Objective: To study the effect of adjuvant therapy of ganglioside sodium on intracranial pressure (ICP), partial pressure of brain tissue oxygen (PbtO2), nerve injury molecules, nerve protection molecules and indexes ...Objective: To study the effect of adjuvant therapy of ganglioside sodium on intracranial pressure (ICP), partial pressure of brain tissue oxygen (PbtO2), nerve injury molecules, nerve protection molecules and indexes of oxidative stress in patients with acute severe craniocerebral injury. <br> Methods: Forty-seven patients with severe craniocerebral injury treated in the emergency department of our hospital during the period time from December 2012 to October 2015 were selected for retrospective analyses. They were divided into the ganglioside group and the normal treatment group according to the usage of ganglioside sodium in the process of the emergency treatment. At days 1, 3, 5 and 7 before and after treatment, theICP and PbtO2 in patients of the two groups were measured. After 7 days of treatment, the nerve injury molecules, nerve protection molecules and the indexes of oxidative stress in serum of the patients of the two groups were determined. <br> Results: At days 1, 3, 5 and 7 before and after treatment, theICP in patients of the ganglioside group were all significantly lower than those of the normal treatment group, while the PbtO2 were all significantly higher than those of normal treatment group. After 7 days of treatment, the contents of serum methane dicarboxylic aldehyde, advanced oxidation protein products, 8-hydroxy-2'-deoxyguanosine urine, S100β, glial fibrillary acidic portein, neuron specific enolase, myelin basic protein, neuroglobin and ubiquitin carboxyl-terminal hydrolase L1 in patients of the ganglioside group were notably lower than those of the normal treatment group, while the contents of superoxidase dismutase, glutathione peroxidase, catalase, nerve growth factor and brain derived neurotrophic factor were significantly higher than those of the normal treatment group. <br> Conclusions: The adjuvant therapy of ganglioside sodium in patients with severe craniocerebral injury can effectively reduceICP, improve PbtO2 and alleviate the injuries of neurons and glial cells caused by oxidative stress.展开更多
BACKGROUND Severe craniocerebral injury(STBI)is a critical physical trauma caused by a sudden external force acting on the head.The condition is complex and changeable,and disability and mortality rates are high.Altho...BACKGROUND Severe craniocerebral injury(STBI)is a critical physical trauma caused by a sudden external force acting on the head.The condition is complex and changeable,and disability and mortality rates are high.Although the life of STBI patients can be saved through treatment,the sequelae of consciousness,speech,cognitive impairment,stiffness,spasm,pain and abnormal behavior in the early rehabilitation stage can be a heavy burden to a family.In the past,routine nursing was often used to treat/manage STBI;however,problems,such as improper cooperation and untimely communication,reduced therapeutic effectiveness.AIM To investigate the effect of a proposed care bundle to optimize the first aid process and assess its effectiveness on the early rehabilitation nursing of patients with STBI.METHODS From January 2019 to December 2020,126 STBI patients were admitted to the emergency department of Chongqing Emergency Medical Center.These patients were retrospectively selected as the research participants in the current study.The study participants were then divided into a control group(61 cases)and a study group(65 cases).The control group was treated with routine nursing.The study group adopted the proposed care bundle.The National Institutes of Health Stroke Scale/Score and Glasgow Coma Scale(GCS)were used to evaluate neurological function before and after emergency treatment.After 3 mo of rehabilitation,experimental outcomes were assessed.These included the GCS,Barthel Index,complication rate,muscle strength grade and satisfaction.RESULTS There was no significant difference in gender,age,cause of injury and GCS between the two groups.After emergency,the National Institutes of Health Stroke Scale/Score of the study group(10.23±3.26)was lower than that of the control group(14.79±3.14).The GCS score of the study group(12.48±2.38)was higher than that of the control group(9.32±2.01).The arrival time of consultation in the study group was 20.56±19.12,and the retention time in the emergency room was 45.12±10.21,which were significantly shorter than those in the control group.After 3 mo of rehabilitation management,the GCS and Barthel Index of the study group were 14.56±3.75 and 58.14±12.14,respectively,which were significantly higher than those of the control group.The incidence of complications in the study group(15.38%)was significantly lower than that in the control group(32.79%).The proportion of muscle strength≥grade III in the study group(89.23%)was significantly higher than that in the control group(50.82%).The satisfaction of patients in the study group was significantly higher than that in the control group.CONCLUSION Care bundles are used to optimize the nursing process.During first-aid,care bundles can effectively improve the rescue effect and improve neurological function of STBI patients as well as shorten the treatment time.In early rehabilitation,they can effectively improve the consciousness of STBI patients,improve the activities of daily living,reduce the risk of complications,accelerate the recovery of muscle strength and improve their satisfaction.展开更多
BACKGROUND Intracranial infection is a common clinical disease.Computed tomography(CT)and magnetic resonance imaging(MRI)have certain sensitivity and have good diagnostic efficacy.AIM To study the application value of...BACKGROUND Intracranial infection is a common clinical disease.Computed tomography(CT)and magnetic resonance imaging(MRI)have certain sensitivity and have good diagnostic efficacy.AIM To study the application value of MRI and CT in the diagnosis of intracranial infection after craniocerebral surgery.METHODS We selected 82 patients who underwent craniocerebral surgery(including 40 patients with intracranial infection and 42 patients without infection)during the period from April 2016 to June 2019 in our hospital.All 82 patients received CT and MRI examinations,and their clinical data were reviewed.A retrospective analysis was performed,and the coincidence rate of positive diagnosis and the overall diagnosis coincidence rate of different pathogenic infection types were measured with the two examination methods.The diagnostic sensitivity and specificity as well as the positive and negative predictive values of the two examination methods were compared.RESULTS For all types of pathogenic infections(Staphylococcus aureus,Staphylococcus hemolyticus,Staphylococcus epidermidis,and others),MRI scans had higher positive diagnostic coincidence rates than CT scans;the overall diagnostic coincidence rate,sensitivity,specificity,positive predictive value,and negative predictive values were significantly higher with MRI examinations than with CT examinations,and the differences were statistically significant(P<0.05).CONCLUSION MRI examination can accurately diagnose intracranial infection after clinical craniocerebral surgery.Compared with CT,MRI had higher diagnostic efficiency.The diagnostic sensitivity and specificity,the diagnostic coincidence rate,and the positive and negative predictive values were significantly higher with MRI than with conventional CT,which can be actively promoted.展开更多
Objective:To study the effects of large doses of vitamin C and vitamin E on nerve injury,neurotrophic and oxidative stress in patients with acute craniocercbral injury.Methods:Patients with acute cranioccrebral trauma...Objective:To study the effects of large doses of vitamin C and vitamin E on nerve injury,neurotrophic and oxidative stress in patients with acute craniocercbral injury.Methods:Patients with acute cranioccrebral trauma who were admitted to the Third People's Hospital of Zigong from April 2014 to December 2016 were selected as the subjects and were randomly divided into two groups.The control group received conventional treatment,and the intervention group received large doses of vitamin C and vitamin E combined with conventional treatment.On the yh day and 7th day after treatment,peripheral blood was collected and serum was isolated,then the contents of nerve injury index NSE,S 100B,NGB,UCH-L1,Tf,Ft and neurotrophic indexes NTF-α,BDNE NGF and IGF-I were determined by Enzyme-linked immunosorbent assay kit,and the contents of SOD,GPx,CAT,OH-,O2,MDA and AOPP were measured by radioactive immunoprecipitation kit.Results:3th day and 7th day after treatment,the contents of NSE,S100B,NGB,UCH-L1,Tf,Ft,NTF-α,BDNF,NGF,IGF-Ⅰ,OH-,O2-,MDA and AOPP in the intervention group were all significantly lower than those in the control group.The content of SOD,GPx and CAT in serum in the intervention group was significantly higher than that in the control group.Conclusions:High-dose vitamin C and vitamin E treatment can alleviate nerve injury,oxidative stress response,and improve neurotrophic state in patients with acute craniocerebral injury.展开更多
