Relationship between ultrasound parameters of the umbilical and middle cerebral arteries and intrauterine fetal distress

BACKGROUND By comprehensively analyzing the blood flow parameters of the umbilical and middle cerebral arteries,doctors can more accurately identify fetal intrauterine distress,as well as assess its severity,so that timely interventions can be implemented to safeguard the health and safety of the fetus.AIM To identify the relationship between ultrasound parameters of the umbilical and middle cerebral arteries and intrauterine distress.METHODS Clinical data of pregnant women admitted between January 2021 and January 2023 were collected and divided into the observation and control groups(n=50 each),according to the presence or absence of intrauterine distress.The ultrasound hemodynamic parameters of the uterine artery(UtA),fetal middle cerebral artery(MCA),and umbilical artery(UmA)were compared with neonatal outcomes and occurrence of intrauterine distress in the two groups.RESULTS Comparison of ultrasonic hemodynamic parameters,resistance index(RI),pulsatility index(PI),and systolic maximal blood flow velocity of UmA compared to diastolic blood flow velocity(S/D),revealed higher values of fetal MCA,PI,and S/D of UmA in pregnant women with UtA compared to controls(P<0.05),while there was no difference between the two groups in terms of RI(P<0.05)The incidence of a neonatal Apgar score of 8-10 points was lower in the observation group(66.7%)than in the control group(90.0%),and neonatal weight(2675.5±27.6 g)was lower than in the control group(3117.5±31.2 g).Further,cesarean section rate was higher in the observation group(70.0%)than in the control group(11.7%),and preterm labor rate was higher in the observation group(40.0%)than in the control group(10.0%).The incidence of fetal distress,neonatal growth restriction and neonatal asphyxia were also higher in the observation group(all P<0.05).CONCLUSION Fetal MCA,UmA,and maternal UtA hemodynamic abnormalities all develop in pregnant women with intrauterine distress during late pregnancy,which suggests that clinical attention should be paid to them,and monitoring should be strengthened to provide guidance for clinical intervention.

Abnormal volumetric brain morphometry and cerebral blood flow in adolescents with depression

BACKGROUND Prior research has demonstrated that the brains of adolescents with depression exhibit distinct structural alterations.However,preliminary studies have documented the pathophysiological changes in certain brain regions,such as the cerebellum,highlighting a need for further research to support the current understanding of this disease.AIM To study brain changes in depressed adolescents.METHODS This study enrolled 34 adolescents with depression and 34 age-,sex-,and education-level-matched healthy control(HC)individuals.Structural and functional alterations were identified when comparing the brains of these two participant groups through voxel-based morphometry and cerebral blood flow(CBF)analysis,respectively.Associations between identified brain alterations and the severity of depressive symptoms were explored through Pearson correlation analyses.RESULTS The cerebellum,superior frontal gyrus,cingulate gyrus,pallidum,middle frontal gyrus,angular gyrus,thalamus,precentral gyrus,inferior temporal gyrus,superior temporal gyrus,inferior frontal gyrus,and supplementary motor areas of adolescents with depression showed an increase in brain volume compared to HC individuals.These patients with depression further presented with a pronounced drop in CBF in the left pallidum(group=98,and peak t=-4.4324),together with increased CBF in the right percental gyrus(PerCG)(group=90,and peak t=4.5382).In addition,17-item Hamilton Depression Rating Scale scores were significantly correlated with the increased volume in the opercular portion of the left inferior frontal gyrus(r=-0.5231,P<0.01).CONCLUSION The right PerCG showed structural and CBF changes,indicating that research on this part of the brain could offer insight into the pathophysiological causes of impaired cognition.

Viscoelastic evaluation of fetal umbilical vein for reconstruction of middle cerebral artery

The transplantation of artificial blood vessels with 〈 6 mm inner diameter as substitutes for human arterioles or veins has not achieved satisfactory results. Umbilical vein has been substituted for ar- tery in vascular transplantation, but it remains unclear whether the stress relaxation and creep be- tween these vessels are consistent. In this study, we used the fetal umbilical vein and middle cere- bral artery from adult male cadavers to make specimens 15 mm in length, 0.196-0.268 mm in tu- nica media thickness, and 2.82-2.96 mm in outer diameter. The results demonstrated that the stress decrease at 7 200 seconds was similar between the middle cerebral artery and fetal umbilical vein specimens, regardless of initial stress of 18.7 kPa or 22.5 kPa. However, the strain increase at 7 200 seconds of fetal umbilical veins was larger than that of middle cerebral arteries. Moreover, the stress relaxation experiment showed that the stress decrease at 7 200 seconds of the fetal umbilical vein and middle cerebral artery specimens under 22.5 kPa initial stress was less than the decrease in these specimens under 18.7 kPa initial stress. These results indicate that the fetal umbilical vein has appropriate stress relaxation and creep properties for transplantation. These properties are advantageous for vascular reconstruction, indicating that the fetal umbilical vein can be transplanted to repair middle cerebral artery injury.

