Influences of blood lipids on the occurrence and prognosis of hemorrhagic transformation after acute cerebral infarction: a case-control study of 732 patients

Background: To study the influence of blood lipid levels on hemorrhagic transformation(HT) and prognosis after acute cerebral infarction(ACI).Methods: Patients with ACI within 72 h of symptoms onset between January 1 st, 2015, and December 31 st, 2016, were retrospectively analyzed. Patients were divided into group A(without HT) and group B(HT). The outcomes were assessed after 3 months of disease onset using the modified Rankin Scale(m RS). An m RS score of 0–2 points indicated excellent prognosis, and an m RS score of 3–6 points indicated poor prognosis.Results: A total of 732 patients conformed to the inclusion criteria, including 628 in group A and 104 in group B. The incidence of HT was 14.2%, and the median onset time was 2 d(interquartile range, 1–7 d). The percentages of patients with large infarct size and cortex involvement in group B were 80.8% and 79.8%, respectively, which were both significantly higher than those in group A(28.7 and 33.4%, respectively). The incidence rate of atrial fibrillation(AF) in group B was significantly higher than that in group A(39.4% vs. 13.9%, P<0.001). The adjusted multivariate analysis results showed that large infarct size, cortex involvement and AF were independent risk factors of HT, while total cholesterol(TC) was a protective factor of HT(OR=0.359, 95% CI 0.136–0.944, P=0.038). With every 1 mmol/L reduction in normal TC levels, the risk of HT increased by 64.1%. The mortality and morbidity at 3 months in group B(21.2% and 76.7%, respectively) were both significantly higher than those in group A(8.0% and 42.8%, respectively). The adjusted multivariate analysis results showed that large infarct size(OR=12.178, 95% CI 5.390–27.516, P<0.001) was an independent risk factor of long-term unfavorable outcomes, whereas low-density lipoprotein cholesterol(LDL-C) was a protective factor(OR=0.538, 95% CI 0.300–0.964, P=0.037). With every 1 mmol/L reduction in normal LDL-C levels, the risk of an unfavorable outcome increased by 46.2%. Major therapies, including intravenous recombinant human tissue plasminogen activator(r TPA), intensive lipid-lowering statins and anti-platelets, were not significantly related to either HT or long-term, post-ACI poor prognosis.Conclusions: For patients with large infarct sizes, especially those with cortex involvement, AF, or lower levels of TC, the risk of HT might increase after ACI. The risk of a long-term unfavorable outcome in these patients might increase with a reduction in LDL-C.

Effect of ultra-low frequency repetitive transcranial magnetic stimulation on dysphagia in elderly patients with acute cerebral infarction and quality of life

Objective:To investigate the clinical effect of ultra-low frequency repetitive transcranial magnetic stimulation on dysphagia in elderly patients with acute cerebral infarction and its impact on quality of life.Methods:60 elderly patients with dysphagia caused by acute cerebral infarction were randomly divided into rTMS group and control group,30 cases in each group.Both groups received routine drug therapy and swallowing function training.rTMS group was additionally treated by ultra-low frequency(10mHZ)repetitive transcranial magnetic stimulation for 14 days.The changes of NIHSS score andADL score and NSE serum level and Wa Tian drinking water experiment and Fujishima Ichiro dysphagia scale score and SWAL-QOL score and SF-36 score were observed between the two groups before and after treatment.The clinical effect was evaluated by Wa Tian drinking water experiment.Results:After treatment,The clinical effective rate in rTMS group was significantly higher compared with that in the control group(P<0.05),NIHSS score and serum NSE level were significantly lower compared with the control group(P<0.05),ADL score and Fujishima Ichiro dysphagia score and SWAL-QOL score and SF-36 scores were significantly higher compared with the control group(P<0.05).After treatment,SF-36 total score(or SWAL-QOL Score)was negatively correlated with NSE serum level and NIHSS score,which was positively correlated with ADL score and Fujishima Ichiro dysphagia scale score score.Conclusion:Ultra-low frequency rTMS therapy can reduce NSE level,effectively improve dysphagia in elderly patients with acute cerebral infarction and significantly improve the elderly patients'life quality.

