Cerebral arterial blood flow,attention,and executive and cognitive functions in depressed patients after acute hypertensive cerebral hemorrhage

BACKGROUND Intracerebral hemorrhage mainly occurs in middle-aged and elderly patients with hypertension,and surgery is currently the main treatment for hypertensive cerebral hemorrhage,but the bleeding caused by surgery will cause damage to the patient's nerve cells,resulting in cognitive and motor dysfunction,resulting in a decline in the patient's quality of life.AIM To investigate associations between cerebral arterial blood flow and executive and cognitive functions in depressed patients after acute hypertensive cerebral hemorrhage.METHODS Eighty-nine patients with depression after acute hypertensive cerebral hemorrhage who were admitted to our hospital between January 2019 and July 2021 were selected as the observation group,while 100 patients without depression who had acute hypertensive cerebral hemorrhage were selected as the control group.The attention span of the patients was assessed using the Paddle Pin Test while executive function was assessed using the Wisconsin Card Sorting Test(WCST)and cognitive function was assessed using the Montreal Cognitive Assessment Scale(MoCA).The Hamilton Depression Rating Scale(HAMD-24)was used to evaluate the severity of depression of involved patients.Cerebral arterial blood flow was measured in both groups.RESULTS The MoCA score,net scores I,II,III,IV,and the total net score of the scratch test in the observation group were significantly lower than those in the control group(P<0.05).Concurrently,the total number of responses,number of incorrect responses,number of persistent errors,and number of completed responses of the first classification in the WCST test were significantly higher in the observation group than those in the control group(P<0.05).Blood flow in the basilar artery,left middle cerebral artery,right middle cerebral artery,left anterior cerebral artery,and right anterior cerebral artery was significantly lower in the observation group than in the control group(P<0.05).The basilar artery,left middle cerebral artery,right middle cerebral artery,left anterior cerebral artery,and right anterior cerebral artery were positively correlated with the net and total net scores of each part of the Paddle Pin test and the MoCA score(P<0.05),and negatively correlated with each part of the WCST test(P<0.05).In the observation group,the post-treatment improvement was more prominent in the Paddle Pin test,WCST test,HAMD-24 score,and MoCA score compared with those in the pre-treatment period(P<0.05).Blood flow in the basilar artery,left middle cerebral artery,right middle cerebral artery,left anterior cerebral artery,and right anterior cerebral artery significantly improved in the observation group after treatment(P<0.05).CONCLUSION Impaired attention,and executive and cognitive functions are correlated with cerebral artery blood flow in patients with depression after acute hypertensive cerebral hemorrhage and warrant further study.

Postoperative Care for Patients with Hypertensive Intracerebral Hemorrhage

This article summarizes the postoperative care plan for patients with hypertensive intracerebral hemorrhage(HICH).Nursing strategies are analyzed in terms of the level of consciousness,pupil care,vital sign care,temperature care,complication care,and early rehabilitation care,with the goal of providing reference for follow-up care of HICH patients.

Cognitive impairment in cerebral small vessel disease induced by hypertension

Hypertension is a primary risk factor for the progression of cognitive impairment caused by cerebral small vessel disease,the most common cerebrovascular disease.Howeve r,the causal relationship between hypertension and cerebral small vessel disease remains unclear.Hypertension has substantial negative impacts on brain health and is recognized as a risk factor for cerebrovascular disease.Chronic hypertension and lifestyle factors are associated with risks for stro ke and dementia,and cerebral small vessel disease can cause dementia and stroke.Hypertension is the main driver of cerebral small vessel disease,which changes the structure and function of cerebral vessels via various mechanisms and leads to lacunar infarction,leukoaraiosis,white matter lesions,and intracerebral hemorrhage,ultimately res ulting in cognitive decline and demonstrating that the brain is the to rget organ of hypertension.This review updates our understanding of the pathogenesis of hypertensioninduced cerebral small vessel disease and the res ulting changes in brain structure and function and declines in cognitive ability.We also discuss drugs to treat cerebral small vessel disease and cognitive impairment.

