Nghiên cứu sự biến đổi một số chỉ số sinh học và tác dụng của điều trị tái tăng áp trong bệnh giảm áp cấp tính thực nghiệm

185 60 0
Nghiên cứu sự biến đổi một số chỉ số sinh học và tác dụng của điều trị tái tăng áp trong bệnh giảm áp cấp tính thực nghiệm

Đang tải... (xem toàn văn)

Tài liệu hạn chế xem trước, để xem đầy đủ mời bạn chọn Tải xuống

Thông tin tài liệu

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 RESULTS OF THESIS .140 REFFERENCES 141 APPENDIXES 158 viii ABBREVIATIONS AND DEFINITIONS Num Abbre Deffinition Vietnamese Meaning 2D ADP Two Dimension Adenosine diphosphate Hai chiều ALT Alanine transaminase Enzym chuyển amin Alanine APTT Activated Partial Thời gian thromboplastin Thromboplastin Time hoạt hóa phần Ar Argon Khí argon ARN Acid Ribonucleic A-xít Ribonucleic AST Aspartate transaminase Enzym chuyển amin Aspartate ATA Atmospheres Absolute ATP Adenosine triphosphate 10 Aβ β-amyloid 11 BTG Beta thromboglobulin 12 Conc Concentration 13 CPK Creatine phosphokinase 14 CSF Cerebrospinal fluid T-Tau T-tau 15 CT Áp suất khí tuyệt đối Nồng độ Protein T-Tau dịch não tủy Computerized Chụp cắt lớp vi tính Tomography 16 DCS Decompression sickness Bệnh giảm áp 150 79 Bain B.J., Bates J., Alaffan M., et al (2011) Dacie and Lewis Practical Haematology, 11th Ed Pub Churchill Livingstone, China, 12, 11-17, 34-46 80 Michelson A.D (2007) Platelets (2nd Ed.) Pub Academic Press, USA, 45-75 81 Rao G.H.R (2013) Handbook of Platelet Physiology and Pharmacology Kluwer Academic Publisher, Masssachusetts, USA, 1-20 82 Linden M.D (2013) Platelet physiology In: Methods in Molecular Biology; 992: 13-30 83 Cung Thị Tý (2014) Cơ chế đông - cầm máu xét nghiệm thăm dò, Hội chứng sợi huyết - đơng máu rải rác lịng mạch, Trong: Bài giảng Huyết học-Truyền máu (Sau Đại học) NXB Y học, tr 247-315 84 Nguyễn Thị Bích Ngọc (2011) Nghiên cứu tình trạng rối loạn đơng máu nghẽn tắc mạch bệnh nhân hội chứng thận hư nguyên phát người lớn Luận án tiến sỹ y học, Học viện Quân y, 15-50 85 Hoàng Quang Phan Hải Nam (2010) Hóa sinh y học Giáo trình Đại học Sau đại học NXB Quân đội Nhân Dân, Hà Nội, tr 346380, 540-571 86 Phạm Huy Năng, Nguyễn Thị Minh Phương (2007) Nghiên cứu ứng dụng điều trị bệnh giảm áp đề xuất quy trình điều trị bệnh giảm áp Tạp chí Y học thực hành, 588: 77-88 87 Lautridou J., Pichereau V., Artigaud S., et al (2016) Effect of simulated air dive and decompression sickness on the plasma proteome of rats Proteomics Clinical Applications, 10: 614-620 88 Zhang K., Wang M., Wang H., et al (2017) Time Course of Endothelial Dysfunction Induced by Decompression Bubbles in Rats Frontiers in Physiology, 8(181): 1-9 151 89 Gempp E., Louge P., Maistre S., et al (2014) Neuron-specific enolase and S100B protein levels in recreational scuba divers with neurological decompression sickness Diving and Hyperbaric Medicine, 44(1): 26-29 90 Wang C., Liu X., Mao R., et al (2014) Changes in levels of TNF-α and GFAP in brain and spinal cord of rabbits with decompression disease Zhonghua Lao Dong Wei Sheng Zhi Ye Bing Za Zhi., 32(8): 607-609 91 Wang C., Liu X., Qi R., et al (2015) Role of tumor