Fetal umbilical vein transplantation for the repair of middle cerebral artery injury

It is necessary to investigate the longitudinal tensile mechanical characteristics of the middle cere- bral artery and the fetal umbilical vein prior to applying fetal umbilical vein transplantation for repair of injured middle cerebral artery. Fifteen fresh fetal umbilical vein specimens and 15 normal human fresh cadaver middle cerebral artery specimens were collected for longitudinal tensile testing at the speed of 0.5 mm/min and at normal human temperature. The results showed that under 16.0 kPa physiological stress, the strain value of fetal umbilical vein specimens was larger, while the maximal stress and elastic modulus values were less than those of middle cerebral artery specimens. Our findings indicate that fetal umbilical vein has good elastic properties and the stress-strain curve of the fetal umbilical vein is similar to that of the middle cerebral artery. Fetal umbilical vein transplan- tation can, therefore, potentially repair the injured middle cerebral artery.

Effects of Electro-acupuncture Preconditioning on Focal Cere bral Blood Flow in Artery and Vein of Rats with Middle Cere bral Artery Occlusion

Objective:To investigate the effects of electro-acupuncture preconditioning on focal cerebral blood flow(CBF)in artery and vein of rats with middle cerebral artery occlusion(MCAO),and to provide experimental evidences for primary prevention of ischemic stroke.Method:Eighteen male Sprague-Dawley rats(two months old)were divided into 3 groups:electro-acupuncture preconditioning group(EA group),ischemia group(Is group)and Dazhui and Baihui sham group(six rats per group).The rats in the EA group were given electro-acupuncture preconditioning at Dazhui and Baihui with 2/15 density wave current for 30 minutes per day,5 days consecutively.After preconditioning,enhanced laser speckle contrast analysis was implemented to get false color images before making middle cerebral ischemia occlusion model.Then getting false color images two hours during ischemia by laser speckle contrast analysis again.Result:④Relative CBF in focal cortical artery:There were significant differences at every time point in EA group and Is group(P<0.01,P<0.05)comparing with that before occlusion respectively.Compared with that before ischemia,there was significant difference at 120 min after ischemia in sham group(P<0.05);compared with that at 30 min after occlusion,there was significant difference at every time point in EA group from the time point 60 min after occlusion;there was significant difference at every time point in EA group and Is group(P<0.05)comparing with sham group;Compared with sham group,there was significant difference at 30min and 60 min after ischemia in EA group(P<0.05).④Relative CBF in focal cortical vein:There was significant difference at every time point in sham group comparing with that before occlusion(P<0.05);compared with that before occlusion,there was significant difference from 45 min after occlusion in EA group(P<0.05);compared with that before occlusion,there was significant difference from 105 min after occlusion in sham group(P<0.05);there was significant difference at 120 min after occlusion comparing with 60 min after occlusion in EA group;compared with sham group,there was significant difference at every time point in EA group and Is group(except 30 min after occlusion)(P<0.05),respectively;compared with Is group,there was significant difference at 30,45,60 min after occlusion in EA group(P<0.05).④The infarct brain volume detected 24 h after reperfusion in EA group was significantly smaller comparing with that in Is group(P<0.05).Conclusion:Electro-acupuncture preconditioning could increase CBF velocity in artery and vein of focal cortex in rats with MCAO,which also had time-dependence.Additionally,electro-acupuncture preconditioning could decrease the infarct volume detected 24h after reperfusion,which possibly was correlated with the blood supply in ischemic penumbra.

