Objective To explore the standard large decompressive craniotomy in treatment severe traumatic brain injury lateral fissure area damage to the clinical curative effect and application value .Methods 56 patients with severe craniocerebral trauma lat-eral fissure area injury in our hospital from February 2010 to December 2012 were randomly divided into the standard group and the conventional group ,28 cases in each group ,and treated by the standard large decompressive craniotomy and routine big bone flap craniotomy hematoma removal respectively .The various index of clinical effect and prognosis were observed and compared between the two groups .Results The Glasgow coma score(GCS) on postoperative 3 ,7 d in the standard group were obviously higher than those in the conventional group ,but the intracranial pressure (ICP) ,midline shift and cerebral edema volume were significantly low-er than those in the the conventional group ,the differences had statistical significance (P< 0 .05) ,after 1 -year follow -up ,the GOS score and the survival rate in the standar group were significantly higher than those in the conventional group (P<0 .05) . Conclusion The effect of the standard large decompressive craniotomy for treating severe craniocerebral trauma lateral fissure area damage is superior to the conventional big bone flap craniotomy hematoma removal ,can effectively remove the hematoma ,reduce the intracranial pressure ,save the patient′s life and improve the quality of life ,which is worthy of clinical attention and promotion .

Objective To investigate the changes of antibrain-antibody (AB-Ab) in blood serum and the effect of AB-Ab on blood-brain barrier (BBB) and cerebral edema after the traumatic brain injury (TBI) in rabbits.Methods Forty-five New Zealand rabbits were randomly divided into control group (n =5),sham operation group (fenestration only without injury,n =15) and TBI group (severe lateral fluid percussion brain injury,n =15) according to the random number table.Sham and TBI animals were subdivided at postoperative 1,3,7 and 14 days.Level of AB-Ab,BBB permeability and brain water content were determined after operation.Results At each time point,serum AB-Ab level,BBB permeability and brain water content were higher in sham operation group and TBI group than in control group (P ＜0.05).At postoperative 3,7 and 14 days,serum AB-Ab level,BBB permeability and brain water content were higher in TBI group than in sham operation group (P ＜ 0.05).Conclusion Serum level of AB-Ab is significantly increased after TBI along with synchronous changes in BBB permeability and brain water content,indicating that AB-Ab may be associated with the increase of BBB permeability and brain edema.

Objective To explore the effects of microsurgical technique treatment on acknowledge ability ,activities of daily liv-ing ,cortex blood perfusion and neuropeptide levels of brain glioma patients .Methods Microsurgical technique treatment and tradi-tional operation were given to 87 brain glioma patients ,respectively .The acknowledge ability and activities of daily living were measured by HDS ,MMSE and ADL ;the cortex blood perfusion were revealed by PET ,and the neuropeptide levels including argi-nine vasopressin ,oxytocin ,β-endorphin ,somatostatin and neurotensin of patients from two different surgical groups were compared . Results As compared with the traditional operation ,the acknowledge ability and activities of daily living of patients from microsur-gical treatment group were significantly improved(P<0 .05) ,the cortex blood perfusion were statistically increased (P<0 .05) and the levels of five kinds of neuropeptide were all profoundly increased (P< 0 .05) .Conclusion Microsurgical technique treatment could improve the acknowledge ability and activities of daily living of brain glioma patients ,the mechanisms of which could be the increase of cortex blood perfusion and theincrease of neuropeptide levels .

Objective To observe the dynamic change of brain natriuretic peptide (BNP) in plasma of elderly patients with hy-pertensive intracerebral hemorrhage ,and to explore the relationship between BNP levels and cerebral edema .Methods 56 elderly patients with hypertensive intracerebral hemorrhage were recruited and divided into the operation group (n=26) and the non-opera-tion group(n=30) ,25 hypertensive patients were collected as the control group .ELISA was applied to detect the levels of plasma BNP at 6 ,24 ,72 ,168 h after the onset of hypertensive intracerebral hemorrhage .The non-invasion brain edema monitor was utilized to dynamically monitor the cerebral edema degrees .Results The plasma BNP levels in the operation group and the non-operation group at 6 ,24 ,72 ,168 h were higher than those in the control group ,the differences showed statistical difference (P<0 .05) ,but which at 168 h in the operation group was lower than that in the non-operation group ,cerebral edema appeared at 24 h in the two groups ,and reached the peak value at 72 h in the operation group and at68 h in the non-operation group;the changes of plasma BNP levels had positive correlation with cerebral edema degree (r=0 .685 ,P<0 .05) .Conclusion Dynamic monitoring of plasma BNP levels is an effective indicator for early diagnosis and monitoring of acute brain edema in elderly patients with hypertensive in-tracerebral hemorrhage .

Objective To investigate relationship of immunoglobulin concentrations (IgG,IgA,and IgM)and decrease of serum Mg2+ concentration in patients with severe traumatic brain injury (sTBI).Methods Sixty patients with sTBI were randomly divided into control group and study group.Intravenous injection of MgSO4 was given to study group.Levels of Mg2+ in serum and immunoglobulin (IgG,IgA,and IgM) in both groups were measured at 1,3,7,and 14 days after injury so as to analyze correlations of serum Mg2+ concentration with each humoral immune indices.Results IgG concentration at days 3 and 7 in study group were (10.79 ± 2.65) g/L and (10.2 1 ± 2.54) g/L respectively,higher than that in control group (P ＜ 0.05).IgM at days 3 and 7 in study group were (1.27 ± 0.32) g/Land (1.31 ± 0.25) g/L respectively,higher than that in control group (P ＜ 0.05).Difference of IgA level between the two groups was not significant.Level of Mg2 + was positively related to levels of IgM and IgG,but not to level of IgA.Pathological amelioration at day 14 between the two groups showed insignificant difference.Conclusion Intravenous replenishment of MgSO4 for patients with sTBI at acute phase can improve humoral immunosuppressive state,but can not ameliorate prognosis.

Objective To investigate the effect of neutrophil elastase (NE) inhibitor on the blood-brain barrier(BBB) permeabili-ty and hydrocephalus in rats with traumatic brain injury (TBI) .Methods 99 SD rats were randomly divided into the control group , the TBI group and the intervention group(dividing into 5 sub-groups:6 ,24 ,48 ,72 ,168 h) .The hydraulic impact model of rats was duplicated .Sivelestat sodium was given in the intervention group .The NE concentration in the brain tissue ,BBB permeability and brain water content were detected in each group and performed the comparative analysis .Results The NE concentration in the brain tissue ,BBB permeability and brain water content at each timepoint in the TBI group and the intervention groups were higher than those in the control group .The NE concentration at 24 ,48 ,72 ,168 h in the intervention group was lower than that in the TBI group .The BBB permeability and the brain water content at 48 ,72 ,168 h in the intervention group were lower than those in the TBI group(P<0 .05) .Conclusion Sivelestat sodium can inhibit the NE release in TBI rat brain tissue ,reduce the BBB permeability and the occurrence of hydrocephalus ,which indicating that sivelestat sodium has the protective effect on TBI secondary lesion in rat .