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Objective To study the dynamic expression and distribution of high mobility group box 1 (HMGB-1)in diffuse axonal injury (DAI)in rats and to clarify its involvement in the inflammatory reaction after DAI in rats,in order to provide new targets for the clinical treatment of DAI.Methods A DAI model was established using a coronal rotation device and evaluated by HE,Glees-Marsland silver staining,and Mallory phosphotungstic acid hematoxylin staining.Immunohistochemistry,Western blot and RT-PCR were used to detect the expression and distribution of HMGB-1 in the cortex of DAI rats at 6 h,1 d,3 d and 7 d.And TUNEL was used to examine the apoptosis of neurons in DAI rats.Results Immunohistochemical results showed that at 6 h and 1 d after DAI,the number of HMGB-1-positive cells decreased,but at 3 and 7 d it began to increase.Western blot also showed that during the early stage after DAI (6 h and 1 d),the level of HMGB-1 protein in the cortex was significantly lower than that in the control group,but at the late stage (3 and 7 d)after DAI it significantly increased compared with that in the control group until 7 d.RT-PCR showed that at 6 h after DAI there was no significant increase in the level of HMGB-1mRNA,but at 1 d there was a slight increase compared with the control group;at 3 and 7 d,it showed an obvious significance.TUNEL staining indicated that the significant neuronal apoptosis appeared as early as 6 h after DAI,and reached the peak at 3 d;it started to decrease at 7 d but still remained at a relatively high level.Conclusion The dynamic expression and distribution of HMGB-1 showed significant changes with the time course after DAI in rats.They decreased at the early stage but increased at the late stage.At the early stage, HMGB-1 is mainly passively released by the necrotic neurons,and at the late stage it may be actively secreted by the active inflammatory cells.HMGB-1 may mediate the post-DAI neural cell apoptosis by inducing the inflammatory reaction.
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OBJECTIVE: This study was conducted to assess the clinical significance of traumatic brain stem injury (TBSI) reflected on Glasgow Coma Score (GCS) and Glasgow Outcome Score (GOS) by various clinical variables. METHODS: A total of 136 TBSI patients were selected out of 2695 head-injured patients. All initial computerized tomography and/or magnetic resonance imaging studies were retrospectively analyzed according to demographic- and injury variables which result in GCS and GOS. RESULTS: In univariate analysis, mode of injury showed a significant effect on combined injury (p<0.001), as were the cases with skull fracture on radiologic finding (p<0.000). The GCS showed a various correlation with radiologic finding (p<0.000), mode of injury (p<0.002), but less favorably with impact site (p<0.052), age (p<0.054) and skull fracture (p<0.057), in order of statistical significances. However, only GOS showed a definite correlation to radiologic finding (p<0.000). In multivariate analysis, the individual variables to enhance an unfavorable effect on GCS were radiologic finding [odds ratio (OR) 7.327, 95% confidence interval (CI)], mode of injury (OR; 4.499, 95% CI) and age (OR; 3.141, 95% CI). Those which influence an unfavorable effect on GOS were radiologic finding (OR; 25.420, 95% CI) and age (OR; 2.674, 95% CI). CONCLUSION: In evaluation of TBSI on outcome, the variables such as radiological finding, mode of injury, and age were revealed as three important ones to have an unfavorable effect on early stage outcome expressed as GCS. However, mode of injury was shown not to have an unfavorable effect on late stage outcome as GOS. Among all unfavorable variables, radiological finding was confirmed as the only powerful prognostic variable both on GCS and GOS.
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Humans , Brain , Brain Stem , Coma , Imidazoles , Magnetic Resonance Imaging , Multivariate Analysis , Retrospective Studies , Skull FracturesABSTRACT
5.Negative nitrogen balance nutritional index in the study group were significantly better than that of the control group(P
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Objective To study the therapeutic effect of sub-hypothermia on 80 patients with diffusing axonal injury (DAI) and its prognosis.Methods All 80 patients with DAI were randomly divided into the sub-hypothermia group(40 cases)and the control group(40 cases). All patients'vital sign,intracranial pressure (ICP) and blood sugar were measured. 40 cases of the patients with DAI were treated by sub-hypothermia, the rectal temperate (RT) reached 32 0℃～35 0℃,sub-hypothermia lasted for 1～7 days; the control group was treated routine. According to Glasgow Outcome Scale (GOS), the prognosis of the patients was evaluated 3 months later.Results In comparison with the control group, increased ICP and raised blood sugar in sub-hypothermia group were significantly decreased (P
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AIM: To observe the curative effect of Angong Niuhuang Bolus on diffuse axonal injury(DAI) prognosis. METHODS: 30 cases of DAI treated with Angong Niuhuang Bolus in addition to conventional modern therapy as treatment group,another 30 cases with modern therapy only as control group,the curative effect of Angong Niuhuang Bolus on DAI was observed and analyzed through the comparisons of GCS,clinical effectiveness and death rate. RESULTS: GCS of treatment group was higher than that of the control group(P
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Objective To investigate the indicators for identifying diffuse axonal injury by blunt forces in forensic pathological practice. Methods The DAI model was produced by the fluid - percussion method in cats. The cerebral samples were stained by H. E. , Bodian, Kluver - Barrera stain and NF Immunohistochemistry. Changes of axons and myeline sheath were observed at different intervals after injury. Positive NF immunostained area in axons was measured, and the data was analyzed by SPSS 11.5 for windows. Results Changes of axons in subcortical white matter and brainstem were observed in the forms of swollen, waved and distorted axons in early stage after injury (1-2 hours). Markedly torn, vacuolated axons with formation of the retraction balls from 4 hours after injury were specifically demonstrated in NF immunohistochemistry (P