Predicting obstetric outcomes of advanced maternal age through determination of hemodynamics of uterine artery, umbilical artery and fetal cerebral middle artery

Objective: The purpose of this study was to investigate the relationship between pregnancy outcome in older pregnant women and the uterine artery and fetal hemodynamic parameters in the third trimester. Methods: Randomized selection of 100 patients in our hospital delivery and late pregnancy monitoring of uterine artery and fetal hemodynamics in patients. (1) There were compared and analyzed the hemodynamic parameters (PSV, EDV, RI, PI, S/D) of the uterine artery, umbilical artery and fetal middle cerebral artery in the third trimester between 36 elderly patients with normal pregnancy outcome (≥35 years old, observation group) and 32 patients with normal age of normal pregnancy (<35 years old, control group). (2) There were compared and analyzed the hemodynamic parameters of the uterine artery, umbilical artery and fetal middle cerebral artery in the third trimester between 32 elderly patients with abnormal pregnancy outcome and 36 elderly patients with normal pregnancy outcome. Results: (1) Normal pregnancy outcomes in different age groups, the hemodynamic parameters of uterine artery, umbilical artery and fetal middle cerebral artery were not significantly different. (2) The high age group had different pregnancy outcomes,Fetal middle cerebral artery PI was statistically significant, there was no significant difference in Uterine artery and umbilical artery of the hemodynamic parameters. Conclusion: Color Doppler ultrasonography to evaluate the PI value of fetal middle cerebral artery in older pregnant women has a certain reference value to judge whether there is hypoxia and distress and neonatal prognosis in the fetus, and to provide some reference information for clinicians to predict the pregnancy outcome of the older pregnant women.

Therapeutic effects of different durations of acupuncture on rats with middle cerebral artery occlusion

Acupuncture is regarded as an effective therapy for cerebral ischemia. Different acupuncture ma- nipulations and durations may result in different therapeutic effects. In the present study, the Neig uan （PC6） acupoint of rats with occluded middle cerebral arteries was needled at a fixed frequency （3 Hz） with different durations, i.e., 5, 60 and 180 seconds under a twisting-rotating acupuncture method. Results showed that different durations of acupuncture had different therapeutic effects, with 60 seconds yielding a better therapeutic effect than the other two groups. This duration of treatment demonstrated rapid cerebral blood flow, encouraging recovery of neurological function, and small cerebral infarct volume. Experimental findings indicated that under 3 Hz frequency, the treatment of needling Neiguan for 60 seconds is effective for ischemic stroke.

Pulsed arterial spin labeling effectively and dynamically observes changes in cerebral blood flow after mild traumatic brain injury

Cerebral blood flow is strongly associated with brain function, and is the main symptom and diagnostic basis for a variety of encephalopathies. However, changes in cerebral blood flow after mild traumatic brain injury remain poorly understood. This study sought to observe changes in cerebral blood flow in different regions after mild traumatic brain injury using pulsed arterial spin labeling. Our results demonstrate maximal cerebral blood flow in gray matter and minimal in the white matter of patients with mild traumatic brain injury. At the acute and subacute stages, cerebral blood flow was reduced in the occipital lobe, parietal lobe, central region, subcutaneous region, and frontal lobe. Cerebral blood flow was restored at the chronic stage. At the acute, subacute, and chronic stages, changes in cerebral blood flow were not apparent in the insula. Cerebral blood flow in the temporal lobe and limbic lobe diminished at the acute and subacute stages, but was restored at the chronic stage. These findings suggest that pulsed arterial spin labeling can precisely measure cerebral blood flow in various brain regions, and may play a reference role in evaluating a patient＇s condition and judging prognosis after traumatic brain injury.

Electroacupuncture induces acute changes in cerebral cortical mi RNA profile, improves cerebral blood flow and alleviates neurological deficits in a rat model of stroke

Electroacupuncture has been shown to improve cerebral blood flow in animal models of stroke. However, it is unclear whether electroacupuncture alters mi RNA expression in the cortex. In this study, we examined changes in the cerebral cortical mi RNA profile, cerebral blood flow and neurological function induced by electroacupuncture in a rat model of stroke. Electroacupuncture was performed at Renzhong（GV26） and Neiguan（PC6）, with a frequency of 2 Hz, continuous wave, current intensity of 3.0 m A, and stimulation time of 1 minute. Electroacupuncture increased cerebral blood flow and alleviated neurological impairment in the rats. mi RNA microarray profiling revealed that the vascular endothelial growth factor signaling pathway, which links cell proliferation with stroke, was most significantly affected by electroacupuncture. Electroacupuncture induced changes in expression of rno-mi R-206-3p, rno-mi R-3473, rno-mi R-6216 and rno-mi R-494-3p, and these changes were confirmed by quantitative real-time polymerase chain reaction. Our findings suggest that changes in cell proliferation-associated mi RNA expression induced by electroacupuncture might be associated with the improved cerebral blood supply and functional recovery following stroke.