BACKGROUND Craniocerebral injuries encompass brain injuries,skull fractures,cranial soft tissue injuries,and similar injuries.Recently,the incidence of craniocerebral injuries has increased dramatically due to the inc...BACKGROUND Craniocerebral injuries encompass brain injuries,skull fractures,cranial soft tissue injuries,and similar injuries.Recently,the incidence of craniocerebral injuries has increased dramatically due to the increased numbers of traffic accidents and aerial work injuries,threatening the physical and mental health of patients.AIM To investigate the impact of failure modes and effects analysis(FMEA)-based emergency management on craniocerebral injury treatment effectiveness.METHODS Eighty-four patients with craniocerebral injuries,treated at our hospital from November 2019 to March 2021,were selected and assigned,using the random number table method,to study(n=42)and control(n=42)groups.Patients in the control group received conventional management while those in the study group received FMEA theory-based emergency management,based on the control group.Pre-and post-interventions,details regarding the emergency situation;levels of inflammatory stress indicators[Interleukin-6(IL-6),C-reactive protein(CRP),and procalcitonin(PCT)];incidence of complications;prognoses;and satisfaction regarding patient care were evaluated for both groups.RESULTS For the study group,the assessed parameters[pre-hospital emergency response time(9.13±2.37 min),time to receive a consultation(2.39±0.44 min),time needed to report imaging findings(1.15±4.44 min),and test reporting time(32.19±6.23 min)]were shorter than those for the control group(12.78±4.06 min,3.58±0.71 min,33.49±5.51 min,50.41±11.45 min,respectively;P<0.05).Pre-intervention serum levels of IL-6(78.71±27.59 pg/mL),CRP(19.80±6.77 mg/L),and PCT(3.66±1.82 ng/mL)in the study group patients were not significantly different from those in the control group patients(81.31±32.11 pg/mL,21.29±8.02 mg/L,and 3.95±2.11 ng/mL respectively;P>0.05);post-intervention serum indicator levels were lower in both groups than pre-intervention levels.Further,serum levels of IL-6(17.35±5.33 pg/mL),CRP(2.27±0.56 mg/L),and PCT(0.22±0.07 ng/mL)were lower in the study group than in the control group(30.15±12.38 pg/mL,3.13±0.77 mg/L,0.38±0.12 ng/mL,respectively;P<0.05).The complication rate observed in the study group(9.52%)was lower than that in the control group(26.19%,P<0.05).The prognoses for the study group patients were better than those for the control patients(P<0.05).Patient care satisfaction was higher in the study group(95.24%)than in the control group(78.57%,P<0.05).CONCLUSION FMEA-based craniocerebral injury management effectively shortens the time spent on emergency care,reduces inflammatory stress and complication risk levels,and helps improve patient prognoses,while achieving high patient care satisfaction levels.展开更多
The management of craniocerebral trauma begins at the site of the accident. This is one of the diseases for which pre-hospital care is well codified. The objective of this study is to report the experience of the Emer...The management of craniocerebral trauma begins at the site of the accident. This is one of the diseases for which pre-hospital care is well codified. The objective of this study is to report the experience of the Emergency Aid Medical Service (EMAS) of BENIN in the pre-hospital management of craniocerebral trauma. 146 head injuries were cared for. 116 were male. The mean age was 32 years with extremes ranging from 2 to 77 years. Etiology in 68% of patients was a public road accident. And the request for the use of the EMAS was made by highway users for 41% of the injuries. About 5.5% were severe cranio-brain injuries, more than 75% of which had died in intensive care. In 77% of the EMAS interventions, there was an intensive care physician in the team. 34 wounded had been transported in a vacuum mattress. The rigid cervical collar was used in 8 major traumas. All the wounded were transported by ambulance. The duration of hospitalization varied from a few hours in the emergency department to 90 days in the hospital ward. 9 patients died. One of them, who died in an ambulance, was a woman. The prehospital medical care of head trauma in BENIN is still progressing.展开更多
<div style="text-align:justify;"> <span style="font-family:Verdana;"><strong>Objective:</strong> So as to provide a theoretical basis for the future development of intervent...<div style="text-align:justify;"> <span style="font-family:Verdana;"><strong>Objective:</strong> So as to provide a theoretical basis for the future development of intervention measures to reduce the negative psychological mood of caregivers. To investigate the psychological status of the main caregivers for patients who were transferred out of ICU after craniocerebral tumor surgery and analyze their factors. <strong>Methods:</strong> 112 patients with cerebral tumor surgery were reviewed from sun yat-sen university cancer hospital. The research object is caregivers. The general data questionnaire, hospital anxiety depression scale and migration of ICU patients’ family members stress questionnaire scale investigation are collected. Multiple linear regression analysis in cerebral tumor patients with postoperative ICU transition out main factors influencing the psychological condition of the caregivers. <strong>Results:</strong> The anxiety and depression scores were (15.60 ± 5.83) and (38.73 ± 3.23) respectively. The results of multiple regression analysis showed that the gender, education level, relationship with the patient and family monthly income of the primary caregivers of the patients were the influencing factors of anxiety, depression and migration stress psychological state (P < 0.05). <strong>Conclusion:</strong> The main caregivers of patients who were transferred out of ICU after craniocerebral tumor surgery had relatively severe anxiety, depression and migration stress. Medical staff should pay attention to the psychological status of caregivers and take effective measures to promote their physical and mental health.</span> </div>展开更多
The authors report on their experience in the medical and surgical management of three cases of penetrating craniocerebral injuries caused by a nail. In all three cases, it was an aggression. Two of the three patients...The authors report on their experience in the medical and surgical management of three cases of penetrating craniocerebral injuries caused by a nail. In all three cases, it was an aggression. Two of the three patients were male. The cranial locations affected were respectively left parietal, right temporal and right frontal. The Glasgow coma score (GCS) was between 9 and 13. None of the patients had a motor deficit. A plain skull radiographs was performed for each patient. All patients underwent surgery and all received antibiotic therapy and tetanus vaccination. In two cases, post-operative outcome was simple. Recovery was complete without sequelae. The patient with a GCS of 9 died the day after surgery.展开更多
Objective.This study will analyze the clinical value of enteral nutrition treatment in patients with severe craniocerebral injury and discuss the safety of this treatment.Methods.This study selected patients who were ...Objective.This study will analyze the clinical value of enteral nutrition treatment in patients with severe craniocerebral injury and discuss the safety of this treatment.Methods.This study selected patients who were treated in the hospital from January 2017 to December 2018.After the screening,all patients were diagnosed as severe craniocerebral injury.Fortyfour patients who have met the experimental criteria were undergone enteral nutrition treatment to improve the condition.The success rate of catheterization and the changes in patient’s vital signs were analyzed.Especially the effect on the disease after the insertion of nasogastric tubing for nutritional treatment.Results.From the treatment results,the success rate of catheterization was 95.45%(42/44).In term of the timeline,the average was(36.5±2.7)min,the shortest time was 30 minutes and the longest time was no more than 5 minutes.The vital signs were stable before and after treatment and no complications such as arrhythmia.For those 42 successful patients,the average time for jejunal nutrition therapy was(36.2±4.1)days,the shortest was 27 days while the longest was 53 days and no adverse cases occurred.Conclusion.Enteral nutrition has a clinical application on patients with severe craniocerebral injury and can meet the nutritional needs of patients.Moreover,it has a high degree of feasibility and safety which is conducive to the early recovery of patients and has been well received.展开更多
