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From January 1993 to December 1996, we treated 482 cases of cervical spondylopathy with a combined method of point-injection and needle-warming via moxibustion. Except for the cases of sympathetic nerve type and spinal cord type, the combined method was superior to traction therapy in the control group and reported as follows.Clinical DataThe Criteria of Diagnosis and Curative Effect in TCM issued by the State Administrative Bureau of TCM and Pharmacy in 1994 was adopted for the enrollment of patients of cervical spondylopathy and the pathological typing. Only the patients who had completed the treatment and with complete records were collected for analysis.
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兔全脑缺血及再灌注对脊髓酶组织化学的影响
短暂性脑缺血发作(TIA)在临床上较为多见,严重危害人类的健康,降低了人们的生活质量.为探讨全脑短暂性缺血,尤其是椎基底动脉系短暂性缺血发作(VB TIA),对脊髓灰质酶组织化学的影响,探索VB TIA与脊髓损伤(spinal cord injury ,SCI)之间的联系,本实验用酶组织化学方法作了研究.
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出生后不同时间大鼠脊髓神经干细胞的培养特点
神经干细胞研究一直是神经科学领域的热点.目前国内外学者已经建立了神经干细胞的分离和培养技术[1].本研究分析大鼠出生后不同时间大鼠脊髓神经干细胞的培养特点,为应用神经干细胞积累经验.
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脊髓栓系的诊断及合并脊柱侧凸的手术治疗进展
脊髓栓系综合征(tethered spinal cord syndrome, TCS)是由各种先天因素和后天因素导致脊髓或圆锥受拉,脊髓缺血、缺氧,受到损伤发生病理改变而出现的一系列神经功能损伤的症状和畸形的综合征。1953年在临床上首次报道,1981年由Yamada命名[1]。脊髓栓系出现临床症状的不多,因此早期脊髓栓系的诊断并不多。随着影像技术,特别是MR技术的发展,一些隐匿的脊髓栓系被人们发现的越来越多。由于脊髓栓系一旦出现临床症状常表现为进行性加重的器质性损害,因此早期诊断早期治疗显得尤为重要。
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第一届全国脊柱外科青年医师暨脊柱脊髓护理学术论坛会议纪要
为进一步促进我国脊柱外科青年医师和护理同道们的学术交流,由中国康复医学会脊柱脊髓损伤专业委员会第一届青年委员会和护理学组主办、中南大学湘雅二医院脊柱外科承办的第一届全国脊柱外科青年医师暨脊柱脊髓护理学术论坛于2014年1月10日至11日在湖南长沙顺利召开。来自国内300余名专家与代表参加了此次学术盛会。在本次会议上,国内众多著名脊柱外科与护理专家、青年技术骨干齐聚一堂,采取主题演讲和专题报告等形式,就脊柱外科和护理领域中的焦点问题展开了热烈研讨。
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脊柱外科术中脊髓监测
术中脊髓监测(intraoperative spinal cord monitoring,ISCM;spinal cord monitoring during surgery,SCMDS)是指在涉及神经系统的手术中监测神经系统完整性的手段,包括运动系统监测和感觉系统监测.通过监测了解手术是否造成神经系统损伤,及时采取措施防止或减少术后的功能损害.本文对现有的各种用于脊柱手术中的脊髓监测手段作一综述.介绍每种方法的可靠性、准确性等,以供临床参考.
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远程缺血预处理对脊髓缺血再灌注损伤保护作用的研究进展
近年来,需要术中阻断胸腹主动脉的外科手术大大增加,由此引起的脊髓缺血性损伤会导致脊髓功能障碍,甚至截瘫[1];脊髓慢性压迫性疾病如颈椎病、椎管狭窄症、后纵韧带骨化症等在行减压手术后可发生脊髓损伤,即脊髓缺血再灌注损伤(spinal cord ischemic reperfusion injury,SCⅡ).对脊髓损伤目前尚缺乏确切有效的治疗方法,预防脊髓损伤和阻止脊髓继发性损伤是目前研究的重点.远程缺血预处理(remote ischemic preconditioning,RIPC)是指一个器官或组织经短暂缺血再灌注处理后通过释放生化信使到循环中或激活神经通路而对远隔器官产生保护作用.1997年,Matsuyama等[2]首先报道了脊髓RIPC对脊髓缺血再灌注损伤的保护作用,目前已成为脊髓缺血再灌注损伤研究的热点.现就RIPC对脊髓缺血再灌注损伤保护作用的研究进展综述如下.
