Surgical intervention combined with weight-bearing walking training promotes recovery in patients with chronic spinal cord injury:a randomized controlled study

For patients with chronic spinal cord injury,the co nventional treatment is rehabilitation and treatment of spinal cord injury complications such as urinary tract infection,pressure sores,osteoporosis,and deep vein thrombosis.Surgery is rarely perfo rmed on spinal co rd injury in the chronic phase,and few treatments have been proven effective in chronic spinal cord injury patients.Development of effective therapies fo r chronic spinal co rd injury patients is needed.We conducted a randomized controlled clinical trial in patients with chronic complete thoracic spinal co rd injury to compare intensive rehabilitation(weight-bearing walking training)alone with surgical intervention plus intensive rehabilitation.This clinical trial was registered at ClinicalTrials.gov(NCT02663310).The goal of surgical intervention was spinal cord detethering,restoration of cerebrospinal fluid flow,and elimination of residual spinal cord compression.We found that surgical intervention plus weight-bearing walking training was associated with a higher incidence of American Spinal Injury Association Impairment Scale improvement,reduced spasticity,and more rapid bowel and bladder functional recovery than weight-bearing walking training alone.Overall,the surgical procedures and intensive rehabilitation were safe.American Spinal Injury Association Impairment Scale improvement was more common in T7-T11 injuries than in T2-T6 injuries.Surgery combined with rehabilitation appears to have a role in treatment of chronic spinal cord injury patients.

中国农村老年人群血浆中7种微量元素水平分析

目的了解我国农村地区65岁及以上老年人群血浆中铝、钙、镉、铜、铁、铅和锌等7种微量元素水平。方法采集长年生活于我国四川、山东两省四县市农村的老年人群188人的血样,应用ICP质谱仪测定血浆中的该7种微量元素含量。结果农村≥65岁老年人群血浆中铝、钙、镉、铜、铁、铅、锌的平均含量分别为0.97mg/L、52.07mg/L、1.75μg/L,0.65mg/L、3.64mg/L、3.91μg/L和7.88mg/L。结论本调查研究显示了中国农村老年人群目前7种微量元素水平现况,可为进一步研究这些微量元素与老年人群健康的关系及开展防治老年性疾病提供科学参考。

Surgical intervention combined with weight-bearing walking training improves neurological recoveries in 320 patients with clinically complete spinal cord injury:a prospective self-controlled study

Although a large number of trials in the SCI field have been conducted,few proven gains have been realized for patients.In the present study,we determined the efficacy of a novel combination treatment involving surgical intervention and long-term weight-bearing walking training in spinal cord injury(SCI)subjects clinically diagnosed as complete or American Spinal Injury Association Impairment Scale(AIS)Class A(AIS-A).A total of 320 clinically complete SCI subjects(271 male and 49 female),aged 16–60 years,received early(≤7 days,n=201)or delayed(8–30 days,n=119)surgical interventions to reduce intraspinal or intramedullary pressure.Fifteen days post-surgery,all subjects received a weight-bearing walking training with the“Kunming Locomotion Training Program(KLTP)”for a duration of 6 months.The neurological deficit and recovery were assessed using the AIS scale and a 10-point Kunming Locomotor Scale(KLS).We found that surgical intervention significantly improved AIS scores measured at 15 days post-surgery as compared to the pre-surgery baseline scores.Significant improvement of AIS scores was detected at 3 and 6 months and the KLS further showed significant improvements between all pair-wise comparisons of time points of 15 days,3 or 6 months indicating continued improvement in walking scores during the 6-month period.In conclusion,combining surgical intervention within 1 month post-injury and weight-bearing locomotor training promoted continued and statistically significant neurological recoveries in subjects with clinically complete SCI,which generally shows little clinical recovery within the first year after injury and most are permanently disabled.This study was approved by the Science and Research Committee of Kunming General Hospital of PLA and Kunming Tongren Hospital,China and registered at ClinicalTrials.gov(Identifier:NCT04034108)on July 26,2019.

Comparative transcriptomics analysis of Zygosaccharomyces mellis under high-glucose stress

The high-glucose tolerance of yeast is the main factor determining the efficiency of high-density alcohol fermentation.Zygosaccharomyces mellis LGL-1 isolated from honey could survive under 700 g/L high-glucose stress and its tolerant characteristics were identified in our previous study.This study was performed to explore and clarify the high-glucose tolerance mechanism of Z.mellis LGL-1.Comparative transcriptomic analysis was used to analyze the genes with differential expression in Z.mellis under high-glucose conditions of 300,500 and 700 g/L.With 300 g/L samples as reference,there were 937 and 2380 differentially expressed genes(DEGs)in the 500 and 700 g/L samples,respectively.Meanwhile,there was 825 significant DEGs in the 700 g/L samples compared with that of the 500 g/L samples.The result revealed that transcriptional changes in multiple metabolic pathways occur in response to high-glucose stress.q-RT PCR analysis further confirmed that several stress response pathways,such as the high osmolarity glycerol mitogen-activated protein kinase(HOG-MAPK)signal transduction pathway,trehalose synthesis pathway and oxidative stress response are closely related to high-glucose tolerance in Z.mellis.This study clarifies mechanisms of Z.mellis in response to high-glucose osmotic stress,providing theoretical basis for the process control of high-density alcohol fermentation.

