大鼠脊髓压迫损伤后COX-2基因和蛋白的表达

目的观察大鼠脊髓压迫损伤后COX-2mRNA和蛋白在脊髓组织内表达的时间特征,以及COX-2的空间分布特点。方法以压迫装置致脊髓损伤后,在伤后不同时间点(30min、3h、6h、24h、72h、1w)分别应用RT-PCR、Western blotting、免疫组化技术检测COX-2mRNA和蛋白表达和分布。结果RT-PCR和Western blotting显示,COX-2mRNA和蛋白伤后30min表达开始增加,于伤后6h达到峰值,伤后1w表达接近基础水平。免疫组化提示,COX-2蛋白在假手术组表达仅见于脊髓血管内皮细胞,伤后COX-2蛋白表达见于损伤区附近脊髓灰质内的神经元和血管内皮细胞,损伤中心部位COX-2免疫阳性细胞少见。结论脊髓压迫损伤早期可快速诱导COX-2基因的表达上调和蛋白的合成,伤后COX-2蛋白分布发生变化,主要位于脊髓神经元和血管内皮细胞。     

Combined Muscle Motor and Somatosensory Evoked Potentials for Intramedullary Spinal Cord Tumour Surgery

Purpose

To evaluate whether intraoperative neurophysiologic monitoring (IONM) with combined muscle motor evoked potentials (mMEPs) and somatosensory evoked potentials is useful for more aggressive and safe resection in intramedullary spinal cord tumour (IMSCT) surgery.

Materials and Methods

We reviewed data from consecutive patients who underwent surgery for IMSCT between 1998 and April 2012. The patients were divided into two groups based on whether or not IONM was applied. In the monitored group, the procedures were performed under IONM using 75% muscle amplitude decline weaning criteria. The control group was comprised of patients who underwent IMSCT surgery without IONM. The primary outcome was the rate of gross total excision of the tumour on magnetic resonance imaging at one week after surgery. The secondary outcome was the neurologic outcome based on the McCormick Grade scale.

Results

The two groups had similar demographics. The total gross removal tended to increase when intraoperative neurophysiologic monitoring was used, but this tendency did not reach statistical significance (76% versus 58%; univariate analysis, p=0.049; multivariate regression model, p=0.119). The serial McCormick scale score was similar between the two groups (based on repeated measure ANOVA).

Conclusion

Our study evaluated combined IONM of trans-cranial electrical (Tce)-mMEPs and SEPs for IMSCT. During IMSCT surgery, combined Tce-mMEPs and SEPs using 75% muscle amplitude weaning criteria did not result in significant improvement in the rate of gross total excision of the tumour or neurologic outcome.     

颈髓肿瘤的诊疗特点

目的:探讨颈髓肿瘤的诊疗特点。方法:回顾分析我院35例颈髓肿瘤手术病人。结果:颈髓肿瘤因其位于颅颈交界,临床表现呈多样性,易被误诊及致术后并发症。结论:了解颈髓肿瘤的诊疗特点可避免临床误诊,减少颈髓、臂丛神经及脑的手术性创伤及继发损害从而防止术后并发症;操作轻柔,不损伤脊髓供血血管,避免脊髓牵拉损伤,是手术成功的关键。     

大鼠脊髓损伤及继发损伤时脊髓诱发电位与运动诱发电位的变化

本文采用改良Ａｌｌｅｎ’ｓ法，分别以５０ｇ／ｃｍ和１００ｇ／ｃｍ打击大鼠Ｔ１３～Ｌ１脊髓，造成不同程度的脊髓损伤，分别观察伤后２４小时内的ＳｐＥＰ和ＣＭＥＰ的变化，以了解不同程度损伤对ＳｐＥＰ和ＣＭＥＰ的影响及ＳｐＥＰ、ＣＭＥＰ的变化与脊髓继发性损伤发展过程的关系。结果表明：①两种不同程度的脊髓损伤均可造成大鼠脊髓ＳｐＥＰ，ＣＭＥＰ的明显变化，尤以ＳｐＥＰ变化明显。损伤越重，电位改变越明显．②在脊髓损伤后１～２４小时内，伤后１０分钟ＳｐＥＰ，ＣＭＥＰ波幅却有明显降低，４～８小时进一步降低。两次降低有明显差异。ＳｐＥＰ峰潜伏时延长，以４～８小时显著。表明原发损伤后在受损部位存在继发性损伤，提示阻止继发损伤的时间应早于伤后４小时，并尽可能提前。     

