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Objective To compare the immediate effects of acupuncture at the true and false acupoints of Yanglingquan on functional connectivity in sensorimotor network(SMN)and dorsal attentional network(DAN)of stroke patients based on functional magnetic resonance imaging(fMRI)technology;To explore the central regulatory mechanism and acupoint specificity of acupuncture in stroke patients with hemiplegia.Methods Totally 20 patients with stroke and hemiplegia were included in the study.fMRI scans of acupuncture at the true and false acupoints of Yanglingquan were performed once every 2 weeks,and motion-related SMN and DAN were extracted by independent component analysis to compare the differences in functional connectivity.Results In SMN,after acupuncture at the Yanglingquan true acupoint,the functional connectivity was enhanced compared with before acupuncture.The enhanced brain areas included the right anterior central gyrus,superior temporal gyrus,inferior frontal gyrus,cuneiform lobe,and anterior cuneiform lobe,as well as the left middle temporal gyrus,occipital gyrus,superior temporal gyrus,parahippocampal gyrus,inferior frontal gyrus,and superior temporal gyrus.After acupuncture at the Yanglingquan false acupoint,the functional connectivity was enhanced compared with before acupuncture.The enhanced brain areas included the right anterior central gyrus,superior frontal gyrus,middle frontal gyrus,and cingulate gyrus,as well as the left medial frontal gyrus,anterior cingulate gyrus,lentiform nucleus,and caudate nucleus.In DAN,after acupuncture at the Yanglingquan true acupoint,the functional connectivity was enhanced compared with before acupuncture.The enhanced brain areas included the right anterior cingulate lobe,superior temporal gyrus,middle temporal gyrus,and occipital gyrus,as well as the left cingulate gyrus,posterior cingulate gyrus,and anterior cingulate lobe.After acupuncture at the Yanglingquan false acupoint,the functional connectivity was enhanced compared with before acupuncture,and the enhanced brain areas included the right anterior cingulate gyrus,left anterior cingulate gyrus,and medial frontal gyrus.Conclusion Acupuncture at Yanglingquan can activate SMN and DAN bilateral related brain regions in patients with hemiplegia,which may promote the recovery of motor function by regulating the initiation and execution of motor activities,and has more acupoint specificity compared with false acupoint.
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Objective:To explore the changes of sensorimotor network functional connectivity and coefficient of variation of dyanmic functional connection in stroke patients before and after acupuncture on the left Yanglingquan by means of functional magnetic resonance, and explore the effect mechanism of needle retention.Methods:Twenty five patients with right subcortical cerebral infarction who were hospitalized in Dongzhimen Hospital from September 2014 to September 2019 were selected as the experimental group.In the same period 21 healthy controls were selected as healthy control group. The resting state and acupuncture state images were collected by functional magnetic resonance imaging, and the images were preprocessed. The sensory motor brain network of subjects was extracted by independent component analysis (ICA). The functional connectivity and dynamic changes were compared before and after acupuncture based on the sensory motor network.Results:In the experimental group, there were differences between acupuncture state and resting state in the left inferior parietal lobule. The acupuncture state was stronger than the resting state (P < 0.05, GRF correction). The coordinates of the peak point were (-27, -51, 48), the T value of the peak point was 5.502, and the number of voxels was 12. The variation of dynamic functional connectivity in the sensory motor network of acupuncture state was significantly lower than that in resting state( P<0.05, GRF correction), the peak point coordinates were (-5, -30, 39), the peak T value was -3.152, and the number of voxels is 9.In the control group, there was no significant difference between acupuncture state and resting state in functional connection of sensory motor network, while the difference of sensory motor network and thalamus between acupuncture state and resting state was statistically significant. The intensity of acupuncture state was lower than that of resting state ( P<0.05, GRF correction), the coordinates of peak point were (-12, 3, 6), the T value of peak point was -4.253, and the number of voxels was 183.There was no significant difference in the variation of dynamic functional connectivity in sensory motor network before and after acupuncture. Compared with the healthy control group, the functional connectivity of the experimental group was stronger than that of the healthy control group ( P<0.05, GRF correction). The coordinates of the peak point were (0, 42, 48), the T value of the peak point was 3.988, and the number of voxels was 53.The difference in the resting state of thalamus in the experimental group was weaker than that in the healthy control group ( P< 0.05, GRF correction), the coordinates of the peak point were (- 9, -15, 9), the T value of the peak point was -6.596, and the number of voxels was 101; there was no significant difference in the dynamic functional connectivity variability between the two groups, but there were scattered differences in the resting state ( P<0.05, GRF correction). With age, gender and course of disease as control variables, partial correlation analysis showed that the average functional connectivity strength in the sensory motor network of the experimental group was significantly higher than that of the Fugl Meyer assessment (FMA) of the lower limbs. There was a negative correlation between the scores of FMA. The correlation coefficient between the average functional connectivity in the sensory motor network of acupuncture state and the FMA score of lower extremity was -0.533 ( P=0.011), and the correlation coefficient between the average functional connectivity in the sensory motor network of acupuncture state and FMA score of lower extremity was -0.485 ( P=0.022). Conclusion:The brain function in acupuncture state sensorimotor network of patients with cerebral infarction is different from that in resting state, and this operation mode also has time-related fluctuation changes.
