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@#Necroptosis is a newly discovered form of programmed cell death, which is activated by the binding of death receptors and their ligands and executed through specific path ways. At present, this form of cell death has been proved to be involved in a variety of diseases,such as cancer, autoimmune diseases, traumatic brain injury and brain ischemia-reperfusion injury.
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@#Objective To explore the factors related with bladder function after surgical intervention in patients with first lumbar burst fractures uniting isolated conus medullaris syndrome (CMS). Methods 25 patients complicated CMS in 618 patients with Ｌ1 burst fracture were analyzed retrospectively. Results The recovery rate of patients with saddle sensation weakness was higher than the patients with saddle sensation disappeared (P<0.05). There was no difference in bladder function between patients accepted surgery within 2 weeks and more than 2 weeks (P>0.05). Conclusion Saddle sensation before surgery related with the recovery of bladder function.
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@#ObjectiveTo investigate the characteristics of patients with flaccid paralysis after high spinal cord injury. Methods1014 cases with traumatic spinal cord injury were investigated. The patients with flaccid paralysis after high spinal cord injury (spinal fractures above the level of T10) were analyzed. Results6 patients were ananlyzed, including 5 males and 1 female, mean of age was (42±12). The neurological injury involved C7 to T8, and the fractures involved T3 to T10. 3 cases had the neurological deterioration upward at least 3 spinal segments after operation compared with the fractures. One case accomplicated with severe pain in the chest had the subacute progressive ascending myelopathy up to C7 level. MRI showed extensive atrophy of thoracic spinal cord 6 months later in 5 cases. ConclusionThe incidence of flaccid paralysis after high spinal cord injury was rare. It presents the extensive thoracic spinal cord atrophy, and the causes and mechanisms are not clear.
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@#ObjectiveTo observe the hindlimb motor end-plate morphology and activity of acetyl cholinesterase (AChE) in different types of muscle fiber end-plate areas after spinal cord injury and spinal cord reconstruction tubes inducing spinal cord regeneration. Methods43 adult Wistar rats were randomly divided into spinal cord transected group at T8 (Cx group), spinal cord transected with transplantation of reconstruction tubes group (CxTp group) and control group (Co group). 2 weeks, 4 weeks, 3 months, 6 months and 12 months after operation, gastrocnemius, soleus and extensor digitorum longus were dissected respectively, and stained with gold chloride to observe the motor end-plate and stained with Karnovsky-Roots to detect AChE. ResultsIn Cx group, the end-plates degenerated since 3 months after operation, while the AChE activity declined. In CxTp group, end-plate structure and morphology were relatively stable and there were no signs of degeneration. ConclusionAfter spinal cord injury, motor end-plates undergo degeneration. The spinal cord reconstruction tubes graft can prevent end-plate degeneration and benefit for AChE reactivation and motor end-plate morphological and structural plasticity towards the direction of neurological rehabilitation.
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@#Objective To research the incidence rate,potential etiologic factors,treatment of complications in patients with acute spinal column and spinal cord injury.Methods The date of 543 patients with acute spinal column and spinal injury were analyzed retrospectively.Results Of 543 patients,242 cases(44.6%)had complications.The first to third complications were hyponatremia(202 cases,37.2%),urinary tract infections(150 cases,27.6%)and pulmonary infections(54 cases,9.9%)respectively.The incidence rate of hyponatremia and pulmonary infections in patients with complete cervical spinal cord injuries increased obviously.Conclusion Early rehabilitation and active prevention can prevent the complications in patients with acute spinal column and spinal cord injury.
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@#Spinal cord plasticity includes spontaneous neuronal plasticity and task-dependent plasticity which was respectively driven by spinal cord injury and special treatment.Spontaneous plasticity occurred at neuronal and synaptic sites,displaying various forms of axonal sprouting,unmasking of relatively ineffective functional connections and modification of synaptic efficacy.Task-dependent plasticity demonstrated reactivation of central generator pattern and functional reorganization of extensive spinal circuits.Exploration,induction and guidance of spinal cord plasticity will help determine the most optimal treatments and expand therapy methods to further promote function recovery of patients with spinal cord injury.
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Objective To prevent and manage spinal ischemia caused by cross-clamping the thoracoabdominal aorta often undertaken in clinical surgical practice. Methods Forty-five rabbits were divided for 3 experiments. A variety of vasoactive agents were used to manage spinal ischemia; The effect of cerebrospinal fluid drainage was evaluated; Hypothermia was used to alleviate the spinal ischemia injury. Results Among the above three experiments neuron degeneration was the mildest in hypothermia group though prostaglandin and cerebrospinal fluid drainage do have some positive effects. Conclusion It was suggested that administration of hypothermia and prostaglandin are the most effective for the prevention of spinal ischemic injury during major thoracoabdominal aorta surgery.