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BACKGROUND: Previous clinical studies have found that acupoint dressing therapy using Expectorant Choking Formula is effective in improving swallowing function in patients with post-stroke swallowing disorders, but the mechanism of action is unclear. In the brainstem swallowing center, the nucleus ambiguus is the main component of the swallowing center in the ventral region, which can induce swallowing movements and swallowing time, while glutamate receptors, γ-aminobutyric acid receptors, and c-fos protein in the nucleus ambiguus are closely related to swallowing. OBJECTIVE: To investigate the effects of acupoint dressing therapy using Expectorant Choking Formula on the expression of glutamate receptors, γ-aminobutyric acid receptors, and c-fos protein in the nucleus ambiguus of rats with ischemia-reperfusion injury, and to investigate the mechanism of swallowing disorder in rats with cerebral ischemia-reperfusion treated by acupoint dressing therapy using Expectorant Choking Formula. METHODS: Seventy Sprague-Dawley rats were randomly divided into normal group (n=16), ischemia-reperfusion injury model group (n=18), patching group (n=18), and sham patching group (n=18). The model group, patching group, and sham patching group were modeled by reperfusion after 90 minutes of transient cerebral ischemia using the thread-occlusion method. After 6 hours of modeling, neurological function was scored and the rats with a score of 2 were selected for subsequent experiments. The rats were treated with acupoint dressing therapy using Expectorant Choking Formula on the second day of modeling, the sham patching group was given drug-free dressing on the basis of the model preparation, and the other two groups were kept normally for 1 month. Body mass, swallowing initiation response time and the number of swallows were recorded in each group on days 2, 7, 14 and 30 after modeling. After 4 weeks of treatment, the water content in brain tissue was measured; the expression of gamma-aminobutyric acid A receptor α1, N-methyl-D-aspartate receptor 1 and c-fos protein in the nucleus ambiguus of the medullary swallowing center was detected by immunohistochemistry, RT-PCR and western blot. RESULTS AND CONCLUSION: Compared with the normal group, the body mass, the number of swallows within 1 minute and swallow initiation reaction time of rats in the model, patching and sham patching groups decreased on days 14 and 30 after modeling (P < 0.05), and the swallow initiation reaction time was prolonged (P < 0.05); on day 30, the body mass and the number of swallows of rats increased in the patching group compared with the model group (P < 0.05), while the swallowing initiation time was shortened (P < 0.05). After 4 weeks of treatment, the water content of brain tissue was significantly reduced in the patching group compared with the model group (P < 0.05). Compared with the model group, the positive expression and the mRNA and protein expression of gamma-aminobutyric acid A receptor α1 in the nucleus ambiguus of the medulla oblongata were increased in the patching group but still lower than those in the normal group; the positive expression and the mRNA and protein expression of N-methyl-D-aspartate receptor 1 and c-fos were decreased in the patching group but significantly higher than those in the normal group (P < 0.05). These findings indicate that the acupoint dressing therapy using Expectorant Choking Formula could improve the swallowing function of rats with post-stroke swallowing disorder, and its mechanism of action might be related to improving the degree of brain edema, regulating the neurotransmitters glutamate receptors, gamma-aminobutyric acid A receptors and c-fos protein levels in the nucleus ambiguus. [ABSTRACT FROM AUTHOR]

Objective To investigate the neuroprotective effect of ibuprofen on ischemic stroke (IS) rats by regulating nuclear factor E2-related factor 2 (Nrf2)/non-glycosylated xCT (SLC7A11 )/glutathione peroxidase 4 (GPX4) signaling pathway. Methods Forty eight IS rats prepared under the middle cerebral artery infarction model were randomly divided into IS group, treatment group (30 mg/kg ibuprofen), inhibitor group (30 mg/kg ML385 ), and treatment + inhibitor group (30 mg/kg ibuprofen + 30 mg/kg ML385). Another 12 rats were set as a sham-operated group, where the rats were prepared only by separating the blood vessels instead of ligating them. After intervention, the neurological function of the rats was scored, and the rate of cerebral infarction and the content of cerebral edema were detected. After that, the rat brain tissue was removed to observe the morphological changes of neurons, measure the contents of iron ion and detect the expression of proteins related to the Nrf2/ SLC7A11/GPX4 signaling pathway. Results Compared with the sham operation group, the neurological function score, cerebral infarction rate, cerebral edema content and iron ion content in IS group were significantly increased, and the expressions of Nrf2, SLC7A11 and GPX4 were obviously decreased (P < 0.05) ; compared with the IS group, the neurological function score, cerebral infarction rate, cerebral edema content and iron ion content in the treatment group were obviously decreased, and the expressions of Nrf2, SLC7A11, and GPX4 were significantly increased as well. The neuroprotection of the treatment group on IS rats was reversed in the inhibitor group. Conclusion Ibuprofen can protect nerve damage in IS rats, which may be related to the activation of Nrf2/ SLC7A11/GPX4 signaling pathway. [ABSTRACT FROM AUTHOR]

