Postoperative changes of Th17/Treg balance in patients with intracranial aneurysm rupture / 南方医科大学学报

<p><b>OBJECTIVE</b>To observe the dynamic changes of Th17/Treg balance in patients following surgical intervention for intracranial aneurysm rupture.</p><p><b>METHODS</b>The percentage of Th cells and the intracellular IL-17 level, Treg cell percentage and transforming growth factor -β1 (TGF-β1) levels were examined in 73 patients with rupture of aneurysms before and at 24 h, 72 h and 1 week after operation, with 62 patients with unruptured aneurysms and 65 healthy volunteers as the control. The correlations among the immune cells, cytokines and clinical characteristics of the patients (NIHSS, ADL and hospitalization stay) were analyzed.</p><p><b>RESULTS</b>Th17 percentage and intracellular IL-17 levels were significantly higher in the patients with ruptured and unruptured aneurysms than in the healthy volunteers, and were significantly higher in patients with ruptured aneurysms than in those with unruptured aneurysms. Treg cell percentage and TGF-β1 level were significantly lower in patients with aneurysms than in the healthy volunteers, and were lower in patients with ruptured aneurysms than in those with uruptured aneurysms (P<0.05). Patients with intracranial aneurysm rupture showed significantly increased Th17 cell percentage and IL-17 level but significantly lowered Treg cell percentage and TGF-β1 at 24 h following the surgery (P<0.05); these changes were reversed significantly at 72 h and 1 week after the surgery. Th17 cell percentage and IL-17 level were positively correlated with NIHSS and the length of postoperative hospital stay but inversely correlated with ADL; Treg cell percentage and TGF-β1 were inversely correlated with NIHSS and hospital stay but positively with ADL (P<0.05).</p><p><b>CONCLUSION</b>In patients with intracranial aneurysms, the systemic immune inflammatory response is highlighted by excessive Th17 cells and insufficient Treg cells, which are closely related with the outcomes of the patients following surgical intervention. Evaluation of Th17/Treg balance and the cytokine levels can help to assess the prognosis of patients with aneurysm rupture.</p>

Changes in CD4(+)CD25(+) regulatory T cells in patients with spontaneous subarachnoid hemorrhage / 南方医科大学学报

<p><b>OBJECTIVE</b>To explore the role of CD4(+)CD25(+) regulatory T cells (Treg) in the occurrence of spontaneous subarachnoid hemorrhage (SAH).</p><p><b>METHODS</b>Fifteen patients with spontaneous SAH, 15 with traumatic SAH, and 15 with headache without organic pathologies as confirmed by lumbar puncture (control group) were examined with flow cytometry for Treg in the peripheral blood and cerebrospinal fluid and intracellular cytokine interleukin-10 (IL-10) and transforming growth factor beta1 (TGF-β1) levels. The Glasgow score (GCS), neurological deficit score (NIHSS), headache, visual analog scale (VAS) and hospitalization time were compared between the two SAH groups.</p><p><b>RESULTS</b>Spontaneous SAH patients showed significantly lowered peripheral blood Treg, IL-10, and TGF-β1 in the cerebrospinal fluid compared with the patients with traumatic SAH and the control group (P<0.05), and the 3 measurements were comparable between the latter two groups (P>0.05). After administration of treatment, of Treg content in spontaneous SAH patients increased progressively and became comparable with those in the other two groups at the third and fourth lumbar punctures. Spontaneous SAH patients showed significantly lower GCS, NIHSS, and VAS with shorter hospital stay than the traumatic SAH patients. Correlation analysis showed that Treg, IL-10 and TGF-β1 were all inversely correlated with NIHSS, VAS, and duration of hospitalization but positively correlated with GCS (the absolute r values were all greater than 0.6, P<0.05).</p><p><b>CONCLUSION</b>Treg deficiency can be an important mechanism for the occurrence of spontaneous SAH, and a higher level of Treg indicates a better outcome of the patients.</p>

Effect of environment on extremely severe road traffic crashes: retrospective epidemic analysis during 2000-2001 / 中华创伤杂志(英文版)

<p><b>OBJECTIVE</b>To make an epidemiological analysis of the effect of environment on extremely severe road traffic crashes (RTCs).</p><p><b>METHODS</b>Epidemiologic data of extremely severe RTCs associated with environmental factors, including weather, topography, road conditions and other traffic conditions in Mainland China during 2000-2001, were collected and analyzed.</p><p><b>RESULTS</b>(1) During 2000-2001, there were 3365 extremely severe RTCs with 13666 deaths, 12204 injuries and a direct economical loss of 136 million RMB. (2) Most extremely severe RTCs occurred in fine weather days and in the daytime. The high occurrence sites were plain areas, horizontal and straight roads, Grade B and C roads, ordinary road segment, and asphalt, smooth and mixed roads. (3) Compared with other RTCs, extremely severe RTCs were more likely to happen under following conditions: on cloudy, snowing, misty and blustering days; in hill and mountainous areas; on crooked and sloping roads; on freeway, Grade A, B, and C roads; mixed roads; ordinary, bridge, narrow and transitional roads; sand and dirt-roads; without traffic control measures; night without lighting. (4) Extremely severe RTCs of mountainous area or crooked and sloping roads were most severe in terms of deaths and injures per crash.</p><p><b>CONCLUSIONS</b>Extremely severe RTCs are closely related with environmental factors. Rational road programming, enhancing road establishment and improving road conditions are probably effective measures to reduce the road traffic injuries.</p>