In this study, rats were put into traumatic brain injury-induced coma and treated with median nerve electrical stimulation. We explored the wake-promoting effect, and possible mechanisms, of median nerve electrical st...In this study, rats were put into traumatic brain injury-induced coma and treated with median nerve electrical stimulation. We explored the wake-promoting effect, and possible mechanisms, of median nerve electrical stimulation. Electrical stimulation upregulated the expression levels of orexin-A and its receptor OX1R in the rat prefrontal cortex. Orexin-A expression gradually in-creased with increasing stimulation, while OX1R expression reached a peak at 12 hours and then decreased. In addition, after the OX1R antagonist, SB334867, was injected into the brain of rats after traumatic brain injury, fewer rats were restored to consciousness, and orexin-A and OXIR expression in the prefrontal cortex was downregulated. Our ifndings indicate that median nerve electrical stimulation induced an up-regulation of orexin-A and OX1R expression in the pre-frontal cortex of traumatic brain injury-induced coma rats, which may be a potential mechanism involved in the wake-promoting effects of median nerve electrical stimulation.展开更多
Prognostication of coma patients after brain injury is important, yet challenging. In this study, we evaluated the predictive value of amplitude-integrated electroencephalography （aEEG） for neurological outcomes in ...Prognostication of coma patients after brain injury is important, yet challenging. In this study, we evaluated the predictive value of amplitude-integrated electroencephalography （aEEG） for neurological outcomes in coma patients. From January 2013 to January 2016, 128 coma patients after acute brain injury were prospectively enrolled and monitored with aEEG. The 6-month neurological outcome was evaluated using the Cerebral Performance Category Scale. aEEG monitoring commenced at a median of 7.5 days after coma onset. Continuous normal voltage predicted a good 6-month neurological outcome with a sensitivity of 93.6% and specificity of 85.2%. In contrast, continuous extremely low voltage, burst-suppression, or a flat tracing was correlated with poor 6-month neurological outcome with a sensitivity of 76.5% and specificity of 100%. In conclusion, aEEG is a promising predictor of 6-month neurological outcome for coma patients after acute brain injury.展开更多
BACKGROUND： Several studies have reported the use of zolpidem for induced arousal after permanent vegetative states. However, changes in brain function and EMG after zolpidem treatment requires further investigation....BACKGROUND： Several studies have reported the use of zolpidem for induced arousal after permanent vegetative states. However, changes in brain function and EMG after zolpidem treatment requires further investigation. OBJECTIVE： To investigate the effect of zolpidem, an unconventional drug, on inducing arousal in patients in a permanent vegetative state after brain injury using visual single photon emission computerized tomography and digitized cerebral state monitor. DESIGN： A self-controlled observation. SETTING： Shenzhen People＇s Hospital. PARTICIPANTS： Seven patients in a permanent vegetative state were selected from the Department of Neurosurgery, Shenzhen People＇s Hospital from March 2005 to May 2007. The group included 5 males and 2 females, 24-55 years of age, with a mean age of 38.5 years. All seven patients had been in a permanent vegetative statement for at least six months. The patient group included three comatose patients, who had sustained injuries to the cerebral cortex, basal ganglia, or thalamus in motor vehicle accidents, and four patients, who had suffered primary/secondary brain stem injury. Informed consents were obtained from the patients＇ relatives. METHODS： The patients brains were imaged by ^99Tc^m ECD single photon emission computerized tomography prior to treatment with zolpidem [Sanofi Winthrop Industrie, France, code number approved by the State Food ＆ Drug Administration （SFDA） J20040033, specification 10 mg per tablet. At 8：00 p.m., 10 mg zolpidem was dissolved with distilled water and administered through a nasogastric tube at 1 hour before and after treatment and 1 week following treatment, respectively. Visual analysis of cerebral perfusion changes in the injured brain regions before and after treatment was performed. Simultaneously, three monitoring parameters were obtained though a cerebral state monitor, which included cerebral state index, electromyographic index, and burst suppression index. MAIN OUTCOME MEASURES： Comparison