Objective To investigate the effect and mechanism of intragastric administration of pentoxifylline (PTX) on brain edema in rats with acute hepatic encephalopathy. Methods Sixty male SD rats were divided into the control group, model group, low-dose PTX [50 mg/ (kg•d)] group, medium-dose PTX group [100 mg/ (kg•d)] and highdose PTX [200 mg/ (kg•d)] group, with 12 rats in each group. From day 1 to day 3, rats in the model group, low-dose PTX group, medium-dose PTX group, and high-dose PTX group were given thioacetamide by intraperitoneal injection for 3 consecutive days to establish the rat models of acute hepatic encephalopathy. Rats in the control group were given the same volume of normal saline through intraperitoneal injection. From the 4th day of the experiment, rats in the low-dose, medium-dose, and high-dose PTX groups were given 50, 100, and 200 mg/ (kg•d) PTX by gavage, respectively, and rats in the model group and control group were given the same volume of distilled water by gavage for 7 consecutive days. The di⁃ et, exercise and other general conditions of rats in each group during the experiment were observed, and the body weight of rats after gavage was measured. After gavage, the mental state of rats in each group was observed by the elevated plus maze, the spontaneous movement ability (the average spontaneous movement distance per minute of rats and the per⁃ centage of central activity time) was observed by the open field test, and the spatial learning and memory ability (the plat⁃ form finding latency) was observed by the Morris water maze. Blood ammonia, alanine aminotransferase (ALT) and aspar⁃ tate aminotransferase (AST) were detected by automatic biochemical analyzer. After the rats were decapitated, the perme⁃ ability of blood-brain barrier (EB content in rat brain) was observed, the water content of brain tissues was measured, and the aquaporin 4 (AQP4) mRNA and protein in the brain tissues were detected by real-time quantitative PCR and Western blotting. The levels of tumor necrosis factor-α (TNF-α) and interleukin-1β (IL-1β) in the brain tissues were detected by ELISA. Results Compared with the control group, the rats in the model group showed decreased activity, listless spirit, loss of appetite, slow response to external stimuli, and weight loss (all P<0. 05) ； the percentage of open arm entry, the percentage of open arm retention time, the average spontaneous movement distance per minute, and the percentage of cen⁃ tral activity time decreased (all P<0. 05) ； the latency of seeking platform was prolonged (P<0. 05), the levels of blood am⁃ monia, ALT and AST increased (all P<0. 05), the content of EB in the brain tissues, the water content of the brain tis⁃ sues, and the relative expression levels of AQP4 mRNA and protein in the brain tissues increased (all P<0. 05) ； and the levels of TNF-α and IL-1β in the brain tissue increased (all P<0. 05) . Compared with the model group, the general condi⁃ tion of the rats in the high-dose PTX group was improved, and the body weight increased (P<0. 05), the percentage of open arm entry, the percentage of open arm retention time, the average spontaneous movement distance per minute, the percentage of central activity time increased (all P<0. 05), and the platform-seeking latency was shortened (P<0. 05) ； the levels of blood ammonia, ALT and AST, the content of EB in brain, the water content of the brain tissues, the relative ex⁃ pression levels of AQP4 mRNA and protein in the brain tissues, and the levels of TNF-α and IL-1β in the brain tissues de⁃ creased (all P<0. 05) . Conclusion The intragastric administration of PTX [200 mg/ (kg•d) ］ can improve brain edema in rats with acute hepatic encephalopathy, and its mechanism may be related to down-regulating AQP4 expression and re⁃ ducing TNF-α and IL-1β levels in the brain tissues. [ABSTRACT FROM AUTHOR]

