丹参对脊髓损伤后伤区血流量及血液流变学指标的影响

目的 :比较应用丹参对兔脊髓损伤 (SCI)后伤区血流量及血液流变学指标的影响 ,探讨丹参对脊髓损伤的保护机制。方法 :5 8只成年日本大耳白兔 ,随机分成四组 ,A组 10只 ,作为正常组 ;B、C、D组各 16只 ,分别作对照组、地塞米松 (Dex)治疗组和丹参治疗组。比较脊髓损伤前后及应用Dex、丹参治疗后伤区血流量 (SCBF)及血液流变学指标的变化。结果 :脊髓损伤后 ,SCBF下降 ,血液粘度(ηb)、纤维蛋白原 (Fib)、细胞聚集指数 (RAI)增高。Dex对脊髓SCBF和血液流变学指标异常的改善不明显 ,而使用丹参治疗后 ,脊髓SCBF增高 ,血液流变学指标明显改善。结论 :丹参对脊髓损伤具有保护作用 ,且疗效较Dex明显 ,为临床治疗提供依据。     

碱性成纤维细胞生长因子对脊髓缺血／再灌注损伤的保护作用

目的观察碱性成纤维细胞生长因子（basic fibroblast growth factor,bFGF）对脊髓缺血／再灌注损伤的保护作用。方法建立大鼠脊髓缺血／再灌注损伤动物模型。实验分对照组、缺血／再灌注组和bFGF组。测定血浆丙二醛、肌酸磷酸激酶、谷草转氨酶和乳酸脱氢酶含量。测定脊髓标本丙二醛、内皮素、细胞线粒体钙含量和组织湿／干重比值。结果缺血／再灌注组与对照组比较,血浆和脊髓的各项生化指标显著增高（P〈0．05）;使用bFGF后,血浆及脊髓各项测定指标较缺血／再灌注组相比明显降低（P〈0．05）。结论bFGF可减轻脊髓缺血／再灌注损伤,对脊髓有保护作用。     

右美托咪定在大鼠脊髓缺血再灌注损伤中的 保护作用及机制研究

目的 探讨右美托咪定对大鼠脊髓缺血/再灌注损伤的保护作用及PI3K/Akt传导通路在其中的作用。方法 30只成年雄性大鼠随机分为假手术组、模型组和右美托咪定治疗组,每组10只。建立大鼠脊髓缺血/再灌注损伤模型,对再灌注损伤后6 h、12 h、24 h、48 h实验大鼠后肢运动功能进行评分,检测缺血脊髓前角组织中P-AKT的表达水平及神经元的凋亡指数。结果 右美托咪定可改善脊髓缺血/再灌注损伤后实验大鼠的后肢运动功能(P＜0.05);提高脊髓前角P-AKT的表达水平(P＜0.05),抑制缺血/再灌注损伤所致的脊髓神经元的凋亡(P＜0.05)。结论 右美托咪定对脊髓缺血/再灌注损伤有一定的保护作用,其机制可能与激活PI3K/Akt传导通路,从而抑制神经元的凋亡有关。     

康复护理对无骨折脱位型颈脊髓损伤患者 椎管扩大成形术后的影响

目的 探讨康复护理对无骨折脱位型颈脊髓损伤患者椎管扩大成形术后的影响。方法 选取2018年1月~6月于我院行手术的无骨折脱位型颈脊髓损伤患者60例作为研究对象,按照随机数表法分为研究组和对照组,每组30例。研究组采用康复护理进行术后护理,对照组采用常规护理。比较两组患者术后神经功能改善情况和并发症发生率。结果 研究组颈部神经功能改善的优良率为80.00%,高于对照组的60.00%,差异有统计学意义（P＜0.05）;研究组术后并发症发生率为10.00%,低于对照组的23.33%,差异有统计学意义（P＜0.05）。结论 康复护理能够促进无骨折脱位型颈脊髓损伤患者椎管扩大成形术后的神经功能恢复,减少术后并发症发病几率。     

MEK5/ERK5在大鼠脊髓损伤修复过程中表达水平动态变化及临床意义

目的 以大鼠为模型观察脊髓损伤修复过程中MEK5/ERK5(mitogen extracellular signal-regulated kinase 5/extracellular signal kinase 5)表达水平变化及临床指导意义.方法 将成年健康雄性大鼠随机分为实验组和假手术组,应用western-blotting蛋白质印迹技术和Real-Time PCR实时荧光定量检测技术分别检测脊髓损伤后1天,3天,7天,14天后MEK5、ERK5两种蛋白及其mRNA表达水平动态变化情况,通过考察P-ERK(phosphorylated extracellular signal kinase 5)表达水平考察ERK5激活情况.结果 RT-PCR显示实验组组MEK5 mRNA和ERK5 mRNA表达水平均随时间呈逐渐增加的动态变化规律,且与假手术组相比表达水平明显增加;Western blotting显示实验组MEK5表达水平随时间先增加后回落,ERK5表达水平随时间逐渐增加,P-ERK表达水平随时间增加.结论 ERK5表达水平与脊髓损伤修复过程呈正相关,ERK5的促组织细胞分裂增殖的功能可能有助于脊髓损伤加速修复.     

