Traumatic brain injury (TBI) contributes to hypocoagulopathy associated with prolonged bleeding and hemorrhagic progression. Bloodletting puncture therapy at hand twelve Jing-well points (BL-HTWP) has been applied as a first aid measure in various emergent neurological diseases, but the detailed mechanisms of the modulation between the central nervous system and systemic circulation after acute TBI in rodents remain unclear. To investigate whether BL-HTWP stimulation modulates hypocoagulable state and exerts neuroprotective effect, experimental TBI model of mice was produced by the controlled cortical impactor (CCI), and treatment with BL-HTWP was immediately made after CCI. Then, the effects of BL-HTWP on the neurological function, cerebral perfusion state, coagulable state, and cerebrovascular histopathology post-acute TBI were determined, respectively. Results showed that BL-HTWP treatment attenuated cerebral hypoperfusion and improve neurological recovery post-acute TBI. Furthermore, BL-HTWP stimulation reversed acute TBI-induced hypocoagulable state, reduced vasogenic edema and cytotoxic edema by regulating multiple hallmarks of coagulopathy in TBI. Therefore, we conclude for the first time that hypocoagulopathic state occurs after acute experimental TBI, and the neuroprotective effect of BL-HTWP relies on, at least in part, the modulation of hypocoagulable state. BL-HTWP therapy may be a promising strategy for acute severe TBI in the future.

中文翻译：

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手部十二井穴放血治疗小鼠急性创伤性脑损伤凝血病改善神经功能恢复

创伤性脑损伤 (TBI) 会导致与长期出血和出血进展相关的低凝状态。手头十二井穴放血穿刺疗法（BL-HTWP）已被用作各种神经系统疾病的急救措施，但啮齿动物急性脑外伤后中枢神经系统与体循环调节的详细机制仍有待研究不清楚。为了研究BL-HTWP刺激是否调节低凝状态并发挥神经保护作用，通过受控皮质撞击器（CCI）制作小鼠实验性TBI模型，并在CCI后立即用BL-HTWP进行治疗。然后，确定BL-HTWP对急性TBI后神经功能、脑灌注状态、凝血状态和脑血管组织病理学的影响，分别。结果表明，BL-HTWP 治疗可减轻脑灌注不足并改善急性 TBI 后的神经功能恢复。此外，BL-HTWP 刺激通过调节 TBI 凝血功能障碍的多个标志来逆转急性 TBI 诱导的低凝状态，减少血管源性水肿和细胞毒性水肿。因此，我们首次得出结论，急性实验性 TBI 后发生低凝状态，BL-HTWP 的神经保护作用至少部分依赖于低凝状态的调节。BL-HTWP 治疗可能是未来急性重症 TBI 的一种有前景的策略。通过调节 TBI 凝血病的多个标志，减少血管源性水肿和细胞毒性水肿。因此，我们首次得出结论，急性实验性 TBI 后发生低凝状态，BL-HTWP 的神经保护作用至少部分依赖于低凝状态的调节。BL-HTWP 治疗可能是未来急性重症 TBI 的一种有前景的策略。通过调节 TBI 凝血病的多个标志，减少血管源性水肿和细胞毒性水肿。因此，我们首次得出结论，急性实验性 TBI 后发生低凝状态，BL-HTWP 的神经保护作用至少部分依赖于低凝状态的调节。BL-HTWP 治疗可能是未来急性重症 TBI 的一种有前景的策略。