[Show abstract][Hide abstract]ABSTRACT: To explore the effects of Xingnaojing injection on cerebral edema and blood-brain barrier (BBB) in rats following traumatic brain injury (TBI).
A total of 108 adult male Sprague-Dawley rats were used as subjects and randomly assigned to three groups: sham-operation, TBI and Xingnaojing injection groups (10 ml/kg/d, intraperitoneal injection). TBI in rats was set up by the improved device of Feeney's weight-dropping model with the impact of 600 g.cm. Brain water content and BBB permeability expressed as Evans blue content were measured at 1, 3, 5 and 7 days after surgery.
In sham-operation group, brain water content and Evans blue content in brain tissue were 78.97%+/-1.22% and 5.13 microgram+/-0.71 microgram. Following TBI, water content in brain tissue was increased significantly at 1, 3, 5 and 7 days (83.49%+/-0.54%, 82.74%+/-0.72%, 80.22%+/-0.68%, 79.21%+/-0.60%), being significantly higher than that in sham operation group (P less than 0.05). Evans blue content was increased in TBI group (16.54 microgram+/-0.60 microgram, 14.92 microgram+/-0.71 microgram, 12.44 microgram+/-0.92 microgram, 10.14 microgram+/-0.52 microgram) as compared with sham-operation group(P less than 0.05). After treatment with Xingnaojing injection, brain water content decreased as compared with TBI group (81.91%+/-1.04%, 80.38%+/-0.72%, 79.54%+/-0.58%, 78.60%+/-0.77%, P less than 0.05). Xingnaojing injection also reduced the leakage of BBB as compared with TBI group (15.11 microgram+/-0.63 microgram, 13.62 microgram+/-0.85 microgram, 10.06microgram+/-0.67 microgram, 9.54 microgram+/-0.41 microgram, P less than 0.05).
Xingnaojing injection could alleviate cerebral edema following TBI via reducing permeability of BBB.
No preview · Article · Jun 2010 · Chinese Journal of Traumatology (English Edition)
[Show abstract][Hide abstract]ABSTRACT: Brain edema leading to an expansion of brain volume has a crucial impact on morbidity and mortality following traumatic brain injury as it increases intracranial pressure, impairs cerebral perfusion and oxygenation, and contributes to additional ischemic injuries. Classically, two major types of traumatic brain edema exist: "vasogenic" and "cytotoxic/cellular". However, the cellular and molecular mechanisms contributing to the development/resolution of traumatic brain edema are poorly understood and no effective drugs can be used now. Aquaporin-4 (AQP4) is a water-channel protein expressed strongly in the brain, predominantly in astrocyte foot processes at the borders between the brain parenchyma and major fluid compartments, including cerebrospinal fluid and blood. This distribution suggests that AQP4 controls water fluxes into and out of the brain parenchyma. In cytotoxic edema, AQP4 deletion slows the rate of water entry into brain, whereas in vasogenic edema, AQP4 deletion reduces the rate of water outflow from brain parenchyma. AQP4 has been proposed as a novel drug target in brain edema. These findings suggest that modulation of AQP4 expression or function may be beneficial in traumatic brain edema.
No preview · Article · Apr 2010 · Chinese Journal of Traumatology (English Edition)
[Show abstract][Hide abstract]ABSTRACT: To investigate the changes and effects of arginine vasopressin (AVP) in patients with acute traumatic subarachnoid hemorrhage (tSAH).
The plasma and cerebrospinal fluid (CSF) level of AVP, and intracranial pressure (ICP) were measured in a total of 21 patients within 24 hours after tSAH. The neurological status of the patients was evaluated by Glasgow Coma Scale (GCS). Correlation between AVP and ICP, GCS was analyzed respectively. Meanwhile, 18 healthy volunteers were recruited as control group.
Compared with control group, the levels (pg/ml) of AVP in plasma and CSF (x+/-s) in tSAH group were significantly increased within 24 hours (38.72+/-24.71 vs 4.54+/-1.38 and 34.61+/-21.43 vs 4.13+/-.26, P less than 0.01), and was remarkably higher in GCS less than or equal to 8 group than GCS larger than 8 group (50.96+/-36.81 vs 25.26+/-12.87 and 44.68+/-31.72 vs 23.53+/-10.94, P less than 0.05). The CSF AVP level was correlated with ICP (r eqaul to 0.46, P less than 0.05), but no statistically significant correlation was found between plasma AVP, CSF AVP and initial GCS (r equal to -0.29, P larger than 0.05 and r equal to -0.32, P larger than 0.05, respectively). The ICP (mm Hg) in tSAH patients was elevated and higher in GCS less than or equal to 8 group than in GCS larger than 8 group (25.9+/-9.7 vs 17.6+/-5.2, P less than 0.05).
Our research suggests that AVP is correlated with the severity of tSAH, and may be involved in the pathophysiological process of brain damage in the early stage after tSAH. It seems that compared with the plasma AVP concentration, CSF AVP is more related to the severity of tSAH.
