人脐带间充质干细胞移植联合小剂量超短波对大鼠脊髓损伤星形胶质细胞形成的影响

目的:探讨人脐带间充质干细胞移植联合小剂量超短波治疗对大鼠脊髓损伤(SCI)星形胶质细胞形成的影响。方法:将90只SD大鼠随机分成5组:假手术组(n=6)、对照组(n=21)、小剂量超短波(ultrashort wave,USW)治疗组(n=21)、人脐带间充质细胞移植组(human umbilical cord mesenchymal stem cells,h UCMSCs)(n=21)、USW治疗+h UCMSCs移植组(n=21)。h UCMSCs移植组、USW治疗+h UCMSCs移植组在损伤后立即使用微量注射器刺破硬脊膜垂直缓慢注入5μl含细胞密度为1×106/μl的细胞悬液;USW治疗组、USW治疗+h UCMSCs移植组大鼠在SCI后1d起采用对置法接受每天1次、每次7min的小剂量USW治疗。大鼠的运动功能用Basso Beattie Bresnahan评分(BBB评分)进行评定,SCI大鼠取材后分别对组织进行纵向切片行HE染色、免疫荧光染色,检测移植后h UCMSCs细胞存活及向星形胶质细胞分化,损伤区域附近内源性干细胞向星形胶质细胞分化及SCI后4周时纤维化形成的情况。结果:(1)SCI大鼠造模后1—2周内损伤周围组织附近,由内源性干细胞分化的星型胶质细胞形成胶质屏障,发挥保护作用。(2)SCI14d,移入h UCMSCs细胞位于损伤区域内,部分移入的干细胞向星形胶质细胞去分化。损伤周围的星形胶质细胞多由内源性干细胞分化而来,人源干细胞特异性标记物MAB1281在此区域不表达。(3)USW+h UCMSCs移植组,USW协同h UCMSCs通过旁分泌作用改善损伤区域微环境,从而促进更多内源性干细胞聚集损伤处分化为星形胶质细胞,并阻碍坏死物质及炎症扩散(P0.01 vs对照组、小剂量USW组、h UCMSCs移植组)。(4)USW+h UCMSCs移植抑制SCI后巨噬细胞等细胞产生的不利于轴突生长的纤维瘢痕,h UCMSCs移植在过程中扮演重要的作用(P0.01 vs对照组、小剂量USW组)。(5)USW+h UCMSCs移植更好促进SCI后大鼠运动恢复(P0.01vs对照组、小剂量USW组、h UCMSCs移植组)。结论:小剂量USW治疗协同急性期人脐带间充质干细胞移植通过旁分泌作用治疗脊髓损伤大鼠,使损伤周围聚集更多内源性干细胞并分化为星形胶质细胞形成屏障抑制坏死物质与炎症扩散,从而促进运动功能恢复。     

自制穿衣训练器在脑卒中手指精细功能恢复中的应用

目的探讨自制穿衣训练器在脑卒中手指精细功能恢复中的应用效果。方法将80例脑卒中手指精细功能障碍患者随机分为对照组与干预组各40例。对照组采用常规治疗室内康复训练方法(运动疗法、作业疗法、物理疗法等);干预组在对照组基础上使用自制穿衣技能训练器进行训练。比较两组患者干预前及干预4周后手功能Fugl-Meyer运动功能评定(手指部分、协调能力与速度)、简易上肢机能检查、改良Barthel指数和满意度。结果干预组患者的Fugl-Meyer运动功能评分(手指部分、协调能力与速度)、简易上肢机能检查得分、改良Barthel指数能力评分及满意度显著高于对照组(均P0.01)。结论使用穿衣技能训练器的脑卒中患者能够改善手指精细运动功能与协调能力,提高患者日常活动能力,从而提高患者满意度。     

骨髓间充质干细胞联合超短波对大鼠脊髓损伤后早期AQP-4和GAP-43的影响

目的:探讨骨髓间充质干细胞(bone marrow stromal cells,BMSCs)联合超短波(ultrashort wave,USW)治疗对大鼠脊髓损伤(spinal cord injury,SCI)后功能恢复、水通道蛋白4(aquaporin-4,AQP-4)和生长相关蛋白43(growth associated protein 43,GAP-43)表达的影响。方法:30只雌性SD大鼠,随机分为5组:sham组、control组、USW组、BMSCs组、USW+BMSCs联合治疗组,采用改良Allen's法制作大鼠SCI模型,术后1d、1周、2周、3周、4周用BBB评分法评价后肢运动功能的恢复情况。术后4周取材行AQP-4和GAP-43的免疫组化染色,并行阳性细胞计数,进行比较分析。结果:术后4周BBB评分各组比较有显著性意义,USW组、BMSCs组、USW+BMSCs组与control组比较P0.001、P0.05、P0.001。USW组、BMSCs组、USW+BMSCs组AQP-4表达水平明显低于control组,有显著性意义(P0.001、P0.05、P0.001)。GAP-43的表达上,BMSCs组、USW+BMSCs组明显多于control组及USW组,分别比较均有显著性意义(P0.001)。结论:单纯USW治疗即可明显改善SCI后神经功能;单纯USW治疗及BMSCs移植治疗均可减轻水肿,以USW作用最为显著;而在促进轴突再生方面,BMSCs组意义更为明显。二者联合治疗在促进功能恢复上并未显现出协同作用,但是在减轻水肿和促进轴突生长方面有协同作用。     

