Animals ; Animals, Newborn ; Brain Edema ; prevention & control ; Hypoxia-Ischemia, Brain ; prevention & control ; Progesterone ; therapeutic use ; Rats ; Rats, Wistar

OBJECTIVETo observe the therapeutic effect and safety of three-step acupuncture for the secondary prevention of ischemic cerebral apoplexy.

METHODSOne hundred and twenty cases of first-episode ischemic cerebral apoplexy were randomly divided into an observation group and a control group according to the visiting sequence, 60 cases in each group. Both groups were treated on the basis of the routine treatment, the observation group was treated with three-step acupuncture combined with oral administration of Aspirin for six months. The threestep acupuncture includs scalp acupuncture, body point acupuncture and rehabilitation training. The control group was treated with oral administration of Aspirin alone. Six-month follow-up was done in two groups. Then the recurrence rate of ischemic cerebral apoplexy, the improvement of neurologic impairment, activity of daily living and TCM symptom scores and the safety of three-step acupuncture between two groups were compared.

RESULTSThe recurrence rate was 10.2% (5/49) in observation group, and 16.7% (9/54) in control group. There was no significant difference between two groups (P > 0.05). The observation group was superior to the control group in improving the scores of the neurologic impairment, activity of daily living and TCM symptom (P < 0.01, P < 0.001). There was no severe adverse reaction in two groups except 2 cases of gastrointestinal reaction caused by oral administration of Aspirin in control group.

CONCLUSIONThree-step acupuncture has a certain therapeutic effect for both treatment and the secondary prevention of ischemic cerebral apoplexy, and it is one of the safe and effective methods for treating and preventing ischemic cerebral apoplexy in clinic.

Acupuncture Therapy ; Adult ; Aged ; Brain Ischemia ; prevention & control ; therapy ; Female ; Humans ; Male ; Middle Aged ; Secondary Prevention ; Stroke ; prevention & control ; therapy

OBJECTIVETo evaluate the efficacy and the mechanism of application of selective head cooling on neuronal morphological damage during postischemic reperfusion in a rabbit model.

METHODS168 New Zealand rabbits were randomized into three groups. Group I [n = 24, (38 +/- 0.5) degrees C, non-ischemic control]; Group II [n = 72, (38 +/- 0.5) degrees C, normothermic reperfusion]; Group III [n = 72, (28 +/- 0.5) degrees C, selective head cooling, initiated at the beginning of reperfusion). Animals in three subgroups (n = 24, each) of Group II and Group III had reperfused lasting for 30, 180 and 360 min respectively. Using computerized image analysis technique on morphological changes of nucleus, the degree of neuronal damage in 12 regions were differentiated into type A (normal), type B (mild damaged), type C (severely damaged) and type D (necrotic). Fourteen biochemical parameters in brain tissues were measured.

RESULTSAs compared with Group I, the counts of type A neuron decreased progressively, and those of type B, C and D increased significantly in Group II during reperfusion (P < 0.01). In Group II, vasoactive intestinal peptide, b-endorphine, prostacyclin, T3 and Na+, K(+)-ATPase were correlated with the changes of type A; b-endorphine and thromboxane with type B; glucose and vasopressin with type C; Na+, K(+)-ATPase, glutamic acid, T3 and vasoactive intestinal peptide with type D (P < 0.05). As compared with Group II, the counts of type A increased, and those of type C and D significantly decreased in Group III (P < 0.01). In Group III, Ca2+, Mg(2+)-ATPase were correlated with the changes of type A, C and D (P < 0.01).

CONCLUSIONSelective head cooling for sex hours during postischemic reperfusion does improve neuronal morphological outcomes in terms of morphological changes.

Animals ; Brain Ischemia ; pathology ; Cold Temperature ; Neurons ; pathology ; Rabbits ; Reperfusion Injury ; prevention & control ; Resuscitation ; methods

This essay summarizes experimental studies on the protective effect of traditional Chinese medicines and their extracts on cerebral ischemia in the past decade. It classifies reported traditional Chinese medicines into three types-plant medicines, animal medicines and mineral medicines, and specifies the advance of their effective components, extracts and their preparations in treating cerebral ischemia.
Animals ; Brain Ischemia ; prevention & control ; Drugs, Chinese Herbal ; therapeutic use ; Humans ; Medicine, Chinese Traditional

