简介：AbstractBackground:Traumatic brain injury, one of the leading causes of death in adults under 40 years of age in the world, is frequently caused by mechanical shock, resulting in diffuse neuronal damage and long-term cognitive dysfunction. Many existing TBI animal models revival with expensive equipment or special room are needed or the processes of operations are complex and not easy to be widely used. Therefore, a simpler TBI model needs to be designed.Methods:Our TBI model is an innovation of the modeling method through air guns shutting rubber bullets. A core facet is the application of our designed rubber bullet impact device. It could focus the hitting power to the fixed site of the brain, thus triggering a mild closed head injury. Moreover, the degree of damage can be adjusted by the times of shots.Results:Our model induced blood-brain barrier leakage and diffused neuronal damage. Besides, it led to an increased level of Tau phosphorylation and resulted in cognitive dysfunction within several weeks post-injury.Conclusion:Our TBI model is not only simple and time-saving but also can simulate mild brain injuries in clinical. It is suitable for exploring pathobiological mechanisms as well as a screening of potential therapies for TBI.

简介：Traumaticbraininjury(TBI)istheleadingcauseofdeathanddisabilityofpersonsunder45yearsoldintheUnitedStates,affectingover1.5millionindividualseachyear.Ithadbeenthoughtthatrecoveryfromsuchinjuriesisseverelylimitedduetotheinabilityoftheadultbraintoreplacedamagedneurons.However,recentstudiesindicatethatthematuremammaliancentralnervoussystem(CNS)hasthepotentialtoreplenishdamagedneuronsbyproliferationandneuronaldifferentiationofadultneuralstem/progenitorcellsresidingintheneurogenicregionsinthebrain.Furthermore,increasingevidenceindicatesthattheseendogenousstem/progenitorcellsmayplayregenerativeandreparativerolesinresponsetoCNSinjuriesordiseases.Insupportofthisnotion,heightenedlevelsofcellproliferationandneurogenesishavebeenobservedinresponsetobraintraumaorinsultssuggestingthatthebrainhastheinherentpotentialtorestorepopulationsofdamagedordestroyedneurons.Thisreviewwilldiscussthepotentialfunctionsofadultneurogenesisandrecentdevelopmentofstrategiesaimingatharnessingthisneurogeniccapacityinordertorepopulateandrepairtheinjuredbrain.

简介：Thecingulum,theneuraltractconnectingtheorbitofrontalcortexwiththemedialtemporallobe,playsanimportantroleincognition(Bushetal.,2000).Itisalsoimportantinmemorybecauseitprovidescholinergicinnervationstothecerebralcortexafterobtaininginnervationfromthemedialseptalnucleus,the

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简介：Deareditor,Itiswithgreatinterestthatwereadthearticle“Relationshipofcalcitoningene-relatedpeptidewithdiseaseprogressionandprognosisofpatientswithseveretraumaticbraininjury”(Chenetal.,2018).Inthisstudy,theauthorsevaluated121patientswhoweredividedintomild/moderatetraumaticbraininjury(TBI)(n=61),severeTBI(n=35)andcontrol(n=25)groups,andmeasuredserumlevelsofcalcitoningene-relatedpeptide(CGRP)andserumendothelin-1(ET-1).TheyfoundthatlowlevelsofCGRPandhighlevelsofET-1wereassociatedwithhighmortalityat6months.IdentificationofmorphologicalabnormalitiesonCTscansisveryimportantforevaluatingpatientswithTBIbecausedifferentdiagnosesaremadebasedondifferentimagingfindings(Maasetal.,2005).

简介：ObjectiveTrauma在在沙特阿拉伯的年轻年龄组之中是死亡和病态的领先的原因并且开发国家。这研究试图为临床的严厉作为一个潜在的预言者与创伤的大脑损害(TBI)在孩子评估血小板计数的秋天，outcome.MethodsTotally，有TBI的74个病人从开始2008年1月到目的进入我们的医院的小儿科的特别护理单位(PICU)2010年3月(27个月)。基线注册标准是很长时间12年，在在损伤事件以后的4个小时以内的承认，和缩短的损害规模(AIS)(或)，3.1；相对风险(RR)，2.15。接收装置操作特征(巨鸟)曲线和Youden索引证明PFP的最佳截止点在51.5%.ConclusionPFP与TBI的严厉被增加，它能也为它的结果作为一个重要独立预言因素被拿。

