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1.
Rev. bras. ortop ; 57(3): 384-391, May-June 2022. tab, graf
Article in English | LILACS | ID: biblio-1388028

ABSTRACT

Abstract Objective The "Self-report S4-5 sensory and motor function questionnaire (S4-5Q)" is a short questionnaire that aims to assess the function of the sacral segments, S4 and S5, after a spinal cord injury (SCI), with the purpose of replacing the rectal exam test. The aim of the present study was to carry out a cross-cultural adaptation of the S4-5Q to the Brazilian Portuguese language and to investigate the test-retest reliability of this version. Method The translation and cross-cultural adaptation was performed using the methodology of translation and backtranslation. Initially, translations were done by three independent translators. Their synthesis was then submitted to an expert committee for analysis (SCI health professionals); then, the backtranslation to the original language was sent to the original author and, after all the adjustments, the final version was completed. For test-retest reliability, 24 individuals with chronic SCI were recruited (2 evaluations with an interval of 7 to 14 days between them). Statistical analysis was performed using IBM-SPSS (Version 20, SPSS Inc, Chicago, IL, USA) with data pretabulated in Microsoft Excel (Microsoft Corporation, Redmond, WA, USA). Reliability was tested with Cohen Kappa, and internal consistency with Cronbach α, both adopting p < 0.05 as significant. Results In the reliability analysis, the results of all questions showed almost perfect agreement (Kappa > 0.81) and good internal consistency (Cronbach α: 0.65-0.77) between the questions and final classification. Conclusion The cross-culturally adapted S4-5Q is reliable to be applied to the Brazilian population with chronic SCI to determine their S4-5 sensory and motor function.


Resumo Objetivo O "Self-report S4-5 Sensory and Motor Function Questionnaire (S4-5Q)" é um breve questionário de avaliação da função dos segmentos sacrais S4 e S5 após uma lesão medular (LM), cuja finalidade é substituir o exame de toque retal. O objetivo do presente estudo foi realizar uma adaptação transcultural do questionário S4-5Q para a língua portuguesa do Brasil e investigar a confiabilidade teste-reteste desta versão. Método A tradução e a adaptação transcultural foram realizadas utilizando a metodologia de tradução e retrotradução. Inicialmente, as traduções foram realizadas por três tradutores independentes. Sua síntese foi então submetida a um comitê de especialistas (profissionais de saúde com experiência em LM). Em seguida, a retrotradução para o idioma original foi enviada ao autor original, sendo que a versão final foi concluída após todas as adaptações. Para a confiabilidade teste-reteste, foram recrutados 24 indivíduos com lesão medular espinal (LME) em fase crônica (2 avaliações com intervalo de 7 a 14 dias entre elas). A análise estatística foi realizada no IBM-SPSS (Version 20, SPSS Inc, Chicago, IL, USA) com dados pré- tabulados no programa Microsoft Excel (Microsoft Corporation, Redmond, WA, EUA). A confiabilidade foi testada por meio do coeficiente Kappa de Cohen, e a consistência interna foi medida através do α de Cronbach, ambas adotando p < 0,05 como significante. Resultados Na análise de confiabilidade, os resultados de todas as perguntas apresentaram concordância quase perfeita (Kappa > 0,81) e boa consistência interna (α de Cronbach: 0,65-0,77) entre as perguntas e a classificação final. Conclusão O questionário S4-5Q adaptado culturalmente é confiável, podendo ser aplicado à população brasileira com LME crônica, com o objetivo de avaliar a função sensorial e motora nos segmentos sacrais S4-S5.


Subject(s)
Humans , Sacrococcygeal Region , Spinal Cord Injuries , Cross-Cultural Comparison , Surveys and Questionnaires
2.
Rev. mex. anestesiol ; 45(1): 30-34, ene.-mar. 2022. tab, graf
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1389177

ABSTRACT

Resumen: Introducción: El manejo correcto de la vía aérea en los pacientes politraumatizados es crucial, ya que es necesario tener una vía aérea segura y proveer adecuada ventilación sin emperorar una probable lesión medular. Objetivo: Determinar el efecto de la maniobra de fijación en línea (MILS del inglés Manual In-Line Stabilisation) en la clasificación de Cormack-Lehane (CL), así como la correlación con el índice de masa corporal (IMC). Material y métodos: En un estudio descriptivo en el Centro Hospitalario del Estado Mayor Presidencial en la Ciudad de México se incluyeron 56 pacientes con estado físico ASA I a IV. El anestesiólogo realizó la laringoscopía directa bajo MILS y valoró el grado de CL. Inmediatamente después se reposicionó al paciente en posición de olfateo, se efectuó nueva laringoscopía directa y se revaloró de nuevo el grado de CL. Resultados: Los grados del CL fueron significativamente diferentes entre la posición MILS versus olfateo. Los grados de CL fueron en su mayoría altos cuando se posicionó al paciente en MILS (75% de los pacientes clasificados entre III y IV) y disminuyeron significativamente al ser cambiados a posición de olfateo. Conclusión: Se observa mejoría del CL cuando se cambia de posición MILS a olfateo.