of the three brain function indices, cerebral perfusion in the areas of brain injury, and clinical indices before and after treatment. RESULTS： All seven patients were included in the final analysis. （1） Following treatment, the parameters of cerebral state index and electromyographic index were significantly higher than before treatment （P 〈 0.05）. The burst suppression index was significantly lower than before treatment （P 〈 0.05）. （2） Cerebral perfusion in areas of brain injury improved significantly in all subjects compared to before treatment. CONCLUSION： The findings of visual single photon emission computerized tomography and digitized cerebral state monitor reveal that Zolpidem appears to be an effective treatment for restoring brain function to certain patients in a permanent vegetative state.展开更多
Visual fixation is an item in the visual function subscale of the Coma Recovery Scale-Revised （CRS-R）. Sometimes clinicians using the behavioral scales find it difficult to detect because of the motor impairment in ...Visual fixation is an item in the visual function subscale of the Coma Recovery Scale-Revised （CRS-R）. Sometimes clinicians using the behavioral scales find it difficult to detect because of the motor impairment in patients with disorders of consciousness （DOCs）. Brain- computer interface （BCI） can be used to improve clinical assessment because it directly detects the brain response to an external stimulus in the absence of behavioral expres- sion. In this study, we designed a BCI system to assist the visual fixation assessment of DOC patients. The results from 15 patients indicated that three showed visual fixation in both CRS-R and BCI assessments and one did not show such behavior in the CRS-R assessment but achieved significant online accuracy in the BCI assessment. The results revealed that electroencephalography-based BCI can detect the brain response for visual fixation. Therefore, the proposed BCI may provide a promising method for assisting behavioral assessment using the CRS-R.展开更多
BACKGROUND:Traumatic brain injuries are common and costly to hospital systems.Most of the guidelines on management of traumatic brain injuries are taken from the Brain Trauma Foundation Guidelines.This is a review of ...BACKGROUND:Traumatic brain injuries are common and costly to hospital systems.Most of the guidelines on management of traumatic brain injuries are taken from the Brain Trauma Foundation Guidelines.This is a review of the current literature discussing the evolving practice of traumatic brain injury.DATA SOURCES:A literature search using multiple databases was performed for articles published through September 2012 with concentration on meta-analyses,systematic reviews,and randomized controlled trials.RESULTS:The focus of care should be to minimize secondary brain injury by surgically decompressing certain hematomas,maintain systolic blood pressure above 90 mmHg,oxygen saturations above 93%,euthermia,intracranial pressures below 20 mmHg,and cerebral perfusion pressure between 60-80 mmHg.CONCLUSION:Much is still unknown about the management of traumatic brain injury.The current practice guidelines have not yet been sufficiently validated,however equipoise is a major issue when conducting randomized control trials among patients with traumatic brain injury.展开更多
Orexins, produced in the lateral hypothalamus, are important neuropeptides that participate in the sleep/wake cycle, and their expres- sion coincides with the projection area of the vagus nerve in the brain. Vagus ner...Orexins, produced in the lateral hypothalamus, are important neuropeptides that participate in the sleep/wake cycle, and their expres- sion coincides with the projection area of the vagus nerve in the brain. Vagus nerve stimulation has been shown to decrease the amounts of daytime sleep and rapid eye movement in epilepsy patients with traumatic brain injury. In the present study, we investigated whether vagus nerve stimulation promotes wakefulness and affects orexin expression. A rat model of traumatic brain injury was established using the free fall drop method. In the stimulated group, rats with traumatic brain injury received vagus nerve stimulation （frequency, 30 Hz, current, 1.0 mA; pulse width, 0.5 ms; total stimulation time, 15 minutes）. In the antagonist group, rats with traumatic brain injury were intracerebroventricularly injected with the orexin receptor type 1 （OXIR） antagonist SB334867 and received vagus nerve stimulation. Changes in consciousness were observed after stimulation in each group. Enzyme-linked immunosorbent assay, western blot assay and