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Objective:To explore the clinical application value of limb remote ischemic postconditioning (LRIPC) in patients with acute cerebral infarction after recanalization.Methods:A total of 78 patients with acute cerebral infarction admitted to the First Affiliated Hospital of Shantou University Medical College from June 2017 to March 2019 were selected. According to the random number table method, they were divided into the observation group with 39 cases (LRIPC + conventional medical treatment) and the control group with 39 cases (conventional medical treatment). The National Institutes of Health Stroke Scale (NIHSS) and Montreal Cognitive Assessment scale (MoCA) scores, the changes of cerebral blood perfusion, cerebral infarction volume and the levels of nerve function indexes before and after the treatment were compared and analyzed.Results:After the treatment, the NIHSS scores in the observation group were lower than thosein the control group, and the MoCA scores were higher than those in the control group, the differences were statistically significant ( P<0.05). After the treatment, the mean transit time of cerebral blood flow in the observation group was shorter than that in the control group, while the regional cerebral blood flow and regional cerebral blood volume were higher than those in the control group, the differences were statistically significant ( P<0.05). After the treatment, the volume of cerebral infarction in the observation group was lower than that in the control group ( P<0.05). After the treatment, the levels of matrix metalloproteinase 9 and S-100B protein in the observation group were lower than those in the control group: (142.45 ± 36.23) mg/L vs. (176.89 ± 42.63) mg/L, (2.52 ± 0.46) μg/L vs. (3.61 ± 0.75) μg/L; and the level of nerve growth factor was higher than that in the control group: (143.49 ± 10.58) μg/L vs. (124.96 ± 13.62) μg/L, the differences were statistically significant ( P<0.05). Conclusions:LRIPC can improve the nerve functions, cognitive functions andreduce the volume of cerebral infarction by improving cerebral blood flow. It also has a good effect on alleviating the neurological functional impairment after vascular recanalization.
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Objective To evaluate the predicting value of the marker of endothelial injury: plasma matrix metalloproteinase-9( MMP-9) and high sensitivity C-reactive protein( hsCRP) level on the progression of acute anterior circulating territory infarction progressing to malignant middle cerebral artery infarction (m-MCAI). Methods 90 patients with acute anterior circulating territory infarction, in which 46 patients progressed to m-MCAI, were collected and sampled consecutively. The plasma MMP-9 and hsCRP of all patients were determined by ELISA and immunotur-bidimetry,respectively,at admission. And the clinical characters and cranial CT features of the patients were analyzed. Results At admission,the plasma MMP-9 level in the patients with m-MCAI(242.0 ±58.0)ng/ml was significantly higher than that in the patients with non m-MCAI( 169.0 ± 50.0) ng/ml( P < 0. 01) ,the plasma hsCRP level in the patients with m-MCAI(6.25 ±1.2) ng/ml was significantly higher than that in the patients with non m-MCAI( 1.55 ± 0.9) mg/ml( P <0. 01).Conclusion The increased level of plasma MMP-9 and hsCRP could be predictors for the m-MCAI proceeding.
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BACKGROUND: Based on previous studies, the combination of basic fibroblast growth factor (bFGF) with graft may accelerate the procedure of vascular invasion of anterior cruciate ligament (ACL) graft. The antigenicity of graft could be inhibited by the destruction of major histolocompatibility complex (MHC) through the treatment of allogenous tendon by freeze. The freeze. dried tendon showed advantages including prolonged storage time. availability for transport and possibility of commercial application. There is no experimental and clinical study on the graft substance of bFGF combined tendon in ACL reconstruction in animal model so far. OBJECTIVE: To observe histologically the effect of exogenous application or bFGF combined to freeze-dried tendon on angiogenic enhancement in early ACL reconstruction. DESIGN, TIME AND SETTING: Controlled animal study, which was performed in the Department of Orthopeadics, Xijing Hospital. Fourth Military Medical University of Chinese PLA between June 2006 and June 2007.MATERIALS: Fourteen dogs were used in the experiment. METHODS: Extensor digitorum longus tendon was harvested from the rest 2 dogs and treated by freeze-dry as graft for other experimental dogs. bFGF(100 u g/L)was combined to freeze-dried tendon and then transplanted into one side knee to substitute the original ACL. While only freeze-dried tendon was used in the transplantation at the other side as control. MAIN OUTCOME MEASURES: Twelve of them were randomly divided into 6 groups according to the 6 time points,i,e.,1,2,3,4,5,6 weeks after surgery(2 dogs in each group).The histological observation with HE staining was done under microscope to mainly observe the angiogenesis in the transplanted ACL. RESULTS: Neovascularization occurred at the 2nd to 3rd weeks and reached the peak at the 4th to 5th weeks postoperatively at the experimental sides. By contrast. The neovascularization occurred at the 4th to 5th weeks postoperatively at the control sides. Neovascularization in the combined group was longer and deeper than that in the control group. CONCLUSION: The time of neovascular formation and the depth of vascular penetration into the tendon in the group of bFGF combined to freeze-dried tendon are superior to those in the control group.