Objective: To investigate the effects of mild hypothermia on cerebral oxygen metabolism and brain injury in patients with severe craniocerebral injury. Methods: A total of 78 patients with severe craniocerebral injury...Objective: To investigate the effects of mild hypothermia on cerebral oxygen metabolism and brain injury in patients with severe craniocerebral injury. Methods: A total of 78 patients with severe craniocerebral injury who underwent emergency treatment in Huanggang Central Hospital between September 2015 and May 2017 were selected as the research subjects and divided into control group (n=39) and mild hypothermia group (n=39) by random number table. Control group received clinical standard large trauma craniotomy for severe craniocerebral injury, and mild hypothermia group received routine surgery and postoperative mild hypothermia therapy. The cerebral oxygen metabolism and brain injury in two groups of patients were detected immediately after admission (T0), 1 week after treatment (T1) and 4 weeks after treatment (T2). Results: At T0, there was no statistically significant difference in the levels of cerebral oxygen metabolism indexes, cerebral blood flow parameters and brain injury markers between the two groups. At T1 and T2, PO2 levels in mild hypothermia group were higher than those in control group while Da-jvO2 levels were lower than those in control group;cerebral blood flow parameters Vs and Wv levels were higher than those in control group while PI levels were lower than those in control group;brain injury markers MBP, AQP-4 and S-100B contents were lower than those in control group while BDNF contents were higher than those in control group. Conclusion: Adjuvant mild hypothermia therapy after routine surgery may further reduce the cerebral oxygen metabolism and relieve the brain injury in patients with severe craniocerebral injury.展开更多
Objective:To investigate the clinical efficacy of dexmedetomidine in the regulation of TLR4/My D88/NF-κB in the prevention of paroxysmal sympathetic over-excitation (PSH) in patients with severe head injury. Methods:...Objective:To investigate the clinical efficacy of dexmedetomidine in the regulation of TLR4/My D88/NF-κB in the prevention of paroxysmal sympathetic over-excitation (PSH) in patients with severe head injury. Methods:One hundred patients with severe head injury who were admitted to our hospital from September 2016 to May 2019 were enrolled. The randomized digital table method was divided into 50 cases in the study group and the control group. Patients in the study group were given dexmedetomidine at a dose of 1.0 μg/kg before anesthesia induction, followed by infusion at 0.4 μg / (kg·h), and the control group was injected with the same amount of normal saline. The incidence of PSH, clinical symptoms, imaging findings, mechanical ventilation time, tracheal intubation/incision duration, ICU hospitalization time, total length of hospital stay, and GCS scores three months after discharge were compared between the two groups. At the same time, the fluorescence intensity, TLR4, NF-κB expression level and tumor necrosis factor-α (TNF-α) expression levels in peripheral blood CD14+ monocytes of the two groups were detected. Results:The incidence of PSH was significantly lower in the study group than in the control group at 7 and 3 months (P<0.05). The total length of hospital stay, duration of ICU hospitalization, intraoperative tracheotomy, and mechanical ventilation time were significantly lower in the study group than in the control group. And the GCS score was higher than the control group, and the difference was statistically significant (P<0.05). In addition, the imaging results showed that there were some differences in the location of imaging lesions between the two groups. The proportion of lesions in the ventricular system and surrounding areas was higher in the control group than in the study group (P<0.05). And the T14-T3 CD14+ PBMC MyD88 fluorescence intensity, TLR4 and NK-κB positive expression rate were significantly higher than those of T0 (P<0.05), but the MyD88 fluorescence intensity, TLR4 and NK-κB positive expression rate in the study group were significantly lower than those in the control group at T1~T3 (P<0.05). The levels of serum TNF-α in T1~T3 groups were significantly higher than those in T0 (P<0.05), but the levels of serum TNF-α in T1~T3 in the study group were significantly lower than those in the control group (P< 0.05). Conclusions:Dexmedetomidine can reduce the oxidative stress response in patients with severe head injury by inhibiting TLR4/My D88/NF-κB signaling pathway, thus effectively reducing the risk of PSH and improving the prognosis of patients.展开更多
Objective:To study and analyze the clinical effect of continuous nursing in the process of postoperative rehabilitation for patients with craniocerebral trauma.Methods:From August 2018 to July 2021,40 patients who cam...Objective:To study and analyze the clinical effect of continuous nursing in the process of postoperative rehabilitation for patients with craniocerebral trauma.Methods:From August 2018 to July 2021,40 patients who came to our hospital for craniocerebral trauma treatment were randomly selected as clinical experimental research objects,and they were divided into continuous nursing group and routine nursing group.The rehabilitation of patients in the two groups before and after postoperative nursing was observed and counted.Results:Before nursing intervention,there was no significant difference in MMSE score and Fugl-Meyer score between the two groups,p>0.05.After nursing,the scores were scored again at 3 and 6 months after nursing.It was found that the two groups were improved,but the improvement range in the continuous nursing group was significantly higher than that in the routine nursing group,the difference was statistically significant(p<0.05).From the score of quality of life,the scores of physical pain,psychological function,mental health and social function in the continuous nursing group were better than those in the routine nursing group,the difference was statistically significant(p<0.05).Conclusion:Using continuous nursing measures for rehabilitation nursing of patients with craniocerebral trauma after discharge can significantly improve the quality of life of patients,restore the mental state and limb function of patients,and has significant clinical effect.展开更多
The experimental models of craniocercbral wounds caused by 7. 62 mm bullets, i. e. thepenetrating craniocerebral injury, the tangential brain injury and the tangential skull injury, were es-tablished in dogs. The cran...The experimental models of craniocercbral wounds caused by 7. 62 mm bullets, i. e. thepenetrating craniocerebral injury, the tangential brain injury and the tangential skull injury, were es-tablished in dogs. The craniocerebral ballistics, craniocerebral pathology, serum and cerebrospinal flu-id total lactate dehydrogenase, blood-brain barrier permcabalities, and the pathophysiology ofcardiovascular and respiratory systems were studied. These results suggest that: 1. These injuries ofhigh-velocity missile can all cause general brain damage and intracranio-hematomas ; 2. The severityof the wound depends on the site of the injury, the kinetic energy of the missile force and the effectof the temporary cavity ; 3. The brain injury can seriously damage the blood brain barrier, leadingto brain edema ; 4. The dysfunction of respiratory and cardiovascular system is the fatal complicationendangering the life of the subjects ; 5. Estimating serum and cerebrospinal fluid total lactatedehydrogenase is a simple and valuable way to judge the severity and prognosis of this injury.展开更多
The results of treating the closed injury of brain with two methods are reported, one is Western medicine treatment (control group), and the other is acupuncture combined with Western medicine treatment (acupuncture g...The results of treating the closed injury of brain with two methods are reported, one is Western medicine treatment (control group), and the other is acupuncture combined with Western medicine treatment (acupuncture group). The total curative rate of the latter is 86 %, and that of the former is 56 %. The therapeutic effect of acupuncture group is better than that of control group. Coordinating acupuncture therapy in early stage is thus certainly necessary. At the same time, pathogenesis of the disease and the mechanism of acupuncture treatment are also discussed.展开更多