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简介：Objective:Tostudythecorrelationbetweenbrainedema,elevatedintracranialpressure(ICP)andcellapoptosisintraumaticbraininjury(TBI).Methods:Inthisstudy,totally42rabbitsin7groupswerestudied.Sixoftheanimalswereidentifiedasacontrolgroup,andtheremaining36animalswereequallydividedinto6TBIgroups.TBImodelswereproducedbythemodifiedmethodofFeeney.Aftertheimpact,ICPofeachsubjectwasrecordedcontinuouslybyanICPmonitoruntiltheanimalwassacrificedatscheduledtime.Theapoptoticbraincellsweredetectedbyanterminaldeoxynucleotide-transferase-mediateddUTP-digoxigeninnickendlabeling(TUNEL)assay.Cerebralwatercontent(CWC)wasmeasuredwithadryingmethodandcalculatedaccordingtotheElliottformula.Then,ananalysiswasconductedtodeterminethecorrelationbetweenthecountofapoptoticcellsandtheclinicalpathologicalchangesofthebrain.Results:Apoptoticcellcountbegantoincrease2haftertheimpact,andreacheditsmaximumabout3daysaftertheimpact.ThepeakvalueofCWCandICPappeared1dayand3daysaftertheimpact,respectively.ApoptoticcellcounthadapositivecorrelationwithCWCandICP.Conclusions:InTBI,occurrenceofbrainedemaandICPincreasemightleadtoapoptosisofbraincells.Anytherapywhichcanrelievebrainedemaand/ordecreaseICPwouldbeabletoreduceneuronapoptosis,therebytoattenuatethesecondarybraindamage.

简介：Theadipocytokine,apelin-13,isanabundantlyexpressedpeptideinthenervoussystem.Apelin-13protectsthebrainagainstischemia/reperfusioninjuryandattenuatestraumaticbraininjurybysuppressingautophagy.However,secondaryapelin-13effectsontraumaticbraininjury-inducedneuralcelldeathandblood-brainbarrierintegrityarestillnotclear.Here,wefoundthatapelin-13significantlydecreasescerebralwatercontent,mitigatesblood-brainbarrierdestruction,reducesaquaporin-4expression,diminishescaspase-3andBaxexpressioninthecerebralcortexandhippocampus,andreducesapoptosis.Theseresultsshowthatapelin-13attenuatessecondaryinjuryaftertraumaticbraininjuryandexertsaneuroprotectiveeffect.

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简介：AbstractPurpose:Traumatic brain injury (TBI) generally causes mortality and disability, particularly in children. Machine learning (ML) is a computer algorithm, applied as a clinical prediction tool. The present study aims to assess the predictability of ML for the functional outcomes of pediatric TBI.Methods:A retrospective cohort study was performed targeting children with TBI who were admitted to the trauma center of southern Thailand between January 2009 and July 2020. The patient was excluded if he/she (1) did not undergo a CT scan of the brain, (2) died within the first 24 h, (3) had unavailable complete medical records during admission, or (4) was unable to provide updated outcomes. Clinical and radiologic characteristics were collected such as vital signs, Glasgow coma scale score, and characteristics of intracranial injuries. The functional outcome was assessed using the King's Outcome Scale for Childhood Head Injury, which was thus dichotomized into favourable outcomes and unfavourable outcomes: good recovery and moderate disability were categorized as the former, whereas death, vegetative state, and severe disability were categorized as the latter. The prognostic factors were estimated using traditional binary logistic regression. By data splitting, 70% of data were used for training the ML models and the remaining 30% were used for testing the ML models. The supervised algorithms including support vector machines, neural networks, random forest, logistic regression, naive Bayes and k-nearest neighbor were performed for training of the ML models. Therefore, the ML models were tested for the predictive performances by the testing datasets.Results:There were 828 patients in the cohort. The median age was 72 months (interquartile range 104.7 months, range 2-179 months). Road traffic accident was the most common mechanism of injury, accounting for 68.7%. At hospital discharge, favourable outcomes were achieved in 97.0% of patients, while the mortality rate was 2.2%. Glasgow coma scale score, hypotension, pupillary light reflex, and subarachnoid haemorrhage were associated with TBI outcomes following traditional binary logistic regression; hence, the 4 prognostic factors were used for building ML models and testing performance. The support vector machine model had the best performance for predicting pediatric TBI outcomes: sensitivity 0.95, specificity 0.60, positive predicted value 0.99, negative predictive value 1.0; accuracy 0.94, and area under the receiver operating characteristic curve 0.78.Conclusion:The ML algorithms of the present study have a high sensitivity; therefore they have the potential to be screening tools for predicting functional outcomes and counselling prognosis in general practice of pediatric TBIs.