Effects of different frequencies of repetitive transcranial magnetic stimulation on the recovery of upper limb motor dysfunction in patients with subacute cerebral infarction

Studies have confirmed that low-frequency repetitive transcranial magnetic stimulation can decrease the activity of cortical neurons, and high-frequency repetitive transcranial magnetic stimulation can increase the excitability of cortical neurons. However, there are few studies concerning the use of different frequencies of repetitive transcranial magnetic stimulation on the recovery of upper-limb motor function after cerebral infarction. We hypothesized that different frequencies of repetitive transcranial magnetic stimulation in patients with cerebral infarction would produce different effects on the recovery of upper-limb motor function. This study enrolled 127 patients with upper-limb dysfunction during the subacute phase of cerebral infarction. These patients were randomly assigned to three groups. The low-frequency group comprised 42 patients who were treated with 1 Hz repetitive transcranial magnetic stimulation on the contralateral hemisphere primary motor cortex （M1）. The high-frequency group comprised 43 patients who were treated with 10 Hz repetitive transcranial magnetic stimulation on ipsilateral M1. Finally, the sham group comprised 42 patients who were treated with 10 Hz of false stimulation on ipsilateral M1. A total of 135 seconds of stimulation was applied in the sham group and high-frequency group. At 2 weeks after treatment, cortical latency of motor-evoked potentials and central motor conduction time were significantly lower compared with before treatment. Moreover, motor function scores were significantly improved. The above indices for the low- and high-frequency groups were significantly different compared with the sham group. However, there was no significant difference between the low- and high-frequency groups. The results show that low- and high-frequency repetitive transcranial magnetic stimulation can similarly improve upper-limb motor function in patients with cerebral infarction.

Major ozonated autohemotherapy promotes the recovery of upper limb motor function in patients with acute cerebral infarction

Major ozonated autohemotherapy is classically used in treating ischemic disorder of the lower limbs In the present study, we performed major ozonated autohemotherapy treatment in patients with acute cerebral infarction, and assessed outcomes according to the U.S. National Institutes of Health Stroke Score, Modified Rankin Scale, and transcranial magnetic stimulation motor-evoked potential. Compared with the control group, the clinical total effective rate and the cortical potential rise rate of the upper limbs were significantly higher, the central motor conduction time of upper limb was significantly shorter, and the upper limb motor-evoked potential amplitude was significantly increased, in the ozone group. In the ozone group, the National Institutes of Health Stroke Score was positively correlated with the central motor conduction time and the motor-evoked potential amplitude of the upper limb. Central motor conduction time and motor-evoked potential amplitude of the upper limb may be effective indicators of motor-evoked potentials to assess upper limb motor function in cerebral infarct patients. Furthermore, major ozonated autohemotherapy may promote motor function recovery of the upper limb in patients with acute cerebral infarction.

Effects of Xuefu Zhuyu Decoction combined with conventional therapy on inflammatory response, oxidative stress, endothelium and related factors in patients with acute cerebral infarction

Objective: To explore the effects of Xuefu Zhuyu Decoction combined with conventional therapy on inflammatory response, oxidative stress, endothelium and related factors in patients with acute cerebral infarction. Methods: A total of 162 patients with acute cerebral infarction admitted to our hospital from November 2016 to January 1818 were selected as subjects. According to the random sampling method, the subjects were divided into 81 cases in the control group and 81 cases in the observation group. The control group was treated with conventional intracranial pressure, anticoagulation, anti-oxidation and lipid-lowering treatment. The observation group was treated with Xuefu Zhuyu Decoction on the basis of the control group. The changes of inflammatory response, oxidative stress, endothelium and related factors were compared and analyzed. Results:Before treatment, the levels of TNF-α, CRP, SOD, MDA, AOPPS, NO, ET-1, MMP-9, PAF and IGF-1 in the two groups were not significantly different, and there was no statistical significance. After treatment, the levels of TNF-α and CRP in the two groups were significantly lower than those before treatment, and the levels of TNF-α and CRP in the observation group were significantly lower than control group;the levels of MDA and AOPPS in the two groups were significantly lower than those before treatment, while the level of SOD was significantly higher than before treatment, and the levels of MDA and AOPPS in the observation group were significantly lower than control group, while the level of SOD was significantly higher. In the control group;the level of ET-1 in the two groups was significantly lower than that before treatment, while the level of NO was significantly higher than that before the treatment, and in the observation group the level of ET-1 was significantly lower than the control group, while the level of NO was significantly higher. In the control group;the levels of MMP-9 and PAF in the two groups were significantly lower than those before treatment, while the level of IGF-1 was significantly higher than before treatment, and the levels of MMP-9 and PAF in the observation group were significantly lower than control group, while the level of IGF-1 was significantly higher than control group. Conclusions: Xuefu Zhuyu Decoction combined with conventional treatment of acute cerebral infarction can effectively reduce inflammation and oxidative stress, improve vascular endothelial function and nerve function, and significantly reduce the degree of brain injury, which has clinical significance.

