Effect of Minocycline on Acute Closed Spinal Cord Injury in Rats / 中国康复理论与实践

Objective:To investigate the neuroprotective effect of minocycline on the secondary injury after acute closed spinal cord injury in rats. Methods:A total of 24 Sprague-Dawley male rats were randomly divided into saline group (n = 8), magnesium chloride group (n = 8) and minocycline group (n = 8). The closed spinal cord injury model was prepared with balloon compression in the dorsal spinal cord of rat, which was evaluated with magnetic resonance imaging. All rats were successively administered their own drugs for seven days after injury, respectively. They were assessed with BBB score two to 31 days after operation. Their motor-evoked potential and sensory-evoked potential were detected 31 days after operation, and then Luxol Fast Blue was used to observe the area of secondary injury. Results:Animal magnetic resonance imaging showed hypointense in T2 images in T10 spinal cord. BBB score was more in the minocycline group than in the saline group since 17 days after operation (P < 0.05). The amplitude of motor-evoked potential was higher in the minocycline group than in the saline group (P < 0.05), while the area of secondary injury was less (P < 0.05). Conclusion:Minocycline may protect the nerves from secondary injury after acute spinal cord injury.

An Experimental Study on the Optimal Timing for the Repair of Incomplete Facial Paralysis by Hypoglossal-facial 'Side'-to-side Neurorrhaphy in Rats / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>To investigate the optimal timing for the repair of persistent incomplete facial paralysis by hypoglossal-facial 'side'-to-side neurorrhaphy in rats.</p><p><b>METHODS</b>A total of 30 adult rats with crushed and bulldog-clamped facial nerve injury were randomly divided into 5 groups (n = 6 each) that were subjected to injury without nerve repair or with immediate repair, 2-week-delayed repair, 4-week-delayed repair, or 8-week-delayed repair. Three months later, the effects of repair in each rat were evaluated by facial symmetry assessment, electrophysiological examination, retrograde labeling, and axon regeneration measurement.</p><p><b>RESULTS</b>At 3 months after injury, the alpha angle significantly increased in the group of rats with 4-week-delayed repair compared with the other four groups. Upon stimulation of the facial nerve or Pre degenerated nerve, the muscle action potentials MAPs were recorded in the whisker pad muscle, and the MAP amplitude and area under the curve in the 4-week-delayed repair group were significantly augmented at 3 months post-injury. Similarly, the number of retrograde-labeled motor neurons in the facial and hypoglossal nuclei was quantified to be significantly greater in the 4-week-delayed repair group than in the other groups, and a large number of regenerated axons was also observed.</p><p><b>CONCLUSION</b>The results of this study demonstrated that hemiHN-FN neurorrhaphy performed 4 weeks after facial nerve injury was most effective in terms of the functional recovery of axonal regeneration and activation of facial muscles.</p>

Outcomes of Microendoscopic Discectomy and Percutaneous Transforaminal Endoscopic Discectomy for the Treatment of Lumbar Disc Herniation: A Comparative Retrospective Study

STUDY DESIGN: Retrospective, case control evaluation of 86 patients who underwent microendoscopic discectomy (MED) and percutaneous transforaminal endoscopic discectomy (PTED) for the treatment of lumbar disc herniation (LDH). PURPOSE: To evaluate the safety and the outcomes of MED and PTED for the treatment of LDH. OVERVIEW OF LITERATURE: MED and PTED are minimally invasive surgical techniques for lower back pain. Studies to date have shown that MED and PTED are safe and effective treatment modalities for LDH. METHODS: A retrospective study was performed in patients with LDH treated with MED (n=50) and transforaminal endoscopic discectomy (PTED; n=36) in our hospital. All patients were followed-up with self-evaluation questionnaires, Oswestry disability index (ODI), medical outcomes study 36-item short form health survey and MacNab criteria. All the patients in both groups were followed up to 12 months after the operation. RESULTS: ODI questionnaire responses were not statistically different between the MED and PTED groups (53.00 vs. 48.72) before treatment. Average scores and minimal disability after 5 days to 12 months of follow-up were 4.96 in the MED group and 3.61 in the PTED group. According to MacNab criteria, 92.0% of the MED group and 94.4% of the PTED group had excellent or good results with no significant difference. CONCLUSIONS: There was no significant difference between MED and PTED outcomes. Further large-scale, randomized studies with long-term follow-up are needed.

