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Objective:To evaluate the status and influencing factors of psychiatric comorbidities of patients with epilepsy (PWEs) in Hubei province during the outbreak of COVID-19.Methods:From February 23, 2020 to March 5, 2020, a network questionnaire survey (including demographic characteristics, seizures, Generalized Anxiety Disorder Scale-7 score, Patient Health Questionnaire-9 score, Insomnia Severity Index score) was conducted among 570 PWEs who visited the Epilepsy Center of Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology during April 1, 2019 and January 20, 2020. SPSS 22.0 software was used for correlation analysis of sociodemographic characteristics, epilepsy related factors, perceived threat to the COVID-19 and psychiatric comorbidity (depression, anxiety and insomnia) of PWEs during the COVID-19 epidemic.Results:A total of 362 valid questionnaires were included for analysis (the response rate was 63.51%,362/570). Thirty-four (9.4%), forty-seven (13.0%) and seventy-one (19.6%) patients suffered from anxiety, depression and insomnia, respectively. Patients with seizure frequency ≥2 times/month before the epidemic ( OR=3.395,95% CI 1.561-7.384, P=0.002), poor subjective quality of life during the epidemic ( OR=10.753,95% CI 1.938-59.654, P=0.024), and moderate to severe worry about bad impact of the epidemic on epilepsy ( OR=3.077, 95% CI 1.382-6.853, P=0.006) were more likely to be anxious. Patients with poor subjective quality of life during the epidemic ( OR=6.188, 95% CI 1.317-29.079, P=0.021) were more likely to be depressed. Patients with COVID-19 related symptoms ( OR=3.609, 95% CI 1.674-7.778, P=0.001), children ( OR=3.090, 95% CI 1.759-5.431, P<0.001), seizure frequency ≥2 times/month before the epidemic ( OR=1.907, 95% CI 1.017-3.575, P=0.044), and moderate to severe worry about unanticipated seizures ( OR=2.555, 95% CI 1.370-4.764, P=0.003) were more likely to suffer from insomnia. Conclusions:During the COVID-19 epidemic, parts of PWEs suffered from anxiety, depression and insomnia. PWEs with poor subjective quality of life, high frequency of epileptic seizures before the epidemic, excessive worry about bad impact of the epidemic on epilepsy and excessive worry about unanticipated seizures were prone to anxiety, depression and insomnia.
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Objective:To design and compile quality evaluation questionnaire on problem-based learning (PBL) of Neurology and to test its reliability and validity.Methods:Referring to the framework of the evaluation system and according to the characteristics of the discipline, we designed the questionnaire on PBL of Neurology. The clinical medical students who participated in neurologic PBL course were taken as the objects of investigation. The reliability of the questionnaire and the reliability of internal consistency were tested. Correlation analysis and exploratory factor analysis were used to evaluate the validity of the questionnaire.Results:The questionnaire on PBL of Neurology included three first-level indicators: teaching plan quality evaluation, teaching method evaluation and teaching quality evaluation, containing 6 second-level indicators and 25 third-level indicators. The correlation coefficient ρ=0.990 ( P<0.01) showed that the retest reliability was good. The cronbach's α coefficient is 0.901, meeting the internal consistency reliability requirement. And the content validity correlation coefficient was 0.307-0.7 ( P<0.05), indicating that each third-level index had a significant correlation with the total score, and the questionnaire item design was good. The three first-level indicators were used as common factors to evaluate the structural validity by exploratory factor analysis and identify the direction of optimization. Conclusion:The questionnaire has good reliability and validity, which can be used as a tool for scientific evaluation on PBL of neurology, and also provide an optimization direction for further research in the future.
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Spontaneous intracerebral hemorrhage (ICH) continues to be associated with the highest mortality and morbidity of all forms of stroke. Early identification and management of ICH is crucial. Blood pressure control, care in a dedicated stroke unit, identification of secondary etiologies, reversal of associated coagulopathy, and neurosurgical management, when indicated, are essential to optimizing outcomes.