Evaluation of changes of intracranial blood flow after carotid artery stenting using digital subtraction angiography flow assessment

AIM: To evaluate the changes of intracranial blood flow after carotid artery stenting(CAS), using the flow assessment application "Flow-Insight", which was developed in our department.METHODS: Twenty patients treated by CAS participated in this study. We analyzed the change in concentration of the contrast media at the anterior-posterior and profile view image with the flow assessment application "Flow-Insight". And we compared the results with N-isopropyl-p-[123I] iodoamphetamine-single-photon emission computed tomography(IMP SPECT) performed before and after the treatment. RESULTS: From this study, 200% of the parameter "blood flow" change in the post/pre-treatment is suggested as the critical line of the hyperperfusion syndrome arise. Although the observed blood flow increase in the digital subtraction angiography system did not strongly correlate with the rate of increase of SPECT, the "Flow-Insight" reflected the rate of change of the vessels well. However, for patients with reduced reserve blood flow before CAS, a highly elevated site was in agreement with the site analysis results. CONCLUSION: We concluded that the cerebral angiography flow assessment application was able to more finely reveal hyperperfusion regions in the brain after CAS compared to SPECT.

Clinical Efficacy of Modified Erchen Decoction on Cervical Spondylotic Vertebral Arteriopathy with Stagnation and Blockade of Phlegm-dampness Syndrome and Effects on Cerebral Blood Flow Parameters

OBJECTIVE: To observe the effect of Modified Erchen Decoction on cervical spondylotic vertebral arteriopathy with stagnation and blockade of phlegm-dampness syndrome and effects on cerebral blood flow parameters. METHODS: A total of 80 cervical spondylotic vertebral arteriopathy(CSA) patients with stagnation and blockade of phlegmdampness syndrome admitted to our hospital from October 2016 to April 2017 were selected and randomly divided into observation group and control group, with 40 cases in each group. The observation group was treated with Modified Erchen Decoction and the control group was given conventional treatment with Western medicine. After 4 weeks of treatment, the main clinical symptoms and signs(vertigo, neck and shoulder pain, headache, psychological and social adjustment, daily life and work) and cerebral blood flow parameters [the peak values of intracranial vertebral-basal artery diastolic blood flow velocity(Vd) and systolic blood flow velocity(Vp)] were compared between the 2 groups. The total clinical effective rate and adverse reactions during treatment were also compared. RESULTS: After treatment, the total effective rate of the observation group was 90.0%, which was significantly higher than that of the control group(77.5%). The difference between the two groups was statistically significant(P < 0.05). After treatment, The scores of vertigo, neck and shoulder pain, headache, psychology and society adaptation, daily life and work were significantly increased(P < 0.05), and the above scores of the observation group were increased more obviously. The difference between the groups was statistically significant(P < 0.05). After treatment, the levels of Vd and Vp were significantly increased(P < 0.05), and the increase of the above indexes was more obvious in the observation group. The difference between the 2 groups was statistically significant(P < 0.05). There were no significant abnormalities in blood routine, urine routine, liver function and renal function. There was no significant difference in the incidence of adverse reactions between the 2 groups.(P > 0.05). CONCLUSION: The treatment of vertebral artery type cervical spondylopathy with stagnation and blockade of phlegm-dampness syndrome by Modified Erchen Decoction can effectively relieve the main clinical symptoms and signs, improve cerebral blood flow parameters, and improve the peak values of vertebral-basal artery diastolic blood flow velocity(Vd) and systolic blood flow velocity(Vp), which is safe and effective, and helps to promote the recovery of cervical function.