No preview · Article · Feb 2010 · Chinese Journal of Traumatology (English Edition)
[Show abstract][Hide abstract]ABSTRACT: To evaluate plasma arginine vasopressin (AVP) level in patients with traumatic brain injury and investigate the role of AVP in the process of brain edema.
A total of 30 patients with traumatic brain injury were involved in our study. They were divided into two groups by Glasgow Coma Scale: severe traumatic brain injury group (STBI, GCS less than or equal to 8) and moderate traumatic brain injury group (MTBI, GCS larger than 8). Samples of venous blood were collected in the morning at rest from 15 healthy volunteers (control group)and within 24 h after traumatic brain injury from these patients for AVP determinations by radioimmunoassay. The severity and duration of the brain edema were estimated by head CT scan.
Plasma AVP levels (ng/L) were (mean+/-SD): control, 3.06+/-1.49; MTBI, 38.12+/-7.25; and STBI, 66.61+/-17.10. The plasma level of AVP was significantly increased within 24 h after traumatic brain injury and followed by the reduction of GCS, suggesting the deterioration of cerebral injury (P less than 0.01). And the AVP level was correlated with the severity (STBI r equal to 0.919, P less than 0.01; MTBI r equal to 0.724, P less than 0.01) and the duration of brain edema (STBI r equal to 0.790, P less than 0.01; MTBI r equal to 0.712, P less than 0.01).
The plasma AVP level is closely associated with the severity of traumatic brain injury. AVP may play an important role in pathogenesis of brain edema after traumatic brain injury.
No preview · Article · May 2007 · Chinese Journal of Traumatology (English Edition)
[Show abstract][Hide abstract]ABSTRACT: To detect the levels of dipalmitoyl phosphatidyl choline (DPPC) in the sputum of the patients with acute cerebral injury without primary pulmonary injury after mechanical ventilation treatment.
DPPC levels in sputum of 35 patients with acute cerebral injury but without pulmonary injury were detected with high performance liquid chromatography at the beginning of ventilation and 16-20 days, 21-40 days, and 41-60 days after ventilation, respectively.
There was no significant difference of the DPPC levels between 16-20 days after ventilation (3.36+/-0.49) and at the beginning of ventilation (3.37+/-0.58) (P>0.05). The mean levels of DPPC decreased significantly at 21-40 days (2.87 mg/ml+/-0.26 mg/ml, P<0.05) and 41-60 days (1.93 mg/ml+/-0.21 mg/ml, P<0.01) after ventilation compared with that at the beginning of ventilation. At the same period, the peak inspiratory pressure and the mean pressure of airway increased significantly, whereas the static compliance and the partial pressure of oxygen in artery decreased significantly. Among the 25 patients who received ventilation for more than 20 days, 8 (32%) had slightly-decreased partial pressure of oxygen in artery compared with that at the beginning of ventilation.
Mechanical ventilation can decrease the DPPC levels, decrease the lung compliance and increase the airway pressure, even impair the oxygenation function in patients with acute cerebral injury. Abnormal DPPC is one of the major causes of ventilator-associated lung injury.
No preview · Article · Jun 2006 · Chinese Journal of Traumatology (English Edition)
[Show abstract][Hide abstract]ABSTRACT: To investigate the alternations of thyroid hormone in traumatic patients with severe inflammatory response syndrome (SIRS).
Fifty traumatic patients with severe SIRS were enrolled and divided into two groups according to whether they presented multiorgan dysfunction syndrome (MODS). Thyroid hormone measurements were taken, including total triiodothyronine (TT3), total thyroxine (TT4), free triiodothyronine (FT3), free thyroxine (FT4) and thyroid stimulating hormone (TSH). The acute physiology and chronic health evaluation II (APACHE II) score was calculated according to clinical data. The outcomes of recovery or deterioration were recorded, as well as the length of time from the onset of SIRS to the time thyroid hormones were measured.
Euthyroid sick syndrome (ESS) was presented in 45 cases. TT3 level was negatively correlated with APACHE II score (r = -0.330, P<0.05), and TT3/TT4 value was negatively correlated with the duration of SIRS( r = -0.316, P<0.05). TT3, TT4 and FT3 levels in MODS patients were significantly lower than those without MODS (P<0.05). MODS patients got low TT4 or FT4 level more frequently than those without MODS (P<0.05). Compared with the patients in normal TSH group, the patients with decreased TSH had lower T3, T4, recovery rate and higher APACHE II scores, MODS incidence, but there was no difference between two groups (P>0.05).
Trauma patients with severe SIRS have high possibility to get ESS, which occurs more frequently and severely in MODS patients. It shows the influences of SIRS on the thyroid axes. With the persistence and aggravation of SIRS, there is a progressive reduction of thyroid hormone.
No preview · Article · Apr 2006 · Chinese Journal of Traumatology (English Edition)