immunohistochemistry were used to assess the levels of orexin-A and OX1R expression in the prefrontal cortex. In the stimulated group, consciousness was substantially improved, orexin-A protein expression gradually increased within 24 hours after injury and OX1R expres- sion reached a peak at 12 hours, compared with rats subjected to traumatic brain injury only. In the antagonist group, the wake-promoting effect of vagus nerve stimulation was diminished, and orexin-A and OX1R expression were decreased, compared with that of the stim- ulated group. Taken together, our findings suggest that vagus nerve stimulation promotes the recovery of consciousness in comatose rats after traumatic brain injury. The upregulation of orexin-A and OXIR expression in the prefrontal cortex might be involved in the wake-promoting effects of vagus nerve stimulation.展开更多
This study was a retrospective analysis of outcome of surgically treated acute traumatic epidural hematomas based on the Glasgow coma scale. The series enrolled forty-six consecutive cases of acute traumatic epidural ...This study was a retrospective analysis of outcome of surgically treated acute traumatic epidural hematomas based on the Glasgow coma scale. The series enrolled forty-six consecutive cases of acute traumatic epidural hematomas. The mean age of patients was 29.56 years and 63.04% of the patients were between 21 and 30 years of age. Forty-tree out of 46 (93.47%) of the patients were males. Road traffic crash was the main mode of injury. The severity of the traumatic brain injury was classified according to the Glasgow coma scale score at admission. The injury was mild or moderate in 35 (76.08%) cases and severe in 11. Eight patients (17.39%) presented with pupillary abnormalities. The computed tomography scanning of the head has objectivized the epidural hematoma in all patients and has shown a mass effect with midline shift in all but one case (45/46). The most frequent surgical procedure done was craniotomy. Six (13.04%) patients died (GOS 1), but 38 (82.60%) recovered fully (GOS 5) and two (04.34%) were disabled but independent (GOS 4). The Glasgow coma score at admission was very predictive for good or poor outcome, since all patients but one who died and all survivors who were disabled were comatose at admission (GCS ≤ 8).展开更多
A total of 43 prolonged coma patients with diffuse axonal injury received the somatosensory evoked potential examination one month after injury in the First Affiliated Hospital, School of Medicine, Zhejiang University...A total of 43 prolonged coma patients with diffuse axonal injury received the somatosensory evoked potential examination one month after injury in the First Affiliated Hospital, School of Medicine, Zhejiang University in China. Somatosensory evoked potentials were graded as normal, abnormal or absent （grades I-III） according to N20 amplitude and central conduction time. The outcome in patients with grade III somatosensory evoked potential was in each case unfavorable. The prognostic accuracy of grade III somatosensory evoked potential for unfavorable and non-awakening outcome was 100% and 80%, respectively. The prognostic accuracy of grade I somatosensory evoked potential for favorable and wakening outcome was 86% and 100%, respectively. These results suggest that somatosensory evoked potential grade is closely correlated with coma severity and degree of recovery. Somatosensory evoked potential is a valuable diagnostic tool to assess prognosis in prolonged coma patients with diffuse axonal injury.展开更多
Objective:To evaluate the effect of promoting resuscitation and the effect differences between acupuncture combined with hyperbaric oxygen therapy(HBOT)and simple HBOT in the patients with coma of acute carbon monoxid...Objective:To evaluate the effect of promoting resuscitation and the effect differences between acupuncture combined with hyperbaric oxygen therapy(HBOT)and simple HBOT in the patients with coma of acute carbon monoxide poisoning(ACMP).Methods:A total of 36 patients with ACMP coma were randomized into a simple HBOT group and acupuncture combined with HBOT group,18 cases in each one.In the simple HBOT group,HBOT was provided once a day for 2 weeks.In the acupuncture combined with HBOT group,acupuncture was provided during HBOT.The acupuncture was given before the patients were sent to the hyperbaric oxygen chamber and the needles were retained until the hyperbaric oxygen treatment was completed.The acupoints included B?ihuì(百会 GV 20),Shuǐgōu(水沟 GV 26),Sìshéncōng(四神聪 EX-HN1),Fēngchí(风池 GB20),Hégǔ(合谷 LI 4),Tàichōng(太冲 LR 3)and Yǒngquán(涌泉 KI 1).The needles