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Objective To investigate the clinical features,pathogenesis,diagnosis and treatment of neonatal cerebral infarction(NCI)in order to have a further understanding of its clinical features,to enhance therapeutic effica﹣cy and to improve prognosis. Methods The clinical history,head magnetic resonance imaging( MRI)+ diffusion Weighted imaging(DWI)data and folloW－up results of 39 neonates With NCI admitted into the Department of Neonato﹣logy,Gaozhou People＇s Hospital and the Second Affiliated Hospital of Shantou University Medical College from January 2013 to March 2018 Were retrospectively analyzed. Results All the 39 children Were diagnosed as NCI by MRI +DWI,among Which 30 cases(76. 92%)Were full－term infants,and 9 cases(23. 08%)Were premature infants,in Which 61. 54%(24／39 cases)Were males,and 17 cases(43. 59%)Were performed With emergency cesarean section because of umbilical cord around neck,intrauterine distress or maternal pregnancy hypertension respectively. TWenty－five patients(64. 10%)had the history of perinatal hypoxia. The presentation of MRI shoWed 32 cases(82. 10%)of ischemic cerebral infarction and 7 cases(17. 90%)of hemorrhagic cerebral infarction,While middle cerebral artery and its branches Were more susceptible to NCI With a left hemisphere predominance. Sixteen patients(41. 03%)developed convulsions. TWo patients died of purulent meningoencephalitis associated With NCI. One patient gave up treatment in the neonatal period and died 2 days after discharge. One patient died of cerebral palsy and pneumonia at the age of 11 months. Nine cases(31. 03%)developed cerebral palsy,and 2 patients developed speech disturbance so they could not express complex sentences. Conclusions Perinatal hypoxia and emergency cesarean section may be closely related to the incidence of NCI. NCI resulting from purulent meningoencephalitis is more severe and has a Worse prognosis. Considering the facts that NCI usually does not have specific clinical manifestations in the early stage,MRI +DWI,as the gold standard for the diagnosis of NCI,could be performed to facilitate early diagnosis and intervention.
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Objective To investigate the protective function of cytoglobin (CYGB) on neurodevelopment of the neonatal rats with hypoxic-ischemic brain damage (HIBD).Methods Healthy seven day old Sprague-Dawlay rats were randomly divided into sham operated group,HIBD group,HIBD+Hemin group and HIBD+zinc protoporphyrin (ZnPP) group.The rats of HIBD,HIBD+Heminand HIBD+ZnPPgroup were given normal saline (0.5 ml),Hemin (50 mg/kg) and ZnPP (50 mg/kg) intraperitoneally respectively,and 12 hours later the left carotid arteries of these rats were ligated and cut off,then hypoxic treated for 2 hours to establish the HIBD models.At 0,24,48 h after HIBD models were established,the expressions of CYGB in the cerebral cortex and hippocampus were observed by immunohistochemistry analysis.At 48 h after HIBD,histopathological changes of brain were observed after HE staining.At 72 h after HIBD,the water content of the brain was observed.At 28 days after HIBD,long term study memory outcome was assessed by Morris water maze.Analysis of variance and Bonferroni test were applied as statistical methods.Results (1)The expression of CYGB in brain(expressed by average gray value which negatively correlated with protein levels):At 0 h,the average gray value of CYGB in the cerebral cortex in HIBD+ Hemin and HIBD group were 166.7±5.1 and 207.1±5.1,which were lower than that in sham operated group (232.3±3.4); but in HIBD+ZnPP group,it was higher (234.9±4.5)(P＜0.05).The average gray value of CYGB was decreased with the extension of hypoxic-ischemic time.At 48 h,the average gray value of CYGB was the lowest in HIBD+Hemin group (126.0± 2.6),followed by HIBD group (150.9±4.5) and HIBD+ZnPP group (163.7±6.3),and the highest was in sham operated group (232.1±5.8)(all P＜0.01).(2) Histopathologic changes of the brain:At 48 h,typical cerebral infarction and hemorrhage were seen in HIBD,HIBD+Hemin and HIBD+ZnPP group,but those were less severe in HIBD + Hemin group than in HIBD + ZnPP group.(3) The water content of the brain:At 72 h,the water content of the left brain in HIBD and HIBD+ZnPP group was (86.5±0.4)％ and (87.3±0.3)％,which was higher than that in right brain [(85.6±0.2)％ and (85.9±0.2)％] (t 12.57 and 11.32,P＜0.01,respectively).(4)Function of the hippocampus:Morris water-maze showed that the longest average escape latency in HIBD+ZnPP group [(76.7±29.8) s],followed by HIBD group [(71.0±30.5) s],HIBD+ Hemin group [(46.7±34.0) s],and sham operated group [(38.3±30.3) s] (all P＜0.01).(5) Long-term histopathologic changes of the brain:At 34 d,brain atrophy rate was the highest in HIBD+ZnPP group [(34.07± 6.75) ％],and then in HIBD group [(29.73± 6.53) ％] and HIBD+ Hemin group [(18.33±4.52)％],which were all higher than that in the sham operated group [(1.55±1.32)％](all P＜0.01).HE staining showed that the hippocampal stratum pgramidale was getting thinner and a large number of neurons was lost in HIBD and HIBD+ ZnPP group,but only a small amout of neurons was lost in HIBD+ Hemin group.Conclusions Increased expression of CYGB in HIBD brain could mitigate the short term and long term pathological injury,and protect the long-term study memory function of the hippocampus.
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Objective To investigate the expression and change of cytoglobin(Cygb)gene on hypoxicischemic brain damage(HIBD).Methods Fifty SD rats of 7days old were divided into four study groups and one control group.The brain tissues were taken at 4hours,12hours,24hours and 48hours after the onset of HIBD.Cygb mRNA was determined by the reverse transcription PCR.One-way method of GraphPad Prism was used for statistics.Results The fragment length of PCR products was identical with experimental design.The expression level of Cygb gene increased at 4h after ischemia,and peaked at 24h.48h after HIBD,the Cygb gene level began to decrease.Conclusion The expression of Cygb in brain tissue increased rapidly after HIBD of newborn rats,suggesting that Cygb may have important function in the protection process of HIBD.