OBJECTIVE:To investigate clinical efficacy of cerebroventricular perfusion and intrathecal perfusion of vancomy-cin assisting with continuous drainage in the treatment of intracranial infection secondary to traumatic brain injury,and its effects on cerebrospinal fluid indexes and intracranial pressure. METHODS:One hundred and eighty patients with intracranial infection secondary to traumatic brain injury selected from Sanya Hospital of TCM during Jan. 2012 to Jun. 2015 were randomly divided into control group and observation group according to lottery,with 90 cases in each group. They were given cerebroventricular perfu-sion and intrathecal perfusion of vancomycin(20 mg dissolved in 5 mL normal saline)in cella lateralis and lumbar cisterna respec-tively combined with continuous drainage,q12 h. Both groups received treatment for 7 d.Clinical efficacy,the time of infection con-trol were compared between 2 groups as well as body temperature,intracranial pressure and cerebrospinal fluid indexes before and after treatment,and the occurrence of ADR. RESULTS:After treatment,total response rate of observation group (95.56%) was significantly higher than that of control group (77.78%),with statistical significance (P<0.05). The time of infection control in observation group [(9.67 ± 1.10)d] was significantly shorter than in control group [(11.84 ± 1.29)d],with statistical significance (P<0.05). Body temperature,intracranial pressure,cerebrospinal fluid protein and leukocyte of 2 groups were significantly lower than before treatment;cerebrospinal fluid glucose level was increased significantly compared to before treatment;above indexes of observation group were significantly better than those of control group,with statistical significance(P<0.05).There was no statisti-cal significance in the incidence of ADR between 2 groups(P>0.05). CONCLUSIONS:The intrathecal perfusion of vancomycin as-sisting with continuous drainage in the treatment of intracranial infection secondary to traumatic brain injury can effectively speed up the rehabilitation process,reduce the body temperature and intracranial pressure,and is helpful to improve the relevant cerebro-spinal fluid indexes. Therapeutic efficacy of it is better than that of cerebroventricular perfusion.

Objective To study the risk factors for PSD and post-stroke cognitive impairment (PSCI) after first AIS.Methods One hundred and three AIS patients were divided into non PSD group (n=77) and PSD group (n=26) according to their HAMD score and into non-PSCI group (n=30) and PSCI group (n=73) according to their MoCA score.Their depression and congnitive impairment were assessed,their demographic and clinical data were recorded.Risk factors for PSD and PSCI were analyzed by multivariate logistic regression analysis.Results The incidence of CHD,serum homocysteine level,rate of foci in front of head,HAMA score and rate of MoCA score＜21 were significantly higher in PSD group than in non PSD group (38.5％ vs 19.5％,P=0.04;20.12±12.96 μmol/L vs 14.73±6.41 μmol/L,P=0.01;84.6％ vs 61.0％,P=0.02;12.04±9.95 vs 3.35±2.79,P=0.00;65.4％ vs 42.9％,P=0.04).The age was significantly older,the rate of solitudianrians was significantly higher,the number of males was significantly greater,the middle school education level was significantly higher,the history of smoking and alcohol comsumption was significantly longer,the serum hemoglobulin level was significantly higher in PSCI group than in non PSCI group (P＜0.05).Multivariate logistic regression analysis showed that anxiety and hyperhomocysteinemia were the independent risk factors for PSD and age was the independent risk factor for PSCI (P＜0.05).Conclusion The relationship between first acute PSD and PSCI is uncertain.PSD and PSCI are characterized by their own independent risk factors.