Volume 93  ·   Issue 07  ·  2013

To explore the feasibility of single-stage skipping two-level pedicle subtraction osteotomy (PSO) for severe thoracolumbar kyphosis (Cobb>100°) in advanced ankylosing spondylitis (AS).

Ten AS patients with thoracolumbar kyphosis undergoing skipping two-level PSO were retrospectively reviewed.The most frequent levels of osteotomy was L1 and L4 (n=7), followed by T12 and L3 (n=2) and L2 and L5 (n=1).All patients were males with a mean age of 28.5±9.1 years (range:17-47).The pre- and post-operative values of thoracic kyphosis (TK), lumbar lordosis (LL),globe kyphosis (GK), local kyphosis of osteotomized vertebra (LK1, LK2) and sagittal imbalance (SVA) were measured.

Significant differences were observed with respects to the improvements of LL, GK, LK1, LK2 and SVA (P<0.01). LL, GK, LK1, LK2 and SVA improved from 41.9°, 113.4°, 40.5°,-0.3°and 25.2 cm preoperatively to-44.1°, 71.6°, 13.5°,- 26.8°and 5.8 cm postoperatively respectively.The mean operative duration was 370 minutes (range:290- 420) and the estimated volume of blood loss 2600 ml (range:1700-3800).Dural tear occurred intra-operatively in 1 patient.One had a transient brachial plexus paralysis and resolved after 1 week postoperatively.One had transient raiculopathy in right lower extremity and recovered completely 3 weeks postoperatively.

As a safe and effective technique for correction of severe thoracolumbar kyphosis (Cobb>100°) secondary to AS, single-stage skipping two-level PSO osteotomy can achieve larger correction and better sagittal alignment with a mean correction of 86°in terms of LL.

To explore the features of pelvic parameters in patients with adolescent idiopathic scoliosis (AIS) and the relationships with spinal sagittal parameters and evaluate their roles in sagittal balance.

A total of 112 AIS patients from March 2007 to February 2011 were recruited.Six parameters were evaluated from lateral standing radiographs:pelvic incidence (PI), sacral slope (SS), pelvic tilt (PT), lumbar lordosis (LL), thoracic kyphosis (TK) and sagittal vertical axis (SVA).Pearson′s correlation was used to determine the relationship between the above parameters and t-test applied to compare the differences between the subgroups: (1) by the major curve types in coronal plane (primary thoracic curve vs.primary lumbar curve); (2) by the value of SVA (positive vs.negative).

The values of PI and SSin our cohort were 47.2°and 39.4°and they were lower than those in Caucasians as previously reported.PI was correlated with SS, PT and LL (r=0.562,0.773 and 0.278 respectively) ; TK not correlated with pelvic parameters (PI, PT and SS).SVA correlated with both spinal (TK, LL) and pelvic parameters (PI, PT).In the subgroup analyses, the values of PIand SS were significantly higher in the primary thoracic curve subgroup than those in the primary lumbar curve subgroup (49.4°vs 45.1°, 41.0°vs 38.0°).The values of PI and PT were distinctively higher in the positive SVA subgroup than those in the negative SVA subgroup (54.6°vs 45.6°, 14.3°vs 6.2°).

Ethnic differences exist in the main pelvic parameters and their values are lower in Chinese than in Caucasians.There are also differences among different types of AIS.The values of main pelvic parameters are higher in AIS patients with a primary thoracic curve than in those with a primary lumbar curve.Pelvic parameters play an important role in maintaining a sagittal balance.The main pelvic parameters have influences on sagittal lumbar configuration but little on thoracic segment.A high PI value leads to a forward lean in torso with an increased PT as a result of compensation and vice versa.The alteration of PT is a major compensatory pattern of pelvis.The features of pelvic parameters should be considered during surgical planning.

To explore the effects of wide posterior release on the correction of severe and rigid thoracic scoliosis in sagittal plane.

A total of 37 idiopathic scoliosis patients (26 females and 11 males) with severe and rigid thoracic curves corrected with posterior pedicle screw system between 2006 and 2009 were recruited.Their average age was 17.3 years (range:14- 22) at operation and the thoracic Cobb angle was between 70-100°.They were separated into 2 groups: group A (n=15) with wide posterior release and group B (n=22) with posterior soft tissue release alone.The preoperative, postoperative and latest standing posteroanterior and lateral radiographs during follow-ups were reviewed.

