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BACKGROUND:Glial scar and cavity formation fol owing spinal cord injury inhibits axonal entrance, so limited axonal regeneration, less secretion of neurotrophic factor and inhibitors in the microenvironment of axonal growth are considered as major impediments for impacting functional recovery of patients with spinal cord injury. OBJECTIVE:To analyze literatures home and abroad related to the biological characters of astrocytes and glial scar hyperplasia after spinal cord injury, and to provide a theoretical basis for the mechanism underlying glial scar formation fol owing spinal cord injury. METHODS:PubMed and Wanfang databases were retrieved using the keywords“astrocytes, reactive astrogliosis, glial scar, spinal cord injury”in English and Chinese, respectively. Final y 62 literatures were selected for overview. RESULTS AND CONCLUSION:Currently, studies concerning the biological characters of astrocytes, reactive astrogliosis and glial scar formation fol owing spinal cord injury have achieved some progresses. Studies mainly focus on the sole impediment for spinal cord injury, and treatment also aims at inhibiting single factor, but interactions among factors have not been confimed. In addition, the regulatary mechanisms of specific intracel ular and extracel ular signal molecule in the astrocytes, and effective control and interference of glial scar formation fol owing spinal cord injury stil need in-depth study.
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BACKGROUND:With the development of spinal cord injury study, different methods of establishing spinal cord injury models have emerged, including spinal cord contusion, fal ing weight, spinal compression, chemical burn, radiation, hormone, spinal transection and hemi-section. However, lots of them are not perfect enough. OBJECTIVE:To design the injury device of spinal cord injury and establish different degrees of spinal cord injury models. METHODS:To design the device of producing spinal cord injury and establish different degrees of spinal cord dorsal compression injury in Sprague-Dawley rats by various weights (m1=10 g, m2=20 g, m3=30 g) and time points (T1=3 s, T2=5 s). Rats were randomly divided as m1T1, m2T1, m3T1, m1T2, m2T2 and m3T2 groups. While sham group was also made. RESULTS AND CONCLUSION:Basso-Beattie-Bresnahan (BBB) score in injury groups decreased significantly after operation, when compared with the sham group (P<0.01). The m 1T1 group showed no significant difference in BBB score from other groups (P<0.01). The BBB score of m1T2 group was significant higher than m2T2 group and m3T2 group at 8 weeks after operation (P<0.05). The somatosensory evoked potential and motion evoked potential of injury groups were longer than sham group at 8 weeks after operation (P<0.01). The motion evoked potential of each injury groups were significantly longer after operation (P<0.05). The somatosensory evoked potential was significantly longer in injury groups, except m1T1 and m1T2 groups (P<0.05). The self-designed device can be applied to establish different degrees of spinal cord injury models.
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BACKGROUND:Total knee replacement is regarded an effective treatment of knee osteoarthritis, based on the transformation of biology-psychology-social medicine pattern, the concept of“quality of life”has attracted increasing concerns. OBJECTIVE:To observe the effects of total knee replacement surgery on the pain, function and quality of life among elder patients with severe knee osteoarthritis. METHODA total of 102 elder patients with severe knee osteoarthritis were recruited from the Second Affiliated Hospital of Inner Mongolia Medical University between January 2010 and January 2013. The clinical manifestations and 12-month fol ow-up outcomes were observed and recorded. The involved patients were randomly divided into two grouptreatment group (59 cases, receiving total knee replacement) and control group (43 cases, receiving expectant treatment such as drugs, but no surgery). Patients were evaluated using HSS scale and WHOQOL-100 scale before surgery and 12 months after surgery. Furthermore, the correlation between influencing factors and HSS and WHOQOL-100 scores was analyzed. RESULTS AND CONCLUSION:At 12 months postoperatively, the HSS scores of patients in treatment group was (82.03±10.17) points, which was obviously higher than that in control group (P0.50). The regression analysis shows that marital status (β=1.988), complication (β=2.035) and HSS scores (β=2.108) are the main influencing factors for the quality of life among patients undergoing replacement. Experimental findings indicate that, HSS score is an effective indicator to assess the effect of total knee replacement on the pain and function of elder patients with severe knee osteoarthritis. WHOQOL-100 is introduced to further improve the assessment of quality of life after total knee replacement surgery in severe knee osteoarthritis. The marital status, complication and HSS scores are the key influencing factors for the quality of life among severe knee osteoarthritis patients. Deep vein thrombosis affects the out-of-bed time, and the mate-accompanying during the fol ow-ups plays a positive role on the quality of life and mental state of patients.
