ABSTRACT
Objective To observe the effect of panobinostat (LBH589) on the early brain injury (EBI) in the model of subarachnoid hemorrhage(SAH) in SD rats.Methods SD rats were randomly divided into 4 groups:sham(10 rats) and SAH(10 rats),SAH + vehicle(20 rats) and SAH + Panobinostat (20 rats).Drug or vehicle was given by lateral-ventricular stereotaxic injection 24h before the SAH model was introduced.Water contents and the neurological scores were determined at 24h post-SAH.The levels of Ac-H3K27 in frontal and lateral lobe were detected by Western blot.Results The mean neurological score of the SAH group was higher than that of the sham group(F =13.000,P =0.007).The water content of the SAH group was higher than that of the sham group (F =8.229,P =0.019).The level of Ac-H3K27 was higher in the SAH + Panobinostat group than that in the SAH +vehicle group(F =41.250,P =0.000).The mean neurological score of the SAH + Panobinostat group was lower than that of the SAH + vehicle group(F =9.560,P =0.011).The water content of the SAH + Panobinostat group was lower than that of the SAH + vehicle group (F =8.211,P =0.020).The correlation analysis indicated that the level of acetylation of H3 was negatively correlated with the neurological score (r =-0.585,P =0.046).Conclusion Panobinostat can improve the neurological behavior and alleviate early brain injury in the SAH model.
ABSTRACT
Objective@#To observe the effect of panobinostat (LBH589) on the early brain injury (EBI) in the model of subarachnoid hemorrhage(SAH) in SD rats.@*Methods@#SD rats were randomly divided into 4 groups: sham(10 rats) and SAH(10 rats), SAH+ vehicle(20 rats) and SAH+ Panobinostat(20 rats). Drug or vehicle was given by lateral-ventricular stereotaxic injection 24h before the SAH model was introduced.Water contents and the neurological scores were determined at 24h post-SAH.The levels of Ac-H3K27 in frontal and lateral lobe were detected by Western blot.@*Results@#The mean neurological score of the SAH group was higher than that of the sham group(F=13.000, P=0.007). The water content of the SAH group was higher than that of the sham group (F=8.229, P=0.019). The level of Ac-H3K27 was higher in the SAH+ Panobinostat group than that in the SAH+ vehicle group(F=41.250, P=0.000). The mean neurological score of the SAH+ Panobinostat group was lower than that of the SAH+ vehicle group(F=9.560, P=0.011). The water content of the SAH+ Panobinostat group was lower than that of the SAH+ vehicle group(F=8.211, P=0.020). The correlation analysis indicated that the level of acetylation of H3 was negatively correlated with the neurological score(r=-0.585, P=0.046).@*Conclusion@#Panobinostat can improve the neurological behavior and alleviate early brain injury in the SAH model.
ABSTRACT
Objective To explore the dynamic change and clinical signiticance of plasma D-damer level in patients with cerebral hemorrhage and acute craniocerebral injury.Methods 50 patients with cerebral hemorrhage and 40 patients with acute craniocerebral injury were selected,The enzyme-linked immunosorbent assay (ELISA) was used to measure plasma D-dimer level in two groups of patients after onset,and the results were compared with 40 healthy controls.Results The levels of plasma D-dimer in the patients with cerebral hemorrhage were 1.59mg/L,2.10mg/L,1.03 mg/L,0.82mg/L at 3 h,6h,12h,2d after onset,which in the patients with acute craniocerebral injury were 1.61mg/L,2.02mg/L,1.01mg/L and 0.67mg/L,respectively.And the plasma D-dimer levels were 0.50mg/L,0.49mg/L,0.47mg/L,0.48mg/L in the control group at 3h,6h,12h and 2d after onset.The levels of plasma D-dimer in the patients with acute craniocerebral injury were significantly higher than those in the control group,and the differences were statistically significant (t =9.35,12.17,4.03,3.05,all P ＜ O.05).At 7d after onset,the D-dimer levels in the cerebral hemorrhage group and acute craniocerebral injury group were 0.53mg/L,0.55mg/L,respectively,which of the control group was 0.47mg/L,there was no statistically significant difference among the three groups(P ＞ 0.05).Conclusion Cerebral hemorrhage patients and acute craniocerebral injury patients have high coagulation and fibrinolytic activity in brief increase trend,dynamic observation of plasma D-dimer level in patients with cerebral hemorrhage and acute craniocerebral injury is helpful to determine courses,condition and evaluate prognosis.