OBJECTIVE: To observe the effects of "" acupuncture on cerebral blood flow in high-risk patients of cerebral ischemic stroke based on arterial spin labeling (ASL) and perfusion-weighted imaging (PWI), and to evaluate the clinical efficacy. METHODS: A total of 180 patients with transient ischemic attacks (TIA) / minor ischemic stroke (MIS) were randomly divided into an acupuncture A group, an acupuncture B group and a medication group, 60 cases in each group. The patients in the acupuncture A group were treated with "" acupuncture at Baihui (GV 20), Fengfu (GV 16), Yamen (GV 15), Dazhui (GV 14), Shenzhu (GV 12), Zhiyang (GV 9), Mingmen (GV 4), Yaoyangguan (GV 3) and Jingjiaji (EX-B 2), once a day; the patients in the acupuncture B group were treated with identical acupoints but was given once every other day; the patients in the medication group were treated with oral administration of nimodipine tablets, 30 mg, three times daily. All the three groups were treated for four weeks. ASL and PWI, including relative cerebral blood volume (rCBV), relative cerebral blood flow (rCBF), relative mean transit time (rMTT) and relative time to peak (rTTP), were conducted before and after treatment; the changes of the test indexes were compared before and after treatment. The clinical efficacy of the three groups was compared. RESULTS: Compared before treatment, the numbers of ASL normal perfusion in the 3 groups were significantly increased after treatment (all <0.01); the number of ASL normal perfusion in the acupuncture A group was higher than that in the acupuncture B group (<0.05), but was not significantly different from that in the medication group (>0.05). Compared before treatment, rCBV and rCBF in the 3 groups were significantly increased after treatment (all <0.01), and rMTT and rTTP were significantly reduced (all <0.01). After treatment, rCBV and rCBF in the acupuncture A group were higher than those in the acupuncture B group (all <0.05); the rMTT and rTTP in the acupuncture A group were lower than those in the acupuncture B group (all <0.05); the differences of PWI parameters after treatment were not statistically significant between the acupuncture A group and medication group (all >0.05). The total effective rate was 88.3% (53/60) in the acupuncture A group, 73.3% (44/60) in the acupuncture B group and 90.0% (54/60) in the medication group; the total effective rate in the acupuncture A group was superior to that in the acupuncture B group (<0.05), but was not significantly different from that in the medication group (>0.05). CONCLUSION "" acupuncture could effectively improve the hypoperfusion of cerebral blood flow in patients with high risk of cerebral ischemic stroke, reduce the incidence of severe CIS; acupuncture for once a day is better than once every other day.
Acupuncture Therapy ; Brain Ischemia ; prevention & control ; Cerebrovascular Circulation ; Humans ; Risk Factors ; Stroke

Hypoxic-ischemic encephalopathy (HIE) in neonates is the brain injury caused by perinatal asphyxia or hypoxia and is a major cause of death in neonates and nervous system dysfunction in infants and young children. Although to a certain degree, mild hypothermia therapy reduces the mortality of infants with moderate to severe HIE, it cannot achieve the expected improvements in nervous system dysfunction. Hence, it is of vital importance to search for effective therapeutic methods for HIE. The search for more therapies and better preventive measures based on the pathogenesis of HIE has resulted in much research. As an important link in the course of HIE, energy failure greatly affects the development and progression of HIE. This article reviews the research advances in the treatment and prevention of energy failure in the course of HIE.
Energy Metabolism ; Humans ; Hypothermia, Induced ; Hypoxia-Ischemia, Brain ; prevention & control ; therapy ; Infant, Newborn ; Infant, Newborn, Diseases ; prevention & control

OBJECTIVETo analyze the mechanism of neuroprotection of insulin and which blood glucose range was benefit for insulin exerting neuroprotective action.

DATA SOURCESThe study is based on the data from PubMed.

STUDY SELECTIONArticles were selected with the search terms "insulin", "blood glucose", "neuroprotection", "brain", "glycogen", "cerebral ischemia", "neuronal necrosis", "glutamate", "γ-aminobutyric acid".

RESULTSInsulin has neuroprotection. The mechanisms include the regulation of neurotransmitter, promoting glycogen synthesis, and inhibition of neuronal necrosis and apoptosis. Insulin could play its role in neuroprotection by avoiding hypoglycemia and hyperglycemia.

CONCLUSIONSIntermittent and long-term infusion insulin may be a benefit for patients with ischemic brain damage at blood glucose 6-9 mmol/L.

Blood Glucose ; drug effects ; Brain Ischemia ; prevention & control ; Humans ; Hyperglycemia ; prevention & control ; Insulin ; therapeutic use ; Neuroprotective Agents ; therapeutic use

Cerebral ischemia-reperfusion injury(CIRI) is an important factor hindering the recovery of ischemic stroke patients after blood flow recanalization. Mitochondria, serving as the "energy chamber" of cells, have multiple important physiological functions, such as supplying energy, metabolizing reactive oxygen species, storing calcium, and mediating programmed cell death. During CIRI, oxidative stress, calcium overload, inflammatory response, and other factors can easily lead to neuronal mitochondrial dyshomeostasis, which is the key pathological link leading to secondary injury. As reported, the mitochondrial quality control(MQC) system, mainly including mitochondrial biosynthesis, kinetics, autophagy, and derived vesicles, is an important endogenous mechanism to maintain mitochondrial homeostasis and plays an important protective role in the damage of mitochondrial structure and function caused by CIRI. This paper reviewed the mechanism of MQC and the research progress on MQC-targeting therapy of CIRI in recent 10 years to provide theoretical references for exploring new strategies for the prevention and treatment of ischemic stroke with traditional Chinese medicine.
Brain Ischemia/prevention & control* ; Calcium/metabolism* ; Humans ; Ischemic Stroke ; Mitochondria/pathology* ; Reactive Oxygen Species/metabolism* ; Reperfusion Injury/prevention & control*

Animals ; Berberine/therapeutic use* ; Brain Ischemia/prevention & control* ; Glutathione Peroxidase ; Rats ; Rats, Sprague-Dawley ; Reperfusion Injury/prevention & control*

Brain ; pathology ; Cerebrovascular Circulation ; Humans ; Hypoxia-Ischemia, Brain ; diagnosis ; pathology ; prevention & control ; Infant, Newborn ; Infant, Premature ; Magnetic Resonance Imaging