Cattle encephalon glycoside and ignotin(CEGI)injection is a compound preparation formed by a combination of muscle extract from hea lthy rabbits and brain gangliosides from cattle,and it is generally used as a neuropr...Cattle encephalon glycoside and ignotin(CEGI)injection is a compound preparation formed by a combination of muscle extract from hea lthy rabbits and brain gangliosides from cattle,and it is generally used as a neuroprotectant in the treatment of central and peripheral nerve injuries.However,there is still a need for high-level clinical evidence from large samples to support the use of CEGI.We therefore carried out a prospective,multicenter,randomized,double-blind,parallel-group,placebo-controlled study in which we recruited 319 patients with acute cerebral infarction from 16 centers in China from October 2013 to May 2016.The patients were randomized at a 3:1 ratio into CEGI(n=239;155 male,84 female;61.2±9.2 years old)and placebo(n=80;46 male,34 female;63.2±8.28 years old)groups.All patients were given standard care once daily for 14 days,including a 200 mg aspirin enteric-coated tablet and 20 mg atorvastatin calcium,both taken orally,and intravenous infusion of 250–500 mL 0.9%sodium chloride containing 40 mg sodium tanshinone IIA sulfonate.Based on conventional treatment,patients in the CEGI and placebo groups were given 12 mL CEGI or 12 mL sterile water,respectively,in an intravenous drip of 250 mL 0.9%sodium chloride(2 mL/min)once daily for 14 days.According to baseline National Institutes of Health Stroke Scale scores,patients in the two groups were divided into mild and moderate subgroups.Based on the modified Rankin Scale results,the rate of patients with good outcomes in the CEGI group was higher than that in the placebo group,and the rate of disability in the CEGI group was lower than that in the placebo group on day 90 after treatment.In the CEGI group,neurological deficits were decreased on days 14 and 90 after treatment,as measured by the National Institutes of Health Stroke Scale and the Barthel Index.Subgroup analysis revealed that CEGI led to more significant improvements in moderate stroke patients.No drug-related adverse events occurred in the CEGI or placebo groups.In conclusion,CEGI may be a safe and effective treatment for acute cerebral infarction patients,especially for moderate stroke patients.This study was approved by the Ethical Committee of Peking University Third Hospital,China(approval No.2013-068-2)on May 20,2013,and registered in the Chinese Clinical Trial Registry(registration No.ChiCTR1800017937).展开更多
Cattle encephalon glycoside and ignotin(CEGI)injection is known as a multi-target neuroprotective drug that contains numerous liposoluble molecules,such as polypeptides,monosialotetrahexosyl ganglioside(GM-1),free ami...Cattle encephalon glycoside and ignotin(CEGI)injection is known as a multi-target neuroprotective drug that contains numerous liposoluble molecules,such as polypeptides,monosialotetrahexosyl ganglioside(GM-1),free amino acids,hypoxanthine and carnosine.CEGI has been approved by the Chinese State Food and Drug Administration and widely used in the treatments of various diseases,such as stroke and Alzheimer's disease.However,the neuroprotective effects of CEGI beyond the time window of thrombolysis(within 4.5 hours)on acute ischemic stroke remain unclear.This study constructed a rat middle cerebral artery occlusion model by suture-occluded method to simulate ischemic stroke.The first daily dose was intraperitoneally injected at 8 hours post-surgery and the CEGI treatments continued for 14 days.Results of the modified five-point Bederson scale,beam balance test and rotameric test showed the neurological function of ischemic stroke rats treated with 4 m L/kg/d CEGI improved significantly,but the mortality within 14 days did not change significantly.Brain MRI and 2,3,5-triphenyltetrazolium chloride staining confirmed that the infarct size in the 4 m L/kg/d CEGI-treated rats was significantly reduced compared with ischemic insult only.The results of transmission electron microscopy and double immunofluorescence staining showed that the hippocampal neuronal necrosis in the ischemic penumbra decreased whereas the immunopositivity of new neuronal-specific protein doublecortin and the percentage of Ki67/doublecortin positive cells increased in CEGI-treated rats compared with untreated rats.Our results suggest that CEGI has an effective neuroprotective effect on ischemic stroke when administered after the time window of thrombolysis.The study was approved by the Animal Ethics Committee of The Third Military Medical University,China.展开更多