中医情志治疗对脊髓损伤患者正负性情绪的影响

目的:探讨中医情志治疗对改善脊髓损伤患者正性负性情绪的效果。方法:将68例脊髓损伤患者,随机分为对照组(常规康复治疗)、实验组(情志干预+常规康复治疗)各34例,采用正性负性情绪量表(PANAS),焦虑自评量表(SAS)、抑郁自评量表(SDS),于干预前及干预6个月进行测评和对照研究,并将干预前两组患者SAS、SDS评分分别与国内常模比较。结果:1两组患者干预前SAS、SDS评分均明显高于国内常模,具有显著性差异(t=6.63,7.08,9.03,12.19;P0.01);2实验组干预后SAS、SDS、负性情绪(NA)评分降低,正性情绪(PA)评分升高,与对照组比较差异有统计学意义(t=4.69,6.13,-3.86,4.27;P0.01)。结论:中医情志治疗可改善脊髓损伤患者的焦虑抑郁情绪,减轻患者负性情绪。     

坐骨神经火器性断裂伤后腰脊髓及脊神经节内微循环损伤特点

目的 :研究坐骨神经火器性断裂伤后脊髓和脊神经节内微循环的变化特点。方法 :通过 5 3式滑膛枪建立兔坐骨神经火器性断裂伤模型 ,在伤后第 1、3、7、15、3 0天取材。采用伊文思兰 (Evan’sblue ,EB)示踪、光电镜观察、组织含水量测定等方法检测脊髓、脊神经节内微循环变化特点。结果 :坐骨神经火器性断裂伤后 ,脊髓及脊神经节内微循环受到破坏 ,表现为内皮细胞变性、坏死及脱落 ,对EB的通透性明显增高 ,组织含水量增高 ,3天达高峰 ,脊神经节损伤较脊髓严重 ;伤后 3 0天腰脊髓、脊神经节内微循环的通透性仍高于正常。结论 :脊神经节及脊髓内微循环受到破坏是坐骨神经火器性断裂伤的重要特征之一 ,脊神经节损伤较脊髓严重     

The Effects of Age on the Morphometry of the Cervical Spinal Cord and Spinal Column in Adult Rats: An MRI‐Based Study

Rat models are commonly used to investigate the pathophysiological pathways and treatment outcomes after spinal cord injury (SCI). The high incidence of fall‐induced SCI in older adults has created a need for aging models of SCI in rats to investigate potential age‐related differences in SCI severity and outcomes. The aims of this study were to determine the influences of age and vertebral level on the geometries of the cervical spinal cord and spinal column in a rat model. Three young (3 months) and three aged (12 months) Fischer 344 rats were imaged in a high field (7 T) small‐animal magnetic resonance imaging system. All spinal cord geometry variables (including depth, width, and axial cross‐sectional area) and one spinal canal variable (depth) were significantly larger in the aged specimens by an average of 8.1%. There were main effects of vertebral level on all spinal cord variables and four spinal canal variables with values generally larger at C4 as compared to C6 (average increases ranged from 5.7% to 12.9% in spinal cord measures and 5.4% to 6.8% in spinal canal measures). High inter‐rater reliability between two measurers was observed with a mean intraclass correlation of 0.921 and percent difference of 0.9% across all variables measured. This study clearly demonstrates that cervical spinal cord geometry changes between the ages of 3 and 12 months in Fischer 344 rats. This information can aid in the planning and interpretation of studies that use a rat model to investigate the influence of age on cervical SCI. Anat Rec, 297:1885–1895, 2014. © 2014 Wiley Periodicals, Inc.     

