Microglia:a promising therapeutic target in spinal cord injury

Microglia are present throughout the central nervous system and are vital in neural repair,nutrition,phagocytosis,immunological regulation,and maintaining neuronal function.In a healthy spinal cord,microglia are accountable for immune surveillance,however,when a spinal cord injury occurs,the microenvironment drastically changes,leading to glial scars and failed axonal regeneration.In this context,microglia vary their gene and protein expression during activation,and proliferation in reaction to the injury,influencing injury responses both favorably and unfavorably.A dynamic and multifaceted injury response is mediated by microglia,which interact directly with neurons,astrocytes,oligodendrocytes,and neural stem/progenitor cells.Despite a clear understanding of their essential nature and origin,the mechanisms of action and new functions of microglia in spinal cord injury require extensive research.This review summarizes current studies on microglial genesis,physiological function,and pathological state,highlights their crucial roles in spinal cord injury,and proposes microglia as a therapeutic target.

Assessment of hindlimb motor recovery affer severe thoracic spinal cord injury in rats: classification of CatWalk XT■ gait analysis parameters

Assessment of locomotion recovery in preclinical studies of experimental spinal cord injury remains challenging. We studied the CatWalk XT■gait analysis for evaluating hindlimb functional recovery in a widely used and clinically relevant thoracic contusion/compression spinal cord injury model in rats. Rats were randomly assigned to either a T9 spinal cord injury or sham laminectomy. Locomotion recovery was assessed using the Basso, Beattie, and Bresnahan open field rating scale and the CatWalk XT■gait analysis. To determine the potential bias from weight changes, corrected hindlimb(H) values(divided by the unaffected forelimb(F) values) were calculated. Six weeks after injury, cyst formation, astrogliosis, and the deposition of chondroitin sulfate glycosaminoglycans were assessed by immunohistochemistry staining. Compared with the baseline, a significant spontaneous recovery could be observed in the CatWalk XT■parameters max intensity, mean intensity, max intensity at%, and max contact mean intensity from 4 weeks after injury onwards. Of note, corrected values(H/F) of CatWalk XT■parameters showed a significantly less vulnerability to the weight changes than absolute values, specifically in static parameters. The corrected CatWalk XT■parameters were positively correlated with the Basso, Beattie, and Bresnahan rating scale scores, cyst formation, the immunointensity of astrogliosis and chondroitin sulfate glycosaminoglycan deposition. The CatWalk XT■gait analysis and especially its static parameters, therefore, seem to be highly useful in assessing spontaneous recovery of hindlimb function after severe thoracic spinal cord injury. Because many CatWalk XT■parameters of the hindlimbs seem to be affected by body weight changes, using their corrected values might be a valuable option to improve this dependency.

欧洲卒中组织颅内动脉瘤和蛛网膜下腔出血处理指南

背景伴或不伴蛛网膜下腔出血（subarachnoidhaemorrhage，SAH）的颅内动脉瘤是一个重要的健康问题，其总体发病率约为9／10万，在不同国家存在很大差异，在某些国家可高达20／10万。采用保守治疗时，发病最初数月内病死率为50％～60％。在动脉瘤未经处理的患者中，约1剧寄在初次出血恢复后6个月内死于再次出血。此外，血管痉挛、脑积水、迟发性缺血性神经功能缺损以及其他并发症均会影响预后。本指南旨在为伴和不伴颅内动脉瘤的SAH以及未破裂颅内动脉瘤患者的处理提供全面的推荐意见。方法我们使用Medline和Embase进行广泛的文献检索（时间范围为1960年至2011年）。写作组成员通过面谈和电话会议的形式讨论各条推荐意见。按照欧洲神经科学学会联盟标准对检索结果进行分级。欧洲卒中组织指南委员会成员对本指南进行了审阅。结果本指南为SAH的流行病学、危险因素和预后提供了循证信息，并为破裂和未破裂颅内动脉瘤的诊断和治疗方法提供了循证推荐意见。我们明确了动脉瘤生长和破裂的多种危险因素，并且提供了诊断性检查、监测和一般处理（血压、血糖、体温、血栓预防、抗癫痫治疗和类固醇的使用）的推荐意见。特异性治疗干预需考虑处理时机、夹闭和弹簧圈栓塞。本指南还涉及并发症的处理，如脑积水、血管痉挛和迟发性缺血性神经功能缺损等，并对非动脉瘤性SAH和未破裂动脉瘤的处理提供了推荐意见。结论破裂颅内动脉瘤是一种严重的疾病，具有很高的继发并发症风险，需要在治疗此类患者方面有着丰富经验的医疗中心内及时治疗。本指南为破裂或未破裂颅内动脉瘤患者的处理提供了实用的循证建议。应用这些措施能改善SAH的预后。