Preliminary experiences in minimally invasive transforaminal lumbar interbody fusion / 中华外科杂志

<p><b>OBJECTIVE</b>To explore clinical application of minimally invasive transforaminal lumbar interbody fusion (TLIF) for the management of lumbar disorders and discuss its indications, surgical techniques and clinical effectiveness.</p><p><b>METHODS</b>From Jan 2005 to Dec 2006, 31 selected patients (22 males and 9 females, aged from 41 to 63 years) with degenerative lumbar diseases were treated with minimally invasive TLIF assisted by METRx X-Tube micro-endoscopy system. The index diagnosis was lumbar disc herniation with Lumbar spinal stenosis in 7, lumbar disc herniation with segmental instability in 16, grade 1 to 2 of lumbar spondylolisthesis in 8. The surgical methods was performed with bilateral or unilateral pedicle screws insertion and a single rectangle cage posterolateral placement. The operating time, blood loss, blood transfusion, drainage, visual analogue scale (VAS), preoperative and postoperative JOA scores were observed as well as radiographic evaluation. The results were compared with standard TLIF group respectively.</p><p><b>RESULTS</b>A total of 116 pedicle screws and 31 cages were implanted of which 4 patients were treated with unilateral pedicle screws fixation. Four pedicle screws were found misplaced in CT scans after surgery. The average operating time was 199 min, blood loss 359 ml, volume of transfusion 32 ml drainage 81 ml, and VAS was 2.37 about 72 hours after surgery, which had statistic difference compared with control group. There was no statistic difference on postoperative improvement rate and JOA scores in two groups.</p><p><b>CONCLUSIONS</b>Minimally invasive TLIF minimizes paraspinal muscle trauma and blood loss, shortens the operating and recovery time. A good long-term outcome can be gained compared with standard procedures.</p>

Biomechanical evaluation of vertebroplasty using calcium sulfate cement for thoracolumbar burst fractures / 中华创伤杂志(英文版)

<p><b>OBJECTIVE</b>To evaluate the biomechanical performance of vertebroplasty using calcium sulfate cement for thoracolumbar burst fractures.</p><p><b>METHODS</b>Sixteen bovine thoracolumbar spines (T11-L1) were divided into 4 groups (A,B,C and D). After burst-fracture model was created, 12 vertebral bodies in Groups A, B and C were augmented with calcium sulfate cement (CSC), calcium phosphate cement (CPC) and polymethylmethacrylate (PMMA) bone cement, respectively. Each anterior vertebral body height was measured with a caliper at 4 time points: intact conditions (HInt), post-fracture (HFr), post-reduction (HRe) and post-vertebroplasty (HVP). The filling volume of 3 different bone cements was also measured. Each vertebral body was compressed at 0.5 mm/s using a hinged plating system on a materials testing machine to 50% of the post-vertebroplasty height to determine strength and stiffness. Difference was checked using t test or One-way ANOVA.</p><p><b>RESULTS</b>The average strike energy was 66.2 J. Vertebroplasty with different cements could sustain vertebral height. The average filling volume of bone cement in 3 groups was 4.35 ml (CSC), 3.72 ml (CPC) and 3.95 ml (PMMA), respectively, and there was no statistically significant difference among them (P larger than 0.05). Vertebroplasty with PMMA completely restored strength (116%) and stiffness (105%). CSC or CPC partly recovered vertebral strength and stiffness. However, greater strength restoration was got with CSC (1659 N) as compared with CPC (1011N, P less than 0.01). Regarding stiffness, differences between CSC (140 N/mm+/-40 N/mm)and the other two bone cements (CPC:148 N/mm+/-33 N/mm, PMMA:236 N/mm+/-97 N/mm) were not significant (P larger than 0.05).</p><p><b>CONCLUSIONS</b>For a burst-fracture of calf spine, use of CSC for vertebroplasty yields similar vertebral stiffness as compared with PMMA or CPC. Although augmentation with CSC partly obtains the normal strength, this treatment still can be applied in thoracolumbar burst fractures with other instrumental devices in light of its bioactivation.</p>

Action of Schwann cells implanted in cerebral hemorrhage lesion / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>To investigate whether there is neogenesis of myelin sheath and neuron after transplantation of Schwann cells into cerebral hemorrhage lesion.</p><p><b>METHODS</b>Schwann cells were expanded, labeled with BrdU in vitro and transplanted into rat cerebral hemorrhage with blood extracted from femoral artery and then injected into the basal nuclei. Double immunohistochemistry staining and electron microscopy were used to detect the expression of BrdU/MBP and BrdU/GAP-43 and remyelination.</p><p><b>RESULTS</b>BrdU/MBP double positive cells could be seen at 1 week up to 16 weeks after transplantation of Schwann cells. Thin remyelination was observed under electron microscope. GAP-43 positive cells appeared after 12 weeks and were found more in Hippocamp.</p><p><b>CONCLUSIONS</b>Grafted Schwann cells participate in remyelination and promoter nerve restore in rat cerebral hemorrhage.</p>

