ObjectiveTo observe the effect of lappaconitine (LA) on brain water content and serum IL-I,IL-2 and TNF-α levels in rats with traumatic brain injury (TBI) as well as its cerebral protective function.MethodsA total of 24 male SD rats were involved in the study and randomly divided into control group,TBI group and TBI +LA group,with eight rats per group.The rats in the TBI group and TBI + LA group were inflicted with fluid percussion injury ( FPI ).The rats in the TBI + LA group were treated with LA (4 mg/Kg/d,ip,for 10 consecutive days).The neurological score,brain water content and serum IL-I,IL-2 and TNF -α concentrations were detected at time points including TO ( before FPI ),T1 (one day after FPI),T2 (five days after FPI) andT3 (10 days after FPI).Results At each time point after FPI,the neurological dysfunction was observed in both the TBI group and TBI + LA group.The neurological dysfunction was gradually alleviated from TI to T3 in the FPI + LA group,which showed significant lower neurological score as compared with the TBI group (P ＜0.05 or 0.01 ).The brain water content in the TBI group and TBI + LA group was significantly higher than that in the control group at each time point after FPI.Meanwhile,the water content of the TBI + LA group was significantly lower than that of the TBI group ( P ＜ 0.01 ).The serum IL-1,IL-2 and TNF-alpha concentrations in the TBI group and TBI + LA group were significantly higher than those in the control group at each time point after FPI,and the serum IL-I,IL-2 and TNF-αt concentrations of the TBI + LA group were significantly lower than those of the TBI group ( P ＜ 0.01 ).Conclusions LA exerts cerebral protective effects of TBI rats by relieving the neurological dysfunction and cerebral edema and reducing the serum IL-1,IL-2 and TNF-α concentrations.

BACKGROUND:There is a lack of the research concerning the biocompatibility of nano-hydroxyapatite/polyphenylene sulfide (nHA/PPS) composites.OBJECTIVE:To evaluate the in vivo biocompatibility of nHA/PPS composites based on the completed research in vitro.METHODS:Systemic toxicity test:Sprague-Dawley rats were given the intraperitoneal injection of nHA/PPS extract or normal saline.The general situation,body mass and the histological changes of the liver and kidney were observed at 72 hours after injection.Delayed type hypersensitivity test:nHA/PPS extract or normal saline was injected subcutaneously into the back of the rats.Afterwards,skin irritation symptoms were observed at 72 hours.Local reaction experiment:nHA/PPS composites and polyethylene were respectively implanted into the back of the rats.The pathological changes of the implanted materials and their surrounding tissues were observed at 15 and 30 days after implantation.RESULTS AND CONCLUSION:(1) The rats were in good situation after nHA/PPS injection;the body mass increased steadily,which showed no significant difference from the control group (P ＜ 0.05);the morphology and color of the liver and kidney were normal,and the systemic toxicity of the composite materials was normal according to the degree of toxicity classification.(2) There were no obvious skin irritation symptoms after the subcutaneous injection of nHA/PPS composites,and the primary irritation index was less than 0.4,suggesting a low hypersensitivity.After implantation of nHA/PPS composites,there was no obvious degradation,absorption and rejection,and both the degree of inflammatory reaction (15 days ≤ level Ⅲ,30 days ≤ level Ⅱ) and the thickness of fibrous capsule (15 days ≤ level Ⅲ,30 days ≤ level Ⅱ) revealed the good biocompatibility of the composites.These results suggest that the nHA/PPS composites hold an excellent biocompatibility in vivo.