Serum vascular endothelial growth factor and cortisol expression to predict prognosis of patients with hypertensive cerebral hemorrhage

BACKGROUND Cerebral hemorrhage is a common and severe complication of hypertension in middle-aged and elderly men.AIM To investigate the correlation between vascular endothelial growth factor(VEGF)and cortisol(Cor)and the prognosis of patients with hypertensive cerebral hemorrhage.METHODS A hundred patients with hypertensive intracerebral hemorrhage were enrolled from January 2020 to December 2022 and assigned to the hypertensive intracerebral hemorrhage group.Another 100 healthy people who were examined at our hospital during the same period were selected and assigned to the healthy group.Peripheral venous blood was collected,and serum Cor and VGEF levels were measured through enzyme linked immunosorbent assay.RESULTS A statistically significant difference in serum Cor and VGEF levels was observed among patients with varying degrees of neurological impairment(P<0.05).Serum Cor and VGEF levels were significantly higher in the severe group than in the mild-to-moderate group.Cor and VEGF levels were significantly higher in patients with poor prognoses than in those with good prognoses.Multiple logistic regression analysis revealed that serum Cor and VGEF levels were independent factors affecting hypertensive intracerebral hemorrhage(P<0.05).CONCLUSION Cor and VGEF are associated with the occurrence and development of hypertensive cerebral hemorrhage and are significantly associated with neurological impairment and prognosis of patients.

High Blood Pressure Increases the Risk of Cerebral Microbleeds in Hypertensive Individuals

Introduction: Hypertension is the leading preventable risk factor for major cardiovascular diseases worldwide. Recently, compelling evidence has emerged associating hypertension with cerebral microbleeds (CMBs), which are subclinical hemorrhages in the brain resulting from structural abnormalities in the small vessels that supply the brain. In addition to overall elevated blood pressure (BP), elevation in individual parameters such as systolic BP, diastolic BP, pulse pressure and mean arterial pressure could also individually be important risk factors for CMBs. This study aimed to assess the association between CMBs and blood pressure, and assess blood pressure parameters that could be possible risk factors for CMB. Methods: A retrospective case-control study was conducted from August 2021 to September 2022 on patients who underwent MRI due to primary complaints of limb disorders, loss of consciousness, persistent dizziness, and intermittent headaches. The patients were divided according to MRI results into 52 cases (those who had CMBs) and 52 controls (those who had no CMBs). Extracted data were analyzed in SPSS. Chi-square test, binary logistic regression, and Spearman’s correlation analysis were conducted. Results: In total, 104 cases and control patients were assessed, with mean (±SD) age 70.6 ± 8.56 vs 68.9 ± 8.93 years respectively (p > 0.05). CMB patients had more cases of stroke, hyperlipidemia and diabetes than non-CMB patients. Systolic blood pressure (SBP), diastolic blood pressure, pulse pressure (PP) and mean arterial pressure (MAP) were all considerably raised in CMB patients than non-CMBs patients. Blood pressure grades were positively correlated with the severity of CMBs (r = 0.22;p = 0.044). Logistic regression analysis showed that SBP and MAP were independent risk factors for CMBs (age and sex adjusted odds ratio = 1.420;95% CI: 1.030 - 1.851, and 1.310;95% CI: 1.011 - 1.631 respectively). Conclusions: In summary, this study found that hypertension was positively correlated with CMBs severity, and that SBP and MAP are independent risk factors for CMBs in patients with hypertension.

High matrix metalloproteinase-9 expression induces angiogenesis and basement membrane degradation in stroke-prone spontaneously hypertensive rats after cerebral infarction

Basement membrane degradation and blood-brain barrier damage appear after cerebral infarc- tion, severely impacting neuronal and brain functioning; however, the underlying pathogenetic mechanisms remain poorly understood. In this study, we induced cerebral infarction in stroke- prone spontaneously hypertensive rats by intragastric administration of high-sodium water （1.3% NaC1） for 7 consecutive weeks. Immunohistochemical and immunofluorescence assays demonstrated that, compared with the non-infarcted contralateral hemisphere, stroke-prone spontaneously hypertensive rats on normal sodium intake and Wistar-Kyoto rats, matrix metalloproteinase-9 expression, the number of blood vessels with discontinuous collagen IV expression and microvessel density were significantly higher, and the number of continuous collagen IV-positive blood vessels was lower in the infarct border zones of stroke-prone sponta- neously hypertensive rats given high-sodium water. Linear correlation analysis showed matrix metalloproteinase-9 expression was positively correlated with the number of discontinuously collagen IV-labeled blood vessels and microvessel density in cerebral infarcts of stroke-prone spontaneously hypertensive rats. These results suggest that matrix metalloproteinase-9 upregula- tion is associated with increased regional angiogenesis and degradation of collagen IV, the major component of the basal lamina, in stroke-prone spontaneously hypertensive rats with high-sodi- um water-induced focal cerebral infarction.