necrosis factoralpha in spinal cord injury of rabbits with decompression sickness Zhonghua Lao Dong Wei Sheng Zhi Ye Bing Za Zhi., 33(10): 771-773 92 Wang H.T., Fang Y.Q., Bao X.C., et al (2015) Expression changes of TNF-α, IL-1β and IL-6 in the rat lung of decompression sickness induced by fast buoyancy ascent escape Undersea And Hyperbaric Medicine, 42(1): 23-31 93 Shahim P., Arnell P., Kvarnstrom A., et al (2015) Cerebrospinal fluid markers of central nervous system injury in decompression illness - a case-controlled pilot study Diving and Hyperbaric Medicine, 45(4): 240-243 94 Su C.L., Wu C.P., Chen S.Y., et al (2004) Acclimatization to neurological decompression sickness in rabbits American Journal of Physiology-Regulatory, Integrative and Comparative Physiology, 287: R1214-R1218 95 Schroeder C.A., Smith L.J (2011) Respiratory Rates and Arterial Blood-Gas Tensions in Healthy Rabbits Given Buprenorphine, Butorphanol, Midazolam, or Their Combinations Journal of the American Association for Laboratory Animal Science, 50(2): 205-211 152 96 Hadanny A., Fishlev G., Bechor Y., et al (2015) Delayed Recompression for Decompression Sickness: Retrospective Analysis Plos ONE, DOI:10.1371/journal.pone.0124919, 1-13 97 Chen S., Xiong L., Wang Q., et al (2002) Tetramethylpyrazine attenuates spinal cord ischemic injury due to aortic cross-clamping in rabbits BioMed Central Neurology, 2(1): 1-6 98 Joslin J.O (2009) Blood Collection Techniques in Exotic Small Mammals Journal of Exotic Pet Medicine, 18(2): 117-139 99 Bộ Y tế (2009) Kỹ thuật xét nghiệm huyết học-truyền máu, Sách đào tạo cử nhân kỹ thuật y học NXB Y học, Hà Nội, tr 36-68, 111-136 100 Sunlong (2016) Principle of Rabbit Platelet Factor (PF-4) and BTG Elisa Kit 1-7 101 Abrahamsohn P.A., Santos M.F., Zorn T.M.T (2007) Basic Histology Text and Atlas, 11th Ed The McGraw-Hill Companies, 1-5 102 Zhou L., Schmaier A.H (2005) Platelet Aggregation Testing in Platelet-Rich Plasma: Description of Procedures With the Aim to Develop Standards in the Field American Journal of Clinical Pathology, 123: 172-183 103 White J.G (2004) Electron Microscopy Methods for Studying Platelet Structure and Function In: Platelets and Megakaryocytes, Vol 1: Functional Assays Humana Press Inc., Totowa, NJ, 47-63 104 Siermontowski P., Kaczerska D., Morawiec B., et al (2012) Determination of Acid-Base Balance During the Acute Stage of Experimental Pulmonary Barotrauma and After its Hyperbaric Treatment Bulletin of the Veterinary Institute in Pulawy, 56: 183-188 105 Mazur A., Lambrechts K., Buzzacott P., et al (2014) Influence of Decompression Sickness on Vasomotion of Isolated Rat Vessels International Journal of Sports Medicine, 35: 551-558 153 106 Vann R.D., Pollock N.W., Freiberger J.J., et al (2007) Influence of bottom time on preflight surface intervals before flying after diving Undersea And Hyperbaric Medicine, 34(3): 211-220 107 Ljubkovic M., Dujic Z., Møllerløkken A., et al (2011) Venous and arterial bubbles at rest after no-decompression air dives Medicine and Science in Sports and Exercise, 43(6): 990-995 108 Pilmanis A.A., Webb J.T., Kannan