Objective To compare the differences of disease spectrum between patients with brain trauma injury (TBI) in the high altitude areas and those in the plain areas.Methods The front page information of medical records of local TBI patients admitted to military hospitals from 2001 to 2007 was extracted from the Chinese Trauma Database.Ten military hospitals from high altitude areas (high altitude group) and 10 military hospitals with the same hospital level from plain areas (plain group) were selected and the patients in the two groups were compared for their differences in general condition and disease spectrum.Results High altitude group displayed a larger proportion of male patients (P＜0.01),a lower age (P＜0.01),a smaller proportion of patients with Han nationality (P＜0.01),asmaller proportion of emergency patients (P＜0.01),a larger proportion of critically ill patients (P＜0.01),a lower median of hospital days (P＜0.01),a lower operation rate (P＜0.01),as compared with the plain group.The injury of the patients with TBI in turn were intracranial organ injury (excluding those with skull fracture),open wound of head,neck,and trunk,skull fracture,injury of nerves and spinal cord.The orders of TBI disease spectrum of the high altitude and plain groups were the same,but the disease compositions of the two groups had significant difference (P＜0.01).Conclusions Thereexist significant differences in demographics,admission status and disease spectrum of TBI patients inhigh altitude and plain areas.However,the current clinical treatments of TBI in high altitude areas are usually with reference to the experience in plain areas,which is worthy of paying attention by relevant departments.

Objective To observe the effect of acute hypervolemic hemodilution (AHH) with two kinds of hydroxyethyl starches including Voluven and HES on the renal function of emergency surgery patients with brain injury.Methods This study involved 54 brain injury patients treated with emergency surgery,who were randomly divided into Voluven group ( AHH130 group),HES group ( AHH200 group) and Ringer's lactate group (LR group),with 18 patients in each group.All the patients were managed with inhalation anesthesia.ECG,MAP,CVP and SpO2 were observed in operation.The blood urea nitrogen (BUN),urine creatinine ( BCr,UCr),urinary albumin (ALB) and urinary α1-microglobulin ( α1-MG) were detected before AHH ( T0 ),at the end of operation ( T1 ),at 4 hours ( T2 ),day 1 ( T3 ),day 2 (T4) and day 3 (T5) after operation.The creatinine clearance (CCr) and fractional sodium clearance (FSC) were calculated and the urine output,fluid replacement,blood loss and blood transfusion recorded.Results The HR,CVP and MAP in the three groups were within the normal range of variation at all time points,with statistical difference for comparison between groups and within group ( P ＞ 0.05 ).There was no significant difference in urine output and blood loss,while the intraoperative fluid volume and blood transfusion in the AHH130 group and the AHH200 group were significantly less than those in the LR group (P ＜ 0.01 ).There was no statistical difference in aspects of BUN,BCr and urinary ALB at each time point between and within the three groups ( P ＞ 0.05 ).After treatment with AHH,the urinary α1-MG level in the AHH130 group and AHH200 group was significantly increased ( P ＜0.01 ),which was decreased at T5 but was still higher than that at T0 ( P ＜ 0.01 ),and was higher than that in the LR group at all time points (P＜0.05).After treatment with AHH,CCr was decreased in the AHH130 group and AHH200 group,which reached the lowest level at T2,with statistical difference compared with the levd at T0 ( P ＜0.01 ).Then,CCr was recovered to normal at T5.FSC in the three groups after AHH treatment was increased slightly and the most significantly at T2,which was not statistically different compared with that at T0 ( P ＞ 0.05) and FSC was not statistically different between and within groups at other time points (P ＞0.05).All the values about the renal function in all the groups changed within the normal range at each time point.Conclusions AHH with Voluven or HAES is a feasible and safe blood conservation measure that can significantly reduce the allogeneic blood transfusion but exert insignificant effect on renal function of the brain injury patients with normal renal function before emergency surgery.

Objective To analyze the space-time characteristic of traumatic brain injury (TBI) caused by Chinese Wenchuan earthquake and discuss opportunity and mode of medical intervention. Methods A retrospective study was done on 92 patients with TBI admitted into our department during Chinese Wanchuan earthquake.Results All 92 patients came from champaign located at northwest of Chengdu. Of all, 76 patients were admitted within 12 hours after earthquake. Surgical operation Wag done on 10 patients, of whom 3 died.Conclusions In the early period after earthquake, TBI patients make a large proportion and have fast change of injury severity. All patients come from champaign with conven-ient transportation. For TBI patients, early emergent operation after admission can significantly elevate success rate of mcdical intervention.

OBJECTIVETo study the curative effect of wilsonii injecta on severe head injury (SHI).

