目的 探讨热休克蛋白70羧基末端相互作用蛋白(Carboxylterminus of Hsp70 interacting pro-tein,CHIP)过表达对缺氧(Hypoxia,H)/复氧(Reoxygenation,R)诱导下受体相互作用蛋白激酶3(Receptor-interacting protein kinase 3,RIPK3)介导的神经细胞程序性死亡的影响.方法 将体外培养的小鼠脑神经瘤(Mouse neuroblastoma N2a cells,Neuro-2a)细胞分为正常组(正常培养)、H/R组(构建H/R模型)、H/R+空载体组(转染pcDNA 3.1空载体质粒后构建H/R模型)和H/R+CHIP过表达组(转染pcDNA 3.1-CHIP过表达质粒后构建H/R模型);采用实时荧光量PCR(Real-time fluorescence quantitative PCR,qPCR)检测细胞中CHIP mRNA相对表达水平;免疫印迹法(Western blotting)检测细胞中CHIP,RIPK3和混合系列蛋白激酶样结构域(Mixed lineage kinase domain-like protein,MLKL)蛋白相对表达水平;细胞计数试剂盒-8(Cell counting kit-8,CCK-8)法检测细胞存活率;试剂盒检测细胞乳酸脱氢酶(Lactate dehydrogenase,LDH)漏出量和白细胞介素-6(Interleukin-6,IL-6)、肿瘤坏死因子-α(Tumor necrosis factor-α,TNF-α)、超氧化物歧化酶(Superoxide dismutase,SOD)、丙二醛(Malondialdehyde,MDA)水平;2,7-二氯二氢荧光素二乙酸酯(2,7-Di-chlorodi hydrofluorescein diacetate,DCFH-DA)法检测活性氧(Reactive oxygen species,ROS)水平.结果 与正常组比较,H/R组细胞中CHIP mRNA,CHIP蛋白表达水平和细胞存活率以及SOD水平均明显降低,而LDH漏出量和RIPK3,MLKL蛋白表达以及IL-6,TNF-α,ROS,MDA水平均明显升高(P<0.05);与H/R组比较,H/R+空载体组中上述各指标水平均无明显变化(P>0.05);与H/R+空载体组比较,H/R+CHIP过表达组细胞中CHIP mRNA,CHIP蛋白表达水平和细胞存活率以及SOD水平均明显升高,而LDH漏出量和RIPK3,MLKL蛋白表达以及IL-6,TNF-α,ROS,MDA水平均明显降低(P<0.05).结论 CHIP过表达可通过抑制RIPK3介导的神经细胞程序性坏死来减轻H/R诱导的神经细胞损伤.

目的 分析血浆正五聚蛋白3(Pentraxin 3,PTX3)对动脉瘤性蛛网膜下腔出血后脑血管痉挛的预测价值.方法 收集本院2016年2月-2019年2月186例动脉瘤性蛛网膜下腔出血患者作为研究对象,经颅多普勒检测仪检测大脑中动脉(Middle cerebral artery,MCA)流速,MCA平均流速(Mean velocity of MCA,MCA Vm)>120 cm/s,且同侧Lindegaard≥3为血管痉挛组(92例),其余为无血管痉挛组(94例);收集2组一般资料;酶联免疫吸附(Enzyme linked immunosorbent assay,ELISA)法检测血浆中PTX3水平;绘制受试者工作特性曲线(Receiver operator characteristic curve,ROC)分析血浆中PTX3对动脉瘤性蛛网膜者发生脑血管痉挛的诊断价值;以血浆PTX3水平<4.73 ng/mL和≥4.73 ng/mL分为PTX3低表达组和PTX3高表达组,分析血浆PTX3水平与一般资料的关系;Logistic分析影响动脉瘤性蛛网膜下腔出血患者发生脑血管痉挛的因素.结果 无血管痉挛组与血管痉挛组年龄、治疗方法、高血压病史、Fisher分级、Hunt-Hess分级存在明显差异(P<0.05);与无血管痉挛组比较,血管痉挛组血浆PTX3水平升高(P<0.05);ROC曲线显示,血浆PTX3水平预测动脉瘤性蛛网膜下腔出血患者发生脑血管痉挛的ROC曲线下面积为0.777,截断值为4.73 ng/mL,其敏感性为68.50％、特异性为74.50％;血浆PTX3水平与年龄、治疗方法、Fisher分级、Hunt-Hess分级关系密切(P<0.05);Logistic分析显示,PTX3、年龄、Fisher分级、Hunt-Hess分级是影响动脉瘤性蛛网膜下腔出血患者发生脑血管痉挛的独立危险因素.结论 动脉瘤性蛛网膜下腔出血脑血管痉挛患者血浆PTX3水平升高,PTX3对动脉瘤性蛛网膜下腔出血患者发生脑血管痉挛具有一定诊断价值.