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Great improvements have been made in diagnosis and treatment of intracerebral hemorrhage in recent years. Chinese guidelines for diagnosis and treatment of intracerebral hemorrhage 2019 are published by Chinese Society of Neurology and Chinese Stroke Society in this issue of Chinese Journal of Neurology. The purpose of the guideline is to provide up-to-date recommendations in management of acute intracerebral hemorrhage, especially etiological classification, hematoma enlargement, anti-hypertension, surgicalized treatment, prevention of deep venous thrombosis,and intracerebral hemorrhage recurrence, etc. The principle of individualized treatment on the basis of guideline is emphasized.
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Objective To investigate the time course of cerebral infarction with diffusion kurtosis imaging-related parameters.Methods According to the time interval from symptom onset to MRI examination, 114 cases of cerebral infarction were divided into five groups:8 cases of hyperacute phase(less than 6 hours), 14 cases of acute(>6-24 h), 60 cases of early subacute(>24 h-7 d), 20 cases of late subacute(>7-14 d), and 12 cases of chronic phase ( >14 d-2 months).They underwent routine diffusion weighted imaging (DWI) and diffusion kurtosis imaging (DKI) scanning, and apparent diffusion coefficient ( ADC) and DKI-derived parameters were obtained from them.The derived diffusion parameters were compared among different phases in the patients , and the percent of changes in the infarcted regions were calculated.Paired t-test was used to compare the difference of each parameter between the infarcted region and contralateral normal region , and their correlation with time interval was tested using Pearson correlation analysis.Results Except for chronic phase , mean kurtosis ( MK) , axial kurtosis ( K∥) , radial kurtosis (K⊥)map showed uneven high signal in the infarcted regions , while mean diffusion(MD), axial diffusion(D∥), radial diffusion(D⊥) showed uniform low signal.MK values in the infarcted regions of hyperacute, acute, early subacute and late subacute phase (1.331 ±0.357,1.578 ±0.453,1.519 ±0.455, 1.403 ±0.275 ) increased significantly , compared with the contralateral normal mirror regions ( 0.850 ± 0.236,0.827 ±0.194,0.865 ±0.144,0.939 ±0.212) (t values were 5.242,6.907,12.416,5.629, respectively.P values were all less than 0.01 ).MK, K∥, K⊥ achieved a peak in the acute and early subacute phase , and showed more amplitude than the decrease of MD , D∥, D⊥.Then they gradually reduced, and tended to normalize.MK, MD, ADC had a significant correlation with the time onset of cerebral infarction ( r was 0.354, 0.747, 0.723, respectively, P values were all less than 0.05 ).Conclusion Diffusion kurtosis imaging can provide more diffusion information than conventional DWI , which can better reflect the microstructure changes in tissue.
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Different antiepileptic drugs (AEDs) may cause similar adverse effects, one of which is diplopia. However, the AEDs causing diplopia and the dose-response effect of each drug remains uncertain. In this study, we compared several second-generation AEDs to find out whether they would contribute to the risk of diplopia and their effect-causing dose. A meta-analysis was performed on 19 studies in agreement with our inclusion criteria. The results showed that eight commonly used second-generation AEDs (gabapentin, levetiracetam, oxcarbazepine, lamotrigine, pregabalin, topiramate, vigabatrin and zonisamide) could cause diplopia. The reported odds ratios (ORs) ranged from 1.406 to 7.996. Ranking risks from the highest to the lowest ORs of the eight AEDs of any dose resulted in the following order: use of oxcarbazepine (7.996), levetiracetam (7.472), lamotrigine (5.258), vigabatrin (3.562), pregabalin (3.048), topiramate (2.660), gabapentin (1.966), zonisamide (1.406). Taking into account the ORs above, we can conclude that second-generation AEDs of any dose may cause diplopia. However, the levetiracetam-caused diplopia needs to be further studied according to the data (OR, 7.472; 95% confidence interval, 0.375-148.772). These findings ask for better concerns about patients' quality of life when giving antiepileptic treatments.
