BACKGROUND: Astragalus membranaceus plays an important role in the adjustment of immunological function. Whether does it have protective effect on neuron in the intervention of acute craniocerebral injury and what is the pathway in effect?OBJECTIVE: To observe the effect of astragalus membranaceus on activity of nitric oxide synthetase after brain injury.DEDIGN: Randomized controlled trial.SETTING: Neurosurgery institute of Lanzhou Military Area Command of Chinese PLA.MATERIALS: This experiment was completed in the Laboratory of Neurosurgery Institute of Lanzhou Military Area Command of Chinese PLA. Fifty-four healthy SD rats were divided randomly into 3 groups: brain injury group( n=24), astragalus membranaceus group( n = 24) and control group( n = 6). Injury and astragalus membranaceus groups were sampled at 4different time points(0.5 hour, 2 hours, 6 hours, and 24 hours) after injury,6 rats were sacrificed at each time point.METHODS: The brain injury and astragalus membranaceus groups were prepared by improved Feeney' s free falling method. Bone windows were opened for the control group, but no brain injury produced. After injury, rats in astragalus membranaceus group were immediately injected 200 mg/kg astragalus membranaceus intraperitoneally rat cerebral injury models were established and the nitric oxide synthetase concentration was tested at different time points.MAIN OUTCOME MEASURES: Activity of nitric oxide synthetase in the brain tissue of rats in each group.RESULTS: All 54 rats entered the final analysis. Nitric oxide synthetase activity in brain injury and astragalus membranaceus groups increased sharply contrasting with control group at 30 minute after injury [ (46.44 ± 13.45),(43.15 ± 12.43), (40. 46 ± 12. 85) nkat/L, P ＜0.05], reaching the peak at 2hours[ (67.49 ± 22.45), (64. 26 ± 19.78) nkat/L, P ＜ 0.01 ], starting to drop from6 hours [(63.46±24. 68), (52.91 ±21.36) nkat/L, P ＜0. 01], and getting to basic level at 24 hours[ (41.23 ± 12. 57), (40.92 ± 12. 25) nkat/L,P ＞ 0.05 ]. In the astragalus membranaceus treated group, nitric oxide synthetase activity dropped at 2 hours and 6 hours after injury contrasting with injury group( P ＜ 0. 05, P ＜ 0. 01 respectively).CONCLUSION: Nitric oxide synthetase activity increases in the injured brain tissue and astragalus membranaceus can protect injured neuron by inhibiting nitric oxide synthetase activity.

Objective To study the clinical significance of MR imagings features in the diagnosis on central neurocytoma ( CNC ) . Methods From January 2010 to December 2012,9 patients with CNC were analyzed and examined by MRI before surgery,then received postoperative pathology examination. Results CNC were in the left lateral ventricle of 9 patients, closely linked with the Monro hole, of which 4 cases were in the first 2/3 of central ventricle of the left lateral ventricle,3 cases in the septum pellucidum and growth to bilateral ventricles,2 cases of infiltrating in the septum pellucidum and base side adhesion. For CNC,MRI signal was not uniform,solid part T1WI showed equal or slightly low signal,multiple cysts and signal cord like structure with the ventricular wall and septum pellucidum adhesion. By contrast-enhanced CT scan,there were the solid part heterogeneous obvious enhancement in 4 cases,moderate and slight uneven enhancement in 3 cases and 2 cases respectively. Uniform size,round or oval cells were showed by HE staining,and the synaptophysin was positive in 6 ca-ses by immunohistochemical staining,positive expression of glial fibrillary acidic protein in 3 cases. After operation,3 patients were lost to fol-low up,for 6 cases were followed up,survival of 2 cases in 3 years,4 cases in 2 years. Conclusion The results suggest that MRI display is located near the lateral ventricle central Monro hole before and lesions suggestive of CNC in young patients. For most CNC,synaptophysin has positive expression by immunohistochemical staining.

Objective: To investigate the effects of complex prescription astragalus mongholicus injection(复方黄芪注射液) on the serum concentrations of neuron-specific enolase(NSE),myelin basic protein(MBP) and S100 protein B(S100B) in cases with acute severe craniocerebral injury.Methods: One hundred and ninety-six patients with acute severe craniocerebral injury were randomly divided into two groups.The treated group was treated with complex prescription astragalus mongholicus injection plus conventional treatments including dehydration,antibiotics,organ functional support,nerve nutrition,prevention of complication,etc;the control group was treated with conventional treatments alone.The concentrations of NSE,MBP and S100B in plasma at admission and at 4,7 and 10 days after treatment were determined;the Glasgow coma score(GCS) at admission and at 1 week and 2 weeks after hospitalization and the Glasgow outcome scale(GOS) after 3 months were compared to observe the long-term efficacy in the patients.Results: After treatment,the concentrations of serum NSE,MBP and S100B in the treatment group were all lower than those in the control group,the differences being significant(NSE(14.62?3.38)?g/L vs.(21.54?5.68) ?g/L,MBP(7.52?1.06) mg/L vs.(10.21?2.01) mg/L,S100B(0.90?0.28) ?g/L vs.(1.20?0.34) ?g/L,all P0.05);the GCSs of the patients at 1 week,2 weeks and GOS at 3 months after treatment in the complex prescription astragalus mongholicus injection group were significantly higher than those in the control group(GCS, 1 week(9.8?2.6)score vs.(7.2?2.1) score,2 weeks(10.6?3.0) score vs.(7.8?2.2) score;GOS,3 months after treatment(4.8?1.0) score vs.(3.6?0.8) score,all P