Chitosan/TPP-Hyaluronic Acid Nanoparticles: A New Vehicle for Gene Delivery to the Spinal Cord

Abstract

Gene delivery offers therapeutic promise for the treatment of neurological diseases and spinal cord injury. Several studies have offered viral vectors as vehicles to deliver therapeutic agents, yet their toxicity and immunogenicity, along with the cost of their large-scale formulation, limits their clinical use. As such, non-viral vectors are attractive in that they offer improved safety profiles compared to viruses. Poly(ethylene imine) (PEI) is one of the most extensively studied non-viral vectors, but its clinical value is limited y its cytotoxicity. Recently, chitosan/DNA complex nanoparticles have een considered as a vector for gene delivery. Here, we demonstrate that DNA nanoparticles made of hyaluronic acid (HA) and chitosan have low cytotoxicity and induce high transgene expression in neural stem cells and organotypic spinal cord slice tissue. Chitosan-TPP/HA nanoparticles were significantly less cytotoxic than PEI at various concentrations. Additionally, chitosan-TPP/HA nanoparticles with pDNA induced higher transgene expression in vitro for a longer duration than PEI in neural stem cells. These results suggest chitosan-TPP/HA nanoparticles may have the potential to serve as an option for gene delivery to the spinal cord.     

外加电场对实验性大鼠脊髓损伤作用的研究

目的:探讨脊髓损伤后外加电场(electric fields,EF)对脊髓血流量(spinal cord blod flow,SCBF)及神经功能的影响。方法:Wistar大鼠20只,随机分为对照组(CON组)和EF治疗组(EF组)。Allen's打击法50 gcm(5 g×10 m)致伤大鼠L1～L2段脊髓,给予EF治疗,于伤前、伤后即刻、1、3、6、24 h分别记录T12段脊髓血流量、脊髓感觉诱发电位。术后7、14天行联合行为评分(CBS)。结果:与盐水对照组比较,应用EF后,大鼠SCBF、SEP明显优于CON组(P<0.05)。结论:EF能有效改善损伤早期脊髓微循环,保护脊髓神经功能。     

Initiation of Locomotor Activity in Spinal Cats by Epidural Stimulation of the Spinal Cord

Acute and chronic experiments on lower spinal (T10–T12) cats were performed to investigate the effects of epidural stimulation of the dorsal surface of the spinal cord on the initiation of locomotor activity. A zone located at the border between segments L4 and L5 was identified, stimulation of which induces locomotor activity. The parameters of epidural stimulation of the spinal cord effective in activating the stepping movement generator were identified. Epidural stimulation leading to the initiation of movement activity was shown to depend on intracentral and peripheral mechanisms activating the segmental, intersegmental and propriospinal reflex systems of the spinal cord. A leading role was demonstrated for the propriospinal system of the dorsolateral funiculi in activating the generators of stepping movements in epidural stimulation of the spinal cord.     

Morphofunctional Changes in Spinal Cord Neurons After Epidural Lidocaine

Morphofunctional and histoenzymological changes in spinal cord neurons of mongrel dogs were studied after epidural administration of isobaric 2% lidocaine solution. Control animals received epidural 0.9% sodium chloride. The results obtained from these studies provide evidence for the absence of pathological structural-metabolic changes in nerve tissue after treatment with lidocaine. The occurrence of certain morphofunctional rearrangements in spinal cord neurons were typical of animals of both the experimental and control groups. The changes recorded varied within the limits of physiological variation and provided evidence predominantly of the functional response of these nerve tissue structures to epidural injections of both sodium chloride and lidocaine.     