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BACKGROUND:Studies have shown that bone marrow mesenchymal stem cells under certain conditions can differentiate into nerve cells. Bone marrow mesenchymal stem celltransplantation can rebuild nervous system function and improve functional disorders in patients. Glycosides of cistanche also have a protective effect against nerve cellinjury. Their combination has been less reported. OBJECTIVE:To observe the effectiveness of Cistanche deserticola and bone marrow mesenchymal stem celltransplantation on spinal cord injury in rats. METHODS:Fifty adult Wistar rats with spinal cord injury were randomly divided into four group:a Cistanche deserticola group (intragastric administration of 20 mL/kg Cistanche deserticola concentrated solution per day), a celltransplantation group (10μL of 1×108/L bone marrow mesenchymal stem cellsuspension), a combination group (10μL of 1×108/L bone marrow mesenchymal stem cellsuspension+intragastric administration of 20 mL/kg Cistanche deserticola concentrated solution per day) and a control group (intragastric administration of 20 mL/kg normal saline per day). The intragastric administration lasted for 30 days in each group. RESULTS AND CONCLUSION:After 30 days of treatment, the expression of Nestin was significantly higher in the combination group than the other groups. After 12 weeks, Basso, Beattie, and Bresnahan scores was significantly higher in the combination group than the other groups (P<0.05);somatosensory and motor evoked potential latencies were also improve significantly in the combination group compared with the other groups (P<0.05). These findings indicate that oral administration of Cistanche deserticola combined with bone marrow mesenchymal stem cells can significantly improve the motor and neurophysiological function of spinal cord injury rats. Cistanche deserticola can improve the survival of transplanted bone marrow mesenchymal stem cells in rats with spinal cord injury.
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Objective To evaluate a new model of anterior spinal cord injury (SCI) syndrome and to explore the pathophysiology of SCI. Methods Fifty-five Wistar rats were randomly divided into a sham-operated group ( 10 rats) and an experimental group (45 rats). A metal hook was fixed in front of the rats'abdomens to compress the ventral part of the spinal cord in the experimental group. According to the degree and time of compression,the rats in the experimental group were divided into light, moderate, heavy injury subgroups. The tilt board test and the Bosso-Beattie- Bresnahan (BBB) locomotor rating scale were used to assess the rats' behavior at the 1st , 7th andl4th days and after 4 and 8 weeks. The latency of somatosensory evoked potential (SEP) and motor evoked potential (MEP) were measured before and 8 weeks after the operation. Results After the operation the gradients in the tilt board test and BBB scores in the experimental subgroups were all significantly lower than in the sham-operated group. There were also significant differences among the 3 severity subgroups. Eight weeks after the operation the average MEP latencies in the experimental subgroups were significantly longer than in the sham-operated group, and there were also significant differences among the 3 severity sub-groups. MEP in the heavy injury subgroup was significantly longer compared with the sham-operated group. Conclusions Obvious behavioral and neuroelectrophysiological changes were observed in the injured rats. Models of different severity could be prepared and reproduced to simulate clinical SCI.
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Objective To observe the effect of electroacupuncture and body-weight supported treadmill training in the treatment of spinal cord injury (SCI) after fractures of the thoracolumbar segment of the spine.Methods Forty-three patients with SCI after fractures of the thoracolumbar segment of the spine were randomly divided into a treatment group (22 cases) and a control group (21 cases). The patients in the treatment group were treated with electroacupuncture and body-weight supported treadmill training, while those in the control group were treated mainly with drugs. Patients were scored with the American Spinal Injury Association (ASIA) assessment and the modified Barthel index (MBI) initially and after 6 months. Results The ASIA and MBI scores of all patients were significantly higher after 6 months than before treatment, but those in the treatment group were significantly higher than those in the control group. Excellent and good ratings were applied to 77% of the treatment group, while only 48% of the control group, a statistically significant difference. Conclusions Electroacupuncture and body-weight supported treadmill training can effectively improve ability in the activities of daily living, sensation and locomotor abilities after thoracolumbar vertebral fractures.
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Objective To observe the effectiveness of comprehensive rehabilitation for neurogenic bladder of patients with spinal cord injury and prevent urinary tract infection (UTI). Methods Fifty-seven patients with spinal cord injury were randomly divided into two groups: treatment group (29 cases) and control group (28 cases). The patients in treatment group were treated with comprehensive rehabilitation,while those in control group were treated mainly with catheterization and TDP equipment. Scored with Barthel index and the rate of UTI. Results It was shown that the improvement of Barthel index after treatment [(8.93 ± 6.27) scores] and the rate of UTI [13.79%(4/29)] were significantly better than those in control group[(5.16 ± 6.82) scores,67.86%(19/28)], which had significant differences (P＜ 0.05). Conclusion Comprehensive rehabilitation can reconstruct bladder function and prevent UTI of patients with spinal cord injury effectively.