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Objective To investigate the therapeutic effects of Xingzhi Yinao (XZYN) particles combined with hyperbaric oxygen therapy on cognitive impairment and motor dysfunction in patients with delayed encephalopathy after acute carbon monoxide poisoning (DEACMP). Methods Sixty-seven patients with DEACMP were admitted to the Affiliated Yantai Yuhuangding Hospital of Qingdao University from January 2011 to December 2015, and they were randomly divided into a control group (given conventional treatment such as inhalation of oxygen, cytidine diphosphate cholin and vitamin B, 19 cases), a hyperbaric oxygen (HBO) treatment group (given conventional treatment + hyperbaric oxygen therapy once a day, 24 cases) and a XZYN particles treatment (XZYN group, given conventional treatment, hyperbaric oxygen and XZYN particles, 24 cases), the therapeutic course being 2 months in the three groups. Before and after treatment for 1 and 2 months, the cognitive function and motor function of the patients were evaluated by the use of activity of daily living (ADL) scale, Montreal cognitive assessment (MoCA) scale, and mini-mental state examination (MMSE) scale; the severity of cerebral white matter injury was assessed by age related white matter changes (ARWMC) scale; and the electromyographic evoked potential was used to detect the amplitude and latency of P300 to assess the severity of cognition impairment and prognosis. Results With the prolongation of therapeutic time, after treatment, the neurological function scores of ADL, MoCA, MMSE and amplitude of P300 were increased, while ARWMC was decreased and the latency of P300 was shortened gradually in the three groups, and the changes of above indexes after treatment for 2 months in XZYN group were more significant than those in either HBO group or control group[ADL score: 70.2±8.3 vs. 60.5±8.1, 23.0±6.1, MoCA score: 26.1±3.1 vs. 22.2±2.7, 18.2±3.6, MMSE score:25.9±4.1 vs. 22.4±3.5, 18.1±4.5, ARWMC score: 7.0±2.1 vs. 8.7±2.2, 15.2±3.3, latency of P300 (ms):332.9±20.4 vs. 352.5±23.6, 381.7±30.3, amplitude of P300 (μV): 6.5±1.6 vs. 5.6±1.3, 4.1±1.5, all P < 0.05]. Conclusion The hyperbaric oxygen therapy combined with XZYN particles for treatment of patients with DEACMP can significantly improve their cognitive and motor functions and ameliorate the severity of cerebral white matter injury.
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Objective To investigate the therapeutic effect of oxiracetam combined with dexamethasone for treatment of patients with severe acute carbon monoxide poisoning (ACOP).Methods Eighty-seven patients with severe ACOP admitted to Affiliated Hospital of Xuzhou Medical University from January 2013 to July 2016 were enrolled, and they were divided into observation group (47 cases) and control group (30 cases) according to random number table method. The two groups were given conventional nerve nutrition, hyperbaric oxygen and symptomatic treatment, while in the observationgroup, on the basis of conventional treatment the patients received intravenous drip of dexamethasone 5 mg (with addition of normal saline 100 mL), once a day for consecutive 3 days, and intravenous drip of oxiracetam 3.0 g plus 100 mL normal saline, once a day for consecutive 7 days. The changes of mini-mental state examination (MMSE), Barthel index and Glasgow coma scale (GCS) were observed after discharge for 30 days, and the differences of the incidence of delayed encephalopathy after acute carbon monoxide poisoning (DEACMP) and hospitalization time between the two groups were compared.Results After treatment the MMSE and GCS scores of the two groups were higher than those before treatment, and the Barthel score was lower than that before onset. After discharge for 30 days, MMSE score (26.93±2.92 vs. 24.20±6.82), GCS (14.41±1.32 vs. 13.98±2.13), Barthel (94.78±12.62 vs. 85.25±19.57) of the observation group were significantly higher than those of control group, and the incidence of DEACMP was obviously lower than that in the control group [8.5% (4/47) to 17.5% (7/40)], the differences between the two groups being statistically significant (allP 0.05).Conclusion Early combined application of oxiracetam and dexamethasone can significantly improve the cognition and self-care abilities and reduce the incidence of DEACMP in patients with severe ACOP after discharge for 30 days.
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OBJECTIVE: To observe the mouse nerve growth factor on early intervention in rats with acute carbon monoxide intoxication delayed encephalopathy control effects, and preliminarily discuss the pathogenesis of delayed encephalopathy. METHODS: Ninety-two weight only 180-230 g, male Wistar rats were randomly divided into two experimental groups (n=40), and a healthy control group (n=12), namely the CO poisoning group (COP) of the group; mouse nerve growth factor (NGF plays group); healthy controls (NC group). Experimental group was according to 150 mL·kg-1 intraperitoneal injections of CO in the preparation of animal model of acute carbon monoxide poisoning, in the control group rats were injected with equal volume of air. NGF group rats were injected within 30 min after poisoning muscle injection of mouse nerve growth factor, once a day, every time 18 μg·kg-1, total 7 days; Control group and the COP were given intramuscular isodose physiological saline. NGF group rats were treated with 18 μg·kg-1·d-1 NGF (total 7 times); NC group and COP group treated with the same dose saline. 90 min, 7 day, 14 day and 21 day groups of rats serum myelin basic protein (MBP) levels were monitored. The routine preparation of brain tissue frozen pathology slice, line HE and MBP immunohistochemical staining. Animal intelligence is assessed by Morris water maze experiment, in the 120 s in rats to determine correctly through the platform number less than 3 times DEACMP. RESULTS: All rats showed typical toxic after CO poisoning. Experimental group rats died 29, including COP death cases in the group, the model NGF group of 15, 14, mortality rates were 37.50%, 35.00% respectively. Morris water maze experiment results showed that the COP in the group 8 rats were judged to be delayed encephalopathy; model NGF group has 5 only be judged to be delayed encephalopathy; COP group rats serum MBP content increased significantly, model NGF group close to normal.Differences were obvious in poisoning after 7 days, 14 days.Pathological examination showed the COP group delayed encephalopathy rats in poisoning 90 min-21 d in hippocampus, subcortical neurons damage, such as myelin basic protein depigmentation pathological changes.The above pathological changes can be observed in each group, the COP group rats lesion severity is heavy, model NGF group was lighter. CONCLUSION: Mouse nerve growth factor can significantly reduce the incidence of delayed encephalopathy in rats, but can't reduce the mortality. Myelin basic protein (MBP) in the pathogenesis of delayed encephalopathy may play an important role.
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Objective To explore the relative factors on delayed encephalopathy after acute carbon monoxide poisoning(DEACMP)and the signifiance of P 300 for judging the severity and prognosis of DEACMP.Methods Thirteen aspects such as contact time with carbon monoxide (CO)?coma time et al were analysed between 44 patients with DEACMP (DEACMP group)and 42 patients with acute CO poisoning but without DEACMP (ACMP group). P 300 s were studied in the patients with P 300 as compared with the patients had just caught acute CO poisoning (DEACMP group).and 44 normal controls (NC group).Results There was extremely significant difference in contact time with CO,coma lasting time,treatment time with hyperbaric oxygen,age,complication ( P