N., et al (2003) The risk of altitude decompression sickness at 12,000 m and the effect of ascent rate Aviation, Space, and Environmental Medicine, 74(10): 1052-1057 109 Blatteau J.E., Peny C., Pontier J.M., et al (2008) Influence of repetitive open sea dives and clinical exercises on right-to-left shunting in healthy divers British Journal of Sports Medicine, 42: 934-936 110 Toklu A.S., Cimsit M., Yildiz S., et al (2014) Decompression sickness cases treated with recompression therapy between 1963 and 1998 in Turkey: Review of 179 cases Undersea and Hyperbaric Medicine, 41(3): 217-221 111 Zanchi J., Ljubkovic M., Denoble P.J., et al (2014) Influence of Repeated Daily Diving on Decompression Stress International Journal of Sports Medicine, 35: 465-468 112 Vallee N., Gaillard S., Peinnequin A., et al (2013) Evidence of cell damages caused by circulating bubbles: high level of free mitochondrial DNA in plasma of rats Journal of Applied Physiology, 115: 1526-1532 113 Sureda A., Batle J.M., Capó X., et al (2014) Scuba diving induces nitric oxide synthesis and the expression of inflammatory and regulatory genes of the immune response in neutrophils Physiological Genomics, 46: 647-654 154 114 Perovic A., Nikolac N., Braticevic M.N., et al (2017) Does recreational scuba diving have clinically significant effect on routine haematological indexes? Biochemia Medica, 27(2): 325-331 115 Inwood M.J (1973) Experimental evidence in support of the hypothesis that intravascular bubbles active the hemostatic process In: Proceeding of a sympossium on blood bubble interaction in decompression sickness, Canada, 171-197 116 Mazza J.J., et al (2002) Manual of Clinical Hematology, 3rd Ed Lippincott Williams & Wilkins, 25-27 117 Bao X.C., Chen H., Fang Y.Q., et al (2015) Clopidogrel reduces the inflammatory response of lung in a rat model of decompression sickness Respiratory Physiology & Neurobiology, 211: 9-16 118 Blatteau J.E., Maistre S., Lambrechts K., et al (2015) Fluoxetine stimulates anti-inflammatory IL-10 cytokine production and attenuates sensory deficits in a rat model of decompression sickness Journal of Applied Physiology, 119: 1393-1399 119 Lehtosalo J., Tervo T., Laitinen L.A (1983) Bubbles and Hematologic Alterations in Intracranial Veins During Experimental Decompression Sickness Acta Neuropathologica (Berl), 59: 139-144 120 Olszanski R., Radziwon P., Piszcz J., et al (2010) Activation of platelets and fibrinolysis induced by saturated air dives Aviation, Space, and Environmental Medicine, 81(6): 585-588 121 Pontier J.M., Gempp E., Ignatescu M (2012) Blood platelet-derived microparticles release and bubble formation after an open-sea air dive Applied Physiology, Nutrition, and Metabolism, 37: 888–892 122 Enjeti A.K., Lincz L.F., Seldon M (2007) Detection and Measurement of Microparticles: An Evolving Research Tool for Vascular Biology Seminars in thrombosis and hemostasis, 33: 771-779 155 123 Thijs T., Nuyttens B.P., Deckmyn H., et al (2010) Platelet physiology and antiplatelet agents Clinical Chemistry and Laboratory Medicine, 48(Suppl 1): S3-S13 124 Ellins E.A., Rees