Cattle encephalon glycoside and ignotin(CEGI)injection is a compound preparation formed by a combination of muscle extract from hea lthy rabbits and brain gangliosides from cattle,and it is generally used as a neuropr...Cattle encephalon glycoside and ignotin(CEGI)injection is a compound preparation formed by a combination of muscle extract from hea lthy rabbits and brain gangliosides from cattle,and it is generally used as a neuroprotectant in the treatment of central and peripheral nerve injuries.However,there is still a need for high-level clinical evidence from large samples to support the use of CEGI.We therefore carried out a prospective,multicenter,randomized,double-blind,parallel-group,placebo-controlled study in which we recruited 319 patients with acute cerebral infarction from 16 centers in China from October 2013 to May 2016.The patients were randomized at a 3:1 ratio into CEGI(n=239;155 male,84 female;61.2±9.2 years old)and placebo(n=80;46 male,34 female;63.2±8.28 years old)groups.All patients were given standard care once daily for 14 days,including a 200 mg aspirin enteric-coated tablet and 20 mg atorvastatin calcium,both taken orally,and intravenous infusion of 250–500 mL 0.9%sodium chloride containing 40 mg sodium tanshinone IIA sulfonate.Based on conventional treatment,patients in the CEGI and placebo groups were given 12 mL CEGI or 12 mL sterile water,respectively,in an intravenous drip of 250 mL 0.9%sodium chloride(2 mL/min)once daily for 14 days.According to baseline National Institutes of Health Stroke Scale scores,patients in the two groups were divided into mild and moderate subgroups.Based on the modified Rankin Scale results,the rate of patients with good outcomes in the CEGI group was higher than that in the placebo group,and the rate of disability in the CEGI group was lower than that in the placebo group on day 90 after treatment.In the CEGI group,neurological deficits were decreased on days 14 and 90 after treatment,as measured by the National Institutes of Health Stroke Scale and the Barthel Index.Subgroup analysis revealed that CEGI led to more significant improvements in moderate stroke patients.No drug-related adverse events occurred in the CEGI or placebo groups.In conclusion,CEGI may be a safe and effective treatment for acute cerebral infarction patients,especially for moderate stroke patients.This study was approved by the Ethical Committee of Peking University Third Hospital,China(approval No.2013-068-2)on May 20,2013,and registered in the Chinese Clinical Trial Registry(registration No.ChiCTR1800017937).展开更多
Fluid-attenuated inversion recovery （FLAIR） vascular hyperintensity （FVH） is used to assess leptomeningeal collateral circulation, but clinical outcomes of patients with FVH can be very different. The aim of the p...Fluid-attenuated inversion recovery （FLAIR） vascular hyperintensity （FVH） is used to assess leptomeningeal collateral circulation, but clinical outcomes of patients with FVH can be very different. The aim of the present study was to assess a FVH score and explore its relationship with clinical outcomes. Patients with acute ischemic stroke due to middle cerebral artery M1 occlusion underwent magnetic resonance imaging and were followed up at 10 days （National Institutes of Health Stroke Scale） and 90 days （modified Rankin Scale） to determine short-term clinical outcomes. Effective collateral circulation indirectly improved recovery of neurological function and short-term clinical outcome by extending the size of the pial penumbra and reducing infarct lesions. FVH score showed no correlation with 90-day functional clinical outcome and was not sufficient as an independent predictor of short-term clinical outcome.展开更多
