Electroacupuncture has been widely used to treat cognitive impairment after cerebral ischemia,but the underlying mechanism has not yet been fully elucidated.Studies have shown that autophagy plays an important role in...Electroacupuncture has been widely used to treat cognitive impairment after cerebral ischemia,but the underlying mechanism has not yet been fully elucidated.Studies have shown that autophagy plays an important role in the formation and development of cognitive impairment,and the phosphoinositide 3-kinase(PI3K)/Akt signaling pathway plays an important role in autophagy regulation.To investigate the role played by the PI3K/Akt signaling pathway in the electroacupuncture treatment of cerebral ischemia/reperfusion rat models,we first established a rat model of cerebral ischemia/reperfusion through the occlusion of the middle cerebral artery using the suture method.Starting at 2 hours after modeling,electroacupuncture was delivered at the Shenting(GV24)and Baihui(GV20)acupoints,with a dilatational wave(1-20 Hz frequency,2 mA intensity,6 V peak voltage),for 30 minutes/day over 8 consecutive days.Our results showed that electroacupuncture reduced the infarct volume in a rat model of cerebral ischemia/reperfusion injury,increased the mRNA expression levels of the PI3K/Akt signaling pathwayrelated factors Beclin-1,mammalian target of rapamycin(mTOR),and PI3K,increased the protein expression levels of phosphorylated Akt,Beclin-1,PI3K,and mTOR in the ischemic cerebral cortex,and simultaneously reduced p53 mRNA and protein expression levels.In the Morris water maze test,the latency to find the hidden platform was significantly shortened among rats subjected to electroacupuncture stimulation compared with rats without electroacupuncture stimulation.In the spatial probe test,the number of times that a rat crossed the target quadrant was increased in rats subjected to electroacupuncture stimulation compared with rats without electroacupuncture stimulation.Electroacupuncture stimulation applied to the Shenting(GV24)and Baihui(GV20)acupoints activated the PI3K/Akt signaling pathway and improved rat learning and memory impairment.This study was approved by the Animal Ethics Committee of the First Affiliated Hospital of Henan Unive展开更多
目的探讨急性缺血性脑卒中(AIS)经阿替普酶静脉溶栓治疗后出血性转化(HT)的影响因素。方法选取2015-01—2017-07作者医院收治的经阿替普酶静脉溶栓治疗的AIS患者348例,根据阿替普酶静脉溶栓后是否发生HT将患者分为出血组和未出血组。回...目的探讨急性缺血性脑卒中(AIS)经阿替普酶静脉溶栓治疗后出血性转化(HT)的影响因素。方法选取2015-01—2017-07作者医院收治的经阿替普酶静脉溶栓治疗的AIS患者348例,根据阿替普酶静脉溶栓后是否发生HT将患者分为出血组和未出血组。回顾性收集所有研究对象的临床资料(人口统计学、血管危险因素和实验室检查指标等),采用多因素Logistic回归分析探讨ALS经阿替普酶静脉溶栓治疗后发生HT的独立危险因素。结果出血组32例,未出血组316例。两组患者间基线血糖、基线美国国立卫生研究院卒中量表(National Institute of Health stroke scale,NIHSS)评分、发病至静脉溶栓治疗时间、心房颤动史、溶栓24h后收缩压以及抗血小板药物服用史差异均有统计学意义(均P<0.05)。多因素Logistic回归分析结果显示,基线血糖(OR=3.781,95%CI:1.851~11.765)、基线NIHSS评分(OR=2.678,95%CI:1.384~10.441)、发病至静脉溶栓治疗时间(OR=2.436,95%CI:1.324~4.488)、心房颤动史(OR=4.538,95%CI:2.036~14.132)和溶栓24h后收缩压(OR=1.581,95%CI:1.071~6.415)是发生HT的独立危险因素(均P<0.05)。结论基线血糖、基线NIHSS评分、发病至静脉溶栓治疗时间、心房颤动史和溶栓24h后收缩压是脑梗死患者静脉溶栓后发生HT的危险因素。展开更多
Studies have confirmed that low-frequency repetitive transcranial magnetic stimulation can decrease the activity of cortical neurons, and high-frequency repetitive transcranial magnetic stimulation can increase the ex...Studies have confirmed that low-frequency repetitive transcranial magnetic stimulation can decrease the activity of cortical neurons, and high-frequency repetitive transcranial magnetic stimulation can increase the excitability of cortical neurons. However, there are few studies concerning the use of different frequencies of repetitive transcranial magnetic stimulation on the recovery of upper-limb motor function after cerebral infarction. We hypothesized that different frequencies of repetitive transcranial magnetic stimulation in patients with cerebral infarction would produce different effects on the recovery of upper-limb motor function. This study enrolled 127 patients with upper-limb dysfunction during the subacute phase of cerebral infarction. These patients were randomly assigned to three groups. The low-frequency group comprised 42 patients who were treated with 1 Hz repetitive transcranial magnetic stimulation on the contralateral hemisphere primary motor cortex （M1）. The high-frequency group comprised 43 patients who were treated with 10 Hz repetitive transcranial magnetic stimulation on ipsilateral M1. Finally, the sham group comprised 42 patients who were treated with 10 Hz of false stimulation on ipsilateral M1. A total of 135 seconds of stimulation was applied in the sham group and high-frequency group. At 2 weeks after treatment, cortical latency of motor-evoked potentials and central motor conduction time were significantly lower compared with before treatment. Moreover, motor function scores were significantly improved. The above indices for the low- and high-frequency groups were significantly different compared with the sham group. However, there was no significant difference between the low- and high-frequency groups. The results show that low- and high-frequency repetitive transcranial magnetic stimulation can similarly improve upper-limb motor function in patients with cerebral infarction.展开更多
基金supported by the National Natural Science Foundation of China,No.81574042the Traditional Chinese Medicine Special Research Projects of Henan Province of China,No.2018JDZX011(both to XDF).
