Yichao Jin

A rat model of smoke inhalation injury

Context: Smoke inhalation injury is the leading cause of acute respiratory failure in critical burn victims. Advances in the treatment of smoke inhalation injury have been limited in the past years. To further explore the pathogenesis, stable and practical animal models are necessary. Objective: To develop a rat model of smoke inhalation injury. Materials and methods: The smoke composition including the particulate matters, irritant gases, chemical carcinogens was measured. The blood gas values, pro-inflammatory and protein concentration in bronchoalveolar lavage fluid and lung wet to dry weight ratio were assayed. Pathological evaluations of pulmonary were performed at 24 h, 96 h, 7 days and 28 days post-injury. Masson–Goldner trichrome staining was performed on day 7 and 28 post-injury, along with the measurement of hydroxyproline and collagen I and III. Results: In our present animal model, smoke inhalation caused a significant hypoxemia and CO poisoning. A surge of pro-inflammatory response and microvascular hyperpermeability with neutrophils accumulations were also found in our animal model. At 24 h post-smoke inhalation, the hematoxylin and eosin results exhibited that there were inflammatory exudates and diffuse hemorrhage in the lung tissue with significant edema. With the time going, the lung injuries appeared at alveolar collapse and alveolar septum thickening, which indicated that smoke inhalation further induced damage to lung parenchyma. Specially, the markedly collagen deposition appeared at 28 days post-injury indicated that pulmonary fibrosis happened. Discussion and conclusion: In conclusion, this rat smoke inhalation injury model induced by our novel self-made smoke generator could be used for acute and chronic lung injury experiments.

Seizure outcome after surgical resection of supratentorial cavernous malformations plus hemosiderin rim in patients with short duration of epilepsy.

OBJECTIVE The objective of this study was to retrospectively review the postoperative seizure outcome in patients with short duration of epilepsy associated with cavernous malformations and analyze the effect of surgical methods on seizure outcome in such population. METHODS 36 patients with short duration of epilepsy (shorter than 12 months) associated with cavernous malformations in temporal or frontal lobe underwent microsurgical resection. The patients were retrospectively divided into two groups: Group A (21 patients) with complete removal of hemosiderin rim and Group B (15 patients) with partial removal of hemosiderin rim. Clinical follow-up was achieved with telephone correspondence or outpatient assessment. The seizure outcome was based on Engels classification. RESULTS After a mean follow-up period of 18 months, 77.8% of the patients (28/36) were classified into Engel class I, including 19 patients (90.5%) in the complete removal of hemosiderin rim group (Group A) and 9 patients (60%) in the partial removal of hemosiderin rim group (Group B). Seizure outcome was significantly better in Group A. There was no mortality and all the postoperative neurological deficits were recovered at the time of follow-up. CONCLUSION The analysis of the seizure outcome demonstrate patients with short duration of epilepsy associated with cavernous malformations could benefit greatly from complete resection of hemosiderin rim and cavernous malformations.

Residual hemifacial spasm after microvascular decompression: prognostic factors with emphasis on preoperative psychological state

Residual hemifacial spasm (HFS) after microvascular decompression (MVD) is common, and the factors associated with residual HFS are still controversial. In the present study, we analyzed the outcome of 212 patients with hemifacial spasm after a single microvascular decompression and evaluated the prognostic factors involved in residual hemifacial spasm. Based on our study, possible prognostic factors included indentation of the root exit zone (REZ), preoperative illness duration, and preoperative psychological state. We suggest that MVD should be performed as early as possible for it may decrease the rate of residual HFS. Preoperative assessment of psychological state in HFS patients is a timely intervention that should be implemented to minimize the residual HFS.

Postoperative complications of central neurocytoma.

Abstract Six patients with central neurocytoma were retrospectively examined, including diagnosis and treatment process as well as postoperative complications. Clinical follow-ups were performed through telephone calls or outpatient service. Of the 6 patients, a total of 5 patients had 1 or more postoperative complications. The postoperative complications included hydrocephalus, basal ganglia edema, epidural hematoma of the operated region and the remote region, and intracranial infection; 5 patients underwent the cortical fistulization approach and 1 underwent the longitudinal fissure-corpus callosum approach. The neoplasms of 3 patients were totally resected and those of the other 3 patients were subtotally resected. Preoperative accurate diagnosis of central neurocytoma is of great importance for the drawing up of the operation strategy; in addition to magnetic resonance imaging and computed tomography, digital subtraction angiography and magnetic resonance spectroscopy could be helpful for the preoperative diagnosis of central neurocytoma. Subtotal resection of the lesion and the longitudinal fissure-corpus callosum approach may be useful for the reduction of postoperative complications.

Spontaneous resolution of nontraumatic chronic subdural hematoma associated with anti-aggregation therapy.

Spontaneous resolution of chronic subdural hematoma (CSDH) is rare, especially for the nontraumatic cases. Here, we present 1 case of a 70-year-old female patient with spontaneous resolution of CSDH. She was chronically anticoagulated after percutaneous coronary intervention. Moreover, she denied previous mild head trauma and bleeding episodes. For personal reasons, she declined surgery. Treatment just included mannitol, which was used to alleviate the symptoms. Intermittent computed tomography showed gradually resolution of CSDH. Spontaneous resolution of nontraumatic CSDH is rare, with different mechanisms and computed tomography characteristics compared with that of traumatic CSDH. Dimerized plasmin fragment D in venous blood may be more sensitive in the judgment of types of CSDH.

Chondroma located in cerebral parenchyma without meningeal attachment.

