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Objective To observe spinal cord neurotoxicity injury induced by mixture of bupiv-acaine-lidocaine compared with mixture of ropivacaine-lidocaine.Methods Forty-eight SD rats,weig-hing 250-300 g,were randomly allocated into 6 groups (n =8):NS group (group N),1.065% bupi-vacaine group (group B),1.5% ropivacaine group (group R),5% lidocaine group (group L),mix-ture group of 5% lidocaine and 1.065% bupivacaine (group LB)or mixture group of 5% lidocaine and 1.5% ropivacaine (group LR).The rats were given intrathecal cathetering after anesthesia.Tail-flick test (TFL)and the mechanical withdrawal threshold (MWT)of rats in each group were meas-ured 1 d before operation (the baseline values)and 1 d,2 d,3 d and 4 d after intrathecal administra-tion.The movement of rat double hind legs were observed at 10 min,30 min,1 h,2 h,3 h and 4 h and 1 d,2 d,3 d and 4 d after intrathecal administration,and the changes of recovery time of lower limbs were recorded.The rats were sacrificed 4 days postoperatively followed by observation on the indexes mentioned above,and spinal cord and cauda equine were taken for staining.Then the patho-logical changes of spinal cord were observed under light and electron microscope,and caudal nerve was rated for pathological injury.Results TFLs of group LR were obviously longer than those of group N,L,B,R,LB 1-4 d after intrathecal administration (P <0.05);Compared with the group N,there was no statistical difference of TFL in the group L,B,R,LB;there was no statistically sig-nificant difference of rat MWT in comparison among the six groups at each time point.There was no statistically significant difference among six groups in recovery time of movement after intrathecal ad-ministration;and the pathological injury scores were obviously higher in group LR than that of group N,L,B,R,LB (P <0.05),respectively.Compared with the group N,there was no statistical difference of the pathological injury scores in the group L,B,R and LB,respectively.Under light microscopy observa-tion:the structure of spinal cord was normal in group N,B and R.In group L and LB,there was focal ede-ma of neurofibers.In group LR,there was edema of neurofibers or demyelination,accompanied with white mass edema in posterior horn of spinal cord.Under electron microscope,only slight edema of medullated fi-bers and unmyelinated nerve fiber was seen in group B and group R;part of the medullated fibers appeared sparse focal lamellar structure in group L and group LB;swelling and degeneration of neuraxon,separation of neuraxon from myelin sheath and disappearance of unmyelinated nerve fiber were seen in group LR. Conclusion The mixture of 5% lidocaine with 1.5% ropivacaine is more neurotoxic to spinal cord than the single administration of lidocaine or ropivacaine,moreover it is not obviously changed compared with the mixture of lidocaine with equipotent bupivacaine.
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Objective To investigate the efficacy of botulinum toxin type A injection with ankle-foot orthosis (AFO) for the treatment of post-stroke lower limb spasticity.Methods One hundred and three stroke patients with lower limb spasticity were randomly divided into control group,observation group and treatment group.The patients in control group were given routine treatment,those in observation group were given botulinum toxin type A injection in addition to routine treatment,and those in treatment group were treated with AFO on the basis of the interventions of observation group.Before treatment and at 1,3 and 6 months after treatment,clinic spasticity index (CSI) and Fugl-Meyer assessment (FMA),Berg balance scale (BBS) and functional independence measure (FIM) were used to evaluate the efficacy of all groups.Results When compare the assessment results at 1 month after treatment with those before treatment,statistically significant difference in terms of scores of CSI,FMA and FIM were revealed in treatment group and observation group (P ＜ 0.05),but not in the control group (P ＞ 0.05).Within-group comparison with the results at 1 month after treatment,the scores of CSI at 3 and 6 months increased in control group and observation group,while decreased in treatment group(P ＜ 0.05),although the scores of FMA and FIM increased in all groups and the increase was statistically significant only in treatment group(P ＜ 0.05).Between-group comparison of the scores in CSI,FMA and FIM showed no significant difference between the observation and control groups(P ＞ 0.05).It was shown that the scores of BBS at 1,3,and 6 months improved continuously in all groups(P ＜0.05),the improvements in treatment group were significantly greater than that of observation group and control group (P ＜ 0.05).Conclusion Ultrasound-guided botulinum toxin type A injection with AFO could further improve lower limb muscle spasticity,and enhance motor,balance and activities of daily life for stroke patients.