Superficial Temporal Artery to Middle Cerebral Artery Bypass and Endovascular Parent Artery Occlusion in the Treatment of Giant Intracranial Aneurysms

The authors are reporting on a study drawn from unpublished dissertation done by the corresponding author when he completed his neurosurgical training in Paris, France in 2004, few years before the advent of flow diverters. The study was a retrospective review of giant intracranial aneurysms treated by superficial temporal artery to middle cerebral artery bypass combined with endovascular occlusion of the parent artery. From 1990 to 2003, 29 consecutive cases of giant cerebral aneurysms, not suitable to selective treatment were managed in that way. Twenty-one medical records had enough data to allow objective evaluation. Sixteen female and five male patients bearing 21 giant aneurysms were involved. Their mean age was 46 years. The aneurysm was revealed by mass effect in 13 cases and subarachnoid hemorrhage in one case. On admission 19 patients presented with unruptured aneurysms and two have sustained a subarachnoid hemorrhage. The balloon occlusion test before the bypass operation was not tolerated in 18 patients. The treatment was completed in 19 patients and 17 of them had parent artery occlusion with latex detachable balloons. The only death of the series occurred before the endovascular treatment. The mean follow-up period was 30 months. After completion of the treatment, 16 (84%) patients had no symptom. Aneurysm recanalization or rupture was not observed after the parent artery occlusion. With the combination of superficial temporal artery to middle cerebral artery bypass + endovascular parent artery occlusion, 90% of giant intracranial aneurysms untreatable selectively were permanently excluded with a good outcome in 95%.

Enhancing hippocampal blood flow after cerebral ischemia and vasodilating basilar arteries:in vivo and in vitro neuroprotective effect of antihypertensive DDPH

1-（2,6-Dimethylphenoxy）-2-（3,4-dimethoxyphenylethylamino）-propane hydrochloride （DDPH） is a novel antihypertensive agent based on structural characteristics of mexiletine and verapamine. We investigated the effect of DDPH on vasodilatation and neuroprotection in a rat model of cerebral ischemiain vivo, and a rabbit model of isolated basilar arteriesin vitro. Our results show that DDPH （10 mg/kg） significantly increased hippocampal blood flowin vivo in cerebral ischemic rats, and exerted dose-dependent relaxation of isolated basilar arteries contracted by histamine or KCl in thein vitro rabbit model. DDPH （3 × 10–5 M） also inhibited histamine-stimulated extracellular calcium inlfux and intracellular calcium release. Our ifndings suggest that DDPH has a vasodilative effect bothin vivo andin vitro, which mediates a neuropro-tective effect on ischemic nerve tissue.

Characterization of cerebral blood flow dynamics with multiscale entropy

Based on the laser speckle contrast imaging(LSCI)and the multiscale entropy(MSE),we study in this work the blood flow dynamics at the levels of cerebral veins and the surrounding network of microcerebral vessels.We discuss how the phenylephrine-related acute peripheral bypertension is refected in the cerebral circulation and show that the observed changes are scale dependent,and they are signifcantly more pronounced in microcerebral vessels,while the macrocerebral dynamics does not demonstrate authentic inter-group distinctions.We also consider the permeability of blood-brain barrier(BBB)and study its opening caused by sound exposure.We show that alterations associated with the BBB opening can be revealed by the analysis of blood flow at the level of macrocerebral vessels.

EFFECTS OF ACUPUNCTURE AT FENGCHI POINT (GB 20) ON CEREBRAL BLOOD FLOW

Blood velocity in the vertebral artery and the basilar artery was observed before and after acupuncture at Fengchi point (GB 20) in 97 patients by transcranial Doppler ultrasonic detecting. The results showed that the blood velocity in patients with either high or low blood flow had significant changes after acupuncture (P【 0.001).

Relationship of gelatinases-tight junction proteins and blood-brain barrier permeability in the early stage of cerebral ischemia and reperfusion

Gelatinases matrix metalloproteinase-2 and matrix metalloproteinase-9 have been shown to mediate claudin-5 and occludin degradation, and play an important regulatory role in blood-brain barrier permeability. This study established a rat model of 1.5-hour middle cerebral artery occlusion with reperfusion. Protein expression levels of claudin-5 and occludin gradually decreased in the early stage of reperfusion, which corresponded to the increase of the gelatinolytic activity of matrix metalloproteinase-2 and matrix metalloproteinase-9. In addition, rats that received treatment with matrix metalloproteinase inhibitor N-[（2R）-2-（hydroxamidocarbonylmethyl）-4-methylpenthanoyl]-L- tryptophan methylamide （GM6001） showed a significant reduction in Evans blue leakage and an inhibition of claudin-5 and occludin protein degradation in striatal tissue. These data indicate that matrix metalloproteinase-2 and matrix metalloproteinase-9-mediated claudin-5 and occludin degradation is an important reason for blood-brain barrier leakage in the early stage of reperfusion. The leakage of the blood-brain barrier was present due to gelatinases-mediated degradation of claudin-5 and occludin proteins. We hypothesized that the timely closure of the structural component of the blood-brain barrier （tight junction proteins） is of importance.

