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Background: The aim of this study was to establish a rat model of open craniocerebral injury at simulated high altitude and to examine the characteristics of this model.Methods: Rats were randomly divided into a plain group and a high altitude group and their corresponding control groups.A rat model of open craniocerebral injury was established with a nail gun shot.Simulated high altitude conditions were established with a hypobaric chamber at 0.6 ATA to mimic pressure at an altitude of 4000 meters.Mortality,brain water content (BWC),Evans blue (EB) content,pathology,regional cerebral blood flow (rCBF),partial pressure of brain tissue oxygen (PbtO2) and brainstem auditory evoked potential (BAEP) were observed at different time point after injury.Results: The model was stable and reproducible.The mortality of the high altitude group was significantly greater than the plain group within 72 h after injury (P< 0.05).BWC and EB content increased by 48 h after injury (P< 0.05); pathological changes in damaged brains were more serious.In contrast,rCBF and PbtO2 had markedly decreased by 72 h (P <0.01); BAEP values were significantly prolonged (P <0.05).Moreover,inverse correlation between rCBF and BWC and positive correlation between rCBF and PbtO2 were found.Conclusion: The rat model of open craniocerebral injury at simulated high altitude can be established successfully using a nail gun shot and a hypobaric chamber.The injury characteristics at high altitude were more serious,rapid,and prolonged than those in the plain group.