Objective To explore emergency treatment strategies for the patients with brain hernia combined with hemorrhagic shock after severe traumatic brain injury and their effect on prognosis.Methods A retrospective analysis was made on 54 patients (study group) with brain hernia combined with hemorrhagic shock treated with selective treatment strategies from May 2006 to May 2009. Another 48 patients with the same injuries treated with no selective treatment strategies from April 2003 to April 2006 were used as control group. The mortality within one week and the GOS six months after injury were compared in two groups. Results There was no statistical difference in aspects of sex, age, injury mechanism, GCS and blood loss in both groups (P＞0.05). Thirteen patients died in the study group within the first week, with mortality rate of 24.1%. While 16 patients died in the control group at the first week, with mortality rate of 33.3% (P＜0.05). GOS half year after injury in the study group was better than that in the control group (P＜0.05).Conclusion Early selective treatment strategy based on degree of shock may obtain better outcome for patients with brain hernia combined with hemorrhagic shock after severe brain injury.

Objective To study the changes of proteome expression in brain tissues from rats with severe traumatic brain injury(sTBI). Methods Total protein of brain tissues were obtained at days 3,7 and 14 for two-dimensional gel electrophoresis to screen and identify differential protein spots.Results We screened 17 differential protein spots that were involved in cellular metabolism,stress and inflammatory reaction. Conclusion Some differential proteins involved in sTBI can be found by twodimensional gel electrophoresis.

Objective To locally inject human umbilical cord blood (HUCB) mesenchymal stem cells (MSCs) to rat traumatic brain injury (TBI) model to investigate expression of neural markers and neurological functional improvement. Methods HUCB-MSCs were labeled by bis-benzimide for over 24 hours and stereotactically transplanted into the brain of the rats. All rats were divided into four groups, ie, sham injury group, TBI group, control (TBI + PBS) group and treatment (TBI + MSCs) group, Im-munohistochemical methods and immanofluorescence staining were used to observe the survival, migration and differentiation of the transplanted cells. The neurological functional improvement was evaluated by u-sing the neurological severity score (NSS). Results There existed a large number of MSCs survived in local region of the brain that received transplants, when some MSCs differentiated into neurons or astro-cytes and expressed the neurocyte markers including NSE and GFAP around the grafted site. Treatment group had significantly improved scores compared with sham injury group, TBI group and control group. Conclusions HUCB-MSCs transplantation can potentially improve neurological functional after TBI and may be a good alternative to bone marrow cells for stem cell transplantation or cell therapy.

Objective To explore the efficacy of ultra-early stent-assisted coil (SAC) in the treatment of intracranial rupture of wide- necked aneurysms. Methods The angiographic and clinical data of 24 patients (including 8 male, 16 female, age ranged from 29 to 86 years, with a median age 59) with acutely ruptured wide-necked intracranial aneurysms treated with SAC were retrospectively analyzed. The postoperative complications and clinical results were observed. The postoperative embolization was assessed according to the Raymond grading standard. The assessment of the follow-up results from 6 to 12 months after procedure was observed according to the modified Rankin Scale (mRS) score. Results Procedure-related complications occurred in 3 patients (12.5%). All of them were hemorrhagic events, of which 2 cases died. Perioperative death was found in 3 cases. Of the 19 surviving patients, 17 showed good recovery (mRS 0-2). After 6 to 12 months of DSA, no recurrence of aneurysm was found in 10 follow-up patients. Conclusion Ultra-early stent-assisted coil treatment for intracranial wide-neck rupture aneurysm can improve the success rate of embolization and reduce the recurrence.

Objective To explore the correlation between serum levels of histone deacetylase 3(HDAC3) and the signal molecule SMAD family member 3(SMAD3) and the degree of neurological deficit in patients with acute ischemic stroke(AIS). Methods From June 2021 to June 2022,104 patients diagnosed with AIS in our hospital were selected. Using the National Institutes of Health Stroke Scale(NIHSS),they were divided based on the degree of neurological impairment into mild group(32 cases),moderate group(37 cases),and severe group(35 cases). At the same time,98 healthy volunteers from health examination in our hospital were included as the control group. The expression levels of HDAC3,SMAD3,tumor necrosis factor-α(TNF-α),interleukin-1β(IL-1β),and interleukin-6(IL-6) in serum were measured by using enzyme-linked immunosorbent assay. Pearson correlation analysis was used to analyze the correlation between the expression of HDAC3 and SMAD3.Spearman correlation analysis was used to analyze the correlation between the expression of HDAC3 and SMAD3 and NIHSS score and the degree of neurological deficit. Results Compared with the control group,the AIS group showed significantly higher levels of triglyceride,total cholesterol,low-density lipoprotein cholesterol,fibrinogen,TNF-α,IL-1β,and IL-6 and a significantly lower level of HDL-C(all P<0.05). HDAC3 and SMAD3 levels were significantly higher in the AIS group than in the control group(both P<0.05). HDAC3 and SMAD3 levels in the severe group were significantly higher than those in the moderate and mild groups,and those in the moderate group were significantly higher than those in the mild group(all P<0.05). The Pearson correlation analysis showed that the serum expression levels of HDAC3 and SMAD3 in the AIS patients were positively correlated(P<0.05). The Spearman correlation analysis showed positive correlations between the expression of HDAC3 and SMAD3 and NIHSS score(r=0.339,0.563;both P<0.001)and the degree of neurological impairment(r=0.698,0.572;both P<0.001). Conclusion Serum HDAC3 and SMAD3 levels in patients with AIS were abnormally increased,and both were related to the degree of neurological deficit.