D.A., Deanfield J.E., et al (2016) Increased fibrinogen responses to psychophysiological stress predict future endothelial dysfunction implications for cardiovascular disease? Brain, Behavior, and Immunity, 1-7 125 Lazzarino A.I., Hamer M., Gaze D., et al (2015) The association between fibrinogen reactivity to mental stress and high-sensitivity cardiac troponin T in healthy adults Psychoneuroendocrinology, 59: 37-48 126 Xu W., Hang J., Guo L., et al (2012) Plasma Fibrinogen: A Possible Link Between Job Stress and Cardiovascular Disease Among Chinese Workers American Journal of Industrial Medicine, 55: 167-175 127 Eftedal I., Fredriksen H.A., Hjelde A., et al (2015) Evaluating PAI-1 as a biomarker for stress in diving: human serum total PAI-1 is unaltered after h dry exposures to 280 kPa hyperbaric air Physiological Reports., 3(6): e12437 128 Cappelletti R.M (2012) Fibrinogen and fibrin: structure and functional asspects, In: Thrombin Function and Pathophysiology Nova Science Publisher, 263-291 129 Kamath S., Blann A.D., Lip G.Y.H (2001) Platelet activation: assessment and quantification European Heart Jounal, 22(17): 1561-1571 130 Gurney D., Lip G.Y.H., Blann A.D (2002) A reliable Plasma Marker of Platelet Activation: Dose it exist? American Journal of Hematology, 70: 139-144 131 Michelson A.D and Furman M.I (2005) Markers of Platelet Activation and Granule Secretion In: Platelet Function: Assessment, Diagnosis, and Treatment Humana Press Inc., Totowa, 301-314 156 132 Rucinski B., Knight L.C., Niewiarowski S., et al (1986) Clearance of human platelet factor by liver and kidney: its alteration by heparin American Journal of Physiology, 251(4 Pt 2): H800-H807 133 Sueyasu T., Takeshige Y (1956) Electron microscopic study on the blood platelets of the rabbit The Kurume Medical Journal, Vol 3, No 3, 114-128 134 Yoshimoto Y., Hasebe T., Takahashi K., et al(2013) Ultrastructural characterization of surface-induced platelet activation on artificial materials by transmission electron microscopy Microscopy Research and Technique, 76: 342-349 135 Neumuller J., Meisslitzer-Ruppitsch C., Ellinger A., et al (2013) Monitoring of Platelet Activation in Platelet Concentrates Using Transmission Electron Microscopy Transfusion Medicine and Hemotherapy, 40(2): 101-107 136 Peng B., Chen M.M., Jiang Z.L., et al (2017) Preventive effect of rosiglitazone on liver injury in a mouse model of decompression sickness Diving and Hyperbaric Medicine, 47(1): 17-23 137 Jacey M.J., Heyder E., Williamson R.A., et al (1976) Biochemistry and hematology of decompession sickness: a case report Aviation, Space and Enviromental Medicine, pp 657-666 138 Eftedal O.S., Lydersen S., Brubakk A.O (2007) The relationship between venous gas bubbles and adverse effects of decompression after air dives Undersea and Hyperbaric Medicine, 34(2): 99-105 139 Vann R.D., Denoble P.J., Howle L.E., et al (2009) Resolution and severity in decompression illness Aviation, Space and Environmetal Medicine, 80(5):466-471 157 140 Nguyễn Bảo Nam, Phạm Văn Non, Nguyễn Trường Sơn (2016) Kết điều trị ca tai biến lặn nặng trị liệu tái tăng