Objective:To explore the clinical value of dynamic ultrasound monitoring of optic nerve sheath diameter(ONSD)in the treatment of patients with moderate and severe head injury(CI).Methods:A total of 160 patients with m...Objective:To explore the clinical value of dynamic ultrasound monitoring of optic nerve sheath diameter(ONSD)in the treatment of patients with moderate and severe head injury(CI).Methods:A total of 160 patients with moderate and severe CI admitted to the First Affiliated Hospital of Hainan Medical University from January 2018 to January 2020 were selected and divided into observation group(80 cases)and control group(80 cases)a Januaryccording to the random number table.Patients in control group and observation group were dehydrated to reduce intracranial pressure(ICP)according to clinical symptoms/brain CT and ONSD monitoring guidance.National Institutes of Health Stroke Scale(NIHSS),Acute Physiology and Chronic Health EvaluationⅡ(APACHEⅡ),Glasgow Coma Scale(GCS),complications,prognosis,ICU stay time and mechanical ventilation time were compared between the two groups.Results:NIHSS score[control group:(19.58±3.19)points vs(37.98±5.75)points,observation group:(10.33±2.42)points vs(38.05±5.83)points]and APACHE II score[control group:(14.55±2.17)points vs(19.87±3.50)points,observation group:(8.71±2.03)points vs(20.12±3.56)points]of the two groups at 1 month after injury were significantly lower than those at admission(P<0.05),GCS score[control group:(10.78±1.66)points vs(8.03±1.34)points,observation group:(13.10±1.72)points vs(7.99±1.32)points]were significantly higher than that at admission(P<0.05).At 1 month after injury,NIHSS score[(10.33±2.42)points vs(19.58±3.19)points],APACHE II score[(8.71±2.03)points vs(14.55±2.17)points]in the observation group were significantly lower than those in the control group(P<0.05),and GCS score[(13.10±1.72)points vs(10.78±1.66)points]in the observation group was significantly higher than that in the control group(P<0.05).The proportion of hydrocephalus(2.50%vs 12.50%),total complication rate(5.00%vs 21.25%),proportion of severe disability(5.00%vs 17.50%),proportion of survival in plant man(3.75%vs 15.00%),mortality rate(2.50%vs 12.50%),ICU stay time[(5.01±1.25)d vs(8.38±2.29)D],mechanical ventilation time[(2.18±0.75)D]in observation group were lower than those in the control group,and the good rate(56.25%vs 32.50%)and the total effective rate(93.75%vs 72.50%)in the control group were significantly higher than those in the control group(P<0.05).Conclusion:Dynamic ultrasound monitoring ONSD is effective in guiding dehydration treatment of patients with moderate and severe CI,it can significantly reduce ICP and complications,improve prognosis,which is worthy of promotion and application.展开更多
Objective:To study the effect of edaravone combined with cattle encephalon glycoside and ignotin injection adjuvant therapy on nerve function impairment in patients with severe craniocerebral injury.Methods: A total o...Objective:To study the effect of edaravone combined with cattle encephalon glycoside and ignotin injection adjuvant therapy on nerve function impairment in patients with severe craniocerebral injury.Methods: A total of 68 patients with severe craniocerebral injury who were treated in our hospital between January 2013 and May 2016 were collected and divided into control group and observation group according to the random number table, 34 cases in each group. Control group of patients received conventional + cattle encephalon glycoside and ignotin injection therapy, and observation group of patients received conventional +cattle encephalon glycoside and ignotin injection + edaravone therapy. The differences in serum levels of nerve injury indexes, oxidative stress indexes and inflammatory mediators were compared between the two groups of patients before and after treatment.Results: Before treatment, the differences in serum levels of nerve injury indexes, oxidative stress indexes and inflammatory mediators were not statistically significant between two groups of patients. After treatment, serum nerve injury index BNP level in observation group was higher than that in control group while S-100B, GFAP and NSE levels were lower than those in control group;serum oxidative stress indicators MDA and MPO levels were lower than those in control group while SOD and GSH-Px levels were higher than those in control group;serum inflammatory mediators IL-6, IL-8 and TNF-α levels were lower than those in control group.Conclusion:Edaravone combined with cattle encephalon glycoside and ignotin injection adjuvant therapy can effectively reduce the nerve function impairment in patients with severe craniocerebral injury, and the specific mechanisms are related to its effect on reducing the oxidative stress and inflammation.展开更多
Objective:To observe and discuss the clinical effect of standard decompressive craniectomy combined with cerebrospinal fluid circulation reconstruction in the treatment of severe craniocerebral injury.Methods:Seventy ...Objective:To observe and discuss the clinical effect of standard decompressive craniectomy combined with cerebrospinal fluid circulation reconstruction in the treatment of severe craniocerebral injury.Methods:Seventy patients who underwent surgery in our hospital were selected as subjects for this study.The time was from August 2016 to August 2018,and patients were divided into experimental group(35 cases)and control group(35 cases)according to the random number table method.The control group was treated with a single standard decompressive craniectomy according to clinical symptoms.The experimental group was treated with standard decompressive craniectomy combined with cerebrospinal fluid circulation reconstruction.The surgical treatment effect,GCS(Glasgow Coma Scale)score and operation time were compared between the two groups.Results:After comparison,the surgical treatment effect of the experimental group was higher than that of the control group and there was a significant difference between the two groups(P<0.05).The GCS score and operation time of the experimental group were also better than of the control group and there was a significant difference the two groups(P<0.05).Conclusion:The use of standard decompressive craniectomy combined with cerebrospinal fluid circulation reconstruction in the treatment of severe craniocerebral injury is more effective and worthy of widespread promotion and application.展开更多
Objective:To study the relationship of cerebral edema with apoptosis, inflammatory factor generation and AQPs expression in the rat model with closed craniocerebral injury.Methods:Male SD rats were selected as experim...Objective:To study the relationship of cerebral edema with apoptosis, inflammatory factor generation and AQPs expression in the rat model with closed craniocerebral injury.Methods:Male SD rats were selected as experimental animals and divided into model group and control group. Model group were established into the closed craniocerebral injury models and control group received sham operation. The water content of damaged brain tissue as well as the expression of apoptosis molecules, the generation of inflammatory factors and the expression of aquaporins (AQPs) molecules were measured 7 d after model establishment.Results:The water content of brain tissue of model group was significantly higher than that of control group;Homer1a, Pim-3, Bcl-2, AQP1, AQP4 and AQP9 mRNA expression in brain tissue of model group were significantly lower than those of control group while Cdk5, FasL and Caspase-3 mRNA expression as well as NF-kB, TNF-α, IL-1β, IL-6 and p-JNK generation were significantly higher than those of control group. Homer1a, Pim-3, Bcl-2, AQP1, AQP4 and AQP9 mRNA expression in brain tissue of model group were negatively correlated with water content while Cdk5, FasL and Caspase-3 mRNA expression as well as NF-kB, TNF-α, IL-1β, IL-6 and p-JNK generation were positively correlated with water content.Conclusion:The excessive apoptosis, increased inflammatory factor generation and decreased AQPs expression are closely related to the occurrence of cerebral edema in the process of closed craniocerebral injury.展开更多
Objective: To investigate the effects of hyperbaric oxygen intervention on cerebral oxygen metabolism, cerebral injury and oxidative stress response in patients with craniocerebral injury. Methods: A total of 78 patie...Objective: To investigate the effects of hyperbaric oxygen intervention on cerebral oxygen metabolism, cerebral injury and oxidative stress response in patients with craniocerebral injury. Methods: A total of 78 patients with traumatic craniocerebral injury who were treated in our hospital between September 2015 and January 2018 were selected as the research subjects and divided into control group (n=39) and hyperbaric oxygen group (n=39) by random number table method. Control group received clinical routine intervention for patients with traumatic craniocerebral injury, hyperbaric oxygen group received hyperbaric oxygen intervention on the basis of routine intervention, and the intervention lasted for one month. The differences in the cerebral oxygen metabolism indexes, cerebral injury-related indexes and oxidative stress indexes were compared between the two groups of patients immediately after admission and after 1 month of treatment. Results: Immediately after admission, the levels of cerebral oxygen metabolism indexes as well as the contents of cerebral injury-related indexes and oxidative stress indexes were not significantly different between the two groups. After 1 month of treatment, cerebral oxygen metabolism indexes SjvO2 and CERO2 levels in hyperbaric oxygen group were higher than those in control group whereas A-vDO2 level was lower than that in control group;serum cerebral injury-related indexes GFAP, MBP, RBP4, SAA and NSE contents were lower than those of control group;serum oxidative stress indexes CAT and T-AOC contents were higher than those of control group whereas ROS and LHP contents were lower than those of control group. Conclusion: Hyperbaric oxygen intervention can effectively optimize the cerebral oxygen metabolism, reduce the cerebral injury and inhibit the systemic oxidative stress response in patients with craniocerebral injury.展开更多