Objective To investigate clinical characteristics， treatment and prognosis of acute necrotizing encephalopathy （ANE） in children. Methods Three pediatric cases of ANE were reported. Literature review was conducted from PubMed， Web of Science， CNKI and Wanfang Data in recent 10 years by using the searching word of “acute necrotizing encephalopathy” in both Chinese and English. Clinical data of children with ANE under the age of 14 who had atypical radiographic features were collected and analyzed. Results All three pediatric cases of ANE presented with fever and convulsion as the initial symptoms. CT scan of the head revealed cerebral edema alone. The patients died after rapid progression into multiple organ dysfunction syndrome （MODS）. After literature review， 19 pediatric cases of ANE with atypical radiographic features were collected. Clinical efficacy of combined use of high-dose glucocorticoid （hormone） shock， intravenous infusion of human immunoglobulin， plasma exchange， antiviral and targeted therapy remained elusive. A majority of survivors developed sequela. Conclusions ANE is a rare disease with rapid progression， extremely high mortality， poor prognosis and unknown pathogenesis. No effective treatment is available. Previously， diagnostic criteria of ANE are determined based on typical MRI features， which are not in accordance with clinical practice and may delay the diagnosis and treatment. Therefore， for children with acute brain dysfunction in seasons when viral diseases are prevalent， it is necessary to lift restrictions on imaging diagnostic criteria， or develop a new scoring diagnostic criterion combined with clinical practice， which is conducive to prompt clinical diagnosis and active intervention and treatment for ANE. Clinicians should deepen their understanding of ANE and avoid missed diagnosis and misdiagnosis. [ABSTRACT FROM AUTHOR]

Objective To study the possible mechanism of 7-hydroxyethyl chrysin (7-HEC) on high altitude cerebral edema (HACE). Methods A rat model of high altitude cerebral edema was established. The activity of superoxide dismutase (SOD) and the content of malondialdehyde (MDA) in rat brain tissues were measured. The expression levels of apoptosis, cell cycle and autophagy related proteins were detected by Western blotting to explore the protective effect of 7-HEC on high altitude cerebral edema and its mechanism. Results Compared with the control group, the content of MDA in the brain tissue of the hypoxia model group was significantly up-regulated; the activity of SOD was significantly down-regulated, the relative expression of CyclinD1, CyclinE1, CDK6 and CDK2, apoptotic proteins Bcl-2, PARP, and autophagy protein LC3-B were down-regulated; and the relative expression of apoptotic protein Bax and autophagy protein P62 were up-regulated; the difference was statistically significant (P<0.05); Compared with the hypoxia model group, the content of MDA was down-regulated and the activity of SOD was significantly up-regulated in the 7-HEC administration group. The relative expression of CyclinD1, CyclinE1, CDK6, CDK2, apoptotic proteins Bcl-2, PARP, autophagy protein LC3-B was up-regulated and the relative expression of apoptotic proteins Bax and the relative expression of autophagy protein P62 was down-regulated in the 7-HEC administration group. The difference was statistically significant (P<0.05). Conclusion 7-HEC has a certain protective effect on high altitude cerebral edema, and its mechanism may be related to the regulation of cell cycle, autophagy, apoptosis and oxidative stress pathways. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To comprehensively evaluate sodium aescinate for injection from effectiveness, safety, economy, innovation, suitability and accessibility. METHODS: PubMed, the Cochrane Library, Embase, CBM, CNKI, Wanfang Data and WebCRD were systematically retrieved. The rapid health technology assessment (HTA) was used to analyze the effectiveness, safety and economy of sodium aescinate for injection. National Medical Products Administration, Center for Drug Evaluation of National Medical Products Administration and other professional websites, pharmacopoeia and drug instructions of various countries were retrieved to analyze the innovation, suitability and accessibility of sodium aescinate for injection. RESULTS: (1) In terms of effectiveness and safety, the study population included cerebral edema induced by cerebral hemorrhage, cerebral edema induced by cerebral ischemia, swelling induced by surgery and swelling induced by trauma. The study protocol was sodium aescinate for injection versus mannitol, sodium aescinate for injection versus other positive drugs, sodium aescinate for injection versus blank control, sodium aescinate for injection combined with mannitol versus mannitol, sodium aescinate for injection combined with edaravone versus edaravone, sodium aescinate for injection combined with edaravone versus sodium aescinate for injection, sodium aescinate for injection combined with edaravone versus blank control, the study group and the control group were given routine treatment. Sodium aescinate for injection alone or in combination with positive drugs such as mannitol could significantly improve the treatment efficiency and reduce the incidence of adverse drug reactions. (2) In terms of economics, the application of sodium aescinate for injection combined with mannitol in trauma-induced swelling had the best incremental cost-effectiveness ratio, and the incremental cost-effectiveness ratio in patients with cerebral infarction was inferior to low molecular weight heparin sodium. Sodium aescinate for injection was the class B drug under medical insurance, which had limitations on reimbursement. (3) In terms of innovation, sodium aescinate for injection had two patents in analysis and detection methods and preparation methods. (4) In terms of suitability, the quality standard of sodium aescinate for injection was the national standard, and the injection dosage form had a certain influence on the suitability of drug use. (5) In terms of accessibility, the registered production enterprises of sodium aescinate for injection were located in 11 provinces and municipalities directly under the central government, and the supply of sodium aescinate for injection was well accessible. CONCLUSIONS: The clinical effectiveness and safety of sodium aescinate for injection in patients with cerebral edema induced by hemorrhagic stroke, cerebral edema induced by ischemic stroke, swelling induced by surgery and swelling of traumatic body are significant. The economy of single drug in patients with cerebral edema induced by ischemic stroke and swelling induced by trauma is medium. There are no economic studies on the use of sodium aescinate for injection in patients with surgical swelling. [ABSTRACT FROM AUTHOR]