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Adolescent , Adult , Aged , Aged, 80 and over , Child , Humans , Middle Aged , Young Adult , Anticonvulsants , Therapeutic Uses , Diplopia , Drug Therapy , Placebo EffectABSTRACT
Different antiepileptic drugs (AEDs) may cause similar adverse effects, one of which is diplopia. However, the AEDs causing diplopia and the dose-response effect of each drug remains uncertain. In this study, we compared several second-generation AEDs to find out whether they would contribute to the risk of diplopia and their effect-causing dose. A meta-analysis was performed on 19 studies in agreement with our inclusion criteria. The results showed that eight commonly used second-generation AEDs (gabapentin, levetiracetam, oxcarbazepine, lamotrigine, pregabalin, topiramate, vigabatrin and zonisamide) could cause diplopia. The reported odds ratios (ORs) ranged from 1.406 to 7.996. Ranking risks from the highest to the lowest ORs of the eight AEDs of any dose resulted in the following order: use of oxcarbazepine (7.996), levetiracetam (7.472), lamotrigine (5.258), vigabatrin (3.562), pregabalin (3.048), topiramate (2.660), gabapentin (1.966), zonisamide (1.406). Taking into account the ORs above, we can conclude that second-generation AEDs of any dose may cause diplopia. However, the levetiracetam-caused diplopia needs to be further studied according to the data (OR, 7.472; 95% confidence interval, 0.375-148.772). These findings ask for better concerns about patients' quality of life when giving antiepileptic treatments.
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The purpose of this study was to evaluate the effect of adenosine A2A receptor antagonist ZM241385 on amygdala-kindled seizures and its roles in epileptogenesis. Electrodes were implanted into the right amygdala of male adult Wistar rats. Kindling was accomplished by using stimulus strength of 500 μA applied daily to the amygdala until 10 consecutive stage 5 seizues were induced. Then effect of ZM241385 was studied in fully kindled rats after intracerebroventricular administration of the drug. In addition, the effect on kindling progression was evaluated through ZM241385 injection before daily stimulation. In all experiments, behavioral changes in the rats in response to ZM241385 were monitored closely. The results showed that, in fully amygdala-kindled rats, ZM241385 (0.001-0.1 nmol/L) decreased afterdischage duration (ADD), motor seizure duration (MSD), stage 5 duration (S5D) and seizure duration (SD), but only the effect on ADD was dose-dependent. The doses of 0.001-0.1 nmol/L had no influence on stage 4 latency (S4L) and seizure stage (SS). The dosages of 0.0001 and 1 nmol/L of ZM241385 did not exert any effect on all seizure parameters. In contrast to the results in fully amygdala-kindled rats, ZM241385 (0.001-0.1 nmol/L) had minimal or no effects on the progression of amygdala-kindled seizures. We are led to the conclusion that although ZM241385 had no influence on the progression of amygdala-kindled seizures, it had potent anti-convulsant profile and little adverse effects at the dosage of 0.001-0.1 nmol/L, suggesting that the agent is effective against the amygdala-kindled seizures.
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Objective To observe the efficacy and the side-effects of sodium valproate (VPA) in patients with epilepsy in rural China. Methods Epilepsy patients were selected from rural areas of Tianmen in Hubei province and Tiandong county in Guangxi province according to the inclusion and exclusion criteria.Efficacy evaluation standard depending on the change of seizure frequency compared with the situation prior to entering the treatment group. Among the treated patients, no seizures, seizure reduced ＞ 75%, seizure reduced 50%-75% sums for the total effective rate. Results All 607 patients with epilepsy were treated and followed up, the male were 395 (65. 1% ) female 212 (34. 9% ), and 579 patients were treated for 12 months. Patients with generalized tonic-clonic seizures were 517 (85.2%), absence seizures 20 (3. 3% )and the other types of seizures 70 (11.5% ) including simple partial seizures, tonic, clonic, myoclonic or atonic seizures etc. The completed control of seizures ( without any seizures) during the period after taking 3 months, 6 months, 12 months were 270 (45.5%), 249 (42. 3% ) and 238 (41.1%) respectively. The total effective rates in the three periods were 65.2% , 75.4% and 85.5% respectively. The 58 patients in the total group showed side-effects during the follow-up period, mainly including drowsiness, lethargy,fatigue, dizziness, headache and tremor. Nineteen patients (3. 1% ) quitted the treatment group.Conclusions The VPA is an effective antiepileptic drug and no more severe side-effects. It is the same as Phenobarbital and suitable to be used in rural areas of China.