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伴脊髓压迫脊柱转移瘤患者的术前评估与手术治疗进展
死于恶性肿瘤的患者30%~70%存在脊柱转移瘤,其中转移至胸椎者70%,腰椎20%,颈椎10%;伴有脊髓压迫的患者占10%~20%[1,2].以往对脊柱转移瘤倾向于保守治疗,近年来随着医疗技术的进步,脊柱转移瘤患者生存期延长,其中少数患者甚至可能获得长期生存的机会.对脊柱转移瘤患者进行完善的诊断和恰当的治疗,可提高患者的生活质量.现就伴脊髓压迫脊柱转移瘤患者的术前评估与手术治疗进展综述如下.
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磁共振弥散张量成像评估脊髓病变的临床应用进展
常规MRI可以清晰显示脊髓占位、水肿、出血或受压等征象,成为目前临床诊断脊髓病变的重要手段,但对脊髓微结构及病变真实范围显示的敏感性低,与神经功能缺失程度不符,损伤程度难以量化,且对纤维束的受损情况无法直观显示[1].磁共振弥散张量成像(MR-diffusion tensor imaging,MR-DTI)技术是在弥散加权成像(diffusion-weighted imaging,DWI)基础上发展起来的,着重研究活体内水分子的扩散特性,以三维立体角度分解、量化组织弥散各向异性的信号数据,使微结构显示更加精细,并通过纤维束失踪成像(fiber tractography,FT)技术重建纤维束微观方向图,分析中枢神经纤维网络的完整性和方向性.
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骨转移性肿瘤姑息性放疗模式选择与性价比关系
骨转移性肿瘤常引起疼痛症状,甚至发生转移性脊髓压迫(metastatic spinal cord compression,MSCC)、病理性骨折等并发症,给患者生活带来严重影响.放疗能较快缓解疼痛和较好维持骨解剖结构稳定,因而成为骨转移性肿瘤局部姑息性治疗的一个重要治疗方式.目前,骨转移性肿瘤姑息性放疗的剂量分割模式尚未统一,故就近年来的研究做综述.
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To investigate the effect of early rehabilitation on neurofunctional outcome after surgery in chil-dren with spinal tumors, this study reviewed the medical charts and radiographic records of 70 pediatric patients (1-17 years old) who received spinal tumor surgical removal. The peddiatric patients received rahabilitation treatment at 4 (range, 2-7) days after surgery for 10 (range, 7-23) days. Results from the Modiifed McCormick Scale, Functional Independence Measure for Chil-dren, American Spinal Injury Association Impairment Scale and Karnofsky Performance Status Scale demonstrated that the sensory function, motor function and activity of daily living of pedi-atric children who received early rehabilitation were signiifcantly improved. Results also showed that tumor setting and level localization as well as patients’s clinical symptoms have no inlfuences on neurofunctional outcomes.
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Accumulating evidence has demonstrated that the sodium-potassium-chloride co-transporter 1 and potassium-chloride co-transporter 2 have a role in the modulation of pain transmission at the spinal level through chloride regulation in the pain pathway and by effecting neuronal excitability and pain sensitization. The present study aimed to investigate the analgesic effect of the speciifc sodium-potassium-chloride co-transporter 1 inhibitor bumetanide, and the change in spinal sodium-potassium-chloride co-transporter 1 and potassium-chloride co-transporter 2 expression in a rat model of incisional pain. Results showed that intrathecal bumetanide could decrease cumulative pain scores, and could increase thermal and mechanical pain thresholds in a rat model of incisional pain. Sodium-potassium-chloride co-transporter 1 expression in-creased in neurons from dorsal root ganglion and the deep laminae of the ipsilateral dorsal horn following incision. By contrast, potassium-chloride co-transporter 2 expression decreased in neurons of the deep laminae from the ipsilateral dorsal horn. These ifndings suggest that spinal sodium-potassium-chloride co-transporter 1 expression was up-regulated and spinal potassi-um-chloride co-transporter 2 expression was down-regulated following incision. Intrathecal bumetanide has analgesic effects on incisional pain through inhibition of sodium-potassi-um-chloride co-transporter 1.
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关键词: spinal cord
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关键词: spinal cord
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It remains unclear whether spinal cord ischemia-reperfusion injury caused by ischemia and other non-mechanical factors can be monitored by somatosensory evoked potentials. Therefore, we monitored spinal cord ischemia-reperfusion injury in rabbits using somatosensory evoked potential detection technology. The results showed that the somatosensory evoked potential latency was significantly prolonged and the amplitude significantly reduced until it disappeared during the period of spinal cord ischemia. After reperfusion for 30-180 minutes, the amplitude and latency began to gradual y recover; at 360 minutes of reperfusion, the latency showed no significant difference compared with the pre-ischemic value, while the somatosensory evoked potential amplitude in-creased, and severe hindlimb motor dysfunctions were detected. Experimental findings suggest that changes in somatosensory evoked potential latency can reflect the degree of spinal cord ischemic injury, while the amplitude variations are indicators of the late spinal cord reperfusion injury, which provide evidence for the assessment of limb motor function and avoid iatrogenic spinal cord injury.
