To observe the mechanism of hypoxia-inducible factor-1α（HIF-1α）/vascular endothelial growth factor（VEGF）/Notch signaling pathway regulated by the secretion of exosome miR-210 in ischemic stroke rats.

SD rats were randomly divided into sham operation group，model group and electroacupuncture group，with 6 rats in each group. In the later stage experiment，SD rats were randomly divided into sham operation group，model group，exosome group（plasma exosome extracted after injection of electroacupuncture after modeling）and miR-210siRNA group（plasma exosome and miR-210siRNA extracted after injection of electroacupuncture after modeling）. HIF-1αinhibitor group（plasma exosomes and HIF-1αinhibitor group extracted after electroacupuncture treatment after modeling），20 in each group. The modified middle cerebral artery occlusion（MCAO）rat model was established in the preliminary experiment，and was reperfused after ischemia for 1 h. The electroacupuncture group was treated with electroacupuncture，and“Shuigou（DU26）”and“Baihui（DU20）”were selected for 30 min for a total of 3 days. The plasma exosomes of the rats in the electroacupuncture group were extracted for injection in the later experimental exosome group，miR-210siRNA group and HIIF-1αinhibitor group. After the experiment was completed，the samples were collected. The nerve function of rats was evaluated by Longa nerve function deficit score before and after the experiment. The concentration of exosomes was measured by BCA and the morphology and size of exosomes were observed by transmission electron microscopy. The expressions of exosome signature proteins CD63，CD9 and CD81 were detected by Western blot. HE staining was used to observe the pathological morphology of cerebral ischemic tissue in rats. The expressions of miR-210mRNA，CD34，HIF-1α，VEGF and Notch mRNA in the exosomes of rats in the early experimental period and those in the striatal brain of rats in the late experimental period were detected by real-time fluorescence quantitative PCR.

Compared with those of the sham operation group，Longa nerve function scores in the model group were higher（P<0.001）. Compared with that of the model group，the Longa nerve function score of rats in the electroacupuncture group was lower（P<0.05）. Compared with that in the sham operation group，the exosome concentration in the model group and the electroacupuncture group was higher（P<0.001），and the presence of exosome signature proteins CD63，CD9 and CD81 was true，that is，there were exosomes in the serum extracted by electroacupuncture in the previous experiment. In the later experiment，compared with that of the model group，the percentage of cerebral infarction volume in the exosome group，miR-210siRNA group and HIF-1αinhibitor group decreased（P<0.001）and the neuronal swelling，nucleus atrophy and chromatin staining were improved in the exosome group. Expressions of miR-210mRNA，CD34，HIF-1α，VEGF and Notch mRNA were increased in exosome group，miR-210siRNA group and HIF-1αinhibitor group（P<0.05）. Compared with that of the exosome group，the percentage of cerebral infarction volume of rats in miR-210siRNA group and HIF-1αinhibitor group was increased（P<0.001）and the pathological damage of brain tissue of rats in both miR-210siRNA group and HIF-1αinhibitor group was increased. And compared with those in the miR-210siRNA group，the arrangement of nerve cells was more disordered，the number of dense mass was more and the nucleus wrinkled was more serious in the HIF-1αinhibitor group. The expressions of miR-210mRNA，CD34，HIF-1α，VEGF and Notch mRNA were decreased in miR-210siRNA group and HIF-1αinhibitor group（P<0.05）.

Electroacupuncture can alleviate nerve function injury in rats，promote the production of exosome miR-210，regulate HIF-1α/VEGF/Notch signaling pathway，promote angiogenesis after cerebral ischemia，and then alleviate cerebral ischemia reperfusion injury.