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Objective To explore the curative effect of noninvasive ventilation with bi-level positive airway pressure (BiPAP) on acute cerebral infarction patients with obstructive sleep apnea and hypoventilation syndrome (OSAHS).Methods One hundred and twenty-seven acute cerebral infarction patients with OSAHS,admitted to our hospital from December 2010 to January 2013,were prospectively collected; they were randomly divided into BiPAP treatment group (n=93) and control group (n=93),and all the patients received conventional treatment of ischemic stroke,and patients in the BiPAP treatment group also accepted BiPAP treatment; patients in these two groups were divided into four subgroups:total anterior circulation infarct (TACI) group,partial anterior circulation infarct (PACI) group,posterior circulation infarct (POCI) group and lacunar circulation infarct (LACI) group.NIHSS was employed on the patients before treatment,and 1,2,4,8,12 and 24 weeks after treatment.All the clinical events of the patients within 24 weeks of treatment were recorded.Results The NIHSS scores in BiPAP treatment patients of POCI subgroup 1,2,4,8,12 and 24 weeks after treatment were significantly increased as compared with those in the control patients of POCI subgroup at the same time points (P＜0.05); the NIHSS scores in BiPAP treatment patients of TACI subgroup 2,4,8,12 and 24 weeks after treatment were significantly increased as compared with those in the control patients of TACI subgroup at the same time points (P＜0.05); the NIHSS scores in BiPAP treatment patients of PACI subgroup 4,8 and 12 weeks after treatment were significantly increased as compared with those in the control patients of PACI subgroup at the same time points (P＜0.05); however,no significant difference was noted in LACI subgroup at each time points (P＞0.05).No statistical differences on incidences of death,recurrent stroke,transient cerebral hemorrhage attack,myocardial infarction,pneumonia and stroke depression were noted between the two groups (P＞0.05).Conclusion Noninvasive ventilation with BiPAP can improve the prognosis and decrease the disability grade of OSAHS patients combined with TACI,PACI or POCI,but can not reduce the rate of clinical events.
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Objective To study the collateral circulation in focal cerebral ischemia rats after being injected vascular endothelial growth factor (VEGF) by three different injection ways (intrathecal injection,intracranincal injection and intravenous injection).Methods Sixty healthy male SD rats were randomly divided into five groups:intrathecal injection (IT) group,intracranincal injection (IC) group,intravenous injection (IV) group,operation (OP) group and sham operated (SH) group (n=12).Middle cerebral artery occlusion (MCAO) was performed to induce focal cerebral ischemia models in rats of the four groups,except the sham-operated group; 10 ng VEGF was given to the injection groups right after the inducement,24 and 48 h after the inducement.The neurological scale was performed in all the rats 12 h and 3 d after the inducement.The expressions of VEGF and F8 in the periphery of infarcts were detected in the five groups 3,7 and 14 d after ischemia reperfusion.Results The VEGF expressions in the four groups,expected the sham-operated group,increased gradually 3,7 and 14 d after ischemia reperfusion,with significant difference between each two time points (P＜0.05).The VEGF expressions of IT and IC groups were higher than that in the IV and OP groups (P＜0.05),and that of IV group was significantly higher than that of OP group (P＜0.05).The F8 expression in the four groups,expected the sham-operated group,increased gradually 3,7 and 14 d after ischemia reperfusion,with significant difference between each two time points (P＜0.05).The F8 expression of IT and IC groups was obviously higher than that of the IV and OP groups 14 d after reperfusion (P＜0.05),and that of IV group was significantly higher than that of OP group (P＜0.05).Conclusion All the three different injection ways can improve the formation of collateral circulation in MACO rats,but intrathecal and intracranincal injections are better than intravenous injection.
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Objective To study the effect of human urinary kallidinogenase (HUK) on neural cell apoptosis in rats after focal cerebral ischemia-reperfusion (FCIR) injury and on Caspase-3 expression.Methods Sixty-six SD rats were randomly divided into sham-operated group (n=6),ischemic-reperfusion group and HUK treatment group.The latter 2 groups were subdivided into 6,12,24,72 and 168 h reperfusion groups (n=6).Middle cerebral artery occlusion models of transient focal cerebral ischemia in the latter 2 groups were established by suture-occluded method. Rats of the HUK treatment group were given tail vein injection of HUK once daily at dosage of 17.5 ×10-3 PNAU/mL and at 1.0 mL/kg manner 3 h after reperfusion. The numbers of apoptotic cells and Caspase-3 positive cells in the cerebral cortex were evaluated with terminal dUTP nick end labeling (TUNEL) assay and immunohistochemistry. Results Cell apoptosis was noted 6 h after the focal cerebral ischemia-reperfusion,reaching its peak level at 24 h,and the apoptotic cells could still be seen at 168 h after the injury.And the expression of Caspase-3 positive cells peaked at 24 h after the injury,and high expression was still noted at 168 h after the injury. The levels of apoptotic cells and the expression of Caspase-3 positive cells in HUK treatment group at different time points (except for 168 h subgroup) decreased significantly as compared with those in ischemic-reperfusion group (P＜0.05). Conclusion HUK may decrease the number of apoptotic cells in the initial 72 h of FCIR injury by down-regulating the Caspase-3 expression.
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Objective To explore the effect of human urinary kallikrein on the expression of VEGF in focal cerebral ischemia-reperfusion rats. Methods Fifty-six male SD rats were randomly divided into sham operated group (n=8), saline group (n=24) and human urinary kallikrein group (n=24).The latter 2 groups were made into middle cerebral artery occlusion (MCAO) models, and subdivided into 5 subgroups according to the five time points of 6, 12, 24, 72 h, and 7 d after ischemia-reperfusion.We used the methods of nerve function scales, TTC staining, infarct size estimation, detection with light microscope to evaluate the MCAO rat models at different time points, and analyzed the changes of the expression of VEGF in the center and the periphery of infarcts at different time points by immunohistochemical methods. Results The degrees of neurological impairment in the rats of human urinary kallikrein group were lighter than those of saline group (P＜0.05). The average infarct size of rats at 24 h was (53 261.96±7 326.75) μm3 in human urinary kallikrein group, (92 715.84±13 755.44) μm3 in saline group, and the difference between the 2 groups was significant (P＜0.05). The expression of VEGF in the rats of human urinary kallikrein group was higher than that of saline group at different time points (P＜0.05). Conclusions Human urinary kallikrein has neuroprotective effect after ischemia reperfusion injury, and can promote the levels of VEGF expression.