Expression of neurocan mRNA and ultrastructure of brain tissue after cerebral ischemia and reperfusion in stroke-prone renovascular hypertensive rats treated by electroacupuncture

We established a stroke-prone renovascular hypertensive rat model by bilateral constriction of the renal artery with sliver loop clips. After ten weeks, middle cerebral artery occlusion was induced for 2 hours. The rats then received electro-acupuncture at Baihui （DU 20） and Dazhui （DU 14） after onset of ischemia for 30 days. In situ hybridization study showed that electroacupuncture significantly reduced the number of neurocan mRNA-positive cells in the ischemic penumbra and hippocampal tissues of rats. Electron microscopy results demonstrated that the structure of neurons and blood vessels in the ischemic tissues were restored with electroacupuncture. Overall, these data suggest that electroacupuncture may protect neurons against ischemic reperfusion injury in stroke-prone renovascular hypertensive rats, which may be regulated by downregulation of expression of nerve inhibitory factor neurocan mRNA.

Value of inflammatory mediator profiles and procalcitonin in predicting postoperative infection in patients with hypertensive cerebral hemorrhage

BACKGROUND Hypertensive cerebral hemorrhage(HICH)is a common clinical cerebrovascular disease and one of the most serious complications of hypertension.Early warning of the occurrence of infection during treatment and timely anti-infective treatment are of great significance for the early prevention and treatment of postoperative infection in patients with HICH.Changes in the levels of inflammatory mediators,which are closely related to the occurrence and development of postoperative infection,and procalcitonin(PCT),which is a sensitive indicator for diagnosing bacterial infections,are widely used in clinical practice.AIM To explore the application value of inflammatory mediator profiles and PCT in predicting postoperative infection in patients with HICH.METHODS A total of 271 patients who underwent HICH surgery at our hospital between March 2019 and March 2021 were selected and divided into the infection(n=80)and non-infection(n=191)groups according to whether postoperative infection occurred.The postoperative infection status and etiological characteristics of the infective pathogens in the infection group were analyzed.Changes in inflammatory mediator profile indices and PCT levels were compared between the two groups,pre-and postoperatively.RESULTS A total of 109 strains of pathogenic bacteria were detected in the infection group,including 67 strains(61.47%)of gram-negative bacteria,32 strains(29.36%)of gram-positive bacteria,and 10 strains(9.17%)of fungi.The main infection site of the patients in the infection group was the respiratory system(63.75%).Preoperative interleukin(IL)-4,IL-6,IL-10,tumor necrosis factor-α,interferon-γ,and PCT levels were higher in the infection group than in the non-infection group(P<0.05),and there were no significant differences in the IL-2 Levels between the two groups(P>0.05).The inflammatory mediator profile indices and PCT levels were higher in the two groups of patients on the first postoperative day than preoperatively(P<0.05),and were higher than those in the non-infection group(P<0.05).Logistic regression analysis showed that preoperative IL-6 and PCT levels correlated with postoperative infection(P<0.05).Operating characteristic curve analysis results showed that the area under the curve(AUC)values of preoperative IL-6 and PCT levels in predicting postoperative infection in patients with HICH were 0.755 and 0.824,respectively.The AUC value of joint detection was 0.866,which was significantly higher than that of the single index(P<0.05).CONCLUSION Preoperative IL-6 and PCT levels are correlated with postoperative infection in patients with HICH.Their detection is clinically significant for early identification of patients at high risk for postoperative infection.