BACKGROUND： Studies have shown that latency changes of some elements in a somatosensory evoked potential （SEP） and motor evoked potential （MEP） can reflect electrical activity of cerebral cortical neurons and con...BACKGROUND： Studies have shown that latency changes of some elements in a somatosensory evoked potential （SEP） and motor evoked potential （MEP） can reflect electrical activity of cerebral cortical neurons and conduction of white matter nerve fibers. However, there is a paucity of information regarding the dynamic observation of SEP and MEP following cerebral ischemic injury. OBJECTIVE： To explore SEP and MEP changes following acute ischemic stroke, and investigate the role of evoked potentials in monitoring brain function in stroke. DESIGN, TIME AND SETTING： A randomized, controlled, animal experiment was performed at the Chongqing Key Laboratory of Neurology, Affiliated Hospital of Chongqing Medical University from September 2007 to August 2008. MATERIALS＂ Hydrogen blood flow detector was purchased from Soochow University Medical Instrument Co., China, and Power lab system was purchased from AD Instruments, Inc., USA. METHODS A total of 36 healthy, adult, male, Sprague Dawley rats were randomly assigned to four groups （n = 9）, including three ischemia groups （12, 24 and 72 hours of ischemia） and a sham-surgery group. The rat model of acute ischemic stroke was established by middle cerebral artery occlusion （MCAO） in the left hemisphere. MAIN OUTCOME MEASURES＂ SEP and MEP of the left limbs were detected, and cerebral blood flow was measured by the hydrogen cleaning method. RESULTS： The latency of positive wave 1 （P1）, negative wave 1 （N1） and positive wave 2 （P2） waves in SEP, and latency of negative wave 1,2 （N1, N2） waves in MEP were significantly prolonged with increasing ischemic duration following MCAO （P 〈 0.01）, but cerebral blood flow was significantly decreased （P 〈 0.05, or P 〈 0.01）. CONLUSION： Ischemic stroke prolongs the latency of SEP waves （P1, N1, P2） and MEP waves （N1, N2）, and cerebral cortical evoked potential may correlate with cerebral blood flow changes. This indicates that SEP and MEP can be used to evaluate brain function following acute ischemic stroke.展开更多
Pericytes,as the mural cells surrounding the microvasculature,play a critical role in the regulation of microcirculation;however,how these cells respond to ischemic stroke remains unclear.To determine the temporal alt...Pericytes,as the mural cells surrounding the microvasculature,play a critical role in the regulation of microcirculation;however,how these cells respond to ischemic stroke remains unclear.To determine the temporal alterations in pericytes after ischemia/reperfusion,we used the 1-hour middle cerebral artery occlusion model,which was examined at 2,12,and 24 hours after reperfusion.Our results showed that in the reperfused regions,the cerebral blood flow decreased and the infarct volume increased with time.Furthermore,the pericytes in the infarct regions contracted and acted on the vascular endothelial cells within 24 hours after reperfusion.These effects may result in incomplete microcirculation reperfusion and a gradual worsening trend with time in the acute phase.These findings provide strong evidence for explaining the“no-reflow”phenomenon that occurs after recanalization in clinical practice.展开更多
We have developed a new three dimensional (3-D) conductivity imaging approach and have used it to detect human brain conductivity changes corresponding to acute cerebral stroke. The proposed Magnetic Resonance Electri...We have developed a new three dimensional (3-D) conductivity imaging approach and have used it to detect human brain conductivity changes corresponding to acute cerebral stroke. The proposed Magnetic Resonance Electrical Impedance Tomography (MREIT) approach is based on the J-Substitution algorithm and is expanded to imaging 3-D subject conductivity distribution changes. Computer simulation studies have been conducted to evaluate the present MREIT imaging approach. Simulations of both types of cerebral stroke, hemorrhagic stroke and ischemic stroke, were performed on a four-sphere head model. Simulation results showed that the correlation coefficient (CC) and relative error (RE) between target and estimated conductivity distributions were 0.9245±0.0068 and 8.9997%±0.0084%, for hemorrhagic stroke, and 0.6748±0.0197 and 8.8986%±0.0089%, for ischemic stroke, when the SNR (signal-to-noise radio) of added GWN (Gaussian White Noise) was 40. The convergence characteristic was also evaluated according to the changes of CC and RE with different iteration numbers. The CC increases and RE decreases monotonously with the increasing number of iterations. The present simulation results show the feasibility of the proposed 3-D MREIT approach in hemorrhagic and ischemic stroke detection and suggest that the method may become a useful alternative in clinical diagnosis of acute cerebral stroke in humans.展开更多
