Effects of Scalp Acupuncture on Serum NSE and S-100β Concentrations and Postoperative Cogni- tive Function of Elderly Patients Undergoing Hip Replacement / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To explore the effect of Scalp acupuncture on serum neuron specific enolase (NSE) and S-100β concentrations, and incidence rates of postoperative delirium (POD) and postoperative cognitive function (POCD) of elderly patients undergoing hip replacement.</p><p><b>METHODS</b>Eighty-four patients undergoing scheduled hip replacement under combined spinal-epidural anesthesia (CSEA) were assigned to the control group (group C) and the scalp acupuncture group (group S) according to random digit table, 42 cases in each group. In group S, scalp acupuncture was additionally performed according to International Standardized Scheme for Scalp Acupuncture. Scalp acupuncture was performed during the operation from the MS1 middle line of forehead [1 cun before Shenting (GV24), including Shenting (GV24)] and MS5 middle line of vertex [from Baihui (DU20) to Qianding (DU21), including Baihui (DU20) and Qianding (DU21)]. The operation time and post-operative length of stay were observed. The midazolam dosage, hemorrhage amount, fluid transfusion amount, urine amount, use rates of ephedrine and atropine during the operation were also observed and compared between the two groups. The occurrence rate of POD and POCD at post-operative day 3 (T₁), week 1 (T₂), month 3 (T₃), and month 6 (T₄) were measured. Eighteen patients were randomly selected to collect blood from internal jugular vein before anesthesia t₀), immediately after ending the surgery (t₁), 6 h after operation (t₂), 24 h after operation (t₃), and 48 h after operation (t₄), respectively. Serum levels of NSE and S-100β were correspondingly measured.</p><p><b>RESULTS</b>There was no statistical difference in the operation time, midazolam dosage used during the operation, hemorrhage amount, fluid transfusion amount, urine amount, use rates of ephedrine and atropine (P > 0.05). Compared with group C, the post-operative length of stay was shortened in group S (P < 0.05). The incidence rate of POD and that of POCD at each time point were lower in group S (P < 0.05). The expression level of NSE decreased at t₂, t3, and t₄, and the expression level of S100β also decreased at t₁, t₂, t₃, and t₄(P < 0.05). There was no statistical difference in expression levels of NSE or S100β between the two groups at other time points (P > 0.05).</p><p><b>CONCLUSION</b>Scalp acupuncture could attenuate central nervous system lesion and improve POCD of elderly patients undergoing hip replacement.</p>

Lecithin-cholesterol acyltransferase gene 511C/T polymorphism is associated with cerebral hemorrhage / 中华神经医学杂志

Objective To explore the distribution of lecithin cholesterol acyltransferase (LCAT)gene 511C/T polymorphism in Chinese Han population and the association of its polymorphism with the occurrence of cerebral hemorrhage (CH). Methods The LCAT gene 511C/T polymorphism was identified by PCR, single-strand conformation polymorphism (SSCP) and DNA sequencing in 150 patients with CH and 122 age- and gender-matched healthy controls. Results The 511 situs of the fourth extron in LCAT gene existed polymorphism; C/T in this situs of both groups satisfied Hardy-Weinberg equilibrium. The CT genotype frequency (3.3%) and T allele frequency (1.7%) in patient group were not significantly higher than those (1.6%, 0.8%, respectively) in controls (P＞0.05).The level of high-density lipoprotein cholesterol (HDL-C) in 511CC subgroup ([1.44±0.42] mmol/L) was significantly higher than that in 511CT subgroup ([1.06±0.30] mmol/L) of patient group (P＜0.05).Conclusion The LCAT gene 511C/T polymorphism is not possibly a predisposing factor of CH in Chinese Han population. T allele frequency might be connected with the metabolism of HDL-C.

Relationship between NF-κB1 gene polymorphism and acute progressive cerebral infarction of Chinese Han population in Qingdao district / 中华神经医学杂志

Objective To explore the relationship between NF-kB1-94ins/delATTG gene polymorphism and acute progressive cerebral infarction(APCD ofChinese Hart population in Qingdaodistrict Methods We detected the polymorphism of NF-κB1 -94ins/delA TTG gene in 100 patients with acute cerebral infarction (ACI group) and 99 patients with acute progressive cerebral infarction (APCI group) by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP)analysis. The changes of expression of NF-κBp65 in PBMC cellular nucleus in the 2 groups were detected by cell immunohistochemistry. Results The frequency of TT genetype and T allele in the APCI group was significantly higher than that in the ACI group (P<0.05). Analysis on the relative risk of allele frequency showed that patients with T allele had 1.622 times of risk in having APCI than patients with C allele; logistic regressive analysis indicated that NF-κB1 TT genotype was independently related to the attacking of APCI (OR=2.14, 95% CI: 2.654-8.296, P<0.05). The expressions of NF-κBp65 of PBMC cellular nucleus of TT genotypic individuals in APCI group were significantly higher than those in ACI group (P<0.05); logistic regressive analysis indicated that the expressions of NF-KBp65 in PBMC cellular nucleus of TT genotypic individuals were independently related to the attacking of APCI (OR=1.96; 95% CI: 2.267-7.691; P<0.05). Conclusion The NF-κB1 gene polymorphism might participate in the onset of APCI and T allele of NF-κB1 gene might be a genetic risk factor of getting APCI for Chinese Han populations in Qingdao district. The NF-κB1 T allele carrier might increase the happening of APCI through up regulating the expression of NF-kB1.