Objective:To assess the efficacy of butylphthalide and sodium chloride injection combined with interventional therapy in treatment of patients with acute anterior circulation macrovascular occlusive stroke.Methods:Clinical data of 92 patients with acute anterior circulation macrovascular occlusive stroke admitted to the Department of Neurology of Luoyang Central Hospital Affiliated to Zhengzhou University from February 2018 to June 2019 were retrospectively analyzed. Among them, 46 cases were treated with auxiliary arterial thrombolysis, aspiration thrombectomy or balloon dilatation (control group); and 46 patients were treated with butylphthalide and sodium chloride injection combined with Solitaire AB (S-AB) recyclable stent (study group). In control group the lesions were located in distal end internal carotid artery ( n=4), M1 segment of middle cerebral artery ( n=18) and M2 segment of middle cerebral artery ( n=24). In study group the lesions were located in the distal end of internal carotid artery ( n=5), M1 segment of middle cerebral artery ( n=15) and M2 segment of middle cerebral artery ( n=26). The cerebral infarction thrombolysis classification was used to evaluate vascular recanalization during operation. The neurological function of the patients before and 4 weeks after operation was evaluated with National Institutes of Health Stroke Scale Score (NIHSS); and the Disease Disability Scale Score (MRS) was also used to evaluate the neurological function before and 2 and 4 weeks after operation. Results:There was no significant difference in NIHSS score before treatment between control group and study group (22.8±5.2 vs. 23.4±4.1, t=0.614, P=0.54); after treatment the NIHSS of study group was significantly lower than that of control group (7.6±1.1 vs. 12.2±1.6, t=16.068, P<0.01). The success rate of vascular recanalization in the study group was higher than that of the control group [91%(42/46) vs. 76%(35/46), χ 2=3.903, P=0.04]. The short-term recanalization rate was 84% (39/46) and occlusion rate was 15%(7/46) in study group, while those in control group were 70% (32/46) and 30% (14/46), respectively (χ 2=6.566, P=0.01; χ 2=6.566, P=0.01) . MRS scores at 2 and 4 weeks after operation in the study group (5.51±0.34, 2.39±0.47) were better than those in the control group (6.87±0.46, 3.26±0.39; t=16.125, 9.661, all P<0.01) . Conclusion:Butylphthalide and sodium chloride injection combined with S-AB recyclable stent can enhance the nerve function and improve the hemagglutination mechanism in patients with acute anterior circulation macrovascular occlusive stroke and also significantly improve the vascular recanalization rate.

目的 探讨颈动脉支架成形术(CAS)治疗颈动脉狭窄的临床疗效及术后诱发症状性脑梗死的危险因素.方法 选取笔者所在医院2013年1月—2018年12月收治的272例颈动脉狭窄患者为研究对象进行回顾性分析,所有患者均行颈动脉支架成形术治疗,比较患者手术前后颈动脉狭窄程度及mRS评分,术后随访6个月,依据患者是否发生症状性脑梗死分为脑梗死组和正常组,采用多因素Logistic回归分析颈动脉狭窄患者颈动脉支架成形术后诱发症状性脑梗死的危险因素.结果 所有颈动脉狭窄患者术后颈动脉狭窄程度和mRS评分较术前显著下降(P<0.05);脑梗死组和正常组在年龄、脑梗死病史、合并冠心病及心功能不全、术中操作不当方面比较具有显著差异(P<0.05),脑梗死组的年龄大于正常组(P<0.05),脑梗死病史、合并冠心病及心功能不全、术中操作不当、有抗血小板药物抵抗占比明显高于正常组(P<0.05);多因素Logistic回归分析结果显示,年龄、脑梗死病史、术中操作不当、有抗血小板药物抵抗及心功能不全等均是颈动脉狭窄患者颈动脉支架成形术后诱发症状性脑梗死的危险因素.结论 颈动脉狭窄采用颈动脉支架成形术治疗疗效肯定,对于术后诱发症状性脑梗死的危险因素,临床应予以重视并积极防范.