Objective:To study the correlation of serum C-type natriuretic peptide (CNP) and insulin-like growth factor-Ⅱ (IGF-Ⅱ) contents with brain injury and inflammatory response in patients with craniocerebral trauma.Metho...Objective:To study the correlation of serum C-type natriuretic peptide (CNP) and insulin-like growth factor-Ⅱ (IGF-Ⅱ) contents with brain injury and inflammatory response in patients with craniocerebral trauma.Methods: Patients with craniocerebral trauma who were treated in the First Affiliated Hospital of Xi'an Jiaotong University between March 2015 and July 2017 were included in the case group of the study, and the healthy volunteers who received physical examination during the same period were included in the control group. The contents of CNP, IGF-Ⅱ, nerve markers and pro-inflammatory cytokines in serum as well as the expression of inflammatory signaling molecules in peripheral blood were measured.Results: CNP and IGF-Ⅱ contents in serum of case group were significantly lower than those of control group whereas UCH-L1, GFAP, S100B, Tau, MIP-1α, IL-1β, IL-6, IL-8 and TNF-α contents in serum as well as JAK2, STAT3, MEK and ERK1/2 mRNA expression in peripheral blood were significantly higher than those of control group;CNP and IGF-Ⅱ contents in serum of case group were negatively correlated with UCH-L1, GFAP, S100B, Tau, MIP-1α, IL-1β, IL-6, IL-8 and TNF-α contents in serum as well as JAK2, STAT3, MEK and ERK1/2 mRNA expression in peripheral blood.Conclusion: The decrease of serum CNP and IGF-Ⅱ in patients with craniocerebral trauma is closely related to the aggravation of brain injury and the over-activation of inflammatory response.展开更多
文摘Objective: To study the effect of adjuvant therapy of ganglioside sodium on intracranial pressure (ICP), partial pressure of brain tissue oxygen (PbtO2), nerve injury molecules, nerve protection molecules and indexes of oxidative stress in patients with acute severe craniocerebral injury. <br> Methods: Forty-seven patients with severe craniocerebral injury treated in the emergency department of our hospital during the period time from December 2012 to October 2015 were selected for retrospective analyses. They were divided into the ganglioside group and the normal treatment group according to the usage of ganglioside sodium in the process of the emergency treatment. At days 1, 3, 5 and 7 before and after treatment, theICP and PbtO2 in patients of the two groups were measured. After 7 days of treatment, the nerve injury molecules, nerve protection molecules and the indexes of oxidative stress in serum of the patients of the two groups were determined. <br> Results: At days 1, 3, 5 and 7 before and after treatment, theICP in patients of the ganglioside group were all significantly lower than those of the normal treatment group, while the PbtO2 were all significantly higher than those of normal treatment group. After 7 days of treatment, the contents of serum methane dicarboxylic aldehyde, advanced oxidation protein products, 8-hydroxy-2'-deoxyguanosine urine, S100β, glial fibrillary acidic portein, neuron specific enolase, myelin basic protein, neuroglobin and ubiquitin carboxyl-terminal hydrolase L1 in patients of the ganglioside group were notably lower than those of the normal treatment group, while the contents of superoxidase dismutase, glutathione peroxidase, catalase, nerve growth factor and brain derived neurotrophic factor were significantly higher than those of the normal treatment group. <br> Conclusions: The adjuvant therapy of ganglioside sodium in patients with severe craniocerebral injury can effectively reduceICP, improve PbtO2 and alleviate the injuries of neurons and glial cells caused by oxidative stress.
文摘BACKGROUND Severe craniocerebral injury(STBI)is a critical physical trauma caused by a sudden external force acting on the head.The condition is complex and changeable,and disability and mortality rates are high.Although the life of STBI patients can be saved through treatment,the sequelae of consciousness,speech,cognitive impairment,stiffness,spasm,pain and abnormal behavior in the early rehabilitation stage can be a heavy burden to a family.In the past,routine nursing was often used to treat/manage STBI;however,problems,such as improper cooperation and untimely communication,reduced therapeutic effectiveness.AIM To investigate the effect of a proposed care bundle to optimize the first aid process and assess its effectiveness on the early rehabilitation nursing of patients with STBI.METHODS From January 2019 to December 2020,126 STBI patients were admitted to the emergency department of Chongqing Emergency Medical Center.These patients were retrospectively selected as the research participants in the current study.The study participants were then divided into a control group(61 cases)and a study group(65 cases).The control group was treated with routine nursing.The study group adopted the proposed care bundle.The National Institutes of Health Stroke Scale/Score and Glasgow Coma Scale(GCS)were used to evaluate neurological function before and after emergency treatment.After 3 mo of rehabilitation,experimental outcomes were assessed.These included the GCS,Barthel Index,complication rate,muscle strength grade and satisfaction.RESULTS There was no significant difference in gender,age,cause of injury and GCS between the two groups.After emergency,the National Institutes of Health Stroke Scale/Score of the study group(10.23±3.26)was lower than that of the control group(14.79±3.14).The GCS score of the study group(12.48±2.38)was higher than that of the control group(9.32±2.01).The arrival time of consultation in the study group was 20.56±19.12,and the retention time in the emergency room was 45.12±10.21,which were significantly shorter than those in the control group.After 3 mo of rehabilitation management,the GCS and Barthel Index of the study group were 14.56±3.75 and 58.14±12.14,respectively,which were significantly higher than those of the control group.The incidence of complications in the study group(15.38%)was significantly lower than that in the control group(32.79%).The proportion of muscle strength≥grade III in the study group(89.23%)was significantly higher than that in the control group(50.82%).The satisfaction of patients in the study group was significantly higher than that in the control group.CONCLUSION Care bundles are used to optimize the nursing process.During first-aid,care bundles can effectively improve the rescue effect and improve neurological function of STBI patients as well as shorten the treatment time.In early rehabilitation,they can effectively improve the consciousness of STBI patients,improve the activities of daily living,reduce the risk of complications,accelerate the recovery of muscle strength and improve their satisfaction.
文摘BACKGROUND Intracranial infection is a common clinical disease.Computed tomography(CT)and magnetic resonance imaging(MRI)have certain sensitivity and have good diagnostic efficacy.AIM To study the application value of MRI and CT in the diagnosis of intracranial infection after craniocerebral surgery.METHODS We selected 82 patients who underwent craniocerebral surgery(including 40 patients with intracranial infection and 42 patients without infection)during the period from April 2016 to June 2019 in our hospital.All 82 patients received CT and MRI examinations,and their clinical data were reviewed.A retrospective analysis was performed,and the coincidence rate of positive diagnosis and the overall diagnosis coincidence rate of different pathogenic infection types were measured with the two examination methods.The diagnostic sensitivity and specificity as well as the positive and negative predictive values of the two examination methods were compared.RESULTS For all types of pathogenic infections(Staphylococcus aureus,Staphylococcus hemolyticus,Staphylococcus epidermidis,and others),MRI scans had higher positive diagnostic coincidence rates than CT scans;the overall diagnostic coincidence rate,sensitivity,specificity,positive predictive value,and negative predictive values were significantly higher with MRI examinations than with CT examinations,and the differences were statistically significant(P<0.05).CONCLUSION MRI examination can accurately diagnose intracranial infection after clinical craniocerebral surgery.Compared with CT,MRI had higher diagnostic efficiency.The diagnostic sensitivity and specificity,the diagnostic coincidence rate,and the positive and negative predictive values were significantly higher with MRI than with conventional CT,which can be actively promoted.
