Objective To investigate the expression of GABA_A receptor in the process of activation of hippocampal neurons and explore the epileptogenesis. Methods The activated hippocampal neuron products (experiment group) and the serum-free-medium (control group) were injected into rat's lateral ventricle, respectively, then we observed the behaviors, electroencephalographic (EEG) and immunochemical changes of GABA_A receptor in rats. Results 10~30 min after administration of pentetrazole (PTZ)-activated hippocampal neuronal products, Ⅱ～Ⅲ class epileptic behaviors were found in the experiment group. EEG showed many short distance moderate amplitude sharp waves, sharp and slow wave complex. The behaviors of rats and EEG results were normal in the control group. GABA_A receptor positive cells extensively spread over cerebral cortex, hippocampal CA_1 and dentate gyrus in the control group, and the expression of GABA_A receptor significantly decreased in the experiment group.Conclusion Activated hippocampal neuronal products could induce epilepsy. One of its mechanisms might be related to the decrease of GABA_A content.

Objectives To examine the effects of enhanced external counterpulsation on arterial elasticity in stroke patients to provide clinical evidence for secondary prevention of patients with cerebral ischemic stroke. Methods Total 192 patients with ischemic stroke were enrolled and then divided into the EECP (n=107) and control (n=85) group. Auto-matic measurement synchronous atherosclerosis detector was use to measure brachial-ankle pulse wave velocity (BaP-WV) and cardio-ankle vascular index (CAVI). The difference of BaPWV and CAVI were evaluated before, at 36 hours and one month after EECP. Results The BaPWV and CAVI significantly decreased at 36 hours and 1 month after treat-ment in EECP groups compared to either pre-therapy or control groups (all P<0.05). Conclusions EECP can signifi-cantly reduce the BaPWV and CAVI and improve the arterial elasticity in patients with cerebral ischemic stroke. Thus, arterial elasticity may be an important index to evaluate the effects of EECP on cerebral ischemic stroke.

Objective To discuss the artery effects of enhanced external counterpulsation for the progressive stroke patients.Methods Ninety-two progressive stroke patients who were treated in the Fourth People's Hospital of Shenzhen from August 2010 to February 2015 were selected and equally divided into the treatment group and the control group based on the random number table.The control group were received conventional therapy,and the treatment group were added treated with enhanced extemal counterpulsation therapy.Results All patients were successfully completed treatment,the C-reactive protein (CRP) and Endothelin-1 (ET-1) were presented decreased significantly after treatment (P＜ 0.05),and the C RP and ET-1 values in the treatment group were (2.09±2.11) mg/L,(13.98±6.30) mg/L,significantly lower than those of the control group((8.12±2.46) mg/L,(46.09± 11.02) mg/L;t =15.309,14.985;P＜0.05).After treatment,the FMD and NMD values in the treatment group were significantly increased from (5.26±1.34)％ to (11.93 ±2.13) ％,and from (13.20±5.33)％ to (22.98±8.34)％,in the control groupand were from (5.27±1.33)％ to (8.10±1.43) ％,and from (13.67±4.10)％ to (16.09±5.12)％ (t=16.934,21.787,8.443,12.345;P ＜0.05),and the value of FMD and NMD in treatment group were significantly higher than in the control group(t =7.982,9.113;P ＜ 0.05).The cardio ankle vascular index (CAVI) and brachial ankle pulse wave velocity (baPWV) values in the treatment group were significantly reduced after treatment,the difference was significant (P＜0.05),and compared with the control group the difference was also statistically significant (t =4.281,8.456;P＜ 0.05).Conclusion Enhanced external counterpulsation for the progressive stroke patients can effectively inhibit the expression of endothelin and inflammatory factors,improve endothelium-dependent relaxation of blood vessels,improve arterial elasticity,and thus play more effective treatment.

ObjectiveTo observe the therapeutic efficacy of early acupoint stimulation and physical therapy on patients with cerebral infarction.Methods100 cases of cerebral infarction were divided randomly into the treatment group A (n=50), treatment group B (n=50) and other 50 cases were selected as the control group. The treatment group A received physical therapy, the treatment group B received acupoint stimulation and physical therapy, the control group only received routine therapy. Fugl-Meyer assessment (FMA) and Barthel index (BI) were used to assess physical function and activities of daily living (ADL) at pre-therapy and 3 months post-therapy respectively.ResultsThe scores of FMA and BI in three groups were similar at pre-therapy stage (P>0.05). The treatment groups showed much higher scores of FMA and BI than those in the control group after 3 months' follow-up (P<0.05), so were the scores in treatment group B compared with the scores in treatment group A.ConclusionEarly rehabilitation is much more effective, the therapeutic efficacy of acupoint stimulation and physical therapy is better than single physical therapy.