Infusion of the colloid hydroxyethylstarch has been used for volume substitution to maintain hemodynamics and microcirculation after e.g., severe blood loss.In the last decade it was revealed that hydroxyethylstarch c...Infusion of the colloid hydroxyethylstarch has been used for volume substitution to maintain hemodynamics and microcirculation after e.g., severe blood loss.In the last decade it was revealed that hydroxyethylstarch can aggravate acute kidney injury, especially in septic patients.Because of the serious risk for critically ill patients, the administration of hydroxyethylstarch was restricted for clinical use.Animal studies and recently published in vitro experiments showed that hydroxyethylstarch might exert protective effects on the blood-brain barrier.Since the prevention of blood-brain barrier disruption was shown to go along with the reduction of brain damage after several kinds of insults, we revisit the topic hydroxyethylstarch and discuss a possible niche for the application of hydroxyethylstarch in acute brain injury treatment.展开更多
Previous studies have suggested that miR-324-3p is related to the pathophysiology of cerebral ischemia,but the mechanism underlying this relationship is unclea r.In this study,we found that miR-324-3p expression was d...Previous studies have suggested that miR-324-3p is related to the pathophysiology of cerebral ischemia,but the mechanism underlying this relationship is unclea r.In this study,we found that miR-324-3p expression was decreased in patients with acute ischemic stroke and in in vitro and in vivo models of ischemic stro ke.miR-324-3p agomir potentiated ischemic brain damage in rats subjected to middle cerebral artery occlusion,as indicated by increased infarct volumes and cell apoptosis rates and greater neurological deficits.In a PC12 cell oxygen-glucose deprivation/reoxygenation model,a miR-324-3 p mimic decreased cell viability and expression of the anti-apoptotic protein BCL2 and increased expression of the pro-apoptotic protein BAX and rates of cell apoptosis,whereas treatment with a miR-324-3p inhibitor had the opposite effects.Silencing miR-324-3p increased adenosine A1 receptor(A1R)expression thro ugh regulation of GATA binding protein 2(GATA2).These findings suggest that silencing miR-324-3p reduces ischemic brain damage via the GATA2/A1R axis.展开更多
Objective: To summarize a decade of research on various aspects of Sowthistle-leaf Ixeris seedling for acute cerebral infarction. Methods: Thirty-six papers were collected from searches of CNKI, Wanfang, PubMed, and o...Objective: To summarize a decade of research on various aspects of Sowthistle-leaf Ixeris seedling for acute cerebral infarction. Methods: Thirty-six papers were collected from searches of CNKI, Wanfang, PubMed, and other databases and then they were summarized. Results: Researchers have carried out widespread and various pharmacological studies of Sowthistle-leaf Ixeris seedling, and have pursued different research directions on its etiology and pathogenesis, syndrome differentiation and treatment methods for acute cerebral infarction (ischemic stroke). With the development of Chinese medicine, its safety and non-toxic side effects have been recognized by the majority of scholars. The research results have contributed significantly to the treatment of acute cerebral infarction by Sowthistle-leaf Ixeris seedling. Conclusion: Sowthistle-leaf Ixeris seedling has extensive medicinal value and unique advantages in the treatment of acute cerebral infarction, especially in expanding brain vessels, increasing blood flow, reducing thrombosis, protecting brain cells, improving neurological impairment, and it has no toxic side effects.展开更多
