Luoyutong Treatment Promotes Functional Recovery and Neuronal Plasticity after Cerebral Ischemia-Reperfusion Injury in Rats.

Luoyutong (LYT) capsule has been used to treat cerebrovascular diseases clinically in China and is now patented and approved by the State Food and Drug Administration. In this retrospective validation study we investigated the ability of LYT to protect against cerebral ischemia-reperfusion injury in rats. Cerebral ischemia-reperfusion injury was induced by middle cerebral artery occlusion followed by reperfusion. Capsule containing LYT (high dose and medium dose) as treatment group and Citicoline Sodium as positive control treatment group were administered daily to rats 30 min after reperfusion. Treatment was continued for either 3 days or 14 days. A saline solution was administered to control animals. Behavior tests were performed after 3 and 14 days of treatment. Our findings revealed that LYT treatment improved the neurological outcome, decreased cerebral infarction volume, and reduced apoptosis. Additionally, LYT improved neural plasticity, as the expression of synaptophysin, microtubule associated protein, and myelin basic protein was upregulated by LYT treatment, while neurofilament 200 expression was reduced. Moreover, levels of brain derived neurotrophic factor and basic fibroblast growth factor were increased. Our results suggest that LYT treatment may protect against ischemic injury and improve neural plasticity.

A pilot study on the correlation of tongue manifestation with the site of cerebral infarction in patients with stroke.

OBJECTIVE: To discuss the correlation of tongue manifestation with the site of cerebral infarction in patients with acute cerebral infarction. METHODS: From March 2008 to February 2009, 200 cases of hospitalized patients with first unilateral cerebral infarction were chosen in the Department of Neurology, Xuanwu Hospital. The correlation of different tongue color, fur texture, fur color with the site of cerebral infarction was analyzed. RESULTS: The site of cerebral infarction in patients were compared between different tongue color by Chisquare test (P=0.314), and further correspondence analysis demonstrated that there was correlation between red tongue and cortical-subcortical infarction group. The site of cerebral infarction in patients were compared between thick fur group and thin fur group, cortical-subcortical infarction occurred more frequently in the former (P=0.0008). The site of cerebral infarction in patients were compared between dry fur group, moist fur group and smooth fur group, correspondence analysis demonstrated there was correlation between dry fur and cortical-subcortical group. The site of cerebral infarction in the patients were compared between white fur group, white-yellow fur group and yellow fur group (P=0.010), and correspondence analysis demonstrated there was correlation between white fur and brainstem infarction; white-yellow fur has relationship with cortical infarction; subcortical infarction was weakly related with white-yellow fur; there was closer relationship between yellow fur and cortical-subcortical infarction. CONCLUSION: The change of tongue manifestation was associated with the site of cerebral infarction in patients, providing a new combining site for diagnosing cerebrovascular diseases by integrative medicine.

A pilot study on the relationship between tongue manifestation and the degree of neurological impairment in patients with acute cerebral infarction.

OBJECTIVE: To discuss the relationship between tongue manifestation and the degree of neurological impairment in the patients with acute cerebral infarction. METHODS: Two hundred patients with first unilateral cerebral infarction were recruited. The relationship between different tongue manifestation and National Institute of Health Stroke Scale (NIHSS) were analyzed. RESULTS: NIHSS scores in the patients from different tongue color groups were analyzed and further analysis demonstrated that the NIHSS score was higher in the patients with red or bluish-purple tongue than that of those with the pink (P <0.01). On tongue fur, the NIHSS score in the patients with thick fur was higher than that of those with the thin (P=0.003). NIHSS score in patients with slippery, moist or dry fur was significant different (P=0.003), Further analysis demonstrated that the NIHSS score was higher in the patients with dry fur than that of those with moist fur, and had statistical significance (P=0.01). The NIHSS score was higher in patients from greasy fur group than that of the non-greasy (P=0.002). There was significant difference of NHISS score in the patients with different fur color (P=0.000), and further analysis demonstrated that the NHISS score in white-yellow, yellow fur group were higher than that of the white (P=0.06 or 0.000). CONCLUSION: The changes of tongue manifestation might be associated with the degree of neurological impairment in the patients with acute cerebral infarction.

Study on the correlation of tongue manifestation with fibrinogen and neutrophil in acute cerebral infarction patients.

OBJECTIVE: To investigate the correlation of tongue manifestation with the fibrinogen level and the neutrophil count in blood of acute cerebral infarction patients. METHODS: A total of 200 patients with first unilateral cerebral infarction in Neurology Department of Xuanwu Hospital from March, 2008 to February, 2009 were recruited in this study. The correlation of the tongue fur color and texture with the blood fibrinogen level and the neutrophil count was analyzed in these patients. RESULTS: The level of fibrinogen and neutrophil count in thick fur group were significantly higher than that in thin fur group (P<0.05). There was no statistical difference in the level of fibrinogen and neutrophil count found between moist fur and dry fur. Statistical significance existed in the level of fibrinogen between the greasy tongue fur group and non-greasy tongue fur group (P<0.05). The level of fibrinogen and the neutrophil count were compared among different fur color groups, revealing that the level of fibrinogen in yellowish fur group was higher than that of white fur group and normal value with statistical significance (P<0.05) with neutrophil count in yellowish fur group being significantly higher than that in white fur group. CONCLUSION: Our results suggested that the change of tongue manifestation was associated with the level of fibrinogen and the neutrophil count in the blood of cerebral infarction patients.

