With the popularization of cardiopulmonary resuscitation (CPR) technology, the success rate of restoration of spontaneous circulation (ROSC) is gradually improved, and the survival rate and neurological outcome of patients with cardiac arrest are improved. Currently, therapeutic methods for cerebral resuscitation after cardiac arrest are limited. In addition to mild hypothermia for clinical application, the majority of drugs remain in the animal experimental stage. Finding effective brain protection drugs has become a hot spot in the field of brain resuscitation research. This article will review the pharmaceutical progress of research for cerebral resuscitation after cardiac arrest, so that we can study the brain protection mechanism of these drugs better and more targeted.
Cerebrovascular Circulation/drug effects* ; Heart Arrest/drug therapy* ; Humans ; Pharmaceutical Research/trends* ; Resuscitation/methods*

PURPOSETo investigate the effects of salvianolic acid B (SAB) on tumor necrosis factor a (TNF-α) induced alterations of cerebral microcirculation with a bone-abrading model.

METHODSThe influences of craniotomy model and bone-abrading model on cerebral microcirculation were compared. The bone-abrading method was used to detect the effects of intracerebroventricular application of 40 μg/kg·bw TNF-α on cerebral venular leakage of fluorescein isothiocyanate (FITC)- albulmin and the rolling and adhesion of leukocytes on venules with fluorescence tracer rhodamine 6G. The therapeutical effects of SAB on TNF-α induced microcirculatory alteration were observed, with continuous intravenous injection of 5 mg/kg·h SAB starting at 20 min before or 20 min after TNF-α administration, respectively. The expressions of CD11b/CD18 and CD62L in leukocytes were measured with flow cytometry. Immunohistochemical staining was also used to detect E-selectin and ICAM-1 expression in endothelial cells.

RESULTSCompared with craniotomy method, the bone-abrading method preserved a higher erythrocyte velocity in cerebral venules and more opening capillaries. TNF-α intervention only caused responses of vascular hyperpermeability and leukocyte rolling on venular walls, without leukocyte adhesion and other hemodynamic changes. Pre- or post-SAB treatment attenuated those responses and suppressed the enhanced expressions of CD11b/CD18 and CD62L in leukocytes and E-selectin and ICAM-1 in endothelial cells induced by TNF-α.

CONCLUSIONSThe pre- and post-applications of SAB during TNF-α stimulation could suppress adhesive molecular expression and subsequently attenuate the increase of cerebral vascular permeability and leukocyte rolling.

Animals ; Benzofurans ; pharmacology ; Blood Flow Velocity ; Cerebrovascular Circulation ; drug effects ; Craniotomy ; Disease Models, Animal ; E-Selectin ; metabolism ; Intercellular Adhesion Molecule-1 ; metabolism ; Mice ; Mice, Inbred C57BL ; Microcirculation ; drug effects ; Random Allocation ; Reference Values ; Tumor Necrosis Factor-alpha ; administration & dosage

OBJECTIVETo investigate the protective effects of high-dose ulinastatin on the vital organs in patients undergoing total arch replacement for type A aortic dissection.

METHODSBetween September 2014 and March 2016, 66 patients with type A aortic dissection underwent total arch replacement at our center. Thirty-six of the patients received ulinastatin treatment at 300 000 U/8 h from admission to 3 days postoperatively and at 300 000 U/2 h during cardiopulmonary bypass surgery (UTI group), and the other 30 patients did not receive perioperative ulinastatin treatment (control group). The surgical data and blood biochemistry profiles on days 1, 3, and 5 postoperatively were compared between the two groups, and the postoperative ICU stay, re-operation for bleeding, ventilation for over 7 days, ultrafiltration for postoperative renal failure, tracheotomy, incidences of pulmonary and neurological complications and hospital death were also compared.

RESULTSs The operating time, cardiopulmonary bypass time, ACP time, cardiac arrest time, the lowest rectal temperature and frequency of bilateral and unilateral antegrade selective cerebral perfusion were similar between the two groups (P>0.05). Compared with those in the control group, patients in UTI group had lower lactate, S-100 and neuron specific enolase levels on the first postoperative day and higher OI on the 1st, 3rd, and 5th postoperative days (P<0.05), but serum creatinine, blood urea nitrogen, total bilirubin, and alanine aminotransferase levels were comparable between the two groups (P>0.05). No significant differences were found in the frequency of re-operation for bleeding, ultrafiltration for renal failure, tracheotomy, neurological complications or hospital death after the operation between the two groups, but the patients in UTI group had a shorter ICU time, a less frequent long-term ventilation and a lower incidence of pulmonary infection (P<0.05).

