OBJECTIVE: To explore the effects of Xingnaojing injection combined with modified large bone flap decompression on postoperative intracranial pressure (ICP) and serum inflammatory factors in patients with severe traumatic brain injury (STBI).METHODS: In retrospective analysis, STBI patients were selected from Wuhan Municipal Third Hospital during May 2014-Nov. 2016, and then divided into control group and observation group according to therapy plan, with 32 cases in each group. Control group received modified large bone flap decompression and rountine postoperative infection. Observation group was given Xingnaojing injection 30 mL, once a day, after modified large bone flap decompression, for consecutive 30 d. ICP levels and GCS score were compared between 2 groups 3, 5, 7 d after surgery. The levels of serum inflammatory factors (hs-CRP, TNF-α, IL-2, IL-6) were compared before surgery and 7 d after surgery. SF-36 score were observed before surgery and one month after surgery. GOS grading and the incidence of complication were observed one month after surgery. RESULTS: There was no statistical significance in baseline information between 2 groups (P>0. 05). Before surgery, there was no statistical significance in GCS score, serum inflammatory factor level or SF-36 score between 2 groups (P>0. 05). GOS grading of observation group was better than that of control group after surgery (P<0. 05). Compared with control group, the levels of ICP in observation group were decreased significantly 3, 5, 7 d after surgery (P<0. 05), while GCS score was increased significantly (P<0. 05); 7 d after surgery, the levels of serum inflammation factors were decreased significantly (P<0. 05). SF-36 score was increased significantly one month after surgery (P<0. 05), and the incidence of incisional hernia and acute encephalocele were decreased significantly (P<0. 05); there was no statistical significance in the incidence of delayed hematoma, hydrocephalus or interstitial brain edema (P>0. 05). CONCLUSIONS: Prognosis effect of Xingnaojing injection combined with modified large bone flap decompression may be better than modified large bone flap decompression alone in the treatment of STBI, and there is difference between them.

Objective:To explore the practical effect of multi-disciplinary treatment learning (MDT-L) combined with PBL+CBL teaching on the clinical clerkship of neurosurgery.Methods:In the study, 30 neurosurgery clinical interns accepted by Wuhan Third Hospital from January 2019 to December 2019 were set as the control group, and 30 neurosurgery clinical interns from January 2020 to December 2020 were set as the research group. The control group implemented conventional teaching, and the research group used MDT-L combined with PBL+CBL teaching. After the clerkship, the two groups' clinical clerkship results, changes of comprehensive abilities before and after clerkship, professional quality after clerkship, and satisfaction with teaching methods were compared. SPSS 26.0 was used for t test and chi-square test. Results:After the clerkship, the theoretical knowledge and operational skills assessment scores of the research group were significantly higher than those of the control group ( P<0.05). There was no statistically significant difference in the scores of the two groups in learning interest, analytical ability, communication skills, innovation ability and file management ability before the clerkship ( P>0.05). While, after the clerkship, the comprehensive ability scores of the above dimensions of the two groups increased, and the comprehensive ability scores of the study group were all higher than those of the control group ( P<0.05). After the clerkship, the scores of professional ability, problem analysis and solving ability, mastery of diagnosis and treatment procedures, scoring of medical documents writing and total scoring of professional quality in the study group were all higher than those in the control group ( P<0.05). The satisfaction scores of the study group on the attractiveness, effectiveness and practicality of the teaching method were higher than those of the control group ( P<0.05). Conclusion:The application of MDT-L combined with PBL+CBL teaching in neurosurgery clinical clerkship can not only improve the performance of internship, but also enhance the comprehensive ability of interns and improve their professional quality and satisfaction.