Clinical Study on Zhuyu Tongfu (逐瘀通腑) Serial Recipe Combined with Acupuncture and Massotherapy in Treating Hypertensive Cerebral Hemorrhage

Objective. To observe the clinical efficacy and mechanism of Zhuyu Tongfu （逐瘀通腑, ZYTF） Serial Recipe combined with acupuncture and massotherapy in treating hypertensive cerebral hemorrhage （HCH）. Methods： One hundred and eighteen patients with hypertensive cerebral hemorrhage, on the basis of conventional Western medicine treatment, were randomly divided into ZYTF combined with acupuncture and massotherapy group （treated group） and simple Western medicine group （control group） ; the clinical efficacy, neurofunction deficit scoring （NDS） alterations and hematoma absorption rate of both groups were observed, and also the plasma superoxide dismutase （SOD） activity, plasma lipid peroxidase （LPO） content, erythrocyte glutathion peroxidase （GSH-Px） activity, hematocrit （Ht） and the whole blood viscosity （Va） change were also observed. Results： In the treated group, the clinical efficacy, NDS improvement and hematoma absorption rate were superior to that of the control group; comparison between the two groups after treatment showed that plasma SOD activity and GSH-Px activity got more elevated and plasma LPO content, Ht and Va more lowered in the the treated group than those in the control group. Cenclusien： ZYTF combined with acupuncture and massotherapy has better effect, its therapeutic mechanism was possibly correlated to the elevation of plasma SOD activity, GSH-Px activity and lowering of plasma LPO content, Ht and Va.

Hypertensive-Nimodipine Therapy for Middle Cerebral Artery Vasospasm after Resection of Glioblastoma Multiforme: A Case Report and Literature Review

Delayed cerebral ischemia (DCI) due to post-brain tumor resection vasospasm is an often unrecognized yet debilitating complication. We present a patient with DCI after the resection of glioblastoma multiforme (GBM). To our knowledge, this is the first report on DCI after GBM resection. A 52-year-old female patient with headache for one month underwent subtotal resection of a left temporal GBM encasing the proximal middle cerebral artery (MCA). She was well during the immediate postoperative period but developed right upper limb dense monoparesis on postoperative day four with computed tomographic angiography confirming left MCA vasospasm. Symptoms were significantly alleviated with weeklong hypertensive therapy and nimodipine administration;however they recurred soon after cessation of treatment. A high index of clinical suspicion is needed for the diagnosis of post-tumor resection DCI. Any new postoperative neurological deficit that cannot be explained by hemorrhage, seizures or infection should be expeditiously investigated by angiography or transcranial Doppler sonography. Prompt initiation of hypertensive and nimodipine therapy can possibly reverse neurological deficit. Treatment should be guided by Doppler, angiographic or perfusion imaging studies and not by clinical improvement alone.

EXPRESSION OF IL-2 AND SIL-2R AND ALTERATION OF CELL IMMUNITY IN PATIENTS WITH HYPERTENSIVE CEREBRAL HEMORRHAGE

Objective To study the expression of interleukin-2(IL-2), soluble interleukin-2 receptor (sIL-2R), determine the alteration of erythrocytic immunity and T cell subgroup in the blood of outer circulation in patients with hypertensive cerebral hemorrhage so and to probe into the relationship between them, and to explore the clinical significance. Methods Enzyme linked immnunosorbent assay (ELISA) was used to determine the content of IL-2 and sIL-2R. The immunoadsorption was employed to examine the erythrocytic immune activity and its regulating function. Streptavidin-peroxidase(S-P) was used to determine the cell number of CD3 (cluster of differentiation3), CD4 and CD8. Results The content of IL-2 in the group with hypertensive cerebral hemorrhage was significantly lower than that in the control group (P<0.01), and the content of sIL-2R increased. Red blood cell C_ 3b receptor (RBC.C_ 3b R) and RBC immune adherence enhancing factor (RFEB) dropped greatly (P<0.01), while RBC immune complex rosette (RBC.ICR) and RBC immune adherence inhibiting factor (RFIR) increased greatly. The cell number of CD3 and CD4decreased (P<0.01) and there was no obvious change in CD8 (P<0.05). Conclusion The decrease of immune function was observed in patients with hypertensive cerebral hemorrhage. The determination of the content of IL-2, sIL-2R, erythrocytic immunity and the activity of T subgroup has an important clinical significance in the occurrence, development, treatment, and prognosis of hypertensive cerebral hemorrhage.