CONCLUSIONHigh-dose ulinastatin offers protection on pulmonary function and lowers the specific brain injury markers in patients with type A aortic dissection after total arch replacement, but its protective effects on brain is uncertain.

Aneurysm, Dissecting ; surgery ; Aorta, Thoracic ; surgery ; Aortic Aneurysm, Thoracic ; surgery ; Body Temperature ; Brain ; drug effects ; Cardiopulmonary Bypass ; Cerebrovascular Circulation ; Glycoproteins ; therapeutic use ; Humans ; Incidence ; Lactic Acid ; blood ; Lung ; drug effects ; Perfusion ; Phosphopyruvate Hydratase ; blood ; Postoperative Period ; Protective Agents ; therapeutic use ; S100 Proteins ; blood ; Time Factors

Recent studies showed that pathology of alcoholic encephalopathy was associated with cerebral vascular damage. TMP (tetramethyl- pyrazine) is widely used in the treatment of cerebrovascular diseases, however, it has not been reported whether TMP can relieve alcohol-induced cerebral vascular damages. The study was performed to investigate the learning and memory, cerebrovascular pathological changes and the expressions of vascular endothelial growth factor (VEGF) and serum levelsofendothelin-1 (ET-1) in the rat model of chronic alcoholic encephalopathy, and explore the effects of TMP intervention on alcoholic encephalopathy. In the present study, the rat model of chronic alcoholic encephalopathy was established by the gavage administration of alcohol; the learning and memory ability was tested by Morris water maze; the expression of VEGF was measured by RT-PCR and Western blot; and the serum levels of ET-1 was measured by radioimmunoassay. We found that alcohol intoxication impaired learning and memory, induced VEGF overexpression and increased ET 1 concentrations. TMP intervention improved learning abilities, increased the VEGF expression and reduced ET-1 level. These results indicate that TMP exhibits therapeutic effects on chronic alcoholic encephalopathy.
Alcohol-Induced Disorders, Nervous System ; complications ; drug therapy ; physiopathology ; Animals ; Cerebrovascular Circulation ; drug effects ; Disease Models, Animal ; Endothelin-1 ; blood ; Learning ; drug effects ; Male ; Memory ; drug effects ; Pyrazines ; pharmacology ; therapeutic use ; Random Allocation ; Rats ; Rats, Wistar ; Vascular Endothelial Growth Factor A ; analysis ; Vasodilator Agents ; pharmacology ; therapeutic use

OBJECTIVETo investigate the effect of Zige lyophilized powder for injection in improving the acute cerebral microcirculation disturbance in rats.

METHODWindow craniotomy was performed for rats after the drug administration for 14 days. The experimental microcirculation disturbance model was duplicated with high molecule dextran. After the drug administration, the micro-vein diameters of cerebral pla mater of various groups were observed and recorded under the biological microscope. The blood flow volume was monitored by laser Doppler flow-meter. HCT was measured by the electric resistance method. The hemorheological indexes were detected by the auto-hemorheological instrument.

RESULTZige lyophilized powder for injection (16.40, 32.70, 65.40 mg x kg(-1)) could significantly expand the micro-vein diameter of cerebral pla mater, improve the downward trend of the blood flow volume, and reduce the various hemorheological indexes.

CONCLUSIONZige lyophilized powder for injection shows the effect in improving the cerebral microcirculation.

Animals ; Brain ; blood supply ; drug effects ; Brain Ischemia ; drug therapy ; physiopathology ; Cerebrovascular Circulation ; drug effects ; Drugs, Chinese Herbal ; administration & dosage ; Humans ; Male ; Powders ; administration & dosage ; Rats ; Rats, Sprague-Dawley

Currently, there are many traditional Chinese medicine (TCM) injections for treating ischemic stroke in the market, most of them have the efficacy of promoting blood circulation and removing blood stasis, but their reasonable applications are worth consideration. From the angles of traditional Chinese medicine and modern medicine, TCM injections that are commonly used in clinics were detected for their indications and pharmacological effects, compared in terms of their characteristics of clinical application, precautions, prohibition on use, caution and adverse reactions and categorized, in order to help clinicians with reasonable application of TCM injections.
Blood Circulation ; drug effects ; Cerebrovascular Disorders ; drug therapy ; physiopathology ; Drugs, Chinese Herbal ; administration & dosage ; Humans ; Injections

Cerebrovascular Circulation ; drug effects ; Computer Systems ; Fibrinolytic Agents ; administration & dosage ; pharmacology ; Humans ; Infarction, Middle Cerebral Artery ; drug therapy ; physiopathology ; Infusions, Intravenous ; Male ; Middle Aged ; Regional Blood Flow ; drug effects ; Thrombolytic Therapy ; Tissue Plasminogen Activator ; administration & dosage ; pharmacology

OBJECTIVETo explore an effective therapy for children of early cerebral palsy.

