Application of intraoperative electrophysiological monitoring in vertebral canal decompression surgery for acute spinal cord injury.

OBJECTIVE: This study aimed to evaluate the joint monitoring of somatosensory evoked potentials (SEPs) and motor evoked potentials (MEPs) in vertebral canal decompression surgery for acute spinal cord injury. METHODS: Twenty-four patients, who were admitted to the hospital for the surgical treatment of spinal cord injury with SEP and MEP monitoring, were assigned to the intraoperative monitoring group (group I). In addition, 24 patients who were admitted to the hospital for the surgical treatment of spinal cord injury without SEP or MEP monitoring were assigned to the control group (group C). RESULTS: In group I, there were significant changes before and after decompression surgery in the P40 latency and amplitude, and in the latency of MEP in the abductor hallucis brevis (AHB), in patients with improved spinal nerve function following surgery. In contrast, there were no significant differences in the P40 latency or amplitude, or the latency of MEP in the AHB, in patients who showed no improvement after surgery. CONCLUSION: In vertebral canal decompression surgery for acute spinal cord injury, the application of joint MEP and SEP monitoring can timely reflect changes in spinal cord function.

[Clinical research on bedsores treated with fire needle therapy].

OBJECTIVE: To discuss the clinical efficacy of fire needle therapy on bedsores. METHODS: Fifty-four cases of bedsores were divided randomly into a fire needling group and a filiform needling group, 27 cases in each one. In fire needling group, fire needle therapy was applied. In fifliform needling group, common needling technique with filiform needle was adopted. The wound surface and Ashi points around the sores were punctured in either group. The efficacy and the treatment session required in different phases were observed in two groups. RESULTS: The satisfactory rate of the efficacy was 91.4% (53/58) in fire needling group and was 75.9% (41/54) in common needling group, indicating statistical significant difference in comparison (P < 0.05). The sessions in the phases III and IV of bedsores increased significantly as compared with those in the phase II of two groups (both P < 0.05), of which, the sessions in phases III and IV of fire needling group were shortened apparently as compared with those of filiform needling group (P < 0.05). CONCLUSION: The efficacy of the fire needling therapy is superior to that of common needling on bedsores, and it is an effective approach to bedsores.

[Dynamic observation of pathological changes and expression of nuclear factor-kappaB in the intestinal mucosa of rats after diffuse brain injury].

OBJECTIVE: To investigate the dynamic pathological changes in the intestinal mucosa of rats and the role of activation of nuclear factor-kappaB (NF-kappaB) in the alteration in intestinal mucosal barrier dysfunction after diffuse brain injury. METHODS: The animal model established by Marmarou was used to produce diffuse brain injury. One hundred and fifty male Wistar rats were randomly divided into nine groups in terms of postinjury time: 1, 2, 4, 8, 12, 24, 48, 72, 168 hours after injury, and control group. Mucosal thickness, villous height and width were estimated under light microscope, and expression of NF-kappaB was assessed with immunohistochemical staining in control group to compare with those in injury groups. RESULTS: Mucosal thickness, villous height and width were diminished and the optical density of expression of NF-kappaB was much higher in the injury groups than those of control group. CONCLUSION: The structure of intestinal mucosa is damaged in the earlier stages after diffuse brain injury. NF-kappaB is activated by cellular stress, which may be involved in the pathogenesis of secondary intestinal lesion.

[The relationship between expression of fas mRNA and apoptosis after traumatic brain injury in rats and the role of GM-1 in protecting the brain].

OBJECTIVE: To explore the mechanism of apoptosis after traumatic brain injury (TBI) in rats and elucidate the role of GM-1 by detecting the expression of Fas mRNA and apoptosis in hippocampi. METHODS: After creating the model of Marmarou cranio-cerebral trauma and offering GM-1 therapy, we observed the expression of Fas mRNA and apoptotic cell death using in situ hybridization and terminal deoxynucleotidyl transferase-mediated dUTP-biotin in situ nick end labeling (TUNEL) technique. RESULTS: Increased expression of Fas mRNA and increased apoptotic cells in hippocampi after TBI were observed. GM-1 could decrease the expression of Fas mRNA and apoptotic cell death. CONCLUSION: The increased expression of Fas mRNA may be a noteworthy cause of apoptotic cell death after traumatic brain injury. GM-1 may play a protective role by way of decreasing the expression of Fas mRNA and apoptotic cell death.