Morphology of platelet Golgi apparatus and their significance after acute cerebral infarction

Blood samples were harvested from the antecubital vein of 20 fasting patients with acute cerebral infarction at 1, 7 and 15 days after onset to prepare blood platelet suspension. Fasting antecubital vein blood was collected from an additional 20 normal adults as controls. Under transmission elec- tron microscope, platelet Golgi tubules and vesicles became significantly thickened, enlarged, and irregular after acute cerebral infarction. Alpha granules in platelets significantly reduced in number, especially 1 day after cerebral infarction. Under immunoelectron microscopy, a few alpha granules aggregated around Golgi tubules and vesicles after infarction. These results suggested that platelet Golgi apparatus displayed significant morphological changes, which were possibly associated with enhanced synthetic and secretory functions of activated platelets after acute cerebral infarction. This study used Golgi apparatus blocking agent Brefeldin A to block Golgi apparatus in an aim to study the effects of Golgi apparatus on CD40L expression on the surface of activated platelets. Flow cytometry revealed that CD40L expression on activated platelet surfaces decreased significantly when Golgi apparatus was blocked, which indicated that Golgi apparatus participated in the syn- thesis and transport of CD40L to the platelet surface.

Effects of Xingnaojing Injection on Cerebral Neurological Function and ET-1, hs-CRP and TNF-α Levels in Elderly Patients with Acute Cerebral Infarction

OBJECTIVE: To observe the effects of Xingnaojing Injection on the function of cranial nerves and the level of ET-1,hs-CRP and TNF-α in elderly patients with acute cerebral infarction. METHODS: A total of 86 elderly patients with acute cerebral infarction were randomly divided into observation group and control group. The 43 cases in the control group were treated by conventional Western medicine, and 43 cases in the observation group were treated by Xingnaojing injection on the basis of the treatment in control group. After 2 weeks' treatment in Xuancheng People's Hospital of Anhui Province, the neurological function(NIHSS score and MMSE score), daily living ability(BI Index score and ADL score),laboratory indicators(hs-CRP, ET-1, TNF-α) of the 2 groups before and after the treatment were observed and compared,the total clinical effectiveness of the 2 groups were compared. RESULTS: The total effective rate was 88.4% in the observation group, which was signi?cantly higher than that in the control group(62.8%)(P < 0.05). The NIHSS scores in the 2 groups were both signi?cantly increased after the treatment(P < 0.05) while the MMSE scores were signi?cantly decreased(P < 0.05) in the 2 groups, and the scores' improvement in the observation group was signi?cantly higher than that in the control group(P < 0.05). The BI score and ADL score were significantly increased in the 2 groups after the treatment(P < 0.05), and the improvements were obvious in the observation group. The levels of ET-1, hs-CRP and TNF-αin the 2 groups were signi?cantly decreased after the treatment(P < 0.05), and the indexes in the observation group were signi?cantly lower than that in the control group(P < 0.05). CONLUSIONS: Xingnaojing injection can reduce the levels of serum ET-1, hs-CRP and TNF-α, as well as the degree of neurological de?cit in the treatment of elderly patients with acute cerebral infarction. It is also helpful for the prognosis and outcomes of patients with cerebral infarction.

Hypoxic preconditioning stimulates angiogenesis in ischemic penumbra after acute cerebral infarction

Previous studies have demonstrated the protective effect of hypoxic preconditioning on acute cerebral infarction, but the mechanisms underlying this protection remain unclear. To investigate the protective mechanisms of hypoxic preconditioning in relation to its effects on angiogenesis, we in- duced a photochemical model of cerebral infarction in an inbred line of mice （BALB/c）. Mice were then exposed to hypoxic preconditioning 30 minutes prior to model establishment. Results showed significantly increased vascular endothelial growth factor and CD31 expression in the ischemic penumbra at 24 and 72 hours post infarction, mainly in neurons and vascular endothelial cells. Hypoxic preconditioning increased vascular endothelial growth factor and CD31 expression in the ischemic penumbra and the expression of vascular endothelial growth factor was positively related to that of CD31. Moreover, hypoxic preconditioning reduced the infarct volume and improved neu- rological function in mice. These findings indicate that the protective role of hypoxic preconditioning in acute cerebral infarction may possibly be due to an increase in expression of vascular endothelial growth factor and CD31 in the ischemic penumbra, which promoted angiogenesis.