目的 通过与症状性大动脉粥样硬化性急性椎基底动脉闭塞资料对比,评估症状性非急性期椎基底动脉闭塞再通的可行性、有效性和安全性.方法 回顾性分析2017年6月至2019年4月郑州大学附属洛阳中心医院采用介入再通手术治疗的18例优势侧椎基底动脉非急性闭塞患者和32例急性粥样硬化性椎基底动脉闭塞患者一般资料和手术资料.单因素分析两组患者脑梗死溶栓(TICI)治疗后血流分级≥2b比例、血管开通时间、术前术后改良Rankin量表(mRS)评分、术后症状改善、围手术期并发症以及90 d mRS评分、支架内再狭窄差异.结果 非急性闭塞组、急性闭塞组分别有16例、30例术后即刻TICI血流分级≥2b,血管成功开通率分别为88.9％(16/18)、93.8％ (30/32)(P=0.948);术后分别有13例、23例症状改善(P=0.979);围手术期发生并发症分别有4例(22.2％)、4例(12.5％)(P＞0.05);术后90 d再狭窄发生率分别为33.3％(6/18)、9.4％ (3/32) (P=0.075);术后90 d mRS评分≤2分比例分别为55.6％(10/18)、65.6％(21/32) (P=0.481).结论 非急性椎基底动脉闭塞血管内开通术虽操作复杂、存在一定风险,但可行、安全有效.确切疗效仍有待大样本、多中心前瞻性研究证实.

目的 探讨促红细胞生成素(EPO)对慢性脑缺血大鼠脑组织凋亡与促凋亡蛋白表达水平的影响.方法 采用双侧颈总动脉永久性结扎法建立慢性脑缺血大鼠模型,随机分为对照组、假手术组、模型组、EPO组.比较各组大鼠的神经功能评分,Morris水迷宫观察大鼠记忆能力,比较各组大鼠脑组织中超氧化物歧化酶(SOD)活性、丙二醛(MDA)、过氧化氢酶(CAT)活性以及谷胱甘肽(GSH)水平,苏木精-伊红(HE)染色法观察脑组织细胞形态,末端脱氧核苷酸转移酶介导的dUTP缺口末端标记测定(TUNEL)检测脑组织细胞凋亡率,蛋白免疫印迹法(Western-blot)检测脑组织中凋亡相关蛋白表达水平.结果 与假手术组相比,模型组大鼠神经功能评分、细胞凋亡率、Caspase-3、Bax、Omi/HtrA2蛋白水平均升高(P<0.05),逃避潜伏期延长(P<0.05),穿越平台次数减少(P<0.05),SOD、CAT、GSH及Bcl-2蛋白水平降低(P<0.05),MDA含量升高(P<0.05);与模型组相比,EPO组神经功能评分、细胞凋亡率、MDA含量及Caspase-3、Bax、Omi/HtrA2蛋白水平降低(P<0.05),逃避潜伏期缩短(P<0.05),穿越平台次数增加(P<0.05),SOD、CAT、GSH活性及Bcl-2蛋白水平升高(P<0.05).结论 EPO对慢性脑缺血大鼠的脑组织损伤有保护作用,可能与其能够增强抗氧化能力、抑制脑组织细胞凋亡有关.

目的 比较颅内血管栓塞取栓术前持续抽吸(CAPTIVE)取栓和单纯支架取栓治疗急性缺血性前循环大血管闭塞的临床效果.方法 回顾性分析2016年10月至2017年12月在郑州大学附属洛阳中心医院接受介入取栓治疗的62例急性前循环大血管闭塞患者临床资料.根据取栓术式不同,分为CAPTIVE组(n=34)和单纯支架取栓组(n=28).分析比较两组基线资料、手术开通效果与手术相关并发症,评估两种技术临床疗效.结果 单因素比较结果显示,CAPTIVE组患者取栓次数、穿刺-开通时间、术后24 h NIHSS评分较术前差、术后mTICI分级、术后3个月mRS评分均优于单纯支架取栓组,差异均有统计学意义(P＜0.05);栓子逃逸显著低于单纯支架取栓组(P=0.025),颅内出血、症状性颅内出血、蛛网膜下腔出血和死亡差异均无统计学意义(P＞0.05).结论 CAPTIVE取栓与单纯支架取栓相比,可有效提高血管开通成功率,缩短开通时间,减少栓子逃逸概率,且不增加症状性颅内出血等并发症,改善患者临床预后.