áp kết hợp với oxy cao áp Kỷ yếu cơng trình nghiên cứu khoa học Y học Biển, Tại Hội thảo Quốc gia Y tế Biển - Đảo lần thứ V, tr 61-73 141 Lee J., Kim K., Park S (2014) Factors associated with Residual Symptoms after Recompression in Type I Decompression Sickness American Journal of Emergency Medicine, doi: 10.1016/j.ajem.2014.12.011 142 Đevenica D., Markotic A., Rezic - Muzinic N., et al (2016) Hyperbaric environment up-regulates CD15s expression on leukocytes, down-regulates CD77 expression on renal cells and upregulates CD34 expression on pulmonary and cardiac cells in rat Iranian Journal of Basic Medical Sciences, 19: 821-828 143 Cleland J.F (1986) Hemostasis, decompression sickness and migraine Journal of Hyperbaric Medicine, pp 55-58 144 Gupta S.K., Sharma A.K (2000) Effects of hyperbaric oxygen therapy on hematological and biochemical indexes Indian Journal of Aerospace Medicine, 44(1):1-5 158 APPENDIXES 1st APPENDIX LIST OF SUBJECTS Ordinal number Rabbit Historical number st PHASE: EVALUATION THE INFLUENCE OF DIVING FACTORS ON DECOMPRESSION SICKNESS Protocol 1 10 A1 A2 A3 A4 A6 A110 A120 A121 A122 A123 MH11A1 MH12A2 MH13A3 MH14A4 MH15A6 MH16A110 MH17A120 MH18A121 MH19A122 MH110A123 11 12 13 14 15 16 17 18 19 20 A13 A14 A15 A16 A132 A133 A134 A155 A156 A157 MH21A13 MH22A14 MH23A15 MH24A16 MH25A132 MH26A133 MH27A134 MH28A155 MH29A156 MH210A157 21 A9 MH31A9 22 A12 MH32A12 23 A17 MH33A17 24 A18 MH34A18 25 A19 MH35A19 26 A20 MH36A20 27 A22 MH37A22 28 A23 MH38A23 29 A24 MH39A24 30 A27 MH310A27 Protocol Protocol 159 Ordinal number Mơ hình 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 Rabbit Historical number B1 B2 B3 B4 B5 B6 B7 B8 B9 B10 MH41B1 MH42B2 MH43B3 MH44B4 MH45B5 MH46B6 MH47B7 MH48B8 MH49B9 MH410B10 2ST PHASE: DECOMPRESSION SICKNESS AND NON TREATMENT A31 BGA01 A32 BGA02 A33 BGA03 A36 BGA04 A37 BGA05 A38 BGA06 A39 BGA07 A40 BGA08 A41 BGA09 A42 BGA10 A43 BGA11 A44 BGA12 A45 BGA13 A46 BGA14 A47 BGA15 A48 BGA16 A49 BGA17 A50 BGA18 A51 BGA19 A52 BGA20 A55 BGA23 A56 BGA24 A61 BGA25 A64 BGA26 A66 BGA28 A67 BGA29 A70 BGA30 A71 BGA31 A72 BGA32 A73 BGA33 A74 BGA34 A75 BGA35 A76 BGA36 A77 BGA37 160 Ordinal number 75 76 77 78 79 80 81 82 83 84 85 86 87 88 89 90 91 92 93 94 95 96 97 98 99 100 101 102 103 104 105 106 107 Rabbit A78 A79 A80 A81 A82 A83 A84 A85 A86 A87 A88 A90 A91 A92 A93 A94 A95 A96 A97 A98 A99 A100 A101 A102 A144 A145 A146 A147 A148 A150 A152 A153 A154 Historical number BGA38 BGA39 BGA40 BGA41 BGA42 BGA43 BGA44 BGA45 BGA46 BGA47 BGA48 BGA50 BGA51 BGA52 BGA53 BGA54 BGA55 BGA56 BGA57 BGA58 BGA59 BGA60 BGA61 BGA62 BGA63 BGA64 BGA65 BGA66 BGA67 BGA68 BGA69 BGA70 BGA71 2ST PHASE: DECOMPRESSION SICKNESS AND TREATMENT 108 109 110 111 112 113 114 115 116 117 118 119 A166 A175 A177 A178 A179 A182 A185 A186 A189 A190 A191 A192 ĐT01 ĐT02 ĐT03 ĐT04 ĐT05 ĐT06 ĐT07 ĐT08 ĐT09 ĐT10 ĐT11 ĐT12 161 162 2ST Appendix EXPERIMENTAL HISTORY OF RABBIT 163 3rd Appendix DEMONSTRATION OF BUBBLE GRADE 164 4th Appendix AMERICAN NAVY RECOMPRESSION TREATMENT

Ngày đăng: 04/10/2019, 15:29

Từ khóa liên quan

Tài liệu cùng người dùng

  • Đang cập nhật ...

Tài liệu liên quan