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Empirical Study of the Protective Effect of Minimally Invasive Hematoma Aspiration Combinated Monosialoganglioside on Nervous Tissue

Author: ZhangLiHong
Tutor: WangSuPing
School: Dalian Medical University
Course: Neurology
Keywords: Intracerebral hemorrhage stereotaxis hematoma aspiration Monosialoganglioside(GM1) Nerve tissue Nerve function Brain edema
CLC: R743.3
Type: Master's thesis
Year: 2008
Downloads: 65
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Abstract

Background and objectiveIntracerebral hemorrhage (ICH) is a common disease in nervous system, the characteristic of which are high attack rate, disability rate and case fatality rate, and it is one of the severe diseases that influence survival and live standard for human being, Stereotaxis hematoma aspiration that has been carried out recent years has many ascendancy compared with traditional method including simple operation, spacious indication, light damage ,highly curative effect,low mortality ,it is a ideal management method for ICH.But because of partly cleaned hematoma, remnant blood constituent sequently damage brain tissue , to some extent influence convalescence of nerve function.So it is necessary that approach drug treatment to aim directly at mechanism of cerebral hemorrhage after hematoma aspiration.But at present drug treatment after hematoma aspiration remain vacant. Destination of our experiment is to approach brain protection of GM1 injected hematoma cavity and abdominal cavity after hematoma aspiration and compare difference of dosage of hematoma cavity and abdominal cavity. Accordingly provid experiment ground for clinical management of ICH.Materials and Method1. In this experiment 75mature male Sprague-Dawley rats were used. They were divided into three groups randomly: the stereotaxis hematoma aspiration group, the hematoma aspiration combinated GM1 injected abdominal cavity group, the hematoma aspiration combinated GM1 injected hematoma cavity group. 2. ICH was induced by injection of collagenase IV into the caudate nucleus of rats. 3000u urokinase(dissolved by 5ul saline )was injected hematoma cavity after 10h, then 1 h later, the clot was aspirated. All groups were setted bullet.3. GM1(2mg/kg, 5ul volume) freeze drying, injectable powder was statim injected into hematoma cavity after aspiration,the time of injection was 5 minutes, continual administration before execute; Abdominal cavity group, dosage of administration was 20mg/kg, frequency of administration was identical with hematoma cavity group.4. The rats of every groups were decapitated and dislodged brain at 3d after collagenase was injected.5. The rats of every groups were made score of nerve function at corresponding time points(1d,3d,5d,7d after collagenase was injected) and decapitated and dislodged brain.6.The dislodged brain were setted 4% paraformaldehyde, fixxed 3h at room temperature, imbedded into paraffin after dehydration , prepared section (5um thickness).7.GFAP, AQP4, Caspase-3 positive cells were observed by the immunohistochemistry method.8. Optical density of immunohistochemistry figure was analyzied by Image-ProPlus. positive cells were counted at 3 highpower field by light microscope. water content was calculated by Eliot formula: water content=(Wet weight-Dry Weight)/ Wet weight×100﹪. Statistics data was demonstrate by Mean±SD, mono-factor square analysis was made by SPSS11.5 statistical program coefficient correlation between caspase-3、GFAP cell population and score of nerve function was counted by Pearson.Results1.positive cells and protein express of AQP4 of aspiration group appeared peak at 3d after collagenase was injected.2.Water content of hematoma cavity group、abdominal cavity group was significantly decreased(p<0.05) compared with aspiration group at 3d.3.Positive cells and protein express of GFAP、AQP4、Caspase-3 of hematoma cavity group、abdominal cavity group was significantly decreased compared with aspiration group at 3 d(p<0.05)、5d、7d, especially at 5d、 7d(p<0.01).4. Neurologic functional recovery of hematoma l cavity group、abdominal cavity group was better significant compared with aspiration group at 3d(p<0.05)、5d、7d, especially at 5d、7d(p<0.01).5. Hematoma cavity group and abdominal cavity group were compared, positive cells and protein express of GFAP、AQP4、Caspase-3of the former was significantly decreased at 3d(p<0.05)、5d、7d, especially at 5d、7d(p<0.01); Neurologic functional recovery of the former was better significant at 3d(p<0.05)、5d、7d, especially at 5d、7d(p<0.01); Diversity of water content of two groups was not significant at 3d(p>0.05).6. Between the score of neurofunction after aspiration and the number of caspase-3、GFAP, correlation coefficient respectively is 0.835 0.783 .Conclusions1. Aquaporin 4 possibly participates formation of ICH brain edema.2. Monosialoganglioside(GM1) has effect of relieving brain edema, down regulation of Aquaporin 4 maby is one of the mechanisms of relieving brain edema.3. Defect of the nerve function of ICH possibly relate apoptosis and accrementition of horizontal cell.4. GM1 has effect of suppressing apoptosis and accrementition of horizontal cell,which possibly is one of the mechanisms of promoting neurologic functional recovery.5. Stereotaxis hematoma aspiration combinated GM1 injected into hematoma cavity is better economic、available therapeutic regimen of protective effect on brain of ICH.

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