All patients were operated successfully.No statistic difference existed in the average operative duration between two groups (P>0.05).The average volume of blood loss was 874 ml in Group A versus 712 ml in Group B (P<0.05).The average coronal Cobb angle on postoperative standing photograph was 27.4°(68.1% correction) in Group A and 35.6°(56.9% correction) in Group B.For comparing sagittal correction results in patients with similar thoracic sagittal deformities, we distinguished subgroup A1 (preoperative TKA<40°) from subgroup A2 (preoperative TKA>40°) in group A and subgroup B1 (preoperative TKA<40°) from subgroup B2 (preoperative TKA>40°) in group B.The postoperative TKA was 26.8°(>9.2°than preoperation) in subgroup A1 and 12.5°(3.1°<preoperation) in subgroup B1 (P<0.05).The postoperative TKA was 28.4° (24.9°<preoperation) in subgroup A2 and 39.1°(10.3°<preoperation) in subgroup B2 (P<0.05).There was one case of dural leakage in group A.A leakage of cerebrospinal fluid was cured with a prone position and wound compression.One case of infection in superficial part of wound in group B was cured after debridement.No nerve system injury, deep infection or instrumentation failure was found.During a follow-up period of 2 years, there was no obvious correction loss or trunk decompensation.

In idiopathic scoliosis patients with severe and rigid thoracic curves, wide posterior release via a posterior approach may help to correct the deformity in sagittal plan and achieve more coronal correction in these curves.

To evaluate the prevalence and influencing factors of residual disease in women with stageⅠa1 squamous cervical carcinoma after conization.

The medical records and histopathologic slides of 83 women diagnosed with stageⅠa1 squamous cervical carcinoma after cervical conization undergoing subsequent hysterectomy at our hospital between January 2003 and December 2007 were reviewed.The correlations between the presence of residual lesions and clinicopathological features were analyzed.

Among them, 31 (37.3%) had residual disease in hysterectomy specimens, including CIN1 (n=5), CIN2-3 (n=10), microinvasive carcinoma (n=11) and invasive carcinoma (n=5).In univariate analysis, menopause, procedure of conization,and status of cone margins were associated with the prevalence of residual disease in stageⅠa1 cervical carcinoma after conization.However, Logistic regression analysis revealed status of cone margins as an independent risk factor for residual disease in stageⅠa1 cervical carcinoma after conization.

Status of cone margins is an independent risk factor for residual disease in stageⅠa1 cervical carcinoma after conization.Further treatment should be performed in patients with positive or nearing cone margins.

To evaluate the effects of catheter-direct thrombolysis in acute deep venous thrombosis (DVT).

A total of 86 cases were divided into 2 groups of peripheral venous thrombolysis (group A, n=33) and catheter-direct thrombolysis (group B, n=53).The curative effect of two groups was compared by swelling rate and vascular potency.

No significant difference existed in swelling rate between two groups (P>0.05).Vascular patency rates of group B was significantly better than those of group A (P<0.01).The incidence of bleeding had no significant difference (P>0.05) and there was no asymptomatic pulmonary embolism in two groups.

Both treatments of acute DVT are effective in improving symptoms.But catheterdirected thrombolysis results in significant vascular patency rate and does not increase the risk of thrombolytic bleeding.

To summarize the experience in anesthetic management for total thoracoabdominal aorta replacement without cardiopulmonary bypass.

From October 2009 to September 2010,10 patients of Fuwai Hospital received off-pump total thoracoabdominal aorta replacement.Of these patients,5 were subjected to Standford B aortic dissection, 2 were Standford A aortic dissection received total aortic arch replacement combined with transaortic stented graft implantation into the descending aorta.1 were Marfan′s syndrome,and 2 were thoracoabdominal aorta.All operations used the technique which preserved blood was transfused back by pump via the femoral artery.

The average surgery time was (7.4±1.2) h and extubation time was (14.1±2.5) h,the descending thoracic aorta crossclamp time was (11.5±3.6) min,the intercostal artery reconstruction time was (16.4±5.5) min,the required amount of blood products was fresh frozen plasma (600.5±542.8) ml,platelet (1.7±0.8) U, red blood cell (4.3±2.4) U,autoblood salvage (465.7±242.3) ml.Three patients occured atelectasis and one patient occurred seroperitoneum postoperation.All of the 10 patients were discharged from hospital without any neurologic complications.

