The Study On Promoting Ischemic Brain Injure Nervous System Functional Recovery In Animal Experiment And Clinic Case By Early Exercise Intervention

Ischemic brain injure is one of the common clinical diseases and often caused brain nerve tissue cell ischemic, odema, necrosis , result in serial symptoms and signs. Even appeared nonreversiber brain damage, can leave behind various kinds of nervous system sequelae. For approach the effection of early exercise intervention for ischemic brain injure nervous system functional recovery , This study take the method of contrasting experiment and clinical effect by observe early movement training for ischemic reperfusion rat model brain ischemic recovery stage brain tissue microtubule-2 content effect and rat behavioral change, to juge early movement effect for functional recovery of brain injury animal. At the same time, take the MDI, PDI for index in different stage of clinical high risk neonate ischemic brain injury cases. To observe the effect of promotion for premature and low birth weight,HIE nervous system function recovery.MAP -2 belong to structure-associated protein family clan, it is an heat-stable lipid protein, mainly reside in neuron body and dendrite. It is one of the most profused protein in the brain. It link with microtubule to promote microtubule stable, to constitute cytokelet, participate neuron development and structure stable,to form ecptoma and synapse plasticity adjustment.MAP-2 has a intimate relationship with ischemic brain injury. A lot of studies indicate that MAP-2 is a sensitive mark for brain ischemic. Moreover confirmed, MAP-2 is not only the early mark for neuron injury, but also related to re-establish of damage neuron in ischemic semidarkness band. The mechanism for MAP-2 loss after brain ischemic is not clear at present, maybe brain ischemic cause neuron membrane de-pole, excitatory amino acids(EAA) release, continue activation EAA receptor, ca++ increase endocell liberation calcium level by NMDA and non-NMDA receptor inflow, to destroy calcium homeostasis, cause MAP-2 anomaly lipid acidize, Thus inhibition microtubule construction, promote depolymerize, MAP-2 lost at finally.MAP-2 mainly expressed in pericargon, dendrite, dendritic spine, connected with signal protein and membrance receptor at postsynaptic membrance skeleton. It is substrate of conduction way for many nerves signals, adjust neuron synaptic plasticity and cystoskeleton dynamics. It is imperative for nerves function. The lost of neuron MAP-2 is related to neuron disorganization and lead to death of handicapped neuron. By detect MAP-2 content inside brain after intervention, we can get the message indirectly about cranial nerve function condition and the result of intervention.HIE is refers to serious ischemic and hypoxic brain damage because of intrauterine asphyxia or many kinds diseases of heart and brain postnatal. The main pathological changes about brain tissue is oedema, lenition and necrosis, hemorrhage. It has heavy clinical condition, high case fatality rate and mutilation rate, can cause many kinds of permanence nerves functional defect, such as mental retardation, spastic paralysis and epilepsy. It not only cause neonatal death ambibirth period, but also main causies for mutilation after neonatal period. The pathogenesis for HIE is complicated,still not completely understood. Include brain energy disbolism, reperfusion injury, apoptosis, calcium balance confused, oxygen free radical produced, excitatory amino acids increased.The purpose for this study is a contrast study by combination of animal experiment and clinical case, to approach the result of promote nervous system function recovery by early exercise intervention, and provide theory and clinical evidence for clinical therapy of ischemic brain diseases.The finding of this study shows:1. In MCAO model animal experiment, the behavious test grade for ischemic reperfusion exercise group rat is a little lower than purely ischemic reperfusion group in 2 hours and 24 hours after operation but increased 7 days later; the test grade much higher in 14 and 21 days. The difference between two groups has extremely statistical significance.2. After MCAO model finished, the MAP-2 immune positive material decreased or absence at ischemic center zone both in brain ischemic reperfusion exercise group and purely ischemic reperfusion group, but immune positive materials at ischemic perimeter zone increased. The MAP-2 immune positive materials much higher at ischemic zone in ischemic reperfusion exercise group than in purely ischemic reperfusion group. The difference between two groups has extremely statistical significance.3. In premature and low birth weight high risk infants group by early synthetic intervention, It's MDI score 1.6 high than routine group in 6 months. There is no significant difference between two groups; Intervention group score 2.2, 7.6 and 7.7 higher than routine group during 12, 18 and 24 month age; the difference have extremely statistical significance. For PDI contrast, intervention group score 3.8, 9.1 12.2 and 12.6 higher respectively than routine group during 6, 12 18 and 24 months age. All months age compared have extremely statistical significance.(p<0.01)4. Compare early exercise intervention HIE group with control group, check their MDI and PDI in 6 and 12 months age, the results shows MDI has no significance difference in 6 months age but PDI do has. In 12 months age , both MDI and PDI in intervention group much higher than control group. The difference have extremely statistical significance.(P<0.01)Conclusion:1. Early exercise training can promote limbs function recovery for minor MCAO rats, re-regulation MAP-2 express at ischemic cortical area in brain tissue. It suggest that rat limbs function recovery maybe related to nerve regeneration in molecular level.2. Early synthetic movement intervention can obviously improve the prognosis of brain injuried high risk neonates and HIE patients, promote nerve regeneration and recovery of brain function, cut down nervous system sequel, thus elevate life quality for brain injury neonates.3. Early synthetic movement intervention can obviously improve mental development for premature and low birth weight neonates. By enrichment training of earlier start moving and motor capacity, can obviously improve motor development and enhance mental development for premature and low birth weight neonates.4. Early exercise intervention has a certain effect. It is worth spreading and utilizing in the basic level child care department and community by family connective clinic service intervention mode, and provide supports for elevation population diathesis.