ABSTRACT
Objective:To investigate the role of basic fibroblast growth factor (bFGF) in decreasing intracranial pressure in rats after intra-abdominal hypertension (IAH).Methods:A total of 60 healthy SD rats were selected for the experiment. Secondary IAH rat models were established by hemorrhagic shock/resuscitation, followed by injecting nitrogen into the peritoneal cavity of the rats to maintain an intra-abdominal pressure of 12mmHg and above. According to the random number table, the rats were divided into control group, IAH group, IAH+ bFGF group (bFGF group) and IAH+ bFGF+ PD173074 group (antagonist group), with 15 rats per group. Indicators were measured 4 hours after injury, including intracranial pressure, brain morphological observation, apparent diffusion coefficient (ADC) value, lactic acid content of brain MRI, brain water content and Evans blue exudation. Immunofluorescence staining, Western blotting and PCR were used to detect the expressions of phosphorylate-fibroblast growth factor receptor 1, 2 (p-FGFR1, 2), Zonula occludens-1 (ZO-1), β-catenin, matrix metalloproteinases 9 (MMP9), interleukin-1β (IL-1β) in brain microvascular endothelial cells (BMECs).Results:The intracranial pressure in IAH group [(5.52±0.45)mmHg] gradually increased 4 hours after injury compared control group [(3.36±0.30)mmHg]. Compared with IAH group, the intracranial pressurein bFGF group [(4.46±0.41)mmHg] was decreased ( P<0.05). Compared with bFGF group, the intracranial pressure in antagonist group [(5.36±0.44)mmHg] was enhanced ( P<0.05). Brain morphological observations in IAH group showed swelling and obvious cerebral edema, accompanied with a small amount of subarachnoid hemorrhage. Compared with IAH group, cerebral edema and brain swelling were relieved in bFGF group, while the antagonist group still showed cerebral edema and obvious brain swelling. At 4 hours after injury, MRI examination showed that the relative ADC value in IAH group (cortex: 0.82±0.11, corpus callosum: 1.26±0.17) was lower than that in control group (cortex: 1.00±0.13, corpus callosum: 1.43±0.15)( P<0.05). Compared with IAH group, the relative ADC value in bFGF group (cortex: 0.94±0.16, corpus callosum: 1.36±0.16) was increased ( P<0.05). Compared with bFGF group, the relative ADC value in antagonist group (cortex: 0.87±0.13, corpus callosum: 1.30±0.14) was decreased ( P<0.05). Relative lactic acid content in IAH group (cortex: 15.50±2.14, corpus callosum: 10.82±1.90)was higher than that in control group (cortex: 1.00±0.23, corpus callosum: 0.70±0.20)( P<0.05). Compared with IAH group, the relative lactic acid content in bFGF group (cortex: 10.85±1.42, corpus callosum: 6.96±1.30) was decreased ( P<0.05). Compared withbFGF group, the relative lactic acid content in antagonist group (cortex: 13.71±1.61, corpus callosum: 9.12±1.52) was increased ( P<0.05). The brain water content in IAH group [(87.9±0.8)%] was higher than that in control group [(76.3±0.9)%]. Compared with IAH group, the brain water content in bFGF group [(83.2±1.0)%] was decreased( P<0.05). Compared with bFGF group, the brain water content in antagonist group[(85.4±0.8)%] was increased ( P<0.05). Evans blue exudation in IAH group [(3.22±0.29)μg/ml] was greater than that in control group [(0.42±0.22)μg/ml]( P<0.05). Compared with IAH group, the Evans blue exudation in bFGF group [(2.04±0.25)μg/ml] was decreased ( P<0.05). Compared with bFGF group, the Evans blue exudation in antagonist group [(2.92±0.20)μg/ml] was increased ( P<0.05). Compared with control group, the expression of p-FGFR1 in BMECs in IAH group was weakened 4 hours after injury, but p-FGFR2 remained unchanged, the expressions of ZO-1, β-catenin protein and mRNA were weakened, and the expressions of MMP9, IL-1β protein and mRNA were enhanced ( P<0.05). Compared with IAH group, the expressions of p-FGFR1, ZO-1, β-catenin protein and mRNA were enhancedin bFGF group, and the expressions of MMP9, IL-1β protein and mRNA were weakened as well ( P<0.05). However, the expressions of p-FGFR1, ZO-1 and β-catenin protein and mRNA in antagonist group were weaker than those in bFGF group, and the expressions of MMP9 and IL-1β protein and mRNA were stronger than those in the bFGF group ( P<0.05). Conclusion:After IAH, the rat model presents damaged blood-brain barrier, increased cerebral edema, and increased intracranial pressure, and the use of bFGF can improve these symptoms. FGFR1 of BMECs is a key receptor for bFGF to play a protective role, and its receptor inhibitor PD173074 can attenuate the protective effect of bFGF.
ABSTRACT
Objective To compare the clinical effect of spring coil embolization under auxiliary technology and stent implantation spring coil embolization in treatment of intracranial aneurysms.Methods The medical records of 102 patients with intracranial aneurysms who were treated by endovascular embolization were retrospectively analyzed.These patients were divided into stent implantation spring coil embolization (n=58) and aux iliary spring coil embolization group(n=44) according to different treatment methods.The therapeutic effect of postoperative aneurysm embolization for patients of the two groups was evaluated.The postoperative hospitalization time,NIHSS score,ADL score and prognosis of patients in the two groups 6 months after treatment were compared.The incidence of complications of patients in the two groups was compared.Results There was no significant difference between the two groups about complete embolization rate,sub-total embolization rate and partial embolization rate after aneurysm surgery(72.73％,20.45％,6.82％ vs 68.97％,25.86％,5.17％)(P＞0.05).The postoperative hospitalization time of patients in the assistive coil embolization group (10.45±2.32) d was significantly less than that in the stent-assisted coil embolization (12.97±2.56) d (P＜0.05),but there was no significant difference in postoperative NIHSS score and ADL score between the two groups [(6.63±3.81),(60.12±9.80) vs (8.35±4.03),(59.63±9.47)(P＞0.05)].The recovery rate of patients in the assistive coil embolization group (68.18％) was significantly higher than that in the stent-assisted coil embolization group (55.17％) (P＜0.05),while the mortality rate (0％) was significantly lower than that in the stent-assisted coil embolization group (6.90％) (P＜0.05).The incidence of complications such as intraoperative cerebral vasospasm,postoperative gastrointestinal bleeding and postoperative cerebral infarction (9.09％,6.82％,4.55％) was significantly lower in the assistive coil embolization group than that in the stent-assisted coil embolization group (25.86％,20.69％,17.24％) (P＜0.05),while there was no significant difference in aneurysm recurrence rate between the two groups (13.64％ vs 10.34％)(P＞0.05).Conclusion Compared with stent implantation spring coil embolization,the spring coil embolization under auxiliary technology can significantly shorten the postoperative hospitalization time,improve the prognosis and reduce the incidence of postoperative complications.
ABSTRACT
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 .