METHODSA total of 120 patients with SHI were divided randomly into 2 groups, the patients treated with conventional methods as Group A (n=60) and the patients treated with wilsonii injecta as Group B (n=60). The changes of neural function indexes were evaluated with Glasgow Coma Scale (GCS) before treatment and with Glasgow Outcome Scale (GOS) after treatment, simultaneously, the parameters of hemorrheological indexes (HI), brain electrical activity map (BEAM) and transcranial Doppler sonography (TCD) were observed before and after treatment.

RESULTSIn Group B, the clinical GCS, the HI, the BEAM and the prognosis GOS were improved much more than those in Group A. And the TCD parameters in Group B decreased, which had significant difference compared with that in Group A (P<0.01).

CONCLUSIONSWilsonii injecta can rapidly improve the injured p ersons' conscious states, the abnormal BEAM and the surviving quality. It suggests that the improvement of the HI is related to the relief of the vasospasm of the arterial blood vessels in the brain, which may be one of the important mechanisms of wilsonii injecta in improving the prognosis.

Adult ; Brain Injuries ; diagnostic imaging ; drug therapy ; Brain Mapping ; Female ; Follow-Up Studies ; Glasgow Coma Scale ; Glasgow Outcome Scale ; Humans ; Injury Severity Score ; Male ; Plant Extracts ; administration & dosage ; Probability ; Reference Values ; Treatment Outcome ; Ultrasonography, Doppler

Neurodegenerative disease is a kind of degenerative diseases of the central nervous system that seriously endanger human health. The complement 3 (C3)-complement 3a receptor (C3aR) pathway is one of the important pathways for classical complement cascade activation. A large number of studies have shown that the C3-C3aR pathway can mediate and regulate the interaction of astrocyte-microglia axis in neurons, resulting in function changes in central nervous system. In addition, studies in recent years have found that the C3-C3aR pathway is closely related to the occurrence and progress of neurodegenerative diseases, such as Alzheimer's disease, Parkinson's disease, stroke, and epilepsy. This article reviews the progress of C3-C3aR pathway and discuss the role of C3-C3aR pathway in several important neurodegenerative diseases, and it provides a new idea fo treatment of these diseases.

Objective To explore the principal component analysis (PCA)-Logistic regression model in predicting hospital-acquired pneumonia (HAP) in patients with craniocerebral injury, and find the influencing factors of mortality and HAP occurrence in patients with craniocerebral injury. Methods One hundred and eight patients with craniocerebral injury, admitted to our hospital from December 2011 to November 2017, were chosen in our hospital. Clinical diagnoses, 36 treatment indicators and laboratory results were constituted the original data set; 12 principal components with cumulative contribution>2/3 were extracted as independent variables, and mortality and HAP occurrence were as dependent variables to establish PCA-Logistic regression model. Receiver operating characteristic (ROC) curve was applied to forecast performance of PCA-R model. Results PCA-Logistic regression showed that 4 principal components had significant influence in mortality, and 5 principal components had significant influence in HAP outcomes. Open craniocerebral injury and coagulation changes were the clinical indexes with the highest coefficient when mortality was the outcome index. Gender and parenteral nutrition were the clinical indexes with the highest coefficient when HAP was outcome index. PCA-R model was able to identify the risk factors and forecast the clinical outcomes (HAP, sensitivity:83.9％, specificity: 94.8％, area under the curve [AUC]: 0.949; mortality, sensitivity: 92.3％, specificity:93.7％, AUC: 0.983). Conclusion PCA-Logistic regression model can effectively mine the clinical variables of patients with craniocerebral injury; insufficiency of blood perfusion after severe craniocerebral injury is an important factor affecting the survival of patients, and abnormal nutritional support may be an important clinical factor affecting the occurrence of HAP in patients.

The myelin-associated protein Nogo-A was considered to be the axon growth inhibitory factor, which participates in a variety of pathophysiological regulation of nervous system. In recent years, a growing number of studies have shown that Nogo-A protein is closely related to epilepsy by regulating dendritic plasticity, mediating abnormal nerve migration and regulating glial cell activation, etc. This article will review the research progress of Nogo-A in epilepsy in recent years.