[Relationship between tongue presentations and serum level of C-reactive protein in patients with acute cerebral infarction].

OBJECTIVE: To investigate the relationship between tongue presentations and the serum level of C-reactive protein (CRP) in patients with acute cerebral infarction (ACI). METHODS: Tongue presentations of 200 incipient unilateral ACI patients were observed, their serum CRP level was determined, and the relationship between the two entries was analyzed. RESULTS: Serum level of CRP in patients with thick tongue coating were significantly more than those with thin coating (117 cases vs. 73 cases); tongue coating was greasy in 149 patients and un-greasy in 51 patients. Spearman correlation analysis showed that the serum level of CRP was positively correlated with the thickness of tongue coating (r = 0.186, P = 0.008); also with the greasy degree. The difference of CRP levels in patients with different color and dryness of tongue was insignificant statistically (P > 0.05). CONCLUSION: Correlation between tongue presentations and serum CRP level is possibly existed in patients with ACI.

[Role of nitric oxide in pathogenesis of cold nerve injury].

OBJECTIVE: To study the role of nitric oxide (NO) in the pathogenesis of cold nerve injury and to explore its mechanism. METHODS: Cold nerve injury model was established in rat's sciatic nerve. Consistent and intermittent cooling of 4 degrees C for 2 hours were respectively applied to the sciatic nerves. Nerve samples were taken at different time points: immediately post-cooling and 4 h, 1 d & 3 d post-cooling. The group of aminoguanidine (AG) intervention was also established. Then NO levels in the nerves and blood serum were detected. Induced nitric oxide synthase (iNOS) in ganglion was determined by immunohistochemistry. Morphology of cooled sciatic nerves in the AG groups (consistent & intermittent cooling AG groups) and control groups (1 d time point of consistent & intermittent cooling groups) was observed by light microscope and electron microscope. RESULTS: At the time points of immediacy, 4 h, 3 d in the consistent cooling groups and the time points of immediacy, 4 h, 1 d in the intermittent cooling groups, different incremental degrees of NO levels in the cooled nerves (0.146 +/- 0.047), (0.216 +/- 0.048), (0.137 +/- 0.035), (0.154 +/- 0.027), (0.260 +/- 0.027), (0.218 +/- 0.042) micromol/g as compared with those of controls (0.098 +/- 0.022), (0.158 +/- 0.030), (0.085 +/- 0.020), (0.127 +/- 0.016), (0.72 +/- 0.027), (0.174 +/- 0.026) micromol/g, P < 0.01, P < 0.05). And NO levels in the cooled nerves at the time points of 4 h, 1 d, 3 d in the intermittent cooling groups were higher than those in the consistent cooling groups (P < 0.01, P < 0.05). NO levels in blood serum at the time points of immediacy and 1 d in the intermittent cooling groups (4.98 +/- 1.33) micromol/L, (4.02 +/- 0.68) micromol/L were higher than those in the consistent cooling groups (2.47 +/- 0.36) micromol/L, (3.00 +/- 0.67) micromol/L, P < 0.01). Both in consistent cooling and intermittent cooling groups, different incremental degrees of areas and integrated optical density (IOD) of iNOS positive staining in ganglions were found in cooled side as compared with the control side at different time points (P < 0.01, P < 0.05, P > 0.05), while those at the time point of immediacy in the intermittent cooling groups (131 686 +/- 24 549) , (4.1 +/- 0.13) x 10(9) were higher than those in the consistent cooling groups (78 558 +/- 34 849), (2.1 +/- 0.93) x 10(9), P < 0.05. NO level of cooled nerves in the intermittent cooling AG group (0.178 +/- 0.030) micromol/g was lower than those at the time point of 1 d in intermittent cooling groups (0.218 +/- 0.042) micromol/g, P < 0.05). Also a reduction of NO levels of blood serum, areas and IOD of iNOS positive staining was found in the AG groups as compared with the control groups (P < 0.05) while the reduction was more significantly found in the intermittent cooling AG group (P < 0.01, P < 0.05). Through light microscope and electron microscope, more severe pathological injury of cooled nerve was seen in the intermittent cooling group as compared with 1d time point of the consistent cooling groups, and a marked reduction of pathological injury was found when AG was administered. It was also more significant in the intermittent cooling AG group. CONCLUSION: NO plays a causative role in the pathogenesis of cold nerve injury, especially in intermittent cold nerve injury. The expression of iNOS is the main source of NO. Production of free radicals and the resulting toxic injury may be its main mechanism.