简介：OBJECTIVE:Theaimofthisstudywastoevaluatetheeffectivenessandsafetyofstemcelltransplantationforspinalcordinjury(SCI).DATASOURCES:PubMed,EMBASE,Cochrane,ChinaNationalKnowledgeInfrastructure,ChinaScienceandTechnologyJournal,Wanfang,andSinoMeddatabasesweresystematicallysearchedbycomputertoselectclinicalrandomizedcontrolledtrialsusingstemcelltransplantationtotreatSCI,publishedbetweeneachdatabaseinitiationandJuly2016.DATASELECTION:RandomizedcontrolledtrialscomparingstemcelltransplantationwithrehabilitationtreatmentforpatientswithSCI.Inclusioncriteria:(1)PatientswithSCIdiagnosedaccordingtotheAmericanSpinalInjuryAssociation(ASIA)InternationalstandardsforneurologicalclassificationofSCI;(2)patientswithSCIwhoreceivedonlystemcelltransplantationtherapyorstemcelltransplantationcombinedwithrehabilitationtherapy;(3)oneormoreofthefollowingoutcomesreported:outcomesconcerningneurologicalfunctionincludingsensoryfunctionandlocomotorfunction,activitiesofdailyliving,urinationfunctions,andseverityofSCIoradverseeffects.Studiescomprisingpatientswithcomplications,withoutfull-text,andpreclinicalanimalmodelswereexcluded.QualityoftheincludedstudieswasevaluatedusingtheCochraneriskofbiasassessmenttoolandRevManV5.3software,providedbytheCochraneCollaboration,wasusedtoperformstatisticalanalysis.OUTCOMEMEASURES:ASIAmotorscore,ASIAlighttouchscore,ASIApinprickscore,ASIAimpairmentscalegradingimprovementrate,activitiesofdailylivingscore,residualurinevolume,andadverseevents.RESULTS:Tenstudiescomprising377patientswereincludedintheanalysisandtheoverallriskofbiaswasrelativelylowlevel.Fourstudiesdidnotdetailhowrandomsequencesweregenerated,twostudiesdidnotclearlystatetheblindingoutcomeassessment,twostudieslackedblindingoutcomeassessment,onestudylackedfollow-upinformation,andfourstudiesc

简介：BACKGROUND:Studieshavedemonstratedthatthemechanismsunderlyingcellularapoptosissignaltransductionfocusontwopathways:intracellularmitochondriaandextracellulardeathreceptor.Thecurrentevidencesupportsthatsignaltransductionofcellularapoptosisalsoincludesendoplasmicreticulumstresssignaltransduction.OBJECTIVE:ToobserveCaspase-12expressionandcellularapoptosisfollowingischemiainratswithprogressivespinalcordcompression,andtoverifytheinfluenceofendoplasmicreticulumstressontheapoptosisinducedbyspinalcordinjury.DESIGN,TIMEANDSETTING:Arandomized,controlled,animaltrialwasperformedattheInstituteofNeuroscienceinChongqingMedicalUniversitybetweenJanuaryandOctoberin2006.MATERIALS:Immunohistochemicalkit,diaminobenzidine,andTUNELkitwerepurchasedfromBeijingZhongshanBiotechnology,China;rabbitanti-ratCaspase-12monoclonalantibodywasprovidedbySantaCruz,USA.METHODS:SixtyWistarrats,aged3-4months,wererandomlyassignedtoamodelgroup(n=50),whichunderwentspinalcordcompressionintheL_1segmentfollowingL_1laminectomyandarticularprocessexcisiontoestablishamodelofprogressivespinalcordcompression,andasham-surgerygroup(n=10),whichunderwentonlylaminectomy.Startingwiththefirstdayaftersurgery,theratswerelocallyanesthetized,theskinwasopened,andthescrewwasrotatedby1/4ofacycle,twiceweekly.MAINOUTCOMEMEASURES:At3,7,14,21,and28daysaftersurgery,ratsfromeachgroupwereanesthetized,andthespinalcordswereresected.Pathologicalchangesfollowingspinalcordcompressionweredeterminedusinghematoxylin-eosinstaining,Nissldye,andtransmissionelectronmicroscopy.TheTUNELmethodwasusedtoobserveneuronalapoptosisinthecompressedspinalcordsegments.ImmunohistochemistryandWesternblotwereutilizedtodetectCaspase-12expressioninthecompressedsegments.RESULTS:Cellularswelling,neuraldegeneration,andalteredendoplasmicreticulumstructureswereobservedat3days

