Neuroprotective effect of estrogen after chronic spinal cord injury in ovariectomized rats

BACKGROUND: At present, there is still lack of effective drugs for chronic spinal cord injury, whereas it is found recently that estrogen has a neuroprotective effect on brain and spinal cord injuries. OBJECTIVE: To observe the effect of estrogen on the apoptosis of nerve cells after gradual chronic spinal cord injury in ovariectomized rats. DESIGN: A randomized controlled animal trial. SETTING: Institute of Orthopaedics, the Second Hospital of Lanzhou University. MATERIALS: Sixty-five female Wistar rats of common degree, weighing 220–250 g, were provided by the experimental animal center of Lanzhou University. The rats were randomly divided into sham-operated group (n =5), estrogen-treated group (n =30) and saline control group (n =30), and the latter two groups were observed at 1, 3, 7, 14, 28 and 60 days respectively, and 5 rats for each time point. METHODS: All the rats were treated with bilateral oophorectomy 2 weeks before the experiment. T10 vertebral lamina was revolved into using plastic screw. The spinal canal impingement was not induced initially. After that, the original incision was opened to expose the screw every 7–10 days. MAIN OUTCOME MEASURES: The apoptosis and Caspase-3 positive cells in the damaged spinal cord were detected using terminal deoxynucleotidal transferase-mediated dUTP-biotin nick end labeling (TUNEL) method and Caspase-3 immunohistochemical staining at 1, 3, 7, 14, 28 and 60 days after chronic spinal cord injury respectively. RESULTS: Totally 65 rats were used, and the deleted ones during the experiment were supplemented by others. Changes of Caspase-3 expression after spinal cord injury: In the sham-operated group, only a small amount of Caspase-3 proteins were observed in the rat spinal cord, mainly located in motor neurons of spinal cord anterior horn. In the estrogen-treated group and saline control group, positive cells expressed occasionally at 1 day postoperatively, began to increase obviously at 7 days after injury, strongly expressed at 14 and 28 days, but decreased at 60 days, mainly located in the neurons of spinal cord gray matter anterior horn, and they expressed fewer in the motor neurons and white matter of ventral horn, and there were obvious differences between the estrogen-treated group and saline control group at 7, 14, 28 and 60 days (P < 0.05). CONCLUSION: Estrogen can reduce the apoptosis of nerve cells and promote the recovery of neurological function following gradual chronic spinal cord injury.     

改良神经刺激仪定位在全麻下乳腺癌术中对神经的保护作用

目的探讨改良神经刺激仪对神经定位的效果，以防止乳腺癌手术对运动神经的损伤，提高手术成功率及术后生活质量。方法选择ASAⅠ～Ⅱ级，乳腺癌预计手术中难以辨认神经血管走行的女性患者20例。应用Stimuplex HNS 12／BRAUN周围神经刺激仪，改良为双极刺激电极在术前、术后均对胸背神经支配的背阔肌、胸长神经支配的前锯肌以及胸前神经支配的胸肌进行肌电检测，以确定手术中神经损伤情况。结果18例患者手术前胸大肌动作电位为（1．59±0．4）mv，手术后为（1．58±0．3）mv，前后比较差异无统计学意义（P〉0．05）。手术前神经传导速度为（40．57±2．33）m／s，手术后为（40．43±2．18）m／s，前后比较差异无统计学意义（P〉0．05）。仅2例出现轻度神经损伤。结论改良神经刺激仪能准确定位神经，避免了神经的直接损伤，基本上达到了肌电图仪的神经探测功能。     

小儿肾母细胞瘤与腹膜后神经母细胞瘤侵犯肾脏的CT鉴别要点

肾母细胞瘤又称肾胚胎瘤或腺肉瘤，是小儿腹膜后最常见的恶性肿瘤，约占小儿恶性肿瘤的20％。肾母细胞瘤可发生于肾的任何部位。肿瘤生长迅速。可生长至20-30cm，肿瘤增大可突破包膜侵及肾外组织。神经母细胞瘤亦为小儿常见腹膜后肿瘤之一，发病率仅低于肾母细胞瘤。当肿痛侵犯肾脏时，两者之间有时难以鉴别，因此。笔者重点分析两考的CT征象并进行比较，寻求鉴别要点。     

72例糖尿病病人褥疮的护理体会

褥疮也称压疮，是由于局部组织长期受压，导致神经营养紊乱及血液循环障碍。好发于长期卧床者，尤其是老年人、昏迷患者、截瘫患者，严重者可危及生命。糖尿病患者由于活动减少，血流缓慢，同时由于糖代谢、脂质代谢异常，使糖原物质沉积于皮下，引起血管基底膜增厚，管腔变窄，血液循环不良，使褥疮极易发生而难于愈合。本院于2006年6月～2008年12月间收治了72例糖尿病并发褥疮感染的患者，经积极治疗、精心护理后病情好转，褥疮痊愈。现将护理体会介绍如下。     