Abstract: Introduction: Correct airway management of polytraumatized patients is crucial because of the necessity of securing the airway and providing adequate ventilation without worsening a probable spinal cord injury. Objective: Determine the effect of manual inline stabilization (MILS) on Cormack-Lehane classification and if there is any correlation with body mass index (BMI). Material and methods: In a descriptive study at the Centro Hospitalario del Estado Mayor Presidencial in Mexico City, we included 56 patients with ASA physical status I to IV. The anesthesiologist performed direct laryngoscopy while MILS was performed and observed the CL grade. Immediately after, the patient was repositioned into the sniffing position, direct laryngoscopy was performed, and the CL grade was observed again. Results: The CL grades observed were significantly different between MILS vs. Sniffing position. CL grades were mainly high when positioned in MILS (75% classified as grades III and IV) and diminished significantly when changed to the sniffing position. Conclusion: Improvement of CL grade was observed when changing from MILS to sniffing position.

3.
Motriz (Online) ; 28: e10220006821, 2022. tab
Article in English | LILACS | ID: biblio-1375940

ABSTRACT

Abstract Aim: This study aims to characterize the stress, recovery, mood, and motivation together with the training load of athletes with cervical spinal cord injury (CSCI) during a period of resumption of wheelchair rugby (WCR) training. Additionally, it aims to compare the psychological and load training aspects during a competitive preseason and determine the correlations between training load, mood, stress, and recovery. Methods: We evaluated variables such as mood (Brazilian Mood Scale, BRAMS), stress and recovery (Recovery-Stress Questionnaire for Athletes, RESTQ-Sport 76) and training load (Subjective Perception of Effort - SPE) of eight high-performance athletes of wheelchair rugby with CSCIs at three different times (E1 = returning from vacation, E2 = half of the preseason, and E3 = after 2 months of training) for 2 months at a monthly interval. We also evaluated motivation (Sport Motivation Scale) at E1 and E3. Results: Results indicated few changes during the competitive preseason in terms of stress, recovery, and mood. However, the training load decreased toward the end of this period. Furthermore, we found that physical complaints positively correlated with depression when resuming training. In the middle of the competitive preseason period, we also noted positive correlations between conflict/pressure and fatigue and between fatigue and energy loss. At the end of this period, the SPE and arbitrary units correlated positively with conflict/pressure. Conclusion: We found few changes during the competitive preseason in terms of stress, recovery, and mood but not motivation, which did not change during this period. On the other hand, the training load decreased at the end of the competitive preseason. Furthermore, we observed correlations between training load and psychological aspects at different times.


Subject(s)
Humans , Spinal Cord Injuries/physiopathology , Exercise , Psychology, Sports , Para-Athletes , Stress, Physiological , Wit and Humor , Motivation
4.
Article in Chinese | WPRIM | ID: wpr-933993

ABSTRACT

Objective:To observe any effect of magnetic stimulation of the primary motor cortex and sacral nerve roots on urinary retention after spinal cord injury.Methods:Forty patients experiencing urine retention after a spinal cord injury were randomly divided into an experimental group and a control group, each of 20. Both groups received conventional treatment and repeated magnetic stimulation of the roots of the sacral nerve. The experimental group also received repeated magnetic stimulation of the bilateral primary motor cortices (M1 region). Bladder capacity and pressure indices, residual urine volume and life quality were evaluated in both groups before and after 8 weeks of treatment.Results:After the treatment, the average maximum bladder pressure, first sensation capacity, residual urine volume and life quality score of both groups had improved significantly, but the improvements in average first sensation capacity, residual urine volume and life quality score of the experimental group were significantly greater than those of the control group. There was, however, no significant difference in the groups′ average maximum bladder pressure after the treatment.Conclusion:Magnetic stimulation of the primary motor cortex and sacral nerve roots can significantly improve the sensory function of the bladder, reduce residual urine volume and improve the life quality of persons experiencing urinary retention after a spinal cord injury.

5.
Article in Chinese | WPRIM | ID: wpr-933987

ABSTRACT

Objective:To observe any effects of electroacupuncture (EA) on urodynamics and bladder c-Kit expression in rats with urination disorders after spinal cord injury (SCI).Methods:Complete spinal cord injury models were created in female Sprague-Dawley rats by transecting the spine at the thoracic or sacral level. On day 22 after the injury, the rats with successful modeling were randomized into a thoracic spinal cord injury (TSCI) group, a TSCI+ EA group, a sacral spinal cord injury (SSCI) group and an SSCI+ EA group, each of 10. Both EA groups were given 15 minutes of EA at the Guanyuan (CV4) and Sanyinjiao (SP6) points daily for 14 days. After the intervention, urination function was evaluated using bladder volume, compliance and residual urine volume. Hematoxylin and eosin staining was used to observe any morphological changes in bladder tissues. The gene and protein expression of c-Kit in bladder tissues were detected using real-time quantitative polymerase chain reactions and western blotting.Results:Compared with the sham group, the bladder volume and compliance of the TSCI group decreased significantly, while the average residual urine volume increased significantly. In the SSCI group the average residual urine volume, bladder volume and compliance all increased significantly. The modeling altered the morphology of the bladder in all of the SCI rats. The average expression of c-Kit mRNA and protein increased significantly in TSCI group, but both decreased significantly in the SSCI group. EA improved the histological structure of the SCI rats′ bladders.Conclusions:EA can bi-directionally regulate bladder c-Kit expression, and that is a possible mechanism for improving urinary incontinence and urine retention after an SCI.

