 72 hours after resuscitation,compared with group CPR;the concentration of TNF-? and IL-6 in the serum in EA group and BGT group at 4 hours after resuscitation,the difference was statistically meaning(P<0.05).6)in group EA,the expression of protein NF-?B in brain hippocampus was decreased significantly(P<0.05);EA group was similar to GTS group.4.Conclusion 1)EA pretreatment can increase rats survival rate after cardiopulmonary resuscitation,reduce NDS score,however intraperitoneal injection the alpha bungarotoxin,alpha 7nAChR antagonists,can reverse this effect.2)EA can reduce inflammatory cell infiltration and decrease the level of inflammatory factors in the hippocampus of rats.The mechanism may be that it can reduce the expression of NF-?B through the cholinergic anti-inflammatory pathway,and exert the protective effect.