ABSTRACT
Objective To investigate the effect of cisternostomy on the prognosis of patients with traumatic brain injury (TBI).Methods A retrospective case control study was conducted to analyze the clinical data of 46 patients with TBI admitted to Shanxi Dayi Hospital from May 2017 to September 2018.There were 37 males and nine females,aged 24-80 years [(49.8 ± 15.7)years].The injury severity score (ISS) was 6-42 points [(25.0 ± 8.2)points],and the Glasgow Coma score (GCS) was 3-14 points [(3.4 ± 1.7) points].Twenty-three patients underwent routine surgery only (control group),and 23 patients underwent cisternostomy (cisternostomy group) on the basis of routine surgery.Intracranial pressure monitoring was performed in both groups before surgery.The postoperative intracranial pressure,intracranial pressure 1 week after operation,postoperative mechanical ventilation time,neurosurgical ICU (NICU) time,postoperative dehydration dose,decompressive craniectomy rate,postoperative infection rate,mortality rate,length of hospital stay,GCS at discharge,and Glasgow outcome score (GOS) of 3 months of follow-up were compared between the two groups.Results Compared with the control group,the cistemostomy group had lower postoperative intracranial pressure [(7.1 ± 5.7) mmHg vs.(14.2 ± 12.0) mmHg)],intracranial pressure 1 week after operation [(11.8 ± 0.5) mmHg vs.(14.0 ± 0.7) mmHg],postoperative dosage of dehydrating agent [0 (0-500.0) ml vs.1 275 (787.5-3 812.5) ml] and decompression rate (57％ ∶ 91％) (P ＜ 0.05).There were no significant differences between the cistemostomy group and control group in postoperative mechanical ventilation time [120 (42.0-225.0)hours vs.89(65.5-203.5)hours],NICU time [236(182.0-340.5)hoursvs.281 (114-400)hours],postoperative infection rate (4％ vs.0),mortality rate (13％ vs.39％) and hospital stay [32 (20.0-44.5) hours vs.25 (12.0-30.5)hours] (P ＞ 0.05).The cisternostomy group had higher GCS score at discharge than the control group [(10.7 ± 4.2) points vs.(7.9 ± 4.2) points] (P ＜ 0.05).After 3 months of follow-up,18 patients in the cisternostomy group showed good prognosis,better than that in the control group (11 patients) (P ＜ 0.05).Conclusion For TBI patients,cisternostomy can clear the blood cerebrospinal fluid,reduce harmful metabolic products in the brain,reduce intracranial pressure and hence improve the prognosis of patients.
ABSTRACT
Objective To investigate the role of endoplasmic reticulum stress ( ERS) in human brain gliomas cell(SHG-44) apoptosis induced by proteasome inhibitor MG-132. Methods Human glioma cells were passage cultured. Glioma cells were treated by MG-132 with varying concentration(5, 10, 15 and 50 μmol/L) for 24 h. Compared with cells prior to the treatment (control group), cell viability was detected by MTT assay and the expression of ERS associated proteins GRP78 and apoptosis associated proteins Caspsse-12 was examined by PCR and Western-blotting. Results After MG-132 treatment for 24 h, SHG-44 cell viability was decreased significantly (39 %) (P <0.05), and continued to show a significant decline with the increasing concentration of MG-132 (P <0.05). RT-PCR results showed that the expression of ERS associated proteins GRP78 in SHG-44 cells were significantly increased after 5, 10, 15 and 50 μmol/L MG-132 treatment, and the expression of Caspase-12 was significantly increased after 5 μmol/L MG-132 treatment, slightly increased after 10 and 15 μmol/L treatment compared with that after 5 μmol/L treatment and reached the peak after 50 μmol/L treatment. Western-blotting results of GRP78 in SHG-44 cells were same as results of RT-PCR. Conclusion ERS may be involved in the apoptosis of gliomas cells induced by proteasome inhibitor MG-132.