简介：Objective:　ToinvestigatethevalueoftranscranialDoppler(TCD)ultrasonographyinevaluatingtheoutcomeofseveretraumaticbraininjuryandtocorrelatetheTCDvalueswithintracranialpressure(ICP)andcerebralperfusionpressure(CPP)monitoring.　　Methods:　AprospectivestudywasconductedtoevaluatethecontributionofTCDultrasonographytoneurologicaloutcomeinaseriesof96severetraumaticbraininjurypatients.ThequantitativevariablesofTCDultrasonographyincludedthemeanbloodflowvelocityofthemiddlecerebralartery(MCA)andpulsatilityindexwithinthefirst24hoursofadmission.TheICPandCPPvalueswerealsorecorded.Outcomein6monthspostinjurywasevaluatedusingtheGlasgowOutcomeScale(GOS4-5wasconsideredas“good”andGOS1-3as“poor”).　　Results:　ThemeanbloodflowvelocityoftheMCAwaslargerthan40cm/sin30(51%)patientswithgoodoutcomewhereasitwaslessthan40cm/sin27(73%)patientswithpooroutcome(P<0.025).ThemeanPIincasesofgoodoutcome(34patients,57%)waslowerthan1.5whereasinpooroutcome(30patients,83%)washigherthan1.5(P<0.001).ThecorrelationsofICPandCPPtopulsatilityindexwerestatisticallysignificant(P<0.01).　　Conclusions:　TCDultrasonographyisvalidinpredictingthepatientsoutcomeof6monthsandcorrelatessignificantlywithICPandCPPvalueswhenitisperformedinthefirst24hoursofseveretraumaticbraininjury.

简介：Objective:Tostudytheeffectsofmagnesiumsulfateonbrainmitochondrialrespiratoryfunctioninratsafterexperimentaltraumaticbraininjuryandthepossiblemechanism.Methods:ThemiddledegreebraininjuryinratswasmadebyBIM-IIImulti-functionimpactingmachine.Thebrainmitochondrialrespiratoryfunctionwasmeasuredwithoxygenelectrodeandtheultra-structuralchangeswereobservedwithtransmissionelectronmicroscope(TEM).Results:1.ThebrainmitochondrialrespiratorystageIIIandrespirationcontrolratereducedsignificantlyintheuntreatedgroupswithin24and72hours.ButtreatedGroupAshowedcertaindegreeofrecoveryofrespiratoryfunction;treatedGroupBshowedfurtherimprovement.2.UntreatedGroup,treatedGroupsAandBhaddifferentdegreesofmitochondrialultra-structuraldamagerespectively,whichcouldbeattenuatedafterthetreatmentwithmagnesiumsulfate.Conclusions:Themitochondrialrespiratoryfunctiondecreasessignificantlyaftertraumaticbraininjury.ButitcanbeapparentlyimprovedaftermagnesiumsulfatemanagementalongwiththeattenuateddamageofmitochondriadiscoveredbyTEM.Thelongercourseoftreatmentcanobtainabetterimprovementofmitochondrialrespiratoryfunction.

简介：Objective:Tostudytheeffectofmildhypothermiaonglucosemetabolismandglycerolofbraintissueinpatientswithseveretraumaticbraininjury(STBI)usingclinicalmicrodialysis.Methods:Thirty-onepatientswithSTBI(GCS≤8)wererandomlydividedintohypothermicgroup(GroupA)andcontrolgroup(GroupB).Microdialysiscatheterswereinsertedintothecerebralcortexofperilesionalandnormalbraintissue.AllsampleswereanalyzedusingCMAmicrodialysisanalyzer.Results:Incomparisonwiththecontrolgroup,lactate/glucoseratio(L/G),lactate/pyruvateratio(L/P)andglycerol(Gly)inperilensionaltissueweresignificantlydecreased;L/Pinnormalbraintissuewassignificantlydecreased.Incontrolgroup,L/G,L/PandGlyinperilensionaltissuewerehigherthanthatinnormalbraintissue.Inthehypothermicgroup.L/Pinperilensionaltissuewashigherthanthatinrelativenormalbrain.Conclusions:MildhypothermiaprotectsbraintissuesbydecreasingL/G,L/PandGlyinperilensionaltissueandL/Pin'normalbrain'tissues.Theenergycrisisandmembranephospholipiddegradationinperilensionaitissueareeasiertohappenaftertraumaticbraininjury,andmildhypothermiaprotectsbrainbetterinperilensionaltissuethaninnormalbraintissue.