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Ischemic stroke (IS) is the result of a combination of multiple risk factors, and its pathogenesis involves multiple systemic physiological and pathological changes. Recent studies have found that the activation of renin-angiotensin system (RAS) is closely related to the development of IS. In this review, we mainly summarize the generation of RAS and pathogenesis of RAS in IS.
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Objective To observe the clinical efficacy of synergism of TCM medicinal oxygen therapy in treating acute cerebral infarction.Methods Eighty cases were randomly divided into treatment group and control group, 40 cases in each group, and 1 case was lost in treatment group. Based on routine treatment, the control group was treated with low flow oxygen inhalation only, while the treatment group was treated with TCM medicinal oxygen therapy. The course of treatment was 2 weeks. The two groups were scored with National Institutes of Health Stroke Scale (NIHSS) and Stroke Symptom Scale of TCM (SSTCM) before and after the course to evaluate the therapeutic effect. Results The scores of NIHSS and SSTCM in both groups after the treatment were with statistical significance (P<0.05). There was no statistical difference in the scores of NIHSS between two groups after the treatment (P=0.10). There were statistical difference in the scores of SSTCM between two groups after the treatment (P<0.05). The clinically curative effect rate in treatment group was76.9% (30/39), which was superior to that of 60.0% (24/40) in the control group, with statistical significance (P=0.27).Conclusion TCM medicinal oxygen therapy can improve the neurological deficit and enhance the efficacy.
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Objective To observe the impact of ningxinjieyu capsule on contents of monoamine neurotransmitters and their metabolites in cerebral cortex of chronic depression model rats.Methods The chronic stressed depression model rats were established by chronic unpredictable stress and separation.the model rats randomly divided into model group,ningxinjieyu high-dose group(10.8 mg/(kg · d)),mid-dose group(3.6 mg/(kg · d)),low-dose group(1.2 mg/(kg · d)) and Fluoxetine group(3.6 mg/(kg · d)) and the normal rats as the control group.Finally the changes of Noradrenaline (NE),Dopamine (DA),5-hydroxy tryptamine (5-HT),3,4-dihydroxyphenylacetic acid (DOPAC) and homovanillic acid (HVA) would be observed using HPLC-ECD technique.Results Compared with the control group,the contents of NE,DA and 5-HT were significantly lower in the model group (P<0.01).Compared with the model group,the contents of DA were increased in the different concentrations of ningxinjieyue capsule groups,and the contents of 5-HT were higher in the low-dose and high-dose groups ((272.15± 129.89) ng/g,(445.08± 127.56) ng/g,(375.33±52.38) ng/g) ; the contents of NE were increased in the low-dose and mid-dose groups ((408.08 ± 89.55) ng/g,(530.12± 149.87) ng/g,(542.53 ± 96.10) ng/g) ; the contents of HVA were increased in the mid-dose and high-dose groups; the contents of DOPAC were increased in the low-dose group; the contents of 5-HT,DA and NE were increased in the fluoxetine group(P<0.01 or P<0.05).Conclusion Ningxinjieyu capsule has antidepressant effect,the mechanisms might be regulated to the contents of monoamine neurotransmitters and their metabolites in cerebral cortex.
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Default-Mode Network (DMN), a new concept that has been put forward during researches of the complicated brain metabolism , has brought great significance to the studies of resting state brain function .A large quantity of studies on DMN of neurology and psychiatry diseases have been carried out recently .In this review paper , we are trying to give a detailed explanation of DMN and its recent research progresses in neurology and psychiatry diseases .