Objective: To investigate the expression of Toll like receptor 4 (TLR4), aquaporin-4 (AQP-4) and nitric oxide (NO) in the brain of hypertensive intracerebral hemorrhage (HICH) rats and their relationship with brain edema. Methods: 48 SHR rats were randomly divided into sham operation group, hich 12 h group, hich 24 h group, hich 48 h group, hich 72 h group and hich 7 d group. Bacterial collagenase 0.4u was used to prepare 2 滋L. The rat model of intracerebral hemorrhage was established by stereotactic injection into the right caudate nucleus of the rat brain. The sham operation group was injected with the same amount of normal saline. The expression of TLR4, AQP-4 and NO and the change of brain water content were observed at the corresponding time points. Pearson test was used to analyze the correlation between brain water content and the expression of TLR4, AQP-4 and NO in hich rats. Results: The expression level of TLR4 in hich rats at each time point was significantly higher than that in sham operation group, and the expression level of TLR4 in hich rats at other time points was significantly higher than that in hich 12 h group (P<0.05). The expression level of AQP-4 in hich rats was significantly higher than that in sham operation group at each time point (P<0.05). The level of NO in hich rats was significantly lower than that in sham operation group at each time point (P<0.05). At each time point, the brain water content of hich rats was significantly higher than that of sham operation group (P<0.05), and the brain water content of rats in each group increased and then decreased (P<0.05). Pearson test showed that the brain water content of hich rats was positively correlated with the expression levels of TLR4 and AQP-4, and negatively correlated with the level of NO (P<0.05). Conclusion: The dynamic changes of TLR4, AQP-4 and NO in brain tissue of hich rats are correlated with brain water content, suggesting that they are involved in the formation and regression of brain edema, which provides new ideas and directions for the subsequent clinical diagnosis and treatment of hich. [ABSTRACT FROM AUTHOR]