6.
Article in Chinese | WPRIM | ID: wpr-933966

ABSTRACT

Objective:To examine the risk factors for neuropathic pain (NP) after a spinal cord injury (SCI).Methods:A total of 115 patients with a SCI were analyzed retrospectively. They were divided into an NP group of 53 and a non-NP group of 62 according to the occurrence of NP. Gender, age, length of stay, occupation, level of education, cause of injury, spinal fracture, degree of SCI, the injury′s plane and complications at admission (diabetes, hypertension, anemia, venous thrombosis, pressure sores, urinary tract infection or hypoproteinemia) were recorded. T-tests and chi-squared tests were used to compare those factors between the two groups, and multivariate logistic regressions were evaluated to identify the risk factors for NP.Results:Twenty-three of the 53 cases of NP (43%) had developed within 1 month of the SCI. Thirty-seven (75%) experienced pain below the plane of the SCI. The main features reported were squeezing (34%) and numbness (26%). The multivariate logistic regression showed that the occurrence of NP was most strongly related to gender (women being particularly at risk) and venous thrombosis at admission.Conclusions:Women are at particular risk of feeling NP after an SCI, and venous thrombosis is an independent risk factor. NP should be diagnosed and treated quickly to reduce the negative impact on patients′ life quality.

7.
Article in Chinese | WPRIM | ID: wpr-933956

ABSTRACT

Objective:To explore the effect of combining repetitive transcranial magnetic stimulation (rTMS) with treadmill training in treating spinal cord injury (SCI).Methods:Fifty female Sprague-Dawley rats were randomly divided into a sham-operation (C) group, an SCI group, a treadmill training (TT) group, a treadmill training followed by rTMS (TR) group and an rTMS followed by treadmill training (RT) group. The C group only underwent laminectomy without spinal cord injury, while the model of T9 incomplete spinal cord injury was established in the other groups using the Louisville Injury System Apparatus impactor. One week after the operation the TT began. The TR group received rTMS immediately after the treadmill training and the RT group received it before. The treadmill′s speed started at 3.6m/min and gradually increased to 6m/min within 1 week. There was one 15min session a day, 5 days a week, for 8 weeks in total. The rTMS intensity was 30% of the maximum output intensity at 10Hz in 5s bursts with an interval of 25s. It lasted 10min, for a total of 1000 pulses. Hind limb motor functioning was evaluated using the Basso, Beattie & Bresnahan (BBB) locomotor rating scale and a grid walking test. The H max/M max ratio was used to quantify the excitability of the motor neurons. Immunohistochemistry was employed to detect the expression of 5-hydroxytryptamine (5-HT), 5-hydroxytryptamine 1A receptor (5-HT 1AR) and 5-hydroxytryptamine 2A receptor (5-HT 2AR). Results:The average BBB scores of the RT group were significantly higher than the SCI group′s averages from the 7th to 9th week after the injury. At the ninth week the average BBB score of the RT group was significantly higher than the TT group′s average. At the eighth and ninth week the average BBB scores of the TR group were significantly higher than in the SCI group. The number of drops in the RT group was significantly lower than in the SCI group at the seventh and ninth week. At the ninth week, the number of drops of the TR group was significantly lower compared with the SCI group. The H max/M max ratio of the SCI group was significantly higher than in the C and TR groups at the fifth and ninth week, while that of the TR group was significantly lower than the SCI group′s ratio at the ninth week. The expression of 5-HT, 5-HT 1AR and 5-HT 2AR in the RT and TR groups was significantly higher than in the SCI group, and the relative 5-HT 1AR density of the RT and TR groups was significantly higher than in the SCI and TT groups. Compared with the other 4 groups, the expression of 5-HT 2AR in the SCI group had increased significantly. Conclusions:Combining rTMS with treadmill training can significantly promote the recovery of locomotor function after incomplete spinal cord injury.

8.
Article in Chinese | WPRIM | ID: wpr-933953

ABSTRACT

Objective:To observe any effect of functional magnetic stimulation (FMS) of the sacral 3 nerve root on relieving urine retention after a spinal cord injury.Methods:Forty-four patients with neurogenic bladder disorders after a spinal cord injury were divided at random into a 5Hz group ( n=14), a 20Hz group ( n=15), and a sham stimulation group ( n=15). In addition to conventional bladder control training, the 5Hz and 20Hz groups were given 20 minutes of FMS of the sacral 3 nerve root at the appropriate frequency five days a week for 4 weeks. The sham stimulation group was not given any stimulation. A detailed urination diary was kept during the treatment, and before and after the 4 weeks, everyone′s bladder pressure volume was assessed and an electromyogram was recorded. Results:After the treatment those in the 5Hz and 20Hz groups had improved significantly in terms of average bladder capacity, bladder pressure, residual urine volume, daily number of urethral catheterizations, daily micturition frequency, single urine output, H-reflex latency, and the amplitude and incubation period of the F wave. Those in the sham stimulation group showed no consistent improvement in any of these indicators. Moreover, the average residual urine volume, daily urination frequency and H-reflex latency and amplitude of the 20Hz group were significantly better than those of the 5Hz group.Conclusions:Magnetic stimulation of the S3 nerve roots can effectively improve the urination of persons with neurogenic bladder disorders after a spinal cord injury. The preferred frequency is 20Hz.

