| Background and purpose:Brain injury is neurosurgery common and Frequently-occurring disease, especially with the development of modern society, the increase of traffic accidents and weapons of war changes, the incidence of head injury gradually increased, Trauma accounted for 35% to 50%. Severe head injury accounts in brain injury for about 18% to 20%,which Mostly occurs in young adults, mainly in brain injury, brainstem injury, intracranial hematoma, the mortality and disability are high. the clinical prognosis is extremely poor and serious decline in quality of life, it produces great economic burden on the families and society. With the current overall level of medical improvement in mortality in some areas can be reduced to about 20%. In recent years, both domestic and international attach importance to the treatment of traumatic brain injury, but it is limited to the treatment of acute life-saving, and renewed the late mortality and disability are high, it is the key point that how to promote nerve cell regeneration is to promote the function of the nervous system and even complete recovery. In the 90 years in the late 20th century,"Nature"magazine has published that using adult sheep cell nucleus cloning"Dolly"and Kelong Shu, it ignited the hope of nerve cells can be regenerated. There are already successful reports of the neural stem cell transplantation in animal experiments at home and abroad. Although, Neural stem cells can be amplified in vitro and differentiated into neurons, astrocytes and oligodendrocytes,but the number of neural stem cells is little, wide distribution of neural stem cells and Difficulties derived, the difficulty of establishing in neural stem cells of no immunogenicity, the difficulties of the choice of transfection vectors and the existence of ethical issues of the allograft and so on, these reasons makes it is limited in the clinical application of the neural stem cells.Studies have proved that bone marrow stromal cells also known as mesenchymal stem cells is a pluripotent stem cells, which can be transplanted into the brain of rats and differentiated into neurons, astrocytes, oligodendrocytes.It Provide the basis for its clinical application research. Large animal model of traumatic brain injury study that G-CSF can mobilize bone marrow stem cells migrate into the blood to the damaged area and differentiate into neural cells, promote their functional recovery. However, recent reports said that G-CSF may exacerbate brain damage of the excitatory poisoning mouse model of neonatal brain injury, the clinical effectiveness and safety of G-CSF have been questioned, so G-CSF should be carefully applied in clinical trials, especially in neonatal patients. In this paper, G-CSF treated patients with severe head injury, we assessed the efficacy and safety of recombinant human granulocyte-colony-stimulating factor (G-CSF) after craniocerebral injury.Methods:A total of 60 patients with severe craniocerebral injury were intered into the study.30 patients were randomized to experimental group,30 patients to control group. The experimental group were treated with G-CSF 300μg once a day subcutaneously for 3 days. We assessed the efficacy of granulocyte-colony-stimulating factor (G-CSF) after craniocerebral injury on circulating CD34+stem cells,besides CD133+stem cells.We also assessed its efficacy through the comparison on MRS. blood counts were measured to assess the safety.Results:experimental group increased CD34+and CD133+count apparently compare to prior treatment (P＜0.05). there is an apparent growth in the content of NAA on MRS(P＜0.05).A synchronic rise in white cell count (P＜0.001) was also seen. After the treatment at one month the GCS score in experimental treatment group improved slightly than in the controlled group,but the difference was not significant (t=0.032, P＞0.05). Follow-up 3 months,6 months, GCS score was significantly higher than the control group (t=1.418,1.592, P＜0.05), And the 6-month follow-up of the efficacy of the experimental group significantly better than the control group (Z=3.576, P＜0.01). Experimental group, no serious adverse reactions.Conclusions apply granulocyte-colony-stimulating factor Mobilizes Bone Marrow Stem Cells to the damaged area and differentiate into neuron cell, it can improve the nerval functions apparently.
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