目的探讨重组人促红细胞生成素(recombinat human erythropoietin,rhEPO)对大鼠视神经(optic nerve,ON)不完全损伤后视网膜神经元凋亡的抑制作用和对视功能修复的影响。方法雄性Long Evans大鼠随机分为实验组和对照组,每组25只。制作ON...目的探讨重组人促红细胞生成素(recombinat human erythropoietin,rhEPO)对大鼠视神经(optic nerve,ON)不完全损伤后视网膜神经元凋亡的抑制作用和对视功能修复的影响。方法雄性Long Evans大鼠随机分为实验组和对照组,每组25只。制作ON不完全损伤模型。实验组和对照组按ON夹伤后不同时间分为伤后1d、3d、5d、7d、14d5个时间点。实验组伤后即时、3d、5d、7d,按5000U·kg-1体重腹腔内注射rhEPO;对照组注射等量生理盐水。伤后1d、3d、5d、7d、14d取材。取材前行闪光视觉诱发电位检测。应用TUNEL法检测视网膜神经元的凋亡。结果伤后7d、14d对照组视网膜凋亡细胞密集分布于视网膜节细胞层及内、外核层。实验组7d、14d视网膜凋亡细胞明显减少,视网膜节细胞层的凋亡细胞与对照组相比有非常显著差异(P<0.01)。2组闪光视觉诱发电位潜伏期各时间点组间比较无显著性差异(P>0.05)。伤后1d、3d、5d、7d实验组P1-N2波振幅和对照组相比无显著性差异(P>0.05);伤后14d时有显著差异(P<0.05)。结论rhEPO对ON不完全损伤后视网膜神经元的凋亡具有抑制作用,可以促进视功能的恢复。展开更多
Objectives: To improve the diagnosis of damaged spinal motor pathways in incomplete spinal cord injury (iSCI) by assessing the facilitation of lower limbs motor evoked potentials (MEP). Methods: Control subjects (n = ...Objectives: To improve the diagnosis of damaged spinal motor pathways in incomplete spinal cord injury (iSCI) by assessing the facilitation of lower limbs motor evoked potentials (MEP). Methods: Control subjects (n = 12) and iSCI patients (n = 21) performed static and dynamic isometric foot dorsiflexions. MEPs induced by transcranial magnetic stimulation and EMG background of tibialis anterior muscle (TA) were analyzed. Static and dynamic muscle activation was performed at comparable levels of maximal voluntary contraction (MVC). The influence of the motor tasks on the excitability and facilitation of MEPs was compared between controls and iSCI patients. Results: In the controls an increased facilitation of TA MEP at lower levels of dynamic compared with static activation (10-20 % MVC) could be shown. At matched EMG background level the MEP responses were significantly increased. In the iSCI patients at a comparable level of TA activation the MEP responses were significantly reduced and 3 different patterns of MEP responses could be distinguished: i) preserved increment of TA MEP in the dynamic motor task, ii) unchanged MEP size in the dynamic and static motor task, and iii) elicitable MEPs in the dynamic motor task, which were abolished in the static motor task. Conclusions: Static and dynamic motor tasks have different effects on TA MEP facilitation. The task-dependent modulation of TA MEPs is comparable to that described for upper limb muscles. Complementary to the MEP delay this approach allows for an estimation of the severity of spinal tract damage. The task-dependent modulation of TA MEPs is an additional diagnostic tool to improve the assessment and monitoring of motor function in iSCI.展开更多
目的:探讨电针神经干选穴对不完全脊髓损伤患者下肢运动功能的影响。方法:2021年1月至2022年12月本院收治的56例不完全脊髓损伤患者,根据随机数字表分为两组(试验组,即神经干选穴配合疏密波电针组;对照组,即传统选穴配合疏密波电针组,...目的:探讨电针神经干选穴对不完全脊髓损伤患者下肢运动功能的影响。方法:2021年1月至2022年12月本院收治的56例不完全脊髓损伤患者,根据随机数字表分为两组(试验组,即神经干选穴配合疏密波电针组;对照组,即传统选穴配合疏密波电针组,每组各28例)。采用美国脊髓损伤协会(American Spinal Injury Association ASIA)下肢运动评分(Low extremity motor score,LEMS)、改良Ashworth分级(modified Ashworth scale,MAS)、脊髓损伤步行指数Ⅱ(walking index of spinal cord injuryⅡ,WISCIⅡ)及改良Barthel指数(modified Barthel index,MBI)评估患者功能恢复的情况。结果:治疗前两组患者LEMS、MAS、WISCIⅡ和MBI评分比较,差异均无统计学意义(P>0.05);治疗4周后各项指标与治疗前比较,改善均有统计学意义(P<0.05);治疗后(1)LEMS数据试验组和对照组比较,t=2.166,P=0.039(P<0.05),差异具有统计学意义。(2)MAS数据试验组和对照组比较,t=1.434,P=0.157(P>0.05),差异无统计学意义。(3)WISCIⅡ数据试验组和对照组比较,t=2.549,P=0.014(P<0.05),差异具有统计学意义。(4)MBI数据试验组与对照组对比,t=3.174,P=0.02(P<0.05),差异具有统计学意义。治疗期间,两组不良反应发生率无统计学意义(P>0.05)。结论:神经干选穴配合疏密波电针对不完全脊髓损伤患者下肢运动功能疗效确切,对促进患者康复有重要意义,对于改善肌张力方面,两组无明显差异。展开更多