9.
Article in Chinese | WPRIM | ID: wpr-931688

ABSTRACT

Objective:To investigate the effects of sequential organ failure assessment (SOFA) score, Braden Scale score, and nutritional indicators in patients with pressure ulcer after spinal cord injury.Methods:Eighty spinal cord injury patients with pressure ulcer who received treatment in the First People's Hospital of Huzhou, China between January 2019 and February 2020 were included in the patient group. Among these patients, 22 had stage I pressure ulcer, 33 had stage II pressure ulcer, and 25 had stage III pressure ulcer. An additional 140 patients with spinal cord injury but without pressure ulcer who concurrently received treatment in the same hospital were included in the control group. SOFA score, Braden Scale score and nutritional indicators were compared between the two groups. The correlation between SOFA score, Braden scale score and nutritional indicators was analyzed.Results:There were no significant differences in gender, age, hypertension, diabetes, operation condition and American Spinal Injury Association Impairment Scale score between the two groups (all P > 0.05). There were significant differences in body mass index [(24.25 + 1.44) kg/m 2vs. (27.68 + 2.21) kg/m 2, t = 12.44, P < 0.05], use of vasoactive drugs (29.29% vs. 43.75%, χ 2 = 4.71, P < 0.05), length of hospital stay [(10.71 + 2.62) days vs. (16.39 + 3.05) days, t = 14.56, P < 0.05]. SOFA score in the observation group was significantly higher than that in the control group [(9.72 ± 1.18) points vs. (4.51 ± 0.30) points, t = 49.58, P < 0.001]. Braden scale score in the observation group was significantly lower than that in the control group [(10.64 ± 1.05) points vs. (13.49 ± 2.28) points, t = 10.55, P < 0.001]. Serum level of hemoglobin, prealbumin, and albumin in the observation group was (81.03 ± 8.48) g/L, (145.29 ± 14.72) mg/L, (20.24 ± 2.05) g/L, respectively, which were significantly lower than those in the control group [(107.25 ± 10.14) g/L, (170.86 ± 23.75) mg/L, (32.38 ± 4.07) g/L, t = 19.54, 8.71, 24.91, all P < 0.001]. Spearman correlation analysis showed that SOFA score was positively correlated with serum level of hemoglobin, prealbumin, and albumin ( r = 0.50, 0.64, 0.71, all P < 0.05). SOFA score was negatively correlated with Braden Scale score ( r = -0.51, -0.62, -0.75, all P < 0.05). Conclusion:Pressure ulcer in spinal cord injury is caused by combined action of multiple factors. SOFA score, Braden scale score, and combined detection of hemoglobin, prealbumin, and albumin can be used to better evaluate pressure ulcer after spinal cord injury.

10.
Article in Chinese | WPRIM | ID: wpr-930648

ABSTRACT

Objective:To explore the mediating effect of self-efficacy and fatigue between depression and cognitive function in patients with spinal cord injury.Methods:General information questionnaire, Hamilton Depression Scale, Montreal Cognitive Scale, Rehabilitation Exercise Self-Efficacy Scale, Fatigue Revised Scale were used to investigate 256 cases of spinal cord injury patients from December 2018 to August 2020. The deviation-corrected percentile Bootstrap method was used to test the chain mediating effect of rehabilitation exercise self-efficacy and fatigue on depression and cognitive function.Results:Correlation analysis showed that depression was negatively correlated with cognitive function ( r=-0.146, P<0.01), self-efficacy of rehabilitation exercise ( r=-0.115, P<0.01), and positively correlated with fatigue ( r=0.317, P<0.01), self-efficacy of rehabilitation exercise was positively correlated with cognitive function ( r=0.903, P<0.01), and negatively correlated with fatigue ( r=-0.889, P<0.01), and fatigue was negatively correlated with cognitive function ( r=-0.217, P<0.01). The mediation model test showed that depression had a significant direct effect on cognitive function, with an effect value of -0.141 and an effect size of 50.20%. Self-efficacy of rehabilitation exercise and fatigue had a significant mediating effect between depression and cognitive function. The effect value was -0.096, -0.026, the effect size was 34.1%, 9.3%, and the chain mediation effect of rehabilitation exercise self-efficacy-fatigue was also significant, the effect value was -0.018, and the effect size was 6.4%. Conclusions:Depression in patients with spinal cord injury not only directly affects cognitive function, but also indirectly affects cognitive function through the mediating effects of self-efficacy of rehabilitation exercise and fatigue, and the chain-type mediating effect of rehabilitation exercise self-efficacy and fatigue.

