Stem Cell-Based Hair Cell Regeneration and Therapy in the Inner Ear / 神经科学通报·英文版

Hearing loss has become increasingly prevalent and causes considerable disability, thus gravely burdening the global economy. Irreversible loss of hair cells is a main cause of sensorineural hearing loss, and currently, the only relatively effective clinical treatments are limited to digital hearing equipment like cochlear implants and hearing aids, but these are of limited benefit in patients. It is therefore urgent to understand the mechanisms of damage repair in order to develop new neuroprotective strategies. At present, how to promote the regeneration of functional hair cells is a key scientific question in the field of hearing research. Multiple signaling pathways and transcriptional factors trigger the activation of hair cell progenitors and ensure the maturation of newborn hair cells, and in this article, we first review the principal mechanisms underlying hair cell reproduction. We then further discuss therapeutic strategies involving the co-regulation of multiple signaling pathways in order to induce effective functional hair cell regeneration after degeneration, and we summarize current achievements in hair cell regeneration. Lastly, we discuss potential future approaches, such as small molecule drugs and gene therapy, which might be applied for regenerating functional hair cells in the clinic.

Neuroprotective effect of histone deacetylases inhibitor MS-275 following traumatic brain injury in rats / 中华创伤杂志

Objective To evaluate the neuroprotective benefits of histone deacetylases (HDAC)inhibitor MS-275 in rats with moderate traumatic brain injury (TBI).Methods Sixty-eight adult male SD rats were assigned to sham injury + placebo treatment (control group),TBI + placebo treatment (injury group),TBI + MS-275 (15 mg/kg) treatment (treatment group Ⅰ) and TBI + MS-275 (45 mg/kg)treatment (treatment group Ⅱ) according to the random number table.An experimental model of moderate TBI in the rat was induced using a lateral fluid percussion device.MS-275 was dissolved in DMSO and administered (15 and 45 mg/kg) intraperitoneally in seven consecutive days(once a day).The first administration was done in 30 minutes postinjury.Alteration in body weight of rats in each group was recorded after injury.Spatial learning and memory retention in rats was assessed using the Morris Water Maze in days 10-14 after TBI.Brain tissues were sectioned to measure acetyl-histone H3 and neuronal survivals in the hippocampus CA2-3 region using immunohistochemistry and cresyl-violet staining techniques.Results TBI rats showed significant body weight loss in 3 days postinjury as compared with the controls (P ＜0.05) and then gradually gained the body weight in 4-5 days postinjury.No significant difference in actual body weight loss after injury was found among injury group and treatment groups (F =0.149,P ＞0.05).Behavioral result revealed that the animals in treatment groups had significant improvement in cognitive performance as compared with injury group (P ＜ 0.01).Immunohistochemical results presented a markedly increased level of acetyl-histone H3 in both treatment groups,with no significant difference as compared with control group and a trend of increase in the survived neurons in the CA2-3 hippocampus in 14 days postinjury (P ＞ 0.05).Conclusions MS-275 achieves visible improvement of acetyl-histone H3 level and cognitive performance in the acute phase of TBI.Simultaneously,this treatment has an ameliorative effect on pathological changes associated with TBI as well and provides a neuroprotective effect against TBI.

Effects of interleukin-6 in hypothalamus on gastric mucosal injury in rats with stress ulcer / 中华急诊医学杂志

Objective To clarify the role of hypothalamic IL-6 in gastric mucosal blood flow, gastric juice pH value and gastric mucosal injury. Method Model of gastric stress ulcer was established by fluid percussion to make craniocerebral trauma. Twenty male SD rats fed for one week in the experiment room were randomly(random number) divided into control group, one hour group, six hours group and 12 hours group after injury. The levels and distribution of IL-6 in hypothalamus were detected by using immunohistochemistry and Western blot. Simultaneously, gastric pH value, gastric mucosal blood flow and gastric mucosal injury index of rats in each group were measured, and the histology of gastric mucosa was observed. Results IL-6 immunoreactive cells were widely distributed in neuronal cells of hypothalamus of the stressed rats especially in the para-ventricular nucleus (PVN).One hour after injury, the pH value rapidly declined, and the lowest point appeared 6 hours later. One hour after injury, the injury of gastric mucosa was found, and the injury became worse and worse as time got longer and longer. The ulcer index (UI) was increased. One hour after injury, there was a brief increase in blood flow to the peak in gastric mucosa, and then the blood flow declined until 6 hours elapsed and got stable. The experiment prompted the gastric stress ulcer appeared. Conclusions In the SD rats with gastric stress ulcer induced by craniocerebral injury incurred by hydraulic percussion, the hypothalamic IL-6 may activate neuronendocrine metabolism mediated through the activation of PVN, inducing gastric mucosal injury.