Objective To investigate the CT features and clinical significance of pseudo-subarachnoid hemorrhage sign (PSAH) with diffuse brain edema. Methods CT of 13 patients including 5 brain-dead organ donors with non-hemorrhagic disease and 8 non-traumatic critically ill patients with confirmed P-SAH from March 2019 to December 2019 was reviewed. Regions of interest (ROI) were drawn on the cerebral white matter (100 mm²) and fissure (10 mm²) symmetrically on plain CT. The CT values were measured and compared between the 2 groups. The clinical prognosis of non-traumatic critically ill patients was observed. Results On all patients, CT showed diffuse swelling of brain parenchyma, low density, blurred gray-white matter boundary, narrow ventricle under pressure, symmetrically high and linear attenuation in basal cistern and sulci. The CT values in brain death were (26.25±2.28) HU (range: 21.90- 29.8 HU) in the white matter and (41.45±2.42) HU (range: 35.1-45.0 HU) in the fissures. The CT values in non-traumatic critically ill patients were (26.02±2.20) HU (range: 21.9-29.8 HU) in the white matter and (45.07±4.47) HU (range: 35.1-56.9 HU) in the fissures. The average CT value difference of white matter and fissures in all cases were (17.54±3.05) HU. Conclusion In severe diffuse brain edema, typical P-SAH can be seen on plain CT, and the presence of P-SAH often indicates a poor prognosis. [ABSTRACT FROM AUTHOR]

Objective: To investigate the effect of acupuncture combined with Oxiracetam on cerebral hemorrhage and its influence on nerve function and inflammatory factors. Methods: 90 patients with cerebral hemorrhage who were admitted to our hospital in February 2015 and July 2018 were selected, they were divided into control group (n=45) and study group (n=45) according to random number table method. Patients in the control group were treated with oxiracetam, while those in the study group were treated with acupuncture on the basis of the control group. The clinical effect, hematoma volume, brain edema volume, nerve function, cognitive function and inflammatory factors were compared between the two groups, Adverse reactions during treatment were recorded in the two groups. Results: The clinical effect of the study group at 2 courses after treatment was 91.11% (41/45), which was higher than that of the control group 71.11% (32/45) (P<0.05). 2 courses after treatment, mini-mental state examination (MMSE) score of the two groups increased, and that of the study group was higher than that of the control group (P<0.05). The national institutes of health stroke scale (NIHSS) score decreased, and that of the study group was lower than that of the control group (P<0.05). The interleukin-8 (IL-8), tumor necrosis factor-α(TNF-α), and hypersensitive C-reactive protein (hs-CRP) were all decreased in the two groups, and those of the study group were lower than those of the control group (P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P>0.05). Compared with the first day of treatment, the hematoma volume of the two groups increased first and then decreased on the 7th and 28th day of treatment (P<0.05), the volume of brain edema of the two groups decreased continuously (P<0.05). The volume of hematoma and brain edema of the study group were smaller than those of the control group at 28th day after treatment (P<0.05). Conclusion: Acupuncture combined with oxiracetam can effectively improve the clinical symptoms of cerebral hemorrhage patients, reduce the damage of neurological function and inflammation, and it has a good safety. [ABSTRACT FROM AUTHOR]

Objectives: To investigate the neuroprotective effect and mechanism of dl-3-n-butylphthalide (NBP) on rats with brain injury. Methods: A total of 1007-week-old male Sprague-Dawley (SD) rats were randomly divided into 5 groups: sham group, model group, NBP low, medium and high dose groups, 20 in each group. A model of craniocerebral injury in rats was established using controlled cortical impact injury. NBP was dissolved in soybean oil. The low, medium and high dose groups of NBP were orally administered at a dose of 20, 40, and 80 mg / kg for 2 weeks, respectively. The sham group and the model group were orally administered with an equal volume of soybean oil. The modified neurological deficit score (mNSS) was used to evaluate the neurological status of rats. The brain tissue water content and the levels of malondialdehyde (MDA), superoxide dismutase (SOD), and glutathione peroxidase (GSH-Px) in the brain tissues of each group were detected after treatment. TUNEL method was used to identify cell apoptosis. The expressions of Nrf2, NQO-1, HO-1, ApoJ, MMP9, AQP4, Caspase-3 and AKT in brain tissue were detected by RT-PCR, Western blot or Immunohistochemistry. Results: After 2 weeks of NBP treatment, the mNSS score and neuron apoptosis rate in the NBP treatment group were significantly reduced in a dose-dependent manner (P<0.05). Compared with the model group, the brain water content in the NBP treatment group was significantly reduced (P<0.05). Compared with the model group, MDA in the NBP treatment group was significantly reduced, while SOD and GSH-Px were significantly increased (P<0.05). Compared with the model group, the nuclear Nrf2 in the NBP treatment group was significantly increased, while the cytoplasmic Nrf2 was significantly decreased (P<0.05). Compared with the model group, the expression levels of NQO-1 and HO-1 proteins in the NBP treatment group were significantly increased (P<0.05). Compared with the model group, them RNA and protein expression levels of AQP4, MMP-9, ApoJ, and Caspase-3 in the NBP low, medium, and high dose groups were significantly reduced, while AKT was significantly increased (P<0.05). Conclusion: NBP has a certain neuroprotective effect on rats with traumatic brain injury. [ABSTRACT FROM AUTHOR]

