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MINISTRY OF EDUCATION AND TRAINING MINISTRY OF DEFENCE VIETNAM MILITARY MEDICAL UNIVERSITY CAO HONG PHUC RESEARCH ON SOME OF BIOLOGICAL CHANGES AND EFFECTS OF RECOMPRESSION TREAMENT IN EXPERIMENTAL DECOMPRESSION SICKNESS MEDICAL DORTOR PHILOSOPHY THESIS HA NOI-2018 MINISTRY OF EDUCATION AND TRAINING MINISTRY OF DEFENCE VIETNAM MILITARY MEDICAL UNIVERSITY CAO HONG PHUC RESEARCH ON SOME OF BIOLOGICAL CHANGES AND EFFECTS OF RECOMPRESSION TREAMENT IN EXPERIMENTAL DECOMPRESSION SICKNESS Branch: Bio - Medicine Sciense Code: 972 01 01 MEDICAL DORTOR PHILOSOPHY THESIS SUPERVISORS: Assoc.Prof Nguyen Tung Linh, PhD Assoc.Prof Dang Quoc Bao, PhD HA NOI-2018 i COMMITMENT I declare that this is my onw thesis which was carried out by scientific supports of superviors All results that were presented in this thesis have been authentic and published in scientific articles The thesis is not repeated to previous thesises or projects If there is something wrong, I will take my responsibility Author Cao Hong Phuc ii ACKNOWLEGEMEND After years of in-depth research, this thesis has been completed I would like to show my sincerely thanks to the Party Committee, Broad of Directors: Vietnam Military Medical University, Military Hospital No 103, National Institute Of Hygiene And Epidemiology for their facilitation I would also like to thank: Department of Medicine of Arms, Department of Medical Physiology, Department of Experimental Operation, Department of Medical Physics (Vietnam Military Medical University), Departemt of Hematology and Tranfusion, Patho-Histology and Judical Medicine (Military Medical No 103), Laboratory of Micro-Structure (Virus Department, National Institute Of Hygiene And Epidemiology), Department of Post - Graduate Training for their technical help in my study In addition, I am completely grateful to my suppervisors: Asscoc.Prof Nguyen Tung Linh, PhD (first suppervios), Asscoc.Prof Dang Quoc Bao, PhD (second suppervios) The doors of their offices were always open whenever I ran into a trouble spot about my reseach They consistently allowed this paper to be my own work, steered me in the right direction in experimental period They also set good examples for me to follow in doing all scientific tasks Besides, I would like to express my heartfelt gratitude to my parents and parents - in - law for their bringing up and supporting me to make this work possible Last but not least, I am deeply indebted to my wife and my son for being on my side, encouraging me a lots throughout my years of study AUTHOR Cao Hong Phuc iii CONTENT SUBTITLE PAGE COMMITMENT i ACKNOWLEGEMEND ii CONTENT iii ABBREVIATIONS AND DEFINITIONS viii LIST OF TABLES xii LIST OF FIGURES xvi INTRODUTION CHAPTER OVERVIEW 1.1 CLINICAL, INVESTIGATING CHARACTERISTICS OF ACUTE DECOMPRESSION SICKNESS 1.1.1 Causes and risk factors 1.1.2 Clinical characteristics 1.1.3 Investigating characteristics 12 1.1.4 Diagnosis and classification 14 1.1.5 Treatment 16 1.2 INFLUENCES OF THE BUBBLES IN DECOMPRESSION SICKNESS 20 1.2.1 Bubble formation in the decompression sickness 21 1.2.2 Influences of the bubbles in decompression sickness 22 1.3 STUDIES ON ANIMAL MODELS AND BIOLOGICAL CHANGES IN ACUTE DECOMPRESSION SICKNESS 24 iv 1.3.1 Studies on animal models in decompression sickness 24 1.3.2 Some studies of peripheral blood cell changes in acute decompression sickness 26 1.3.3 Some studies of coagulation changes in decompression sickness 28 1.3.4 Some studies of biochemical changes in acute decompression sickness 30 CHAPTER SUBJECTS AND METHODS 34 2.1 SUBJIECTS 34 2.1.1 Subjects 34 2.1.2 Laboratories 34 2.1.3 Period 35 2.2 METHODS 35 2.2.1 Study design 35 2.2.2 Study Issues 40 2.2.3 Study equipments 40 2.2.4 Research indexes and methods 42 2.2.5 Data Analysis 53 CHAPTER RESULTS 55 3.1 ETABLISHING THE EXPERIMENTAL ACUTE DECOMPRESSION SICKNESS MODEL 55 3.1.1 Influence of some diving factors on acute decompression sickness 55 v 3.1.2 Comparision the efficacy of models to cause the decompression sickness 60 3.2 CHANGES IN HEMATOLOGICAL, BIOCHEMICAL AND PATHOHISTOLOGICAL INDEXES IN ACUTE DECOMPRESSION SICKNESS 62 3.2.1 Changes in hematological indexes in acute decompression sickness rabbits 62 3.2.2 Changes in some of biochemical indexes in acute decompression sickness rabbits 72 3.2.4 Some of pathohistological characteristics in acute decompression sickness rabbits 73 3.3 EFFECTS OF RECOMPRESSION TREATMENT IN ACUTE DECOMPRESSION SICKNESS 83 3.3.1 Effects on clinical symptoms in acute decompression sickness rabbits 83 3.3.2 Effects on hematological index in acute decompression sickness rabbits 85 3.3.3 Effects of recompression treatment on some biochemical indexes in in acute decompression sickness rabbits 94 CHAPTER DISCUSSION 97 4.1 ANIMAL MODEL OF EXPERIMENTAL ACUTE DECOMPRESSION SICKNESS 97 4.1.1 Influence of some diving factors on experimental acute decompression sickness 97 vi 4.1.2 Effecting comparison of experimental acute decompression sickness of models 101 4.2 CHANGES IN SOME HEMATOLOGICAL, BIOCHEMICAL, AND PATHOHISTOLOGICAL INDEXES IN EXPERIMENTAL ACUTE DECOMPRESSION SICKNESS 104 4.2.1 Changes of some hematological indexes in experimental acute decompression sickness rabbits 104 4.2.2 Platelet activation in experimental acute decompression sickness 114 4.2.3 Changes of some biochemical indexes in acute decompression sickness rabbits 118 4.2.4 Changes of pathohistological indexes in experimental acute decompression sickness rabbit 120 4.3 EFFECTS OF RECOMPRESSION TREATMENT ON EXPERIMENTAL ACUTE DECOMPRESSION SICKNESS 123 4.3.1 Effects of recompression treatment on clinical symptoms in experimental acute decompression sickness rabbits 123 4.3.2 Effects of the recompression treatment on haematological indexes in acute decompression sickness rabbits 128 4.3.3 Effect of recompression treatment on biochemical indices in acute decompression sickness rabbit 134 CONCLUSION 137 vii SUGGESSTIONS 139 LIST OF PUBLISHED ARTICLES RELATED TO 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