Integrity of the blood-brain barrier structure is essential for maintaining the internal environment of the brain.Development of cerebral infarction and brain edema is strongly associated with blood-brain barrier leak...Integrity of the blood-brain barrier structure is essential for maintaining the internal environment of the brain.Development of cerebral infarction and brain edema is strongly associated with blood-brain barrier leakage.Therefore,studies have suggested that protecting the blood-brain barrier may be an effective method for treating acute stroke.To examine this possibility,stroke model rats were established by middle cerebral artery occlusion and reperfusion.Remote ischemic postconditioning was immediately induced by three cycles of 10-minute ischemia/10-minute reperfusion of bilateral hind limbs at the beginning of middle cerebral artery occlusion reperfusion.Neurological function of rat models was evaluated using Zea Longa’s method.Permeability of the blood-brain barrier was assessed by Evans blue leakage.Infarct volume and brain edema were evaluated using 2,3,5-triphenyltetrazolium chloride staining.Expression of matrix metalloproteinase-9 and claudin-5 m RNA was determined by real-time quantitative reverse transcription-polymerase chain reaction.Expression of matrix metalloproteinase-9 and claudin-5 protein was measured by western blot assay.The number of matrix metalloproteinase-9-and claudin-5-positive cells was analyzed using immunohistochemistry.Our results showed that remote ischemic postconditioning alleviated disruption of the blood-brain barrier,reduced infarct volume and edema,decreased expression of matrix metalloproteinase-9 m RNA and protein and the number of positive cells,increased expression of claudin-5 m RNA and protein and the number of positive cells,and remarkably improved neurological function.These findings confirm that by suppressing expression of matrix metalloproteinase-9 and claudin-5 induced by acute ischemia/reperfusion,remote ischemic postconditioning reduces blood-brain barrier injury,mitigates ischemic injury,and exerts protective effects on the brain.展开更多
文摘Cattle encephalon glycoside and ignotin(CEGI)injection is a compound preparation formed by a combination of muscle extract from hea lthy rabbits and brain gangliosides from cattle,and it is generally used as a neuroprotectant in the treatment of central and peripheral nerve injuries.However,there is still a need for high-level clinical evidence from large samples to support the use of CEGI.We therefore carried out a prospective,multicenter,randomized,double-blind,parallel-group,placebo-controlled study in which we recruited 319 patients with acute cerebral infarction from 16 centers in China from October 2013 to May 2016.The patients were randomized at a 3:1 ratio into CEGI(n=239;155 male,84 female;61.2±9.2 years old)and placebo(n=80;46 male,34 female;63.2±8.28 years old)groups.All patients were given standard care once daily for 14 days,including a 200 mg aspirin enteric-coated tablet and 20 mg atorvastatin calcium,both taken orally,and intravenous infusion of 250–500 mL 0.9%sodium chloride containing 40 mg sodium tanshinone IIA sulfonate.Based on conventional treatment,patients in the CEGI and placebo groups were given 12 mL CEGI or 12 mL sterile water,respectively,in an intravenous drip of 250 mL 0.9%sodium chloride(2 mL/min)once daily for 14 days.According to baseline National Institutes of Health Stroke Scale scores,patients in the two groups were divided into mild and moderate subgroups.Based on the modified Rankin Scale results,the rate of patients with good outcomes in the CEGI group was higher than that in the placebo group,and the rate of disability in the CEGI group was lower than that in the placebo group on day 90 after treatment.In the CEGI group,neurological deficits were decreased on days 14 and 90 after treatment,as measured by the National Institutes of Health Stroke Scale and the Barthel Index.Subgroup analysis revealed that CEGI led to more significant improvements in moderate stroke patients.No drug-related adverse events occurred in the CEGI or placebo groups.In conclusion,CEGI may be a safe and effective treatment for acute cerebral infarction patients,especially for moderate stroke patients.This study was approved by the Ethical Committee of Peking University Third Hospital,China(approval No.2013-068-2)on May 20,2013,and registered in the Chinese Clinical Trial Registry(registration No.ChiCTR1800017937).
