ABSTRACT
Objective To study the expression of aquaporin-4 (AQP-4) in core and marginal region of the contusion brain tissues from patients with severe traffic brain injuries. Methods Thirty patients with severe traffic brain injuries (frontal-temporal brain contusion) admitted into our department from January 2007 to July 2009 were enrolled in the study and divided into three groups according to the period from injury to operation, ie, 0-4 hours (Group A), 5-8 hours (Group B) and 9-12 hours (Group C). The tissue was collected from core and marginal regions of brain contusion in each group. Ten parts of normal brain tissues obtained from the cerebellum to gain good exposure of CPA region tumors were used as control. The expression of AQP-4 in the normal brain tissues and in the tissues from core and marginal region of brain contusion, with GAPDH used as a control. Results The expression of AQP-4 in the marginal region was distinctly higher than that in normal tissues and in the tissues from core region. The AQP-4 expression in the tissues of the core region was lower than that in normal tissues. Conclusions AQP-4 is highly expressed in the tissues from the marginal region early after injury in a time-dependent fashion. Low expression level of AQP-4 in the core region is possibly correlated with early damage of blood brain barrier and peripheral structures.
ABSTRACT
Objective To dynamically observe the effect of mild hypothermia on concentration of plasma S-100B protein in patients with acute severe brain injuries so as to further explore its role in treat-ment of acute severe brain injury. Methods A total of 120 patients with acute severe brain injuries were randomly divided into mild hypothermia group and general group. The patients in mild hypothermia group were treated with mild hypothermia besides conventional therapy, with maintenance of rectal tem-perature at 33℃-35℃ for 3-5 days. Serial concentration of S-IOOB protein in serum was measured in all patients from 6 hours to 6 days after hospitalization. GOS evaluation was done three months after treat-ment. Results The concentration of S-100B protein in serum of mild hypothermia group and general group was significantly higher than of normal group (P <0.05), with significant lower level in mild hypo-thermia group than general group(P <0.05). Mild hypothermia could improve prognosis of patients with acute severe brain injury. Conclusions Early use of mild hypothermia can decrease concentration of S-100B protein in serum, protect neurofunction and improve prognosis, as may be related to its function in alleviating damnification brain cell inflammation reaction mediated by S-100B protein.
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Objective To discuss significance of continuous monitoring of jugular venous oxygen saturation(S_(jv)O_2)in the course of mild hypothermia treatment(MHT)for severe traumatic brain injury (sTBI).Methods Intracranial pressure(ICP),S_(jv)O_2 and brain tissue pressure(P_(bt)O_2)were contin- uously monitored in 36 cases with sTBI for analyzing the correlation between S_(jv)O_2 and P_(bt)O_2.Results (1)There was negative linear correlation between P_(bt)O_2 and ICP(r=-0.978,P＜0.05),negative lin- ear correlation between S_(jv)O_2 and ICP(r=-0.947,P＜0.05)and positive linear correlation between P_(bt)O_2 and S_(jv)O_2(r=0.965,P＜0.05)within 24 hours and at 36 hours and 48 hours after injury.(2) The cases with decreased S_(jv)O_2 value had a worse outcome than those with normal S_(jv)O_2.meanwhile,the cases with abnormal increase of S_(jv)O_2 value had worse prognosis.Prognnsis was improved significantly with increase of S_(jv)O_2 in certain range(P＜0.05).Conclusion Continuous monitoring of S_(jv)O_2 can reflect the condition of hemicerebral oxygen metabolism and guide treatment and predicting outcome.
ABSTRACT
Objective To set up an animal model with severe head injury that is similar to clinical condition and treated with mild hypothermia. Methods A total of 120 SD rats were randomly divided into eight groups (n=15 in each group), ie, before cooling, cooling 6, 12, 24, 48, 72, 96 and 120 hours groups. The model was induced by dropping a object of 60 g from a height of 50 cm onto the epidura and treated with mild hypothermia (32-34℃). Blood pressure and ECG were observed and serum K+, Na+ and Mg 2+levels measured. The change of neuron microstructure in rat cerebral traumatic tissue of every group was observed by transmission electron microscope (TEM). Results Animal mortality increased but serum K+ and Mg 2+levels gradually decreased with the treating time lasting. Serum Na+ showed insignificant change. Bradytachycardia occurred in one rat of 72 hours group, two of 96 hours group and two of 120 hours group. TEM showed that the rat’s encephaledema presented gradual relief trend during mild hypothermia treatment. There was one rat in 96 hours group and one in 120 hours group with diffuse tubuli renales necrosis. Conclusion The established model is in conformity with the characteristics of vital sign, serum electrolyte and cerebral microstructure of clinical severe head injury treated with mild hypothermia.