目的 探讨蛛网膜下腔出血动脉瘤介入治疗的效果.方法 选取本院2016年2月至2019年5月收治的蛛网膜下腔出血动脉瘤患者70例,随机分为两组各35例.A组行介入栓塞术,B组行手术夹闭法治疗.比较两组术后免疫功能、预后和并发症发生率.结果 A组术后1d免疫球蛋白M(IgM)、免疫球蛋白G(IgG)、免疫球蛋白A(IgA)水平高于B组,预后情况优于B组,术后总并发症发生率低于B组,差异均有统计学意义(P<0.05).结论 介入栓塞术治疗蛛网膜下腔出血动脉瘤对机体免疫功能影响较小,可减少并发症发生,改善预后,值得临床推广.

目的:探究对急性脑血栓形成的患者采取参芎葡萄糖注射液联合奥扎格雷治疗的效果.方法:选取郑州大学附属洛阳中心医院2019年2月至2020年2月收治的70例急性脑血栓形成患者为研究对象,按照随机数字表达法将其划分为对照组和观察组,各35例,对照组患者采取奥扎格雷治疗,观察组患者在对照组的治疗基础上联合参芎葡萄糖注射液治疗,观察比较两组患者的临床用药效果.结果:相较于对照组,观察组患者的临床用药总有效率更高,差异具有统计学意义(P＜0.05);两组患者的不良反应发生情况均较少,差异无统计学意义(P＞0.05);治疗后,两组患者的美国国立卫生研究院神经功能缺损评分量表(NIHSS)评分均有所降低,且观察组改善情况更好,差异具有统计学意义(P＜0.05).结论:对急性脑血栓形成的患者采取参芎葡萄糖注射液联合奥扎格雷治疗可取得显著的临床疗效,有助于促进神经功能恢复,改善其生活质量,是一种具有较高应用价值的联合用药方式.

目的:观察酒石酸美托洛尔联合氟桂利嗪治疗偏头痛的效果.方法:选取本院2017年3月-2018年3月收治的偏头痛患者86例,按照随机数字表法分为观察组与对照组,各43例.对照组给予氟桂利嗪(5 mg,qd)治疗,观察组给予酒石酸美托洛尔(25mg,bid)联合氟桂利嗪治疗.比较两组药物起效时间、头痛发作频率、头痛持续时间,治疗前后视觉模拟评分法(VAS)评分、颅内动脉血流情况及不良反应发生情况.结果:治疗后观察组药物起效时间、头痛发作频率、头痛持续时间均短于对照组,差异有统计学意义(P＜ 0.05);治疗1、2个月观察组VAS评分均低于对照组,差异有统计学意义(P＜0.05);治疗后观察组大脑中动脉(MCA)、椎动脉颅内段(VA)、基底动脉(BA)、大脑前动脉(ACA)、大脑后动脉(PCA)平均血流速度均低于对照组,差异有统计学意义(P＜ 0.05);两组不良反应发生率比较差异无统计学意义(P＞0.05).结论:酒石酸美托洛尔联合氟桂利嗪治疗偏头痛的疗效显著,可有效减轻患者疼痛、减慢颅内动脉血流速度,且安全性好.

目的 分析老年脑梗死合并高同型半胱氨酸(Hcy)血症应用叶酸治疗的临床疗效.方法 将我院收治的110例老年脑梗死合并高Hcy血症病例随机分为观察组(常规治疗+叶酸,n=55)与对照组(常规治疗,n=55),观察两组治疗前后血浆Hcy水平、MMSE评分、超敏CRP水平,随访一年统计两组不良预后情况.结果 两组治疗后Hcy水平较治疗前呈下降趋势,且观察组各时间段下降幅度大于对照组(P＜0.05);两组治疗48周后MMSE得分分别为(27.12±6.25)分和(23.01±5.11)分,差异具有统计学意义(P＜0.05),均较治疗前显著上升(P＜0.05);治疗48周后两组超敏CRP水平分别为(4.13±1.02) mg/L和(4.21±1.04) mg/L,差异无统计学意义(P＞0.05),均较治疗前显著下降(P＜0.05);随访一年,两组不良预后事件(死亡、脑梗死复发、脑出血、心肌梗死)发生率无显著性差异(P＞0.05).结论 叶酸治疗可有效降低老年脑梗死患者血浆Hcy水平,改善神经功能,但对超敏CRP水平与远期预后无显著影响,这可能与叶酸不能改善血中炎性指标水平相关.