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To investigate the effects of VitalStim therapy coupled with conventional swallowing training on recovery of post-stroke dysphagia, a total of 120 patients with post-stroke dysphagia were randomly and evenly divided into three groups: conventional swallowing therapy group, VitalStim therapy group, and VitalStim therapy plus conventional swallowing therapy group. Prior to and after the treatment, signals of surface electromyography (sEMG) of swallowing muscles were detected, swallowing function was evaluated by using the Standardized Swallowing Assessment (SSA) and Videofluoroscopic Swallowing Study (VFSS) tests, and swallowing-related quality of life (SWAL-QOL) was evaluated using the SWAL-QOL questionnaire. There were significant differences in sEMG value, SSA, VFSS, and SWAL-QOL scores in each group between prior to and after treatment. After 4-week treatment, sEMG value, SSA, VFSS and SWAL-QOL scores were significantly greater in the VitalStim therapy plus conventional swallowing training group than in the conventional swallowing training group and VitalStim therapy group, but no significant difference existed between conventional swallowing therapy group and VitalStim therapy group. It was concluded that VitalStim therapy coupled with conventional swallowing training was conducive to recovery of post-stroke dysphagia.
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Objective To concentrate on the morbidity of cerebral microbleed (CMB) in patients with hypertension and to analyze the predilection and risk-factor of cerebral microbleed.Method Hypertensive patients were divided into the simple hypertention group, hypertention group with lacunar infarction and hypertention group with cerebral infarction.All of these 65 patients received examination of susceptibility-weighted imaging.Results Ninety-one focuses of cerebral microbleeds were found in these patients:58.2% of these focuses were in both basal ganglia and cerebral ganglion;35.2 percent were in cortex and subcortex;6.6 percent were in brainstem and cerebellum.The total morbidity of CMB was 33.8 percent, 52.4 percent in the group with lacunar infarction and 38.1 percent in the group with cerebral infarction, both were significantly higher than that of 8.7 percent in the simple hypertensive group (χ2= 8.08,P<0.01 andχ2=3.86, P<0.05).Conclusions The focus of CMB suggested the hemorrhagic tendency in endocranial capillary.CMB can be used as a routine exam for the hemorrhagic tendency in endocranial capillary.Synthetic analysis of risk-factor and the result of SWI help clinicians choose suitable treatment for each patient.
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Objective To clinically analyze the frequent stroke localizations of moyamoya disease in order to improve our cognition toward it and reduce missed diagnosis. Methods All 32 patients were prospectively analyzed over the past 10 years in our hospital. Results The ratio of female to male was 1.28 and their age of onset ranged from 7 to 47 years old. Mean age of 5 ischemic stroke patients (15.6%) was 24 and mean age of 21 haemorrhagic stroke patients (65.6%) was 33 while mean age of 6 mixed type stroke patients (18. 8% ) was 32. The frequent ischemic stroke localizations were frontoparietal lobe (60%),temporo-occipital lobe (20%), and periventricular zone (20%). The frequent haemorrhagic stroke iocalizations were periventricular zone (42.8%), ventricle (39.2%), temporo-occipital lobe (10. 8%) and subarachnoid space (7.2%). No cerebellum and brain stem stroke occurred. Conclusion Adult patients usually develop intracranial hemorrhage. Moyamoya disease should be considered severely when adult patients develop periventricular and ventricular intracranial hemorrhage, frontoparietal cerebral infarction or adolescent patients develop ischemic stroke, especially companied with epilepsy.
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Objective To study the validity and reliability of Tengdao's swallowing standard for stroke pa-tients with dysphagia.Methods A total of 128 patients with postroke dysphagia took the swallowing test and then were divided into three sub-groups.Their scores on Tengdao's evaluation and their fluoroscopy results were analyzed using Spearman's correlation coefficient.Intra-class coefficients (ICCs)were used to examine the intra-rater and in-ter-rater reliability of Tengdao's evaluation.Results TenIgdao's evaluation possessed good validity and reliability.There was a high correlation between the scores in Tengdao's evaluation and fluoroscopy results. Conclusions Tengdao's evaluation is valid,reliable,simple and safe.It can be used in the clinic to evaluate the stroke patients with dysphagia.