Spinal Cord Neuronal Pathology in Multiple Sclerosis

The objective of this study was to assess neuronal pathology in the spinal cord in multiple sclerosis (MS), both within myelinated and demyelinated tissue. Autopsy material was obtained from 38 MS cases and 21 controls. Transverse sections were taken from three spinal cord levels and stained using Luxol Fast Blue/Cresyl Violet and myelin protein immunohistochemistry. Measurements of neuronal number and size were made for all neurons within the anterior horns of the gray matter. Neurons were classified as motoneurons or interneurons according to size criteria. In comparison with controls, both motoneuron and interneuron number were reduced in MS cases at the upper cervical (interneuron P  = 0.0549; motoneuron P  = 0.0073) and upper thoracic (interneuron P  = 0.0507; motoneuron P  = 0.0144), but not the lumbar level. Interneuron cross-sectional area was reduced in MS cases at all levels (upper cervical, P  = 0.0000; upper thoracic, P  = 0.0002; lumbar, P  = 0.0337). Neuronal loss appears to be predominantly related to local gray matter plaques, whereas interneuron atrophy occurs in both myelinated and demyelinated areas.     

Bioelectric Activity of Spinal Cord in Patients with Vertebrospinal Pathologies

A method for functional evaluation of spinal cord conducting systems in patients with vertebrospinal diseases is proposed. The method is based on the analysis of changes in electrospinoneurogram recorded with epidural electrodes below the injury during an attempt at voluntary activation of foot muscles. The degree of changes in electrospinoneurogram frequency during voluntary command addressed to motoneurons of the lumbar enlargement reflect the state of descending spinal systems.     

人胎儿脊髓星形胶质细胞形态及分布

目的　观察星形胶质细胞在胎儿脊髓不同发育阶段形态和分布的变化。方法　在引产 19例胎儿脊髓 ,多克隆抗体GFAP ,应用SP免疫组织化学染色和图像分析。结果　星形胶质细胞在中央管、毛细血管周围密度大 ,染色深 ,环绕血管呈辐射状排列。 16W时已有少突起GFAP阳性细胞出现 ,胞体小 ,分布于脊髓白质的周边部 ,细长突起指向中央管方向 ;突起较短的细胞分布于脊髓前后正中沟两侧和中央管周围 ;灰质内阳性细胞主分布于背侧部的两侧 ,突起多而短 ,细胞核大。 2 4W时 ,多突起细胞增多 ,GFAP阳性细胞染色强度、细胞密度接近出生时水平。结论　人胎儿脊髓星形胶质细胞 16W时最多 ,2 4W时逐渐减少至出生时水平     

Therapeutic Effect of Curcumin and Methylprednisolone in the Rat Spinal Cord Injury

In addition to imperiling an individual's daily life, spinal cord injury (SCI), a catastrophic medical damage, can permanently impair an individual's body function. Methylprednisolone (MP), a medically accepted therapeutic drug for SCI, is highly controversial for the lack of consensus on its true therapeutic effect. In recent years, curcumin has served as a potential and novel therapeutic drug in SCI. Our study was intended to investigate the precise effect of MP and curcumin in SCI. We examined the function of MP and curcumin in a SCI model rat, both in vivo and in vitro, and found that there was a momentous improvement in Basso‐Beattie‐Bresnahan scores in the MP‐treated group when compared with Cur‐treated group within 14 days. Results obtained from the histological, immunohistochemistry and ultrastructural examinations evidenced the curative effect of MP was better than curcumin before Day 14. Nonetheless, there was a significant variation in the treatment effect between the MP‐treated and Cur‐treated groups after 14 days. The curcumin's effectiveness was more obvious than MP after 14 days following SCI. As such, we surmise that curcumin has a better therapeutic potential than MP with a prolong treatment time in the wake of SCI. Anat Rec, 301:686–696, 2018. © 2017 Wiley Periodicals, Inc.     

