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Objective:To observe the effect of electroacupuncture based on transcranial magnetic stimulation (TMS) on wakefulness for consciousness disorder. Methods:From January, 2015 to October, 2019, 30 inpatients with consciousness disorder from the General Hospital of Western Theater Command were randomly divided into control group (n = 15) and observetion group (n = 15), Both groups received TMS, and the observetion group received electroacupuncture at Baihui (GV20), Shenting (GV24), bilateral Neiguan (PC6) bilateral Hegu (LI4) and bilateral Yongquan (KI1) in addition, for three months. They were tested the latency of the mismatch negativity (MMN), and assessed with Glasgow Coma Scale (GCS) and persistent vegetative state (PVS) score before, and one month and three months after treatment. Results:The latency of MMN decreased more in the observetion group than in the control group three months after treatment (t = 2.159, P < 0.05). Conclusion:Combination of electroacupuncture on TMS is more effective on wakefulness for consciousness disorder.
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Objective:To investigate the effects of iridoid-rich fraction from Valeriana jatamansi Jones (IRFV) on neuronal pyroptosis in rats with acute spinal cord injury, and to explain the related mechanism of neuroprotection. Methods:Twenty-four healthy male Sprague-Dawley rats were randomly divided into sham-operated group, model group and treatment group, with eight rats in each group. The model of spinal cord injury was established by using a medical aneurysm clip in the latter two groups. Only the lamina was removed without injury to the spinal cord in the sham-operated group. Four hours after the operation, the treatment group was given IRFV solution 10 mg/kg, the model group and the sham-operated group were given the same volume of sodium carboxymethyl cellulose (CMC-Na) solution, for seven days. The rats were sacrificed to detected the pathological changes and the residual area of spinal cord tissue through HE staining. The apoptosis of nerve cells of the spinal cord tissue at the perilesional area was detected by TUNEL fluorescent staining. The levels of interleukin (IL)-1 and IL-18 in serum were detected by ELISA Kit and the expression of NLRP3, Caspase-1 and GSDMD were detected by Western blotting. Results:Compared with the sham-operated group, the residual area of spinal cord tissue decreased (P < 0.05), and the positive rate of TUNEL staining, the level of IL-1 and IL-18, and the expression of pyroptosis-associated proteins (NLRP3, Caspase-1 and GSDMD) increased (P < 0.05) in the model group. Compared with the model group, the pathological condition of the spinal cord tissue improved and the residual area of the spinal cord tissue increased (P < 0.05); the positive rate of TUNEL staining, the level of IL-1 and IL-18 and the expression of NLRP3, Caspase-1 and GSDMD decreased (P < 0.05) in the treatment group. Conclusion:IRFV could attenuate the inflammatory response to exert neuroprotective effects, which may be related to the regulation of NLRP3/Caspase-1 signaling pathway to inhibit the neuronal pyroptosis in rats with acute spinal cord injury.
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Results and Conclusion A total of 236 authors were included, out of whom 49 authors published more than three papers, and high-yielding authors were mainly represented by Zeng Y S and Chen L. There were 162 countries/institutions involved, out of which 85 published more than three papers. Seventy-five journals were included, out of which Exp Neurol was the one with the most articles. There were 107 key words included, and the hot words were spinal cord injury, MSCs, transplantation, bone marrow, repair, and functional recovery, which formed six cluster groups. The trend was to extract and culture progenitor cells and induce their directional differentiation; mechanism of immune regulation, anti-inflammatory and nerve regeneration in the treatment of spinal cord injury by MSCs, as well as the research of tissue engineering technology, biological materials in this field. Objective:To analyze the research status and hotspots of mesenchymal stem cells (MSCs) for treatment of spinal cord injury in the past five years. Methods:The related literatures from 2014 to 2018 in Science Citation Index-Expanded (SCI-E) of Web of Science (WOS) were included. CiteSpace software was used to analyze the cooperation relationship of authors, countries and research institutions. The keywords were taken as nodes for co-occurrence analysis, cluster analysis, dynamic frontier evolution and burst analysis. The co-citation of journals and literatures were taken as nodes for analysis, meanwhile, the visual maps were drawn and the results were analyzed.
