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Objective:To investigate the significance of ventricular intracranial pressure monitoring in the treatment of traumatic multiple intracranial hematoma (TMIH).Methods:The clinical data of 14 TMIH patients treated with ventricular intracranial pressure monitoring from January 2016 to August 2021 in Beijing Luhe Hospital, Capital Medical University were analyzed retrospectively. The patients were followed up 6 months after injury, and the Glasgow outcome score (GOS) was assessed.Results:All the 14 patients successfully completed ventricular intracranial pressure probe placement. Among them, 8 patients recovered well after continuous monitoring of ventricular intracranial pressure and continuous cerebrospinal fluid drainage. Their ventricular intracranial pressure probe was placed for 5 to 10 (7.3 ± 2.2) d, with no intracranial infection occurred; and their GOS was 5 scores 6-month follow-up after injury. Six cases underwent craniotomy for hematoma removal due to the expansion of intracranial hematoma or aggravation of edema, and decompressive craniectomy was performed during the operation; 6-month follow-up after injury, GOS of 5 scores was in 3 cases, 4 scores in 2 cases, 3 scores in 1 case.Conclusions:The condition of TMIH patients is complex and changeable, and ventricular intracranial pressure monitoring can improve the prognosis of TMIH patients.
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Objective To explore the effect of cerebrospinal fluid release combined with controlled decompression under intracranial pressure monitoring on prevention of intraoperative intracranial swelling in patients with acute severe craniocerebral injury. Methods According to the inclusion and exclusion criteria, 90 patients with acute severe craniocerebral injury were randomly divided into study group (48 cases) and control group (42 cases). Patients in the study group underwent ventricular intracranial pressure probe placement, and then the standard decompressive craniectomy. During the operation, cerebrospinal fluid release combined with controlled decompression under intracranial pressure monitoring was applied to prevent brain swelling. Patients in the control group underwent standard decompressive craniectomy combined with controlled decompression to prevent brain swelling. The incidence of intraoperative brain swelling and cerebral infarction within 3 d after surgery, and the mortality within 1 month after surgery were evaluated. Prognosis was evaluated by GOS score after 3 months of follow-up. Results The brain swelling rate, cerebral infarction rate, mortality within 1 month, and Glasgow Coma Scale (GOS) score at 3 months after operation in the study group were better than those in the control group with statistical significance:10.4％(5/48) vs. 28.6％(12/42), 29.2％(14/48) vs. 64.3％(27/42), 18.8％(9/48) vs. 35.7％(15/42)], (2.83 ± 1.08) scores vs.(1.83 ± 0.76) scores, P<0.05. Conclusions Cerebrospinal fluid release combined with controlled decompression under intracranial pressure monitoring can reduce the incidence of intraoperative brain swelling and improve the prognosis of patients with acute severe craniocerebral injury.
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Objective To compare the effects of urapidil and sodium nitroprusside on blood pressure and prognosis in patients with hypertensive intracerebral hemorrhage. Methods One hundred and fifty patients with hypertensive intracerebral hemorrhage from January to December 2017 were divided into urapidil group and sodium nitroprusside group according to the medication, each group with 75 patients. The changes of blood pressure, heart rate, hematoma size and neurological function were compared between the two groups. Results At 10 and 30 min after treatment, the systolic blood pressure and diastolic blood pressure of patients in urapidil group were lower than those in sodium nitroprusside group (P＜0.05). At 60 min after treatment , there was no significant difference on blood pressure between the two groups (P＞0.05). At 10, 30, 60, 120 and 240 min after treatment, the heart rate of patients in urapidil group were significantly lower than those in sodium nitroprusside group (P＜0.05). At 24 and 72 h after treatment, there was no notable difference in the size of hematoma between the two groups (P＞0.05). At 1 month after treatment, the neurological scores between the two groups were significantly different: (10.1 ± 2.1) scores vs. (13.8 ± 5.9) scores, P＜0.05. Conclusions Urapidil can effectively control blood pressure in patients with hypertensive intracerebral hemorrhage. Moreover, it exerts better long-term neuroprotective effect, compared with sodium nitroprusside.
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<p><b>OBJECTIVE</b>To investigate the effect of trans-acting factor(s) on rat glutathione S-transferase P1 gene (rGSTP1) transcription regulation in tumor cells.</p><p><b>METHODS</b>The binding of trans-acting factor(s) to two enhancers of the rGSTP1 gene, glutathione S-transferase P enhancer I (GPEI) and glutathione S-transferase P enhancer II-1 (GPE II-1), was identified by an electrophoretic mobility shift assay (EMSA). The molecular weight of trans-acting factor was measured in a UV cross-linking experiment.</p><p><b>RESULTS</b>Trans-acting factor interacting with the core sequence of GPEI (cGPEI) were found in human cervical adenocarcinoma cell line (HeLa) and rat hepatoma cell line (CBRH7919). These proteins were not expressed in normal rat liver. Although specific binding proteins that bound to GPE II-1 were detected in all three cell types, a 64 kDa binding protein that exists in HeLa and CBRH7919 cells was absent in normal rat liver.</p><p><b>CONCLUSION</b>cGPEI, GPEII specific binding proteins expressed in HeLa and CBRH7919 cells may play an important role in the high transcriptional level of the rGSTP1 gene in tumor cells.</p>
