ABSTRACT
Objective The aim of this study was to explore the regulatory effect of calcitonin gene-related peptide (CGRP) on nitric oxide synthase (NOS) and the nitric oxide (NO) pathway in tibial fracture (TF) healing in the rat model of highly selective denervation.Methods A total of 60 SD rats were randomly divided into three groups of equal number, TF control, TF + sensory denervation (SD), and TF + motor denervation (MD). At 1, 2, 3 and 4 weeks after modeling, osteotylus samples were obtained from the rats for observation of the bone morphology and determination of the expressions of CGRP and NOS by immunohistochemistry and HE staining.Results At 2 and 3 weeks after modeling, the rats of the TF+SD group, as compared with the TF controls, showed significantly decreased expression of CGRP (0.150±0.014 vs 0.210±0.013, P<0.05; 0.143±0.017 vs 0.203±0.013, P<0.05) and that of eNOS in the osteotylus (0.170±0.016 vs 0.219±0.026, P<0.05; 0.158±0.016 vs 0.201±0.013, P<0.05).Conclusion Selective denervation, especially sensory denervation, may change the expression of CGRP and thereby that of NOS in the osteotylus of the rat with tibial fracture, which consequently affects the growth of the osteotylus and fracture healing as well.
ABSTRACT
<p><b>OBJECTIVE</b>To analyze the clinical application of modified Moore classification in lower cervical spine injuries.</p><p><b>METHODS</b>Modified Moore classification was applied in the morphologic description of 200 patients (including 165 males, 35 females,age ranging from 19 to 88 years,with an average age of 52 years) with lower cervical spine injuries from August 2006 to March 2010, cervical spine injury severity score (quantification of stability) in combination with yes/no neurological injury status to classify their clinical diagnosis and management. The treatment was selected according to the fracture type, stability, compression injury of spinal cord or nerve roots, stability of ligamentous injury and other reference factors. According to the ASIA score, 130 cases with injury of spinal cord or nerve root (i.e. 6 cases in Grade A,13 cases in Grade B,43 cases in Grade C, 68 cases in Grade D); and 70 cases with no injury of spinal cord or nerve root. The ASIA score was applied in the evaluation of curative effect in cases with injury of spinal cord or nerve root. Radiodiagnostics was used to observe sequential measurement of cervical vertebrae and height in cases without spinal cord or nerve root injuries.</p><p><b>RESULTS</b>The cervical spine injury distribution is that 35 cases of anterior, left, right lateral and posterior column injury; 33 cases of anterior column injury; 90 cases of anterior and posterior column injury; 5 cases of anterior, left lateral and posterior column injury; 3 cases of anterior, right lateral and posterior column injuries; 3 cases of anterior, left and right lateral column injuries; 2 cases of anterior and right lateral column injuries; 5 cases of anterior and left lateral column injury; 12 cases of posterior column injury; 7 cases of left lateral column injury; 5 cases of right lateral column injury. Surgery operation was given in 98 patients out of 200 cases. Non-surgical treatment was given to 102 patients (including 39 patients who are qualified to receive operation, but patient's relative required non -surgical treatment). Three cases of complete injury of spinal cord showed no recovery of the spinal cord function after operation, no change on the ASIA score, but pain and numbness of limb relieved slightly. Three non-surgical treatment cases showed no change after the treatment. Cases of incomplete injury of spinal cord showed certain recovery on spinal cord function after operation, and the ASIA score was raised 1.2 grades averagely. The ASIA score of cases of incomplete injury of spinal cord after non-surgical treatment was raised 0.3 grades averagely. The alignment and height of cervical vertebras were normal on post-operative radiodiagnostics in patients without injury of spinal cord or nerve root.</p><p><b>CONCLUSION</b>According to modified Moore classification, when the stability quantification score is higher than or equal to 4, it indicated that the cervical vertebras are instability in lower cervical spine injuries. Surgery operation is required in higher score and less stability cases. Cases associated with neurological injury must receive surgery operation. Cases with stability quantification score equals to 3 and neurological injury should also receive surgery operation in general. Surgery operation is not required in cases of stability quantification equal to 3 and without neurological injury,or cases of stability quantification score lower than 3. Applying modified Moore classification in the treatment of lower cervical spine injuries is beneficial for the clinical standardization, diagnosis and treatment and receives satisfactory therapeutic effects.</p>