不同针灸介入时机对大脑中动脉供血区急性脑梗死神经功能预后的影响

目的观察不同针灸介入时机对大脑中动脉供血区急性脑梗死神经功能预后的影响。方法回顾性选取2020年1月—2022年8月收治的116例大脑中动脉供血区急性脑梗死患者的临床资料进行分析,根据针灸介入时机分为两组。两组均进行静脉溶栓及常规药物治疗,观察组61例患者于发病72 h内给予针灸治疗,对照组55例患者于发病2周时给予针灸治疗。检测两组不同时间点侧支循环代偿情况、脑损伤标志物的水平,评估两组不同时间点简易精神状态检查(Mini-mental state examination,MMSE)评分、神经功能评分、Barthel指数(Barthel index,BI)评分、肢体运动功能评分、中医症状评分的差异,统计两组疗效。结果治疗前,两组侧支循环代偿情况比较,差异无统计学意义(P>0.05)。治疗4周和随访时,两组患侧大脑前动脉平均血流速度与对侧大脑中动脉平均血流速度的比值(Ratio of the average flow ve⁃locity of the affected anterior cerebral artery to the average flow velocity of the contralateral middle cerebral artery,iVACA/cVM⁃CA)较治疗前升高,观察组同时间点较对照组更高(P<0.05);两组患侧大脑后动脉平均血流速度与对侧大脑中动脉平均血流速度的比值(Ratio of the average flow velocity of the affected posterior cerebral artery to the average flow velocity of the contralateral middle cerebral artery,iVPCA/cVMCA)与治疗前比较,差异无统计学意义(P>0.05)。治疗前,两组脑损伤标志物比较,差异无统计学意义(P>0.05)。治疗4周和随访时,两组脑源性神经营养因子(Brain-derived neurotrophic factor,BDNF)较治疗前升高,观察组同时间点较对照组更高(P<0.05);两组钙结合蛋白β(Calcium binding proteinβ,S100β)、神经胶质纤维酸性蛋白(Glial fibrillary acid protein,GFAP)较治疗前下降,观察组同时间点较对照组更低(P<0.05)。治疗前,两组Fugl-Meyer评分、中医症状评分等相关评分比较,差异无统计学意义(P>0.05)。治疗4周和随访时,两组MMSE评分、BI评分及上肢和下肢Fugl-Meyer评分较治疗前升高,观察组同时间点较对照组更高(P<0.05);两组美国国立卫生院神经功能缺损(National institutes of health stroke scale,NIHSS)评分、中医症状评分较治疗前下降,观察组同时间点较对照组更低(P<0.05)。观察组总有效率为88.52%(54/61)高于对照组的72.73%(40/55),差异有统计学意义(P<0.05)。结论发病72h内采用针灸治疗可改善大脑中动脉供血区急性脑梗死脑损伤标志物的表达,改善脑血流,促进神经功能的恢复,有利于疾病的康复。

基于“筋骨平衡”理论针刺推拿疗法治疗椎动脉型颈椎病的临床观察

目的浅析椎动脉型颈椎病(cervical spondylotic vertebral arteriopathy,CSA)患者实施基于“筋骨平衡”理论针刺推拿疗法对其中医症状积分、颈性眩晕症状与功能评估量表(cervical vertigo symptom and function assessment scale,ESCV)评分、颈椎曲度及脑血流参数的影响。方法选择该院2019年12月—2021年12月就诊的CSA患者86例实施研究,随机数字表法分作观察组与对照组,各43例;其中对照组脱落2例,剔除1例,共完成40例;观察组脱落1例,剔除1例,共完成41例;对照组予以常规牵引疗法,观察组予以基于“筋骨平衡”理论针刺推拿疗法;比较两组治疗前与治疗后中医症状积分、ESCV评分、颈椎曲度及脑血流参数的变化,并对比两组疗效。结果治疗后,观察组中医症状积分皆显著低于对照组(P<0.05)。治疗后,观察组ESCV评分和颈椎曲度皆明显高于对照组(P<0.05)。治疗后,观察组椎底动脉及左、右椎动脉的Vs与Vd水平均显著高于对照组(P<0.05)。观察组总有效率显著高于对照组[95.12%(39/41)vs 80.00%(32/40),P<0.05]。结论基于“筋骨平衡”理论针刺推拿疗法对CSA患者疗效显著,有效改善中医症状积分、ESCV评分以及颈椎曲度,增强脑血流参数。

