脊髓IL-6在脊神经结扎模型所引起的热痛敏中的作用

目的：研究脊髓中IL-6在大鼠脊神经结扎（spinal nerve ligation,SNL）所引起的神经病理性痛中的作用。方法：建立大鼠SNL模型,以ELISA法检测脊髓IL-6含量。鞘内分别给予外源性IL-6,以及IL-6的中和抗体以拮抗内源性的IL-6,观察大鼠对热刺激的缩足反应潜伏期（paw withdrawal latencies,PWL）。结果：①SNL手术后3天和7天,脊髓IL-6水平明显上调（P〈0.05）。②手术7天后给予外源性IL-6不能明显引起假手术组的PWL变化,但是与给予生理盐水的假手术组和SNL组相比,给予IL-6的SNL组PWL明显下降（P〈0.05）。③手术7天后给予IL-6的中和抗体不能引起假手术组的PWL改变,但是与给予生理盐水的SNL组相比,给予中和抗体的SNL组PWL明显上升（P〈0.05）。结论：IL-6在脊神经结扎模型所引起的神经病理性痛中发挥促伤害性作用     

经皮穿刺椎弓根螺钉内固定治疗胸腰段脊柱骨折的疗效及对患者氧化应激与术后疼痛的影响

摘要 目的：探讨经皮穿刺椎弓根螺钉内固定治疗胸腰段脊柱骨折的疗效及对患者氧化应激及术后疼痛的影响。方法：选取本院2017年4月到2021年4月在本院诊治的胸腰段脊柱骨折患者126例作为研究对象,依据手术方式的不同将其分为微创组与开放组各63例。微创组给予经皮穿刺椎弓根螺钉内固定治疗,开放组给予开放式椎弓根内固定术治疗。结果：微创组的切口长度等围手术指标均少于开放组（P<0.05）;微创组术后1 d、3 d、5 d与7 d的疼痛视觉模拟评分（VAS）低于开放组（P<0.05）;微创组术后7 d的的感染、切口愈合不良、内固定移位、神经根脊髓压迫等并发症发生率为3.2 %,低于开放组的22.2 %（P<0.05）;两组术后7 d的血清P物质（SP）,和β-内啡肽（β-EP）含量高于术前1 d,微创组高于对照组（P<0.05）;两组术后7 d的血清谷胱甘肽过氧化物酶（GSH-Px）与晚期氧化蛋白产物（AOPP）含量高于术前1 d,微创组高于开放组（P<0.05）。结论：经皮穿刺椎弓根螺钉内固定治疗胸腰段脊柱骨折可有效控制氧化应激指标、疼痛介质水平,减少创伤,减轻术后疼痛,降低并发症,有利于患者康复。     

氟氏佐剂诱导大鼠慢性前列腺炎疼痛模型中L5-S2脊髓中枢小胶质细胞的活化

目的:观察大鼠慢性前列腺炎疼痛模型中L5-S2脊段背角小胶质细胞活化的变化.方法:通过前列腺完全弗氏佐剂注射制作大鼠慢性前列腺炎疼痛模型,对照组注射生理盐水,观察时间为0、4、12、24d,用热辐射痛阈测定法和前列腺病理进行疼痛模型鉴定,采用实时荧光定量RT-PCR检测L5-S2脊段后角中小胶质细胞标志物IBA-1的表达.结果:成功建立慢性前列腺炎疼痛大鼠模型,并观察到L5-S2脊髓背角中存在小胶质细胞的活化.结论:慢性前列腺炎疼痛可以引起L5-S2脊髓中枢小胶质细胞活化,小胶质细胞异常活化可引起神经炎性疼痛,有可能与慢性前列腺炎疼痛的持续和泛化有密切关系.     

脊髓细胞外调节激酶1/2在大鼠后足切割痛中的表达和作用

目的：探讨大鼠后足切割后脊髓ERK的表达情况。方法：以大鼠右后足切割作为急性疼痛模型;用免疫组织化学法测试脊髓磷酸化ERK（pERK）表达情况。ERK抑制剂U0126（1μg）在切割前20min或切割后20min鞘内注射。用von Frey纤维测试大鼠机械性痛敏。结果：大鼠后足切割后1min,在切割侧L4-L5脊髓浅层背侧角（板层Ⅰ和板层Ⅱ）ERK被迅速地激活,并在5min达到峰值,随后恢复到基础值。切割前鞘内给予U0126能显著减轻机械性痛敏,然而,切割后鞘内给予U0126对机械性痛敏的作用并不明显。结论：脊髓ERK在大鼠后足切割痛中产生机械性痛敏发挥了重要的作用。     