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The neuropeptides, substance P and calcitonin gene-related peptide, have been shown to be involved in pain transmission and repair of sciatic nerve injury. A model of sciatic nerve defect was prepared by dissecting the sciatic nerve at the middle, left femur in female Sprague Dawley rats. The two ends of the nerve were encased in a silica gel tube. L5 dorsal root ganglia were harvested 7, 14 and 28 days post sciatic nerve injury for immunohistochemical staining. Results showed that substance P and cal-citonin gene-related peptide expression increased significantly in dorsal root ganglion of rats with sci-atic nerve injury. This increase peaked at 7 days, declined at 14 days, and reduced to normal levels by 28 days post injury. The findings indicate that the neuropeptides, substance P and calcitonin gene-related peptide, mainly increased in the early stages after sciatic nerve injury.
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Molecular mechanisms of the Kr?uppel-like family of transcription factors (KLFs) have been studied more in proliferating cells than in post-mitotic cells such as neurons. We recently found that KLFs regulate intrinsic axon growth ability in central nervous system (CNS) neurons in-cluding retinal ganglion cells, and hippocampal and cortical neurons. With at least 15 of 17 KLF family members expressed in neurons and at least 5 structurally unique subfamilies, it is import-ant to determine how this complex family functions in neurons to regulate the intricate genetic programs of axon growth and regeneration. By characterizing the molecular mechanisms of the KLF family in the nervous system, including binding partners and gene targets, and comparing them to deifned mechanisms deifned outside the nervous system, we may better understand how KLFs regulate neurite growth and axon regeneration.
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This study was designed to investigate whether the Notch pathway is involved in the develop-ment of diffuse spinal cord astrocytomas. BALB/c nude mice received injections of CD133+and CD133? cell suspensions prepared using human recurrent diffuse spinal cord astrocytoma tissue through administration into the right parietal lobe. After 7–11 weeks, magnetic resonance imaging was performed weekly. Xenografts were observed on the surfaces of the brains of mice receiving the CD133+ cell suspension, and Notch-immunopositive expression was observed in the xenografts. By contrast, no xenografts appeared in the identical position on the surfaces of the brains of mice receiving the CD133? cell suspension, and Notch-immunopositive expres-sion was hardly detected either. Hematoxylin-eosin staining and immunohistochemical staining revealed xenografts on the convex surfaces of the brains of mice that underwent CD133+ astro-cytoma transplantation. Some sporadic astroglioma cells showed pseudopodium-like structures, which extended into the cerebral white matter. However,it should be emphasized that the sub-cortex xenograft with Notch-immunopositive expression was found in the fourth mouse received injection of CD133? astrocytoma cells. However, these ifndings suggest that the Notch pathway plays an important role in the formation of astrocytomas, and can be considered a novel treat-ment target for diffuse spinal cord astrocytoma.
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MicroRNA-124 (miR-124) is abundantly expressed in neurons in the mammalian central ner-vous system, and plays critical roles in the regulation of gene expression during embryonic neurogenesis and postnatal neural differentiation. However, the expression proifle of miR-124 after spinal cord injury and the underlying regulatory mechanisms are not well understood. In the present study, we examined the expression of miR-124 in mouse brain and spinal cord after spinal cord injury usingin situ hybridization. Furthermore, the expression of miR-124 was examined with quantitative RT-PCR at 1, 3 and 7 days after spinal cord injury. The miR-124 expression in neurons at the site of injury was evaluated by in situ hybridization combined with NeuN immunohistochemical staining. The miR-124 was mainly expressed in neurons through-out the brain and spinal cord. The expression of miR-124 in neurons significantly decreased within 7 days after spinal cord injury. Some of the neurons in the peri-lesion area were NeuN+/miR-124?. Moreover, the neurons distal to the peri-lesion site were NeuN+/miR-124+. These ifndings indicate that miR-124 expression in neurons is reduced after spinal cord injury, and may relfect the severity of spinal cord injury.
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Acellular peripheral allograft scaffolds can be fabricated using chemical extraction techniques, but methods for producing acellular scaffold derived from spinal cord tissue are not currently available.The present study demonstrated that chemical extraction using Triton X-100 and sodium deoxycholate could be used to completely remove the cells, axons and neural sheaths in spinal cord extracellular matrix-derived scaffolds. The matrix fibers were longitudinally arranged in a wave-like formation, and were connected by fiber junctions. Lattice-shaped fiber cages appeared and developed into bone trabecula-like changes. The natural structure of matrix fibers in the scaffolds was maintained; this helps to guide the differentiation and migration of implanted stem cells. Decellularized spinal cord extracellular matrix-derived scaffolds can provide an ideal substance for fabricating tissue-engineered spinal cord.