Effects of mild hypothermia on cerebral oxygen metabolism and brain injury in patients with severe craniocerebral injury

Objective: To investigate the effects of mild hypothermia on cerebral oxygen metabolism and brain injury in patients with severe craniocerebral injury. Methods: A total of 78 patients with severe craniocerebral injury who underwent emergency treatment in Huanggang Central Hospital between September 2015 and May 2017 were selected as the research subjects and divided into control group (n=39) and mild hypothermia group (n=39) by random number table. Control group received clinical standard large trauma craniotomy for severe craniocerebral injury, and mild hypothermia group received routine surgery and postoperative mild hypothermia therapy. The cerebral oxygen metabolism and brain injury in two groups of patients were detected immediately after admission (T0), 1 week after treatment (T1) and 4 weeks after treatment (T2). Results: At T0, there was no statistically significant difference in the levels of cerebral oxygen metabolism indexes, cerebral blood flow parameters and brain injury markers between the two groups. At T1 and T2, PO2 levels in mild hypothermia group were higher than those in control group while Da-jvO2 levels were lower than those in control group;cerebral blood flow parameters Vs and Wv levels were higher than those in control group while PI levels were lower than those in control group;brain injury markers MBP, AQP-4 and S-100B contents were lower than those in control group while BDNF contents were higher than those in control group. Conclusion: Adjuvant mild hypothermia therapy after routine surgery may further reduce the cerebral oxygen metabolism and relieve the brain injury in patients with severe craniocerebral injury.

Effect of ulinastatin + thymosin adjuvant therapy on inflammatory and stress response in patients with severe pneumonia

Objective: To investigate the effect of ulinastatin + thymosin adjuvant therapy on inflammatory and stress response in patients with severe pneumonia. Methods: A total of 66 patients with severe pneumonia who were diagnosed and treated in Huanggang Central Hospital between July 2016 and July 2017 were divided into control group (n=33) and study group (n=33) by random number table. Control group received routine therapy for severe pneumonia, and study group received routine therapy combined with ulinastatin + thymosin adjuvant therapy, which lasted for 1 week. The differences in serum levels of inflammatory factors and stress hormones were compared between the two groups before and after treatment. Results: Before treatment, the differences in serum levels of inflammatory factors and stress hormones were not statistically significant between the two groups. After 1 week of treatment, serum levels of inflammatory factors and stress hormones of both groups of patients were lower than those before treatment, serum levels of pro-inflammatory factors IL-1β, IL-2, IL-6, IL-8 and TNF-α as well as anti-inflammatory factors IL-4, IL-10 and IL-13 of study group were lower than those of control group, and serum stress hormones AngⅠ, AngⅡ, NE and Cor levels were lower than those of control group. Conclusion: Routine therapy combined with ulinastatin + thymosin adjuvant therapy can further inhibit the systemic inflammatory response and stress response and optimize the overall condition in patients with severe pneumonia.