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Objective To study the effects of different concentrations of hypertonic saline (HS) and 20%mannitol on decreasing intracranial pressure (ICP) in patients with moderate-sever traumatic brain injury (TBI). Methods A total of 60 patients were randomly assigned into 7.5%HS group, 3%HS group and 20%mannitol group, 20 patients in each group. All of patients were treated with conventional treatment according to the diagnostic and treatment practices of TBI. When ICP was above 20 mmHg for more than 5 minutes, patients were administered corresponding hypertonic dehydrator. The levels of ICP, mean arterial pressure (MAP), cerebral perfusion pressure (CPP), urine volume per hour and serum sodium were monitored continuously within 6 hours after the initiation of therapy. Results All agents could significantly decrease the ICP (P<0.05), but the onset time in 7.5%HS group was less than that of the other two groups (P<0.05), and the decreased magnitude of ICP and the effective time of decreasing ICP in 7.5%HS group were more than those of the other two groups (P < 0.05). Both 7.5%HS and 3%HS could increase MAP and CPP. There was no statistical difference in serum sodium between both groups , but the diuretic effect in both groups was worse than that of 20%mannitol group. Conclusion The rapidly infusion of 7.5%HS could significantly decrease the ICP, increase the MAP and CPP without obvious side-effect in patients with moderate-sever TBI, and which is a safe and effective therapy for intracranial hypertension after traumatic brain injury .
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Intracranial infection is a common and serious complication of acute severe traumatic brain injury, with high mortality and disability rates, which significantly affects the prognosis. In recent years, with the widespread use of antibiotics, antibiotic-resistance rates of pathogens have risen year by year, and the choice of sensitive antibiotics is less and less, sometimes even in difficulties of no drugs available. This paper reviewed the treatment process of 1 case with intracranial infection caused by multi drug-resistant Klebsiella pneumonia after severe traumatic brain injury . The aim is to summarize the clinical experience.
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Objective To investigate the protective effect of umbilical cord mesenchymal stem cells (UCMSCs) on traumatic brain injury (TBI) in rats.Methods Thirty healthy Sprague-Dawley rats (10 rats for each group) were randomly divided into normal control group (normal),model group (injection of saline after TBI) and UCMSCs transplantation group (injection of UCMSCs after TBI).The rats in experimental groups were sacrificed on the 10th day after UCMSCs transplantation.The percentage of UCMSCs in brain tissue was detected by flow cytometry.The pathological changes of brain tissue were observed by hematoxylin-eosin (HE) staining method.The expressions of vascular endothelial growth factor (VEGF),glial fibrillary acidic protein (GFAP) and brain-derived neurotrophic factor (BDNF) in brain tissue were measured by immunohistochemistry and immunofluorescence double staining.The neurological deficit was evaluated by neurological deficit degree.Results The percentage of CD90,CD73 and CD105 cells in the UCMSCs transplantation group was significandtly higher than that in the model group (0.4％ vs 0.1％,P＜0.05).The results of HE staining showed that the brain injury of the transplanted group was alleviated compared with the model group (P＜0.05).The VEGF of the brain tissue in injury area in the UCMSCs transplantation group was higher than that in the model group (P＜0.05).The number of GFAP and BDNF positive cells in the UCMSCs transplantation group was higher than that in the model group (P＜0.05),and the neurological deficit score was also higher than that in the model group (P＜0.05).Conclusions UCMSCs transplantation for the treatment of TBI rats can effectively reduce the vascular damage in the injury area and promote nerve recovery.
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Objective To investigate the effects of human umbilical cord mesenchymal stem cells (UC-MSCs ) on vascular endothelial growth factor ( VEGF ) and monocyte chemoattractant protein-1 ( MCP-1 ) of acute myocardial ischemia-reperfusion (AMI-R) injury in rats. Methods 24 Sprague-Dawley rats were randomly divided into sham group, AMI-R group and UCMSCs treatment groups on average. The rats were sacrificed on the 10th day after UCMSCs transplantation, and the myocardial tissues below the ligature were taken. The mRNA and protein expressions of MCP-1 of the tissue were detected by RT-PCR and Western Blot respectively, and the expression of VEGF protein was detected by immunohistochemistry. Results The relative expression levels of MCP-1 mRNA and the protein in UCMSCs group were significantly lower than those in sham group and AMI-R group (all P<0.05). The expression of VEGF protein in UCMSCs group was significantly higher than that in sham group and AMI-R group, the differences were statistically significant(all P<0.05). Conclusion UCMSCs transplantation can promote the angiogenesis and decrease the inflammation reaction in the treatment of acute myocardial ischemia-reperfusion injury.
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@# Objective To study the effects of stereotactic technique on hypertensive basal ganglion hemorrhage. Methods 160 patients with hypertensive basal ganglion hemorrhage were divided into 2 groups: surgical group （132 cases）and conservative group （28 cases）. They were assessed with clinical neurologic impairment scale before and 2 weeks and 4 weeks after treatment. The incidence of rehemorrhage was compared. Results The neurologic impairment scores in surgical group and conservative group were (33.90±3.54) and (33.61±3.82) before treatment (P>0.05), (20.89±3.10) and (26.18±3.61) 2 weeks after treatment (P<0.01), (10.28±2.01) and (15.68±3.28) 4 weeks after treatment (P<0.01), respectively. The incidence of rehemorrhage in surgical group and conservative group were 6.1% and 10.7% (P>0.05), respectively. Conclusion The stereotactic technique may recover neurological function much faster.