11.
Article in Chinese | WPRIM | ID: wpr-929684

ABSTRACT

ObjectiveTo investigate the status of self-management in patients with spinal cord injury and the related factors. MethodsFrom May, 2020 to February, 2021, 255 patients from a spinal cord injury club were enrolled, and investigated with the general information questionnaire, self-management ability scale, Chronic Disease Self-efficacy Scale through internet. Multiple linear stepwise regression was used to explore the related factors. ResultsThe scores of disease symptom management, daily life management, intermittent catheterization behavior management, emotional management and social return were (40.458±9.122), (33.945±6.800), (36.709±8.736) and (25.011±4.932), respectively. The average score for the single question of daily life management was the highest (3.772±0.755), while emotional management and social return was the lowest (3.573±0.705). Duration of intermittent catheterization, family members' attitude, self-efficacy and occupation were the related factors of symptom management (R2 = 0.135, F = 7.744, P < 0.001). Self-efficacy, duration of intermittent catheterization, use of hydrophilic coated catheters and complications were the related factors of daily life management (R2 = 0.173, F = 13.042, P < 0.001). Self-efficacy, duration of intermittent catheterization, use of hydrophilic coated catheters and medical insurance were the related factors of intermittent catheterization behavior management (R2 = 0.141, F = 10.259, P < 0.001). Self-efficacy, duration of intermittent catheterization, complications and frequency of intermittent catheter in the last week were the related factors of emotional management and social regression dimensions (R2 = 0.282, F = 19.590, P < 0.001). ConclusionThe self-management of patients with spinal cord injury by clean intermittent catheterization is at medium level. Moreover, it may be affected by many factors. Some of them can be targets of intervention.

12.
Article in Chinese | WPRIM | ID: wpr-940207

ABSTRACT

ObjectiveTo investigate the effect of calycosin-mediated glucoprotein130/Janus kinase/signal transducer and activator of transcription factor (GP130/JAK/STAT) signaling pathway on oxidative injury of astrocytes in spinal cord. MethodAstrocytes in rat spinal cord were isolated and identified by immunofluorescence detection of glial fibrillary acidic protein (GFAP). The cells were respectively pre-treated with 5, 10, 20 μmol·L-1 calycosin for 12 h, and then 100 μmol·L-1 H2O2 (24 h) was added to induce oxidative injury. Cell counting kit-8 (CCK-8) assay was employed to detect cell proliferation and select the optimal concentration of calycosin. The following experimental groups were designed: control group, model group (100 μmol·L-1 H2O2), calycosin group (20 μmol·L-1 calycosin), calycosin + LY294002 group (20 μmol·L-1 calycosin + 10 μmol·L-1 LY294002), and calycosin + Stattic group (20 μmol·L-1 calycosin + 3 μmol·L-1 Stattic). CCK-8 assay and immunofluorescence method were used to detect the proliferation of cells and flow cytometry was applied to detect cell apoptosis and cycle. The protein expression of phosphorylated (p)-JAK2, p-STAT3, p-protein kinase B (Akt), GP130, and interleukin-6 (IL-6) was detected by Western blotting. ResultCompared with the control group, the model group showed low proliferation activity and high apoptosis rate of cells (P<0.05). Compared with the model group, calycosin (20 μmol·L-1) group displayed high proliferation activity and low apoptosis rate of cells (P<0.05). Compared with calycosin (20 μmol·L-1) group, both phosphatidylinosirtol-3-kinases (PI3K) inhibitor LY294002 and STAT3 inhibitor Stattic significantly reduced the proliferation activity and increased the apoptosis rate of cells (P<0.05). The protein expression of p-JAK2, p-STAT3, p-Akt, GP130, and IL-6 in the model group was higher than that in the control group (P<0.05), and the expression of the above indicators was lower in each treatment group than in the model group (P<0.05). ConclusionCalycosin can promote the proliferation and inhibit the apoptosis of astrocytes with oxidative injury by inhibiting the phosphorylation of PI3K/Akt pathway and JAK2/STAT3 pathway.