Study on Compound Salvia Pellet in Treating HypertensiveCerebral Hemorrhage

Objective:To assess the efficacy and safety of compound Salvia pellet (CSP) in treating hypertensive cerebral hemorrhage (HCH). Methods: Control group (n=116) was given HCH conventional therapy, and the treated group (n=118) given the same conventional therapy plus CSP 10 pills through sublingual sucking/6 hrs, the efficacy was compared. Results: (1) The 3rd day after admission CT monitoring showed both the volume of hematoma and hematoma plus edema in the treated group were smaller than those in the control group, the difference was significant (P<0.05); comparison between 14th day and 28th day after admission showed that the difference was significant (P<0.01). (2) The 14th day, 28th day and 3 months after admission, regarding the Chinese stroke scale (CSS), activity of daily living (ADD and modified Barthol index (Bl), the treated group was better than that of control group, the difference was significant (P<0.01). (3) The incidence of brain-heart syndrome reduced as time went by in both groups, but that of the treated group lowered more than that of control group, the difference being significant (P<0.05, or P< 0.01). Conclusion: CSP in treating HCH patients could cease the expansion of cerebral hematoma in the early phase, and accelerate the absorption of cerebral hematoma, improve the cerebral blood flow, alleviate cerebral edema, lower the disability, and elevate the quality of life. Besides, CSP also could prevent and treat brain-heart syndrome. CSP is cheap, convenient in administration, effective and safe.

Effects of ulinastatin combined with surgery on nerve injury, oxygen free radicals and inflammatory factors production of patients with hypertensive intracerebral hemorrhage

Objective: To study the effects of ulinastatin combined with surgery on nerve injury, oxygen free radicals and inflammatory factors production of patients with hypertensive intracerebral hemorrhage. Methods: The patients with hypertensive intracerebral hemorrhage received surgical treatment in our hospital during February 2015 - December 2017 were selected and divided into two groups by random number table. The observation group received ulinastatin combined surgery and the control group received conventional medicine combined with surgery. Before treatment and 1 weeks after treatment, serum levels of nerve damage markers, neurotrophic indexes, oxygen free radicals production indexes and inflammatory cytokines were measured. Results: After treatment, the contents of NSE, VILIP-1, GFAP, S100B, MDA, AOPP, 8-OHdG, NO, ET-1, TNF-α, sICAM-1, sVCAM-1, sICAM-1 of two groups were all decreased, the contents of BDNF, NGF, VEGF, IGF-I were all increased and the decreasing trend of NSE, VILIP-1, GFAP, S100B, MDA, AOPP, 8-OHdG, NO, ET-1, TNF-α, sICAM-1, sVCAM-1, sICAM-1 of observation group was more obvious than that of the control group, the increasing trend of BDNF, NGF, VEGF, IGF-I content was more obvious than that of the control group. Conclusion: The use of ulinastatin combined with surgery in the treatment of hypertensive intracerebral hemorrhage can significantly reduce the damage of nerve function and reduce the production of oxygen free radicals and inflammatory factors.

Study of clinical features of amyloid angiopathy hemorrhage and hypertensive intracerebral hemorrhage

Objective: The purpose of this study was to differentiate between cerebral amyloid angiopathy (CAA) and hypertension (HTN) based on hemorrhage pattern interpretation. Methods: From June 1994 to Oct., 2000, 83 patients admitted to our service with acute intracerebral hemorrhage (ICH) were investigated retrospectively; 41 patients with histologically proven diagnosis of cerebral amyloid angiography and 42 patients with clear history of hypertension were investigated. Results: Patients with a CAA-related ICH were significantly older than patients with a HTN-related ICH (74.0 years vs 66.5 years, P<0.05). There was a significantly higher number of hematomas≥30ml in CAA (85.3%) when compared with HTN (59.5%). No basal ganglional hemorrhage was seen in CAA, but in 40.5% in HTN. In CAA-related ICH, subarachnoid hemorrhage (SAH) was seen in 26 patients (63.4%) compared to only 11 patients (26.2%) in HTN-related ICH. Intraventricular hemorrhage was seen in 24.4% in CAA, and in 26.2% in HTN. Typical features of CAA-related ICH included lobar distribution affecting mainly the lobar superficial areas, lobulated appearance, rupture into the subarachnoid space, and secondary IVH from the lobar hemorrhage. More specifically, multiplicity of hemorrhage, bilaterality, and repeated episodes also strongly suggest the diagnosis of CAA. Multiple hemorrhages, defined as 2 or more separate hematomas in multiple lobes, accounted for 17.1% in CAA-related ICH. Conclusion: There are certain features in CAA on CT and MRI and in clinical settings. To some extent, these features may contribute to distinguishing CAA from HTN related ICH.