Identification of microRNAs and messenger RNAs involved in human umbilical cord mesenchymal stem cell treatment of ischemic cerebral infarction using integrated bioinformatics analysis

In recent years,a large number of differentially expressed genes have been identified in human umbilical cord mesenchymal stem cell(hUMSC)transplants for the treatment of ischemic cerebral infarction.These genes are involved in various biochemical processes,but the role of microRNAs(miRNAs)in this process is still unclear.From the Gene Expression Omnibus(GEO)database,we downloaded two microarray datasets for GSE78731(messenger RNA(mRNA)profile)and GSE97532(miRNA profile).The differentially expressed genes screened were compared between the hUMSC group and the middle cerebral artery occlusion group.Gene ontology enrichment and pathway enrichment analyses were subsequently conducted using the online Database for Annotation,Visualization,and Integrated Discovery.Identified genes were applied to perform weighted gene co-suppression analyses,to establish a weighted co-expression network model.Furthermore,the protein-protein interaction network for differentially expressed genes from turquoise modules was built using Cytoscape(version 3.40)and the most highly correlated subnetwork was extracted from the protein-protein interaction network using the MCODE plugin.The predicted target genes for differentially expressed miRNAs were also identified using the online database starBase v3.0.A total of 3698 differentially expressed genes were identified.Gene ontology analysis demonstrated that differentially expressed genes that are related to hUMSC treatment of ischemic cerebral infarction are involved in endocytosis and inflammatory responses.We identified 12 differentially expressed miRNAs in middle cerebral artery occlusion rats after hUMSC treatment,and these differentially expressed miRNAs were mainly involved in signaling in inflammatory pathways,such as in the regulation of neutrophil migration.In conclusion,we have identified a number of differentially expressed genes and differentially expressed mRNAs,miRNA-mRNAs,and signaling pathways involved in the hUMSC treatment of ischemic cerebral infarction.Bioinformatics and interaction analyses can provide novel clues for further research into hUMSC treatment of ischemic cerebral infarction.

Magnetic resonance diffusion tensor imaging following major ozonated autohemotherapy for treatment of acute cerebral infarction

Major ozonated autohemotherapy has been shown to promote recovery of upper limb motor function in patients with acute cerebral infarction, but whether naajor ozonated autohelnotherapy affects remote in）ury remains poorly understood. Here, we assumed that major ozonated autohemotherapy contributes to recovery of clinical function, possibly by reducing remote injury after acute cerebral infarction. Sixty acute cerebral infarction patients aged 30-80 years were equally and randomly allocated to ozone treatment and control groups. Patients in the ozone treatment group received medical treatment and major ozonated autohemotherapy （47 mg/L, 100 mL ozone） for 10 ± 2 days. Patients in the control group received medical treatment only. National Institutes of Health Stroke Scale score, modified Rankin scale score, and reduced degree of fractional anisotropy values of brain magnetic resonance diffusion tensor imaging were remarkably decreased, brain function improved, clinical efficiency significantly increased, and no obvious adverse reactions detected in the ozone treatment group compared with the control group. These findings suggest that major ozonated autohemotherapy promotes recovery of neurological function in acute cerebral infarction patients by reducing re,note injury, and additionally, exhibits high safety.

Changes of auditory evoked magnetic fields in patients after acute cerebral infarction using magnetoencephalography

Auditory evoked magnetic fields were recorded from 15 patients with acute cerebral infarction and 11 healthy volunteers using magnetoencephalography.The auditory stimuli of 2 kHz pure tone were binaurally presented with an interstimulus interval of 1 second.The intensity of stimuli was 90 dB and the stimulus duration was 8 ms.The results showed that the M100 was the prominent response, peaking approximately 100 ms after stimulus onset in all subjects.It originated from the area close to Heschl’s gyrus.In the patient group,the peak latency of M100 responses was significantly prolonged,and the mean strength of equivalent current dipole was significantly smaller in the affected hemisphere.The three-dimensional inter-hemispheric difference of the M100 positions was increased in the patient group.Our experimental findings suggested that impairment of cerebral function in patients with acute ischemic stroke can be detected using magnetoencephalography with the higher spatial resolution and temporal resolution.Magnetoencephalography could provide objective and sensitive indices to estimate auditory cortex function in patients with acute cerebral infarction.