X线照射对受损脊髓轴索和髓鞘的作用

目的 :探讨 X线对受损脊髓髓鞘和轴索作用。方法 :实验组行脊髓胸腰段半横断 ,术后次日行 X线照射 ,剂量是 35 Gy。对照组行同样手术 ,但不照射。2 4周时行 SP(streptavidin peroxidase conjugataed method,链霉素抗生素蛋白 -过氧化酶连接法 )免疫组化染色和超微结构观察。结果 :实验组脊髓损伤平面上、下段 MBP(myelin basicprotein,髓磷脂基蛋白 )阳性髓鞘数量明显低于对照组 ;实验组损伤平面上段 NF(neuron filament,神经纤维丝 )阳性神经纤维数量与对照组无明显差别 ,实验组损伤平面下段 NF阳性神经纤维数量高于对照组。电镜下实验组脊髓出现明显脱髓鞘改变 ,损伤平面下段可见新生的细小神经纤维束。结论 :35 Gy的 X线照射可以使脊髓出现较多的脱髓鞘变化 ,有促进损伤平面下段 NF阳性纤维增多的作用     

Arterial Blood Supply to the Spinal Cord in Animal Models of Spinal Cord Injury. A Review

Animal models are used to examine the results of experimental spinal cord injury. Alterations in spinal cord blood supply caused by complex spinal cord injuries contribute significantly to the diversity and severity of the spinal cord damage, particularly ischemic changes. However, the literature has not completely clarified our knowledge of anatomy of the complex three‐dimensional arterial system of the spinal cord in experimental animals, which can impede the translation of experimental results to human clinical applications. As the literary sources dealing with the spinal cord arterial blood supply in experimental animals are limited and scattered, the authors performed a review of the anatomy of the arterial blood supply to the spinal cord in several experimental animals, including pigs, dogs, cats, rabbits, guinea pigs, rats, and mice and created a coherent format discussing the interspecies differences. This provides researchers with a valuable tool for the selection of the most suitable animal model for their experiments in the study of spinal cord ischemia and provides clinicians with a basis for the appropriate translation of research work to their clinical applications. Anat Rec, 300:2091–2106, 2017. © 2017 Wiley Periodicals, Inc.     

New Minimally Invasive Model of Spinal Cord Ischemia in Rats

We developed a new minimally invasive model of spinal cord ischemia in rats: intravascular occlusion of the abdominal aorta and its branches. This model can be used on small laboratory animals and allows qualitatively and quantitatively evaluating the morphofunctional state of the nervous system during spinal cord ischemia by clinical manifestations and histological changes. Selective intravascular occlusion determines minimal invasiveness and adequacy of the proposed model to in vivo pathological processes. This model of spinal cord ischemia can be used in experimental pharmacology for evaluation of neuroprotective activity of various drugs and bioactive substances.     

颈脊髓损伤致尿崩症、低钠血症的临床分析

目的探讨颈脊髓损伤致尿崩症、低钠血症的机理及临床治疗经验。方法对2003年5月至2007年8月收治的6例颈脊髓损伤并发尿崩症、低钠血症患者的临床资料进行回顾分析。结果5例经治疗后尿崩症、低钠血症得到明显缓解，1例自动放弃治疗。结论颈脊髓损伤并发尿崩症、低钠血症的原因是多方面的，治疗应限制水摄入、补充钠盐。     