文摘Electroacupuncture has been widely used to treat cognitive impairment after cerebral ischemia,but the underlying mechanism has not yet been fully elucidated.Studies have shown that autophagy plays an important role in the formation and development of cognitive impairment,and the phosphoinositide 3-kinase(PI3K)/Akt signaling pathway plays an important role in autophagy regulation.To investigate the role played by the PI3K/Akt signaling pathway in the electroacupuncture treatment of cerebral ischemia/reperfusion rat models,we first established a rat model of cerebral ischemia/reperfusion through the occlusion of the middle cerebral artery using the suture method.Starting at 2 hours after modeling,electroacupuncture was delivered at the Shenting(GV24)and Baihui(GV20)acupoints,with a dilatational wave(1-20 Hz frequency,2 mA intensity,6 V peak voltage),for 30 minutes/day over 8 consecutive days.Our results showed that electroacupuncture reduced the infarct volume in a rat model of cerebral ischemia/reperfusion injury,increased the mRNA expression levels of the PI3K/Akt signaling pathwayrelated factors Beclin-1,mammalian target of rapamycin(mTOR),and PI3K,increased the protein expression levels of phosphorylated Akt,Beclin-1,PI3K,and mTOR in the ischemic cerebral cortex,and simultaneously reduced p53 mRNA and protein expression levels.In the Morris water maze test,the latency to find the hidden platform was significantly shortened among rats subjected to electroacupuncture stimulation compared with rats without electroacupuncture stimulation.In the spatial probe test,the number of times that a rat crossed the target quadrant was increased in rats subjected to electroacupuncture stimulation compared with rats without electroacupuncture stimulation.Electroacupuncture stimulation applied to the Shenting(GV24)and Baihui(GV20)acupoints activated the PI3K/Akt signaling pathway and improved rat learning and memory impairment.This study was approved by the Animal Ethics Committee of the First Affiliated Hospital of Henan Unive
文摘目的探讨急性缺血性脑卒中(AIS)经阿替普酶静脉溶栓治疗后出血性转化(HT)的影响因素。方法选取2015-01—2017-07作者医院收治的经阿替普酶静脉溶栓治疗的AIS患者348例,根据阿替普酶静脉溶栓后是否发生HT将患者分为出血组和未出血组。回顾性收集所有研究对象的临床资料(人口统计学、血管危险因素和实验室检查指标等),采用多因素Logistic回归分析探讨ALS经阿替普酶静脉溶栓治疗后发生HT的独立危险因素。结果出血组32例,未出血组316例。两组患者间基线血糖、基线美国国立卫生研究院卒中量表(National Institute of Health stroke scale,NIHSS)评分、发病至静脉溶栓治疗时间、心房颤动史、溶栓24h后收缩压以及抗血小板药物服用史差异均有统计学意义(均P<0.05)。多因素Logistic回归分析结果显示,基线血糖(OR=3.781,95%CI:1.851~11.765)、基线NIHSS评分(OR=2.678,95%CI:1.384~10.441)、发病至静脉溶栓治疗时间(OR=2.436,95%CI:1.324~4.488)、心房颤动史(OR=4.538,95%CI:2.036~14.132)和溶栓24h后收缩压(OR=1.581,95%CI:1.071~6.415)是发生HT的独立危险因素(均P<0.05)。结论基线血糖、基线NIHSS评分、发病至静脉溶栓治疗时间、心房颤动史和溶栓24h后收缩压是脑梗死患者静脉溶栓后发生HT的危险因素。
基金several colleague therapists of the Rehabilitation Medicine Department of the Affiliated Hospital of Qingdao University of China for their support and selfless help
文摘Studies have confirmed that low-frequency repetitive transcranial magnetic stimulation can decrease the activity of cortical neurons, and high-frequency repetitive transcranial magnetic stimulation can increase the excitability of cortical neurons. However, there are few studies concerning the use of different frequencies of repetitive transcranial magnetic stimulation on the recovery of upper-limb motor function after cerebral infarction. We hypothesized that different frequencies of repetitive transcranial magnetic stimulation in patients with cerebral infarction would produce different effects on the recovery of upper-limb motor function. This study enrolled 127 patients with upper-limb dysfunction during the subacute phase of cerebral infarction. These patients were randomly assigned to three groups. The low-frequency group comprised 42 patients who were treated with 1 Hz repetitive transcranial magnetic stimulation on the contralateral hemisphere primary motor cortex （M1）. The high-frequency group comprised 43 patients who were treated with 10 Hz repetitive transcranial magnetic stimulation on ipsilateral M1. Finally, the sham group comprised 42 patients who were treated with 10 Hz of false stimulation on ipsilateral M1. A total of 135 seconds of stimulation was applied in the sham group and high-frequency group. At 2 weeks after treatment, cortical latency of motor-evoked potentials and central motor conduction time were significantly lower compared with before treatment. Moreover, motor function scores were significantly improved. The above indices for the low- and high-frequency groups were significantly different compared with the sham group. However, there was no significant difference between the low- and high-frequency groups. The results show that low- and high-frequency repetitive transcranial magnetic stimulation can similarly improve upper-limb motor function in patients with cerebral infarction.