妊娠并发疱疹样脓疱病一例

患者 31岁 ,彝族。因妊娠 4个月余 ,全身皮肤红斑、脓疱、脱屑、痒痛伴发热 10d ,于 2 0 0 2年 7月 2 1日收住院。患者于 10d前无明显诱因出现发热 ,体温高达 39 5℃ ,且双手背、上臂出现红斑、脓疱、痒痛 ,当时未诊治 ,之后病变迅速波及全身 ,持续不退 ,来我院就诊。发病后精神不振、纳差、睡眠不佳 ,尿量少 ,大便正常、关节疼痛。既往无银屑病病史及相关家族史。身体检查 :体温 37 6℃ ,脉搏 10 4次 ,血压 95 /75mmHg(1mmHg =0 133kPa)。一般状况差 ,中度贫血貌 ,心肺部检查无异常发现 ,腹部如孕 5个月。全身皮肤有散在或融合成大片状…     

神经生长因子对糖尿病心脏感觉神经支配和挽救神经病变至关重要

心脏感觉神经系统的分子机制的调节还不清楚。心脏感觉神经损害可导致无痛性心肌梗死，是糖尿瘸（DM）猝死的一个主要原因。现主要探讨神经生长因子（NGF）在心脏感觉神经系统调节中的作用和糖尿病无痛性心肌梗死的机制。     

位点加穴位注射结合Bobath运动疗法治疗小儿脑性瘫痪90例疗效分析

目的 探讨位点加穴位药物注射结合Bobath运动疗法治疗脑瘫患儿的疗效.方法 用少量VitB1、VitB12加生理盐水稀释,按照运动,智力、视听、语言等异常情况在头皮、四肢、腰椎间隙选取相应位点及穴位进行注射刺激,并同时结合Bobath运动疗法,每疗程各10次,隔日交叉进行,疗程间隔7～21d,平均4～5个疗程.对采用上述疗法的90例脑瘫患儿随访6个月,观察疗效.结果 有效率96%,正常化45例(50%),显效27例(30%),有效15例(16.7%),无效3例(3.3%).91.7%(66/72)患儿脑CT有不同程度好转.结论 位点加穴位药物注射结合Bobath运动疗法治疗脑瘫,疗效好、见效快,是一种较理想的疗法.     

肱骨干骨折后桡神经麻痹

肱骨干骨折后桡神经麻痹是临床上常见的骨折合并症，如何处理在学术界意见不一，有主张早期探查神经；骨折不需手术者先观察，待骨折愈合后再决定是否探查神经；对神经观察的时间亦不一致。为此讨论对该问题的体会。     

神经干细胞-脑源性神经营养因子基因工程细胞移植对大鼠缺血性脑损伤的治疗作用

目的 将脑源性神经营养因子(BDNF)基因转入大鼠海马原代培养的神经干细胞(NSCs)中,获得NSCs-BDNF基因工程干细胞并移植治疗大鼠缺血性脑损伤.方法 分离培养新生大鼠海马区NSCs,检测其增殖、分化等特性;构建逆转录病毒载体pLXSN-BDNF,转染NSCs,获得NSCs-BDNF基因工程干细胞,检测其BDNF的表达和活性;建立大鼠大脑中动脉局灶性脑缺血模型,通过立体定向技术将NSCs-BDNF移植入模型缺血侧海马,进行组织学和行为学检测.结果 NSCs-BDNF移植后可以观察到动物行为学的改善,术后4周Longa评分1.343±0.293,脑切片可以观察到海马齿状回神经元数目的增加,术后4周存活率87.5%±6.6%,较对照有统计学意义(P＜0.05).结论 NSCs-BDNF移植对实验性大鼠缺血性脑损伤有修复作用.     

糖尿病周围神经病97例临床特征与神经电生理分析

目的:探讨糖尿病周围神经病(DPN)患者的临床特征与神经电生理变化。方法:分析97例DPN患者的临床特征,比较DPN组和对照组的神经传导速度(NCV)、远端潜伏期、远端波幅3个参数。结果:①临床特征以肢体麻木(59%)最多见、其次为疼痛(42%)。②患者组NCV、远端波幅值低于对照组,远端潜伏期比对照组延长;两组3个参数比较,除腓总神经远端波幅、尺神经感觉传导速度和正中、尺、腓肠神经远端潜伏期外,差异均有统计学意义(P<0.05)。结论:①DPN患者临床特征以肢体麻木和疼痛最多见;②检测NCV、远端潜伏期、远端波幅,能较早发现临床患者。