Effects of Jisuikang on hemorheology and inflammatory factors in rats following spinal cord injury

BACKGROUND： Trauma can damage the spinal cord or cauda equina to different degrees. Previous studies have verified that traditional Chinese medicine has effects on spinal cord injury via a variety of pathways. OBJECTIVE： To observe changes in hemorheology and inflammatory factors in spinal cord injury rats following treatment with the Chinese medicine Jisuikang, to verify the dose-dependent effect of Jisuikang, and to compare its effects with the effects of prednisone. DESIGN, TIME AND SETTING： A randomized study was performed at the Research Institute of Orthopedics, and Experimental Center of First Clinical Medical College, Nanjing University of Traditional Chinese Medicine, China from September 2007 to March 2008. MATERIALS： Jisuikang powdered extract, composed of milkvetch root （30 g）, Chinese angelica （12 g）, red peony root （12 g）, earthworm （10 g）, szechwan lovage rhizome （10 g）, peach seed （10 g） and safflower （10 g） was provided by the Experimental Center, First Clinical Medical College, Nanjing University of Traditional Chinese medicine. Each gram of powdered extract was equivalent to 6.47 g crude drug. METHODS： A total of 72 Sprague Dawley rats were randomly assigned into 6 groups （n = 12）. Rat models of spinal cord injury were established using the occlusion method. Rats in the model group were treated with distilled water. Rats in the 25 g/kg, 12.5 g/kg, and 6.25 g/kg Jisuikang groups were given 25 g＆g, 12.5 g/kg, or 6.25 g/kg Jisuikang by gavage, for 14 days. Rats in the prednisone group received 0.06 g/kg prednisone by gavage, for 7 days. Rats in the normal group were given the same volume of distilled water. The volume of administration was 15 mL/kg. MAIN OUTCOME MEASURES： Rat serum interleukin-10, tumor necrosis factor- α （TNF-α ）, nitric oxide, nitric oxide synthase levels, malondialdehyde content, superoxide dismutase activity and whole blood viscosity were measured in each group. Spinal cord around the site of the model was collected. Half the spinal cord was used for histopathologic examination. The other half was used for measurement of nitric oxide and NOS levels, malondialdehyde contents, and superoxide dismutase activity. RESULTS： Superoxide dismutase activity was higher in the 25 g/kg Jisuikang group than in the model group Malondialdehyde contents, nitric oxide and NOS levels were lower in the 25 g/kg and 12.5 g/kg Jisuikang groups compared with the model group. Whole blood viscosity was lower in the 25 g/kg and 12.5 g/kg Jisuikang groups compared with the model group （P 〈 0.05-0.01）. Serum TNF- α content was lower in each Jisuikang group compared with the model group （P 〈 0.05-0.01）. Serum interleukin-10 levels were greater in the prednisone group and each Jisuikang group compared with the model group （P 〈 0.01）. Mild hemorrhage and necrosis in the rat spinal cord, and unclear neural cell swelling were seen in the 25 g/kg Jisuikang group： Severe hemorrhage and necrosis in the rat spinal cord, and distinct neural cell swelling were seen in the 12.5 g/kg Jisuikang group. Edema in the white matter was found in the 6.25 g/kg Jisuikang group. Pathological changes in the prednisone group were identical to the 25 g/kg and 12.5 g/kg Jisuikang groups. CONCLUSION： Jisuikang inhibits nitric oxide synthase expression, reduces nitric oxide and TNF-α levels decreases malondialdehyde content, increases interleukin-10 levels and superoxide dismutase activity, improves indices of hemorheology, and prevents secondary changes in spinal cord injury, resulting in relieving pathological changes in spinal cord tissue. The outcome was significant in the 25 g/kg Jisuikang group compared with the 12.5 g/kg Jisuikang group.