ABSTRACT
ObjectiveTo investigate value of minimally invasive surgical approach in patients with hypertensive intracerebral hemorrhage in primary hospital.MethodsAccording to the operation procedure,93 cases with basal ganglia hemorrhage were divided into three groups:1.minimally invasive surgery group A (n =37 ),2.ventricular puncture and drainage,lumbar cistern drainage group B(n=10),3.usual operation group C( n =46).Estimated operation effect with computed tomography in 24 hours after operation.Case fatality rate and complication incidence were analyzed after three months of operation according to the Glasgow Outcome Scale (GOS).ResultsMinimally invasive surgery group A had the highest hematoma clearance rate (82.7 ± 8.1 ) ％,group B (78.6±6.5 ％ ),group C (50 ±10％ ).The incidence rate of rebleeding was 8.1％ in group A( n =3 ),10％ in group B ( n =1 ),34.8％ in group C (n =16).The grade Ⅳ of the GOS and the grade Ⅲ of the GOS was respectively 93.8％ and 6.5％,case fatality rate was zero.Conclusion The minimally invasive surgical operation not only lead to less tissue damage and decrease rebleeding,but also improve neurological functional recovery.
ABSTRACT
Objective To summarize efficacy of surgical treatment of acute extradural hematoma. Methods The clinical data of 67 acute extradural hematoma(combined skull fracture) surgery cases were retrospectively analyzed from January 2006 to December 2009. Results Cerebral hernia and the time from the formation of cerebral hernia to operation affacted the prognosis of acute extradural hematoma severely. It was controversial that removal of skull bone or not after cerebral hernia. Conclusions The timely diagnosis and operation of acute extradural hematoma was positive correlation to the prognosis. The simple removal of skull bone impacted limitedly on the prognosis of patients with GCS 3.
ABSTRACT
Objective To study the role of hemorrhagic shock in severe eraniocerebral trauma with stress ulcer.Methods The clinical data of 428 patients of sevcere craniocerebral tramna in 0111"hospital from January 2001 to January 2009 were divided into two groups according to whether or not merging with hemorrhagic shock.The incidence of stress ulcer in two groups was calculated and the PH ofgastric juice and blood in different periods were measured.Results Stress ulcerdevelopedin 56.4%(75/133)ofpatientswith hemorrhagic shockand 12.5%(37/295)of patients with hemorrhagic shock-free,with significant difference between the two groups(P＜0.01).Blood pH differed significantly(P＜0.01)on 2d,but not on 7d(P＞0.05)after injury between the two groups.There wag no significant difference in gastric juice pH on 2d and 7d after injury between the two groups(P＞0.05).Condusion Hemorrhagie shock phys an important role in severe craniocerebral trauma with stress deer.
ABSTRACT
Objective To explore the significance, indicatinos and complications of emergency tracheotomy for patients with severe craniocerbral trauma. Methods The clinical data of 42 patients with severe craniocerbral trauma were retrospectively analyzed. Results Of them, 20 were basically cured (48%), 12 had improvement (29%) ,3 were released from the hospital(7 % ), 1 survived(2 % ) in a vegetative state,and 6 died(14%). Conclu- sion Emergent tracheotomy should be performed on patients with severe craniocerbral trauma to resolve respiratory tract obstruction, improve air current, prevent cerebral anoxia, prevent and treat pulmonary infection, increase the therapeutic efficacy.
ABSTRACT
Objective To explore the measures to prevent acute encephalocele during the decompressive craniotomy in the patients with severe brain injury.Methods The clinical data of 28 patients with severe brain injury,who were treated by extended fronto-temporo-prietal craniotomy were analyzed retrospectively.The sequential dural ineision(SDI)was performed during the operation in all the patients.Results The catastrophic encephalocele did not occur in all the cases even if very hish intracranial pressure wag caused by fulminant brain swelling in some cases.The total removal of hematomas was achieved in 19 cases,but there still was extensive hemorrhage in the operative fieId in 4 eases and secondary intracranial hematomas in the other regions in 5 cases observed on postoperative CT scan.The disappeared basal cistern and the third ventricle could be observed again in 12 eases.According to GOS,9 patienm obrained good recovery,5 was moderately disabled,4 were severely disabled,2 vegetatively survived,and 8 died.Condusion The encephalocele,which is easily produced by rapid decompression,is prevented by eontrollable decompression as early as possible and SDI in the patients with especially severe brain injury.