Effect of minimally invasive intracranial hematoma drainage on inflammatory factors, serum ferritin and serum P substance in patients with hypertensive cerebral hemorrhage

Objective:To study the effect of minimally invasive intracranial hematoma drainage on inflammatory factors, serum ferritin and serum P substance in patients with hypertensive cerebral hemorrhage.Methods:92 cases of hypertensive cerebral hemorrhage patients in our hospital were selected and randomly divided into 2 groups: minimally invasive group (51 cases) and routine group (41 cases). Minimally invasive intracranial hematoma drainage was performed on the minimally invasive group. Bone flap decompression or small bone window craniotomy were used in the routine group. Tumor necrosis factorα (TNF-α), interleukin-6 (IL-6), high sensitive C reactive protein (hs-CRP) and serum protein (SF), serum substance P (SP) in the 2 groups were detected before treatment and 2 weeks after treatment.Results: The comparison of TNF-α, IL-6, hs-CRP, SP, and SF in the two groups before treatment was not statistically significant (P>0.05). TNF-α, IL-6, hs-CRP and SF in both groups after treatment significantly decreased, compared with that before treatment (P<0.01,P<0.05). TNF-α, IL-6, and SF in minimally invasive group decreased more significantly than that in routine group (P<0.01);The comparison of SP in the two groups after treatment significantly increased compared with that before treatment (P<0.01,P<0.05). SP in minimally invasive group increased more significantly than that in routine group (P<0.05).Conclusions:Compared with bone flap decompression or small bone window craniotomy, minimally invasive intracranial hematoma drainage can inhibit inflammatory reaction, reduce the degree of nerve damage and alleviate clinical symptoms more effectively.

Treatment of Hypertensive Cerebral Hemorrhage by Activating Blood Circulation to Remove Stasis

The treatment of hy-pertensive cerebral hemorrhage(HCH)by activatingblood circulation to removestasis(ABCRS)is a newtherapeutic approach,which is initiated by clinical specialists of TCM andintegrative Chinese andwestern medicine.Al-though it is not a flawless

Effects of endoscopic surgery via different approaches on neurological function and complications in patients with hypertensive cerebral hemorrhage

Objective:To study the effects of different approaches of neuroendoscopic treatment on neurological function and complications of patients with hypertensive cerebral hemorrhage.Methods:72 patients with hypertensive cerebral hemorrhage diagnosed and treated in our hospital were selected as research objects.They were divided into the study group(n=37)and the control group(n=35)according to different approaches.The study group was the lateral fissure approach,and the control group was the anterior coronary suture approach.The curative effect,hematoma clearance,postoperative wake time,postoperative cerebral edema,daily living ability,neurological function,and complications in the two groups were observed.Results:The efficacy of the study group was higher than that of the control group,and the differences were statistically significant(P<0.05).The postoperative cerebral edema,postoperative wake time,and postoperative intracranial pressure in the study group were lower than those in the control group,and the hematoma clearance rate in the study group was higher than that in the control group,the differences were statistically significant(P<0.05);At 3 and 6 months after treatment,the daily living ability of the study group was higher than that of the control group,and neurological dysfunction of the study group was lower than that of the control group(P<0.05);The complication rate of the study group was lower than that of the control group(P<0.05);There was no significant difference in mortality rate between the two groups(P>0.05).Conclusion:Different approaches have different effects on patients with hypertensive intracerebral hemorrhage.Compared with the anterior coronary suture approach,the lateral fissure approach has less damage to nerve function,and has less postoperative complications.

Effects of adjuvant ginkgolide injection therapy in perioperative period of hypertensive cerebral hemorrhage on neural functional recovery

