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Objective To evaluate clinical significance of monitoring noninvasive intracranial pressure (NICP) and cerebral perfusion pressure (CPP) in treatment of patients with hypertensive intracerebral hemorrhage. Methods This clinical randomized controlled trial enrolled 120 patients with hypertensive intracerebral hemorrhage who had sought medical treatment in our department from June 2008 through May 2010. They were randomized equally into a monitoring group where NICP and CPP were continuously monitored before and after operation and a non-monitoring group where no monitoring of NICP and CPP was performed. Results In the monitoring group,increased NICP and decreased CPP were shown in 50 patients and only 10 patients were shown with normal NICP (＜26.6mmHg) and CPP (＞ 124.3 mm Hg). The abnormal NICP and CPP continuously monitored were treated with specific interventions like further operation or medication. In the non-monitoring group,patients received only conventional treatments.According to the Glasgow Outcome Scale (GOS), 31 patients (51.7％) had good recovery,20 (33.3％) were moderately disabled,5 (8.3％) severely disabled and 4 (6.7％) dead in the monitoring group while 23 (38.3％) patients had good recovery,18 (30.0％)were moderately disabled,10 (16.7％) severely disabled and 9 (15.0％) dead in the non-monitoring group.The outcomes of the monitoring group were significantly better than those of the non-monitoring group (P＜0.05). Conclusion Continuous monitoring of NICP and CPP before and after operation should be performed in the treatment of patients with hypertensive intracerebral hemorrhage because it is helpful for clinical medication and reducing complications and mortality as well.
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Objective To explore the clinical treatment efficacy of punch drainage combined with ventricle puncture in patients with senile hypertensive hemorrhage. Methods One hundred and sixty-eight patients with senile hypertensive hemorrhage, admitted to our hospital from March 2002 to February 2009, were treated by punch drainage combined with ventricle puncture and hematoma dissolution with urokinase. Meanwhile, follow-up for 6-12 months was performed to every patient; the postoperative treatment effects and complications were evaluated by Glasgow Outcome Scale; the relations between the prognosis and both the amount of intracerebral hemorrhage and grades of consciousness situation were statistically analyzed. Results Good prognosis was noted in 91 patients,mild disability in 41, severe disability and vegetative state in 13, and death in 23; few postoperative complications were noted. The prognoses were significantly different in patients with different amounts of intracerebral hemorrhage; so are those in patients with different grades of consciousness situation (P＜0.05); the prognosis of patients under grade Ⅰ-Ⅱ consciousness situation was better than that of patients under grade Ⅲ-Ⅳ consciousness situation and the prognosis of patients with hemorrhage between 30-70 mL was obviously better than that of patients with hemorrhage above 70 mL. Conclusion The punch drainage combined with ventricle puncture and hematoma dissolution with urokinase is an effective treatment method for patients with senile hypertensive intracerebral hematoma.
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Objective To explore the clinical effects of stereotactic radiofrequency multitarget lesion on the treatment of senile dementia in patients with mental disorder. Methods Under the CT localization, 18 patients with mental retardation were treated by stereotactic surgery of multi-target lesion.Their therapeutic effects were evaluated by Scale and National Psychosurgery Cooperation Request on Modern Psychosurgery Operation Cure (protocol) in 1990. Results Postoperative follow-up was performed for 12-36 months; 9 patients progressed remarkably; 6 got improvement and only 3 showed no changes; the total effective rate was 83.3%. The scores of brief psychiatric rating scale, social disability screening schedule and scale for assessment of positive symptoms after the treatment were significantly lower than those before the treatment (P＜0.05). Mini-mental state examination showed no changes on the intelligence before and after the treatment (P＞0.05). Conclusion The stereotactic surgery of multi-targets lesion is an effective method in treating senile dementia in patients with mental disorder,with few complications and little influences on the intelligence.
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Drug addiction is considered as a chronic, recurrent brain disease characterized by relapse. Repeated exposure to certain drugs, such as morphine, can produce deleterious sequelae, such as drug dependence, tolerance and compulsive drug seeking. In the present study, we investigated the dependence and psychological craving for morphine in rats using the conditioned place preference (CPP) paradigm. On the other hand, to study the effect of morphine on hippocampal sensory gating (N40), double click auditory-evoked potential was recorded during the chronic morphine administration, withdrawal and re-exposure to morphine in rats. The rats in morphine group received a course of morphine (10 mg/kg, i.p.) injection for 12 d, followed by 12 d of withdrawal, 1 d of re-exposure to morphine (2.5 mg/kg, i.p.) and 2 d of the second withdrawal. The rats in the control group were treated in the same way except that saline was applied instead of morphine. CPP test demonstrated that the method of drug administration in the present study induced dependence and psychological craving for morphine in rats. The results in the double click auditory-evoked potential experiment showed that during the chronic morphine administration, hippocampal N40 gating was damaged. In the initial 2 d of the first withdrawal hippocampal N40 gating in morphine group was reduced compared with that in the control group and it was significantly greater on the 3rd day, and then recovered gradually to the normal level from day 4 to day 12. After re-exposure to morphine, hippocampal N40 gating in morphine group was significantly reduced compared with that in the control group, and it remained at a lower level during the following 2 d, suggesting that hippocampal N40 gating in rats was more sensitive to morphine during re-exposure. Our results suggest that long-term repeated morphine administration and re-exposure to morphine disrupt hippocampal N40 gating, and that the effect of morphine addiction on the brain is possibly long-term.