超短波电场对金属周围升温变化的影响

Objective To study the temperature changes around metal in ultrashort wave electric-field and it's influence factors.Methods Medical ultrashort wave therapeutic instrument was used and output switen was set at the 1 st grade.After tuning, one end of metal object was placed into 0.2ml water contained in a plastic tube ( with a length of 2cm and diameter of 2mm).Temperature changes of water around metal in different conditions were measured by digital thermometer.In experiments, several different conditions were studied, such as the length of metal, the vertical distance between metal and electrodes, the location of metal ultrashort electric field and the action duration of ultrashort wave.Results Under the same condition, when the prolate axis of metal paralleled to electrodes and the real lengths of metal outside of electric field were 10cm, 20cm, 30cm, 50cm, 70cm, 90cm, water temperatures around metal rose 4.37, 8.30,18.00, 20.64, 32.92 and 38.96℃, respectively; when the prolate axis of metal paralleled to electrodes and the verticaldistances between metal and one electrode were 1.5, 3.0, 4.5 and 6.Ocm, water temperatures around metal rose 66.03,49.37, 14.80 and 0.87℃, respectively; when the prolate axis of metal was vertical to electrodes and the distanees between one end of metal and electrodes were 5, 9 and 15cm, water temperature around metal rose 56.10,26.64 and11.07℃, respectively; when the vertical distances between metal and the electrode edge were 0,5,10,15cm, water temperatures around metal rose 25.32 , 10.26 ,2.88 and 1.53℃, respectively;when the lengths of metal with a fixed-length,the included real length in electric field, were 20, 10 and 0cm, water temperatures around metal rose 2.84 , 4.04 and7.30℃ , respectively.Under the same condition, the action duration of ultrashort wave were changed to be 5 and 10min,water temperatures around metal rose 24.90 and 39.07℃, respectively.Conclusion This study show that the water temperature rising around metal will be relatively small when:( 1 ) the real length of metal is short ; ( 2 ) the prolate axis of metal parallels to electrodes and is placed in the middle area between two electrodes;(3)the distance between two electrodes increase and the action duration is short;(4)the overall length of metal is contained in electric field between electrodes,or the metal is kept away from electrodes edges.     

超短波电场对金属周围升温变化的影响

目的 探讨超短波电场对金属周围升温变化的影响因素.方法 采用医用超短波治疗仪1档,调谐,输出80 mA,取0.2 ml水作为载体,金属物一端深入水中,改变金属物长度、金属物与电极板间垂直距离、金属物在电磁场中的摆放位置以及超短波的作用时间,采用数字电偶温度表测量不同治疗条件前、后水温的变化.结果 相同条件下,金属线长轴平行于电极板,金属物场外实际长度为10 cm、20 cm、30 cm、50 cm、70 cm、90 cm时,其周围升温分别为4.37℃、8.30℃、18.00℃、20.64℃、32.92℃、38.96℃;金属物长轴平行于电极板,金属线与一侧电极板间垂直间距分别为1.5 cm、3.0 cm、4.5 cm、6.0 cm时,金属周围升温分别为66.03℃、49.37℃、14.80℃、0.87℃;如果金属物长轴垂直于电极板,金属一端与极板间距离为5 cm、9 cm、15 cm时,金属周围升温分别为56.10℃、26.64℃、11.07℃;金属与电场边缘的垂直间距为0 cm、5 cm、10 cm、15 cm时,金属周围升温分别为25.32℃、10.26℃、2.88℃、1.53℃;固定长度的金属物,涵盖入电场内的实际长度分别为20 cm、10 cm、0 cm时,金属周围升温分别为2.84℃、4.04℃、7.30℃;同等条件下,改变超短波作用时间为5 min、10 min时,金属周围升温分别为24.90℃、39.07℃.结论 当金属物长轴平行置于电极板正中间位置,且金属完全置于电场内并远离极板边缘时,通过减短金属物的长度、两极板间的距离以及超短波的作用时间,可降低金属物周围的升温幅度.