基金supported by the National Natural Science Foundation of China,No.81371521
文摘Fluid-attenuated inversion recovery （FLAIR） vascular hyperintensity （FVH） is used to assess leptomeningeal collateral circulation, but clinical outcomes of patients with FVH can be very different. The aim of the present study was to assess a FVH score and explore its relationship with clinical outcomes. Patients with acute ischemic stroke due to middle cerebral artery M1 occlusion underwent magnetic resonance imaging and were followed up at 10 days （National Institutes of Health Stroke Scale） and 90 days （modified Rankin Scale） to determine short-term clinical outcomes. Effective collateral circulation indirectly improved recovery of neurological function and short-term clinical outcome by extending the size of the pial penumbra and reducing infarct lesions. FVH score showed no correlation with 90-day functional clinical outcome and was not sufficient as an independent predictor of short-term clinical outcome.
基金the National Natural Science Foundation of China, No. 30300075China Postdoctoral Science Foundation, No. 20080440995Sichuan Science Fund for Out-standing Youths, No. 05ZQ026-020
文摘BACKGROUND： Studies have shown that latency changes of some elements in a somatosensory evoked potential （SEP） and motor evoked potential （MEP） can reflect electrical activity of cerebral cortical neurons and conduction of white matter nerve fibers. However, there is a paucity of information regarding the dynamic observation of SEP and MEP following cerebral ischemic injury. OBJECTIVE： To explore SEP and MEP changes following acute ischemic stroke, and investigate the role of evoked potentials in monitoring brain function in stroke. DESIGN, TIME AND SETTING： A randomized, controlled, animal experiment was performed at the Chongqing Key Laboratory of Neurology, Affiliated Hospital of Chongqing Medical University from September 2007 to August 2008. MATERIALS＂ Hydrogen blood flow detector was purchased from Soochow University Medical Instrument Co., China, and Power lab system was purchased from AD Instruments, Inc., USA. METHODS A total of 36 healthy, adult, male, Sprague Dawley rats were randomly assigned to four groups （n = 9）, including three ischemia groups （12, 24 and 72 hours of ischemia） and a sham-surgery group. The rat model of acute ischemic stroke was established by middle cerebral artery occlusion （MCAO） in the left hemisphere. MAIN OUTCOME MEASURES＂ SEP and MEP of the left limbs were detected, and cerebral blood flow was measured by the hydrogen cleaning method. RESULTS： The latency of positive wave 1 （P1）, negative wave 1 （N1） and positive wave 2 （P2） waves in SEP, and latency of negative wave 1,2 （N1, N2） waves in MEP were significantly prolonged with increasing ischemic duration following MCAO （P 〈 0.01）, but cerebral blood flow was significantly decreased （P 〈 0.05, or P 〈 0.01）. CONLUSION： Ischemic stroke prolongs the latency of SEP waves （P1, N1, P2） and MEP waves （N1, N2）, and cerebral cortical evoked potential may correlate with cerebral blood flow changes. This indicates that SEP and MEP can be used to evaluate brain function following acute ischemic stroke.
基金financially supported by the China Academy of Chinese Medical Sciences Innovation Fund,No.CI2021A03407(to WZB)the National Natural Science Foundation of China,No.81973789(to FFC).
文摘Pericytes,as the mural cells surrounding the microvasculature,play a critical role in the regulation of microcirculation;however,how these cells respond to ischemic stroke remains unclear.To determine the temporal alterations in pericytes after ischemia/reperfusion,we used the 1-hour middle cerebral artery occlusion model,which was examined at 2,12,and 24 hours after reperfusion.Our results showed that in the reperfused regions,the cerebral blood flow decreased and the infarct volume increased with time.Furthermore,the pericytes in the infarct regions contracted and acted on the vascular endothelial cells within 24 hours after reperfusion.These effects may result in incomplete microcirculation reperfusion and a gradual worsening trend with time in the acute phase.These findings provide strong evidence for explaining the“no-reflow”phenomenon that occurs after recanalization in clinical practice.