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Objective:To investigate the changes of genus-level gut microbiome in patients with spinal cord injury and its significance in clinical rehabilitation. Methods:Fecal samples were collected from 23 patients with spinal cord injury (patients group) and 21 healthy volunteers (control group). Gut microbiome was detected by 16S rDNA high-throughput sequencing. Bioinformatics methods such as species composition analysis and Random Forest were used to analyze the distribution and difference of genus-level gut microbiome between two groups. Results:Compared with the control group, the increased important marker genera in the patients group were as follows: UBA1819, Ruminiclostridium 9, Ruminococcaceae NK4A214 group, Ruminococcus 2, Ruminococceae UCG-005, Ruminiclostridium 5, Flavonifractor belonging to Ruminococceae; Aglistes, dgA-11 gut group, Rikenaceae RC9 gut group belonging to Rikenellaceae; [Eubacterium] oxidoreducens group belonging to Lachnospiraceae; Intestinibacter belonging to Peptostreptococcaceae; Escherichia-Shigella belonging to Enterobacteriaceae; Tannerellaceae belonging to Parabacteroides (|U| > 1.962, P < 0.05). The decreased marker genera in the patients group was Fusobacterium of Fusobacteriaceae (|U| = -2.284, P < 0.05). Conclusion:There are significant differences of gut microbiome in spinal cord injury patients. The relative abundance of Ruminococcaceae relating to depression, Ruminococcus relating to central nervous system diseases, and enteropathogenic bacteria such as Escherichia-Shigella and Erysipelothrix increase; and the relative abundance of butyrate-producing bacteria and anti-inflammatory bacteria benefitting to the intestine decrease; which may play a role in clinic.
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With the deepening of microbial research in central nervous system diseases, the role of gut microbiota in spinal cord injury has also received extensive attention. At present, it is mainly focused on exploring the changes of gut microbiota after spinal cord injury and the potential effects of aryl hydrocarbon receptor agonists, short-chain fatty acids and lipopolysaccharides produced by bacterial metabolism on secondary inflammation after injury, and it is recognized that gut microbiota or supplemental flora metabolites may be a potential pathway for the treatment of spinal cord injury.
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Transcranial direct current stimulation regulates nerve cell transmembrane potential through current, leading to depolarization or hyperpolarization, and changes the excitability of cerebral cortex, thus improving neuropathic pain after spinal cord injury. This article mainly reviewed mechanism, clinical application, safety and limitation of transcranial direct current stimulation to neuropathic pain after spinal cord injury.
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Objective To observe the effect of every-other-day fasting(EODF)on pathology and functional recovery of rats with spinal cord clip-compression injury,and to explore the related mechanism. Methods A total of 36 Sprague-Dawley rats were randomly assigned to groups A(sham operation),B(sham operation and EODF),C(spinal cord injury)and D(spinal cord injury and EODF)with nine rats in each group.The spinal cord injury rat model in T10was established by using medical aneurysm clip in latter two groups.The motor func-tion was assessed by Basso-Beattie-Bresnahan(BBB)score one day before and one day,two,four,six,eight,ten, twelve weeks after operation;and toluidine blue staining was performed for pathological observation at twelve weeks after operation.Another 180 Sprague-Dawley rats were randomly assigned in same way.The level of tu-mor necrosis factor-α(TNF-α)and interleukin-10(IL-10)were detected with ELISA six hours,twelve hours,one day,three days and seven days after operation. Results The BBB score reached lowest on the first day in groups C and D(P<0.05),and gradually increased with time,and were higher in group D than in group C eight weeks,ten weeks and twelve weeks after operation(P<0.05). The pathology in spinal cord was less in group D than in group C.Compared with group A,the level of serum TNF-α increased twelve hours after operation(P<0.05),peaked one day after operation,and returned back seven days after operation;the level of serum IL-10 increased at each time point after operation(P<0.05).Compared with group C,the level of serum TNF-α was lower in group D one day after operation(P<0.05);the level of se-rum IL-10 was not significantly different at each time point after operation(P>0.05). Conclusion Long-term EODF can promote the hind limb motor recovery in rats with spinal cord clip-compression inju-ry,and alleviate pathological damage.EODF might inhibit acute inflammatory reaction at acute stage of spinal cord injury,which may be correlated with its neuroprotective effect.
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BACKGROUND: Dietary intervention may be the most available, safe, economic and efficient approach to treat spinal cord injury. OBJECTIVE: To observe the effects of dietary restriction in the form of every-other-day fasting (EODF) on the pathological changes and functional recovery of rats with clip-compression injury of the spinal cord. METHODS: The models of spinal cord injury were established by a medical aneurysm clip in 36 Sprague-Dawley rats, and model rats were then randomized into four groups: group A with spinal cord injury and EODF, group B with spinal cord injury, group C with sham operation and EODF, and group D with sham operation. Food intake and body mass were observed. Motor functional recovery in rats was assessed by Basso, Beattie, Bresnahan scores at preoperative 1 day and postoperative 1 day, 1, 2, 4, 6, 8, 10, and 12 weeks. At 12 weeks after operation, the morphological changes of the spinal cord were observed through hematoxylin-eosin staining. RESULTS AND CONCLUSION: The Basso, Beattie, Bresnahan score in the group B was decreased to the lowest at postoperative 1 day, and gradually increased with time. At 8-12 weeks after operation, the scores in the group A were significantly superior to those in the group B. At 12 weeks after operation, hematoxylin-eosin staining showed less lesion of the spinal cord in the group A than the group B. These results indicate that EODF can improve the motor functional of rats with spinal cord injury, and exerts effective protection on the injured spinal cord.
