We prospectively investigated noninvasive selective brain cooling (SBC) in patients with severe traumatic brain injury.Sixty-six in-patients were randomized into three groups. In one group, brain temperature was maintained at 33 -35°C by cooling the head and neck (SBC); in a second group, mild systemic hypothermia (MSH; rectal temperature 33 -35°C) was produced with a cooling blanket; and a control group was not exposed to hypothermia. Natural rewarming began after 3 days. Mean intracranial pressure 24, 48 or 72 h after injury was significantly lower in the SBC group than in the control group. Mean serum superoxide dismutase levels on Days 3 and 7 after injury in the SBC and MSH groups were significantly higher than in the control group. The percentage of patients with a good neurological outcome 2 years after injury was 72.7%, 57.1% and 34.8% in the SBC, MSH and control groups, respectively. Complications were managed without severe sequelae. Non-invasive SBC was safe and effective.

The emission of M2X+ cluster ions in thermal ionization mass spectrometry when graphite is loaded on the heating filaments was studied. The emission model of non-reductive thermal ionization of graphite was preliminarily discussed and factors influencing the thermal emission of M2X+ ions were investigated. The results show that the intensities of M2X+ cluster ions are related to ionic radius and crystal lattice energy, and possibly also to the solvation energies of ions. The intensities of M2Cl+ (M stands for K, Rb, and Cs) cluster ions, the M2Cl+/M+ ratios, and the 37Cl/35Cl ratios determined from M2Cl+ ion measurement usually increase with measurement time. The variation of the 37Cl/35Cl ratios determined from Cs2Cl+ ion measurement is lower than those based on K2Cl+ and Rb2Cl+ ion measurement, indicating the lowest isotopic fractionation.

This study was designed to evaluate whether the maximum thickness of subarachnoid blood is an independent prognostic marker of mortality after traumatic subarachnoid haemorrhage. Multivariate analysis showed the maximum thickness of subarachnoid blood was an independent predictor of death versus survival 1 month after injury and was inversely associated with Glasgow Coma Scale (GCS) score. Receiver operating characteristic curve analysis showed that maximum thickness of subarachnoid blood > 6.7 mm immediately after non-surgical resuscitation predicted 1-month mortality with 83.9% sensitivity and 67.1% specificity; its predictive value was similar to that of the GCS score. Addition of maximum thickness of subarachnoid blood to the GCS score did not significantly improve predictive performance. Hence, the maximum thickness of subarachnoid blood is a new independent prognostic marker of mortality and might become an additional, valuable tool for risk stratification and decision making in the acute phase of traumatic subarachnoid haemorrhage.

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This study evaluated interleukin (IL)-11 as an independent prognostic marker of mortality following intracerebral haemorrhage (ICH). Plasma IL-11 levels in patients with ICH were significantly higher than in healthy controls. Multivariate analysis indicated that plasma IL-11 level was an independent predictor for mortality within 1 week of ICH onset and was positively associated with haematoma volume. Receiver operating characteristic curve analysis identified that a baseline plasma IL-11 level > 20.9 pg/ml predicted mortality within 1 week of ICH onset with 81.2% sensitivity and 74.1% specificity. The area under the curve for IL-11 level was significantly smaller than that for the Glasgow Coma Scale score, but similar to that for haematoma volume. IL-11 did not, however, significantly improve the predictive value of the Glasgow Coma Scale or haematoma volume. Thus, IL-11 may be considered as a new independent prognostic marker of mortality and an additional valuable tool for risk stratification and decision-making in the acute phase of ICH.