| Objective:To observe the short-term efficacy of autologous bone marrow mesenchymal stem cells transplantation in the treatment of cerebral hemorrhage and to explore the mechanism of its effect on the repair of cerebral hemorrhage.Methods:This research is divided into two parts: the first part from 2012-01 to 2015-11 during the Liaocheng People's Hospital(Brain Hospital)in 35 patients as the treatment group Department of neurosurgery for treatment of cerebral hemorrhage patients,according to the bleeding amount and the specific condition,were craniotomy or trepanation and drainage of hematoma cavity indwelling drainage tube,and a drainage.Tube in hematoma cavity injection of 3.5m autologous bone marrow mesenchymal stem cells L through postoperative(BMSCs)suspension.In the same period,40 patients with cerebral hemorrhage treated in our hospital were selected as control group.Evaluation of nerve function defect of patients in the two groups before and after transplantation in 6,at 12 months(NIHSS score)and the evaluation of activities of daily living(Barthel index),at the same time the head of NMR,biochemical,blood and tumor marker examination to clinical efficacy and safety monitoring BMSCs transplantation.The second part: in this experiment,the rat model of intracerebral hemorrhage(ICH)was established by collagenase induction,and bone marrow mesenchymal stem cells(BMSCs)were injected into the striatum of rats with intracerebral hemorrhage.The neurological function score and the expression of P75 NTR and TrkA in the two groups were compared between the model group and the bone marrow mesenchymal stem cells(BMSCs)transplantation group.In this study,bone marrow mesenchymal stem cells transplantation can change the expression of P75 NTR and TrkA protein around the hematoma,and play an antagonistic role in apoptosis.Results:1.The NIHSS score and Barthel score of the treatment group and the control group before transplantation were similar.Compared with the control group,the NIHSS score of the treatment group was significantly lower(P<0.01)after 6 months of transplantation,and the Barthel score was significantly higher(P<0.01).At 6 and 12 months after transplantation,the NIHSS score of the treatment group was significantly lower(P<0.01)compared with that before transplantation,and the Barthel score was significantly higher(P<0.01).Postoperative complications: there were 2 patients in the treatment group after the BMSCs transplantation fever reaction,timely physical cooling and drug treatment after the symptoms were relieved,no other adverse reactions and complications.After 6 and 12 months of follow-up,the tumor marker CA-153 was increased in only the lung cancer patients in the treatment group,and the results showed that only of the patients in the treatment group were followed up.The other patients had no obvious abnormalities in MRI,biochemical and blood routine examination.2.After the model was induced by collagenase,Wistar rats had the defects of nervous system function,which lasted for about 5 days,and the neurological function recovered gradually after 7 days.Compared with the model group,the mNSS score of BMSCs group was significantly lower than that of model group(P<0.05)at the end of the seventh day and the 14 day.Compared with the model group,the expression of P75 NTR in hematoma of rats in group BMSCs was significantly decreased(P<0.05)at the end of the day,and the expression of TrkA was significantly increased(P<0.05).Conclusion:1.Autologous bone marrow mesenchymal stem cells(BMSCs)transplantation is safe,feasible and effective in the treatment of patients with cerebral hemorrhage.2.BMSCs injected into intracerebral hemorrhage model in rats,which could survive and recover the nerve function.3.BMSCs transplantation can reduce the expression of P75 NTR in the hematoma of cerebral hemorrhage model rats,and increase the expression of TrkA,which can inhibit the apoptosis of peripheral blood cells and promote the recovery of nerve function. |
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