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Objective To explore the effect of acupuncture at Yanglingquan (GB 34) on white matter structure of stroke patients. Meth-ods 6 stroke patients with left hemiplegia in recovery stage were recruited. The sham acupoint was as control, the diffusion tensor imaging (DTI) data in a 1.5 T SIEMENS scanner before and after acupuncture at Yanglingquan point was collected. Differences between the two con-ditions were compared with the Tract-Based Spatial Statistics (TBSS), which is one of FSL tools. Results The brain areas included left pre-central gyrus, postcentral gyrus, middle temporal gyrus, inferior temporal gyrus, supplementary motor area, inferior frontal gyrus, internal capsule, fornix and bilateral inferior parietal gyrus, in which the verum acupuncture had stronger effect on fractional anisotropy (FA) than the sham acupuncture. White matter tract such as pyramidal tract, arcuate fasciculus, corpus callosum and other inter-cortex association fi-bers passed these brain areas. The fiber tracts and brain areas were found to be involved with multiple brain networks of motor compensa-tion, somatosensory, language and cognition. Conclusion Compared with the sham point, acupuncture at Yanglingquan point can change the microstructure of stroke patients' white matter, mainly in the inaffected side and related to multiple functional networks.
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ObjectiveTo explore the correlation of characteristic symptoms and indexes of brain collateral damageat acute stage of stroke.MethodsSeventy cases who got stroke within 72 hours were included.Five nonspecific symptoms and 6 indexes were observed at two time points.ResultsThere were positive correlations between the number of nonspecific symptoms and the value of Hs-CRP,IL-6,OX-LDL,NSE.The correlation coefficients were 0.307,0.289,0.342,0.253 and P<0.05.Nonspecific symptoms appeared in 1 to 3 groups,altogether 40 cases were involved,and the groups had significant deviation compared with the groupwithoutnonspecificsymptomsonOX-LDL(32.37 ± 31.17)μg/l, NSE(2.82 ± 1.25)ng/ml,MMP-9 (214.97± 137.88) ng/ml and P<0.05.Single symptom especially dull expression and hypersomnia were proved to be related with the indexes.For example,the correlation coefficient was 0.318 between hypersomnia and Hs-CRP.The correlation coefficient was 0.384 between dull expression and IL-6.Conclusion Characteristic symptoms were well correlated and ganged with the indexes from different view or level.It acted as representative combination of brain collateral damage syndrome.
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<p><b>OBJECTIVE</b>To study the effect and safety of Kudiezi injection on patients with acute ischemic stroke.</p><p><b>METHOD</b>Seven hundreds patients were divided into two groups by central randomization system. The study group, 346 cases, was treated with kudiezi injection plus traditional Chinese medicine (TCM) synthesis rehabilitation project, and the control group, 354 cases, was treated with synthetic rehabilitation project. The patients were treated for 10 to 21 days. Before treatment and at the 7th, 14th and 21th day of treatment, the indexes include NIHSS used for evaluating the neurological deficit degree and the motor function score (Fugl-Meyer) for evaluating motor function were observed. The safety index is defined by adverse observation event and laboratory test. The incidence of adverse events and laboratory tests results were observed before and after treatment at the same time.</p><p><b>RESULT</b>Application of generalized estimating equation model, we found that as the treatment time, NIHSS score and FMI score of the two groups showed a trend of improvement. And at the 14th days and 21th days of treatment, compared to the control group the treatment group showed significant statistical difference on the impact of NIHSS and FMI (P<0.05). No serious adverse events were observed.</p><p><b>CONCLUSION</b>Kudiezi injection plus TCM rehabilitation project of ischemic stroke showed some superiority to western medicine rehabilitation program on improving the neurological deficit and motor function. Kudiezi injection is safe and effective in the treatment of acute ischemic stroke.</p>
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Aged , Female , Humans , Male , Middle Aged , Brain Ischemia , Drug Therapy , Drug-Related Side Effects and Adverse Reactions , Drugs, Chinese Herbal , Therapeutic Uses , Injections , Medicine, Chinese Traditional , Product Surveillance, Postmarketing , Stroke , Drug TherapyABSTRACT
