Role And Mechanism Of Enriched Rehabilitation Nursing In Improving Post-Stroke Cognitive Impairment

Objective:1.To observe the effect of enriched rehabilitation nursing on cognitive function of patients with post-stroke cognitive impairment.2.To investigate the effect of metabotropic glutamate receptor(mGluR2)on improving post-stroke cognitive impairment and its mechanism.Methods:1.The study selected the stroke patients who were treated in rehabilitation department of Subei people’s Hospital of Jiangsu Province from October 2018 to December 2019.According to the principle of randomized control,patients who met the inclusion criteria were randomly divided into routine rehabilitation nursing group and enriched rehabilitation nursing group.The conventional rehabilitation nursing group was given the rehabilitation nursing of stroke cognitive impairment in neurology,and the enriched rehabilitation nursing group was given comprehensive rehabilitation nursing combined with enriched environmental concepts.The intervention frequency was once a day,and the intervention was 6 days a week for 12 weeks.The cognitive function of the two groups before and 12 weeks after intervention was evaluated by MOCA scale,Digital Span Test and Stroop Color-Word Test.2.ICR clean male mice were used to make the mouse stroke model by light embolism method.The Y maze was used to compare with the sham operation group,and the experimental mice with cognitive impairment were selected.They were randomly divided into Sham+SE group,PSCI+SE group and PSCI+EE group.After feeding these mice for 2 weeks,Y maze and new object recognition were used to evaluate and test their memory ability.RT-PCR was used to observe and record the gene transcription of mGluR in frontal lobe and hippocampus of these mice The expression of mGluR,acetylated histone H3 and phosphorylated CREB in frontal lobe and hippocampus of mice were detected by Western blot.Results:1.There was no significant difference in general information,MOCA score,Digital Span Test score and Stroop Color-Word Test score before intervention between the two groups(p>0.05).After 12 weeks of intervention,MOCA score,Digit Span Test score and Stroop Color-Word Test score were improved in both groups(p<0.05).The effect of enriched rehabilitation nursing group is better(p<0.05).2.(1)Compared with Sham+SE group,the Y maze spontaneous alternation rate of PSCI+SE group was significantly decreased(p<0.001).The results showed that the new object exploration rate was significantly decreased(p<0.001),mGluR2 mRNA in frontal lobe and hippocampus was down regulated(p<0.01),and the expression of related proteins in frontal lobe and hippocampus was significantly decreased(p<0.01);(2)the spontaneous alternation rate,new object exploration rate,and metabolic mGluR2 in frontal lobe and hippocampus were significantly decreased in PSCI+EE group compared with PSCI+SE group,mRNA transcription,frontal lobe and hippocampus related protein expression were significantly improved(p<0.05),but there was still significant difference between PSCI+SE group and Sham+SE group(p<0.05).Conclusion:1.Enriched rehabilitation nursing can improve the cognitive function of patients with post-stroke cognitive impairment.2.Through the experiment on mice,it is found that the cognitive function of external things can be further restored and the overall cognitive ability can be further improved by means of enriched environment.In this process,the possible mechanisms involved are:increasing the phosphorylation of CREB,improving the imbalance of acetylation homeostasis and increasing mGluR2mRNA transcription and protein expression,and ultimately improve cognitive function.