Abstract：

Objective To study the temperature changes around metal in ultrashort wave electric-field and it's influence factors.Methods Medical ultrashort wave therapeutic instrument was used and output switen was set at the 1 st grade.After tuning, one end of metal object was placed into 0.2ml water contained in a plastic tube ( with a length of 2cm and diameter of 2mm).Temperature changes of water around metal in different conditions were measured by digital thermometer.In experiments, several different conditions were studied, such as the length of metal, the vertical distance between metal and electrodes, the location of metal ultrashort electric field and the action duration of ultrashort wave.Results Under the same condition, when the prolate axis of metal paralleled to electrodes and the real lengths of metal outside of electric field were 10cm, 20cm, 30cm, 50cm, 70cm, 90cm, water temperatures around metal rose 4.37, 8.30,18.00, 20.64, 32.92 and 38.96℃, respectively; when the prolate axis of metal paralleled to electrodes and the verticaldistances between metal and one electrode were 1.5, 3.0, 4.5 and 6.Ocm, water temperatures around metal rose 66.03,49.37, 14.80 and 0.87℃, respectively; when the prolate axis of metal was vertical to electrodes and the distanees between one end of metal and electrodes were 5, 9 and 15cm, water temperature around metal rose 56.10,26.64 and11.07℃, respectively; when the vertical distances between metal and the electrode edge were 0,5,10,15cm, water temperatures around metal rose 25.32 , 10.26 ,2.88 and 1.53℃, respectively;when the lengths of metal with a fixed-length,the included real length in electric field, were 20, 10 and 0cm, water temperatures around metal rose 2.84 , 4.04 and7.30℃ , respectively.Under the same condition, the action duration of ultrashort wave were changed to be 5 and 10min,water temperatures around metal rose 24.90 and 39.07℃, respectively.Conclusion This study show that the water temperature rising around metal will be relatively small when:( 1 ) the real length of metal is short ; ( 2 ) the prolate axis of metal parallels to electrodes and is placed in the middle area between two electrodes;(3)the distance between two electrodes increase and the action duration is short;(4)the overall length of metal is contained in electric field between electrodes,or the metal is kept away from electrodes edges.     

小剂量超短波治疗对大鼠脊髓损伤后VEGF和BDNF的影响

目的:观察小剂量超短波治疗对大鼠脊髓损伤后不同时间点的功能恢复、血管内皮生长因子(VEGF)及脑源性神经营养因子(BDNF)表达的影响,并探讨其作用机制。方法:54只SD大鼠,被随机分成3组:假手术组,暴露硬脊膜后,不予打击,直接缝合;对照组,采用Allen打击法建立大鼠脊髓损伤(spinal cord injury,SCI)模型,不给予任何治疗;超短波组,在SCI后第2天开始给予受损部位小剂量超短波治疗,每日1次,每次7min,治疗至取材前。于造模后第2天,1周、2周、3周、4周采用BBB评分评定大鼠的后肢运动功能,免疫组织化学染色检测VEGF、BDNF的表达,应用图像分析系统进行半定量分析。结果:BBB评分显示随着损伤时间的延长,脊髓损伤各组大鼠运动功能逐渐改善,与对照组相比,超短波组自术后1周起运动功能明显改善(P0.01)。免疫组化染色结果显示术后1周起,对照组、超短波组的VEGF、BDNF阳性表达较假手术组明显增加(P0.001),2周时两组的VEGF、BDNF表达均达高峰后逐渐下降,超短波组高峰持续时间均延长。4个时间点超短波组的VEGF表达较对照组明显增加(P0.01,P0.05,P0.01,P0.001);1周、4周超短波组的BDNF表达较对照组明显增加(P0.01,P0.05)。结论:脊髓损伤后超短波治疗可以增加VEGF的表达,改善组织血液循环,延长BDNF蛋白高峰持续时间,促进神经功能恢复。     

骨髓间充质干细胞移植对脊髓损伤后轴突再生及Nogo-A蛋白表达的影响

正脊髓损伤(spinal cord injury,SCI)可导致患者损伤平面以下运动、感觉、反射及二便功能障碍,给家庭及社会造成严重的负担,目前尚无确切治疗方法。随着干细胞科学的飞速发展,干细胞移植有望成为治疗SCI的一种全新手段~([1])。但干细胞移植后对轴突生长的影响研究较少,而轴突再生对SCI后神经功能恢复起着至关重要的作用。现对骨髓间充质干细胞(bone marrow mesenchymal cells,BMSCs)移植治疗对轴突再生及Nogo-A蛋白表达的影响进行综述,探讨BMSCs移植治疗对促     