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Objective To investigate the dynamic changes of adenosine receptors, A1 (A1R) and A2a (A2aR) in the brain from the acute to chronic phase after kindling and to explore the correlation between seizure and expression level of A1R and A2aR. MethodsRats were randomly selected into the testing model, reference and normal control groups.Testing rats were kindled by lithium choride-pilocarpine, reference rats were treated with saline, and no treatment was given in normal control group. The dynamic expression of A1R and A2aR were detected by RT-PCR, immunofluorescence staining and Western blot at time-points of 24 hours, 1 month and 6 months post-kindling. Results In the acute phase of 24 hours after kindling, the A1R expression level (mRNA level was (1. 1483 ±0. 1182); Western blot result was ( 0. 7872± 0. 0621 ) ; immunofluorescence staining count was ( 76. 17 ± 4. 62 )/HP) was increased and A2aR (mRNA level was (0. 8338±0. 0572) ; Western blot result was (0. 2098 ±0. 0257) ; immunofluorescence staining count was (43. 83 ± 5. 12 )/HP) was decreased.The results showed statistically difference compared with the reference and normal groups (P< 0. 05 ). In the later chronic phase of 1 month and 6 months after kindling, the expression level of A1R was decreased and A2aR was increased. These data revealed statistically significant difference (P <0. 01 ). Furthermore, the comparison of the results in 1 month and 6 months after kindling found that the expression of AIR was lower in 6 months (mRNA level was (0. 5682 ±0. 0443) ; Western blot result was (0. 7749 ±0. 0262) ; immunofluorescence staining count was (38. 50 ±4. 81 )/HP) than in 1 month and that of A2aR was higher in 6 months (mRNA level was (1. 2169±0. 0332) ; Western blot result was (0. 7080 ±0. 0371 ); immunofluorescence staining count was (114. 50 ± 4. 04)/HP). The differences were statistical significant (t = - 19. 02--13.28, P < 0. 05). ConclusionsThe expressions of A1R and A2AR during and after kindling presents a bidirectional change. In the acute phas the expression of AR is regulated to suppress seizures. While in the chronic phase, the repeated seizures result in the change of A1R and A2aR expression in the opposite direction. This mechanism plays an important role in refractory seizures.
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The clinical characters, diagnosis and differential diagnosis of paroxysmal kinesigenic choreoathetosis (PKC), and efficacy of the anti-epileptic drugs (AEDs) were investigated. Thirty-one patients with PKC were collected, and the clinical characters and change of EEG were analyzed. The average age of the first attack was 16.8 years old and the pinnacle was 10 to 20 years old. There were definite causes for every attack and the sudden movement was the most common one (92%). Time for the whole attack was always less than 1 min. The attack presented with muscle tension disturbance (83.9%), movement like dancing (16.1%), abnormal movement of mouth and face and other symptoms (16.2%). The attack tended to be very frequent and 71% patients were beyond once per day. The EEG examination and image scan of primary PKC were normal in most patients. Low dosage of AEDs could control the attack of 50%-77.3% patients. It was concluded that PKC was a common disease of movement disorder. The therapy by AEDs was very effective. PKC should be differentiated from epilepsy and the relationship between PKC and epilepsy needs further research.
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Young Adult , Anticonvulsants/therapeutic use , Diagnosis, Differential , Dystonia/diagnosis , Dystonia/drug therapy , Electroencephalography , Epilepsy/diagnosisABSTRACT
In order to better understand the clinical manifestation of systemic lupus erythematosus (SLE) with intracranial hypertension syndrome (IHS), we analyzed the clinical features and treatment of a typical SLE patient with IHS. SLE is one of the most unpredictable autoimmune diseases involving multiple organ systems that is defined clinically and associated with antibodies directed against cell nuclei. IHS is an uncommon manifestation of neuropsychiatric SLE (NPSLE) and is characterized by an elevated intracranial pressure, papilledema, and headache with occasional abducens nerve paresis, absence of a space-occupying lesion or ventricular enlargement, and normal cerebrospinal fluid chemical and hematological constituents. IHS has been reported in a few sporadic cases in patients with SLE worldwide, but rarely has been reported in China. In this study, a 34-year-old female SLE patient with IHS was reported and pertinent literature reviewed. The clinical presentation, image logical features, and investigatory findings were discussed.
