Résumé
Objective To investigate the changes of CT cerebral perfusion (CTP) and the application value of nuclear magnetic resonance proton spin labeling (3D-ASL) and to conduct a comparative study. Methods Multi-slice spiral CT(MDCT) was used to study the changes of CTP in 22 patients with HAPC. Comparison of CT whole-brain perfusion technique and nuclear magnetic resonance proton spin labeling technique (3D-ASL) in hemodynamic changes of the brain in plateau polycythemia. Results With the aggravation of HAPC, CBF of cerebral cortex and white matter showed a downward trend. Except the white matter of frontal lobe and temporal lobe, the difference of HAPC among different diseases was statistically significant (P < 0.05). Along with the aggravation of, each part of the brain cortex and white matter CBV increase, white matter, and each part CBV difference had statistical significance between different condition (P < 0.05). With the aggravation of the disease, the MTT of cortex and white matter in all parts of the brain increased significantly, and the difference of MTT between different parts of the disease was statistically significant (P < 0.05). HAPC patients along with the aggravation of different level, rCBF is reduced, in addition to the parietal cortex, temporal and occipital white matter, white matter rCBF differences between different parts of different condition have statistical significance (P < 0.05). ROC curve was used to evaluate the diagnostic value of CTP and ASL. The two curves were close to each other, and CTP was slightly better than ASL. Conclusion With the progression of HAPC, cerebral blood flow decreased, blood volume increased, and average blood flow time prolonged in patients with different degrees of HAPC. CTP and ASL had similar effects, and the former had slightly better value.
Résumé
Based on the results of previous data mining,the mechanism of high frequency use of Tibetan medicine in the treatment of high altitude polycythemia(HAPC) was analyzed in this study by network pharmacology. The author obtained the high frequency use data on Tibetan medicine Terminalia chebula,Aucklandia lappa,Crocus sativus and Myristica fragrans for the treatment of HAPC by data mining in the previous period. The first five main active ingredients of each high frequency Tibetan medicine were screened out by reviewing comprehensive literature and TCMSP database. The potential targets of each medicine were screened by PharmMapper and Drug Bank database,and then the targets were imported into MAS 3. 0 database to obtain the corresponding path information. The KEGG database was used for path annotation and GO function enrichment analysis. Finally,Cystoscope 3. 4. 0 software was used to construct " compound-target-path" network for four high-frequency Tibetan medicines. Among them,the target points of four herbs related to HAPC were 16(T. chebula),20(A. lappa),20(C. sativus),and 15(M. fragrans). The common target points included BHMT,F2,ADH5,AKR1 C2,GSK3 B,INSR and PDE4 B,involving pathways related to T. chebula(17),A. lappa(17),C. sativus(24) and M. fragrans(14),and the common pathway was metabolism of xenobiotics by cytochrome P450. The results showed that high-frequency Tibetan medicine had common pathways and targets in treating HAPC,such as T. chebula,A. lappa,C. sativus and M. fragrans.The medicines could reduce hemoglobin and enhance immunity by mediating cell proliferation and oxidative stress,exerting anti-inflammatory effects and participating in regulating blood vessels,showing therapeutic effects for HAPC. In this study,the multi-component,multi-target and multi-pathway mechanism of Tibetan medicine in preventing and treating HAPC was analyzed from the information level,providing a useful reference for further study of Tibetan medicine in preventing and treating plateau diseases from the multi-dimensional perspective.