Objective: To compare the Magnetic resonance imaging(MRI) and computed tomography(CT) manifestations of hypoxic ischemic encephalopathy(HIE) in different severity, and analyze the diagnostic value of MRI in HIE. Methods: 76 neonates with HIE who were admitted to our hospital from January 2017 to August 2019 were selected, including 46 mild cases, 24 moderate cases and6 severe cases, all of whom were examined by MRI and CT, the diagnosis results of neonatal HIE by MRI and CT were compared, the diagnosis results of severity of neonatal HIE and the detection rate of intracranial lesions. Results: With clinical manifestations as the gold standard, 72 of the 76 children with neonate HIE were confirmed by MRI examination, with an accuracy rate of 94.74%. There were 63 cases confirmed as neonate HIE by CT examination, with an accuracy rate of 82.89%. The detection rate of neonate HIE by MRI was significantly higher than that by CT examination(x²=5.365, P=0.021). The coincidence rate of MRI examination for the diagnosis of mild and severe HIE were 71.74%(33/46) and 100.00%(6/6), respectively, which were significantly higher than that of CT examination43.48%(20/46) and 50.00%(3/6)(all P<0.05). The coincidence rates of MRI and CT in the diagnosis of moderate HIE were 75.00%(18/24) and 66.67%(16/24), respectively, with no significant difference(x²=0.403, P=0.525). The overall detection rate of intraventricular hemorrhage, periventricular hemorrhage, subarachnoid hemorrhage, basal ganglia injury, and brain edema was 98.68%(75/76) on MRI,which was higher than 90.79%(69/76) on CT(x²=4.750, P=0.029). Conclusion: Compared with CT, MRI can show the brain tissue structure of the neonates more clearly, and the accuracy of diagnosis and severity of neonate HIE is better than that of CT, and the diagnosis of brain tissue lesion of neonate HIE is also better than that of CT, which has higher diagnostic value. [ABSTRACT FROM AUTHOR]

Objective: To study the effects of Ghrelin on brain edema and expression of MMP-9 in a rat model of intracerebral hemorrhage. Methods: Eighty male SD rats were randomly divided into NC group (n=20), SHAM group (n=20), ICH group (n=20) and Ghrelin group (n=20). Experimental intracerebral hemorrhage model was made by injecting autologous caudate artery blood of the rats. Ghrelin group model was made by injecting Ghrelin at a dose of 10 nmol/Kg d. At 5 observation time (12 h, 24 h, 3 d, 5 d, 7 d), brain functional deficit was evaluated according to Berderson scores. The water content of brain was analyzed by dry/weight measurement. The expression of MMP-9 in brain was detected by Western blotting. Results: Compared with NC group and SHAM group, Berderson scores and water content of brain in ICH group and Ghrelin group were higher at 12 h, 24 h, 3 d, 5 d, 7 d (P<0.05). Compared with ICH group, Berderson scores and water content of brain in Ghrelin group decreased at 5 d, 7 d (P<0.05). The expression of MMP-9 in ICH group was significantly higher than that in NC group and SHAM group (P<0.05) at 12 h, 24 h, 3 d, 5 d, 7 d. Compared with NC group and SHAM group, the expression of MMP-9 in Ghrelin group was higher at 12 h, 24 h, 3 d(P<0.05). The expression of MMP-9 in Ghrelin group was no significant difference with that in NC group and SHAM group at 5 d, 7 d(P>0.05). The expression of MMP-9 in ICH group was higher than that in Ghrelin group (P<0.05) at 5 d, 7 d. Conclusion: In this research, Ghrelin could decrease the expression of MMP-9 in brains of intracerebral hemorrhage rats after 5 d, which contributed to alleviate brain edema and improve the function of nervous system. [ABSTRACT FROM AUTHOR]