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Diagnosis, Differential , Intracranial Hypertension/diagnosis , Intracranial Hypertension/etiology , Lupus Erythematosus, Systemic/complications , Lupus Erythematosus, Systemic/diagnosisABSTRACT
Neural stem cells were labeled with superparamagnetic iron oxide (SPIO) and tracked by MRI in vitro and in vivo after implantation. Rat neural stem cells were labeled with SPIO combined with PLL by the means of receptor-mediated endocytosis. Prussian blue staining and electron microscopy were conducted to identify the iron particles in these neural stem cells. SPIO-labeled cells were tracked by 4.7T MRI in vivo and in vitro after implantation. The subjects were divided into 5 groups, including 5× 105 labeled cells cultured for one day after labeling, 5 × 105 same phase unlabeled cells, cell culture medium with 25 μg Fe/mL SPIO, cell culture medium without SPIO and distilled water. MRI scanning sequences included T1WI, T2WI and T2*WI. R2 and R2* of labeled cells were calculated. The results showed: (1) Neural stem cells could be labeled with SPIO and labeling efficiency was 100%. Prussian blue staining showed numerous blue-stained iron particles in the cytoplasm; (2) The average percentage change of signal intensity of labeled cells on T1WI in 4.7T MRI was 24.06%, T2WI 50.66% and T2*WI 53.70% respectively; (3) T2 of labeled cells and unlabeled cells in 4.7T MRI was 516 ms and 77 ms respectively, R2 was 1.94 s-1 and 12.98 s-1 respectively, and T2* was 109 ms and 22.9 ms, R2* was 9.17 s-1 and 43.67 s-1 respectively; (4) Remarkable low signal area on T2WI and T2*WI could exist for nearly 7 weeks and then disappeared gradually in the left brain transplanted with labeled cells, however no signal change in the right brain implanted with unlabeled cells. It was concluded that neural stem cells could be labeled effectively with SPIO. R2 and R2* of labeled cells were increased obviously. MRI can be used to track labeled cells in vitro and in vivo.
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Neural stem cells were labeled with superparamagnetic iron oxide (SPIO) and tracked by MRI in vitro and in vivo after implantation. Rat neural stem cells were labeled with SPIO combined with PLL by the means of receptor-mediated endocytosis. Prussian blue staining and electron microscopy were conducted to identify the iron particles in these neural stem cells. SPIO-labeled cells were tracked by 4.7T MRI in vivo and in vitro after implantation. The subjects were divided into 5 groups, including 5 x 10(5) labeled cells cultured for one day after labeling, 5 x 10(5) same phase unlabeled cells, cell culture medium with 25 mug Fe/mL SPIO, cell culture medium without SPIO and distilled water. MRI scanning sequences included T(1)WI, T(2)WI and T(2)*WI. R(2) and R(2)* of labeled cells were calculated. The results showed: (1) Neural stem cells could be labeled with SPIO and labeling efficiency was 100%. Prussian blue staining showed numerous blue-stained iron particles in the cytoplasm; (2) The average percentage change of signal intensity of labeled cells on T(1)WI in 4.7T MRI was 24.06%, T2WI 50.66% and T(2)*WI 53.70% respectively; (3) T2 of labeled cells and unlabeled cells in 4.7T MRI was 516 ms and 77 ms respectively, R(2) was 1.94 s(-1) and 12.98 s(-1) respectively, and T(2)* was 109 ms and 22.9 ms, R(2)* was 9.17 s(-1) and 43.67 s(-1) respectively; (4) Remarkable low signal area on T(2)WI and T(2)*WI could exist for nearly 7 weeks and then disappeared gradually in the left brain transplanted with labeled cells, however no signal change in the right brain implanted with unlabeled cells. It was concluded that neural stem cells could be labeled effectively with SPIO. R2 and R(2)* of labeled cells were increased obviously. MRI can be used to track labeled cells in vitro and in vivo.