文摘Objective:To study the effects of large doses of vitamin C and vitamin E on nerve injury,neurotrophic and oxidative stress in patients with acute craniocercbral injury.Methods:Patients with acute cranioccrebral trauma who were admitted to the Third People's Hospital of Zigong from April 2014 to December 2016 were selected as the subjects and were randomly divided into two groups.The control group received conventional treatment,and the intervention group received large doses of vitamin C and vitamin E combined with conventional treatment.On the yh day and 7th day after treatment,peripheral blood was collected and serum was isolated,then the contents of nerve injury index NSE,S 100B,NGB,UCH-L1,Tf,Ft and neurotrophic indexes NTF-α,BDNE NGF and IGF-I were determined by Enzyme-linked immunosorbent assay kit,and the contents of SOD,GPx,CAT,OH-,O2,MDA and AOPP were measured by radioactive immunoprecipitation kit.Results:3th day and 7th day after treatment,the contents of NSE,S100B,NGB,UCH-L1,Tf,Ft,NTF-α,BDNF,NGF,IGF-Ⅰ,OH-,O2-,MDA and AOPP in the intervention group were all significantly lower than those in the control group.The content of SOD,GPx and CAT in serum in the intervention group was significantly higher than that in the control group.Conclusions:High-dose vitamin C and vitamin E treatment can alleviate nerve injury,oxidative stress response,and improve neurotrophic state in patients with acute craniocerebral injury.
基金Supported by Basic Research on Medical and Health Application of the People's Livelihood Science and Technology Project of Suzhou Science and Technology Bureau,No.SYS2020102.
文摘BACKGROUND Craniocerebral injuries encompass brain injuries,skull fractures,cranial soft tissue injuries,and similar injuries.Recently,the incidence of craniocerebral injuries has increased dramatically due to the increased numbers of traffic accidents and aerial work injuries,threatening the physical and mental health of patients.AIM To investigate the impact of failure modes and effects analysis(FMEA)-based emergency management on craniocerebral injury treatment effectiveness.METHODS Eighty-four patients with craniocerebral injuries,treated at our hospital from November 2019 to March 2021,were selected and assigned,using the random number table method,to study(n=42)and control(n=42)groups.Patients in the control group received conventional management while those in the study group received FMEA theory-based emergency management,based on the control group.Pre-and post-interventions,details regarding the emergency situation;levels of inflammatory stress indicators[Interleukin-6(IL-6),C-reactive protein(CRP),and procalcitonin(PCT)];incidence of complications;prognoses;and satisfaction regarding patient care were evaluated for both groups.RESULTS For the study group,the assessed parameters[pre-hospital emergency response time(9.13±2.37 min),time to receive a consultation(2.39±0.44 min),time needed to report imaging findings(1.15±4.44 min),and test reporting time(32.19±6.23 min)]were shorter than those for the control group(12.78±4.06 min,3.58±0.71 min,33.49±5.51 min,50.41±11.45 min,respectively;P<0.05).Pre-intervention serum levels of IL-6(78.71±27.59 pg/mL),CRP(19.80±6.77 mg/L),and PCT(3.66±1.82 ng/mL)in the study group patients were not significantly different from those in the control group patients(81.31±32.11 pg/mL,21.29±8.02 mg/L,and 3.95±2.11 ng/mL respectively;P>0.05);post-intervention serum indicator levels were lower in both groups than pre-intervention levels.Further,serum levels of IL-6(17.35±5.33 pg/mL),CRP(2.27±0.56 mg/L),and PCT(0.22±0.07 ng/mL)were lower in the study group than in the control group(30.15±12.38 pg/mL,3.13±0.77 mg/L,0.38±0.12 ng/mL,respectively;P<0.05).The complication rate observed in the study group(9.52%)was lower than that in the control group(26.19%,P<0.05).The prognoses for the study group patients were better than those for the control patients(P<0.05).Patient care satisfaction was higher in the study group(95.24%)than in the control group(78.57%,P<0.05).CONCLUSION FMEA-based craniocerebral injury management effectively shortens the time spent on emergency care,reduces inflammatory stress and complication risk levels,and helps improve patient prognoses,while achieving high patient care satisfaction levels.
文摘The management of craniocerebral trauma begins at the site of the accident. This is one of the diseases for which pre-hospital care is well codified. The objective of this study is to report the experience of the Emergency Aid Medical Service (EMAS) of BENIN in the pre-hospital management of craniocerebral trauma. 146 head injuries were cared for. 116 were male. The mean age was 32 years with extremes ranging from 2 to 77 years. Etiology in 68% of patients was a public road accident. And the request for the use of the EMAS was made by highway users for 41% of the injuries. About 5.5% were severe cranio-brain injuries, more than 75% of which had died in intensive care. In 77% of the EMAS interventions, there was an intensive care physician in the team. 34 wounded had been transported in a vacuum mattress. The rigid cervical collar was used in 8 major traumas. All the wounded were transported by ambulance. The duration of hospitalization varied from a few hours in the emergency department to 90 days in the hospital ward. 9 patients died. One of them, who died in an ambulance, was a woman. The prehospital medical care of head trauma in BENIN is still progressing.
文摘<div style="text-align:justify;"> <span style="font-family:Verdana;"><strong>Objective:</strong> So as to provide a theoretical basis for the future development of intervention measures to reduce the negative psychological mood of caregivers. To investigate the psychological status of the main caregivers for patients who were transferred out of ICU after craniocerebral tumor surgery and analyze their factors. <strong>Methods:</strong> 112 patients with cerebral tumor surgery were reviewed from sun yat-sen university cancer hospital. The research object is caregivers. The general data questionnaire, hospital anxiety depression scale and migration of ICU patients’ family members stress questionnaire scale investigation are collected. Multiple linear regression analysis in cerebral tumor patients with postoperative ICU transition out main factors influencing the psychological condition of the caregivers. <strong>Results:</strong> The anxiety and depression scores were (15.60 ± 5.83) and (38.73 ± 3.23) respectively. The results of multiple regression analysis showed that the gender, education level, relationship with the patient and family monthly income of the primary caregivers of the patients were the influencing factors of anxiety, depression and migration stress psychological state (P < 0.05). <strong>Conclusion:</strong> The main caregivers of patients who were transferred out of ICU after craniocerebral tumor surgery had relatively severe anxiety, depression and migration stress. Medical staff should pay attention to the psychological status of caregivers and take effective measures to promote their physical and mental health.</span> </div>
文摘The authors report on their experience in the medical and surgical management of three cases of penetrating craniocerebral injuries caused by a nail. In all three cases, it was an aggression. Two of the three patients were male. The cranial locations affected were respectively left parietal, right temporal and right frontal. The Glasgow coma score (GCS) was between 9 and 13. None of the patients had a motor deficit. A plain skull radiographs was performed for each patient. All patients underwent surgery and all received antibiotic therapy and tetanus vaccination. In two cases, post-operative outcome was simple. Recovery was complete without sequelae. The patient with a GCS of 9 died the day after surgery.
文摘Objective.This study will analyze the clinical value of enteral nutrition treatment in patients with severe craniocerebral injury and discuss the safety of this treatment.Methods.This study selected patients who were treated in the hospital from January 2017 to December 2018.After the screening,all patients were diagnosed as severe craniocerebral injury.Fortyfour patients who have met the experimental criteria were undergone enteral nutrition treatment to improve the condition.The success rate of catheterization and the changes in patient’s vital signs were analyzed.Especially the effect on the disease after the insertion of nasogastric tubing for nutritional treatment.Results.From the treatment results,the success rate of catheterization was 95.45%(42/44).In term of the timeline,the average was(36.5±2.7)min,the shortest time was 30 minutes and the longest time was no more than 5 minutes.The vital signs were stable before and after treatment and no complications such as arrhythmia.For those 42 successful patients,the average time for jejunal nutrition therapy was(36.2±4.1)days,the shortest was 27 days while the longest was 53 days and no adverse cases occurred.Conclusion.Enteral nutrition has a clinical application on patients with severe craniocerebral injury and can meet the nutritional needs of patients.Moreover,it has a high degree of feasibility and safety which is conducive to the early recovery of patients and has been well received.