Effects of Wearable Powered Exoskeletal Training on Functional Mobility,Physiological Health and Quality of Life in Non-ambulatory Spinal Cord Injury Patients

BackgroundSpinal cord injury (SCI) is a serious clinical condition that impacts a patient''s physical, psychological, and socio-economic status. The aim of this pilot study was to evaluate the effects of training with a newly developed powered wearable exoskeleton (Hyundai Medical Exoskeleton [H-MEX]) on functional mobility, physiological health, and quality of life in non-ambulatory SCI patients.MethodsParticipants received 60 minutes of walking training with a powered exoskeleton 3 times per week for 10 weeks (total 30 sessions). The 6-minute walking test (6MWT) and timed-up-and-go test (TUGT) were performed to assess ambulatory function. The physiological outcomes of interest after exoskeleton-assisted walking training were spasticity, pulmonary function, bone mineral density, colon transit time, and serum inflammatory markers. Effects of walking training on subjective outcomes were estimated by the Korean version of the Falls Efficacy Scale—International and the 36-Item Short-Form Health Survey version 2.ResultsTen participants finished 30 sessions of training and could ambulate independently. No severe adverse events were reported during the study. After training, the mean distance walked in the 6MWT (49.13 m) was significantly enhanced compared with baseline (20.65 m). The results of the TUGT also indicated a statistically significant improvement in the times required to stand up, walk 3 m and sit down. Although not statistically significant, clinically meaningful changes in some secondary physiological outcomes and/or quality of life were reported in some participants.ConclusionIn conclusion, this study demonstrated that the newly developed wearable exoskeleton, H-MEX is safe and feasible for non-ambulatory SCI patients, and may have potential to improve quality of life of patients by assisting bipedal ambulation. These results suggest that the H-MEX can be considered a beneficial device for chronic non-ambulatory SCI patients.Trial RegistrationClinicalTrials.gov Identifier: {"type":"clinical-trial","attrs":{"text":"NCT04055610","term_id":"NCT04055610"}}NCT04055610     

Transplantation of Mesenchymal Stem Cells for Acute Spinal Cord Injury in Rats: Comparative Study between Intralesional Injection and Scaffold Based Transplantation

Experimental stem cell therapy for spinal cord injury (SCI) has been extensively investigated. The selection of effective cell transplantation route is also an important issue. Although various types of scaffold have been widely tried as a carrier of stem cells to the injured spinal cord, there was little comparative study to investigate the efficacy of transplantation comparing with conventional transplantation route. A total of 48 Sprague-Dawley rats were subjected to standardized SCI, followed by transplantation of allogeneic mesenchymal stem cells (MSCs), either via intralesional injection (IL group), or via the poly (lactic-co-glycolic acid) (PLGA) scaffold (IP group) or chitosan scaffold (IC group). Engraftment and differentiation of the transplanted cells, expression of neurotrophic factors in the injured spinal cord, and functional recovery were compared with those of the control group. The mean numbers of engrafted MSCs in the IL, IP, and IC groups were 20.6 ± 0.7, 25.6 ± 1.7 and 26.7 ± 1.8 cells/high power filed (HPF), respectively. Results showed higher success rate of MSCs engraftment in the scaffold groups compared to the IL group. Expression of neuroprotective growth factors in the SCI lesions showed no significant differences between the IL, IP, and IC groups. The mean Basso, Beattie and Bresnahan locomotor scales at 6 weeks post-transplantation in the IL, IP, IC, and control groups were 7.9 ± 1.1, 7.9 ± 2.1, 8.7 ± 2.1, and 2.9 ± 1.0, respectively. The functional improvement was most excellent in the IC group. The scaffold based MSC transplantation for acute SCI presented the better cell engraftment and neuroprotective effect compared to the intralesional injection transplantation.     

Hybrid III ATD in Inverted Impacts: Influence of Impact Angle on Neck Injury Risk Assessment

The purpose of this paper is to present a protocol of inverted drop-tests using a 50th percentile Hybrid III Anthropomorphic Test Device (ATD) and investigate the influence of angle and velocity at impact on neck injury risk assessment. The tests were based on existing cadaveric experimental protocols for inverted seated positions. In this study selected ATD impact orientations were also assessed in both the sagittal and coronal planes. Twenty-six tests were performed at impact velocities from 1.4 to 3.1 m s⁻¹. The drop tests confirmed previously described behavior of the ATD in axial loading of its head/neck/thorax complex. They also showed a significant influence of the initial impact angle on neck injury criteria currently used by researchers in rollover crashworthiness tests. At 1.4 m s⁻¹, the peak upper neck axial force of 4350 N was reduced by an average 1760 ± 80 N for configurations with 30 degrees initial impact angle in any plane, compared to a reference inverted vertical configuration. The N _ij was also significantly influenced. For a given impact velocity, an out-of-both-planes initial configuration resulted in the highest combined outputs. Based on these results, similar dynamic conditions (intrusion velocity, impact duration) may result in significantly different loadings of the Hybrid III neck.     