The anesthetic management for total thoracoabdominal aortareplacement without cardiopulmonary bypass is feasible.It can reduce the side effects of deep hypothermia circulatory arrest and had a good effect.

To investigate the changes and relation between macular morphology and macular visual function in different degrees of diabetic macular edema.

Seventy-eight eyes of 41 diabetic retinopathy patients were included and graded for diabetic macular edema as follows:31 were graded as no macular edema (NE), 26 as non-clinically significant macular edema (NCSME), and 21 as clinically significant macular edema (CSME).Best corrected visual acuity, macular sensitivity, and macular thickness of all included eyes were examed and quantified.Macular sensitivity and retinal fixation were investigated with MP-1 microperimetry.Optical coherence tomography (OCT) was used to quantify macular thickness.

Macular thickness significantly increased and macular sensitivity markedly decreased from the NE to the CSME group (P<0.01), Visual acuity obviously decreased in the CSME group (P<0.01) compared to the NE and NCSME group,but there was no statistical difference between the NE group and NCSME group.Retinal fixation type was not significantly different among three groups.Visual acuity and macular sensitivity correlated significantly in these three groups (r=-0.751, P<0.01|r=-0.583, P<0.01|r=-0.679,P<0.01).The correlations were noted between retinal sensitivity and macular thickness as well as between visual acuity and macular thickness in the CSME group (r=-0.465, P<0.05|r=0.599,P<0.01), but not in the NE group or in the NCSME group.

Patients will have retinal morphologic and functional changes in early stage of DME, both of which are significantly related as the disease develops.MP-1 microperimetry proved to be consistent with VA in the evaluation of visual function, and may be more sensitive to investigate the changes of macular visual function in the early stage of macular edema.

To explore the values of detecting coronary atherosclerosis by computed tomography angiogram (CTA) on non-cardiac surgery planning and cardiac risk assessment of coronary atherosclerosis during perioperative period.

A total of 89 patients with suspected coronary heart disease (CHD) scheduled for non-cardiac surgery underwent coronary CTA to evaluate luminal stenosis and calculate calcification score.There were 56 males and 33 females with a mean age of 65.1 years.Operative sites included chests (n=29), abdomens and pelvis (n=26), large vessels (n=3), bones and joints (n=19) and other regions (n=12).Reasons of abandoned or postponed surgery were documented to analyze the influence of CTA results on surgery planning.Cardiac events were recorded to assess the correlation with coronary atherosclerosis.

Among them, 75 patients (84.27%) were diagnosed as atherosclerosis while 10 patients (11.24%) were negative| 2 patients had coronary artery bypass and another 2 had stent implantation.According to the results of CTA, 12 operations (13.48%) were canceled and 8 (8.98%) postponed after interventions.Severe stenosis of coronary lumen had significant effects on surgery planning (P=0.003) while calcification score did not.In patients undergoing surgery as scheduled or after intervention,1 had atrial fibrillation at post-operation.

For the patients with suspected CHD scheduled for non-cardiac surgery, severity of coronary stenosis may greatly influence surgery planning.Preoperative coronary CTA may decrease the incidence of cardiac events during perioperative period.

To explore the complications and clinical outcome of liver metastatic cholangiocarcinoma after microwave ablation (MWA) in patients with a history of pancreatoduodenectomy or liver resection with bilioenteric anastomosis.

Retrospective study was made on 10 lesions of intra-hepatic metastatic cholangiocarcinoma undergoing MWA (range:1.5-3.6 cm, mean:3.3±1.3 cm) in 6 patients (5 males and 1 female) from February 2008 to October 2011.All had a history of surgical resection for primary neoplasm and bilioenteric anastomosis.Four cases had intrahepatic biliary dilatation pneumatosis.

All lesions were completely ablated according to the results of contrast-enhanced ultrasound (CEUS) or contrast-enhanced computed tomography/magnetic resonance imaging (CT/MRI) at Month 1 post-MWA.Liver abscess and fistula occurred in 5 ablation zones (5/10) of 4 patients.Three cases were satisfactorily cured with antibiotic dosing, catheter drainage and supportive care.One case died 13 days after MWA.The overall 1,2, 3-year survival rates of were 64.8%, 21.6% and 21.0% respectively (median:15.7 months).