METHODSOne hundred and twenty cases were randomly divided into an acupoint injection group and a medication group, 60 cases in each group. The acupoint injection group was treated with scalp point injection of 0.5-1 mL brain protein hydrolysate into each point, Baihui (GV 20), Fengchi (GB 20) and motor area etc. were selected; the medication group was treated with 10 mL brain protein hydrolysate by intravenous drip. The therapeutic effects in the two groups were observed, and the changes of cerebral blood flow were compared before and after treatment.

RESULTSThe total effective rate of 91.4% in the acupoint injection group was superior to that of 73.7% in the medication group (P<0.05), the acupoint injection group could significantly improve the systolic peak velocity (Vs), end diastolic velocity (Ved) and mean velocity (Vm) of middle cerebral artery (MCA) and anterior cerebral artery (ACA), and decrease the vascular resistance index (RI) (all P<0.05), and the improvement degree was superior to the medication group (all P<0.05).

CONCLUSIONScalp point injection therapy can significantly improve the cerebral microcirculation of patients, and has a good therapeutic effect for early cerebral palsy.

Acupuncture Points ; Cerebral Palsy ; drug therapy ; physiopathology ; Cerebrovascular Circulation ; drug effects ; Child ; Drugs, Chinese Herbal ; administration & dosage ; Female ; Humans ; Injections ; Male ; Protein Hydrolysates ; therapeutic use ; Scalp ; blood supply ; drug effects ; physiopathology

The aim of this study was to develop a nonlinear mixed-effects model for the increase in cerebral oximetry (rSO2) during the rapid introduction of desflurane, and to determine the effect of hypocapnia and N2O on the model. Twelve American Society of Anesthesiologist physical status class 1 and 2 subjects were allocated randomly into an Air and N2O group. After inducing anesthesia, desflurane was then increased abruptly from 4.0 to 12.0%. The PET(CO2), PET(DESF) and rSO2 were recorded at 12 predetermined periods for the following 10 min. The maximum increase in rSO2 reached +24-25% during normocapnia. The increase in rSO2 could be fitted to a four parameter logistic equation as a function of the logarithm of PET(DESF). Hypocapnia reduced the maximum response of rSO2, shifted the EC50 to the right, and increased the slope in the Air group. N2O shifted the EC50 to the right, and reduced the slope leaving the maximum rSO2 unchanged. The N2O-effects disappeared during hypocapnia. The cerebrovascular reactivity of rSO2 to CO2 is still preserved during the rapid introduction of desflurane. N2O slows the response of rSO2. Hypocapnia overwhelms all the effects of N2O.
Adult ; Anesthetics, Inhalation/*pharmacology ; *Cerebral Cortex/blood supply/drug effects/physiology ; Cerebrovascular Circulation/*drug effects/physiology ; Female ; Hemodynamics ; Humans ; Hypocapnia/*metabolism ; Isoflurane/*analogs & derivatives/pharmacology ; Male ; Middle Aged ; Models, Theoretical ; Nitrous Oxide/*metabolism ; *Oximetry ; Random Allocation ; Regional Blood Flow/drug effects

OBJECTIVETo explore the influence of Acorus tatarinowii schott on ultrastructure and permeability of BBB.

METHODThe ultrastructure and permeability of BBB on rats with A. tatarinowii by electron microscope were observed. The even's blue (EB) and sodium phenytoin in brain was determined by UV and HPLC-MS.

RESULTAfter give A. tatarinowii, tight junctions of the endothelial cell opened in cotex, and the concentration of EB and sodium phenytoin in brain are significant increased.

CONCLUSIONA. tatarinowii can increase the permeability of BBB, and show its 'Kaiqiao' effect.

Acorus ; chemistry ; Animals ; Blood-Brain Barrier ; drug effects ; Brain ; cytology ; Cells, Cultured ; Cerebrovascular Circulation ; Drugs, Chinese Herbal ; pharmacology ; Endothelial Cells ; Male ; Microscopy, Electron, Transmission ; Neurons ; diagnostic imaging ; drug effects ; Permeability ; drug effects ; Rats ; Rats, Sprague-Dawley ; Tight Junctions ; drug effects ; ultrastructure ; Ultrasonography