were retained through the entire process of HBOT.Such combined treatment was given once a day for 2 weeks.Before the treatment,the score of Glasgow Coma Scale(GCS)was recorded,the levels of serum interleukin-6(IL-6),interleukin-8(IL-8)and brain-derived growth factor(BDNF)were tested and the time from unconsciousness to resuscitation was recorded of the two groups.After treatment,the levels of serum IL-6,IL-8 and BDNF were tested again and the clinical therapeutic effects were evaluated.Results:At last,there were 16 cases in the simple HBOT group and 17 cases in acupuncture combined with HBOT group got resuscitation.The time from unconsciousness to resuscitation was(5.17±1.10)h in the acupuncture combined with HBOT group,which was less than(6.83±2.73)h in the simple HBOT group,indicating the significant difference in statistic(P<0.05).After treatment,the total effective rate was 94.4% in the acupuncture combined with HBOT group,which was higher than 88.9% in the simple HBOT group,indicating the significant difference in statistic(P<0.05).After treatment,the levels of serum IL-6 and IL-8 were(29.72±3.49)and(67.17±7.61)pg/mL respectively in the acupuncture combined with HBOT group,which were lower as compared with those before treatment,indicating the significant differences in statistic(both P<0.05).The level of IL-8 in the acupuncture combined with HBOT group was lower than(72.67±7.17)pg/mL in the simple HBOT group after treatment,indicating the significant difference in statistic(P<0.05).After treatment,the level of BDNF was(14.78±3.90)pg/mL in the acupuncture combined with HBOT group,higher than the level before treatment,presenting the significant difference(P<0.05),and higher than(12.93 ± 2.59)pg/mL in the simple HBOT group after treatment,presenting the significant difference in statistic(P<0.05).Conclusion:Acupuncture combined with HBOT achieves the superior effect of promoting resuscitation and the clinical therapeutic effects as compared with the simple HBOT.Such combined treatment reduces the levels of serum IL-6 and IL-8,increases the level of serum BDNF in ACMP patients,as well as plays the active role in the prevention from delayed encephalopathy after acute carbon monoxide poisoning.展开更多
基金funded by grants from the National Natural Science Foundation of China,No.81260295the Natural Science Foundation of Jiangxi Province of China,No.20132BAB205063
文摘In this study, rats were put into traumatic brain injury-induced coma and treated with median nerve electrical stimulation. We explored the wake-promoting effect, and possible mechanisms, of median nerve electrical stimulation. Electrical stimulation upregulated the expression levels of orexin-A and its receptor OX1R in the rat prefrontal cortex. Orexin-A expression gradually in-creased with increasing stimulation, while OX1R expression reached a peak at 12 hours and then decreased. In addition, after the OX1R antagonist, SB334867, was injected into the brain of rats after traumatic brain injury, fewer rats were restored to consciousness, and orexin-A and OXIR expression in the prefrontal cortex was downregulated. Our ifndings indicate that median nerve electrical stimulation induced an up-regulation of orexin-A and OX1R expression in the pre-frontal cortex of traumatic brain injury-induced coma rats, which may be a potential mechanism involved in the wake-promoting effects of median nerve electrical stimulation.
基金supported by the National Natural Science Foundation of China(81671198)Shanghai Municipal Education Commission-Gaofeng Clinical Medicine Grant(20152212)the Shanghai Shenkang Clinical Research Plan of the Shenkang Hospital Development Center(16CR3011A)
文摘Prognostication of coma patients after brain injury is important, yet challenging. In this study, we evaluated the predictive value of amplitude-integrated electroencephalography （aEEG） for neurological outcomes in coma patients. From January 2013 to January 2016, 128 coma patients after acute brain injury were prospectively enrolled and monitored with aEEG. The 6-month neurological outcome was evaluated using the Cerebral Performance Category Scale. aEEG monitoring commenced at a median of 7.5 days after coma onset. Continuous normal voltage predicted a good 6-month neurological outcome with a sensitivity of 93.6% and specificity of 85.2%. In contrast, continuous extremely low voltage, burst-suppression, or a flat tracing was correlated with poor 6-month neurological outcome with a sensitivity of 76.5% and specificity of 100%. In conclusion, aEEG is a promising predictor of 6-month neurological outcome for coma patients after acute brain injury.
