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Objective To explore the clinical efficacy and safety of hyper-early embolotherapy in treatment of intracranial ruptured aneurysm.Methods A retrospective analysis was made on 33 patients with intracranial ruptured aneurysm.Preoperative Hunt-Hess grade:grade Ⅰ-Ⅱ in 16 patients,gradeⅢin 5 patients,grade Ⅳ in 9 patients,grade Ⅴ in 3 patients.All patients were confirmed with subarachnoid hemorrhage (SAH) by angiography and then underwent embolization under general anesthesia by detachable coils within 6 h from onset.Results After operation,25 patients (75.8％) recovered well,4 patients (12.1％) were with mild disability with paralysis and aphasia,4 patients (12.1％) were dead (1 patient for intraoperative aneurysm rupture,1 patient for postoperative pneumonia,1 patient for infection of hematoma at puncture site and 1 patient for postoperative gastrointestinal bleeding).Followed up 1-6 months,no rebleeding occurred.Conclusions Hyper-early embolotherapy could avoid rebleeding of the aneurysm,and relieve the vasespasm,without increasing the intra-operative rebleeding rate.Moreover hyper-early embolotherapy could greatly decrease the mortality of poor-grade SAH patients.
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Objective To investigate the effect of progesterone on the expressions of inflammation-related factors of cortical cyclooxygenase-2 ( COX-2 ),prostaglandin E2 ( PGE2 ),inducible nitric oxide synthase (iNOS) and NF-κB in the cortex after traumatic brain injury (TBI) in rats so as to study the possible molecular mechanism of neuroprotective effect of progesterone on TBI.Methods Fortyfive male Spraque-Dawley rats were enrolled in the study and randomly divided into three groups,ie,sham operation group (n =15),TBI group (n =15) and progesterone treatment group (n =15).The rat model of TBI was duplicated with the improved Feeney' s method.The PROG treatment group was given i.p.injections of progesterone ( 16 mg/kg) at 1 and 6 hours after injury.The rats were sacrificed in three groups at 24 hours after injury and the specimens were removed.The changes of the positive cell numbers and protein level of COX-2,PGE2,iNOS and NF-κB in the cortex were examined by immunohistochemistry and Western blot.Results The positive cell numbers and protein levels of COX-2,PGE2,iNOS and NF-κB in the cortex of the TBI group were distinctly higher than those of the sham operation group (P＜O.05).While the positive cell numbers and protein levels of COX-2,PGE2,iNOS and NF-κB in the cortex of the progesterone treatment group were distinctly lower than those of the TBI group ( P ＜O.05).Conclusions Progesterone may exert protective effect on TBI through inhibiting NF-κB activity,blocking the inflammation response course of NF - κB and iNOS and decreasing the expressions of COX-2 and PGE2.
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Objective To investigate the effect of nuclear factor-?B(NF-?B) on the regulation of cyclooxygenase-2(COX-2) and Caspase-3 in hippocampal neurons after traumatic brain injury(TBI) in rats,and explore the neuroprotective effect and the possible mechanism of progesterone(PROG) in hippocampal neurons after TBI.Methods Forty-five male Spraque-Dawley rats were randomly divided into 3 groups: sham-operated group(n=15),TBI group(n=15) and PROG-treated group(n=15,intraperitoneal injection of PROG 16 mg/kg in 1 and 6 h after injury).The rat model of TBI was duplicated with the improved Feeney's method.The rats were sacrificed in 24 h after injury and their brain was resected.Nissl staining,immunohistochemical staining and Western blot assay for NF-?B,COX-2 and Caspase-3 was used to observe the changes of positive cell numbers and protein levels in the hippocampal neurons.Results The numbers of immunoreactive neurons to NF-?B(24.0?2.5),COX-2(35.9?2.7) and Caspase-3(25.1?2.7) were significantly increased in the hippocampus at 24 h after TBI when compared with the positive neuron numbers of NF-?B(1.9?0.9),COX-2(1.5?0.7) and Caspase-3(1.8?0.8) in sham group.After the treatment of PROG,the positive cell number of NF-?B(14.2?1.8),COX-2(16.6?2.7),Caspase-3(11.2?2.4) was reduced obviously as compared with the TBI group(P