RÉSUMÉ
@#Objective To investigate the role of P2Y1 receptors and astrocytes in delayed encephalopathy after acute CO poisoning (DEACMP) and the possible pathogenesis of DEACMP.Methods Male SD rats with acceptable cognitive function were screened by water maze test and randomly divided into two groups:the control group and the CO poisoning group.The poisoning group was subjected to DEACMP model.The behavioral changes,neuronal changes and the expressions of P2Y1 receptor and astrocytes in hippocampus of the two groups were compared at 7,14,21 and 28 d after modeling,respectively.Results Compared with the control group,the escape latencies of rats in the poisoning group were significantly prolonged on the 21st and 28th days after modeling (P<0.05).HE staining showed that the hippocampal pyramidal cells and neurons in the model group exhibited obvious necrosis on days 14,21,and 28 after modeling.The water maze indicated that DEACMP occurred on day 21.Compared with the control group,Western blot analysis showed that the expression levels of P2Y1 and GFAP proteins in the hippocampus of the poisoning group were increased at each time point (P<0.05),which increased first and then decreased.Immunofluorescence showed co-expression of P2Y1 and GFAP in hippocampus.Compared with the control group,the expressions of P2Y1 and GFAP in hippocampal CA1 region were up-regulated at each time point after poisoning (P<0.05). Conclusion The activation of astrocytes by P2Y1 receptor may be one of the pathogenesis of DEACMP,and astrocytes may impair learning and memory ability of co-poisoned rats by mediating immune inflammation,leading to DEACMP.
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Objective To investigate the effect of high frequency (10 Hz),low frequency (1 Hz) and theta burst stimulation (TBS) mode of repetitive transcranial magnetic stimulation (rTMS) on the recovery of motor function in hemiplegic patients following acute ischemic stroke.Methods Seventy-two patients with hemiplegia after acute ischemic stroke were randomly grouped with the random number table.They were treated with low frequency (n=18),high frequency (n=18),and TBS (n=18) rTMS or sham stimulation (control group,n=18),once a day,for 2 weeks.Fugl-Meyer Assessment (FMA) and National Institutes of Health Stroke Scale (NIHSS) were used to evaluate neurological function in all patients before rTMS treatment (on the day before the first treatment) and after treatment (on the day after the last treatment).Results After treatment,the FMA and NIHSS scores in the 4 groups were significantly improved compared with before treatment (all P<0.05).After rTMS treatment,the FMA and NIHSS scores were improved significantly in the high frequency group,low frequency group and TBS group compare with the control group (all P<0.05).There were no significant differences among all the treatment groups.Conclusion sHigh frequency,low frequency and TBS rTMS can improve the recovery of motor function in hemiplegic patients following acute ischemic stroke.There were no significant differences among all the treatment modes.
RÉSUMÉ
Objective To explore the association of increased cerebrospinal fluid pressure with delayed encepha?lopathy after acute carbonmonoxide poisoning. Methods One hundred twenty cases of severe acute carbon monoxide poi?soning patients were included in the present study. All patients underwent lumbar puncture for measurement of cerebro?spinal fluid pressure (mmH2O) within seven days following acute carbon monoxide poisoning. Results Thirty-eight pa?tients of total 120 patients had a delayed encephalopathy and the incident rate of delayed encephalopathy was 31.67%. In?creased cerebrospinal fluid pressure was detected in 34 cases of delayed encephalopathy patients and the abnormal rate was 89.47%. Thirty-two of 38 patients with delayed encephalopathy demonstrated improvement to varying degrees af?ter treatment:6 cases had complete recovery, 26 regained or partially regained the ability to live independently, four died and two were in coma. Cerebrospinal fluid pressure was less than 150 mmH2O in six patients who achieved full recovery, while cerebrospinal fluid pressure was great than 200 mmH2O in six patients who died or were in coma. Cerebrospinal flu?id pressure was around 150~180 mmH2O in patients who regained or partially regained the ability to live independently. Conclusion Elevated cerebrospinal fluid pressure at the early phase of carbon monoxide poisoning may have a predictive value in diagnosis and prognosis of delayed encephalopathy.