目的 探讨血栓通联合丁苯肽治疗老年急性脑梗死的临床应用效果.方法 选取我院2015年3月至2017年3月收治的急性脑梗死老年患者88例为研究对象,随机分为两组,对照组患者(44例)应用丁苯酞注射液治疗,观察组(44例)在此基础上应用血栓通治疗,比较两种治疗方法的临床应用效果.结果 治疗14天后,对照组总有效率仅为77.27%,观察组高达93.18%,两组比较差异显著(P<0.05);两组患者的CVR,BHI显著上升,hs-CRP,IL-8水平显著降低,各项指标均与治疗前存在显著差异(P<0.01),观察组上述指标变化幅度更大,与对照组比较差异有统计学意义(P<0.01).结论血栓通联合丁苯肽治疗老年急性脑梗死可显著提高患者的脑血管储备能力,有效降低其炎症反应,临床疗效显著,值得推广应用.

Objective To evaluate the clinical efficacy and safety of Xingnaojing injection combined with atorvastatin calcium in the treatment of acute cerebral hemorrhage.Methods A total of 68 cases with acute cerebral hemorrhag were divided into control group and treatment group,each group 34 cases.Patients in both groups were given regular treatment.Patients in control group were orally given atorvastatin calcium capsules 20 mg,once a day.Patients in treatment group were received Xingnaojing injection 20 mL by intravenous drip,twice a day on the basis of control group.All patients were treated for 21 d.The clinical efficacy,C reactive protein (CRP),interleukin-1β (IL-1 β),tumor necrosis factor-α (TNF-o),nitric oxide (NO),malondialdehyde (MDA),superoxide dismutase (SOD) and adverse drug reactions were compared in two groups.Results The clinical efficacy in treatment group was 94.12％ (32/34),had significant difference with that in control group,which was 76.47％ (26/34,P ＜0.05).After treatment,the serum CRP of treatment group and control group were (3.72 ±0.86),(5.18 ±0.51)mg· L-1,IL-1β were (4.02 ±0.41),(5.48 ±0.58)ng· L-1,TNF-αwere (19.47 ±2.13),(29.59 ±3.04) μg· L-1,NO were (3.03 ±0.34),(4.11 ±0.42) ng· L-1,MDAwere (6.04 ±0.61),(7.17 ±0.76) μmol · mL-1,SOD were (162.01 ± 16.34),(142.63 ±14.64)U · mL-1 (P ＜ 0.05).In treatment group,patients had headache,nausea,rash,incidence of adverse drug reactions was 8.82％ (3/34 cases).In control group,patients had headache,vision fuzzy,nausea,insomnia,incidence of adverse drug reactions was 14.70％ (5/34 cases,P ＞ 0.05).Conclusion Xingnaojing injection combined with atorvastatin calcium in the treatment of acute cerebral hemorrhag was effective with high safety.

Objective: While interleukin-1 beta (IL-1 beta) could influence the development of various diseases of the central nervous system, the conclusions are controversial in epilepsy and children's febrile seizures. A meta-analysis was conducted to investigate the correlation between IL-1 beta with epilepsy or children's febrile seizures. Methods: Pertinent studies on IL-1 beta and epilepsy or seizure were identified by retrieval of PubMed, EMBASE, Web of Science and EBSCO databases till June, 2016. The standard mean difference (SMD) and corresponding 95% confidence interval (CI) were to evaluate the strength of association. Results: 11 studies with a total of 247 patients and 615 controls were included in this meta-analysis. The results demonstrated that there was no difference in IL-1 beta level between two groups. The SMD was 0.21 (95% CI: -0.15 to 0.57, random effect model). In subgroup analysis, results were similar in child versus adult and epilepsy versus febrile seizures, with SMD 0.24 (95% CI: -0.24 to 0.72) versus 0.18 (95% CI: -0.46 to 0.82), 0.15 (95% CI: -0.37 to 0.67) versus 0.29 (95% CI: -0.27 to 0.84) respectively. In addition, among these studies, 6 evaluated the correlation between IL-6 and epilepsy and children's febrile seizures, and the result demonstrated that higher level of IL-6 was found in these patients, the SMD were 0.68 (95% CI: 0.28-1.07, random effect model). No significant publication bias was found in the studies. Conclusions: No significance of IL-1 beta is found between epilepsy and febrile seizures patients and controls. However, more well-designed studies still need to be performed in the future.