Diagnosis and treatment of cerebrospinal fluid leakage / 中华创伤杂志

Objective To investigate standard diagnosis and treatment of cerebrospinal fluid (CSF) leakage to improve the prognosis of the patients. Methods A retrospective study was done on 75 patients with CSF leakage from January 2004 to March 2007 in our hospital. There were 51 patients with rhinorrhea, nine with otorrhea and 15 with wound/incision leakage. Of all, 39 patients had traumatic leakage, 32 postoperative leakage and four spontaneous leakage. In the study, 23 patients were cured by position testing and drug therapy and 16 by cerebrospinal fluid drainage and/or wound debridement but 36 were treated with surgeries including craniotomy repair in 17, extracranial repair in 17 and CSF shunt in five (three received CSF shunt after repair). Results Of all, 64 patients were cured, 10 gained im-provement but one died. Conclusion Standard diagnosis and treatment of CSF leakage helps improve cure rate and reduce complications.

Early fracture external fixation in treatment of severe traumatic brain injury combined with extremity fracture / 中华创伤杂志

Objective To discuss clinical effects of early (<48 hours after injury) fraeture exter-nal fixation in treatment of severe traumatic brain injury (TBI) combined with extremity fracture. Meth-ods The study involved patients with no statistical difference in aspects of age, sex, GCS, fracture ,distri-bution and general condition. According to different treatment methods at early stage (<48 hours), the pa-tients with TBI were divided into Group A (early extremity fracture external fixation) and Group B (early extremity fracture traction or cast immobilization). A comparative observation was done on complications in-cluding bedsore, pneumonia and deep venous thrombosis and on duration in ICU, hospitalization, time for fracture healing and mortality in two groups. Results Incidence rate of bedsore, pneumonia, deep ve-nous thrombosis and mortality in Group A was lower than that in Group B (P<0.05), and Group A had shorter time for ICU, hospitalization and fracture healing (P < 0.05). Conclusion For patients with se-vere TBI combined with extremity fracture, early fracture external fixation is more effective to reduce com-plications, shorten the recovery time and reduce mortality, compared with conservative methods.

Surgical operation for traumatic superior orbital fissure syndrome following traumatic brain injury / 中华创伤杂志

Objective To compare curative effect of decompression and conservative treatment for traumatic superior orbital fissure syndrome to discuss the operation indications and the operative oppor-tunity for this syndrome. Methods Data of 12 patients (seven males and five females) with 14 sides were compared to evaluate different curative effect between decompression and conservative treatment so as to optimize the initial corresponding treatment. Results The patients were at mean age of 28 years and followed up for mean six months. All patients were complicated by one and more of following symptoms in-cluding ophthalmoplegia, ptosis, proptosis and anaesthesia in the distribution of V1 and a fixed dilated pupil. There was one patient complicated by orbital apex syndrome. CT showed involvement of the superi-or orbital fissure in seven patients. Of seven patients treated with decompression, six got recovery at dif-ferent degrees. Meanwhile, three out of five patients treated with conservative treatment recovered to some extent. Conclusions Early effective treatment can improve the functional rehabilitation of the injured nerve. Decompression of superior orbital fissure is proved to be effective in ameliorating symptome, re-ducing disability and improving quality of life.

Evolution and treatment of traumatic subdural effusion / 中国基层医药

Objective To explore the evolution and treatment of traumatic subdural effusion(TSE).Methods The clinicsl materials of 66 patients with TSE were analyzed retrospectively.Results 53 patients were cured with comervative therapy,and other patients were evolved into chronic subdural hematoma(CSDH).8 patients with CSDH were cured with surgery and others with conservative therapy.Conclusion Patients with TSE don't need surgery,and then patients with clinical characteristics will be operated when TSE evolves into CSDH.