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BACKGROUND: Being a kind of regenerative and auto-transplanting cell, olfactory ensheathing cell (OEC) has been extensively concerned on transplantation treatment for spinal disease. Concerning to the transplantation in treatment of cerebral hemorrhage, it is expected a further accumulation of experimental results at present.OBJECTIVE: To observe the proliferation of neural progenitor cells in cerebral hemorrhagic rats after OEC transplantation and to evaluate the therapeutic effects of OEC transplantation on cerebral hemorrhage.DESIGN: Completely randomized controlled experiment.SETTING: Department of Neurology of Tongji Hospital affiliated to Tongji Medical College of Huazhong University of Science and Technology.MATERIALS: The experiment was performed in Research Center for Clinical Neurology , Tongji Medical College of Huazhong University of Science and Technology from March 2002 to March 2003. Thirty-two healthy male Wistar rats were employed and randomized into 2 groups, 16 rats in each. In OEC transplantation group, on the 3rd day of modeling hemorrhage of caudate nucleus, OEC suspension 10 μL was injected evenly in the brain of rat (1 μL/min). In the control group, physiological saline 10 μL was injected.METHODES: Neural function evaluation was done before transplantation,on the 3rd, 7th, 14th and 30th days after transplantation successively. On the first day after modeling, 1 rat was collected from each of two groups to prepare brain tissue section. Myelin sheath blue staining was used for observation of neuronal axonal myelin sheath. Never fiber argentophil staining was used for observation of never fiber. One rat was collected from each of two groups on the 3rd, 7th, 14th and 30th days after transplantation successively to prepare paraffin section. The survival and migration after OEC transplantation as well as proliferation of neural progenitor cell were observed.The count of neural progenitor cell was recorded.myelin sheath and nerve fiber after cerebral hemorrhage in rats of two function deficits on the 3rd, 7th, 14th and 30th days after cerebral hemorrhage in rats of two groups.around and in hematoma on the 30th day after cerebral hemorrhage: In transplantation group, myelinated amount and nerve fiber amount were cell after cerebral hemorrhage in rats of two groups: on the 7th, 14th and 30th days after cerebral hemorrhage, the amount of neural progenitor cell in OEC transplantation group was more remarkably than that in the control group [(41.1 ±2.4)pcs/vision field, (34.5 ±1.2)pcs/vision field; (43.6±1.2)pcs/vision rield, (37.2±2.0)pcs/vision field; (19.3±1.0)pcs/vision rield, ( 14.2±0.4)pcs/videficits after cerebral hemorrhage in rats of two groups: In OEC transplantation group, on the 14th and 30th days, the evaluation was lower remarkably than the 3rd day [(2.21 ±0.20)scores, (1.50±0.21)scores, (2.74±0.21)scores, (t=2.06, 3.27, P ＜ 0.05)]. In the control group, that on the 30th day after cerebral hemorrhage was lower than that on the 3rd day [(1.96±0.12)scores ,(2.76±0.20) scores, (t=2.47, P ＜ 0.05 )].tion of intracerebral nerve cell, re-myelination and building-up synaptic system so as to recover the motor function and accelerate repair of injured tissue.
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The expression of hypoxia inducible factor-1 alpha (HIF-1alpha) and its relationship to apoptosis in tissues around cerebral bleeding loci was studied. The expression of HIF-1alpha and apoptosis in 37 samples of tissues around cerebral bleeding loci and 9 samples of normal cerebral tissues was assessed by immunohistochemical straining and terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling methods. In 37 tissue samples around cerebral bleeding loci, the positive rate of the HIF-1alpha expression was 40.6%. Especially in the patients with amount of bleeding >60 ml, the positive rate (88.9%) of the HIF-1alpha expression was significantly higher than those with the amount of bleeding ranging from 30-45 ml or 45-60 ml (P<0.05). The expression of HIF-1alpha was increased as the amount of bleeding and operative time increased (P<0.05). There existed a positive correlation between HIF-1alpha labeling index and apoptosis index (n=12, r=0.56, P<0.01). These results suggested that the expression of HIF-1alpha was closely related with the time of hemorrhage and the amount of bleeding, and could induce the apoptosis of neurons.