13.
Article in Chinese | WPRIM | ID: wpr-940110

ABSTRACT

ObjectiveTo investigate the effect of calycosin-mediated glucoprotein130/Janus kinase/signal transducer and activator of transcription factor (GP130/JAK/STAT) signaling pathway on oxidative injury of astrocytes in spinal cord. MethodAstrocytes in rat spinal cord were isolated and identified by immunofluorescence detection of glial fibrillary acidic protein (GFAP). The cells were respectively pre-treated with 5, 10, 20 μmol·L-1 calycosin for 12 h, and then 100 μmol·L-1 H2O2 (24 h) was added to induce oxidative injury. Cell counting kit-8 (CCK-8) assay was employed to detect cell proliferation and select the optimal concentration of calycosin. The following experimental groups were designed: control group, model group (100 μmol·L-1 H2O2), calycosin group (20 μmol·L-1 calycosin), calycosin + LY294002 group (20 μmol·L-1 calycosin + 10 μmol·L-1 LY294002), and calycosin + Stattic group (20 μmol·L-1 calycosin + 3 μmol·L-1 Stattic). CCK-8 assay and immunofluorescence method were used to detect the proliferation of cells and flow cytometry was applied to detect cell apoptosis and cycle. The protein expression of phosphorylated (p)-JAK2, p-STAT3, p-protein kinase B (Akt), GP130, and interleukin-6 (IL-6) was detected by Western blotting. ResultCompared with the control group, the model group showed low proliferation activity and high apoptosis rate of cells (P<0.05). Compared with the model group, calycosin (20 μmol·L-1) group displayed high proliferation activity and low apoptosis rate of cells (P<0.05). Compared with calycosin (20 μmol·L-1) group, both phosphatidylinosirtol-3-kinases (PI3K) inhibitor LY294002 and STAT3 inhibitor Stattic significantly reduced the proliferation activity and increased the apoptosis rate of cells (P<0.05). The protein expression of p-JAK2, p-STAT3, p-Akt, GP130, and IL-6 in the model group was higher than that in the control group (P<0.05), and the expression of the above indicators was lower in each treatment group than in the model group (P<0.05). ConclusionCalycosin can promote the proliferation and inhibit the apoptosis of astrocytes with oxidative injury by inhibiting the phosphorylation of PI3K/Akt pathway and JAK2/STAT3 pathway.

14.
Article in Chinese | WPRIM | ID: wpr-939993

ABSTRACT

ObjectiveTo investigate the changes of bone mineral density of distal femur and proximal tibia in patients with spinal cord injury. MethodsNine inpatients with spinal cord injury in Beijing Bo'ai Hospital for rehabilitation from November, 2018 to January, 2021 were recruited. The bone mineral density of distal femur, proximal tibia, total hip and femoral neck at admission and six months after admission was measured. ResultsCompared with the results of admission, the bone mineral density of distal femur, proximal tibia, total hip and femoral neck decreased significantly six months after admission (∣Z∣ > 2.265, P < 0.01). The percentage of decreased bone mineral density in the femoral neck was inversely correlated with the lower extremity movement score at the second measurement (r = -0.515, P = 0.035). ConclusionWithin one year after the onset of spinal cord injury, the bone mineral density of distal femur and proximal tibia decreases.

15.
Article in Chinese | WPRIM | ID: wpr-928293

ABSTRACT

Spinal cord injury is a severe central nervous system disease, which will cause a series of complex pathophysiological changes and activate a variety of signaling pathways including Notch signaling. Studies have evidenced that activation of the Notch signaling pathway is not conducive to nerve repair and symptom improvement after spinal cord injury. Its mechanisms include inhibiting neuronal differentiation and axon regeneration, promoting reactive astrocyte proliferation, promoting M1 macrophage polarization and the release of proinflammatory factors, and inhibiting angiogenesis. Therefore, it has become a promising therapeutic strategy to inhibit Notch signal as a target in the treatment of spinal cord injury. In recent years, some researchers have used drugs, cell transplantation or genetic modification to regulate Notch signaling, which can promote the recovery of nerve function after spinal cord injury, thereby providing new treatment strategies for the treatment of spinal cord injury. This article will summarize the mechanism of Notch signaling pathway in spinal cord injury, and at the same time review the research progress in the treatment of spinal cord injury by modulating Notch signaling pathway in recent years, so as to provide new research ideas for further exploring new strategies for spinal cord injury.


Subject(s)
Axons/metabolism , Cell Transplantation , Humans , Nerve Regeneration , Signal Transduction/genetics , Spinal Cord/metabolism , Spinal Cord Injuries/metabolism
16.
Article in Chinese | WPRIM | ID: wpr-928283

ABSTRACT

OBJECTIVE@#To compare the clinical effects of total laminectomy with lateral mass screw fixation and single open-door laminoplasty in the treatment of cervical spinal cord injury without fracture and dislocation.@*METHODS@#The clinical data of 75 patients with cervical spinal cord injury without fracture and dislocation treated from December 2014 to April 2020 were retrospectively analyzed, including 65 males and 10 females, aged from 33 to 83 years old with an average of (60.1±11.4) years. According to surgical method, the patients were divided into observation group (36 cases) and control group (39 cases). The observation group was treated with C3-C6 single open-door laminoplasty. In the control group, the C3-C6 whole lamina was opened by "uncovering", and the lateral mass screw was fixed and fused. The general conditions including operation time, intraoperative blood loss, hospital stay and complications such as axial pain, cerebrospinal fluid leakage, postoperative C5 nerve palsy were recorded. Visual analogue scale(VAS), Nurick pain scale, Japanese Orthopaedic Association(JOA) scores and American Spinal Injury Association(AISA) injury scale were used to evaluate the improvement of clinical symptoms and related functional recovery 12 months after operation.@*RESULTS@#There were no statistically significant differences in operation time, intraoperative blood loss and hospital stay between two groups(P>0.05). There were statistically significant differences in JOA, VAS, ASIA and Nurick scores of the all patients between 12 months after surgery and before surgery (P<0.05), and there was no significant difference between groups. There was significant difference in the incidence of C5 nerve root palsy and axial pain between two groups(P<0.05), but there was no significant difference in the complications of cerebrospinal fluid leakage between two groups (P>0.05).@*CONCLUSION@#Total laminectomy with lateral mass screw fixation and single open-door laminoplasty in treating cervical spinal cord injury without fracture and dislocation can obtain satisfactory results in restoring nerve function, alleviating pain and improving daily behavior, but single open-door laminoplasty has the advantages of less trauma and low incidence of complications.