基金Project supported partly by the National Science Foundation (No.BES-0411898) and the National Institues of Health (No. R01EB00178) USA
文摘We have developed a new three dimensional (3-D) conductivity imaging approach and have used it to detect human brain conductivity changes corresponding to acute cerebral stroke. The proposed Magnetic Resonance Electrical Impedance Tomography (MREIT) approach is based on the J-Substitution algorithm and is expanded to imaging 3-D subject conductivity distribution changes. Computer simulation studies have been conducted to evaluate the present MREIT imaging approach. Simulations of both types of cerebral stroke, hemorrhagic stroke and ischemic stroke, were performed on a four-sphere head model. Simulation results showed that the correlation coefficient (CC) and relative error (RE) between target and estimated conductivity distributions were 0.9245±0.0068 and 8.9997%±0.0084%, for hemorrhagic stroke, and 0.6748±0.0197 and 8.8986%±0.0089%, for ischemic stroke, when the SNR (signal-to-noise radio) of added GWN (Gaussian White Noise) was 40. The convergence characteristic was also evaluated according to the changes of CC and RE with different iteration numbers. The CC increases and RE decreases monotonously with the increasing number of iterations. The present simulation results show the feasibility of the proposed 3-D MREIT approach in hemorrhagic and ischemic stroke detection and suggest that the method may become a useful alternative in clinical diagnosis of acute cerebral stroke in humans.
基金supported by a grant from the Forschungskommission der Medizinischen Fakultat,Albert-Ludwigs-Universitat Freiburg(SCHI1123/17,to MAS)。
文摘Infusion of the colloid hydroxyethylstarch has been used for volume substitution to maintain hemodynamics and microcirculation after e.g., severe blood loss.In the last decade it was revealed that hydroxyethylstarch can aggravate acute kidney injury, especially in septic patients.Because of the serious risk for critically ill patients, the administration of hydroxyethylstarch was restricted for clinical use.Animal studies and recently published in vitro experiments showed that hydroxyethylstarch might exert protective effects on the blood-brain barrier.Since the prevention of blood-brain barrier disruption was shown to go along with the reduction of brain damage after several kinds of insults, we revisit the topic hydroxyethylstarch and discuss a possible niche for the application of hydroxyethylstarch in acute brain injury treatment.
基金funded by the National Natural Science Foundation of China,No.81803937(to YCM and QXD)Science and Technology Innovation Activity Plan for College Students of Zhejiang Province(Xinmiao Talent Plan),No.2020R413079(to AQZ)Wenzhou Science and Technology Plan Project,No.Y20210122(to QXD)。
文摘Previous studies have suggested that miR-324-3p is related to the pathophysiology of cerebral ischemia,but the mechanism underlying this relationship is unclea r.In this study,we found that miR-324-3p expression was decreased in patients with acute ischemic stroke and in in vitro and in vivo models of ischemic stro ke.miR-324-3p agomir potentiated ischemic brain damage in rats subjected to middle cerebral artery occlusion,as indicated by increased infarct volumes and cell apoptosis rates and greater neurological deficits.In a PC12 cell oxygen-glucose deprivation/reoxygenation model,a miR-324-3 p mimic decreased cell viability and expression of the anti-apoptotic protein BCL2 and increased expression of the pro-apoptotic protein BAX and rates of cell apoptosis,whereas treatment with a miR-324-3p inhibitor had the opposite effects.Silencing miR-324-3p increased adenosine A1 receptor(A1R)expression thro ugh regulation of GATA binding protein 2(GATA2).These findings suggest that silencing miR-324-3p reduces ischemic brain damage via the GATA2/A1R axis.
基金the National Natural Science Foundation of the People's Republic of China (Grant Nos. 81704051, 81173233)the Scientific Research Foundation for Returned Oversea Chinese Scholars, State Education Ministry (2014)+1 种基金the TCM Standardization Project of the State Administration of Traditional Chinese Medicine (No. ZYYS-2013PJ07)the Talent Cultivation Project of Dongfang Hospital, Beijing University of Chinese Medicine (2015–2017).
