title: Minimally invasive surgery for ICH evacuation followed by rosiglitazone infusion therapy increased perihematomal PPARγ expression and improved neurological outcomes in rabbits.
abstract: OBJECTIVE
  To observe the effects of minimally invasive surgery (MIS) for intracerebral hematoma (ICH) evacuation followed by rosiglitazone infusion therapy on peroxisome proliferator-activated receptor-gamma (PPARγ), blood-brain barrier (BBB) permeability, and neurological function.
  
  
  METHODS
  A total of 75 male rabbits (2.8-3.4 kg) were randomly assigned to a normal control group (NC group), a model control group (MC group), a rosiglitazone group (RSG group), a minimally invasive treatment group (MIS group) or a MIS combined with rosiglitazone group (MIS+RSG group). ICH was induced in all of the animals except for those in the NC group. The rosiglitazone was infused into the hematoma area in the RSG group and the MIS+RSG group. A MIS was performed to evacuate the ICH 6 h after the successful preparation of the ICH model in the MIS group and the MIS+RSG group. Each group included 15 rabbits and was divided equally into 3 subgroups (each subgroup included 5 rabbits that were killed on day 1, day 3, or day 7). Neurological deficit scores were determined, and the perihematomal brain tissue was removed to determine the PPARγ level and BBB permeability.
  
  
  RESULTS
  Neurological deficit scores, perihematomal PPARγ levels, and BBB permeability were all significantly increased in the MC group compared to the NC group. Performing the MIS alone to evacuate the ICH resulted in a marked decrease in these indices. The RSG used alone increased PPARγ levels and decreased BBB disruption. The MIS+RSG group displayed a marked increase in PPARγ levels and a more significant decrease in BBB permeability and neurological deficit scores.
  
  
  CONCLUSIONS
  Performing MIS followed by PPARγ agonist infusion therapy is more efficacious for reducing secondary damage to the brain and improving neurological function.
authors.affiliation: a Department of Emergency , Affiliated Hospital of Guizhou Medical University , Guiyang City , Guizhou Province , China.
authors.forename: Guofeng
authors.initials: G
authors.lastname: Wu
authors.affiliation: a Department of Emergency , Affiliated Hospital of Guizhou Medical University , Guiyang City , Guizhou Province , China.
authors.forename: Junjie
authors.initials: J
authors.lastname: Wu
authors.affiliation: a Department of Emergency , Affiliated Hospital of Guizhou Medical University , Guiyang City , Guizhou Province , China.
authors.forename: Likun
authors.initials: L
authors.lastname: Wang
authors.affiliation: a Department of Emergency , Affiliated Hospital of Guizhou Medical University , Guiyang City , Guizhou Province , China.
authors.forename: Yu
authors.initials: Y
authors.lastname: Jiao
authors.affiliation: b Department of Neurology , Affiliated Huashan Hospital of Fudan University , Shanghai , China.
authors.forename: Houguang
authors.initials: H
authors.lastname: Zhou
authors.affiliation: c Department of Neurology , Affiliated Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology , Wuhan City , Hubei Province , China.
authors.forename: Zhouping
authors.initials: Z
authors.lastname: Tang
mesh_terms: D000704:Analysis of Variance; D000818:Animals; D001812:Blood-Brain Barrier / Q000187:drug effects / Q000502:physiology; D002543:Cerebral Hemorrhage / Q000150:complications / Q000188:drug therapy / Q000601:surgery; D004195:Disease Models, Animal; D005343:Fibrinolytic Agents / Q000627:therapeutic use*; D005786:Gene Expression Regulation / Q000187:drug effects / Q000502:physiology; D008297:Male; D019060:Minimally Invasive Surgical Procedures / Q000379:methods*; D009422:Nervous System Diseases / Q000188:drug therapy / Q000209:etiology / Q000601:surgery; D047495:PPAR gamma / Q000378:metabolism*; D010539:Permeability / Q000187:drug effects; D011817:Rabbits; D000077154:Rosiglitazone; D045162:Thiazolidinediones / Q000627:therapeutic use*; D015898:Tomography Scanners, X-Ray Computed
chemical_list: D005343:Fibrinolytic Agents; D047495:PPAR gamma; D045162:Thiazolidinediones; D000077154:Rosiglitazone
keywords: Blood–brain barrier; Intracerebral hemorrhage; Minimally invasive surgery; PPARγ; Rosiglitazone