超短波电场对金属周围升温变化的影响

Objective To study the temperature changes around metal in ultrashort wave electric-field and it's influence factors.Methods Medical ultrashort wave therapeutic instrument was used and output switen was set at the 1 st grade.After tuning, one end of metal object was placed into 0.2ml water contained in a plastic tube ( with a length of 2cm and diameter of 2mm).Temperature changes of water around metal in different conditions were measured by digital thermometer.In experiments, several different conditions were studied, such as the length of metal, the vertical distance between metal and electrodes, the location of metal ultrashort electric field and the action duration of ultrashort wave.Results Under the same condition, when the prolate axis of metal paralleled to electrodes and the real lengths of metal outside of electric field were 10cm, 20cm, 30cm, 50cm, 70cm, 90cm, water temperatures around metal rose 4.37, 8.30,18.00, 20.64, 32.92 and 38.96℃, respectively; when the prolate axis of metal paralleled to electrodes and the verticaldistances between metal and one electrode were 1.5, 3.0, 4.5 and 6.Ocm, water temperatures around metal rose 66.03,49.37, 14.80 and 0.87℃, respectively; when the prolate axis of metal was vertical to electrodes and the distanees between one end of metal and electrodes were 5, 9 and 15cm, water temperature around metal rose 56.10,26.64 and11.07℃, respectively; when the vertical distances between metal and the electrode edge were 0,5,10,15cm, water temperatures around metal rose 25.32 , 10.26 ,2.88 and 1.53℃, respectively;when the lengths of metal with a fixed-length,the included real length in electric field, were 20, 10 and 0cm, water temperatures around metal rose 2.84 , 4.04 and7.30℃ , respectively.Under the same condition, the action duration of ultrashort wave were changed to be 5 and 10min,water temperatures around metal rose 24.90 and 39.07℃, respectively.Conclusion This study show that the water temperature rising around metal will be relatively small when:( 1 ) the real length of metal is short ; ( 2 ) the prolate axis of metal parallels to electrodes and is placed in the middle area between two electrodes;(3)the distance between two electrodes increase and the action duration is short;(4)the overall length of metal is contained in electric field between electrodes,or the metal is kept away from electrodes edges.     

经颅磁刺激联合骨髓间充质干细胞移植治疗对脊髓损伤大鼠功能恢复的作用机制

目的:观察经颅磁刺激(TMS)联合骨髓间充质干细胞(BMSCs)治疗对脊髓损伤(SCI)大鼠运动功能的影响,初步探讨其作用机制.方法:8周龄清洁级SD大鼠60只,随机分成对照组、模型组、BMSCs组、TMS组、TMS+ BMSCs组,每组12只,采用改良Allen's法制作大鼠SCI模型.SCI后1d、14d、28d分...     

早期跑台训练联合超短波治疗对脊髓损伤大鼠功能恢复的影响

目的 观察早期跑台训练联合超短波治疗对大鼠脊髓损伤（SCI）后4周BBB评分、损伤部位水通道蛋白-4（AQP-4）和胶质纤维酸性蛋白(GFAP)表达的影响,探讨两种方法单独应用及联合应用对SCI的疗效及作用机制。 方法 选取50只雌性SD大鼠,采用改良Allen′s法制作大鼠SCI模型,造模成功（40只）后按照随机数字表法将其分为假手术组、对照组、超短波组、跑台组和联合组,每组8只。术后4周,用BBB评分法评价大鼠后肢运动功能的恢复情况。术后4周取材,SCI部位行GFAP和AQP-4免疫组化染色,测定蛋白表达的积分光密度值（IOD）,进行比较分析。 结果 假手术组BBB评分为21分。余4组术后1 d的BBB评分为0～1分,随着时间延长,评分逐渐增加,除假手术组外,余4组术后4周的BBB评分显著增高（P<0.05）。与对照组同时间点比较,跑台组、联合组大鼠的BBB评分显著较高（P<0.05）。与超短波组同时间点比较,跑台组术后4周［（12.88±3.04）分］,联合组术后2周［（10.12±1.13）分］、3周［（12.38±1.19）分］及4周［（14.50±1.31）分］的BBB评分较高（P<0.05）。SCI术后4周,超短波组、跑台组及联合组AQP-4 IOD均较对照组低（P<0.05）,联合组AQP-4 IOD较超短波组低（P<0.05）。SCI后4周,超短波组、跑台组、联合组GFAP IOD均较对照组低（P<0.05）。与超短波组比较,联合组GFAP IOD较低（P<0.05）。与跑台组比较,联合组GFAP较低（P<0.05）。 结论 跑台训练、超短波治疗均对大鼠SCI后的运动功能恢复有积极作用,其治疗机制可能与减轻损伤部位的AQP-4和GFAP表达有关,且联合应用的疗效更为优异。