Objective The purpose of this study was to assess the imaging features of newly diagnosed high-grade glioma and the effect of relevant factors such as postoperative radiotherapy and chemotherapy on progression-free sur-vival (PFS) time. Methods A total of 54 patients with recurrent high-grade glioma confirmed by pathology or progressive malignant glioma proved by clinical follow-up were included in this retrospective study from 4 clinical centers. The prog-nostic factors selected included MR image features at initial diagnosis (including the maximum diameter of tumor, peritu-moral edema, degree of enhancement, degree of necrosis and presence of cystic or satellite), postoperative radiotherapy and chemotherapy. Kaplan-Meier method and Cox’s proportion-hazards model were used to analyse the factors influenc-ing the progression free survival (PFS) time. Results The univariate Kaplan-Meier analysis revealed that the degree of peritumoral edema (PTE, P=0.001), degree of necrosis (P<0.001) , degree of enhancement (P<0.001), postoperative radio-therapy (P=0.008) and chemotherapy(P=0.035) were significant factors for PFS. Cox multivariate analysis also showed that the degree of PTE(P=0.019),degree of necrosis (P<0.001) were all significantly correlated with PFS. The less edema or necrosis was associated with the longer PFS. In addition, postoperative radiotherapy (P=0.035) and chemotherapy (P=0.049) were also significantly correlated with PFS. The normative chemotherapy and radiotherapy were associated with longer PFS. Conclusions The PTE and necrosis on preoperative MR images can be used to predict the PFS of glioma af-ter total resection. Adjuvant normative chemotherapy and radiotherapy should be recommend for supratentorial high-grade glioma including those even with MRI confirmed total resection.

Objective To explore the therapeutic effect and prognosis of enhanced external counterpulsation (EECP)on acute cerebral ischemic stroke,to provide clinical evidence for the treatment of patients with acute cerebral ischemic stroke.Methods Total171 patients with acute cerebral ischemic stroke were enrolled and measured the NIHSS and mRS,before EECP,after36 hours EECP,and 3-month after attack.Then contrast the difference of these indicators.Result Compare with the control group,after EECP treatment and after 3-month attack,the scores of NIHSS were statistically significant,(after EECP:44.1％ vs 31.5％;after 3-month attack:55.6％ vs 40.5％),(P＜ 0.05).Compare with the control group,after 3-month attack,the score of mRS in EECP group was declined statistically significant,and the rate of favourable prognosis rise obviously (P＜0.05).Conclusion EECP can effectively improve neurological function and promote health and improve prognosis in the patients with acute cerebral ischemic stroke.

Objectives To explore the effects of enhanced external counterpulsation(EECP)on the serum level of C-reactive protein and endothelin-1 in patients with cerebral ischemic stroke,to provide clinical evidence for the treat?ment and secondary prevention of patients with cerebral ischemic stroke. Methods Total 187 patients with ischemic stroke were enrolled measure the serum level of C-reactive protein and endothelin-1, before EECP, after36 hours EECP, and one-month after EECP. Then contrast the difference of these indicators. Result After treatment, the serum levels of C-reactive protein and endothelin-1 in EECP group were obviously decrease and the difference was statistically signifi?cant(hs-CRP 60.1%vs. ET-1 40.9%,P<0.05). After treatment, the serum levels of C-reactive protein and endothelin-1 in EECP group were obviously decrease than that in the control group and the difference was statistically significant ( hs-CRP 41.3%vs. ET-1 24.3%,P<0.05). One-month after EECP, the serum level of endothelin-1 in EECP group was obviously decrease than that in the control group(43.8%vs. 31.8%,P<0.05). One-month after EECP, there was no signif?icant difference in the serum levels of C-reactive protein between the two groups (P>0.05). Conclusion EECP can obvi?ously reduce the serum levels of C-reactive protein and endothelin-1 in the patients with ischemic stroke, which indi?cates that EECP can slow atherosclerotic process.

