Objective To explore the influnce on the endothelin-1 (ET-1) and clinical application value of continuous blood purification (CBP) on the treatment of severe craniocerebral injury with the neurogenic pulmonary edema (NPE).Methods All data about sixty patients with NPE were prospectively studied.These 60 patients were randomly (random number) divided into control group (n =30) and treatment group (n =30).In control group,patients were rapidly given with lowering intracranial pressure,mechanical ventilation,calming,antibiotic therapy and so on.In the treatment group,patients received CBP integrated with routine treatment.On admission and 72 h posttreatment,ET-1,static lung compliance and oxygenation index were observed.Time of mechanical ventilation support,incidence rates of multipal organ dysfunction syndrome (MODS) were compared between two groups.The paired t-test was used for the amount data within the group.Chi-square was used for the constitute ratio and incidence ratio of the each relevant information.P ＜ 0.05 was considered statistically significant.Results Compared to the control group,the level of ET-1 was decreased significantly in the treatment group [(48 ± 10) ng/L vs.(85 ± 14) ng/L] after 72 h post-treatment,while static lung compliance [(60.9 ± 2.3) mL/cmH2O vs.(31.4 ±4.8) mL/cmH2O] and oxygenation index [(317 ± 11) mmHg vs.(192 ± 14) mmHg] increased significantly (P ＜ 0.05).In treatment group and control group,the time of respirator intervention were [(6.0 ± 2.1) d vs.(11 ± 3.2) d],and the statistical significance was shown (P ＜ 0.05).Compared to the control group [56.7％ (17/30)],incidence rate of MODS [20.0％ (6/30)] was lower in treatment group (P ＜ 0.05).Conclusions CBP combined with routine treatment,which can remove ET-1 effectively,improve oxygenation,reduce the time of mechanical ventilation support and incidence rate of MODS.

Exosomes are nanoscale extracellular vesicle structures that communicate and exchange information between cells. They carry a variety of biologically active molecules whose compositions and contents vary according to the origin and recipient cells. Therefore, exosomes can be used as biomarkers. Neurodegenerative diseases are diseases with hidden onset, so early screening and accurate diagnosis is undoubtedly a reliable guarantee to reduce their mortality and increase the cure rate. Exosomes, as a research hotspot in recent years, have great potential for the diagnosis and treatment of diseases given their transport capacity and contents, and have significant advantages in abundance, stability, diversity and accessibility. The purpose of this paper is to discuss exosomes as potential candidates for early diagnosis of neurodegenerative diseases, and thus to elaborate new fields of their application, with a view to providing a richer perspective for clinical prediction and treatment.