Induction of functional recovery by co-transplantation of neural stem cells and Schwann cells in a rat spinal cord contusion injury model / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>To study the transplantation efficacy of neural stem cells (NSCs) and Schwann cells (SC) in a rat model of spinal cord contusion injury.</p><p><b>METHODS</b>Multipotent neural stem cells (NSCs) and Schwann cells were harvested from the spinal cords of embryonic rats at 16 days post coitus and sciatic nerves of newborn rats, respectively. The differential characteristics of NSCs in vitro induced by either serum-based culture or co-culture with SC were analyzed by immunofluorescence. NSCs and SCs were co-transplanted into adult rats having undergone spinal cord contusion at T9 level. The animals were weekly monitored using the Basso-Beattie-Bresnahan locomotor rating system to evaluate functional recovery from contusion-induced spinal cord injury. Migration and differentiation of transplanted NSCs were studied in tissue sections using immunohistochemical staining.</p><p><b>RESULTS</b>Embryonic spinal cord-derived NSCs differentiated into a large number of oligodendrocytes in serum-based culture upon the withdrawal of mitogens. In cocultures with SCs, NSCs differentiated into neuron more readily. Rats with spinal cord contusion injury which had undergone transplantation of NSCs and SCs into the intraspinal cavity demonstrated a moderate improvement in motor functions.</p><p><b>CONCLUSIONS</b>SC may contribute to neuronal differentiation of NSCs in vitro and in vivo. Transplantation of NSCs and SCs into the affected area may be a feasible approach to promoting motor recovery in patients after spinal cord injury.</p>

Experimental Study of Schwann Cells Transplanted into Cerebral Hemorrhage Area of Rats / 中国康复理论与实践

@#ObjectiveTo investigate the effect of Schwann cells (SCs) transplanted into cerebral hemorrhage area on never restore in rat.MethodsSCs were expended and labeled with 5'-Bromodexyuridine (BrdU) in vitro, then transplanted into cerebral hemorrhage area of model rat. Double immunohistochemistry staining was used to detect the expression of BrdU/myelin basic protein (MBP) and BrdU/growth associated protein-43 (GAP-43) respectively.ResultsBrdU/MBP positive cells could be seen one week after transplantation and up to 13 weeks. GAP-43 positive cells appeared in 12 weeks and 13 weeks, which was more in Hippocamp.ConclusionGrafted SCs can participate in remyelination and promoter nerve restore.

Effects of Fluid Resuscitation on Cerebral Protection in A Rat Model of Traumatic Head Injury Complicated with Hemorrhagic Shock / 中国康复理论与实践

@#ObjectiveTo compare the effects of normal saline (NS), 10% hydroxyethyl starch (HES) and hypertonic-hyperoncotic solution (HHS,7.5% NaCl/10% HES) on regional cerebral blood flow (rCBF), brain edema and blood-brain barrier (BBB) in a rat model of traumatic head injury (THI) complicate with hemorrhagic shock. Methods60 SD rats were randomized into 5 groups: sham group (n=12), model group (n=12), NS group (n=12), HES group (n=12) and HHS group (n=12). rCBF and mean arterial pressure (MAP) were determined before and after THI, hemorrhagic shock and resuscitation. Cerebral water content and Evans Blue (EB) content were assessed 3 h after resuscitation.ResultsMAP and rCBF were restored to baseline values immediately after resuscitation in all resuscitated group and began to decrease 15 min, 30 min or 45 min later, respectively(P<0.05). 3 h after resuscitation, the brain water content was higher in NS group than those in sham or HHS group(P<0.05). EB contents of injured hemispheres were higher in model and NS group than those in HES or HHS group(P<0.05). ConclusionSmall-volume resuscitation with HHS can restore MAP and rCBF, decrease brain edema and improve BBB in a rat model of THI complicate with hemorrhagic shock.

Observation in Apotosis Structures of Middle Cerebral Artery Endotheliocyte at the Early Stage after Acute Mechanical Cerebral Vasospasm during the Craniocerebral Operation / 中国康复理论与实践

@#ObjectiveTo observe the ultrastructures of vessel and endotheliocyte in the early stage(2 h after stimulation finished) after acute mechanical middle cerebral artery(MCA) vasospasm in cats.MethodsThe right MCA of 6 cats were mechanically stimulated using a small smooth stainless steel nail in the field acrossing the olfactory tract for 30 min.The diameter of MCA was recorded by metrical ocular of microscope.The changes of the perfusion index of brain tissue were observed through the Laser Doppler flowmetry monitor fixed on the skull.The ultrastructure of vessel and endotheliocyte were investigated through the electron microscope.ResultsThe diameter of MCA decreased to 68.78% of normal.2 h later,the diameter of MCA recovered.The perfusion index of the cortex surface decreased to 42.59% of normal and up to 61.87% 2 h later.The chromatin of endotheliocyte congregated to the side and formed the lunular body.The heaves of mitochondria(MIT) are blurry 2 hours after the mechanical stimulation.ConclusionThe persistent mechanical stimulation can cause acute cerebral vasospasm,which may involve the apoptosis of endotheliocyte of MCA.It is important to reduce the mechanical stimulus to the cerebral vessel in order to avoid acute cerebral vasospasm during clinical and basic craniotomy.