文摘BACKGROUND： Several studies have reported the use of zolpidem for induced arousal after permanent vegetative states. However, changes in brain function and EMG after zolpidem treatment requires further investigation. OBJECTIVE： To investigate the effect of zolpidem, an unconventional drug, on inducing arousal in patients in a permanent vegetative state after brain injury using visual single photon emission computerized tomography and digitized cerebral state monitor. DESIGN： A self-controlled observation. SETTING： Shenzhen People＇s Hospital. PARTICIPANTS： Seven patients in a permanent vegetative state were selected from the Department of Neurosurgery, Shenzhen People＇s Hospital from March 2005 to May 2007. The group included 5 males and 2 females, 24-55 years of age, with a mean age of 38.5 years. All seven patients had been in a permanent vegetative statement for at least six months. The patient group included three comatose patients, who had sustained injuries to the cerebral cortex, basal ganglia, or thalamus in motor vehicle accidents, and four patients, who had suffered primary/secondary brain stem injury. Informed consents were obtained from the patients＇ relatives. METHODS： The patients brains were imaged by ^99Tc^m ECD single photon emission computerized tomography prior to treatment with zolpidem [Sanofi Winthrop Industrie, France, code number approved by the State Food ＆ Drug Administration （SFDA） J20040033, specification 10 mg per tablet. At 8：00 p.m., 10 mg zolpidem was dissolved with distilled water and administered through a nasogastric tube at 1 hour before and after treatment and 1 week following treatment, respectively. Visual analysis of cerebral perfusion changes in the injured brain regions before and after treatment was performed. Simultaneously, three monitoring parameters were obtained though a cerebral state monitor, which included cerebral state index, electromyographic index, and burst suppression index. MAIN OUTCOME MEASURES： Comparison of the three brain function indices, cerebral perfusion in the areas of brain injury, and clinical indices before and after treatment. RESULTS： All seven patients were included in the final analysis. （1） Following treatment, the parameters of cerebral state index and electromyographic index were significantly higher than before treatment （P 〈 0.05）. The burst suppression index was significantly lower than before treatment （P 〈 0.05）. （2） Cerebral perfusion in areas of brain injury improved significantly in all subjects compared to before treatment. CONCLUSION： The findings of visual single photon emission computerized tomography and digitized cerebral state monitor reveal that Zolpidem appears to be an effective treatment for restoring brain function to certain patients in a permanent vegetative state.
基金supported by the National Key Research and Development Program of China (2017YFB1002505)the National Natural Science Foundation of China (61633010, 91420302, and 61503143)+1 种基金the Natural Science Foundation of Guangdong Province, China (2014A030312005 and 2014A030310244)the Pearl River S&T Nova Program of Guangzhou Municipality, China (201710010038)
文摘Visual fixation is an item in the visual function subscale of the Coma Recovery Scale-Revised （CRS-R）. Sometimes clinicians using the behavioral scales find it difficult to detect because of the motor impairment in patients with disorders of consciousness （DOCs）. Brain- computer interface （BCI） can be used to improve clinical assessment because it directly detects the brain response to an external stimulus in the absence of behavioral expres- sion. In this study, we designed a BCI system to assist the visual fixation assessment of DOC patients. The results from 15 patients indicated that three showed visual fixation in both CRS-R and BCI assessments and one did not show such behavior in the CRS-R assessment but achieved significant online accuracy in the BCI assessment. The results revealed that electroencephalography-based BCI can detect the brain response for visual fixation. Therefore, the proposed BCI may provide a promising method for assisting behavioral assessment using the CRS-R.