Neuronal apoptosis and caspase 3 gene expression of in vitro cultured rat hippocampal neurons of epilepsy models / 中国组织工程研究

BACKGROUND: The attack of temporal epilepsy is associated with the loss and death of hippocampal neurons, in which the specific pattern and mechanism of the loss of hippocampal neurons are still unclear, and it is hard to make sure the inevitable association of the epileptic discharge with activation of cysteine-containing ASPartate-specific protease (caspase 3)and neuronal apoptosis, of hippocampal neurons.OBJECTIVE: To observe the neuronal apoptosis and caspase 3 gene expression of in vitro cultured rat hippocampal neurons of epilepsy models.DESIGN: An open experiment.SETTINGS: Department of Neurosurgery, Changhai Hospital, the Second Military Medical University of Chinese PLA; Department of Neurosurgery,Changzheng Hospital, the University.MATERIALS: The experiments were carried out in the Neurosurgery Laboratory of the Second Military Medical University of Chinese PLA from June 2002 to June 2003. Ten male or female SD rats with 24 hours after birth were used. The Caspase 3 flow detection kit was purchased from American BD Company, and polymerase chain reaction (PCR) primers were synthetized by Shanghai Haojia Company.METHODS: ① The SD rats within 24 hours after birth were killed by cutting down the head to remove the brain, then bilateral hippocampi were taken out, and hippocanpal neuron models of epileptic discharge were established. The discharge of the models was recorded with whole cell patch clamp technique. The neurons cultured for 8 days and treated with Mg-free medium were taken as epileptic discharge model group, and those cultured for 8 days but not treated with Mg-free medium were taken as the blank control group, and the changes of potentials were recorded. ② The fulllength cDNA of caspase 3 was cloned with reverse transcription-polymerase chain reaction (RT-PCR), and then it was labeled. The expression of caspase 3 gene and neuronal apoptosis were detected with in situ hybridization and flow cytometry.MAIN OUTCOME MEASURES: ① Results of cDNA cloning of caspase 3; ② Results of Caspase 3 in situ hybridization; ③ Results of apoptosis.RESULTS: ① The products amplified by RT-PCR showed DNA segment lanes of about 800 bp after treated with 12 g/L agarose gel electrophoresis (Figure 1), which was concordant with the predicted value. The detection of DNA sequence showed that the length of the obtained cloning open-reading frame was 843 bp. ② The hybridization showed that in the blank control group, the positively stained hippocampal neurons were less than 10%, the neurites were well-stacked, and formed extensive synaptic association; In the epileptic discharge model group, the positively stained neurons were obviously increased at 3 hours after the Mg-free treatment, and there were many strongly and positively stained neurons at 12 hours, all these neurons kept the neurites, which became little. ③ The flow cytometry showed that at 6 hours after the Mg-free treatment, the apoptotic cells began to increase obviously, the numbers of apoptotic cells in certain times were not the same.CONCLUSION: Epileptic discharge can trigger the caspase 3 gene expression, by which neuronal apoptosis is induced.

Diagnosis and treatment of craniocerebral firearm wounds in peacetime / 中华创伤杂志

Objective To review the features of diagnosis and treatment of craniocerebral firearm wounds in peacetime. Methods A total of 86 cases with various kinds of firearm wounds were retrospectively analyzed for discussing the characteristics of diagnoses and treatment of firearm wounds so as to provide the best treatment methods for firearm wounds of the brain. Results Of all, 80 cases (93%) won full recovery and four (5%) partial recovery but two (2%) were died of massive vascular damage and severe cerebral injuries within 24 hours after operation. Conclusions Craniocerebral firearm wounds are among the most devastating causes for morbidity and mortality in the civilian population. It is important to remove all foreign bodies, especially broken bones and necrotic tissues, and turn the open injury to the close injury. Stereotactic technique, localization of foreign bodies, culture of foreign body bacteria, drug allergy test and correct use of antibiotic and antiepileptic drugs are also critical for eliminating mortality and complications of craniocerebral firearm wounds.