文摘Objective: To summarize a decade of research on various aspects of Sowthistle-leaf Ixeris seedling for acute cerebral infarction. Methods: Thirty-six papers were collected from searches of CNKI, Wanfang, PubMed, and other databases and then they were summarized. Results: Researchers have carried out widespread and various pharmacological studies of Sowthistle-leaf Ixeris seedling, and have pursued different research directions on its etiology and pathogenesis, syndrome differentiation and treatment methods for acute cerebral infarction (ischemic stroke). With the development of Chinese medicine, its safety and non-toxic side effects have been recognized by the majority of scholars. The research results have contributed significantly to the treatment of acute cerebral infarction by Sowthistle-leaf Ixeris seedling. Conclusion: Sowthistle-leaf Ixeris seedling has extensive medicinal value and unique advantages in the treatment of acute cerebral infarction, especially in expanding brain vessels, increasing blood flow, reducing thrombosis, protecting brain cells, improving neurological impairment, and it has no toxic side effects.
基金supported by the National Natural Science Foundation of China,No.30960107the Natural Science Foundation of the Education Department of Sichuan Province of China,No.14ZA0223
文摘Integrity of the blood-brain barrier structure is essential for maintaining the internal environment of the brain.Development of cerebral infarction and brain edema is strongly associated with blood-brain barrier leakage.Therefore,studies have suggested that protecting the blood-brain barrier may be an effective method for treating acute stroke.To examine this possibility,stroke model rats were established by middle cerebral artery occlusion and reperfusion.Remote ischemic postconditioning was immediately induced by three cycles of 10-minute ischemia/10-minute reperfusion of bilateral hind limbs at the beginning of middle cerebral artery occlusion reperfusion.Neurological function of rat models was evaluated using Zea Longa’s method.Permeability of the blood-brain barrier was assessed by Evans blue leakage.Infarct volume and brain edema were evaluated using 2,3,5-triphenyltetrazolium chloride staining.Expression of matrix metalloproteinase-9 and claudin-5 m RNA was determined by real-time quantitative reverse transcription-polymerase chain reaction.Expression of matrix metalloproteinase-9 and claudin-5 protein was measured by western blot assay.The number of matrix metalloproteinase-9-and claudin-5-positive cells was analyzed using immunohistochemistry.Our results showed that remote ischemic postconditioning alleviated disruption of the blood-brain barrier,reduced infarct volume and edema,decreased expression of matrix metalloproteinase-9 m RNA and protein and the number of positive cells,increased expression of claudin-5 m RNA and protein and the number of positive cells,and remarkably improved neurological function.These findings confirm that by suppressing expression of matrix metalloproteinase-9 and claudin-5 induced by acute ischemia/reperfusion,remote ischemic postconditioning reduces blood-brain barrier injury,mitigates ischemic injury,and exerts protective effects on the brain.
文摘目的 探究标准剂量rt-PA静脉溶栓联合动脉取栓治疗急性脑梗死的效果。方法 随机选取海阳市人民医院于2021年7月—2023年7月收治的80例急性脑梗死患者为研究对象,通过随机数表法分成溶栓组与桥接组,各40例。溶栓组运用标准量静脉溶栓治疗,桥接组在经过30 min静脉溶栓治疗之后,对治疗效果不理想的患者,进行机械取栓。比较两组的国立卫生研究院卒中量表(National Institute of Health Stroke Scale,NIHSS)评分以及不良反应发生情况。结果 治疗后24 h、7 d、30 d,桥接组的NIHSS评分均低于溶栓组,差异有统计学意义(P均<0.05)。桥接组的不良反应总发生率为7.50%,溶栓组为2.50%,两组对比,差异无统计学意义(χ^(2)=0.263,P>0.05)。结论 标准剂量rt-PA静脉溶栓联合动脉取栓治疗有效地促进了患者神经功能的恢复,不良反应与溶栓治疗相当,对急性脑梗死的治疗提供了有力的支持。