Objective: To investigate the effect of continuous lumbar cistern drainage on intracranial pressure, complications and prognosis in elderly patients with severe craniocerebral injury. Methods: 60 elderly patients with severe craniocerebral injury admitted in First Affiliated Hospital of Chengdu Medical College from August 2014 to August 2018 were selected as the study subjects. The patients were divided into control group(n=30) and research group(n=30) according to random number table method. The control group was given routine dehydration symptomatic treatment after operation, and the research group was given continuous lumbar cistern drainage on this basis. The clinical efficacy and complications were compared between the two groups, and Intracranial pressure at 3 d, 5 d and 7 d after operation. Follow-up for half a year to observe the prognosis of two groups of patients. Results: The total effective rate of the study group was 90.00% after treatment, which was significantly higher than that 66.67% of the control group(P<0.05). The intracranial pressure of the two groups decreased 3 d, 5 d and 7 d after operation and the study group was lower than control group(P<0.05). The incidence of cerebral infarction, cerebral edema, subdural effusion, epilepsy and longitudinal fissure effusion in the study group was lower than that in the control group(P<0.05), but there was no significant difference in intracranial infection(P>0.05). The number of good cases in the study group was higher than that in the control group, while the number of severe disabilities and deaths in the study group was lower than that in the control group(P <0.05), but there was no significant difference in the number of mild disabilities and plant survival between the two groups(P>0.05). Conclusion: Continuous lumbar cistern drainage is effective in the treatment of elderly patients with severe craniocerebral injury. It can significantly improve the intracranial pressure, reduce the incidence of complications and improve the prognosis of patients. It is suitable for clinical promotion. [ABSTRACT FROM AUTHOR]

ObjectiveTo investigate the effect of inhibition of HIF1α to alleviate the phosphorylation of Cx43 in the acute phase of cerebral ischemia-repufusion(I/R) injury. MethodsOne hundred Sprague-Dawley rats at 4 months age,weight at 300-500 g were randomly divided into 4 sections and 5 groups: sham operation, treament group(I/R4，8 hour+2ME2), vehicle(I/R 8 hour+ DMSO) and injury group(I/R 8 hour). Cerebral ischemia-repufusion injury model were established with clip bilateral ICA, and HIF-1αinhibitor 2ME2 was injected into peritoneal cavity. Half of rats were measured for cerebral water content by Hatashita wet-weight method.Another half rats were sacrificed for investigating the level of total-Cx43, phosphoylated Cx43, Bcl-2, Bax and Caspases-3 by western blot, TNF-α, IL-1β and IL-6 by Elisa kit. Result Unlike static total-Cx43, brain water content, phosphoylated Cx43, Bax, Caspases-3, and IL-1β, IL-6, TNF-α in each treatment group and sham group were significantly lower than in other groups. Bcl-2 by WB showed the opposite result to the above. ConclusionInhibition of HIF-1αcan down-regulate the level of phosphoylation of Cx43 and apoptosis factors.Further more, the level of IL-1, IL-6 and TNF-α were reduced. Simultaneously,these alterations can protect the form and function of brain after cerebral ischemia-repufusion injury. [ABSTRACT FROM AUTHOR]

