Meta analysis of olfactory ensheathing cell transplantation promoting functional recovery of motor nerves in rats with complete spinal cord transection

OBJECTIVE:To evaluate the effects of olfactory ensheathing cell transplantation on functional recovery of rats with complete spinal cord transection.DATA SOURCES: A computer-based online search of Medline(1989–2013),Embase(1989–2013),Cochrane library(1989–2013),Chinese Biomedical Literature Database(1989–2013),China National Knowledge Infrastructure(1989–2013),VIP(1989–2013),Wanfang databases(1989–2013) and Chinese Clinical Trial Register was conducted to collect randomized controlled trial data regarding olfactory ensheathing cell transplantation for the treatment of complete spinal cord transection in rats.SELECTION CRITERIA: Randomized controlled trials investigating olfactory ensheathing cell transplantation and other transplantation methods for promoting neurological functional recovery of rats with complete spinal cord transection were included in the analysis.Meta analysis was conducted using Rev Man 4.2.2 software.MAIN OUTCOME MEASURES: Basso,Beattie and Bresnahan scores of rats with complete spinal cord transection were evaluated in this study.RESULTS: Six randomized controlled trials with high quality methodology were included.Meta analysis showed that Basso,Beattie and Bresnahan scores were significantly higher in the olfactory ensheathing cell transplantation group compared with the control group(WMD = 3.16,95% CI(1.68,4.65); P 0.00001).CONCLUSION: Experimental studies have shown that olfactory ensheathing cell transplantation can promote the functional recovery of motor nerves in rats with complete spinal cord transection.     

Anterior spinal cord infarction caused by fibrocartilaginous embolism

Fibrocartilaginous embolism is a rare cause of anterior spinal cord infarction. We report a case of anterior spinal cord infarction caused by a fibrocartilaginous embolism of 3 months duration in a 23‐year‐old man. Ten days after a trivial strike to the neck and back, he had sudden back pain, weakness of the upper and lower extremities, developed dyspnea and became unconscious. Cervical MRI showed an enlargement of the lower medulla and cervical cord with abnormal signals in the ventral portion. The follow‐up MRI performed 2 months later showed atrophy of the above lesion. On histopathological examination, there was a recent, extensive infarct in the cervical cord and lower medulla. The lesion was symmetrical, and predominantly involved the anterior part of the spinal cord. Moreover, many basophilic, alcian blue‐positive emboli in the arteries and veins of the lesion were detected. This is the first autopsy case of anterior spinal cord infarction caused by a fibrocartilaginous embolism that has been confirmed in China. The clinicopathological features of this case are reviewed in this paper.     

Autologous nerve graft repair of different degrees of sciatic nerve defect: stress and displacement at the anastomosis in a three-dimensional fnite element simulation model

In the repair of peripheral nerve injury using autologous or synthetic nerve grafting, the magnitude of tensile forces at the anastomosis affects its response to physiological stress and the ultimate success of the treatment. One-dimensional stretching is commonly used to measure changes in tensile stress and strain; however, the accuracy of this simple method is limited. Therefore, in the present study, we established three-dimensional finite element models of sciatic nerve defects repaired by autologous nerve grafts. Using PRO E 5.0 finite element simulation software, we calculated the maximum stress and displacement of an anastomosis under a 5 N load in 10-, 20-, 30-, 40-mm long autologous nerve grafts. We found that maximum displacement increased with graft length, consistent with specimen force. These findings indicate that three-dimensional finite element simulation is a feasible method for analyzing stress and displacement at the anastomosis after autologous nerve grafting.     

Characterization of G protein-coupled receptor 56 protein expression in the mouse developing neocortex

GPR56, one of the adhesion G-protein-coupled receptors (GPCRs), plays an important role in the development of the cerebral cortex. Mutations in GPR56 cause a severe human cortical malformation called bilateral frontoparietal polymicrogyria (BFPP), characterized by a global malformation of the cerebral cortex that most severely affects the frontal and parietal regions. To characterize the expression pattern of GPR56 in the developing cerebral cortex, we developed a mouse monoclonal antibody against mouse GPR56. We revealed that GPR56 is expressed in multiple cell types in the preplate, marginal zone, subventricular zone (SVZ), and ventricular zone (VZ). Most interestingly, the expression of GPR56 in preplate neurons showed an anterior-to-posterior gradient at embryonic day (E) 10.5-11.5. In contrast, the expression pattern of the GPR56 ligand, collagen III, revealed no visible gradient pattern. With the widespread expression of GPR56 in the developing cortex, it is difficult to draw a specific conclusion as to which of the GPR56-expressing cells are critical for human brain development. However, the correlation between GPR56 expression in neurons at E10.5-E11.5 and the anatomic distribution of the cortical malformation in both humans and mice suggests that its function in preplate neurons is indispensible.     