Subject(s)
Adult , Aged , Aged, 80 and over , Bone Screws , Case-Control Studies , Cervical Cord/surgery , Cervical Vertebrae/surgery , Female , Humans , Laminectomy/methods , Laminoplasty/methods , Male , Middle Aged , Retrospective Studies , Treatment Outcome
17.
Article in Chinese | WPRIM | ID: wpr-928194

ABSTRACT

Electric field stimulation (EFS) can effectively inhibit local Ca 2+ influx and secondary injury after spinal cord injury (SCI). However, after the EFS, the Ca 2+ in the injured spinal cord restarts and subsequent biochemical reactions are stimulated, which affect the long-term effect of EFS. Polyethylene glycol (PEG) is a hydrophilic polymer material that can promote cell membrane fusion and repair damaged cell membranes. This article aims to study the combined effects of EFS and PEG on the treatment of SCI. Sprague-Dawley (SD) rats were subjected to SCI and then divided into control group (no treatment, n = 10), EFS group (EFS for 30 min, n = 10), PEG group (covered with 50% PEG gelatin sponge for 5 min, n = 10) and combination group (combined treatment of EFS and PEG, n = 10). The measurement of motor evoked potential (MEP), the motor behavior score and spinal cord section fast blue staining were performed at different times after SCI. Eight weeks after the operation, the results showed that the latency difference of MEP, the amplitude difference of MEP and the ratio of cavity area of spinal cords in the combination group were significantly lower than those of the control group, EFS group and PEG group. The motor function score and the ratio of residual nerve tissue area in the spinal cords of the combination group were significantly higher than those in the control group, EFS group and PEG group. The results suggest that the combined treatment can reduce the pathological damage and promote the recovery of motor function in rats after SCI, and the therapeutic effects are significantly better than those of EFS and PEG alone.


Subject(s)
Animals , Electric Stimulation , Polyethylene Glycols/therapeutic use , Rats , Rats, Sprague-Dawley , Recovery of Function/physiology , Spinal Cord , Spinal Cord Injuries/therapy
18.
Article in Chinese | WPRIM | ID: wpr-927398

ABSTRACT

OBJECTIVE@#To observe the effect of moxibustion at oppositely-located points "Mingmen" (GV 4) and "Shenque" (CV 8) on the motor function of the hind limbs and bladder function in rats with neurogenic bladder after suprasacral spinal cord injury (SCI), so as to explore the effect of this therapy on bladder tissue apoptosis mediated by endoplasmic reticulum stress pathway.@*METHODS@#Twenty-eight female Wistar rats were randomly divided into a sham-operation group (8 rats) and a model establishment group (20 rats). Using the modified Allen's method, the spinal cord of T10 segment was injured to establish a neurogenic bladder model in the model establishment group. Sixteen rats were modeled successfully and then divided into a model group (8 rats) and a moxibustion group (8 rats). In the moxibustion group, 2 h after consciousness regaining from modeling anesthesia, moxibustion was exerted at "Shenque" (CV 8) and "Mingmen" (GV 4), 2 cones at each acupoint in one intervention. The intervention was administered once every two days and 5-time intervention was required totally. After intervention, Basso, Beattie and Bresnahan locomotor rating scale (BBB) score for the motor function of the hind limbs, and the urodynamics indexes (maximum bladder capacity, urine leakage pressure and bladder compliance) were compared among groups. HE staining method was adopted to observe the morphological changes of bladder tissue. With Western blot method and real-time PCR assay, the protein and mRNA expressions of the endoplasmic reticulum stress-related genes (glucose- regulated protein 78 [GRP78], activating transcription factor 4 [ATF4] and cysteinyl aspartate specific proteinase-12 [Caspase-12]) were determined.@*RESULTS@#The transitional epithelial cells were arranged irregularly, the bladder wall was getting thinner, and the cellular vacuolar degeneration and neutrophil infiltration were found in the model group. Whereas, compared with the model group, in the moxibustion group, the arrangement of transitional epithelial cells was clear and continuous in layers, the cellular vacuolar degeneration was mild and the infiltration presented in a small amount of neutrophil granulocytes. Compared with the sham-operation group, in the model group, the BBB score was reduced (P<0.01), the maximum bladder capacity and bladder compliance were increased (P<0.01), and the protein expression levels of GRP78, ATF4 and Caspase-12, as well as mRNA expressions were all increased (P<0.01). In comparison with the model group, in the moxibustion group, BBB score was increased (P<0.01), the maximum bladder capacity and bladder compliance were decreased (P<0.01), and the protein and mRNA expression levels of GRP78, ATF4 and Caspase-12 were all decreased (P<0.01).@*CONCLUSION@#Moxibustion at the "oppositely-located points" improves the urination function, alleviate urine retention in neurogenic bladder rats after spinal cord injury. The underlying mechanism may be related to the down-regulation of the expressions of GRP78, ATF4 and Caspase-12 in the endoplasmic reticulum stress pathway of the bladder tissues, and thus to alleviate the apoptosis of bladder tissue.