A high technical success rate of MWA is obtained in the treatment of intrahepatic metastatic cholangiocarcinoma with bilioenteric anastomosis.However, the incidence of abscess formation remains high due to a coexistence of multiple risk factors.

To explore the effects of entacapone on the plasma level of homocysteine (Hcy) in Parkinson′s disease (PD) patients on levodopa.

This cross-sectional study was made up of 4 groups, i.e.'L+E’group (primary PD patients on levodopa and entacapone),'L’group (primary PD patients on levodopa alone),'L(-) ’group (primary PD patients never on levodopa) and control group (people without PD or any other nervous system diseases).They were randomly selected from the PD patient database of our department in September 2012.At the beginning,60 cases were selected for each group.The C677T genotypes of methylenetetrahydrofolate reductase (MTHFR) were identified and the plasma concentrations of Hcy, folic acid and vitamin B12 detected in each subject.Then group t test, single factor analysis of variance and χ² test were used for statistical analysis by SPSS 11.5 software.

Among 240 early subjects, 98 cases with CC genotype at 677 site of MTHFR gene were finally recruited.Statistical analysis revealed no differences in age, gender, plasma concentrations of folic acid and vitamin B12 among the groups.The PD duration of 'L+E’ group (96±21 months) were the longest among 3 groups, followed by those of 'L’ group (51±17 months) and 'L(-)’ group (21±6 months).The treatment duration and daily dose of levodopa in 'L+E’ group (77±22 months, 765±110 mg) were all higher than those in 'L’ group (42±14 months,673±73 mg).The plasma Hcy concentrations of 'L+E’ group (15.1±3.1μmol/L) were lower than those of 'L’ group (20.4±4.7μmol/L), but still higher than those of 'L(-) ’ group (12.2±2.4μmol/L) and control group (9.1±2.2μmol/L).The Hcy concentrations of 'L(-) ’ group were also higher than those of control group.

Entacapone increases the bioavailability of levodopa and simultaneously alleviates partially its resulting hyperhomocysteinemia.

To explore the relationship between muscular impairment rating scale (MIRS) and myopathological changes of myotonic dystrophy type 1 (DM1).

A total of 46 patients at our hospital from May 2003 to June 2011 were diagnosed as DM1.There were 30 males and 16 females.The age of onset ranged from 10 to 57 years old.The major symptoms included distal extremity weakness and myotonia.They were assessed with MIRS and muscle biopsies.The relationship was examined between MIRS and the variation of fiber size, central nuclear, ragged red fibers, proliferation of connective tissue, sarcoplasmic mass.Statistic analysis of pathological changes was made between the groups of MIRS≥4 and≤3.

The scores of MIRS were 2 (n=8), 3 (n=14), 4 (n=23) and 5 (n=1).MIRS had significant correlations with variations of fiber size (P=0.039, r=0.305), degree of nuclear translocation (P=0.002, r=0.451) and ragged red fibers (P=0.013,r=0.364).But there was no significant correlation with the proliferation of connective tissue and sarcoplasmic mass.There were significant differences in nuclear translocation and ragged red fibers.But no significant difference existed in variations of fiber size between the groups of MIRS≥4 and≤3.

The rating scale of MIRS has a certain myopathological basis, especially with regards to the changes in nuclear translocation and ragged red fibers.

To explore the long-term efficacy and safety of adjuvant trastuzumab for HER2-positive early breast cancer.

The clinicopathological data were collected 31 HER2-positive early breast cancer patients on the 1/2-year adjuvant therapy of trastuzumab at our hospital from October 2001 to October 2003.And the disease-free survival, recurrence-free survival, overall survival and safety were respectively analyzed.SPSS 13.0 software was used for statistical analysis.

During a median follow-up period of 9.3 years, 6 cases had recurrence, there were 5 cases of second primary cancer and 4 patients died.In total, the 5 and 10-year recurrence-free survival rates were 83.3% and 80.0%, the 5 and 10-year disease-free survival rates 80.6% and 57.3% and the 5 and 10-year overall survival rates 96.8% and 87.1% respectively.The 10-year recurrence-free survival rate of 13 patients with ER and/or PR positive and 18 ER/PR negative patients were 100.0% and 64.7% (χ²=5.44,P=0.019) and 10-year overall survival rate 100% and 77.8% respectively (χ²=3.163,P=0.075).Trastuzmab was well-tolerated when used as adjuvant treatment.There was no occurrence of cardiac events.

