ABSTRACT
OBJECTIVE:To investigate the effects of Butylphthalide and sodium chloride injection on neurological function and prognosis of elderly patients with hypertensive intracerebral hemorrhage(HICH)after trepanation and drainage surgery. METH-ODS:During Jan. 2015 to Jun. 2016,80 elderly HICH patients were selected from our hospital and then divided into control group and observation group according to random number table,with 40 cases in each group. Both group received trepanation and drain-age surgery. Control group was given routine treatment. Observation group was given Butylphthalide and sodium chloride injection 100 mL,ivgtt,bid,on the fifth day after surgery,on the basis of control group. Both groups received treatment for 14 d. Clinical efficacies of 2 groups were observed. CSS scores were compared between 2 groups before surgery and 28 d after operation;volume of encephaledema,serum levels of homocysteine(HCY)and substance P(SP)were compared between 2 groups before surgery and 14 d after operation. RESULTS:The total response rate of observation group was 87.5％,which was significantly higher than 67.5％ of control group, with statistical significance (P0.05). CSS scores 28 d after operation, SP levels 14 d after operation were significanthy increased,volume of encephaledema and serum levels of HCY in 2 groups were significantly decreased,and the observation group was significantly better than the control group,with statistical significance(P<0.05). CONCLUSIONS:Butylphthalide and sodium chloride injection can significantly improve clinical efficacy and hepatic func-tion damage,relieve postoperative encephaledema,reduce serum levels of HCY and increase SP levels in elderly HICH patients af-ter trepanation and drainage surgery.
ABSTRACT
Objective To investigate the effect of combined application of mannitol and monosialoganglioside on neurological function and its efficacy in brain edema after intracerebral hemorrhage. Methods 92 cases of cerebral edema in patients with cerebral hemorrhage in our hospital, were randomly divided into groups, each group of 46 cases, the control group on the basis of the treatment of mannitol (125mL per times, once per 8h) treatment, the study group on the basic of control group received monosialogangliosides (20mg per times, once daily), 10d for a course of treatment, determination of serum indexes, neurological functions were recorded. Results The effective rate of control group was 71.74%, which was lower than 91.30% of the study group, there was significant difference (P < 0.05); compared with control group after treatment , in study group the intracranial pressure, intracranial hematoma, edema decreased, the urine volume increased, National Institutes of Health Stroke Scale (NIHSS) and quality of life score decreased, interleukin (IL-1β), high sensitive C reaction protein (Hs-CRP), IL-6 and IL-8 levels decreased, Na+-K+-ATP enzyme increased, the ratio of cerebrospinal fluid albumin and serum albumin, matrix metalloproteinase (MMP-2) and MMP-9 decreased, there were significant differences (P < 0.05). Conclusion The effect of the combined application of mannitol and monosialoganglioside on cerebral edema after cerebral hemorrhage is exact and could improve neurologic function.
ABSTRACT
Objective To observe the inhibitory effect of epigallocatechin gallate (EGCG) on encephaledema following traumatic brain injury (TBI) in rats and its mechanism.Methods 200 Wistar rats were randomly divided into three groups: sham operation (n= 20), model (n= 90) and EGCG (n= 90) groups. The classic Feeney free fall drop method was used to establish the model of TBI. In EGCG group, intraperitoneal injection of EGCG in normal saline 100 mg/kg (10 mL/kg) was immediately given to the rats after model establishment, and in model group, equal amount of normal saline was administered with the same method, once 24 hours for 2 days in all the groups. At 24, 48, and 72 hours after the administration in various groups, the changes of water content, superoxide dismutase (SOD) activity and malondialdehyde (MDA) level in brain tissues were determined, cerebral vascular permeability was evaluated by evans blue (EB) content in the brain tissues, the changes of expressions of aquaporin-4 (AQP4) and glial fibrillary acidic protein (GFAP) in brain tissues were determined by immunohistochemical and Western Blot, and the cerebral histopathological changes were observed in various groups.Results Compared with sham operation group, the water content, the vascular permeability and MDA level in brain tissues were significantly higher, while the cerebral SOD activity was significant lower in the model group; the scores of cells with positive AQP4 and GFAP expressions (IHC score) were obviously increased at 24 hours and 72 hours after model establishment, and the levels of expressions of AQP4 and GFAPprotein [integral absorbance (IA) value] were markedly enhanced in model group than those in the sham operation group, the changes being more remarkable at 72 hours after model formation [water content in brain tissues: (89.71±0.94)% vs. (78.34±0.87)%, EB content (μg/g): 9.13±0.66 vs. 2.71±0.72, SOD activity (U/mg): 63.53±12.57 vs. 130.85±9.91, MDA (nmol/mg): 10.19±1.47 vs. 4.57±0.74, IHC score of AQP4: 8.81±1.75 vs. 2.76±0.82, IHC score of GFAP: 9.47±1.32 vs. 6.71±0.52, expression of AQP4 protein (IA value): 1.53±0.05 vs. 0.42±0.05, expression of GFAP protein (IA value): 1.45±0.05 vs. 0.62±0.04, allP < 0.01]. Compared with the model group, the cerebral water content, MDA, IHC scores and protein expressions of AQP4 and GFAP, and cerebral vascular permeability were significantly decreased, while the SOD activity was obviously increased in the EGCG group, and the changes being more significant at 72 hours after model establishment [water content of brain tissues: (86.59±0.89)%, EB content (μg/g): 7.82±0.32, SOD activity (U/mg): 107.58±10.87, MDA (nmol/mg): 5.61±1.64, IHC score of AQP4: 6.92±0.71, IHC score of GFAP: 6.71±0.52, expression of AQP4 protein (IA value): 1.14±0.06, expression of GFAP protein (IA value): 1.21±0.07, all P < 0.01]. Imunohistochemical assay showed: the cerebral contents of AQP4 and GFAP positive cells in the rats of EGCG group were decreased, and their color became lighter.Conclusion The inhibition of EGCG on encephaledema following TBI in rats is related to its effects of decreasing the cerebral vascular permeability, enhancing the level of SOD activity, depressing MDA level and the expressions of AQP4 and GFAP.