电针结合经颅交流电刺激对脑缺血大鼠神经炎症和凋亡相关基因表达的影响

目的:观察电针(electroacupuncture,EA)结合经颅交流电刺激(transcranial alternating current stimulation,tACS)对大脑中动脉闭塞(middle cerebral artery occlusion,MCAO)模型大鼠神经功能、脑血流、炎症-细胞凋亡基因表达的影响,探讨脑缺血再灌注后脑功能康复的神经调控机制。方法:将40只SD大鼠随机分为假手术组(S组)、模型组(M组)、电针组(EA组)、经颅交流电刺激组(T组)及电针结合经颅交流电组(EA+T组),每组8只。缺血再灌注后2h,EA组选取双侧曲池、足三里进行电针干预;T组选取右侧M1区(motor cortex M1,运动皮质M1区)进行tACS干预;EA+T组选取电针结合tACS干预;S组与M组均进行气麻30min/次,连续7天。记录大鼠造模前(B)—造模后7天(D7)的神经缺损评分;B—D7右侧大脑中动脉供血区的血流值,记录血流量;D7时取脑RT-PCR方法检测缺血侧的炎症-细胞凋亡基因的表达。结果:神经缺损评分(neurological deficit scores,NDS):2h、D1时,M组、EA组、T组、EA+T组与S组相比显著增加(P<0.05);D3、D5、D7时,S组与其他各组相比显著降低、M组与其他各组相比显著增加(P<0.05)。EA组、T组、EA+T组各时间均有显著性差异(P<0.05);M组2h、D1、D3、D5、D7与B相比显著上升;D1、D3、D5、D7与2h相比显著下降(P<0.05)。血流量:EA+T组与S组均在2h时下降、D1时上升、D3时下降;EA组则从D3时上升;而M组在D1、D3、D5时与其他各相比均显著下降(P<0.05)。RT-PCR:运动皮质ΔCt法分析(参照基因):EA+T组的天冬氨酸蛋白水解酶12(cysteinyl aspartate specific proteinase12,Caspase 12)表达显著低于T组(P<0.05);EA组、EA+T组的细胞因子白介素-1β(interleukin-1β,IL-1β)、核苷酸结合寡聚化结构域样受体1(nucleotide-binding oligomerization domain-like receptor pyrin domain containing 1,NLRP1a)均显著低于S组(P<0.05)。缺血区2-ΔΔCt分析:M组的内质网应激相关蛋白激活转录因子4(activating transcription factor 4,ATF4)表达显著高于其他各组(P<0.05);M组的B淋巴细胞瘤-2基因(B-cell lymphoma,l-2)显著高于S组、EA组、EA+T组(P<0.01);M组的Bcl-2相关X蛋白(Bcl-2 associated X potein,Bax)、Caspase 12、细胞癌基因fos(cellular oncogene fos,fos)均显著高于S组(P<0.05)。结论:电针结合tACS对缺血性脑卒中的干预可能通过调控ATF4、Bcl-2、Bax、Caspase 12、C-fos的表达发挥调节作用,联合应用在减轻炎症反应、抑制细胞凋亡方面,可能优于单独电针或tACS干预,可为缺血性脑卒中的治疗提供新的策略。

基于彩色多普勒超声分析胎儿脐血流对FGR的诊断价值

目的:探讨彩色多普勒超声胎儿脐血流参数对FGR的诊断价值。方法:回顾性选取2019年12月~2021年12月收治的100例FGR孕妇(研究组)及100例正常孕妇(对照组),均接受超声检测。分析胎儿超声脐血流参数与FGR的关系,Logistic回归分析FGR发生的影响因素。ROC曲线分析胎儿脐血流参数对FGR的诊断价值。结果:Logistic分析显示年龄、羊水过少、低蛋白血症、RI,PI,S/D均是FGR发病的影响因素。ROC分析显示S/D、RI、PI对FGR诊断价值高。结论:FGR胎儿彩色多普勒RI,PI,S/D异常升高,具有良好诊断价值。