The Effect of Electro-Acupuncture on Motor Function Recovery in Patients with Acute Cerebral Infarction:A Randomly Controlled Trial

The aim of this study is to investigate the effect of electro-acupuncture treatment in acute phase of cerebral infarction on the motor functions. In this randomly controlled trial, 86 patients were allocated to two groups, the experimental group given clinical and electro-acupuncture treatments for a period of 4 weeks, and the control group given clinical treatment plus active and/or passive functional exercise. The result showed that the level of impairment and disability in both groups were improvement according to the Chinese Stroke Scale, Brunnstrom-Fugl-Meyer score, and Barthel Index throughout the study and 3 months after. The motor functions and the activities of daily living (ADL) were improved significantly in the electro-acupuncture group as compared with the control group (P

Evaluation of vascular recanalization rate and nerve injury of mechanical thrombectomy combined with rt-PA thrombolysis in treatment of acute cerebral infarction

Objective:To investigate the vascular recanalization rate of mechanical thrombectomy combined with recombinant tissue-type plasminogen activator (rt-PA) thrombolysis in the treatment of acute cerebral infarction and the effect on the nerve injury in patients.Methods:A total of 90 patients with acute cerebral infarction who were treated in our hospital between January 2016 and January 2019 were retrospectively analyzed and divided into the control group (n=46) receiving rt-PA thrombolysis and the observation group (n=44) receiving mechanical thrombectomy combined with rt-PA thrombolysis. The differences in vascular recanalization rate 24 h after treatment as well as serum levels of inflammatory mediators [interleukin-1 (IL-1), interleukin-6 (IL-6), interleukin-7 (IL-7), interleukin-17 (IL-17) and hypersensitive C-reactive protein (hs-CRP)], nerve injury markers [brain-derived neurotrophic factor (BDNF), neuron-specific enolase (NSE) and S100B protein (S100B)] and neurotransmitters [glutamate (Glu) and 5-hydroxytryptamine (5-HT)] before and after treatment were compared between the two groups of patients.Results: 24 h after treatment, the vascular recanalization rate of the observation group was higher than that of the control group (P<0.05). 24 h after treatment and 1 week after treatment, serum IL-1, IL-6, IL-7, IL-17 and hs-CRP levels in the observation group were lower than those in the control group;BDNF level was higher than that in the control group, while NSE and S100B levels were lower than those in the control group;Glu and 5-HT levels were lower than those in the control group (P<0.05). Conclusions: Mechanical thrombectomy combined with rt-PA thrombolysis can increase the early postoperative vascular recanalization rate in patients with acute cerebral infarction, and it also plays an active role in alleviating nerve injury.

Effect of human urinary kallikein on the neurological function and intracranial hemodynamics in patients with acute cerebral infarction

Objective:To explore the effect of human urinary kallikein (HUK) on the neurological function and intracranial hemodynamics in patients with acute cerebral infarction.Methods:A total of 150 patients with acute cerebral infarction who were admitted in our hospital were included in the study and divided into the observation group and the control group with 75 cases in each group according to different treatment protocols. The patients in the two groups were given routine drugs for conservative treatment. On this basis, the patients in the observation group were given HUK. NSE and S-100 protein before treatment, 3, 7, 14, and 28 d after treatment in the two groups were compared. TCD was used to detect the cerebral hemodynamics. NIHSS and BI were used to evaluate the improved degree of neurological function and daily living activities before treatment, 1 and 3 months after treatment.Results: NSE and S-100 protein 3, 7, 14, and 28 d after treatment in the observation group were significantly lower than those in the control group (P<0.05). The blood flow rate of left vertebral artery, right vertebral artery, and basilar artery after treatment in the two groups was significantly elevated (P<0.05). The blood flow rate of left vertebral artery, right vertebral artery, and basilar artery after treatment in the observation group was significantly higher than that in the control group (P<0.05). NIHSS and BI scores 1 and 3 months after treatment in the observation group were significantly superior to those in the control group (P<0.05).Conclusions: HUK can effective reduced the brain tissue injury in patients with acute cerebral infarction, and promote the recovery of neurological function, with an accurate efficacy.