文摘BACKGROUND:Traumatic brain injuries are common and costly to hospital systems.Most of the guidelines on management of traumatic brain injuries are taken from the Brain Trauma Foundation Guidelines.This is a review of the current literature discussing the evolving practice of traumatic brain injury.DATA SOURCES:A literature search using multiple databases was performed for articles published through September 2012 with concentration on meta-analyses,systematic reviews,and randomized controlled trials.RESULTS:The focus of care should be to minimize secondary brain injury by surgically decompressing certain hematomas,maintain systolic blood pressure above 90 mmHg,oxygen saturations above 93%,euthermia,intracranial pressures below 20 mmHg,and cerebral perfusion pressure between 60-80 mmHg.CONCLUSION:Much is still unknown about the management of traumatic brain injury.The current practice guidelines have not yet been sufficiently validated,however equipoise is a major issue when conducting randomized control trials among patients with traumatic brain injury.
基金supported by the Natural Science Foundation of China,No.81260295the Graduate Student Innovation Fund of Jiangxi Province of China,No.YC2015-S090
文摘Orexins, produced in the lateral hypothalamus, are important neuropeptides that participate in the sleep/wake cycle, and their expres- sion coincides with the projection area of the vagus nerve in the brain. Vagus nerve stimulation has been shown to decrease the amounts of daytime sleep and rapid eye movement in epilepsy patients with traumatic brain injury. In the present study, we investigated whether vagus nerve stimulation promotes wakefulness and affects orexin expression. A rat model of traumatic brain injury was established using the free fall drop method. In the stimulated group, rats with traumatic brain injury received vagus nerve stimulation （frequency, 30 Hz, current, 1.0 mA; pulse width, 0.5 ms; total stimulation time, 15 minutes）. In the antagonist group, rats with traumatic brain injury were intracerebroventricularly injected with the orexin receptor type 1 （OXIR） antagonist SB334867 and received vagus nerve stimulation. Changes in consciousness were observed after stimulation in each group. Enzyme-linked immunosorbent assay, western blot assay and immunohistochemistry were used to assess the levels of orexin-A and OX1R expression in the prefrontal cortex. In the stimulated group, consciousness was substantially improved, orexin-A protein expression gradually increased within 24 hours after injury and OX1R expres- sion reached a peak at 12 hours, compared with rats subjected to traumatic brain injury only. In the antagonist group, the wake-promoting effect of vagus nerve stimulation was diminished, and orexin-A and OX1R expression were decreased, compared with that of the stim- ulated group. Taken together, our findings suggest that vagus nerve stimulation promotes the recovery of consciousness in comatose rats after traumatic brain injury. The upregulation of orexin-A and OXIR expression in the prefrontal cortex might be involved in the wake-promoting effects of vagus nerve stimulation.
文摘This study was a retrospective analysis of outcome of surgically treated acute traumatic epidural hematomas based on the Glasgow coma scale. The series enrolled forty-six consecutive cases of acute traumatic epidural hematomas. The mean age of patients was 29.56 years and 63.04% of the patients were between 21 and 30 years of age. Forty-tree out of 46 (93.47%) of the patients were males. Road traffic crash was the main mode of injury. The severity of the traumatic brain injury was classified according to the Glasgow coma scale score at admission. The injury was mild or moderate in 35 (76.08%) cases and severe in 11. Eight patients (17.39%) presented with pupillary abnormalities. The computed tomography scanning of the head has objectivized the epidural hematoma in all patients and has shown a mass effect with midline shift in all but one case (45/46). The most frequent surgical procedure done was craniotomy. Six (13.04%) patients died (GOS 1), but 38 (82.60%) recovered fully (GOS 5) and two (04.34%) were disabled but independent (GOS 4). The Glasgow coma score at admission was very predictive for good or poor outcome, since all patients but one who died and all survivors who were disabled were comatose at admission (GCS ≤ 8).