Protective effect of isoflurane and sevoflurane on ischemic neurons and expression of Bcl-2 and ICE genes in rat brain / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>To study the protective effect of volatile anesthetics, isoflurane and sevoflurane, on ischemic neurons after cerebral ischemia-reperfusion in rats and its possible molecular mechanism.</p><p><b>METHODS</b>Rat cerebral ischemia-reperfusion model was developed by occlusion of the middle cerebral artery (MCA) and bilateral common carotid arteries (CCAs) 1 h after reperfusion. Using flow cytometry (FCM) and Northern blot hybridization, we calculated the number of apoptotic bodies and detected the expression of bcl-2 mRNA and interleukin-1beta converting enzyme (ICE) mRNA.</p><p><b>RESULTS</b>The apoptotic bodies in hippocampus analyzed by FCM peaked at appeared 24 h after reperfusion, and decreased about 54% and 40%, respectively, after treatment with isoflurane and sevoflurane, as compared with ischemic group. There was no significant difference in the expression of bcl-2 mRNA and ICE mRNA between the inhaled anesthetic groups and ischemic group in hippocampus 24 h after MCA/CCAs occlusion.</p><p><b>CONCLUSION</b>Isoflurane and sevoflurane partially inhibit apoptosis but have no significant effect on the expression of bcl-2 and ICE genes.</p>

Amino acids in brain microdialysate tested by HPLC with α-aminobutyric acid as the internal standard / 中国康复理论与实践

@#ObjectiveTo study the effect of testing amino acids levels in brain microdialysate by method of high performance liquid chromatography (HPLC) with α-aminobutyric acid (AABA) as the internal standard.MethodsReversed phase high performance liquid chromatography (RP-HPLC), orthophthaladehyde (OPA) precolumn derivatization method and fluorescence detector were used. The separation was performed using an ODS-C18 column. AABA, an isomeric compound of GABA, served as the internal standard, phosphate buffer solution and methanol as the mobile phase, gradient elution lasted in 35 min.Results7 kinds of amino acids and internal standard were separated completely. The mean recovery of amino acid was 88.2%—102.3%. The mean correlation coeffeicient of the linear relationship was 0.998±0.0015.Limits of detection for amino acids were 1.0—8.6 ppm respectively.ConclusionThe method mentioned above is simple and sensitive for operation, and can be used for determined levels of amino acids in microdialysate.

Management of deep vein thrombosis of lower limbs in patients with severe craniocerebral injury / 中国康复理论与实践

@#Objective To explore the management of deep vein thrombosis (DVT) of lower limbs in patients with severe craniocerebral injury.Methods The clinical data of 9 patients of severe craniocerebral injury with DVT were analyzed respectively.Results All 9 patients were given medicine therapy including thrombolytic, anti coagulating, anti platelet aggregation and antibiotics. 3 cases were cured, 1 case was improved, 4 cases died and 1 case discharged by himself. Conclusion There are risk factors for DVT in patients with severe craniocerebral injury. Early prophylaxis is important. Early diagnosis and treatment are benefited.

Effect of thyrotrophin-releasing hormone analogue, YM14673,on the blood-brain barrier and brain edema after head trauma in rats / 中国康复理论与实践

@#Objective To study the effect of thyrotrophin releasing hormone (TRH) analogue, YM14673, on the brain edema and blood brain barrier after brain injury in rat.Methods The model of brain injury of rats was built by Feeney's methods. The Evans blue solution had been injected i.v. into the rats before the models were made. The rats were divided into four groups: normal, treated with saline, treated with YM14673(Ⅰ:0.1mg/kg and Ⅱ:1mg/kg). The water content in brain was measured 24 h after brain injured. The concentration of Evans blue in brain tissue and blood was measured with fluorometry.Results The rats treated with saline after traumatic injury showed significantly high water content compared with normal group(P<0.01)and the water content of the left hemisphere, which was hit straightly, was higher significantly than that of the right global(P<0.01). The brain water content decreased in the rats treated with YM14673 in all global(P<0.05).There was no significant different between the treated group Ⅰ and groupⅡ.After brain injury, the concentration of Evans blue in brain tissue showed a higher level contrasted with normal group. YM14673 did not influence the concentration of Evans blue in brain tissue. Conclusion YM14673 can decrease the brain edema after brain injury but it cannot decrease the permeability of blood brain barrier.