| Part1 Study on the Correlation between Cognitive Impairment,Hemorheology and TCM Syndrome Types in Acute Ischemic StrokeObjective:To observe the changes of the severity of different syndrome cognitive dysfunction and the related indexes of different syndrome hemorheology after acute ischemic stroke,and to explore the difference of the degree of cognitive dysfunction between different syndrome forms and the correlation between the severity of cognitive dysfunction and the indexes of hemorheology.To seek the objective basis of TCM syndrome differentiation in acute ischemic stroke,so as to determine the role of hemorheology in assessing different syndrome types of acute ischemic stroke and the relationship between hemorheology and cognitive dysfunction after stroke.Methods:120 patients after acute ischemic stroke who met the criteria were clinically collected and divided into four types:wind-phlegm-stasis,Phlegm-heat accumulation,Qi deficiency&blood stasis and yin deficiency&wind movement.After admission,venous blood was collected from the elbow on an empty stomach to detect the level of hemorheology,including indexes such as blood viscosity,plasma viscosity,red blood cell aggregation index and hematocrit.MMSE and MoCA scores were completed within 14 days after admission to assess the severity of cognitive dysfunction after acute ischemic stroke in patients with different syndromes,and statistical analysis was performed on the evaluation results and the detection results of blood flow changes related indicators.To explore the correlation between hemorheology and cognitive impairment in TCM syndrome differentiation and typing by analyzing the corresponding hemorheology level and cognitive impairment degree of different TCM syndrome types.Results:1.The level of blood flow change(including blood viscosity,plasma viscosity,erythrocyte aggregation index and hematocrit)in patients with acute ischemic stroke was significantly higher than that in healthy control group,and there were differences in the level of blood flow change among different TCM syndrome types.Among them,the expression of wind-phlegm-stasis type was the highest followed by the Phlegm-heat accumulation type,Qi deficiency&blood stasis type,while the expression of yin deficiency and wind movement type was the lowest.(P<0.05)2.There were significant differences in the severity of cognitive dysfunction after acute ischemic stroke among the patients with different syndrome types,including mild in yin deficiency and wind movement type,moderate in Qi deficiency&blood stasis type,and Phlegm-heat accumulation type,and severe in wind-phlegm-stasis type.In addition,there was a significant difference between the level of hemorheology and the severity of cognitive impairment,which increased with the level of blood flow-related indicators.(P<0.05)Conclusion:1.There is a certain relationship between the level of hemorheology in patients with acute ischemic stroke and the type of TCM syndrome differentiation.The level of blood rheology was the highest in the wind-phlegm-stasis type,followed by Phlegm-heat accumulation type and Qi deficiency&blood stasis type,and the expression level of yin deficiency and wind movement was the lowest.The results showed that the changes of hemorheology level could provide some objective basis for TCM syndrome differentiation and classification of acute ischemic stroke.2.There is a certain relationship between the severities of cognitive dysfunction in patients with acute ischemic stroke.Among them,the cognitive dysfunction of patients with yin deficiency and wind movement type was mainly mild,that of patients with Qi deficiency&blood stasis and Phlegm-heat accumulation types were moderate,and that of patients with wind-phlegm-stasis type was severe.This indicates that the degree of cognitive impairment can provide a certain objective basis for TCM syndrome differentiation of acute ischemic stroke.In summary,this study clarifies the relationship between the level of Hemorheology and the degree of cognitive impairment of TCM syndrome types.The results show that the degree of hemorheology and cognitive impairment can provide objective basis for TCM syndrome differentiation and typing of acute ischemic stroke.Part2 Neuroprotective Effect of Fe3O4 Nanoenzyme on Acute Ischemic Stroke and Its MechanismObjective:To investigate the protective effect and mechanism of Fe3O4 nanoenzyme on nerve injury in acute ischemic stroke.Methods:The mice were randomly divided into sham group,administration group(15 mg/kg and 50 mg/kg Fe3O4 Nanoenzyme),MCAO group and MCAO preoperative administration group(15 mg/kg and 50 mg/kg Fe3O4 Nanoenzyme).Cerebral ischemic stroke model was established by middle cerebral artery occlusion(MCAO).Fe3O4 Nanoenzyme 0.9%normal saline was diluted.Fe3O4 Nanoenzyme group was given intragastric administration for 3 days before MCAO,once a day,30 min after the last administration,and the same dose of normal saline was given in sham group.The volume of cerebral infarction in mice was detected by TTC staining.Immunohistochemical staining was used to observe the changes of neurons,astrocytes and vascular endothelial cells in CA1 area of hippocampus on the ischemic side.The expression of superoxide dismutase(SOD1)and superoxide dismutase(SOD2)and blood-brain barrier related proteins ZO-1 and Claudin5 in hippocampus of ischemic side were detected by Western blot.Results:50 mg/kg Fe3O4 Nanoenzyme had obvious neuroprotective effect on acute ischemic stroke mice.Compared with MCAO group,50 mg/kg Fe3O4 Nanoenzyme increased the activity of SOD and decreased the content of MDA in the hippocampus of mice on the ischemic side,and significantly decreased the death of neurons in CA1 region of the hippocampus of mice after ischemic stroke.It significantly inhibited the over-activation of astrocytes in hippocampal CA1 region and maintained the integrity of vascular endothelium in hippocampal CA1 region.In addition,Fe3O4 nanoenzyme increased the expression of ZO-1 and Claudin-5 proteins in hippocampus,suggesting that Fe3O4 nanoenzyme plays a neuroprotective role by maintaining the integrity of blood-brain barrier.Conclusion:50 mg/kg Fe3O4 nanoenzyme plays a neuroprotective role in acute ischemic stroke by maintaining the integrity of the blood-brain barrier. |
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