Objective:To study the effect of edaravone combined with cattle encephalon glycoside and ignotin injection adjuvant therapy on nerve function impairment in patients with severe craniocerebral injury.Methods: A total o...Objective:To study the effect of edaravone combined with cattle encephalon glycoside and ignotin injection adjuvant therapy on nerve function impairment in patients with severe craniocerebral injury.Methods: A total of 68 patients with severe craniocerebral injury who were treated in our hospital between January 2013 and May 2016 were collected and divided into control group and observation group according to the random number table, 34 cases in each group. Control group of patients received conventional + cattle encephalon glycoside and ignotin injection therapy, and observation group of patients received conventional +cattle encephalon glycoside and ignotin injection + edaravone therapy. The differences in serum levels of nerve injury indexes, oxidative stress indexes and inflammatory mediators were compared between the two groups of patients before and after treatment.Results: Before treatment, the differences in serum levels of nerve injury indexes, oxidative stress indexes and inflammatory mediators were not statistically significant between two groups of patients. After treatment, serum nerve injury index BNP level in observation group was higher than that in control group while S-100B, GFAP and NSE levels were lower than those in control group;serum oxidative stress indicators MDA and MPO levels were lower than those in control group while SOD and GSH-Px levels were higher than those in control group;serum inflammatory mediators IL-6, IL-8 and TNF-α levels were lower than those in control group.Conclusion:Edaravone combined with cattle encephalon glycoside and ignotin injection adjuvant therapy can effectively reduce the nerve function impairment in patients with severe craniocerebral injury, and the specific mechanisms are related to its effect on reducing the oxidative stress and inflammation.展开更多
Introduction: Cranioencephalic trauma caused by bladed weapons is rare, and that caused by sharp objects is exceptional. The aim of our study was to describe the clinical, therapeutic and evolutionary aspects. Materia...Introduction: Cranioencephalic trauma caused by bladed weapons is rare, and that caused by sharp objects is exceptional. The aim of our study was to describe the clinical, therapeutic and evolutionary aspects. Materials and method: This was a descriptive and analytical study over a 48-month period at CHU la Renaissance from January 1, 2018 to December 31, 2021, concerning patients admitted for penetrating cranioencephalic trauma by pointed object. Results: Twelve cases, all male, of penetrating cranioencephalic sharp-force trauma were identified. The mean age was 34 ± 7 years, with extremes of 11 and 60 years. Farmers and herders accounted for 31% and 25% of cases respectively. The average admission time was 47 hours. Brawls were the circumstances of occurrence in 81.2% of cases. Knives (33%), arrows (25%) and iron bars (16.6%) were the objects used. Altered consciousness was present in 43.8% of cases, and focal deficit in 50%. Scannographic lesions were fracture and/or embarrhment (12 cases), intra-parenchymal haematomas (6 cases) and presence of object in place (4 cases). Surgery was performed in 11 patients. Postoperative outcome was favorable in 9 patients. After 12 months, 2 patients were declared unfit. Conclusion: Penetrating head injuries caused by sharp objects are common in Chad. Urgent surgery can prevent disabling after-effects.展开更多
文摘Cattle encephalon glycoside and ignotin(CEGI)injection is a compound preparation formed by a combination of muscle extract from hea lthy rabbits and brain gangliosides from cattle,and it is generally used as a neuroprotectant in the treatment of central and peripheral nerve injuries.However,there is still a need for high-level clinical evidence from large samples to support the use of CEGI.We therefore carried out a prospective,multicenter,randomized,double-blind,parallel-group,placebo-controlled study in which we recruited 319 patients with acute cerebral infarction from 16 centers in China from October 2013 to May 2016.The patients were randomized at a 3:1 ratio into CEGI(n=239;155 male,84 female;61.2±9.2 years old)and placebo(n=80;46 male,34 female;63.2±8.28 years old)groups.All patients were given standard care once daily for 14 days,including a 200 mg aspirin enteric-coated tablet and 20 mg atorvastatin calcium,both taken orally,and intravenous infusion of 250–500 mL 0.9%sodium chloride containing 40 mg sodium tanshinone IIA sulfonate.Based on conventional treatment,patients in the CEGI and placebo groups were given 12 mL CEGI or 12 mL sterile water,respectively,in an intravenous drip of 250 mL 0.9%sodium chloride(2 mL/min)once daily for 14 days.According to baseline National Institutes of Health Stroke Scale scores,patients in the two groups were divided into mild and moderate subgroups.Based on the modified Rankin Scale results,the rate of patients with good outcomes in the CEGI group was higher than that in the placebo group,and the rate of disability in the CEGI group was lower than that in the placebo group on day 90 after treatment.In the CEGI group,neurological deficits were decreased on days 14 and 90 after treatment,as measured by the National Institutes of Health Stroke Scale and the Barthel Index.Subgroup analysis revealed that CEGI led to more significant improvements in moderate stroke patients.No drug-related adverse events occurred in the CEGI or placebo groups.In conclusion,CEGI may be a safe and effective treatment for acute cerebral infarction patients,especially for moderate stroke patients.This study was approved by the Ethical Committee of Peking University Third Hospital,China(approval No.2013-068-2)on May 20,2013,and registered in the Chinese Clinical Trial Registry(registration No.ChiCTR1800017937).