文摘Objective: To investigate the effects of mild hypothermia on cerebral oxygen metabolism and brain injury in patients with severe craniocerebral injury. Methods: A total of 78 patients with severe craniocerebral injury who underwent emergency treatment in Huanggang Central Hospital between September 2015 and May 2017 were selected as the research subjects and divided into control group (n=39) and mild hypothermia group (n=39) by random number table. Control group received clinical standard large trauma craniotomy for severe craniocerebral injury, and mild hypothermia group received routine surgery and postoperative mild hypothermia therapy. The cerebral oxygen metabolism and brain injury in two groups of patients were detected immediately after admission (T0), 1 week after treatment (T1) and 4 weeks after treatment (T2). Results: At T0, there was no statistically significant difference in the levels of cerebral oxygen metabolism indexes, cerebral blood flow parameters and brain injury markers between the two groups. At T1 and T2, PO2 levels in mild hypothermia group were higher than those in control group while Da-jvO2 levels were lower than those in control group;cerebral blood flow parameters Vs and Wv levels were higher than those in control group while PI levels were lower than those in control group;brain injury markers MBP, AQP-4 and S-100B contents were lower than those in control group while BDNF contents were higher than those in control group. Conclusion: Adjuvant mild hypothermia therapy after routine surgery may further reduce the cerebral oxygen metabolism and relieve the brain injury in patients with severe craniocerebral injury.
基金Nanchong city school cooperative research project in 2018(No.18SXHZ0445).
文摘Objective:To investigate the clinical efficacy of dexmedetomidine in the regulation of TLR4/My D88/NF-κB in the prevention of paroxysmal sympathetic over-excitation (PSH) in patients with severe head injury. Methods:One hundred patients with severe head injury who were admitted to our hospital from September 2016 to May 2019 were enrolled. The randomized digital table method was divided into 50 cases in the study group and the control group. Patients in the study group were given dexmedetomidine at a dose of 1.0 μg/kg before anesthesia induction, followed by infusion at 0.4 μg / (kg·h), and the control group was injected with the same amount of normal saline. The incidence of PSH, clinical symptoms, imaging findings, mechanical ventilation time, tracheal intubation/incision duration, ICU hospitalization time, total length of hospital stay, and GCS scores three months after discharge were compared between the two groups. At the same time, the fluorescence intensity, TLR4, NF-κB expression level and tumor necrosis factor-α (TNF-α) expression levels in peripheral blood CD14+ monocytes of the two groups were detected. Results:The incidence of PSH was significantly lower in the study group than in the control group at 7 and 3 months (P<0.05). The total length of hospital stay, duration of ICU hospitalization, intraoperative tracheotomy, and mechanical ventilation time were significantly lower in the study group than in the control group. And the GCS score was higher than the control group, and the difference was statistically significant (P<0.05). In addition, the imaging results showed that there were some differences in the location of imaging lesions between the two groups. The proportion of lesions in the ventricular system and surrounding areas was higher in the control group than in the study group (P<0.05). And the T14-T3 CD14+ PBMC MyD88 fluorescence intensity, TLR4 and NK-κB positive expression rate were significantly higher than those of T0 (P<0.05), but the MyD88 fluorescence intensity, TLR4 and NK-κB positive expression rate in the study group were significantly lower than those in the control group at T1~T3 (P<0.05). The levels of serum TNF-α in T1~T3 groups were significantly higher than those in T0 (P<0.05), but the levels of serum TNF-α in T1~T3 in the study group were significantly lower than those in the control group (P< 0.05). Conclusions:Dexmedetomidine can reduce the oxidative stress response in patients with severe head injury by inhibiting TLR4/My D88/NF-κB signaling pathway, thus effectively reducing the risk of PSH and improving the prognosis of patients.
文摘Objective:To study and analyze the clinical effect of continuous nursing in the process of postoperative rehabilitation for patients with craniocerebral trauma.Methods:From August 2018 to July 2021,40 patients who came to our hospital for craniocerebral trauma treatment were randomly selected as clinical experimental research objects,and they were divided into continuous nursing group and routine nursing group.The rehabilitation of patients in the two groups before and after postoperative nursing was observed and counted.Results:Before nursing intervention,there was no significant difference in MMSE score and Fugl-Meyer score between the two groups,p>0.05.After nursing,the scores were scored again at 3 and 6 months after nursing.It was found that the two groups were improved,but the improvement range in the continuous nursing group was significantly higher than that in the routine nursing group,the difference was statistically significant(p<0.05).From the score of quality of life,the scores of physical pain,psychological function,mental health and social function in the continuous nursing group were better than those in the routine nursing group,the difference was statistically significant(p<0.05).Conclusion:Using continuous nursing measures for rehabilitation nursing of patients with craniocerebral trauma after discharge can significantly improve the quality of life of patients,restore the mental state and limb function of patients,and has significant clinical effect.
文摘The experimental models of craniocercbral wounds caused by 7. 62 mm bullets, i. e. thepenetrating craniocerebral injury, the tangential brain injury and the tangential skull injury, were es-tablished in dogs. The craniocerebral ballistics, craniocerebral pathology, serum and cerebrospinal flu-id total lactate dehydrogenase, blood-brain barrier permcabalities, and the pathophysiology ofcardiovascular and respiratory systems were studied. These results suggest that: 1. These injuries ofhigh-velocity missile can all cause general brain damage and intracranio-hematomas ; 2. The severityof the wound depends on the site of the injury, the kinetic energy of the missile force and the effectof the temporary cavity ; 3. The brain injury can seriously damage the blood brain barrier, leadingto brain edema ; 4. The dysfunction of respiratory and cardiovascular system is the fatal complicationendangering the life of the subjects ; 5. Estimating serum and cerebrospinal fluid total lactatedehydrogenase is a simple and valuable way to judge the severity and prognosis of this injury.
文摘The results of treating the closed injury of brain with two methods are reported, one is Western medicine treatment (control group), and the other is acupuncture combined with Western medicine treatment (acupuncture group). The total curative rate of the latter is 86 %, and that of the former is 56 %. The therapeutic effect of acupuncture group is better than that of control group. Coordinating acupuncture therapy in early stage is thus certainly necessary. At the same time, pathogenesis of the disease and the mechanism of acupuncture treatment are also discussed.
基金Youth cultivation fund of the First affiliated hospital of Hainan medical university(No.HYFYPY201822)。
文摘Objective:To explore the clinical value of dynamic ultrasound monitoring of optic nerve sheath diameter(ONSD)in the treatment of patients with moderate and severe head injury(CI).Methods:A total of 160 patients with moderate and severe CI admitted to the First Affiliated Hospital of Hainan Medical University from January 2018 to January 2020 were selected and divided into observation group(80 cases)and control group(80 cases)a Januaryccording to the random number table.Patients in control group and observation group were dehydrated to reduce intracranial pressure(ICP)according to clinical symptoms/brain CT and ONSD monitoring guidance.National Institutes of Health Stroke Scale(NIHSS),Acute Physiology and Chronic Health EvaluationⅡ(APACHEⅡ),Glasgow Coma Scale(GCS),complications,prognosis,ICU stay time and mechanical ventilation time were compared between the two groups.Results:NIHSS score[control group:(19.58±3.19)points vs(37.98±5.75)points,observation group:(10.33±2.42)points vs(38.05±5.83)points]and APACHE II score[control group:(14.55±2.17)points vs(19.87±3.50)points,observation group:(8.71±2.03)points vs(20.12±3.56)points]of the two groups at 1 month after injury were significantly lower than those at admission(P<0.05),GCS score[control group:(10.78±1.66)points vs(8.03±1.34)points,observation group:(13.10±1.72)points vs(7.99±1.32)points]were significantly higher than that at admission(P<0.05).At 1 month after injury,NIHSS score[(10.33±2.42)points vs(19.58±3.19)points],APACHE II score[(8.71±2.03)points vs(14.55±2.17)points]in the observation group were significantly lower than those in the control group(P<0.05),and GCS score[(13.10±1.72)points vs(10.78±1.66)points]in the observation group was significantly higher than that in the control group(P<0.05).The proportion of hydrocephalus(2.50%vs 12.50%),total complication rate(5.00%vs 21.25%),proportion of severe disability(5.00%vs 17.50%),proportion of survival in plant man(3.75%vs 15.00%),mortality rate(2.50%vs 12.50%),ICU stay time[(5.01±1.25)d vs(8.38±2.29)D],mechanical ventilation time[(2.18±0.75)D]in observation group were lower than those in the control group,and the good rate(56.25%vs 32.50%)and the total effective rate(93.75%vs 72.50%)in the control group were significantly higher than those in the control group(P<0.05).Conclusion:Dynamic ultrasound monitoring ONSD is effective in guiding dehydration treatment of patients with moderate and severe CI,it can significantly reduce ICP and complications,improve prognosis,which is worthy of promotion and application.