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简介：AbstractIn subarachnoid hemorrhage following traumatic brain injury (TBI), the high intracisternal pressure drives the cerebrospinal fluid into the brain parenchyma, causing cerebral edema. Basal cisternostomy involves opening the basal cisterns to atmospheric pressure and draining cerebrospinal fluid in an attempt to reverse the edema. We describe a case of basal cisternostomy combined with decompressive craniectomy. A 35-year-old man with severe TBI following a road vehicle accident presented with acute subdural hematoma, Glasgow coma scale score of 6, fixed pupils and no corneal response. Opening of the basal cisterns and placement of a temporary cisternal drain led to immediate relaxation of the brain. The patient had a Glasgow coma scale score of 15 on postoperative day 6 and was discharged on day 10. We think basal cisternostomy is a feasible and effective procedure that should be considered in the management of TBI.

简介：Inpatientswhohavesustainedtraumaticbraininjurywithassociatedextremityfracture,thereisoftenaclinicalperceptionthattherateofnewboneformationaroundthefracturesiteincreases.Anovergrowthofcallusisobservedandectopicossificationevenoccursinthemuscle,butthemechanismremainsunclear.Whetherthisrapidly-formednewboneisfracturecallusoravariantofheterotopicossification,acommoncomplicationoftraumaticbrain

简介：AbstractTraumatic brain injury (TBI), a growing public health problem, is a leading cause of death and disability worldwide, although its prevention measures and clinical cares are substantially improved. Increasing evidence shows that TBI may increase the risk of mood disorders and neurodegenerative diseases, including Alzheimer's disease (AD). However, the complex relationship between TBI and AD remains elusive. Metabolic dysfunction has been the common pathology in both TBI and AD. On the one hand, TBI perturbs the glucose metabolism of the brain, and causes energy crisis and subsequent hyperglycolysis. On the other hand, glucose deprivation promotes amyloidogenesis via β-site APP cleaving enzyme-1 dependent mechanism, and triggers tau pathology and synaptic function. Recent findings suggest that TBI might facilitate Alzheimer's pathogenesis by altering metabolism, which provides clues to metabolic link between TBI and AD. In this review, we will explore how TBI-induced metabolic changes contribute to the development of AD.

简介：Objective:ToobservetheeffectsofgangliosideGM1onreductionofbrainedemaandameliorationofcerebralmetabolismaftertraumaticbraininjury(TBI).Methods:AnacuteexperimentalclosedTBImodelinratswasinducedbyafluid-percussionbraininjurymodel.AtfiveandsixtyminutesafterTBI,theanimalswereintraperitoneallyinjectedbygangliosideGM1(30mg/kg)orthesamevolumeofsaline.Atthe6thhourafterTBI,effectsofgangliosideGM1orsalineonchangesofmeanarterialpressure(MAP),contentsofwater,lacticacid(LA)andlipipperoxidation(LPO)intheinjuredcerebraltissueswereobserved.Results:AfterTBI,MAPdecreasedandcontentsofwater,LAandLPOincreasedinbraininjurygroup;however,MAPwasbacktonormallevelsandcontentsofwater,LAandLPOdecreasedingangliosideGM1treatedgroup,comparedwiththoseinbraininjurygroup(P<0.05).Nosignificantdifferencebetweenthesalinetreatedgroupandthebraininjurygroup(P>0.05)wasobserved.Conclusions:GangliosideGM1doeshaveobviousneuroprotectiveeffectonearlyTBI.

简介：目的将在骨折和创伤的大脑损害(TBI)的设置以内观察浆液和胼胝leptin表示。64只男SD老鼠全部的方法A同等地被使随机化进4个组：nonoperated组，TBI组，破裂组，和fracture+TBI组织。老鼠在fracture+TBI以后在2，4，8和12个星期被牺牲。浆液leptin用放射性免疫测定被检测，并且胼胝形成放射学地被测量。胼胝leptin被immunohistochemistry分析。在破裂组，TBI组和联合fracture+TBI组的结果浆液leptin层次都显著地在2星期时间点与控制组相比被增加(P<0。05)。在联合fracture+TBI组的浆液leptin在在损害以后的4和8个星期在破裂和TBI组比那显著地高(P<0。05)。在fracture+TBI胼胝和胼胝体积的leptin积极的房间的百分比比在破裂唯一的组的那些显著地高(P<0。01)。我们在一只老鼠特别在开始的8个星期内在愈合的骨头以内表明了提高的leptin表示的结论骨折和TBI当模特儿。一个靠近的协会在破裂在leptin层次和胼胝形成的度之间存在。