目的 观察神经妥乐平治疗腔隙性梗死患者纯感觉性卒中的近期临床疗效.方法 收集腔隙性梗死纯感觉性卒中患者90例,随机分为治疗组和对照组各45例.治疗组在入院后给予神经妥乐平加甲钴胺治疗,对照组常规治疗,均治疗14 d,观察2组治疗前后感觉神经功能评分及临床疗效.结果 治疗组治疗后感觉障碍较对照组明显改善(P<0.05).结论 神经妥乐平对腔隙性梗死纯感觉性卒中有较好的治疗作用,对于早期神经功能恢复具有一定保护作用.

Objective To investigate the effects of recombinant human erythropoietin(rhEPO)on expressions of tumon necrosis factor-alpha(TNF-α) and inter leukin-6(IL-6) in rats after focal cerebral ischemia and to explore its neuroprotective mechanism.Methods A total of 36 healthy male SD rats were randomly divided into sham-operated group (n=12),model group (n=12) and rhEPO treatment group (n=12).The suture method to make permanent middle cerebral artery occlusion model was adopted.rhEPO treatment group was injected with rhEPO 5000 U/kg intraperitoneally after 2 h of ischemia,whereas model group and sham-operated group were given identical saline at the same time.All rats were decapitated after 24 h of ischemia.6 rats were randomly selected in each group and the infarct volume of groups were measured by Triphenyl tetrazolium chloride (TTC)staining method.The expressions of TNF-α,IL-6 in other rats were detected by immunohistochemistry.Results No infarction was found in sham-operated group.Percentage of infarct volume in model group and rhEPO group were (36.672.40)％ and (27.49± 1.47)％,respectively.Compared with the model group,the volume of infarction in rhEPO group was significantly reduced.Cells stained by immunohistochemistry showed that The numbers of TNF-α-positive cells in the 3 groups were 9.001.41,27.83±2.48,17.50±1.87 and IL 6 positive cells were 8.94±2.31,20.33±3.53,14.83±1.70,respectively.Compared with sham operated group,the expressions of TNF-α and IL 6 in model group were significantly increased (q=16.1,19.6,P＜0.01).Compared with the model group,the expressions of TNF α and IL-6 in rhEPO group were significantly decreased (q=8.19,3.44,all P＜0.01).Conclusions rhEPO can decrease the infarct volume in SD rats after acute focal cerebral ischemic injure.rhEPO might exert its neuroprotective effect by reducing the expressions of TNF α and IL-6.

Objective To study the influence of recombinant human erythropoietin (rHEPO) in expressions of nuclear factor-erythroid 2-related factor 2 (Nrf2) and heme oxygenase-1 (HO-1) in rats after acute cerebral ischemia, explore the anti-oxidant mechanism of rhEPO. Methods Thirty-six healthy male SD rats were randomly divided into sham-operated group,model group,rhEPO treatment group.The rat models of left middle cerebral artery occlusion in the later 2 groups were induced by suture method.rhEPO (5000 IU/kg) was injected intraperitoneally into the rats ofrhEPO treatment group 2 hafter the success of ischemia model making, while those of the sham-operated group and model groupwere given equal volume of saline.Rats were sacrificed 24 h after ischemia; and the levels of Nrf2 andHO-1 in the brain tissues were detected by immunohistochemistry and Western blotting. Results The immunohistochemistry showed that,as compared with those in the sham-operated group,the Nrf2- and HO-1- positive cells obviously increased in rats of the model group and rhEPO treatment group (P＜0.05),and rats of the rhEPO treatment group had significantly larger numbers of Nrf2- and HO-1- positive cells than rats of the model group (P＜0.05); these positive cells were mainly neurons and astrocytes located in ischemic areas.Western blotting also indicated that the expressions of Nrf2 and HO-1 were enhanced in the order of sham-operated group, model group and rhEPO treatment group; statistically significant difference was noted between each 2 groups (P＜0.05). Conclusion The rhEPO may exert a neuroprotective effect by activating Keap1-Nrf2/ARE pathway after acute cerebral ischemia.