Intracranial chondromas are rare benign tumors, which usually originate from skull base synchondrosis. In rarer cases, intracranial chondromas originate from the cerebral parenchyma without meningeal attachment, which is defined as intracerebral chondroma. In this paper, an 18-year-old male patient with intracerebral chondroma is presented. There are only 5 cases of intracerebral chondromas without meningeal attachment published in the literature. According to the clinical data, the intracerebral chondromas are hard hyaline cartilage, irregular lobulated grayish-white mass macroscopically and consist of mature hyaline chondrocyte microscopically. Total removal is the best treatment method for intracerebral chondroma.

Effect of Reflection of Temporalis Muscle During Cranioplasty With Titanium Mesh After Standard Trauma Craniectomy.

AbstractCranioplasty (CP) with titanium mesh after standard trauma craniectomy (STC) has been proven to be a favorable technology. According to reflection of temporalis muscle or not, the CP was divided into 2 operation ways. Effect of reflection of temporalis muscle has not been systematically researched. Thirty-nine patients were enrolled to assess the effect of reflection of temporalis muscle during CP after STC. Cranial index of symmetry was adopted to evaluate the aesthetic results, transcranial Doppler was used to assess change of cerebral blood flow (CBF), functional independence measurements were performed to monitor the improvement of neuronal function, and complications associated with CP were also recorded. The results displayed that reflection of temporalis muscle or not had no effect on the anesthetic results. Both operation ways could improve CBF and neuronal function. Cranioplasty with reflection of temporalis muscle could improve CBF and neuronal function more significantly. Furthermore, reflection of temporalis muscle would not increase complications associated with CP. Reflection of temporalis muscle during CP with titanium mesh after STC proves to be an effective and safe operation way.

Nonaneurysmal subarachnoid hemorrhage and cerebral infarction associated with moyamoya disease.

Moyamoya disease patients with subarachnoid hemorrhage and cerebral infarction are rare, especially when the subarachnoid hemorrhage is nonaneurysmal. Here, we present one 48-year-old male patient with moyamoya disease identified with digital subtraction angiography. His initial symptoms are associated with increased intracranial pressure. Subsequent computed tomography demonstrated subarachnoid hemorrhage and cerebral infarction. Digital subtraction angiography showed no obvious aneurysms. We assume that subarachnoid hemorrhage is associated with the rupture of the moyamoya vessels and transdural anastomotic vessels. The cerebral infarction can be also explained by hemodynamic mechanisms. We should pay more attention to the recurrent hemorrhagic stroke.

Proton Magnetic Resonance Spectroscopy (H1-MRS) Study of the Ketogenic Diet on Repetitive Mild Traumatic Brain Injury in Adolescent Rats and Its Effect on Neurodegeneration

OBJECTIVE A ketogenic diet (KD) improves cellular metabolism and functional recovery after moderate-to-severe traumatic brain injury. Here, we evaluated the changes of neurochemical metabolites after KD therapy for repetitive mild traumatic brain injury (rmTBI) and its possible role in neurodegeneration. METHODS Postnatal day 35 rats were randomly divided into 3 groups: sham, control, and KD groups. Rats in control and KD groups were given 3 rmTBI by a fluid percussion traumatic brain injury device 24 hours apart. All rats were killed at 7 days after the last injury. The ipsilateral cortex were analyzed with hematoxylin and eosin staining; beta-hydroxybutyrate was measured; conventional magnetic resonance imaging and the dry-wet weight method were used to assess the brain edema; changes of neurochemical metabolites were assessed using the ratio of N-acetylaspartate (NAA)/creatine (Cr), choline compound (Cho)/Cr, and NAA/Cho with magnetic resonance spectroscopy; the effect of KD therapy on neurodegeneration was evaluated with double immunofluorescence staining of Iba-1/beclin-1; behavioral outcome was assessed with beam walk/beam balance tests. RESULTS KD significantly elevated beta-hydroxybutyrate levels, and there was no brain edema associated with rmTBI and KD therapy; behavioral assessment showed KD therapy significantly improved motor performance; magnetic resonance spectroscopy showed that rmTBI reduced the ratio of NAA/Cr and had no effect on the ratios of Cho/Cr and NAA/Cho whereas KD increased the ratio of NAA/Cr; double immunofluorescence staining showed KD therapy could significantly decrease microglial beclin-1 expression in the ipsilateral cortex. CONCLUSIONS These results suggest the effect of KD on metabolic status and its possible role in preventing neurodegeneration in adolescent rats after rmTBI.

Ethyl pyruvate attenuates delayed experimental cerebral vasospasm following subarachnoid haemorrhage in rats: possible role of JNK pathway

The pathophysiology of delayed cerebral vasospasm (CVS) after subarachnoid haemorrhage (SAH) is multifaceted and involves endothelial apoptosis and inflammation. Ethyl pyruvate (EP) could attenuate early brain injury following SAH via anti-inflammation and inhibition of the c-Jun N-terminal kinase (JNK) signalling pathway. However, the role of EP in the delayed CVS has yet to be determined. In this study, we examined the effect of EP on endothelial apoptosis and inflammation and explore possible signalling pathways. We found that EP could significantly attenuate the delayed CVS. Possible mechanisms include a decrease in the endothelial cell apoptosis of the basilar artery and alleviation of endothelial inflammation. The JNK signalling pathway may play an important role in the neuroprotective effects of EP on delayed CVS. The results suggest that EP may be a possible therapy for delayed CVS, and the JNK signalling pathway should be targeted for therapeutic purposes in the future.