简介：BACKGROUND:Transplantedmononuclearcell(MNC)ofumbilicalbloodcansurviveincentralnervoussystem(CNS)ofhostthroughbloodbrainbarrier,differentiateintonervercells,migratetodamagedsiteandintegratemorphologicalstrucghandfunctionwithnervecellsofhostsoastoimprovedeficienciesofsensatoryfunction,motorfunctionandcognitivefunctionandinfluenceonstrokesequela.OBJECTIVE:Toobservetheveintransplantationofhumanumbilicalcordbloodstemcells(HUCBSC)forimprovingneurologicalfunction,limbfuntionandactivityofdailylivingofpatientswithstrokeandevaluatethereliability.DESIGN:Self-controlledstudy.SETTING:DepartmentofNeurosurgery,theSecondPeople'sHospitalofZhengzhouCity;Red-crossedBloodCenterofHenanProvince;DepartmentofNeurosurgery,theFistAffiliatedHospitalofZhenzhouUniversity.PARTICIPANTS:Atotalof10patientswithstokesequelawereselectedfromDepartmentofCerebralSurgery,theSecondPeople'sHospitalofZhengzhouCityfromApriltoDecember2005.Therewere9malesand1femaleagedfrom35to75yearswiththemeanageof56years.AllofthemwerediagnosedwithCTandMRIexaminationandcoincidencewithdiagnosticcriteriaofstrokeestablishedbytheFourthNationalAcademicMeetingforCerebrovascularDisease.Allpatientsprovidedinformedconsent.METHODS:80-140mLumbilicalbloodoftermbirthofnewbornwasselectedhermeticallyandmaintainedinsterileplasticbag.Andthen,thebloodwascentrifugatedatthespeedof1500r/minfor30minutesat22℃inordertoseparateMNC,i.e.,HUCBSC.Inaddition,afterfinaldiagnosisduringhospitalization,strokepatientswereperfusedwithHUCBSCthroughsuperficialveinofbackofthehand.Eachpatientwasaveragelypenfusedwith6portionsofHUCBSC(cellularnumbers≥1×108/portion)andtheintervalbetweeneachportionwas1-7dayswiththemeanintervalof4days.MAINOUTCOMEMEASURES:①Neurologicalfunctionofstrokepatientswasevaluatedwithneurologicalfunctiondeficiency(NFD)befor

简介：Spinalcordinjury(SCI)isadevastatingconditionthatnotonlyresultsinalossofmotorfunctionsbutalsosevereautonomicdysfunctions(KrassioukovandClaydon,2006).Autonomicdysreflexia(AD)isalifethreateningepisodeoftransienthypertensionthatoccursupto30x/day(11x/dayon

简介：Somestudieshavesuggestedthatearlysurgicaltreatmentcaneffectivelyimprovetheprognosisofcervicalspinalcordinjurywithoutradiologicalabnormality,butnoresearchhasfocusedonthedevelopmentofaprognosticmodelofcervicalspinalcordinjurywithoutradiologicalabnormality.Thisretrospectiveanalysisincluded43patientswithcervicalspinalcordinjurywithoutradiologicalabnormality.Sevenpotentialfactorswereassessed:age,sex,externalforcestrengthcausingdamage,durationofdisease,degreeofcervicalspinalstenosis,JapaneseOrthopaedicAssociationscore,andphysiologicalcervicalcurvature.Amodelwasestablishedusingmultiplebinarylogisticregressionanalysis.Themodelwasevaluatedbyconcordantprofilingandtheareaunderthereceiveroperatingcharacteristiccurve.Bootstrappingwasusedforinternalvalidation.Theprognosticmodelwasasfollows:logit(P)=-25.4545+21.2576VALUE+1.2160SCORE-3.4224TIME,whereVALUEreferstothePavlovratioindicatingtheextentofcervicalspinalstenosis,SCOREreferstotheJapaneseOrthopaedicAssociationscore(0–17)aftertheoperation,andTIMEreferstothediseaseduration(frominjurytooperation).Theareaunderthereceiveroperatingcharacteristiccurveforallpatientswas0.8941(95%confidenceinterval,0.7930–0.9952).Threefactorsassessedinthepredictivemodelwereassociatedwithpatientoutcomes:agreatextentofcervicalstenosis,apoorpreoperativeneurologicalstatus,andalongdiseaseduration.Thesethreefactorscouldworsenpatientoutcomes.Moreover,thediseaseprognosiswasconsideredgoodwhenlogit(P)≥-2.5105.Overall,themodeldisplayedacertainclinicalvalue.ThisstudywasapprovedbytheBiomedicalEthicsCommitteeoftheSecondAffiliatedHospitalofXi’anJiaotongUniversity,China(approvalnumber:2018063)onMay8,2018.