顺铂联合放射治疗对大鼠脊髓损伤影响的观察

目的探讨顺铂(c isp latin,DDP)联合放射治疗对大鼠脊髓损伤的影响。方法40只W istar大鼠随机分为5组,即空白组、单纯化疗组、单纯放射组、先化后放组和先放后化组。单化组单次腹腔注射顺铂5 mg/kg。单放组和放化联合组采用瓦里安2300 C/D直线加速器6M eV电子线照射大鼠胸段脊髓,照射野为2 cm×4 cm,5Gy/次,隔日1次,总剂量为40 Gy。联合组顺铂与照射的间隔时间为3天。照射结束后5个月,行活体灌注固定,取材,光镜和电镜观察脊髓的形态学变化。结果光镜下,CT组灰质未见改变,白质内部分有髓神经纤维排列紊乱,部分髓鞘板层结构松解、扭曲。RT组灰质未见改变,白质出现部分水肿坏死,髓鞘板层模糊不清。CT+RT组脊髓灰质、白质改变明显,其中CT+放疗组的灰质内可见到明显的神经元核变成细长形,尼氏体数量减少,白质出现大片坏死。电镜下,CT组髓鞘结构出现轻度变化,表现为部分髓鞘的板层结构松解、扭曲。RT组脊髓损伤表现为板层结构水肿、粘连,模糊不清。CT+RT组的脊髓损伤程度严重,表现为正常髓鞘的板层结构完全消失,轴突及神经纤维裸露,血管增生,部分血管内皮细胞坏死。RT+CT组脊髓损伤表现为正常髓鞘的板层结构部分松解、扭曲、断裂。结论顺铂与放疗联用明显加重脊髓损伤,且放疗前加用顺铂脊髓损伤加重。     

The Location of the Major Ascending and Descending Spinal Cord Tracts in all Spinal Cord Segments in the Mouse: Actual and Extrapolated

Information on the location of the major spinal cord tracts in the mouse is sparse. We have collected published data on the position of these tracts in the mouse and have used data from other mammals to identify the most likely position of tracts for which there is no mouse data. We have plotted the position of six descending tracts (corticospinal, rubrospinal, medial and lateral vestibulospinal, rostral and caudal reticulospinal) and eight ascending tracts (gracile; cuneate; postsynaptic dorsal columns; dorsolateral, lateral, and anterior spinothalamic; dorsal and ventral spinocerebellar) on diagrams of transverse sections of all mouse spinal cord segments from the first cervical to the third coccygeal segment. Anat Rec, 2012. © 2012 Wiley Periodicals, Inc.     

电磁场在组织工程修复脊髓损伤中应用

目的：总结电磁场在组织工程修复脊髓损伤中应用进展。方法：应用计算机检索CNKI 1990年1月至2008年4月有关电磁场在组织工程修复脊髓损伤方面的文章，检索词“电磁场，脊髓损伤，组织工程”，限定文献语言种类为中文。同时计算机检索Medline1990年1月至2008年4月有关电磁场在组织工程修复脊髓损伤方面的文章，检索词“electromagnetic fields，spinal cord injury，tissue engineering”，限定文献语言种类为English。对资料进行初审。选取电磁场在组织工程修复脊髓损伤方面的相关文献，查找全文，对文献分析，总结研究内容。结果：电磁场在组织工程修复脊髓损伤中作用机制包括如下：电磁场可通过上调Ca（v）通道的活性，促进神经发育和分化，经颅脑磁刺激可以促进室管膜周围神经经细胞形成，低频电磁场也直接影响细胞间缝隙联接，参与细胞间信息调控。结论：将电磁场用于组织工程修复脊髓损伤，有利于脊髓功能修复。     

Stem Cells: Current Approach and Future Prospects in Spinal Cord Injury Repair

Spinal cord injury (SCI) invariably results in the loss of neurons and axonal degeneration at the lesion site, leading to permanent paralysis and loss of sensation. There has been no successful treatment for severe spinal cord injuries to recover back to normal function yet. Studies have shown that the transplantation of stem cells may provide an effective treatment for SCI because of the self‐renewing and multipotential nature of these cells. Stem cells have the capability to repair injured nervous tissue through replacement of damaged cells, neuroprotection, or the creation of an environment conducive to regeneration by endogenous cells. Up to today several types of stem cells have been transplanted into the injured spinal cord. However, the question of which cell type is most beneficial for SCI treatment is still unresolved. There are still several limitations to the current data sets which require further investigation. Anat Rec, 2010. © 2009 Wiley‐Liss, Inc.