Adjuvant trastuzmab has definite efficacies and excellent safety in the treatment of HER2-positive breast cancer patients.And there was no long-term cumulative cardiac toxicity.

To explore the alteration of collagen ultrastructure and content in uterine ligaments and paraurethral tissue and explore whether the alteration may contribute to stress urinary incontinence (SUI) and pelvic organ prolapse (POP).

The cardinal ligament, uterosacral ligament and paraurethral tissue samples were obtained from 90 subjects undergoing hysterectomy.Collagen ultrastructure was examined with transmission electron microscopy.And collagen content and expression of vasoactive intestinal peptide (VIP) were examined with immunohistochemisty.

The smooth muscle fascicles were thinner in the patients of SUI and POP.Arrangement of smooth muscle fascicles was disorderly.Fiberoblast was metabolically active.The mean collagen fibril diameters in the SUI and POP groups were larger than that in the control group (P<0.01).The mean contents of collagenⅠandⅢin the SUI and POP groups were lower than that in the control group (P<0.01).The expression of VIP was lower (P<0.05).

Predominance of collagen degradation during tissue repair may contribute to and promote POP and SUI.The decrease of VIP might be related with nerve damage or degeneration to cause or accelerate the progress of pelvic organ prolapse.

To explore the effects of low-frequency electric stimulus (LFS) on hippocampal of α5 subunit of extrasynaptic GABAA receptor in kainic acid-induced epilepsy rats and explore the possible mechanism of LFS on hippocampus to treat epilepsy.

A total of 32 male Sprague-Dawley rats were divided randomly into 4 groups:epileptic, pseudo-surgery, LFS treatment and control.The expression ofα5 subunit of extrasynaptic GABAA receptor and the association with the curative effects of LFS were evaluated by behavioristics, real-time fluorogenic quantitative polymerase chain reaction (PCR) and Western blot.

After treatment, the number of seizures in LFS group were significantly lower than that in the epileptic and pseudo-surgery groups (2.88±0.83 vs 8.50±0.93 and 8.88±0.83) (P<0.01).The results of real-time PCR demonstrated that the expression of mRNA of α5 subunits in LFS treatment group was obviously higher than that in epileptic and pseudo-surgery groups (0.74±0.20 vs 0.30±0.16 and 0.31±0.16)(P<0.01), but was lower than 1.10±0.23 in control group.Western blot demonstrated that the protein expression of α5 subunits in LFS (0.75±0.09) and control (0.88±0.09) groups were dramatically higher than that in epileptic (0.22±0.08) and pseudo-surgery (0.26±0.08) groups (P<0.01).

Lowfrequency electric stimulus on hippocampus is effective in controlling epileptic seizures.And the mechanism may be related with the expression level of α5 subunits of extrasynaptic GABAA receptor.

To investigate the effects of mild hypothermia on the expression of ASIC1a and ASIC2a in the rat hippocampus following global cerebral ischemia-reperfusion, so as to speculate the underlying mechanisms of neuroresuscitation.

Ninety five male SD rats were randomly divided into five groups (n=19): sham operation group (Ⅰ), model group (Ⅱ), mild hypothermia group (Ⅲ), PcTX1 group (Ⅳ), mild hypothermia combined Pc TX1 group (Ⅴ).Transient (15 min) global cerebral ischemia was induced by the four-vessel occlusion.PcTX1 (500 ng/ml) 6μl were injected into lateral cerebral ventricle immediately after reperfusion in group Ⅳ and Ⅴ, while the equal volume of normal saline was injected into lateral cerebral ventricle immediately after reperfusion in the other three groups.At the same time, mild hypothermia after reperfusion was performed and lasted for 6 hours in group Ⅲ and Ⅴ, the rectal temperature was reduced to 32-33℃within 15 min, while it was maintained at 36-37℃ by lamp in other three groups.Determination the expression of ASIC1a and ASIC2a protein at 6 h and 24 h of reperfusion, and the expression of ASIC1a and ASIC2a mRNA at 24 h of reperfusion.Observe the pathomorphological changes of hippocampal CA1 neurons at 24 h of reperfusion.Detect the brain water content at 72 h of reperfusion.