文摘Objective:To study the effect of edaravone combined with cattle encephalon glycoside and ignotin injection adjuvant therapy on nerve function impairment in patients with severe craniocerebral injury.Methods: A total of 68 patients with severe craniocerebral injury who were treated in our hospital between January 2013 and May 2016 were collected and divided into control group and observation group according to the random number table, 34 cases in each group. Control group of patients received conventional + cattle encephalon glycoside and ignotin injection therapy, and observation group of patients received conventional +cattle encephalon glycoside and ignotin injection + edaravone therapy. The differences in serum levels of nerve injury indexes, oxidative stress indexes and inflammatory mediators were compared between the two groups of patients before and after treatment.Results: Before treatment, the differences in serum levels of nerve injury indexes, oxidative stress indexes and inflammatory mediators were not statistically significant between two groups of patients. After treatment, serum nerve injury index BNP level in observation group was higher than that in control group while S-100B, GFAP and NSE levels were lower than those in control group;serum oxidative stress indicators MDA and MPO levels were lower than those in control group while SOD and GSH-Px levels were higher than those in control group;serum inflammatory mediators IL-6, IL-8 and TNF-α levels were lower than those in control group.Conclusion:Edaravone combined with cattle encephalon glycoside and ignotin injection adjuvant therapy can effectively reduce the nerve function impairment in patients with severe craniocerebral injury, and the specific mechanisms are related to its effect on reducing the oxidative stress and inflammation.
文摘Objective:To observe and discuss the clinical effect of standard decompressive craniectomy combined with cerebrospinal fluid circulation reconstruction in the treatment of severe craniocerebral injury.Methods:Seventy patients who underwent surgery in our hospital were selected as subjects for this study.The time was from August 2016 to August 2018,and patients were divided into experimental group(35 cases)and control group(35 cases)according to the random number table method.The control group was treated with a single standard decompressive craniectomy according to clinical symptoms.The experimental group was treated with standard decompressive craniectomy combined with cerebrospinal fluid circulation reconstruction.The surgical treatment effect,GCS(Glasgow Coma Scale)score and operation time were compared between the two groups.Results:After comparison,the surgical treatment effect of the experimental group was higher than that of the control group and there was a significant difference between the two groups(P<0.05).The GCS score and operation time of the experimental group were also better than of the control group and there was a significant difference the two groups(P<0.05).Conclusion:The use of standard decompressive craniectomy combined with cerebrospinal fluid circulation reconstruction in the treatment of severe craniocerebral injury is more effective and worthy of widespread promotion and application.
文摘Objective:To study the relationship of cerebral edema with apoptosis, inflammatory factor generation and AQPs expression in the rat model with closed craniocerebral injury.Methods:Male SD rats were selected as experimental animals and divided into model group and control group. Model group were established into the closed craniocerebral injury models and control group received sham operation. The water content of damaged brain tissue as well as the expression of apoptosis molecules, the generation of inflammatory factors and the expression of aquaporins (AQPs) molecules were measured 7 d after model establishment.Results:The water content of brain tissue of model group was significantly higher than that of control group;Homer1a, Pim-3, Bcl-2, AQP1, AQP4 and AQP9 mRNA expression in brain tissue of model group were significantly lower than those of control group while Cdk5, FasL and Caspase-3 mRNA expression as well as NF-kB, TNF-α, IL-1β, IL-6 and p-JNK generation were significantly higher than those of control group. Homer1a, Pim-3, Bcl-2, AQP1, AQP4 and AQP9 mRNA expression in brain tissue of model group were negatively correlated with water content while Cdk5, FasL and Caspase-3 mRNA expression as well as NF-kB, TNF-α, IL-1β, IL-6 and p-JNK generation were positively correlated with water content.Conclusion:The excessive apoptosis, increased inflammatory factor generation and decreased AQPs expression are closely related to the occurrence of cerebral edema in the process of closed craniocerebral injury.
文摘Objective: To investigate the effects of hyperbaric oxygen intervention on cerebral oxygen metabolism, cerebral injury and oxidative stress response in patients with craniocerebral injury. Methods: A total of 78 patients with traumatic craniocerebral injury who were treated in our hospital between September 2015 and January 2018 were selected as the research subjects and divided into control group (n=39) and hyperbaric oxygen group (n=39) by random number table method. Control group received clinical routine intervention for patients with traumatic craniocerebral injury, hyperbaric oxygen group received hyperbaric oxygen intervention on the basis of routine intervention, and the intervention lasted for one month. The differences in the cerebral oxygen metabolism indexes, cerebral injury-related indexes and oxidative stress indexes were compared between the two groups of patients immediately after admission and after 1 month of treatment. Results: Immediately after admission, the levels of cerebral oxygen metabolism indexes as well as the contents of cerebral injury-related indexes and oxidative stress indexes were not significantly different between the two groups. After 1 month of treatment, cerebral oxygen metabolism indexes SjvO2 and CERO2 levels in hyperbaric oxygen group were higher than those in control group whereas A-vDO2 level was lower than that in control group;serum cerebral injury-related indexes GFAP, MBP, RBP4, SAA and NSE contents were lower than those of control group;serum oxidative stress indexes CAT and T-AOC contents were higher than those of control group whereas ROS and LHP contents were lower than those of control group. Conclusion: Hyperbaric oxygen intervention can effectively optimize the cerebral oxygen metabolism, reduce the cerebral injury and inhibit the systemic oxidative stress response in patients with craniocerebral injury.
文摘Objective:To study the correlation of serum C-type natriuretic peptide (CNP) and insulin-like growth factor-Ⅱ (IGF-Ⅱ) contents with brain injury and inflammatory response in patients with craniocerebral trauma.Methods: Patients with craniocerebral trauma who were treated in the First Affiliated Hospital of Xi'an Jiaotong University between March 2015 and July 2017 were included in the case group of the study, and the healthy volunteers who received physical examination during the same period were included in the control group. The contents of CNP, IGF-Ⅱ, nerve markers and pro-inflammatory cytokines in serum as well as the expression of inflammatory signaling molecules in peripheral blood were measured.Results: CNP and IGF-Ⅱ contents in serum of case group were significantly lower than those of control group whereas UCH-L1, GFAP, S100B, Tau, MIP-1α, IL-1β, IL-6, IL-8 and TNF-α contents in serum as well as JAK2, STAT3, MEK and ERK1/2 mRNA expression in peripheral blood were significantly higher than those of control group;CNP and IGF-Ⅱ contents in serum of case group were negatively correlated with UCH-L1, GFAP, S100B, Tau, MIP-1α, IL-1β, IL-6, IL-8 and TNF-α contents in serum as well as JAK2, STAT3, MEK and ERK1/2 mRNA expression in peripheral blood.Conclusion: The decrease of serum CNP and IGF-Ⅱ in patients with craniocerebral trauma is closely related to the aggravation of brain injury and the over-activation of inflammatory response.