<p><b>OBJECTIVE</b>To verify the efficacy and safety of post-marketed fleabane injection combined with Dengzhan Shengmai capsules in the treatment of ischemic stroke (IS).</p><p><b>METHOD</b>A multicentre, prospective, practical, randomized controlled study was carried out to compare the efficacy and safety of Dengzhan group (n = 343) and western medicine group (n = 335), appling "clinical study central stochastic system". The treatment of Dengzhan group is using fleabane injection in acute stage and Dengzhan Shengmai capsules in convalescence. The primary indexes of effect evaluation are the important outcome events in 360 days' follow-up, including mortality, recurrence, disability and quality of life to reflect the effect of clinical study. The indexes of safety evaluation involve laboratory examination results and incidence of adverse events.</p><p><b>RESULT</b>After 360 days' follow-up, 4 people died of IS in Dengzhan group, and the mortality rate of which is 1.17%, while 16 died in Western medicine group (WM group), and the mortality rate is 4.78%, suggesting that the mortality rate of Dengzhan group is significantly lower than WM group (P<0.05). Eleven cases recurred in Dengzhan group, and the recurrence rate of which is 3.21%, while 12 recurred in WM group, and the recurrence rate is 3.59%, indicating that the recurrence rate of Dengzhan group is slightly lower than WM group. The disability rate of Dengzhan group is 39.53%, among which the rate of severely disabled cases are 1.49%, while the disability rate of WM group is 40.13%, among which the rate of severely disabled cases are 3.13%, suggesting that the disability rate of Dengzhan group is lower and the severity of disability is also lighter than WM group. In the field of quality of life, the activity ability and the upper limb function store of stroke patients in Dengzhan group improved far much better than WM group (P<0.05). Analysis of safety suggested that, adverse events occurred in 11 cases in Dengzhan group, among which 4 cases is related with the drug treatment, the incidence of adverse events of which is 1.17%, and the main manifestations involve fever and chilling, rash, nausea, dizziness, palpitation, etc. which were all appeared after the treatment of fleabane injection, and disappeared 1 to 2 days after drug withdrawal. 13 cases occurred abnormal liver function and 2 cases abnormal kidney function in Dengzhan group. According to the judgment of clinical physicians, 3 case of ALT abnormality is possibly related to the treatment, the others are all unrelated with the treatment.</p><p><b>CONCLUSION</b>Fleabane injection and Dengzhan Shengmai capsules are all safe and effective TCM in the treatment of ischemic stroke.</p>
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Brain Ischemia , Drug Therapy , Capsules , Drug-Related Side Effects and Adverse Reactions , Drugs, Chinese Herbal , Therapeutic Uses , Erigeron , Injections , Product Surveillance, Postmarketing , Prospective Studies , Stroke , Drug TherapyABSTRACT
Objective:To investigate the effect of PTS on the related pathophysiological changes and serum IL-6 level at different time points after the middle cerebral artery occlusion (MCAO) in rat’s brain.Methods:The model of focal cerebral ischemia of rat was established by the suture-occluded method.The effect of PTS on the behavioral disturbance,the pathological change of ischemia tissue and the level of serum IL-6 at different time points(3d,7d,28d) after MCAO and cerebral ischemia in rats were studied.ResultsAfter MCAO,different degrees of motion disturbances were observed in all rats.The infarct spot can be observed in all groups except the normal.The nerve cell necrosis can be found in all rats after 24 hour of MCAO.The result showed that PTS could improve the degree of motion disturbance,reduce the infarct spot obviously;after MCAO,the serum IL-6 were increased obviously but could be reduced by PTS.Conclusion:PTS can protect the neurons,reduce and eliminate the infiammatory reaction of cerebral ischemia cascade reaction effectively,which may relate to its inhibiting effect on cell factors such as IL-6 production after cerebral ischemia.
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AIM: The aim of this work is to investigate the protective effects of Ginsenoside Rb 1(Rb 1) on apoptosis induced by hypoxia /hypoglycemia and reoxygenation in cultured rat hippocampal neurons. METHODS: Apoptosis were measured by flow cytometry; Morphological changes and neuronal necrosis were examined under microscope; The leakage of lactic dehydrogenase(LDH) and the product of nitric oxide(NO) were measured. RESULTS: hypoxia /hypoglycemia cultures for 5 h and reoxygenation induced neuronal apoptosis and necrosis,and significantly increased the leakage of LDH and the product of NO. The effects were enhanced with the extending time of reoxygenation. Rb 1 could significantly decrease the percentage of neuronal apoptosis and necrosis, and reduce the leakage of LDH and the product of NO. CONCLUSION: Rb 1 had an effect of anti-neuronal apoptosis. This effect might be related to the inhibition of the activity of NO synthase and NO production.