Effect of danhong injection combined with sodium ozagrel on serum IL-8, TNF-α, VEGF, TBIL and NSE in old patients with acute cerebral infarction

Objective:To study the effect of danhong injection combined with sodium ozagrel on serum IL-8, TNF-α, VEGF, TBIL and NSE in old patients with acute cerebral infarction.Methods:A total of 100 old patients with acute cerebral infarction in our hospital from August 2014 to December 2016 were enrolled in this study. The subjects were divided into the control group (n=50) and the treatment group (n=50) randomly. The control group was treated with sodium ozagrel, the treatment group was treated with danhong injection combined with sodium ozagrel, and both the two groups were treated for 14 days. The serum IL-8, TNF-α, VEGF, TBIL and NSE of the two groups before and after treatment were compared.Results:There were no significantly differences of the serum IL-8, TNF-α, VEGF, TBIL and NSE of the two groups before treatment. The serum IL-8, TNF-α, NSE levels of the two groups after treatment were significantly lower than before treatment, the serum VEGF, TBIL levels of the two groups after treatment were significantly higher than before treatment, and that of the treatment group after treatment were significantly better than the control group.Conclusion:Danhong injection combined with sodium ozagrel can significantly reduce the serum IL-8, TNF-α, NSE levels, improve the serum VEGF, TBIL levels, and reduce inflammation, promote the nerve functional recovery of the old patients with acute cerebral infarction, and it was worthy clinical application.

Effect of Acupuncture on Plasmic Levels of Insulin,Glucagon and Hypercoagulability in NIDDM Complicated by Acute Cerebral Infarction

Twenty-one cases of acute cerebral infarction secondary to NIDDM were treated with acupuncture and conventional therapy, and compared with 16 cases treated with conventional therapy alone. The results showed that acupuncture was more effective in reducing insulin and glucagon levels (P

Effects of Yinxingdamo Injection Combined with Oxiracetam Capsule on Cognitive Function and Neurological Deficit in Patients with Acute Cerebral Infarction

OBJETTIVE: To observe the effects of Yinxingdamo Injection combined with oxiracetam capsule on cognitive function and neurological deficit in patients with acute cerebral infarction. METHODS: A total of 76 patients with acute cerebral infarction were randomly divided into observation group and control group, with 38 patients in each group. Patients in the control group were treated with conventional western medicine and oxiracetam capsules while patients in the observation group were given Yinxingdamo injection intravenous drip treatment on the basis of the same treatment. After 4 weeks of treatment, the cognitive function of the two groups before and after treatment was observed [Simple Intelligence Scale(MMSE Score), Montreal Cognitive Assessment Scale(MoCA Score)], Neurological Deficit [Chinese Stroke Scale(CSS Score), Daily Life Activity ability(ADL score)], free radical biochemical indicators [malondialdehyde(MDA), oxide dismutase(SOD)] changes, and statistical effects of two groups. RESULTS: After treatment, the total effective rate of the observation group was 92.1%, which was significantly higher than 73.7% of the control group(P < 0.05). The MMSE score and MoCA score of the two groups were significantly increased after treatment(P < 0.05), and the MMSE score and MoCA score inobservation group were significantly increased after treatment than the control group(P < 0.05). The CSS scores of the two groups were significantly decreased after treatment(P < 0.05), and the ADL scores were significantly increased(P < 0.05). The improvement of CSS score and ADL score in the observation group were significantly better than those in the control group(P < 0.05), and serum MDA levels were significantly decreased in both groups after treatment(P < 0.05), and SOD levels were significantly increased(P < 0.05), and the improvement of MDA and SOD levels in the observation group was significantly better than that in the control group group(P < 0.05). CONCLUSION: Yinxingdamo injection combined with oxiracetam capsule can effectively inhibit the oxygen free radical reaction injury in patients with acute cerebral infarction, and significantly improve the symptoms of cognitive dysfunction and neurological deficit in patients. Its curative effect is exact and worthy of clinical application.