Objective: To study the effects of adjuvant ginkgolide injection therapy in perioperative period of hypertensive cerebral hemorrhage on neural functional recovery. Methods: Patients with hypertensive cerebral hemorrhage who underwent evacuation of hematoma in Traditional Chinese Medicine Hospital of Shunyi District Beijing between June 2015 and October 2017 were selected and divided into ginkgolide group and normal control group according to the perioperative application of ginkgolide injection or not in the history data. The levels of nerve injury markers and inflammatory stress mediators in serum as well as the expression of inflammatory stress signal molecules in peripheral blood were measured before treatment and 7 d after treatment. Results: Compared with same group before treatment, serum GNS and BDNF levels as well as peripheral blood Wnt1, GSK-3β and β-catenin expression of both groups of patients were significantly higher whereas serum Tau, NSE, OPN, MIF, HMGB1, TNF-α and MDA levels as well as peripheral blood eNOS and p38MAPK expression were significantly lower 7 d after treatment, and serum GNS and BDNF levels as well as peripheral blood Wnt1, GSK-3β and β-catenin expression of ginkgolide group 7 d after treatment were higher than those of normal control group whereas serum Tau, NSE, OPN, MIF, HMGB1, TNF-α and MDA levels as well as peripheral blood eNOS and p38MAPK expression were lower than those of normal control group. Conclusion: Adjuvant ginkgolide injection therapy in perioperative period of hypertensive cerebral hemorrhage can reduce the degree of nerve injury and inhibit the degree of inflammatory stress.

TCD value for evaluating the intracranial hypertension and nerve injury in patients with hypertensive cerebral hemorrhage

Objective: To evaluate the assessment of intracranial hypertension and nerve injury in patients with hypertensive cerebral hemorrhage by transcranial Doppler (TCD). Methods: The patients who were hospitalized for hypertensive cerebral hemorrhage between August 2014 and February 2017 were selected as the cerebral hemorrhage group and healthy subjects who received physical examination during the same period were selected as the control group;TCD was used to determine the PI of affected-side and unaffected-side middle cerebral artery in cerebral hemorrhage group and lumbar puncture was done to measure intracranial pressure. The serum was collected from the two groups to detect the levels of inflammatory cytokines and nerve injury markers. Results: PI level in affected-side middle cerebral artery of cerebral hemorrhage group was significantly higher than that in the unaffected-side and positively correlated with intracranial pressure level;serum IL-1β, TNF-α, ICAM-1, MMP9, YKL-40, Asp, Glu, NPY, NSE and GFAP levels of cerebral hemorrhage group were significantly higher than those of control group, and serum IL-1β, TNF-α, ICAM-1, MMP9, YKL-40, Asp, Glu, NPY, NSE and GFAP levels of cerebral hemorrhage group of patients with high PI level were significantly higher than those of cerebral hemorrhage group of patients with low PI level. Conclusion: TCD parameters can evaluate the degree of intracranial pressure increase and nerve injury in patients with hypertensive cerebral hemorrhage.

EFFECT OF ELECTROACUPUNCTURE ON GENE EXPRESSION OF α- SUBUNIT OF Go-PROTEIN IN THE HIPPOCAMPUS OF RATS WITH HYPERTENSIVE CEREBRAL HEMORRAGE

Objective: To observe the effect of electroacupuncture (EA) on gene expr ession o f α subunit of Go-protein in the brain of rats with hypertensive cerebral hem or rage and study its underlying mechanisms of EA in ameliorating cerebral hemorrag e. Methods: A total of 130 SD rats were randomly divided into nor mal control gro up (n=10), sham operation group (n=40), model group (n=40) and EA group (n=40). The latter 3 groups were further divided into 6 h, 24 h, 48 h and 72 h (tim e course s) subgroups, with 10 rats being in each subgroup. The hypertensive cerebral hem orrage model was induced by injecting 1 μL of collagenase (0.5 U/μL collagena se Type Ⅶ) and heparin (7 U/μL) into the caudate nucleus in rats with renovascul ar hypertension (by clipping the bilateral renal arteries). The gene expression of α subunit of Go-protein in the hippocampus tissue of rats was detected with No rthern blotting hybridization analysis. EA (continuous waves, 120 pulses/min in frequency, 1 mA in intensity and duration of 30 min) was applied to "Shuigou" (水沟 GV 26), bilateral "Neiguan"(内关 PC 6) and bilateral "Housanli"(Zusanl i, 足三里 ST 36). Results: The gene expression of α subunit of Go-protein in th e hippocampus tis sue of the rats was obviously downregulated in hypertensive cerebral hemorrage m odel group and significantly upregulated after EA treatment wit h the extension of time. Conlusion: EA may relieve cerebral hemorr age by regulating the gene transcription of α subunit of Go-protein and incre asing the expression of Go-α protein. This may be one of the molecular mechani sm s of EA in improving hypertensive cerebral hemorrhage.