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Objective To investigate the common reasons for intracranial hemorrhage after cranioplasty ,and to analysis the sig‐nificant perioperative factors of intracranial hemorrhage after cranioplsty .Methods Eight hundred and seventy two cases of cranio‐plasty were retrospectively analyzed ;the postoperative intracranial hemorrhage and perioperative risk factors were conducted with multiple linear regression analysis .Results Among the 872 cases ,46 cases suffered intracranial hemorrhage .We found three signifi‐cant perioperative factors of intracranial hemorrhage after cranioplasty :suspension for epidural ,not completely hemostasis and ex‐cessive drainage in ventriculoperitoneal shunt .Conclusion To avoid the three risk factors as far as possible could effectively reduce the incidence of intracranial hemorrhage after cranioplasty .
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Objective To investigate the effect and underlying mechanism of apolipoprotein E (APOE) genetic polymorphism in treating blood brain barrier (BBB) breakdown after traumatic brain injury (TBI).Methods Human APOE knock-in mice (ε3,ε4),APOE knockout mice,and APOE wild-type mice with each numbering 80 were respectively divided into TBI group (n =50),sham-operation group (n =15) and normal control group (n =15) according to the random number table.TBI group was subdivided at 1 day (n=15),3 days (n=15),and7 days (n=20).TBI was induced with a pneumatically operated injury device.BBB permeability to large or small molecules was evaluated by measuring Evans blue (EB) and fluorescein sodium (NaFI) extravasation into the damage area at 1,3,and 7 days postinjury.Brain water content was determined using the dry-wet method.Western blotting and qRT-PCR for tight junction-associated proteins Occludin and Claudin-5 were performed at 7 days postinjury.Results With respect to normal control group,BBB permeability to EB and NaFI was significantly higher in ε4 and APOE knockout mice than in ε3 and APOE wild-type mice.There appeared significant increase in BBB permeability to EB and NaFI in TBI group,with insignificant differences among rats of each genotype at 1 and 3 days postinjury (P ＞ 0.05).Whereas at 7 days postinjury,BBB permeability to EB in APOE wild-type and e3 mice returned to the normal level (P ＞ 0.05),but it re mained at a high level in APOE knockout and ε4 mice (P ＜ 0.01).Meanwhile,BBB permeability toNaFI was significantly higher in ε4 and APOE knockout mice than in ε3 and APOE wild-type mice (P ＜ 0.01).Brain water content was equivalent among rats of each genotype at 1,3 and 7 days postinjury (P ＞0.05).Western blotting and qRT-PCR demonstrated Occludin and Claudin-5 in ε4 and APOE knockout mice were significantly lower than those in ε3 and APOE wide-type mice (P ＜ 0.05).Conclusion APOE plays an important role in restoration of BBB function after TBI,but ε4 may impede the recovery of BBB breakdown after TBI through its effect on tight junction.
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Objective To investigate the expression of C/EBP homology protein (CHOP) in peripheral brain tissue of patients with severe traumatic brain injury (TBI) and its correlation with the injury severity.Methods The study included peripheral brain tissues of 41 TBI patients (TBI group).Another 16 autopsy specimens succumbed to other diseases (except for TBI or other central nervous system diseases) were selected as controls.The control group and TBI group were subdivided into immaturity group (≤18 years),adult group (18-59 years) and elderly group (＞59 years).According to Glasgow Coma Scale (GCS) on admission,TBI group was classified as severe TBI group (GCS of 6-8) and particularly-severe TBI group (GCS of 3-5).CHOP expression in peripheral tissues after TBI was compared in between different age,gender and GCS.Nerve cell apoptosis was detected by TUNEL technique and correlation between CHOP level and apoptotic number was analyzed.Results There were no age and gender differences regarding CHOP expression in control group (P ＜ 0.05).Compared with control group,expression of CHOP presented notable up-regulation in TBI group (P ＜ 0.05).Expression of CHOP presented no gender difference in TBI group (P ＞ 0.05),but its expression was lower in the aged than in adult or immaturity (P ＜ 0.05) as well as notably higher in particularly-severe TBI group than in severe TBI group (P ＜ 0.05).Nerve cell apoptosis in TBI group was far greater in number than that in control group (P ＜0.05).A positive correlation was observed between CHOP level and apoptotic index (r =0.72,P ＜ 0.05).Conclusion Expression level of CHOP after TBI is closely related to the injury severity and nerve cell apoptosis,but the apoptosis pathway induced by CHOP may not be a major factor in secondary brain injury after TBI in the aged patients.
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[Objective]To evaluate the clinical result after treatment on fracture of distal radius with different fixations of the wood splint/plaster splint/"T" model plate.[Method]There were 236 cases with the fracture of distal radius,there were divided three types of A,B,C according to the AO classification,70 cases in 236 cases were treated with close diaplasis and external wood splint fixation,55 in 236 cases with external plaster splint fixation,III in 236 cases with operation and internal "T" model plate fixation.Results were evaluated by replacement and function after treatment,and percentage of excellence was compared with three different fixation.[Result]236 cases were all followed-up,mean follow-up period was 14.6 months(6~20months).The excellence rate of diaplasis was not significantly different in A and B type by comparing three different fixation,the excellence rate of function with wood splint fixation and "T" type plate internal fixation was better than that of plaster splint fixation in A and B type,there were not significantly difference about the excellence rate of function with the external wood splint fixation and the internal "T" model plate fixation.The excellence rate of function and reduction with"T" type plate internal fixation were better than with plaster splint and wood splint in C type.[Conclusion]The author suggests open reduction with "T" type plate internal fixation about C type fracture,close reduction and external wood splint fixation about A and B type distal radius fracture.