文摘目的探讨重组人促红细胞生成素(recombinat human erythropoietin,rhEPO)对大鼠视神经(optic nerve,ON)不完全损伤后视网膜神经元凋亡的抑制作用和对视功能修复的影响。方法雄性Long Evans大鼠随机分为实验组和对照组,每组25只。制作ON不完全损伤模型。实验组和对照组按ON夹伤后不同时间分为伤后1d、3d、5d、7d、14d5个时间点。实验组伤后即时、3d、5d、7d,按5000U·kg-1体重腹腔内注射rhEPO;对照组注射等量生理盐水。伤后1d、3d、5d、7d、14d取材。取材前行闪光视觉诱发电位检测。应用TUNEL法检测视网膜神经元的凋亡。结果伤后7d、14d对照组视网膜凋亡细胞密集分布于视网膜节细胞层及内、外核层。实验组7d、14d视网膜凋亡细胞明显减少,视网膜节细胞层的凋亡细胞与对照组相比有非常显著差异(P<0.01)。2组闪光视觉诱发电位潜伏期各时间点组间比较无显著性差异(P>0.05)。伤后1d、3d、5d、7d实验组P1-N2波振幅和对照组相比无显著性差异(P>0.05);伤后14d时有显著差异(P<0.05)。结论rhEPO对ON不完全损伤后视网膜神经元的凋亡具有抑制作用,可以促进视功能的恢复。
文摘Objectives: To improve the diagnosis of damaged spinal motor pathways in incomplete spinal cord injury (iSCI) by assessing the facilitation of lower limbs motor evoked potentials (MEP). Methods: Control subjects (n = 12) and iSCI patients (n = 21) performed static and dynamic isometric foot dorsiflexions. MEPs induced by transcranial magnetic stimulation and EMG background of tibialis anterior muscle (TA) were analyzed. Static and dynamic muscle activation was performed at comparable levels of maximal voluntary contraction (MVC). The influence of the motor tasks on the excitability and facilitation of MEPs was compared between controls and iSCI patients. Results: In the controls an increased facilitation of TA MEP at lower levels of dynamic compared with static activation (10-20 % MVC) could be shown. At matched EMG background level the MEP responses were significantly increased. In the iSCI patients at a comparable level of TA activation the MEP responses were significantly reduced and 3 different patterns of MEP responses could be distinguished: i) preserved increment of TA MEP in the dynamic motor task, ii) unchanged MEP size in the dynamic and static motor task, and iii) elicitable MEPs in the dynamic motor task, which were abolished in the static motor task. Conclusions: Static and dynamic motor tasks have different effects on TA MEP facilitation. The task-dependent modulation of TA MEPs is comparable to that described for upper limb muscles. Complementary to the MEP delay this approach allows for an estimation of the severity of spinal tract damage. The task-dependent modulation of TA MEPs is an additional diagnostic tool to improve the assessment and monitoring of motor function in iSCI.
文摘目的:探讨电针神经干选穴对不完全脊髓损伤患者下肢运动功能的影响。方法:2021年1月至2022年12月本院收治的56例不完全脊髓损伤患者,根据随机数字表分为两组(试验组,即神经干选穴配合疏密波电针组;对照组,即传统选穴配合疏密波电针组,每组各28例)。采用美国脊髓损伤协会(American Spinal Injury Association ASIA)下肢运动评分(Low extremity motor score,LEMS)、改良Ashworth分级(modified Ashworth scale,MAS)、脊髓损伤步行指数Ⅱ(walking index of spinal cord injuryⅡ,WISCIⅡ)及改良Barthel指数(modified Barthel index,MBI)评估患者功能恢复的情况。结果:治疗前两组患者LEMS、MAS、WISCIⅡ和MBI评分比较,差异均无统计学意义(P>0.05);治疗4周后各项指标与治疗前比较,改善均有统计学意义(P<0.05);治疗后(1)LEMS数据试验组和对照组比较,t=2.166,P=0.039(P<0.05),差异具有统计学意义。(2)MAS数据试验组和对照组比较,t=1.434,P=0.157(P>0.05),差异无统计学意义。(3)WISCIⅡ数据试验组和对照组比较,t=2.549,P=0.014(P<0.05),差异具有统计学意义。(4)MBI数据试验组与对照组对比,t=3.174,P=0.02(P<0.05),差异具有统计学意义。治疗期间,两组不良反应发生率无统计学意义(P>0.05)。结论:神经干选穴配合疏密波电针对不完全脊髓损伤患者下肢运动功能疗效确切,对促进患者康复有重要意义,对于改善肌张力方面,两组无明显差异。