The difference in the expression of ASIC1a mRNA and protein among the groups was not changed significantly (P>0.05).Compared with groupⅠ, the expression of ASIC2a mRNA and ASIC2a protein was up-regulated in other groups (P<0.05).It was significantly higher in group Ⅲ and Ⅴ than in group Ⅱ and Ⅳ (P<0.05).Compared to 6 h of reperfusion, the expression of ASIC2a protein was higher in groupⅡ, Ⅲ, Ⅳ and Ⅴ respectively after 24 h of reperfusion.Compared to group Ⅰ, the number of pyramidal cells in CA1 region of hippocampus in groupⅡ, Ⅲ, Ⅳ and Ⅴ were decreased at 24 h of reperfusion (P<0.01).Compared to group Ⅱ, the number of pyramidal cells in CA1 region of hippocampus in groupⅢ, Ⅳ and Ⅴ were increased at 24 h of reperfusion (P<0.01); and compared to group Ⅲ and Ⅳ, the number of pyramidal cells at 24 h of reperfusion in group Ⅴ was significantly higher (P<0.01).Compared to groupⅠ, the content of brain water in Ⅱ, Ⅲ and Ⅳ group were increased at 72 h of reperfusion (P<0.01).Compared to group Ⅱ, the content of brain water in group Ⅲ, Ⅳ and Ⅴ were decreased at 72 h of reperfusion (P<0.01).Giving mild hypothermia or PcTX1 could alleviant the damage in CA1 region of hippocampus, with the best effect in group Ⅴ, which administers PcTX1 combined mild hypothermia.

Mild hypothermia attenuates global cerebral ischemia-reperfusion of rat, which may up-regulate the expression of ASIC2a mRNA and protein.Mild hypothermia combined by PcTX1 could induce neuroresuscitation.

To identify the genetic variation of Gag gene in HIV-1 B′subtype infected Chinese people and to evaluate the association between the positive selection sites and HLA restricted CTL response.

We downloaded all HIV-1 B′subtype gag gene sampled from China from the LANL HIV database.The sequences were grouped by years of collection and the mean intra-subtype diversity and divergence were examined by MEGA 5.0 software.The sites under positive selection were estimated by using Hyphy software.Then analyzed the association between positively selected sites and HLA restricted CTL epitopes.

A set of 122 B′subtype HIV-1 gag sequences were collected from Henan, Hubei, Liaoning and Yunnan provinces, grouped by sampling year as<2001, 2001-2003,2004-2006 and 2007-2010.The mean intra-subtype diversity and divergence increased over time (r¹=0.497,P1<0.001;r²=0.593,P2<0.001).This analysis revealed 34 positively selected sites and 97.1% of these sites were located within 47 known CTL epitopes.The most frequent HLA was HLA-A*02 (21.6%) followed by A*11 (9.8%), B*35 (9.8%) and B*57 (5.9%).The percentages of HLA-A/B/C limited CTL epitopes were 43.1%, 49.0% and 7.9%, respectively.

The mean intra-subtype diversity and divergence of B′subtype gag sequences increased over time.B′subtype HIV-1 virus has accumulated adaptations to HLA restricted CTL responses in HIV-1 infected Chinese.

To investigate whether local A1R of Baihui acupoint mediate cerebral ischemia tolerance induced by electro-acupuncture (EA).

Sixty SD rats were randomly divided into five groups, i.e., the sham-operation (S) group, the model group (M), the electroacupuncture (E) group, the CCPA group and the DMSO group.The focal cerebral ischemia/reperfusion model was established by middle cerebral artery occlusion (MCAO) in rats.Rats in the E group were received EA pretreatment baihui acupoint at 2 h before established MCAO.The rats in DMSO group and the CCPA group were injected with DMSO (20 μl) and CCPA (0.1 mmol/L) 20 μl into Baihui,respectively, at 2 h before established MCAO.After 24 h reperfusion, the rats′behavior, cerebral infarct volume, the cerebral Bcl-2 protein expression were assessed.

Compared with M group, the rats′ behavior was improved, the cerebral infarct volume was decreased and the Bcl-2 protein expression was up-regulated (P<0.05) in the E group.Compared with M and DMSO group, the rats′behavior was improved, the cerebral infarct volume was decreased and the Bcl-2 protein expression was up-regulated (P<0.05) in the CCPA group.There were no statistical differences between CCPA and E group.

EA induced cerebral ischemia tolerance.Local A1R of Baihui acupoint possible mediate cerebral ischemia tolerance induced by Electroacupuncture.