| Objective:Ischemic cerebrovascular disease(ICVD),alsoknown as ischemicapoplexy,is cerebrovascular disease that isdue to the shortage of blood supply of the brain,thenischemiaand hypoxia cause a softening of the brain.According to thedata,the incidence rate of cerebral infarction is 100-300/10million,the mortality rate 50-100/10 million,50%-70%ofsurvival have disability,family and the community has beenbrought a heavy economic and social burdens.With the communityspeeding up the aging process,the mortality rate ofcerebrovascular disease is increasing,is one of the majorcauses of human death in the world.Study of cerebral ischemia found that when the supply ofa branch or more of artery of brain is closed,fluid shear stresswould change,which decrease blood flow partly in brain,andthe tissue around infarct form high-flow region,we call itpenumbra which is the foundation of treatment of ischemicstroke,the damage of neurons in the penumbra zone isreversible.Studies have shown that Infarction lesions which iscaused by the shortage of the brain tissue is composed ofcentral necrosis area and ischemic penumbra around,apoptosiswas found in the ischemic penumbra,the key to improve ICVD's curative effect is to ameliorate blood accommodation inischemic region,saving nerve cell at ischemic penumbra.Studies recently show that recovery of nerve cell aftercerebral ischemia is not only related to nutrition factors andgrowth-related factor expression,but also depends onangiogenesis in ischemic area to create the micro-environment.After cerebral vascular occlusion,vascular in the ischemiczone is generated,then there is a trend of forming collateralcirculation,but that's not enough to compensate the originalblood supply,ischemia is not improved.Blood flow which is inthe ischemic can not enough to activate growth factorangiogenes,resulting in a machine-derived collateral circula-tion in vivo difficult to establish.At present,clinical try of postischemic angiogenesis notmature,and have side effects greatly,then there are still manyissues to be resolved.Shortage of therapeutic angiogenesis inthe treatment of cerebrovascular disease prompted us to set oursights on Chinese medicine.Acupuncture treatment of ischemiccerebrovascular disease has a good effect,which has beenaffirmed by the medical practice for many years.This isconnected with the principle of modern medicine on ischemiccerebrovascular disease is due to ischemic factors leading tothe focal sharp attack/cerebral hemisphere dysfunctioncoincides awareness.Instructor-led group in the preliminaryresearch on the basis of further study of angiogenesis ofElectroacupuncture on the point of view of acute cerebralischemic injury has a more important protective mechanism ofthe theoretical value and practical significance.Method:To SD rats were randomly divided into model group (ischemia-reperfusion by 1d,2d,4d,8d a total of fivesub-groups),electro-acupuncture group(ischemia-reperfusionby ld,2d,4d,8d respectively,electroacupuncture plus a totalof five sub-group),sham operation group(neck incision,theonly separation of CCA and the IPA to the PPA,suture unplugged),the normal control group(no treatment,the normal water supplyto the food),6 in each group.The use of middle cerebral arterysuture-induced focal cerebral ischemia model of electro-acu-puncture"Shuigou","Neiguan","Baihui"point,then G6805-Ⅱelectro-acupuncture device,density waves,stimulate con-tinuously each 30 minutes,in ischemia-reperfusion 2h laterthe 1st electro-acupuncture stimulation,and then Electro-acu-puncture in every 12h and cardiac reperfusion therapy lh fixedbefore the last.Detection of the use of behavioral observa-tions of rats in each group score of neurological symptoms;theuse of immunohistochemistry of the cortex of ischemic ratsmicrovessel count,platelet-derived growth factor(PDGF)andits receptor(PDGF-R)protein expression changes;the use ofin situ hybridization detection of the ischemic rat cerebralcortex changes in TGF-βlmRNA and further analysis of theindicators of spatial and temporal changes in the law and theeffects of electro-acupuncture intervention.Results:(1)Electro-acupuncture groups which is evaluated byneurological deficit score is compared with model groups byld,2d,4d,,8d group after reperfusion,which significantlyimprove the nerve missing sign of the rats and whose scores weresignificantly different from the model ones(p＜0.01,p＜0.05).(2)Model group,the expression of CD34 microvascular increase rapidly in 1d after reperfusion,and sustainly to 8dreperfusion.The expression of CD34 around necrosis of cerebralcortex was increased significantly and intensively with strongpositive expression,the cytoplasm of endothelial cells inlateral choroidal,ependymal cells and the small vessel aroundshowed brown.The expression of CD34 was basically samebetween electro-acupuncture group and model group,but theelectro-acupuncture one was more.Electro-acupuncture groupcompared with the model group were significantly different fromreperfusion at different time points,(P＜0.01 or 0.05).(3)In ischemia 30min reperfusion 1d,the immune stainingof PDGF-B and PDGFR-βenhanced,which mainly located inischemic and microglia,astrocytes and endothelial cellsaround.PDGF-B immunostaining specificially in neuronssurrounding the infarct area in 4th day significantly increasedand the number of positive cells also increased.And thespecific immune of PDGFR-βstaining in significantly enhancedin 8th day after ischemia-reperfusion.The expression ofPDGF-BandPDGFR-βin electro-acupuncture group after reper-fusion from ld to 8d increased more than those in model groupsignificantly(P＜0.05),whose zone of expression is the sameroughly as the model group,but the cytoplasm stained a deeper,broader(4)Expression of TGF-βlmRNA in ischemic zone increasedsignificantly in ld after ischemia-reperfusion.That reachedthe peak in 2d after reperfusion,and continued to 8d.Aftertreatment of electro-acupuncture,compared to the same periodof the model group,the expression of TGF-βlmRNA inelectro-acupuncture ld,2d group significantly increased, while there is an increasing trend that expression of positiveceils of TGF-βlmRNA the electro-acupuncture 4d,8d group ofischemic brain tissue was more than the corresponding modelgroup,but no statistical significance(P＞0.05).Conclusion:Electroacupuncture can improve effectively neurologicaldeficit score after ischemic rat brain,not only early andimproving the prognosis in 8d group is still effective later,and promote its recovery of neurological function.By theCD34marker,the microvessel count of electro-acupuncture inischemic areas was more significantly increased than the model,indicating that one of mechanism how electro-acupuncture toimprove the neurological symptoms of cerebral ischemia is topromote the formation of new blood vessels after ischemia-reperfusion.Cerebral ischemia-reperfusion can induce the expression ofPDGF-B,PDGFR-βand TGF-βlmRNA.Compensatory increase in itsexpression suggesting that they involved cascade of brain cellsin ischemia-reperfusion,and make a role of protection in thehealing process of the brain injury.Electro-acupunctureactivated mechanism of endogenous angiogenesis,which relatedto the increase of expression of PDGF-B,PDGFR-βand TGF-βlmRNA.By further analysis of expression of PDGF-B,PDGFR-βand TGF-βlmRNA in each ischemic group,we thought that themechanism of TGF-βlmRNA maybe that acupuncture promoteangiogenesis to play a key point against hypoxic-ischemic braindamage.Electroacupuncture compared to mechanism of exogenous"supplementary"have many advantages,but the electro-acupun- cture activate endogenous reaction is also limited.Therefore,how to further stimulate the potential of body achieve controlof accurately,timely and appropriate amount,and play the bestvascular effects,which is the direction of the current study.
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