ABSTRACT
Objective:To observe the effect of hyperbaric oxygen (HBO) therapy on the pituitary function of patients with subacute traumatic brain injury.Methods:Sixty-six patients with subacute traumatic brain injury and hypopituitarism were randomly divided into a control group ( n=33) and an HBO group ( n=33). Patients in both groups were given conventional treatment including dehydration to reduce intracranial pressure, anti-infection medication, epilepsy and bed sores prevention measures, neurotrophic treatment, fluid replacement and rehabilitation. The HBO group was additionally given HBO at 0.2MPa (2.0ATA), once a day, 6 times a week for a total of 20 administrations. Before and after the treatment, serum adrenocorticotropic hormone (ACTH), growth hormone (GH), thyroid stimulating hormone (TSH), prolactin (PRL), luteinizing hormone (LH), follicle stimulating hormone (FSH), cortisol, insulin-like growth factor 1, free tetraiodothyronine, testosterone, and estradiol levels were detected using chemical immunoluminescence. The ACTH, GH, TSH, PRL, LH and FSH values were used to calculate general pituitary hormone scores. Results:After the treatment, the average PRL, LH and testosterone levels and the general pituitary hormone score in the HBO group were significantly higher than among the controls.Conclusions:HBO treatment can increase the levels of various hormones in patients with subacute traumatic brain injury and promote the recovery of pituitary function.
ABSTRACT
Objective To observe any effect of hyperbaric oxygen therapy on cognitive dysfunction caused by traumatic brain injury,and to explore possible neural mechanisms.Methods Sixty-four patients with cognitive impairment after a traumatic brain injury were randomly divided into a hyperbaric oxygen group (n =32) and a control group (n=32) using a random number table.Both groups accepted routine medical therapy and cognitive rehabilitation training,but the hyperbaric oxygen group additionally received hyperbaric oxygen treatment.Both groups' cognitive functioning was assessed using the Mini Mental State Examination (MMSE) and the Montreal Cognitive Assessment (MoCA) before and after the treatment.Fifteen patients were randomly selected from both groups to receive T1WI and diffusion tensor imaging scans.The correlation between the two evaluation resuhs was analyzed.Results After the intervention,improvement was observed in the average MMSE and MoCA scores of both groups,with the improvement in both average scores in the hyperbaric oxygen group significantly greater than among the control group.There was no significant correlation between the fractional anisotropy (FA) values of damaged white matter and the average MMSE or MoCA score in the controi group,but in the hyperbaric oxygen group there were significant positive correlations between the FA values of the corpus callosum,the anterior limb of the internal capsule and the left superior longitudinal fasciculus and the average MMSE and MoCA scores.Conclusions Hyperbaric oxygen therapy combined with rehabilitation training can further improve cognition after a traumatic brain injury.This is probably due to its adjusting the structure and function of the corpus callosum,of the anterior limb of the internal capsule and of the left superior longitudinal fasciculus.
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Objective To investigate the effects of hyperbaric oxygen (HBO) on homing of exogenous bone marrow mesenchymal stem cells (BMSCs) after traumatic brain injury (TBI) in rats. Methods BMSCs were isolated and cultured with Ficoll density gradient centrifuga-tion, and the surface markers (CD29, CD90, CD45, CD11b) of the third generation were identified with flow cytometry. The authenticated BM-SCs were processed by the cell membrane fluorescent probe CM-DiI before transplantation. Thirty-six Sprague-Dawley rats were divided in-to Sham group (n=6), TBI group (n=6), BMSCs group (n=12), HBO+BMSCs group (n=12). The number and locations of homing of tracing BMSCs were observed under fluorescent microscope after frozen sections, and the expression of stromal cell-derived factor 1 (SDF-1) and CXC chemokine receptor type 4 (CXCR4) proteins were detected with Western blotting one and three days after BMSCs transplantation. Re-sults The fluorescence-labeled BMSCs focused on the injured hemisphere, especially around the damaged brain tissue. The number of hom-ing was more in HBO+BMSCs group than in BMSCs group at the same time (P<0.01), and increased in both groups three days after trans-plantation compared with those of one day after transplantation (P<0.01). The expression of SDF-1 and CXCR4 protein were more in HBO+BMSCs group than in BMSCs group (P<0.05). Conclusion HBO can promote the exogenous BMSCs homing to damaged brain tissue in rats after traumatic brain injury, which is related to the enhancement of SDF-1/CXCR4 axis.