Effect of early rehabilitation training on the serum NGF, NSE, BDNF, and motor function in patients with acute cerebral infarction

Objective:To explore the effect of early rehabilitation training on the serum NGF, NSE, BDNF, and motor function in patients with acute cerebral infarction (ACI).Methods: A total of 150 patients with ACI who were admitted in our hospital from October, 2015 to October, 2016 were included in the study and randomized into the observation group and the control group. The patients in the two groups were given anti-coagulation, anti-platelet aggregation, cerebral circulation improving, and brain cell activators. The patients in the control group were given routine neurological nursing, while the patients in the observation group were given early comprehensive rehabilitation training on the basis of stable vital signs and no disease progression within 48 h. The morning fasting peripheral venous blood before treatment, 2 and 4 weeks after treatment in the two groups was collected. The serum NGF, NSE, BDNF, IL-6, hs-CRP, and TNF-α were detected. The activities of daily living and motor function before treatment, 2 and 4 weeks after treatment in the two groups were evaluated.Results:IL-6, hs-CRP, and TNF-α levels 2 and 4 weeks after treatment in the observation group were significantly lower than those in the control group (P<0.05). NGF and BDNF levels 2 and 4 weeks after treatment in the observation group were significantly higher than those in the control group (P<0.05), while NSE level was significantly lower than that in the control group (P<0.05). MBI and FMA scores 2 and 4 weeks after treatment in the observation group were significantly higher than those in the control group (P<0.05).Conclusions: The early rehabilitation training can effectively reduce the inflammatory reaction of nervous system in patients with ACI, regulate NGF, BDNF, and NSE levels, and play the cerebral function remodeling in order to promote the neural function recovery, and improve the motor function.

Effect of Guhong injection combined with atyplase on vascular endothelial function and fibrinolytic system and related factors in patients with acute cerebral infarction

Objective:To explore the effect of Guhong Injection combined with atyplase on vascular endothelial function and fibrinolytic system and related factors in patients with acute cerebral infarction.Methods:To select 90 patients with acute cerebral infarction in our hospital,divided into control group(48 cases)and observation group(48 cases)randomly.Patients in the control group were treated with alteplase on the basis of routine symptomatic treatment,and the observation group was treated with Guhong injection on the basis of the control group.Before and after treatment,the serum levels of related factors were detected and compared between the two groups.Results:Before treatment,there were no significant differences in serum related factors(ET-1,PAO,H-FABP,VEGF,S100β,BDNF,CEC,Fibulin-5,vWF,P-selectin,t-PA,PAI-1)between the two groups;After treatment,the serum levels of ET-1,PAO,H-FABP,S100β,CEC,Fibulin-5,vWF,P-selectin,PAI-1 in the observation group were significantly lower than those in the control group,and the serum levels of VEGF,BDNF and t-PA were higher than those in the control group,there were significant differences between the two groups.Conclusion:Guhong injection was added to patients with acute cerebral infarction on the basis of routine symptomatic treatment and ateplase,could significantly improve the level of serum related factors,it was more conducive to the control of symptoms and rehabilitation of patients,the effect was definite,it was worth further study and application in clinic.

Correlation of peripheral blood T cell changes with nerve damage, inflammatory response and stress response in patients with acute cerebral infarction

Objective: To investigate the correlation of peripheral blood T cell changes with nerve damage, inflammatory response and stress response in patients with acute cerebral infarction. Methods: 108 patients with acute cerebral infarction who received emergency treatment in Xuefu Hospital of Shaanxi Normal University between September 2015 and August 2017 were selected as the cerebral infarction group, and 100 healthy elderly volunteers who underwent physical examination during the same period were selected as the normal control group. The differences in the expressions of CD4+CD25+ regulatory T lymphocytes in peripheral blood as well as the levels of nerve damage indicators, inflammatory factors and oxidative stress indicators in serum were compared between the two groups. Pearson test was used to evaluate the intrinsic relationship between peripheral blood CD4+CD25+ regulatory T lymphocyte expression and infarction condition in patients with acute cerebral infarction. Results:Peripheral blood CD4+CD25+ regulatory T lymphocyte expression of the cerebral infarction group was higher than that of the normal control group;serum nerve damage indicators UCH-L1, GFAP, and Ang-1 levels were higher than those of the normal control group while IGF-1 and BDNF levels were lower than those of the normal control group;serum inflammatory factors IL-1β, VCAM-1, IL-13, and IL-18 levels were higher than those of the normal control group;serum oxidative stress indicators CAT and T-SOD levels were lower than those of the normal control group whereas MDA level was higher than that of the normal control group. Correlation analysis confirmed that peripheral blood CD4+CD25+ regulatory T lymphocyte expression in patients with acute cerebral infarction was directly correlated with the levels of nerve damage indicators, inflammatory factor, and oxidative stress indicators. Conclusion:The abnormal increase of peripheral blood CD4+CD25+ regulatory T lymphocyte expression in patients with acute cerebral infarction is related to the aggravation of nerve damage and systemic inflammatory stress response.