简介：Forty-threepatientswithchronicspinalcordinjuryforover6monthsweretransplantedwithembryonicolfactoryensheathingcells,2–4×106,intomultiplesitesintheinjuredareaunderthesurgicalmicroscope.Thesympatheticskinresponseinpatientswasmeasuredwithanelectromyography/evokedpotentialinstrument1daybeforetransplantationand3–8weeksaftertransplantation.SpinalnervefunctionofpatientswasassessedusingtheAmericanSpinalInjuryAssociationimpairmentscale.Thesympatheticskinresponsewaselicitedin32casesbeforeolfactoryensheathingcelltransplantation,whileitwasobservedin34casesaftertransplantation.Concomitantly,sympatheticskinresponselatencydecreasedsignificantlyandamplitudeincreasedsignificantlyaftertransplantation.TransplantationofolfactoryensheathingcellsalsoimprovedAmericanSpinalInjuryAssociationscoresformovement,painandlighttouch.Ourfindingsindicatethatolfactoryensheathingcelltransplantationimprovesmotor,sensoryandautonomicnervefunctionsinpatientswithchronicspinalcordinjury.

简介：BACKGROUND:Wehavepreviouslyreportedthatadultentericglia(EG)facilitatethegrowthoftransecteddorsalrootaxonsintotheuninjuredspinalcordtoformfunctionalconnectionswiththeirtargets.OBJECTIVE:ThepresentstudyinvestigatedtheeffectsofEGonspinalcordfunction,tissueinjury,andaxonalregenerationfollowingtransplantationintoinjuredratspinalcords,accordingtohistologicalandfunctionaloutcomes.DESIGN,TIMEANDSETTING:ArandomizedcontrolledanimalexperimentwasperformedatMcMasterUniversity,CanadafromJanuary2006toMarch2008.MATERIALS:EGwereisolatedfromratintestine.METHODS:Oneweekfollowingspinalcordcrush,femaleWistarratswereinjectedwithanEGsuspension(2μL,1×10~5/μL,n=10)orwiththesamevolumeoffreshculturemediumalone(controlanimals,n=11).Thethirdgroupdidnotreceiveanyinjectionfollowinglaminectomyandservedasthesham-operatedcontrols(n=5).MAINOUTCOMEMEASURES:Behaviorwastestedpriortotransplantationandweeklyfollowingtransplantation,withninebehavioralexaminationsintotal.Openfield,hindlimbplacementresponse,footorientationresponse,andinclinedplanetestwereutilized.Immediatelyfollowingthefinalbehavioralexamination,spinalcordT_9toL_1segmentswereharvestedforimmunohistochemicalandhematoxylin-eosinstainingtodetermineastroglialscarring,axonalregenerationandspinalcordlesionsize.RESULTS:RatswithEGtransplantationexhibitedsignificantlybetterlocomotorfunctionwithreducedtissuedamage,comparedwiththecontrolrats.Cysticcavitieswerepresent2monthsafterinjuryinspinalcordsfrombothcontrolgroups.Incontrast,ratsinjectedwithEGdidnotpresentwithcysticlesions.Inaddition,theinjurysiteconsistedofcellularmaterialandnervefibers,andaxonalregenerationwasapparent,withdenselabelingofneurofilament-positiveaxonswithintheinjurysite.Moreover,regeneratingaxonswereintimatelyassociatedwithtransplantedEGCONCLUSION:ThesedataindicatedthatEGenha