Objective To investigate the knowledge, attitude and behavior related to stroke and rehabilitation in the stroke patients and their relatives. Methods Questionnaires were performed in 60 stroke patients and 100 relatives. Results 71.7% patients knew "what is stroke". 40% knew "hypertension is the most risk factors of stroke". 45% patients and 41% relatives knew that the risk factors for stroke were hypertension, diabetes, hyperlipidemia, smoking and drinking. 35% patients and 29% relatives learned that the prevention of stroke should start being young. 50% patients did not understand post-stroke rehabilitation. Patients learned some to limit their smoking, alcohol, salt intake and alter their personality. More than 80% relatives wished to help the patients abstain smoking, limit fat and salt. 55% patients agreed to control the blood pressure. About 40% patients or their families did not know it was necessary to monitor the blood pressure and lipid, 70% relatives would help the patient exercise. Less than 50% patients began to treat their hypertension, heart disease and diabetes. 40% accepted low-fat diet and regular exercise. 35% measured their blood pressure and lipid regularly, or go to the hospital for the medical examination. Conclusion At present, the knowledge, attitude and behavior related to stroke and rehabilitation in stroke patients and their relatives need to be improved.

OBJECTIVE: To evaluate the feasibility of surface tractotomy of trigeminal nerve sensory root (STS) for the treatment of trigeminal neuralgia (TN). METHOD: Seven patients with TN were operated on using the STS. The six patients were followed up for 4.8-9.8 years. The trigeminal nerve root (TNR) obtained from 30 cadavers were performed microanatomical research using paraffin embedding and hematoxylin-eosin staining technique. RESULT: Clinically, the patients' symptoms, such as face ache, disappeared after the surface nerve fiber bundles of trigeminal nerve sensory root (TNSR) were cut off. Only one patient died of brainstem bleeding on postoperative day 18. Histological examination: The common type of sensory root fibers were arranged parallel for 3-6 mm at its exit of brainstem, and then the glial myelin transformed to Schwann cells. The axon bifurcated from outer layer to middle region, and gradually formed the tiny nerve fiber bundles in the surface layer and the giant nerve fiber bundles in the center of the root. CONCLUSION TN can be radical cured by STS without lesioning of nerve functions. Therefore,this new approach is an effective, advanced surgical technique for TN treatment.
Aged ; Denervation ; methods ; Female ; Humans ; Male ; Middle Aged ; Trigeminal Nerve ; surgery ; Trigeminal Neuralgia ; surgery

Objective To investigate the differences of ankle-brachial index (ABI) in patients with stroke subtypes to explore the clinical significance of ABI in stroke subtypes.Methods Four hundred and seventy-five patients,admitted to our hospital from January 1,2011 to December 30,2012,were classified into the different stroke subtypes by standard of the fourth national cerebrovascular conference:188 patients with atherothrombotic infarction,95 with lacunar infarction,73 with cardiogenic cerebral embolism,85 with intracerebral hemorrhage and 34 with subarachnoid hemorrhage.The normal controls consisted of patients who had no cerebrovascular diseases.ABI was measured in all subjects with Doppler ultrasonic measurement.Statistical analysis was used to analyze the influences of atherosclerosis hazards (including ABI) in stroke,and the difference of ABI in different subtypes of stroke.After adjusting other risk factors,the influence of ABI in stroke subtypes was evaluated alone.Results (1)Multiple factor logistic regression analysis showed that hypertension (odds ratio [OR]=3.963,95％confidence interval[CI]:2.128-6.982,P=0.0001),diabetes mellitus (OR=3.413,95％CI:1.785-4.905,P=0.039),smoking (OR=2.216,95％CI:1.942-6.025,P=0.020),and ABI (OR=2.425,95％CI:1.405-3.512,P=0.012) were significantly correlated with the presence of stroke.(2) Analysis of variance showed that there were significant differences in ABI between the atherothrombotic infarction group and the normal control group (P=0.015),between the lacunar infarction group and the normal control group (P=0.020),between the cardiogenic cerebral embolism group and the normal control group (P=0.037),and between the intracerebral hemorrhage group and the normal control group (P=0.023).After adjusting the risk factors of stroke,disorder multi-classification Logistic regression analysis showed that ABI was negatively correlated to atherothrombotic infarction (OR=2.832,95％CI:1.776-5.273,P=0.011),lacunar infarction (OR=2.527,95％CI:1.548-5.152,P=0.026),cardiogenic cerebral embolism (OR=1.922,95％CI:1.336-3.525,P=0.030),and intracerebral hemorrhage (OR=2.332,95％CI:1.243-4.165,P=0.021).Conclusions ABI is independently and strongly related to the risk of stroke.ABI can serve as screening index of atherothrombotic infarction,lacunar infarction,cardiogenic cerebral embolism,and intracerebral hemorrhage.