基金funded by Zhejiang Medicines &Health Sciences Research Fund (Class A) in 2009, No.2009A086
文摘A total of 43 prolonged coma patients with diffuse axonal injury received the somatosensory evoked potential examination one month after injury in the First Affiliated Hospital, School of Medicine, Zhejiang University in China. Somatosensory evoked potentials were graded as normal, abnormal or absent （grades I-III） according to N20 amplitude and central conduction time. The outcome in patients with grade III somatosensory evoked potential was in each case unfavorable. The prognostic accuracy of grade III somatosensory evoked potential for unfavorable and non-awakening outcome was 100% and 80%, respectively. The prognostic accuracy of grade I somatosensory evoked potential for favorable and wakening outcome was 86% and 100%, respectively. These results suggest that somatosensory evoked potential grade is closely correlated with coma severity and degree of recovery. Somatosensory evoked potential is a valuable diagnostic tool to assess prognosis in prolonged coma patients with diffuse axonal injury.
文摘Objective:To evaluate the effect of promoting resuscitation and the effect differences between acupuncture combined with hyperbaric oxygen therapy(HBOT)and simple HBOT in the patients with coma of acute carbon monoxide poisoning(ACMP).Methods:A total of 36 patients with ACMP coma were randomized into a simple HBOT group and acupuncture combined with HBOT group,18 cases in each one.In the simple HBOT group,HBOT was provided once a day for 2 weeks.In the acupuncture combined with HBOT group,acupuncture was provided during HBOT.The acupuncture was given before the patients were sent to the hyperbaric oxygen chamber and the needles were retained until the hyperbaric oxygen treatment was completed.The acupoints included B?ihuì(百会 GV 20),Shuǐgōu(水沟 GV 26),Sìshéncōng(四神聪 EX-HN1),Fēngchí(风池 GB20),Hégǔ(合谷 LI 4),Tàichōng(太冲 LR 3)and Yǒngquán(涌泉 KI 1).The needles were retained through the entire process of HBOT.Such combined treatment was given once a day for 2 weeks.Before the treatment,the score of Glasgow Coma Scale(GCS)was recorded,the levels of serum interleukin-6(IL-6),interleukin-8(IL-8)and brain-derived growth factor(BDNF)were tested and the time from unconsciousness to resuscitation was recorded of the two groups.After treatment,the levels of serum IL-6,IL-8 and BDNF were tested again and the clinical therapeutic effects were evaluated.Results:At last,there were 16 cases in the simple HBOT group and 17 cases in acupuncture combined with HBOT group got resuscitation.The time from unconsciousness to resuscitation was(5.17±1.10)h in the acupuncture combined with HBOT group,which was less than(6.83±2.73)h in the simple HBOT group,indicating the significant difference in statistic(P<0.05).After treatment,the total effective rate was 94.4% in the acupuncture combined with HBOT group,which was higher than 88.9% in the simple HBOT group,indicating the significant difference in statistic(P<0.05).After treatment,the levels of serum IL-6 and IL-8 were(29.72±3.49)and(67.17±7.61)pg/mL respectively in the acupuncture combined with HBOT group,which were lower as compared with those before treatment,indicating the significant differences in statistic(both P<0.05).The level of IL-8 in the acupuncture combined with HBOT group was lower than(72.67±7.17)pg/mL in the simple HBOT group after treatment,indicating the significant difference in statistic(P<0.05).After treatment,the level of BDNF was(14.78±3.90)pg/mL in the acupuncture combined with HBOT group,higher than the level before treatment,presenting the significant difference(P<0.05),and higher than(12.93 ± 2.59)pg/mL in the simple HBOT group after treatment,presenting the significant difference in statistic(P<0.05).Conclusion:Acupuncture combined with HBOT achieves the superior effect of promoting resuscitation and the clinical therapeutic effects as compared with the simple HBOT.Such combined treatment reduces the levels of serum IL-6 and IL-8,increases the level of serum BDNF in ACMP patients,as well as plays the active role in the prevention from delayed encephalopathy after acute carbon monoxide poisoning.