Subject(s)
Animals , Caspase 12/genetics , Electroacupuncture , Endoplasmic Reticulum Stress , Female , Moxibustion , RNA, Messenger , Rats , Rats, Sprague-Dawley , Rats, Wistar , Spinal Cord , Spinal Cord Injuries/therapy , Urinary Bladder, Neurogenic/therapy
19.
Article in Chinese | WPRIM | ID: wpr-927376

ABSTRACT

OBJECTIVE@#To observe the effect of moxibustion at "Guanyuan" (CV 4) and "Shenque" (CV 8) on acetylcholine (Ach), adenosine triphosphate (ATP) and muscarinic-type choline receptor (M2) and purine receptor P2X3 in bladder tissue in the rats with neurogenic bladder (NB) of detrusor areflexia after lumbar-sacral spinal cord injury and explore the underlying mechanism of moxibustion for promoting detrusor contraction.@*METHODS@#Sixty SD rats were randomly divided into a model preparation group (n=45) and a sham-operation group (n=15). In the model preparation group, the modified Hassan Shaker spinal cord transection method was used to prepare the model of NB. In the sham-operation group, the spinal cord transection was not exerted except laminectomy and spinal cord exposure. Among the rats with successfully modeled, 30 rats were selected and divided randomly into a model group and a moxibustion group, with 15 rats in each one. On the 15th day after the operation, moxibustion was applied at "Guanyuan" (CV 4) and "Shenque" (CV 8) in the moxibustion group, 10 min at each acupoint, once a day. The consecutive 7-day treatment was as one course and the intervention for 2 courses was required. Urodynamic test was adopted to evaluate bladder function in rats. Using HE staining, the morphological changes in bladder tissue were observed. The content of Ach and ATP in bladder tissue was measured with biochemical method, and the protein and mRNA expression levels of M2 and P2X3 receptors in bladder tissue were detected with Western blot and real-time fluorescence quantification PCR method.@*RESULTS@#Compared with the sham-operation group, the maximum bladder capacity, leakage point pressure and bladder compliance were increased in the rats of the model group (P<0.05). Compared with the model group, the maximum bladder capacity, the leakage point pressure and bladder compliance were decreased in the rats of the moxibustion group (P<0.05). In the model group, the detrusor fibres were arranged irregularly, bladder epithelial tissues were not tightly connected and cell arrangement was disordered, combined with a large number of vacuolar cells. In the moxibustion group, compared with the model group, the detrusor fibres were arranged regularly, bladder epithelial cells were well distributed and vacuolar cells were reduced. Compared with the sham-operation group, the content of Ach and ATP in bladder tissue was decreased (P<0.05), the protein and mRNA expression levels of M2 and P2X3 receptors were reduced (P<0.05) in the model group. In the moxibustion group, the content of Ach and ATP in bladder tissue was increased (P<0.05) and the protein and mRNA expression levels of M2 and P2X3 receptors were increased (P<0.05) as compared with the model group.@*CONCLUSION@#Moxibustion at "Guanyuan" (CV 4) and "Shenque" (CV 8) may effectively improve bladder function in the rats with NB of detrusor areflexia after lumbar-sacral spinal cord injury and its underlying mechanism is related to promoting the release of Ach and up-regulating the expression of M2 receptor, thereby enhancing the release of ATP and increasing the expression of P2X3 receptor. Eventually, detrusor contraction is improved.


Subject(s)
Animals , Moxibustion/methods , Rats , Rats, Sprague-Dawley , Receptors, Purinergic P2X3/metabolism , Spinal Cord Injuries/therapy , Urinary Bladder , Urinary Bladder, Neurogenic/therapy
20.
Article in Chinese | WPRIM | ID: wpr-924652

ABSTRACT

ObjectiveTo systematically review the efficacy and safety of exosomes derived from bone marrow mesenchymal stem cells (BMSC) on animal models of spinal cord injury. MethodsAnimal studies about BMSC-derived exosomes for spinal cord injury were retrieved from databases of PubMed, Cochrane Library, Web of Science, CNKI and Wangfang Data, from establishment to October, 2021. Two researchers independently screened and extracted the data, and evaluated the risk of bias. The studies were qualitatively analyzed. ResultsA total of 21 studies were included, involving 1 342 animals. Male or female Sprague-Dawley rats were selected for 18 studies, and the body mass of the rats was (200±50) g in 19 studies. The injury nodes focused on T9-11 spinal cord, with various methods. The types, medication time, frequency, concentration and dose of the exosomes were heterogeneous. ConclusionsThe BMSC-derived exosomes can improve the motor function after spinal cord injury, reduce the damage of spinal cord, resist apoptosis and inflammation, reduce the permeability of blood-spinal cord barrier, and promote the growth of axons and blood vessels. More high-quality studies are needed for further verification.

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