Objective: To investigate the effect of edaravone combined with nalmefene in serum nerve cell factors and inflammatory factors in patients with acute severe craniocerebral injury. Methods: 80 patients with acute severe brain injury who were received in our hospital from January 2015 to December 2017 were selected, and they were randomly divided into control group(n=40) and observation group (n=40). The patients in the control group were received routine comprehensive treatment after admission, on this basis, the observation group were given edaravone combined with nalmefene treatment. The levels of serum nerve cell factors, inflammatory factors, Glasgow Coma Scale (GCS), acute physiology and chronic health status II (APACHE II) score were compared between the two groups, the intracranial pressure, brain edema and adverse reaction were observed in the two groups. Results: The levels of serum β-endorphin, S100βprotein and neuron specific enolase (NSE) in the observation group at 1d and 1 week after treatment were lower than those before treatment and in the control group (P<0.05). The levels of serum high sensitivity C reactive protein (hs-CRP), tumor necrosis factor-α(TNF-α), interleukin-8(IL-8) of patients in two groups at 1 week after treatment were lower than before treatment, and the observation group was lower than the control group (P<0.05). The proportion of intracranial pressure <15 mmHg and the proportion of mild cerebral edema at 1 week after treatment in the observation group were higher than that of the control group (P<0.05), proportion of intracranial pressure ≥ 20 mmHg and the proportion of severe brain edema proportion was lower than that of the control group (P<0.05). The score of GCS in the two groups was higher than that before treatment at 1 week after treatment, and the score of APACHE II was lower than that before treatment(P<0.05). The score of GCS in the observation group was higher than that of the control group at 1 week after treatment, and the score of APACHE II was lower than that of the control group(P<0.05). There was no statistically significant difference in the incidence of adverse reactions between the two groups (P>0.05). Concluvion: Edaravone combined with nalmefene can significantly improve nerve cell factors and inflammatory factors levels of patients with acute severe craniocerebral injury, and it promotes the reduction of intracranial pressure and the absorption of brain edema, which is beneficial to the prognosis of the patients and has good safety. [ABSTRACT FROM AUTHOR]

Objective: To explore the expressions of IL-1β and BDNF in serum of patients with hypertensive cerebral hemorrhage and the relationship between the changes of IL-1β and BDNF serum levels and the degree of cerebral edema. Methods: 77 cases of patients with hypertensive cerebral hemorrhage in our hospital from August 2013 to 2015 were selected, and according to the volume of cerebral edema, the patients were divided into the slight cerebral edema group (28 cases), the moderate cerebral edema group (27 cases) and the severe cerebral edema group (22 cases). And another 25 healthy volunteers who received the medical examination in our hospital were selected as the control group. Then the serum levels of BDNF and IL-1β in four groups were measured by ELISA, and the correlation between the dynamic expression of BDNF and IL-1β and the volume of brain edema was analyzed. Results: Compared with the control group, the the level of serum IL-1β in patients with cerebral edema was higher, and the BDNF level was lower, and the difference was statistically significant (P<0.05): The higher the level of serum IL-1β in patients with cerebral edema, and the difference was statistically significant (P<0.05): At the same time, the higher the serum IL-1β beta level in patients with cerebral edema, the highest in 48 h. and then decreased (P<0.05): The lower serum BDNF levels were significantly different in patients with cerebral edema, and the difference was statistically significant (P<0.05): At the same time, the serum level of BDNF in patients with cerebral edema was lower (P<0. 05): Serum IL-1β levels were positively correlated with cerebral edema volume (r=0.656. P<0.05), while serum BDNF levels were negatively correlated with cerebral edema volume (P<0.05, r=-0.675). Conclusion: The severity of cerebral edema in patients with hypertensive cerebral hemorrhage is closely related to serum levels of IL-1β and BDNF. Therefore, the clinical examination of serum levels of IL-1 and BDNF can be performed to determine the severity of cerebral edema. [ABSTRACT FROM AUTHOR]

Objective To evaluate the effect of early hyperbaric oxygen therapy and infant massage in adjunctive treatment of neonatal hypoxic ischemic encephalopathy. Methods Sixty-two children patients with moderate to severe HIE were randomly divided into treatment group and control group. Patients in both groups were given conventional treatment, and additional early experimental group (72h) and infant massage were given as adjunctive treatment to patients in the treatment group. The clinical effects, symptoms relieving time, 7d and 15d neonatal behavioral neurological assessment (NBNA) scores were compared between two groups. Results Compared with the control group, in the experimental group, the consciousness, primitive reflexes, muscle tone, and CT cerebral edema regression time were decreased (P < 0.0l), 7d NBNA score (P < 0.05) and 15d NBNA score (P < 0.0l) were significantly higher. Conclusion Early hyperbaric oxygen therapy and infant massage have significant clinical effects in adjunctive treatment of neonatal hypoxic ischemic encephalopathy, so it is worthy of promotion. [ABSTRACT FROM AUTHOR]