Impact of an Online Medical Internet Site on Knowledge and Practice of Health Care Providers: A Mixed Methods Study of the Spinal Cord Injury Rehabilitation Evidence Project

BackgroundIt is not known whether ongoing access to a broad-based Internet knowledge resource can influence the practice of health care providers. We undertook a study to evaluate the impact of a Web-based knowledge resource on increasing access to evidence and facilitating best practice of health care providers.ObjectiveThe objective of this study was to evaluate (1) the impact of the Spinal Cord Injury Rehabilitation Evidence (SCIRE) project on access to information for health care providers and researchers and (2) how SCIRE influenced health care providers'' management of clients.MethodsA 4-part mixed methods evaluation was undertaken: (1) monitoring website traffic and utilization using Google Analytics, (2) online survey of users who accessed the SCIRE website, (3) online survey of targeted end-users, that is, rehabilitation health care providers known to work with spinal cord injury (SCI) clients, as well as researchers, and (4) focus groups with health care providers who had previously accessed SCIRE.ResultsThe online format allowed the content for a relatively specialized field to have far reach (eg, 26 countries and over 6500 users per month). The website survey and targeted end-user survey confirmed that health care providers, as well as researchers perceived that the website increased their access to SCI evidence. Access to SCIRE not only improved knowledge of SCI evidence but helped inform changes to the health providers’ clinical practice and improved their confidence in treating SCI clients. The SCIRE information directly influenced the health providers’ clinical decision making, in terms of choice of intervention, equipment needs, or assessment tool.ConclusionsA Web-based knowledge resource may be a relatively inexpensive method to increase access to evidence-based information, increase knowledge of the evidence, inform changes to the health providers’ practice, and influence their clinical decision making.     

Anatomical features of tibia and femur: Influence on laxity in the anterior cruciate ligament deficient knee

Background

Until now, there has been a lack of in vivo analysis of the correlation between bony morphological features and laxity values after an anterior cruciate ligament (ACL) injury.

活血通脉汤对脑缺血再灌注损伤大鼠血浆TXB2、6-keto-PGF1α的影响

目的探讨活血通脉汤对脑缺血再灌注损伤大鼠血浆血栓素B2(TXB2)、6-酮前列环素F1α(6-keto-PGF1α)的影响。方法制作脑缺血再灌注模型,70只大鼠随机平均分为活血通脉汤组、阿司匹林阳性对照组、手术组和假手术组,应用放免法分别测定缺血再灌注24、48 h血浆TXB2、6-keto-PGF1α及其比值。结果手术组大鼠脑缺血再灌注24、48h血浆TXB2水平明显高于假手术对照组(P<0.01),6-keto-PGF1α显著低于假手术对照组(P<0.01),血浆TXB2/6-keto-PGF1α比值增加(P<0.01),缺血再灌注24、48 h脑组织缺血范围显著大于假手术对照组(P<0.01)。使用活血通脉汤治疗能降低TXB2水平,升高6-keto-PGF1α水平,使血浆TXB2/6-keto-PGF1α比值保持在正常水平,减少缺血脑组织范围。结论活血通脉汤可纠正脑缺血再灌注后循环血中TXB2/6-keto-PGF1α的平衡失调及降低脑组织缺血程度,减轻脑缺血再灌注损伤。     

Contrasting genetic effects of major histocompatibility complex on ischemic peripheral nerve and spinal cord injury in female rats

We have recently shown that the major histocompatibility complex (MHC) exerts a regulatory influence on the development of neuropathic pain-like behaviors after partial sciatic nerve injury in male rats. In the present study, we assessed the role of the MHC in peripheral nerve injury-induced pain as well as central pain following spinal cord injury in female rats using the following inbred strains: Dark Agouti (DA; RT1^av1), Piebald Virol Glaxo (PVG; RT1^c) and in the MHC-congenic strain PVG–RT1^av1. In line with our previous observation in male rats, PVG–RT1^c displayed more severe allodynia compared to the strains carrying the RT1^av1 haplotype (PVG–RT1^av1 and DA–RT1^av1) following sciatic nerve injury in female rats. However, the MHC did not seem to impact the development of allodynia following spinal cord injury since the two congenic strains PVG–RT1^c and PVG–RT1^av did not differ after spinal cord injury. Interestingly, the DA–RT1^av1 strain displayed significantly more severe allodynia than both PVG strains and this difference was not explained by the extent of spinal cord injury. These results suggest that there are differences in the genetic mechanisms for neuropathic pain development following peripheral or central nervous system injury, both in regarding to the role of the MHC complex as well as non-MHC genes.     