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<p><b>OBJECTIVE</b>To explore the comprehensive program of integrated Chinese and western medicine in the treatment of cognitive impairment in earthquake brain injury.</p><p><b>METHODS</b>The multi-central randomized controlled trial was adopted. The qualified subjects were randomized into an acupuncture + rehabilitation group (38 cases) and a rehabilitation group (35 cases). In the acupuncture + rehabilitation group, acupuncture, hyperbaric oxygen (HBO) and cognitive rehabilitation training were combined as the comprehensive program of integrated Chinese and western medicine in the treatment. In the rehabilitation group, HBO and cognitive rehabilitation training were adopted. The efficacy and safety were assessed.</p><p><b>RESULTS</b>(1) After treatment of 2 months, the intelligent state, cognitive function and activity of daily life of patients were improved in the both groups (all P < 0.01). (2) After treatment of 2 months, the score of MMSE and the score of activity of daily life were (24.11 +/- 4.08) and (75.45 +/- 13.95) in the acupuncture + rehabilitation group, which were more significant as compared with (17.05 +/- 43.84), (66.06 +/- 12.75) in the rehabilitation group, respectively (both P < 0.01). In 6-month follow-up visit after treatment, the cognitive function and activity of daily life were improved continuously in the acupuncture + rehabilitation group, which was more significant as compared with the rehabilitation group (P < 0.01, P < 0.05).</p><p><b>CONCLUSION</b>The integrated Chinese and western medicine of acupuncture, HBO and cognitive rehabilitation training is safe and effective in the treatment of cognitive impairment in earthquake brain injury. The therapeutic effect is more advantageous as compared with the simple rehabilitation program of western medicine.</p>
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Adolescente , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem , Atividades Cotidianas , Terapia por Acupuntura , Lesões Encefálicas , Psicologia , Reabilitação , Terapêutica , Cognição , Terremotos , Resultado do TratamentoRESUMO
<p><b>OBJECTIVE</b>To compare the differences in the efficacy on traumatic spinal cord injury(SCI) in the thoracic and lumbar vertebra between the paraplegia-triple-needling method and the conventional acupuncture therapy.</p><p><b>METHODS</b>The perspectively randomized controlled trial was adopted. Forty-eight cases of traumatic SCI in the thoracic and lumbar vertebra were randomized into an observation group and a control group, 24 cases in each one. The conventional rehabilitation training was applied in both groups. In addition, the paraplegia-triple-needling method was used in the observation group. In the treatment, acupuncture was applied to the points of the Governor Vessel and the Back-shu which, located two segments above and below the spinal injury plane separately. Acupuncture with the electric pulsing stimulation was applied to the motor points of the key muscles of the lower extremities. In the control group, the conventional acupuncture was applied to Huantiao (GB 30), Zusanli (ST 36), Xuanzhong (GB 39) and Sanyinjiao (SP 6). In each group, the treatment was given once a day, one month treatment made 1 session. Totally, 3 sessions of treatment were required. Before and after treatment, as well as in 1-month follow-up visit after treatment, the modified Barthel index (MBI) and the function comprehensive assessment (FCA) were adopted to assess the activities of daily life (ADL) and the comprehensive function of the patients. The score of MBI and FCA were taken as the double response variables to imitate the multilevel model. The changing tendency of MBI and FCA along with the time was observed in two groups.</p><p><b>RESULTS</b>In the follow-up visit, MBI and FCA score were all improved as compared with those before treatment in two groups (all P < 0.05). There were no statistically significant differences in MBI and FCA score at any time point between two groups (all P > 0.05). In 4-month observation, there was a rising tendency with time in MBI and FAC scoe in both groups, which was roughly linear. As time went on, the increasing amplitude in the observation group was much bigger. It was explained that there was no difference in the short-term efficacy between two groups. However, the long-term efficacy in the observation group was much better.</p><p><b>CONCLUSION</b>Both the paraplegia-triple-needling method and the conventional acupuncture therapy can improve the ADL and the comprehensive function of the patients with traumatic SCI of the thoracic and lumbar vertebra. Concerning the long-term efficacy, the paraplegia-triple-needling combined with the rehabilitation training achieves better result. This therapeutic program is safe and effective.</p>