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Objective To evaluate the effects of hyperbaric oxygen post-conditioning on the expression of P2X4 receptors in the spinal dorsal horn and hippocampus of rats with neuropathic pain (NP).Methods Seventytwo male Sprague-Dawley rats,aged 8-10 weeks,weighing 300-350 g,were randomly divided into 3 groups (n =24 each) using a random number table:sham operation group (group S),NP group and hyperbaric oxygen postconditioning group (group H).NP was induced by chronic constrictive injury.The rats in group H underwent hyperbaric oxygen treatment once a day for 7 consecutive days starting from 1 day after NP was successfully induced.After the rats were placed in the hyperbaric oxygen chamber,the pressure was increased at a rate of 10 kPa/min until the hyperbaric oxygen was at 2.0 atmosphere absolute,and maintained at this level for 60 min,and then the pressure was decreased at a rate of 10 kPa/min until the normal pressure was reached.The mechanical paw withdrawal threshold (MWT) and thermal paw withdrawal latency (TWL) were measured at 1 day before NP was induced and 1,3,7 and 14 days after NP was induced.After the end of measurement,6 rats were randomly chosen from each group and then sacrificed and the L4-6 segments of the spinal cord and hippocampal tissues were removed for determination of the expression of P2X4 receptors (by immunohistochemistry).Results Compared with group S,the MWT was significantly decreased,TWL was shortened,and P2X4 receptor expression in the spinal dorsal horn and hippocampus was up-regulated in NP and H groups.Compared with group NP,the MWT was significantly increased and TWL was prolonged,and P2X4 receptor expression in the spinal dorsal horn and hippocampus was down-regulated in group H.Conclusion Hyperbaric oxygen post-conditioning mitigates NP by down-regulating the expression of P2X4 receptors in the spinal dorsal horn and hippocampus of rats.
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Objective To observe the clinical efficacy and safety of local injection of botulinum toxin A ( BTX-A ) combined with infrared polarized light for patients with chronic migraine ( CM ). Methods Ninety-one patients with CM were randomly divided into 4 groups.Group A served as the control group in which Nimodipine was used to treat CM ( n =22 ) ; in group B infrared polarized light was used to irradiate the area of the CM for 50 to 60 d ( n =22 ) ; in group C subcutaneous injections of BTX-A were used ( n =24 ) ; and in group D infrared polarized light irradiation of the affected area was combined with subcutaneous injections of BTX-A ( n =23 ).The onset of headaches,their severity,quality of life,as well as side effects were recorded using the migraine disability assessment scale (MIDAS) and the short form of the medical outcomes study form (MOS-SF).The results obtained before and after 6 months of treatment were compared. Results Both of MIDAS and MOS-SF assessment showed significant differences before treatment and after 1,3 and 6 months of treatment in all groups.After 1,3 and 6 months of treatment,the MIDSA and MOS-SF results revealed statistically significant differences between groups A and D,as well as between groups B and C. Conclusion BTX-A injection combined with infrared polarized light exerts significant therapeutic effects on CM with few side effects.
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Objective To observe the effects of low frequency electrostimulation(LFES)on sleep disorder of patients after acute cerebral infarction(ACI)as evaluated by using polysomnography,and on the recovery of neurological deficits. Methods Seventy cases of acute cerebral infarction were randomly divided into two groups,a treatment group and a control group.Both groups were treated with routine drugs, and the treatment group was also treated with LFES in addition.The changes of neurological deficits(ND) scores and such parameters of polysomnography as sleep latency(SL),total sleep time (TST),sleep efficiency(SE%),sleep maintenance(SMT),rapid eye movement sleep(REM),REM latency(RL),REM time(RT),REM activity(RA),REM density(RD).stage 1 sleep(S1),stage 2 sleep(S2)and deep sleep (S3+4) were observed.Results It was shown that,after treatment,both groups got significant improvement in terms of the ND scores and all the polysomnography parameters except RA,S1 and S2,(P<0.01),and the treatment group improved to a significantly greater extend when compared with the control group (P<0.01).Conclusion It is concluded that LFES could promote recovery of neural function and sleep disorder of ACI patients.
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AIM: To decide the effect that selected siRNA degrades mRNA of IL-1? specifically and suppression of its expression after connected with target site with homology complementary sequence. METHODS: Synthesized DNA expression box aimed directly at target site through PCR reaction in vivo was purified, and transfected into lymphocytes stimulated by LPS. siRNA was transcribed by cellular endogenous RNA polymerase Ⅲ and then evoke the degradation of target mRNA. After 48 hours of transfection, the cell culture supernatant was collected and the concentration of IL-1? was assayed using ELISA. RESULTS: Compared with blank-control and negative-control, selected sequence decreased the expression of IL-1?. Rate of the suppression was about 15%. CONCLUSION: RNAi technology produces specific interference effect in mouse spleen lymphocytes in original culture and inhibits the excretion of IL-1?.