Influence of treadmill training on motor performance and organization of exploratory behavior in Meriones unguiculatus with unilateral ischemic stroke: histological correlates in hippocampal CA1 region and the neostriatum

This study examined the effects of motor stimulation via treadmill on the behavior of male gerbils after external carotid ischemic brain lesion. The animals were assigned to five groups; ischemic with no stimulation (SIG), ischemic with stimulation (SIG 12/24/48/72h after surgery), non-ischemic with no stimulation (CC), non-ischemic with stimulation (CE) and sham, surgery without occlusion with no stimulation (SH). All the animals were tested in the open-field (OF) and rotarod (RR), 4 days after surgery in order to evaluate exploratory behaviors and motor performance. Data were submitted to one-way variance (ANOVA) and Dunnett's post hoc comparisons. SIG and SIG 12 groups showed a significant decrease in motor response (crossing) when compared to the control group (CC) (F=20.65, P<0.05) in the OF. SIG 12 group showed an increase in grooming behavior (F=23.136, P<0.05) and all ischemia groups (SIG, SIG12/24/48/72) spent less time on the RR (F=10.40, P<0.05), when compared to the control group (CC). Histological analyses show extensive lesions in the hippocampus and neostriatum for all groups with ischemia (SIG, SIG12/24/48/72), which are structures involved in the organization of motor behavior. Interestingly, the most pronounced damage was found in animals submitted to motor stimulation 12h after ischemia which can be correlated to the increased number of grooming behavior showed by them in the OF. These findings suggest that motor stimulation through treadmill training improve motor behavior after ischemia, except when it starts 12h after surgery.     

低分子肝素对缺血再灌注大鼠肾组织核因子-κB表达的影响

探讨低分子肝素对缺血再灌注大鼠肾组织核因子-κB（NF-κB）表达的影响。建立大鼠IRI模型，健康WistaI大鼠80只随机分为正常对照组、假手术组、模型未治疗组、LMWH治疗组，后两组又分别分为术后1、3、6、24h组。检测各组血清肌酐（Scr）水平及中性粒细胞（PMNs）细胞间黏附分子-1（ICAM-1）表达；通过光镜和免疫组织化学方法观察各组大鼠肾组织形态学及趋化因子NF-κB表达变化。结果表明：（1）肾缺血再灌注未治疗组造模后1h，Scr水平虽然没有明显变化，但ICAM-1、NF-κB表达增多，肾小管坏死积分值亦较假手术组明显增加（P〈0．01）；（2）缺血再灌注6h以后，两组Scr浓度明显增高（P〈0．01），但LMWH治疗组SCr、ICAM-1、NF-κB表达水平及肾小管坏死积分值均明显低于模型未治疗组（P〈0．05）；（3）肾组织中NF-κB表达与肾小管损伤积分值呈现良好的相关性（r=0．71，P〈0、01）；而NF-κB与ICAM-1间则呈现显著正相关（r=0．62，P〈0．05）。由此说明：（1）ICAM-1、NF-κB在肾缺血再灌注早期的瞬时表达，可能参与了炎症早期的白细胞迁移与浸润，与肾损伤的发生密切相关；（2）LMWH可通过减少ICAM-1及NF-κB的表达，阻抑炎症反应过程，减轻肾组织损伤。     

Influence of sodium arsenite on the genotoxicity of potassium dichromate and ethyl methanesulfonate: studies with the wing spot test in Drosophila

The wing spot test in Drosophila melanogaster was used to investigate the genotoxicity of arsenic and its effects on the action of two clearly genotoxic agents: potassium dichromate (PDC) and ethyl methanesulfonate (EMS). This assay is based on the principle that the loss of heterozygosity of the suitable recessive markers multiple wing hairs (mwh) and flare-3 (flr(3)) can lead to the formation of mutant clones of larval cells, which are then expressed as spots on the wings of adult flies. These spots can be attributed to different genotoxic events: either mitotic recombination or mutation (deletion, point mutation, and specific types of translocation). Pretreatments and chronic cotreatments were comparatively used for combined treatments. From the results obtained it is evident that sodium arsenite (SA) does not increase the frequency of any of the three categories of spots recorded (small, large, and twin spots) at the concentrations tested. The effects of SA in combination with PDC, in both cotreatments and pretreatments, indicate that SA almost suppressed the clones induced by PDC. Nevertheless, no effects of arsenic were observed with respect to the pre- and cotreatments with EMS. Thus, SA does not modify the frequencies of mutant clones induced by EMS.