Cardiovascular dysfunction following spinal cord injury

Both sensorimotor and autonomic dysfunctions often occur after spinal cord injury（SCI）. Particularly, a high thoracic or cervical SCI interrupts supraspinal vasomotor pathways and results in disordered hemodynamics due to deregulated sympathetic outflow. As a result of the reduced sympathetic activity, patients with SCI may experience hypotension, cardiac dysrhythmias, and hypothermia post-injury. In the chronic phase, changes within the CNS and blood vessels lead to orthostatic hypotension and life-threatening autonomic dysreflexia（AD）. AD is characterized by an episodic, massive sympathetic discharge that causes severe hypertension associated with bradycardia. The syndrome is often triggered by unpleasant visceral or sensory stimuli below the injury level. Currently the only treatments are palliative - once a stimulus elicits AD, pharmacological vasodilators are administered to help reduce the spike in arterial blood pressure. However, a more effective means would be to mitigate AD development by attenuating contributing mechanisms, such as the reorganization of intraspinal circuits below the level of injury. A better understanding of the neuropathophysiology underlying cardiovascular dysfunction after SCI is essential to better develop novel therapeutic approaches to restore hemodynamic performance.

Role of hypoxia-induced VEGF in blood-spinal cord barrier disruption in chronic spinal cord injury

Chronic spinal cord lesions （CSCL） which result in irreversible neurologic deficits remain one of tbe most devastating clinical problems. Its patbophysiological mechanism has not been fully clarified. As a crucial factor in the outcomes following traumatic spinal cord injury （SCI）, the blood-spinal cord barrier （BSCB） disruption is considered as an important pathogenic factor contributing to the neurologic impairment in SCI. Vascular endothelial growth factor （VEGF） is a multirole element in the spinal cord vascular event. On one hand, VEGF administrations can result in rise of BSCB permeability in acute or sub-acute periods and even last for chronic process. On the other band, VEGF is regarded to be correlated with anglo- genesis, neurogenesis and improvement of locomotor ability. Hypoxia inducible factor-I （HIFq） is a primary regulator of VEGF during hypoxic conditions. Therefore, hypoxia-mediated up-regulation of VEGF may play multiple roles in the BSCB disruption and react on functional restoration of CSCL. The purpose of this article is to further explore the relationship among HIF-1, hypoxia-mediated VEGF and BSCB dysfunction, and investigate the roles of these elements on CSCL.

Seropositivity rates of water channel protein 4 antibodies compared between a cell-based immunofluorescence assay and an enzyme-linked immunosorbent assay in neuromyelitis optica patients

A total of 66 samples （from 27 cases with neuromyelitis optica, 26 cases with multiple sclerosis, aa 13 cases with optic neuritis） were tested for aquaporin-4 antibody by a cell-based immunofluorescence assay and an enzyme-linked immunosorbent assay. The sensitivities and specificities of the two assays were similar. We further analyzed an additional 68 patients and 93 healthy controls using the enzyme-linked immunosorbent assay. A Kappa test showed good consistency between the two methods in terms of detection of anti-aquaporin-4 antibody in the se of neuromyelitis optica patients. No significant correlations were identified with onset age or disea duration, suggesting that aquaporin-4 antibody is a good marker for neuromyelitis optica. The enzyme-linked immunosorbent assay can be used for quantifying aquaporin-4 antibody concentrations and may be useful to dynamically monitor changes in the levels of aquaporin-4 antibody during disease duration.

The treatment of urinary retention of neurogenic bladder of one patient with diabetes from the perspective of governor vessel:A case report

Objective： To report the clinical effect of traditional acupuncture and moxibustion in the treatment of neurogenic bladder.Methods： A single case of a 57-year-old female with neurogenic bladder retention of urine considering governor vessel in the use of acupuncture and moxibustion. Acupoints selected： Shenshū（肾俞BL 23）,Pángguāngshū（膀胧俞 BL 28）. Yāoyángguan（腰阳关GV 3）, Mìngmén（命门 GV 4）. Moxibustion was applied on Guānyuán（关元 CV4） at the same time.Results： After 6 times of treatment, the patient’s urination function return to normal, avoid the adverse effect of retention catheterization.Conclusion： It is suggested that the combination of acupuncture and moxibustion, and the integration of syndrome differentiation and disease differentiation can effectively treat retention of urine due to neurogenic bladder of patient with diabetes.