神经内镜下经鼻蝶手术切除垂体瘤术后并发症探讨分析

目的总结神经内镜下经鼻蝶手术切除垂体瘤术后并发症的发生原因、治疗和预防方法。方法回顾性分析由同一术者完成的61例神经内镜下经鼻蝶手术切除垂体瘤的临床资料,并对术后并发症进行分析。结果肿瘤全切除41例,次全切除20例。24例侵袭海绵窦中,肿瘤全切除12例,次全切除12例。平均手术时间70min。术后视力下降均有所改善;38例功能性垂体腺瘤中．激素水平下降33例;头痛缓解22例。并发症情况：暂时性尿崩症6例,低钠血症6例,脑脊液漏6例,颅内感染1例,垂体功能降低3例,术区血肿1例,蝶窦炎症3例;经对症处理后,均痊愈或改善。结论内镜手术创伤小、术后并发症少,术前周密的手术计划和风险评估,了解垂体瘤生长特点,及术后严密观察可减少术后并发症、缩短住院时间。     

椎管内神经鞘瘤的手术治疗

目的总结椎管内神经鞘瘤的手术技巧与疗效。方法回顾性分析336例经病理证实的椎管内神经鞘瘤病人的临床资料。均行显微手术切除,根据肿瘤位置不同,采取后正中入路327例,颈前入路6例,腰椎侧方入路2例,胸椎肋间侧方入路1例。术中行电生理监测315例。结果肿瘤全切除320例,近全切除16例。无手术死亡。发生脑脊液漏4例,经腰大池置管引流后均在1周内痊愈。出院时症状好转310例,无变化21例,加重5例。结论椎管内神经鞘瘤为良性肿瘤,采用显微手术技巧大多可获全切除,治疗效果满意。     

Parkinson's Disease with Fatigue: Clinical Characteristics and Potential Mechanisms Relevant to α-Synuclein Oligomer

MethodsPD patients (n=102) were evaluated using a fatigue severity scale and scales for motor and nonmotor symptoms. The levels of three pathological proteins—α-synuclein oligomer, β-amyloid (Aβ)_1-42, and tau—were measured in 102 cerebrospinal fluid (CSF) samples from these PD patients. Linear regression analyses were performed between fatigue score and the CSF levels of the above-listed pathological proteins in PD patients.ResultsThe frequency of fatigue in the PD patients was 62.75%. The fatigue group had worse motor symptoms and anxiety, depression, and autonomic dysfunction. The CSF level of α-synuclein oligomer was higher and that of Aβ_1-42 was lower in the fatigue group than in the non-fatigue group. In multiple linear regression analyses, fatigue severity was significantly and positively correlated with the α-synuclein oligomer level in the CSF of PD patients, after adjusting for confounders.ConclusionsPD patients experience a high frequency of fatigue. PD patients with fatigue have worse motor and part nonmotor symptoms. Fatigue in PD patients is associated with an increased α-synuclein oligomer level in the CSF.     

Delayed induction of alpha B-crystallin in activated glia cells of hippocampus in kainic acid-treated mouse brain

Small heat shock proteins have been implicated in playing a role in various cellular processes, including stress-induced cell death. In kainic acid (KA)-treated rat brain, the immunoreactivity of heat-shock protein 27 (HSP27) was markedly increased in glia cells of the limbic system. In the present study, we demonstrated that alpha B-crystallin, a member of the small heat-shock protein family, was strongly induced in reactive astrocytes in hippocampus after KA-induced seizure. The induction was localized mainly in the CA3 region of hippocampus, where massive neuronal loss occurred. We also demonstrated that the delayed induction of alpha B-crystallin and HSP27 immunoreactivities in the hippocampus of epileptic animals was repressed to the levels seen in control animals with preadministration of the selective nNOS inhibitor 7-nitroindazole (7-NI). This repression was reversed by coinjection of L-arginine, a substrate of NOS. Together, these data suggest a role for alpha B-crystallin and HSP27 in reactive gliosis and/or in delayed neuronal death proceeded after KA-induced seizure.     

Prevalence of upper gastrointestinal bleeding risk factors among the general population and osteoarthritis patients

AIM To assess the prevalence of possible risk factors of upper gastrointestinal bleeding(UGIB) and their agegroup specific trend among the general population and osteoarthritis patients.METHODS We utilized data from the National Health InsuranceService that included claims data and results of the national health check-up program. Comorbid conditions(peptic ulcer, diabetes, liver disease, chronic renal failure, and gastroesophageal reflux disease), concomitant drugs(aspirin, clopidogrel, cilostazol, non-steroidal anti-inflammatory drugs, steroid, anticoagulants, and SSRI), personal habits(smoking, and alcohol consumption) were considered as possible UGIB risk factors. We randomly imputed the prevalence of infection in the data considering the age-specific prevalence of Helicobacter pylori(H. pylori) infection in Korea. The prevalence of various UGIB risk factors and the age-group specific trend of the prevalence were identified. Prevalence was compared between osteoarthritis patients and others.RESULTS A total of 801926 subjects(93855 osteoarthritis patients) aged 20 and above were included. The prevalence of individual and concurrent multiple risk factors became higher as the age increased. The prevalence of each comorbid condition and concomitant drug were higher in osteoarthritis patients. Thirty-five point zero two percent of the overall population and 68.50% of osteoarthritis patients had at least one or more risk factors of UGIB. The prevalence of individual and concurrent multiple risk factors in younger age groups were also substantial. Furthermore, when personal habits(smoking, and alcohol consumption) and H. pylori infection were included, the prevalence of concurrent multiple risk factors increased greatly even in younger age groups.CONCLUSION Prevalence of UGIB risk factors was high in elderly population, but was also considerable in younger population. Patient with osteoarthritis was at higher UGIB risk than those without osteoarthritis. Physicians s h o u ld c o n s id e r in d i v i d u a li z e d r i s k a s s e s s m e n t regardless of age when prescribing drugs or performing procedures that may increase the risk of UGIB, and take necessary measures to reduce modifiable risk factors such as H. pylori eradication or lifestyle counseling.