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简介：Ourpreviousstudieshaveconfirmedthatduringnervetranspositionrepairtoinjuredperipheralnerves,theregeneratednervefibersofmotorneuronsintheanteriorhornofthespinalcordcaneffectivelyrepairdistalnerveandtargetmuscletissueandrestoremusclemotorfunction.Toobservetheeffectofnerveregenerationandmotorfunctionrecoveryafterseveraltypesofnervetranspositionformediannervedefect(2mm),30Sprague-Dawleyratswererandomlydividedintoshamoperationgroup,epineurialneurorrhaphygroup,musculocutaneousnervetranspositiongroup,medialpectoralnervetranspositiongroup,andradialnervemuscularbranchtranspositiongroup.Threemonthsafternerverepair,thewristflexiontestwasusedtoevaluatetherecoveryofwristflexionafterregenerationofmediannerveintheaffectedlimbsofrats.Thenumberofmyelinatednervefibers,thethicknessofmyelinsheath,thediameterofaxonsandthecross-sectionalareaofaxonsintheproximalanddistalsegmentsoftherepairednervesweremeasuredbyosmicacidstaining.Theratioofnewlyproduceddistalmyelinatednervefiberstothenumberofproximalmyelinatednervefiberswascalculated.Wetweightsoftheflexordigitorumsuperficialismusclesweremeasured.Musclefibermorphologywasdetectedusinghematoxylin-eosinstaining.Thecross-sectionalareaofmusclefiberswascalculatedtoassesstherecoveryofmuscles.Resultsshowedthatwristflexionfunctionwasrestored,andthenervegrewintothedistaleffectorinallthreenervetranspositiongroupsandtheepineurialneurorrhaphygroup.Thereweredifferencesinthenumberofmyelinatednervefibersineachgroup.Themagnificationofproximaltodistalnerveswas1.80,3.00,2.50,and3.12inepineurialneurorrhaphygroup,musculocutaneousnervetranspositiongroup,medialpectoralnervetranspositiongroup,andradialnervemuscularbranchtranspositiongroup,respectively.Nevertheless,axondiametersofnewnervefibers,cross-sectionalareasofaxons,thicknessesofmyelinsheath,wet

简介：Thecurrentstudydemonstratedthatinjuryofthespinalcordlateralfuniculusoccursinlivercirrhosis.Thisstudysoughttocomparethemorphologyofthethoracicandlumbarcord,theexpressionoffunctionalproteins,andchangesinvesselsbetweenlivercirrhosisandnon-cirrhosiscorpses.Resultsshowedthatinthelivercirrhosisgroup,thehepaticveinexpanded,thegastrointestinaltractwasfullofcoagulatedblood,blood-stasiswaseasilyseenintheveniplexofthevertebralcanalandthelumbarspinalcord,andthecellbodiesoftheanteriorhorninthethoracicandlumbarcordweresmallerthanthoseinnon-cirrhosiscorpses.Inaddition,nervecellsshrank,Nisslbodieswereconcentratedwithobscurednuclei,andneurofilamentandsynapsincontainingcellbodiesoftheanteriorhornandwhitematterdecreasedinthelivercirrhosisgroup.Theseexperimentalfindingsindicatethatabnormalcirculationofthespinalcord,resultingfromhemodynamicchangeofcirrhoticportalhypertension,maybethemostsignificantcauseofhepaticmyelopathy.

简介：Traumaticinjuriestospinalcordelicitdiversesignalingpathwaysleadingtounselectiveandcomplexpathologicaloutcomes:deathofmultipleclassesofneuralcells,formationofcysticcavitiesandglialscars,disruptionofaxonalconnections,anddemyelinationofsparedaxons,allofwhichcancontributemoreorlesstodebilitatingfunctionalimpairmentsfoundinpatientswithspinal