Changes of bcl-x(L) and bax mRNA expression following traumatic brain injury in rats / 中华创伤杂志(英文版)

<p><b>OBJECTIVE</b>To investigate the changes of bcl-2 gene family and the molecular mechanism of neuronal apoptosis following traumatic brain injury (TBI) in rats.</p><p><b>METHODS</b>Male Sprague-Dawley (SD) rats were subjected to lateral fluid percussion brain injury (FPBI) of moderate severity. The bcl-x(L) and bax mRNA expression was detected by reverse transcription polymerase chain reaction (RT-PCR). In addition to morphological evidence of apoptosis, terminal deoxynucleotide transferase-mediated dUTP-biotin nick-end labeling (TUNEL) histochemistry was used to identify the DNA fragmentation in situ at both light and electron microscope levels, whereas characteristic internucleosomal DNA fragmentation of apoptosis was demonstrated by DNA gel electrophoresis.</p><p><b>RESULTS</b>The apoptotic response to trauma was regionally distinct and may be involved in both acute and delayed cell death. The bcl-x(L) mRNA expression of the impact site was significantly lower (67.42%+/-7.54%) than that of the ipsilateral hemisphere at 6 hours after injury (P<0.01). The decrease of bcl-x(L) mRNA expression preceded apoptosis at 24 hours after injury. The bax mRNA expression rose slowly, doubled at 3 days after injury and returned to the sham level slowly.</p><p><b>CONCLUSIONS</b>Decreased expression of bcl-x(L) mRNA and increased expression of bax mRNA coincides with apoptosis following brain injury. The bcl-2 gene family is involved in neuronal apoptosis after TBI, and the changes of mRNA expression of the family members lead the neuronal cells to apoptosis.</p>

Spatial and temporal profile of apoptosis following lateral fluid percussion brain injury / 中华创伤杂志(英文版)

<p><b>OBJECTIVE</b>To investigate the spatial and temporal profile of neural cell apoptosis following traumatic brain injury (TBI).</p><p><b>METHODS</b>In addition to morphological evidence of apoptosis, TUNEL histochemistry assay was used to identify DNA fragmentation in situ at both light and electron microscopic levels, whereas characteristic internucleosomal DNA fragmentation of apoptosis was demonstrated by DNA gel electrophoresis.</p><p><b>RESULTS</b>Using TUNEL method, we detected massive cells with extensive DNA fragmentation in different regions of the brains of rats subjected to experimental traumatic brain injury. Compared with the sham controls, in the injured cortex, the apoptotic cells were detectable for up to 24 h and reached a peak at 1 week after injury. The number of apoptotic cells in the white matter h ad a significant increase as early as 12 h after injury and peaked at 1 wee k. The number of apoptotic cells increased in the hippocampus at 72 h, whereas i n the thalamus, the peak of apoptotic cells was at 2 weeks after injury. The number of apoptotic cells in most regions returned to sham values 2 months after in jury. Gel electrophoresis of DNA extracted from affected areas of the injured br ain revealed only internucleosomal fragmentation at 185-bp intervals, a feature originally described in apoptotic cell death. And no DNA ladder was detectable in the cortex and hippocampus contralateral to the injured hemisphere.</p><p><b>CONCLUSIONS</b>These data suggest that in addition to the well described necrotic cell death, a temporal course of apoptotic cell death is initiated after brain trauma in selected brain regions.</p>

Determination of Valsartan Concentration in Human Plasma With HPLC / 中国药房

OBJECTIVE:To determine the valsartan concentration in human plasma METHODS:The plasma sample was extracted with a liquid-solid method and determined with HPLC,stationary phase was Hypensil ODS C18(4 6nm?200nm,5?m),mobile phase consisted of acetonitrile and 0 01mol/L KH2PO4 buffer(pH 2 8)(50∶50) The flow rate was 1 5ml/min Detection was performed with fluorescence detector at ?ex 265nm,?em 378nm RESULTS:The retention time of valsartan was about 5 4 minutes,and the linear range of quantity was 0 05～5?g/ml The recoveries of methodology were more than 90%(n=5) Inter-day and intra-day RSD were less then 10%(n=5) CONCLUSION:This method is rapid and accurate It can be applied to determining the plasma valsartan concentration and studying on pharmacokinetics

EFFECTS OF ANTISENSE OLIGONUCLEOTIDES DIRECTED AT TNE-? ON THE INTRACRANIAL PRESSURE IN DOGS FOLLOWING CRANIOCEREBRAL EXPLOSIVE INJURY / 解放军医学杂志