基金the 63rd Batch of First-Class Financing for Chinese Postdoctoral Science Foundation,No.2018M631061(to LT)Macao Youth Scholars Program,No.AM201918(to LT)。
文摘Cattle encephalon glycoside and ignotin(CEGI)injection is known as a multi-target neuroprotective drug that contains numerous liposoluble molecules,such as polypeptides,monosialotetrahexosyl ganglioside(GM-1),free amino acids,hypoxanthine and carnosine.CEGI has been approved by the Chinese State Food and Drug Administration and widely used in the treatments of various diseases,such as stroke and Alzheimer's disease.However,the neuroprotective effects of CEGI beyond the time window of thrombolysis(within 4.5 hours)on acute ischemic stroke remain unclear.This study constructed a rat middle cerebral artery occlusion model by suture-occluded method to simulate ischemic stroke.The first daily dose was intraperitoneally injected at 8 hours post-surgery and the CEGI treatments continued for 14 days.Results of the modified five-point Bederson scale,beam balance test and rotameric test showed the neurological function of ischemic stroke rats treated with 4 m L/kg/d CEGI improved significantly,but the mortality within 14 days did not change significantly.Brain MRI and 2,3,5-triphenyltetrazolium chloride staining confirmed that the infarct size in the 4 m L/kg/d CEGI-treated rats was significantly reduced compared with ischemic insult only.The results of transmission electron microscopy and double immunofluorescence staining showed that the hippocampal neuronal necrosis in the ischemic penumbra decreased whereas the immunopositivity of new neuronal-specific protein doublecortin and the percentage of Ki67/doublecortin positive cells increased in CEGI-treated rats compared with untreated rats.Our results suggest that CEGI has an effective neuroprotective effect on ischemic stroke when administered after the time window of thrombolysis.The study was approved by the Animal Ethics Committee of The Third Military Medical University,China.
文摘Objective:To study the effect of edaravone combined with cattle encephalon glycoside and ignotin injection adjuvant therapy on nerve function impairment in patients with severe craniocerebral injury.Methods: A total of 68 patients with severe craniocerebral injury who were treated in our hospital between January 2013 and May 2016 were collected and divided into control group and observation group according to the random number table, 34 cases in each group. Control group of patients received conventional + cattle encephalon glycoside and ignotin injection therapy, and observation group of patients received conventional +cattle encephalon glycoside and ignotin injection + edaravone therapy. The differences in serum levels of nerve injury indexes, oxidative stress indexes and inflammatory mediators were compared between the two groups of patients before and after treatment.Results: Before treatment, the differences in serum levels of nerve injury indexes, oxidative stress indexes and inflammatory mediators were not statistically significant between two groups of patients. After treatment, serum nerve injury index BNP level in observation group was higher than that in control group while S-100B, GFAP and NSE levels were lower than those in control group;serum oxidative stress indicators MDA and MPO levels were lower than those in control group while SOD and GSH-Px levels were higher than those in control group;serum inflammatory mediators IL-6, IL-8 and TNF-α levels were lower than those in control group.Conclusion:Edaravone combined with cattle encephalon glycoside and ignotin injection adjuvant therapy can effectively reduce the nerve function impairment in patients with severe craniocerebral injury, and the specific mechanisms are related to its effect on reducing the oxidative stress and inflammation.
文摘Introduction: Cranioencephalic trauma caused by bladed weapons is rare, and that caused by sharp objects is exceptional. The aim of our study was to describe the clinical, therapeutic and evolutionary aspects. Materials and method: This was a descriptive and analytical study over a 48-month period at CHU la Renaissance from January 1, 2018 to December 31, 2021, concerning patients admitted for penetrating cranioencephalic trauma by pointed object. Results: Twelve cases, all male, of penetrating cranioencephalic sharp-force trauma were identified. The mean age was 34 ± 7 years, with extremes of 11 and 60 years. Farmers and herders accounted for 31% and 25% of cases respectively. The average admission time was 47 hours. Brawls were the circumstances of occurrence in 81.2% of cases. Knives (33%), arrows (25%) and iron bars (16.6%) were the objects used. Altered consciousness was present in 43.8% of cases, and focal deficit in 50%. Scannographic lesions were fracture and/or embarrhment (12 cases), intra-parenchymal haematomas (6 cases) and presence of object in place (4 cases). Surgery was performed in 11 patients. Postoperative outcome was favorable in 9 patients. After 12 months, 2 patients were declared unfit. Conclusion: Penetrating head injuries caused by sharp objects are common in Chad. Urgent surgery can prevent disabling after-effects.
