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Objective To analyze the changes of serum levels ofαII-spectrin breakdown products (SBDPs)in traumatic brain inj ury (TBI)patients,and further to investigate the clinical diagnosis value of SBDPs for patients with TBI,especially with mTBI.Methods The serum levels of SBDPs were examined in 43 severe TBI (sTBI)patients,43 mild TBI (mTBI)patients and 43 healthy controls using enzyme linked immunosorbent assay (ELISA).The diagnostic usefulness of SBDPs for TBI patients were assessed by Receiver Operating Characteristic (ROC)curves analysis.Results There was no significant difference of SBDP145 among the three groups (F=1.340,P>0.05).Serum levels of SBDP120 in controls,mTBI and con-trols were 7.06±2.23,11.67±9.14 and 12.64±11.44 ng/ml,respectively.Compared with controls,serum levels of SB-DP120 were significantly higher in patients with sTBI (F=9.873,P=0.001)and mTBI (F=9.873,P=0.008),while there was no significant difference of SBDP120 between sTBI patients and mTBI patients (F=9.873,P=0.515>0.05). The area under ROC curve (AUC)of SBDP120 for TBI patients was 0.781 (95% CI:0.690~0.872,P<0.001).For mTBI patients,the area under ROC curve was 0.736 (95% CI:0.624~0.848,P<0.001).And for discriminating TBI patients with CT negative or positive,the area under ROC curve was 0.709 (95% CI:0.582~0.837,P=0.007<0.01).Conclusion The serum levels of SBDP120 were significantly increased in TBI patients,especially mTBI patients.And the serum levels of SBDP120 can be used as potential non-invasive biomarker for mTBI patients.
ABSTRACT
Objective:To explore the risk factors of delayed traumatic intracranial hematoma (DTICH)followed by unilateral large decompressive craniectomy (LDC)and its influence in the prognosis of the severe traumatic brain injury (sTBI)patients,and to improve the successful rate of the rescue.Methods:The clinical data of 130 sTBI patients underwent unilateral LDC were retrospectively analyzed.The patients were divided into DTICH group (n=42)and non-DTICH group (n=88)according to whether the DTICH occurred after operation.The risk factors of DTICH and its influence were contrastively analyzed.Results:The analysis results of the clinical data of patients in two groups showed that preoperative GCS,time from trauma to operation,skull fracture,midline shift > 1 cm, basal cistern disappear,activated partial prothrombin time (APTT),fibrinogen (FIB),and thrombin time (TT) were significantly correlated with the appearance of DTICH (P<0.05).Multivariable Logistic regression analysis showed that the time from trauma to operation, skull fracture, basal cistern disappearing and FIB were the independent risk factors of DTICH (P<0.05).The analysis results of GOS 3 months after operation of the patients in two groups showed that the prognosis of the patients in DTICH group was significantly worse than that in non-DTICH group (P<0.01 ).Conclusion:For those patients who accompanied with shorter time from trauma to operation,skull fracture,basal cistern disappearing and FIB decrease,the appearance of DTICH should be paid attention.DTICH can affect the prognosis of patients;prevention and early diagnosis are crucial to improve the prognosis of patients.
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Objective To analyze the status of healthcare-associated infection(HAI)and characteristics of patho-gens in patients with traumatic brain inj ury and cerebrovascular diseases,and evaluate prevention and control meas-ures.Methods Clinical data of 236 patients with traumatic brain injury and cerebrovascular diseases in a hospital from 2008 to 2010 were analyzed retrospectively.Results A total of 29 patients developed 50 times of HAI,HAI rate was 12.29%,HAI case rate was 21.19%,HAI case rate of respiratory system,urinary system,oral cavity, gastrointestinal tract,skin and soft tissue,and other sites was 46.00%(n=23),30.00%(n=15),8.00%(n=4), 6.00%(n=3),4.00%(n=2),and 6.00%(n=3)respectively.A total of 69 pathogenic strains were detected,per-centage of gram-negative bacteria was 65.22%(n=45),the major were Pseudomonasaeruginosa(n=17),Klebsiel-lapneumoniae(n=12),Escherichiacoli(n=10),and Acinetobacterbaumannii(n=4);percentage of gram-positive bacteria was 30.43%(n=21),the major were Staphylococcusaureus(n=11),Staphylococcusepidermidis (n=7), Streptococcus spp.(n=2);percentage of fungi was 4.35%(n=3).Conclusion HAI in patients with traumatic brain inj ury and cerebrovascular diseases is high,the main infection site is respiratory system,the main pathogens are gram-negative bacteria.Preventive and control measures should be taken accordingly.