The Effect of Electroacupuncture on Neuronal Apoptosis and Related Functions in Rats with Acute Spinal Cord Injury

Objective: To investigate the effect and significance of electroacupuncture (EA) on neuronal apoptosis and hindlimb motor and bladder functional improvement in rats with acute spinal cord injury (SCI). Methods: Sixty healthy Sprague Dawley rats were randomly assigned to sham, model, EA, and EA control groups (n = 15 each). EA group rats received EA treatment at Zhibian and Shuidao acupoints seven times daily, whereas EA control group rats received EA at two points, 0.5 cm away from Zhibian and Shuidao, respectively. Histomorphological changes in spinal cord tissue were examined using hematoxylin-eosin staining. Neuronal apoptosis was detected by TUNEL assay. Bcl-2, Bax, and Bad protein levels were detected using immunohistochemistry. Additionally, hindlimb motor function, residual urine volume and maximum bladder capacity were measured. Results: HE staining revealed a morphologically and structurally intact spinal cord in the EA group, and the tissue contained scattered blood cells without edema. In the EA control group, there were small morphological defects in the spinal cord, and the tissue contained fewer blood cells with local edema. Compared with the EA control and model groups, Bax and Bad levels were significantly decreased in the EA group and Bcl-2 expression was increased (P < 0.05). After SCI, hindlimb function scores, residual urine volume, and maximum bladder capacity in rats of the EA group significantly differed from those of the EA control group (P < 0.05). Conclusion: EA may induce SCI-induced improvements in hindlimb motor and bladder functions by affecting neuronal apoptosis and relevant gene expression changes.

Active Achilles tendon kinesitherapy accelerates Achilles tendon repair by promoting neurite regeneration

Active Achilles tendon kinesitherapy facilitates the functional recovery of a ruptured Achilles tendon However, protein expression during the healing process remains a controversial issue. New Zealand rabbits, aged 14 weeks, underwent tenotomy followed immediately byAchilles tendon microsurgery to repair the Achilles tendon rupture. The tendon was then immobilized or subjected to postoperative early motion treatment （kinesitherapy）. Mass spectrography results showed that after 14 days of motion treatment, 18 protein spots were differentially expressed, among which, 12 were up-regulated, consisting of gelsolin isoform b and neurite growth-related protein collapsing response mediator protein 2. Western blot analysis showed that gelsolin isoform b was up-regulated at days 7-21 of motion treatment. These findings suggest that active Achilles tendon kinesitherapy promotes the neurite regeneration of a ruptured Achilles tendon and gelsolin isoform b can be used as a biomarker for Achilles tendon healing after kinesitherapy.

National incidence of joint dislocation in China:a retrospective survey of 512,187 individuals

Background:Joint dislocations significantly impact public health.However,a comprehensive study on the incidence,distribution,and risk factors for joint dislocations in China is lacking.We conducted the China National Joint Dislocation Study,which is a part of the China National Fracture Study conducted to obtain the national incidence and risk factors for traumatic fractures,and to investigate the incidence and risk factors for joint dislocations.Methods:For this national retrospective epidemiological study,512,187 participants were recruited using stratified random sampling and probability-proportional-to-size method from January 19 to May 16,2015.Participants who sustained joint dislocations of the trunk,arms,or legs(skull,sternum,and ribs being excluded)in 2014 were personally interviewed to obtain data on age,educational background,ethnic origin,occupation,geographic region,and urbanization degree.The joint-dislocation incidence was calculated based on age,sex,body site,and demographic factors.The risk factors for different groups were examined using multiple logistic regression.Results:One hundred and nineteen participants sustained 121 joint dislocations in 2014.The population-weighted incidence rate of joint dislocations of the trunk,arms,or legs was 0.22(95%confidence interval[CI]:0.16,0.27)per 1000 population in 2014(men,0.27[0.20,0.34];women,0.16[0.10,0.23]).For all ages,previous dislocation history(male:OR 42.33,95%confidence interval[CI]:12.03-148.90;female:OR 54.43,95%CI:17.37-170.50)and alcohol consumption(male:OR 3.50,95%CI:1.49-8.22;female:OR 2.65,95%CI:1.08-6.50)were risk factors for joint dislocation.Sleeping less than 7 h/day was a risk factor for men.Compared with children,women aged≥15 years(female 15-64 years:OR 0.16,95%CI:0.04-0.61;female≥65 years:OR 0.06,95%CI:0.01-0.41)were less likely to sustain joint dislocations.Women with more than three children were at higher dislocation risk than women without children(OR 6.92,95%CI:1.18-40.78).Conclusions:The up-to-date data on joint dislocation incidence,distribution,and risk factors can be used as a reference for national healthcare,prevention,and management in China.Specific strategies for decreasing alcohol consumption and encouraging adequate sleeping hours should be developed to prevent or reduce dislocation incidents.Trial Registration:Chinese Clinical Trial Registry,ChiCTR-EPR-15005878.