Low selenium and reduced cognitive function in a cohort elderly study

Cognitive function in the elderly is affected by various environmental,social,and individual factors.Studies show that chemical trace elements are closely related to cognitive function.As a protective factor,selenium promotes cognition in the elderly.However,study results into the effects of selenium on cognition have varied.By eliminating unstable environmental and other related factors,the present study selected elderly individuals from rural areas of the Shandong province to verify whether low selenium exposure is a risk factor for decreased cognitive function.Results demonstrated that age,sex,education,occupation,hypertension,stroke,and body selenium levels were factors affecting cognitive function in the elderly,and that selenium was an important protective factor.Moreover,results supported the hypothesis that a lifelong low selenium level is associated with low cognitive function.

Nail Selenium Level and Diabetes in Older People in Rural China

This cross-sectional study aimed to examine the association between selenium levels and diabetes in an older population with life-long natural exposure to selenium in rural China. A total of 1856 subjects aged 65 years or older from four Chinese rural counties with different environmental selenium levels were evaluated. Analysis of covariance models and logistic regression models were used to examine the relationship between nail selenium levels and serum glucose, serum insulin, insulin resistance [using the Homeostatic Model Assessment for Insulin Resistance （HOMA-IR）], and the risk of diabetes. The mean nail selenium level was 0.461μg/g and the prevalence rate of diabetes was 8.3% in this population. The mean nail selenium level was significantly higher in the group with diabetes than in the group without diabetes （P〈0.0001）. The adjusted odds ratios for diabetes were 2.65 （95% Cl： 1.48 to 4.73）, 2.47 （95% CI： 1.37 to 4.45）, and 3.30 （95% Cl： 1.85 to 5.88） from the second selenium quartile to the fourth quartile, respectively, compared with the first quartile group. The mean serum glucose and HOMA-IR in the higher selenium quartile groups were significantly higher than those of the lowest quartile group. However, no significant differences in insulin were observed among the four quartile groups. A long-term, higher level of exposure to selenium may be associated with a higher risk of diabetes. Future studies are needed to elucidate the association between selenium and insulin resistance.

环境硒水平与农村老年人群认知能力的相关性研究

目的 探讨老年人群认知能力与环境硒水平的相关性,验证体内不同硒水平对老年人群认知能力的影响.方法 选择山东省外环境硒水平不同的淄川区和高密市为调查点,其中淄川区为适硒[硒摄入量（46.73±24.36）mg·kg-1·d-1]地区,高密市为低硒[硒摄入量（11.66±4.72）mg·kg-1·d-1]地区.采用分层抽样方法,分别抽取终身居住于当地年龄≥65岁的农村老年人各500人,利用膳食摄入量调查表,对老年人进行近1年的回顾性膳食调查,计算每日硒总摄入量.采用美国印第安纳大学提供的社区痴呆筛查量表（CSID）、故事记忆测试、动物流畅性测验评定老年人群的认知能力;采用美国老年痴呆症登记联盟（CERAD）词表中提供的方法,对老年人群进行学习测试、学习记忆测试;采用现场采访评定方式,通过问卷调查形式获得老年人群认知能力资料,分析体内硒水平与老年人群认知能力之间的相关性.采集老年人群指甲和静脉血,应用荧光分光光度法检测指甲硒和血硒水平.结果 适硒与低硒地区老年人群硒摄入量[（46.73±24.36）、（11.66±4.72）mg.kg-1·d-1]、指甲硒[（0.605±0.163）、（0.405±0.086）mg/kg]和血硒[（147.44±17.42）、（117.38±22.48）μg/L]组间比较差异有统计学意义（U值分别为31.59、25.00、23.67,P均＜0.01）;硒摄入量与指甲硒和血硒、指甲硒与血硒之间存在正相关（r值分别为0.51、0.46、0.60,P均＜0.01）.老年人群体内硒水平与认知能力,除动物名词叙述测试外,CSID总计分、故事记忆、回忆测试、学习记忆测试组间比较差异有统计学意义（F值分别为2.56、9.18、7.48、4.42,P＜0.05）;剔除可能混杂因素的影响后,除学习记忆测试外,老年人群体内硒水平与CSID总计分、故事记忆、动物流畅、学习测试有明显的正相关（r值分别为0.076、0.138、0.042、0.107,P＜0.05或＜0.01）.结论 环境硒水平与老年人群的认知能力之间呈正相关;环境硒水平高的地区老年人群的认知能力明显高于环境硒水平低的地区.