To investigate the effects of antisense oligonucleotides directed at TNF-? on the intracranial pressure following craniocerebral explosive injury. Eighteen dogs were randomly divided into artificial cerebrospinal fluid (ACSF) group, sense group and antisense group. Using the model of craniocerebral explosive injury, ACSF, the sense oligonucleotides to TNF-? and the antisense oligonucleotides to TNF-? were administered into cerebellomedullar cisterna before injury respectively in three groups, and then the intracranial pressure and contents of brain H 2 O in the bilateral hemispheres in three groups were compared. As compared with the ACSF groups and the sense groups, the contents of brain H 2 O in the antisense groups were significantly reduced( P

Alteration of Bcl-2, Bcl-x and Bax protein expression following fluid per cussion brain injury in rats / 第二军医大学学报

Objective: To investigate the alteration of bcl- 2 gene family in the rat brain and the molecular mechanism of neuronal apoptosis following traumatic brain injury. Methods: Male Sprague -Dawley rats were subjected to lateral fluid percussion brain injury(FPI) of mo derate severity. Bcl-2, Bcl-x and Bax protein expression was detected by immun ohistochemistry. Results: (1) The immunoreactivity of Bcl-2 and Bcl-x protein decreased in the hippocampus ipsilateral impact site as early as 6 h post-injury, and this was the main cause of down-regulation of the ratio of Bcl-2+Bcl-x to Bax. (2) During 1-3 d after injury, the Bax protein express i on increased significantly, while the Bcl-2 and Bcl-x protein expression decre ased relatively slow. The decreased ratio of Bcl-2+Bcl-x to Bax was mainly due to the Bax up-regulation. Conclusion: The bcl-2 gene family is involved in neuronal apoptosis after FBI, and the protein expression alteration of the family members leads the neuronal cell to apoptosis.

The correlation between mRNA and protein expression of bax and bcl-xL follo wing fluid percussion brain injury in rats / 第二军医大学学报

Objective: To investigate the alterations of bcl-2 gene family in the rat brain and the molecular mechanism of neuronal apoptosis follow ing traumatic brain injury (TBI). Methods: Male Sprague-Dawley rats were subjected to lateral fluid percussion brain injury(FPBI) of moderate severity. bax and bcl-xL mRNA and protein expression was detected by RT-PCR an d immunohistochemistry. In addition to morphological evidence of apoptosis, TUNE L histochemistry was used to identify DNA fragmentation in situ under both l ight and electron microscope, whereas characteristic internucleosomal DN A fragm entation of apoptosis was demonstrated by DNA gel electrophoresis. Resul ts: bcl-xL mRNA and protein decreased in the ipsilateral hemisphere t o the impact site as early as 6 h post-injury［(67.42±7.54)% and (85.85±5.72)% r espectively］. The decrease in bcl-xL mRNA and protein preceded apoptosis was observed 12 h post-injury. And this was the main cause of up-regulation of the ratio of bax to bcl-xL in the acute period(minutes-hours) followin g FPBI. bax mRNA and protein were observed to rise slowly, doubled 3 d post- injury, returned to sham level slowly. The delayed cell death (days-weeks) migh t associated with the up-regulation of pro-apoptotic gene bax. Conclusio n: The expression of bcl-xL and bax coincide with apoptosis following TBI. The reg ulation of bax and bcl-xL by TBI occur before transcription. The balance of bax/bcl-xL ratio determines the neurocytes to survive or die following FPBI.

Gelatin-chitosan crosslinked film in prevention of adhesion after craniotomy / 第二军医大学学报

Objective:To study the hemostatic and adhesion-prevention properties of gelatin-chitosan crosslinked film after craniotomy. Methods: Gelatin-chitosan crosslinked film was prepared by casting the mixed solution of dialyzed chitosan and gelatin after crosslinking with glutaraldehyde in freeze dryer. Bleeding time was recorded for bilateral back incisions (5 incisions on each side) in 4 New Zealand white rabbits. Incision on one side was treated with gelatin-chitosan crosslinked film, and on the other was treated with gauze. Hemoglobin amount in films or gauzes was measured to determine the hemostatic effect after bleeding. Bilateral craniotomies were performed at calvaria in 16 adult rabbits. A piece of gelatin-chitosan crosslinked film was put in one randomized side and the other side served as a control. The scar formation was evaluated grossly and histologically on week 2,4,8,12. Results:Bleeding time and hemoglobin amounts in gelatin-chitosan crosslinked film group were superior to those in gauze group(P

Microsurgical anatomy study on acoustic neurinoma operation preserving facial nerve / 第二军医大学学报

