| Research background:Extradural hematoma is a common neurosurgical disease, counts 30% of traumatic intracranial hematoma. Bleeding sites usually locates at pars temporalis or pars parietalis. The clinical symptoms are always caused by the impressed brain tissue. Nowadays, the major healing method of extradural hematoma is surgical intervention which eliminats haematoma to lower acute intracranial hypertension,preserve brain tissue.However, a lot of clinical researchs revealed that many patients who experienced the cleaning epidural hematoma operation presented second brain injury symptoms such as intracranial hypertension, brain edema, brain hypoxia and ischemic to some extent, as a result the issue on how to prevent or lessen the secondary brain injury of the the cleaning epidural hematoma operation had became a hot research spot.While cleaning the extradural hematoma, Yingming Yang et al infused normal sodium which was fewer in volume to the dose of haematoma by using the 6～8 # needle to puncture the subdural cavity.This method could not only support the partly tumbling dura mate encephali but also could hemostasis. Patients who underwent this method recovered better than those who just cleaned the haematoma. So. whether the method of saline injection can relieve the secondary brain injury of the cleaning epidural hematoma operation, and the mechanism becomes the focal point of reseach.A great quantity of researchs revealed that the Inflammatory reaction second to the injured brain tissue is one of the mechanisms of the secondary brain injury. IL-1βis a important proinflammatory cytokine in the Inflammatory reaction after brain injury. IL-1βcan trigger the Inflammatory reaction and cascade amplification,and it can initiate a great number of inflammatory factors to secrete. This procedure have been called"cytokine storm"which result in organic damage in the end.At the same time,Lots of clinical and experimental studies have shown that IL-1βis one of the sensitive indexs to the prognostics of craniocerebral injury. Untill today, the saline injection is effective clinically, and the experiment research have not been reported, so we establish the animal model of extradural hematoma to observe the change of the brain tissue which saline injection after decompression method is applied. In the present study we assessed the effect of the saline injection through behavior changes, morphological changes and expression of IL-1β. Objective:After rabbit EDH model was established,these new zealand rabbits was at random divided into compression group and saline injection group. through the study we assessed the effect of saline injection in rabbit model after we observed the behavior changes, morphological changes and expression of IL-1β.Methods:Fifty rabbits were equally randomized to three groups as follows:①compression group (n=15): rabbits have only been removed extradural pressure After rabbit EDH model was established②saline injection group (n=15): rabbits were injected 0.6ml of normal sodium into cavum subdural after removed extradural pressure③control group (n=15): cranial bones of rabbits were only drilled and the brain iusse were not pressed.④normal group (n=5): The corresponding animals were killed using perfusion-fixation on 6h ,12h or 24h. With HE stain and changes of some brain tissue and expression of IL-1βwere observed.Results:①All rabbits in EDH group showed decreasing diet amount and deteriorating nervous function, while in saline injection group, the above situations were mild. No obvious change of diet and nervous function in control group and normal group.②Morphological structural changes: The structure of brain tissue is no abnormality in control group and normal group. We observed nerve cells and neuroglia cells obviously dropsy,perivascular space enlarged and a great deal of inflammatory cell existed in the brain tissue of the EDH group, All above pathological changes were slight in saline injection group.③expression of IL-1β:Immunocytochemistry results display that the expression of IL-1βof EDH group was increased significantly compared with saline injection group (P<0.05). The expression of IL-1βwere no significant difference between normal group and control group (P﹥0.05). but the expression of IL-1βof normal and control group is decreased significantly compared with saline injection and EDH group (P<0.01).All the results of EDH group show that Inflammatory reaction existed in the brain tissue after extradural hematoma cleaned. And the results of saline injection group show saline injection can degrade Inflammatory reaction to preserve the brain tissue from the secondary injury .Conclusion:①Inflammatory factor IL-1βis increased significantly in EDH group compared with normal and control group(P<0.01),we can know that IL-1βinduces Inflammatory reaction to take part in the secondary injury after the extradural pressure removaled. ②Inflammatory factor IL-1βis decreased significantly in saline injection group compared with EDH group (P<0.05), This study demonstrated that saline injection can reduce IL-1βexpress to prevent Inflammatory reaction, all the lab results show that the saline injection is a useful method.
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