ABSTRACT
Objective To investigate the clinical efficacy and treatment method for no midline shift-severe craniocerebral trauma accompanied with post-traumatic acute diffuse brain swelling (PADBS).Methods 60 PADBS patients were randomly divided into conservative treatment group and operation group,30 patients in each group.The operation group was treated with intracranial pressure monitoring by implantation of the probe and decompressive craniectomy,while the conservative treatment group received conservative treatment.The postoperative recovery was observed.Results The GCS scores of operation group postoperative 7d and 15d were (11.21 ± 2.24) and (12.88 ±2.31),which were obviously higher than (7.47 ± 1.51) and (8.19 ± 1.28) of the conservative treatment group (t =2.215,2.321,all P ＜ 0.05).Postoperative long-term follow-up results indicated that,according to GOS score,63.3％ patients in the operation group recovered well,which was significantly higher than 26.7％ in the conservative treatment group.While the percent of patients with coma or dead was 6.7％ and 10.0％ in the operation group,which were significantly lower than the conservative treatment group (x2 =15.721,4.172,3.84,all P ＜ 0.05).Conclusion In general,PADBS could not be cured easliy,the operation methods of using intracranial pressure monitoring and decompressive craniectomy based on conservative treatment could help to evaluate the trauma objectivly,detect the changes of disease earlier,treat in time and assess the prognosis accurately,all which would reduce the mortality.
ABSTRACT
Objective To investigate the effect of brain derived neurotrophin factor (BDNF) transfected with cationic liposome in protecting nerve tissue and promoting regeneration of the myelin sheath. Methods Wistar rat Schwanns cells (SWCs) were cultured in vitro. The recombinant cationic liposomes mediated PCDNA 3 BDNF was transplanted into SWCs and then into electrical reticular lesion of the brain stem (Group Ⅰ). At the same time, pure cell transplantation group (Group Ⅱ), empty transfected vector cell transplantation (Group Ⅲ) and normal saline injection group (Group Ⅳ) were set. The concentration of BDNF in the brain stem was measured by ELISA, the survival of myelinated basic protein (MBP) and SWCs in the brain stem by immunohistochemistry and the regeneration of the myelin sheath by the transmission electron microscope (TEM). Results One week after transplantation, the concentration of BDNF in the brain stem in the Group Ⅰ was much higher than that in other three groups ( P