Effects of Linggui Bafa on the therapeutic effect and quality of life in patients of post-stroke depression / 中国针灸

<p><b>OBJECTIVE</b>To probe into effects of Linggui Bafa (method for picking eight points linked with extraordinary meridians according to time) on the therapeutic effect and quality of life in patients of post stroke depression.</p><p><b>METHODS</b>One hundred and twenty cases were randomly divided into 3 groups, an observation group 1, an observation group 2 and a control group, 40 cases in each group. All patients were given routine clinical treatments and second level medical prevention. Patients in the observation group 1 received Linggui Bafa acupuncture treatment 2 weeks after stroke; at the same time the observation group 2 was treated with oral administration of Sertraline. The control group did not receive any form of either acupuncture or oral medication, but early rehabilitative intervention and psychological treatment were initiated. Curative effects were evaluated with Hamilton Depression Scale (HAMD), Function Independent Measure (FIM), National Institutes of Health Stroke Scale (NIHSS) and SF-36 after the treatment and 6 months later, respectively.</p><p><b>RESULTS</b>The scores of HAMD, FIM (cognition function) and general health, role-physical, role-emotional, social function, vitality, mental health in SF-36 in the observation group 1 were significantly higher than those in the control group after treatment and 6 months later (P<0.01, P<0.05). The scores of physical function in SF-36 after treatment and NIHSS 6 months later in the observation group 1 were significantly improved than those in the control group (P<0.01, P<0.05). The scores of FIM (cognition function) and role-physical, social function, mental health in SF-36 after treatment and HAMD and general health, social function, mental health in SF-36 6 months later in the observation group 2 were significantly better than those in the control group (P<0.01, P<0.05). The scores of HAMD, FIM (cognition function) and general health, role-emotional, social function, vitality, mental health in SF-36 in the observation group 1 were significantly improved than those in the observation group 2 after treatment and 6 months later (P<0.01, P<0.05). The scores of NIHSS and role-physical in SF-36 in the observation group 1 were significantly higher than those in the observation group 2 6 months later (P<0.05).</p><p><b>CONCLUSION</b>Acupuncture can improve depression symptoms and quality of life of patients with post stroke depression and the effects were better than Sertraline.</p>

Neuronal apoptosis and apoptosis-related gene expression in the hippocampai CA1 region following cerebral ischemia in gerbils and their changes after intervention with mild hypothermia / 中华神经医学杂志

Objective To study the neuronal apoptosis and expressions of apoptosis-related genes in the hippocampal CAI region after cerebral ischemia in gerbils and investigate the protective effects of mild hypothermia. Methods Seventy-two gerbils were randomized equally into sham-operated group, hypothermic sham-operated group, normothermic ischemia-reperfusion (IR) group and hypothermic IR groups, and 5-minute forebrain iscbemia was induced in the latter 2 groups by bilateral common carotid artery obstruction. Normothermic or mild hypothermic condition was applied to the groups after the operation as indicated. At 1, 3 and 7 days after the operation, 6 gerbils were selected from each group for behavioral test using open field test, followed by detection of neuronal apoptosis in the hippocampal CAI region using TUNEL staining and by immunohistocheraistry for p53 and nuclear factor-kB (NF-kB) expressions. Results In normothermic condition, the 5-minute forebrain ischemia induced significant enhancement of the exploratory activities in the gerbils 1, 3 and 7 days after the operation (P<0.05). This enhancement was observed only 1 day after the operation in mild hypothennic condition (P<0.05). Increased neuronal apoptosis and up-regulated expressions of p53 protein and NF-kBin the hippocampal CA1 region occurred after the forebrain ischemia as shown by TUNEL staining and immunohistochemistry, and all these changes were significantly inhibited by the application of mild hypothermia (P<0.05). Conclusions Up-regulated p53 and NF-kB protein expression in the hippocampal CA1 region might be one of the mechanisms for ischemia-induced neuronal apoptosis in gerbils, and mild hypothermia may produce protective effects against these changes for brain protection following the iscbemia.

Long-term effect of acupuncture on quality of life in patients with early stage of stroke / 中国中西医结合杂志

<p><b>OBJECTIVE</b>To study the long-term effects of acupuncture on quality of life in patients with early stage of stroke.</p><p><b>METHODS</b>Eighty patients were randomly assigned to the acupuncture group and the control group, 40 in each. All received conventional Western medical treatment, but for patients in the acupuncture group, acupuncture was applied additionally immediately from 48 h after patients' life signs were stabilized. Curative effects were evaluated with scores of SF-36, function independent measure (FIM) and NIHSS.</p><p><b>RESULTS</b>Effect evaluated immediately after acupuncture operation showed that all the scores in the acupuncture group, except score of recognition function in FIM, and scores of body pain and physical function in SF-36, were improved more significantly than those in the control group (P < 0.05). The effectiveness improved continuously in the 6-month period after stroke in both groups, but more superiority was shown in the acupuncture group in aspects of emotional function, social function and mental health by SF-36 (P < 0.05).</p><p><b>CONCLUSION</b>Early applying acupuncture could raise the physical, social, and psychological functions of stroke patients. Although the effects might decrease to some extent later, acupuncture still showed markedly effect on patients' psychological and social functions as well as on their life satisfaction.</p>