Objective: : T o study the microanatomy of the facial nerve in the cerebellopontine angle (CPA) a nd the internal auditory meatus (IAM) for the preservation of the facial nerve i n the acoustic neurinomas surgery. Methods: Forty sides of CPA f acial nerve of 20 adult cadaver heads were examined. Results: In the pontomedullary sulcus the facial nerve (1.98? 0.10) mm anterior to the vestibulocochlear nerve,(8.76?1.42) mm lateral to the abducent nerve at the points where the nerves join the brain stem at the lateral end of the sulcu s, (8.15?2.18) mm above the junction of the Ⅸ nerve with the medulla. There were 62 nutritious artery supplying the facial nerve in the CPA, mainly from the anterior inferior cerebellaris artery (AICA) and its branches; and 17 in the IA M were mostly from the internal auditory arteria (IAA). Conclusion: To be familiar with the microanatomy of the facial nerve in CPA and IAM is h elpful for localizing the facial nerve and improve its preservation in acoustic neuroma surgery.

Development of the sphenoid sinus affects the surgical approach via saddle area / 第二军医大学学报

Objective: : To investigate whether development of the sph e noid sinus affect the surgical approach via saddle area. Methods: The pneumatization of sphenoid sinus of 50 cadaver heads was studied through t hinner CT scanning of coronal, sagittal and axial position. The sphenoid sinus w as classified according to the degree of pneumatization of sphenoid sinus toward s sphenoid bone, small wing of sphenoid bone and epippium. Results: There were 4% conchal, 18% pre-sellar, 18% semi-sellar, 14% sellar, 46% sellar -occipital in 100 sphenoid sinus cases. The transversal diameter of left and ri ght was 18.48 mm and 17.58 mm; The sagittal diameter of left and right was 2 2.20 mm and 20.82 mm, The vertical diameter of left and right was 21.02 mm and 2 0.38 mm. The distance between centre track and the later wall of sphenoid sinus was 14.78 mm in left side and 15.18 mm in right side. Conclusion: Thinner CT scanning with coronal and sagittal position can clearly show pneum atization of sphenoid sinus on both sides. Different pneumatization of sphenoid sinus provide anatomical basis for choosing operation approach.

Study on metastasis-associated gene in carcinoma by cDNA microarray / 第二军医大学学报

Objective:To understand the molecular pat hophysiology of hepatocellular carcinoma and pancreatic cancer.Methods: We studied novel gene expression by cDNA microarray method. The PCR pro ducts of 4 096 genes and 12 800 gene were spotted onto a kind of chemical-mater ial-coated-glass slide in array. Both the mRNAs from 5 cases of hepatocellular carcinoma and 3 cases of pancreatic cancer were reversely transcribed to cDNAs with the incorporation of fluorescent-labeled dUTP to prepare the hybridization probes. After hybridization, BioDoor4096 and BioDoor12800 cDNA microarray were scanned for the fluorescent intensity. Tumor invasion-related gene expression w as screened through the analysis of difference in gene expression profile.Results:Among 4 096 and 12 800 target genes, there were 15 genes who se expression level differed from normal and carcinoma tissues. Therefore, they might be associated with metastasis.Conclusion:Further analysis of these differentially expressed metastasis-associated genes will be helpful for understanding the molecular mechanism of malignant carcinoma.

Monitoring of somatosensory evoked potential in microsurgery of spinal tumors / 第二军医大学学报

Somatosensory evoked potential(SEP) monitoring was performed intraoperatively in 28 patients with extramedullary or intramedullary tumors.Dissection of intramedullary tumor usually leads to decrease of amplitude and increase of latency in SEP. SEP reappeared at the end of operation in 2 cases of Frankel A grade extramedullary tumors whose SEP disappeared during operation with functional recovering to some degree. In 2 cases of Frankel B and C grade intramedullary tumors, the amplitude of SEP decreased by more than 40% and the latent period in SEP increased by more than 5% during operation,and the surgical procedure was paused for a while.There was slight reversible injury of nerve post operatively. In 8 of 12 cases of Frankel D and E grade intramedullary tumors, the amplitude of SEP descended nearly by 50% and elongation of latency in SEP was about 7% during surgery. SEP was reduced lightly in other 4 cases and all achieved good recovery. Intraoperative monitoring of spinal SEP and cortex SEP can reflect the change of spinal function, reduce post operative complication, and predict prognosis.