Objective To explore the efficacy of minimally invasive surgery in elderly patients with cerebral hemorrhage.Methods Clinical data of hypertensive cerebral hemorrhage patients who were older than 65 years were retrospectively analyzed,and they were divided into two groups by different surgical methods.Regular group:from March 2010 to February 2011,123 cases of conventional bone window surgery.Minimally invasive group:from March 2011 to February 2012,136 cases of minimally invasive surgery.One month after surgery,two groups of patients with the scores of Glasgow outcome scale (GOS) to determine the prognosis.Results The better prognosis rate in minimally invasive group was higher than that in regular group [39.7％(54/136) vs.29.3％(36/123)],but there was no significant difference (P ＞0.05).The incidence rate of death in minimally invasive group was significantly lower than that in regular group [17.6％ (24/136) vs.28.5％ (35/123)],and there was significant difference (P ＜ 0.05).Conclusion For elderly patients with cerebral hemorrhage,the minimally invasive surgery can significantly improve the prognosis.

Recurrent intracerebral hemorrhage is a very serious cerebrovascular disease.Its incidence has shown a clear upward trend, and both disability and mortality have increased significantly compared to the first intracerebral hemorrhage. This article reviews the clinical classification, characteristics, risk factors, pathogenesis, and prognosis of recurrent intracerebral hemorrhage.

Objective:To investigate the relationship and assess the value of serum polyadenosine diphosphate ribose polymerase 1 (PARP1) and forkhead box transcription factor O1 (FOXO1) with cerebral neurological function in patients with severe craniocerebral injury (SCI).Methods:The clinical data of 100 patients with SCI from February 2021 to October 2022 in Baoji High-Tech Hospital were retrospectively analyzed. The Glasgow coma score (GCS) on admission was recorded. According to the modified Rankin score (mRS) 3 months after discharge, the patients were divided into good recovery group (mRS 0 to 2 scores, 62 cases) and poor recovery group (mRS 3 to 5 scores, 38 cases). In addition, 50 individuals who underwent physical examinations in Baoji High-Tech Hospital during the same period were selected as the control group. The serum levels of PARP1 and FOXO1 were measured by enzyme-linked immunosorbent assay. Correlation analysis was performed using Spearman method. Multifactor Logistic regression was used to analyze the independent risk factors for poor cerebral neurological recovery in patients with SCI. The efficacy of PARP1 and FOXO1 in predicting the poor cerebral neurological recovery in patients with SCI was evaluated by the receiver operating characteristic (ROC) curve.Results:The PARP1 and FOXO1 in good recovery group and poor recovery group were significantly higher than those in control group: (4.14 ± 1.19) and (5.98 ± 1.02) μg/L vs. (2.13 ± 0.71) μg/L, (5.83 ± 1.22) and (7.57 ± 3.12) μg/L vs. (4.23 ± 1.34) μg/L, the indexes in poor recovery group were significantly higher than those in good recovery group, and there were statistical differences ( P<0.05). The mRS in poor recovery group was significantly higher than that in good recovery group: (3.92 ± 0.87) scores vs. (1.03 ± 0.80) scores, and there was statistical difference ( P<0.05). Spearman correlation analysis result showed that PARP1 and FOXO1 were positively correlated with mRS score in patients with SCI ( r = 0.673 and 0.646, P<0.05). Multifactor Logistic regression analysis result showed that the GCS, mRS, PARP1 and FOXO1 were independent risk factors for poor neurological recovery in patients with SCI ( HR = 1.039, 1.286, 1.439 and 1.389; 95% CI 1.003 to 1.076, 1.011 to 1.637, 1.029 to 2.012 and 1.009 to 1.912; P<0.05). ROC curve analysis result showed that the area under the curve (AUC) of PARP1 combination with FOXO1 in assessing poor cerebral neurological recovery in patients with SCI was significantly greater than the PARP1 and FOXO1 alone: 0.953 (95% CI 0.918 to 0.988) vs. 0.866 (95% CI 0.796 to 0.936) and 0.859 (95% CI 0.783 to 0.935), Z = 2.162 and 2.188, P = 0.031 and 0.029. Conclusions:The serum PARP1 and FOXO1 levels in patients with SCI are positively correlated with cerebral neurological recovery, and they have predictive value for cerebral neurological recovery status.

Moyamoya disease is a chronic progressive cerebrovascular disease. Its disability rate and lethality rate are higher. The direct and indirect revascularization can increase cerebral blood flow and reduce the occurrence of cerebral ischemia and cerebral hemorrhage. This article reviews the pathophysiological basis of its surgical treatment, surgical timing, indications, surgical treatment methods and efficacy.