Body movements during the off-ice execution of back spins in figure skating

Using an optoelectronic motion capture system, we quantitatively assessed the arrangement of body segments and the displacement of the horizontal projection of the center of mass (CM) in seven skaters performing off-ice back spins on a rotating device (spinner). The position of the CM at the beginning of the spins was not a determining factor, but its rapid stabilization towards the center of the spinner, together with the achievement of a stable arrangement of trunk and limbs, was crucial to get the dynamic equilibrium, necessary for a lasting performance. At full spinning, however, there was an indicative variety of individual body postures. A final deceleration, associable with the loss of body equilibrium, was detected in the last spin of most of skaters.In conclusion, the current investigation demonstrated that the off-ice execution of back spin, a critical movement of ice skating, can be measured in laboratory, thus providing quantitative information to both the skaters and the coaches. The analysis is not invasive, and it may be proposed also for longitudinal evaluations of skating and postural training.     

Accuracy and reproducibility of bending stiffness measurements by mechanical response tissue analysis in artificial human ulnas

Osteoporosis is characterized by reduced bone strength, but no FDA-approved medical device measures bone strength. Bone strength is strongly associated with bone stiffness, but no FDA-approved medical device measures bone stiffness either. Mechanical Response Tissue Analysis (MRTA) is a non-significant risk, non-invasive, radiation-free, vibration analysis technique for making immediate, direct functional measurements of the bending stiffness of long bones in humans in vivo. MRTA has been used for research purposes for more than 20 years, but little has been published about its accuracy. To begin to investigate its accuracy, we compared MRTA measurements of bending stiffness in 39 artificial human ulna bones to measurements made by Quasistatic Mechanical Testing (QMT). In the process, we also quantified the reproducibility (i.e., precision and repeatability) of both methods. MRTA precision (1.0±1.0%) and repeatability (3.1±3.1%) were not as high as those of QMT (0.2±0.2% and 1.3+1.7%, respectively; both p<10⁻⁴). The relationship between MRTA and QMT measurements of ulna bending stiffness was indistinguishable from the identity line (p=0.44) and paired measurements by the two methods agreed within a 95% confidence interval of ±5%. If such accuracy can be achieved on real human ulnas in situ, and if the ulna is representative of the appendicular skeleton, MRTA may prove clinically useful.     

阿米替林对脊髓电刺激治疗幻肢痛疗效的影响

目的：本研究旨在探讨阿米替林干预对脊髓电刺激（SCS）治疗幻肢痛疗效的影响。方法：研究对象为2007年1月至2009年6月在我科行SCS置入术且符合入组标准并自愿参加研究的幻肢痛患者,共获7例。术后SCS均开启,阿米替林治疗在术后1个月时开始。疼痛、情绪、生活质量评估采用视觉模拟评分法（visual analogue scales,VAS法）,现时疼痛强度评分法（presentpain intensity。PPI）,综合性医院焦虑抑郁量表（The Hospital Anxiety and Depression Scale,HAD）,疼痛失能指数（Pain disability index,PDI）。结果：（1）开启SCS后患者的疼痛、抑郁焦虑情绪及生活质量均得到显著改善。（2）所有患者在使用阿米替林治疗以后疼痛、情绪及生活质量也显著改善。结论：阿米替林能显著提高SCS对幻肢痛的疗效。     

Methods for assessment of trunk stabilization,a systematic review

Trunk stabilization is achieved differently in patients with low back pain compared to healthy controls. Many methods exist to assess trunk stabilization but not all measure the contributions of intrinsic stiffness and reflexes simultaneously. This may pose a threat to the quality/validity of the study and might lead to misinterpretation of the results. The aim of this study was to provide a critical review of previously published methods for studying trunk stabilization in relation to low back pain (LBP). We primarily aimed to assess their construct validity to which end we defined a theoretical framework operationalized in a set of methodological criteria which would allow to identify the contributions of intrinsic stiffness and reflexes simultaneously. In addition, the clinimetric properties of the methods were evaluated. A total of 133 articles were included from which four main categories of methods were defined; upper limb (un)loading, moving platform, unloading and loading. Fifty of the 133 selected articles complied with all the criteria of the theoretical framework, but only four articles provided information about reliability and/or measurement error of methods to assess trunk stabilization with test–retest reliability ranging from poor (ICC 0) to moderate (ICC 0.72). When aiming to assess trunk stabilization with system identification, we propose a perturbation method where the trunk is studied in isolation, the perturbation is unpredictable, force controlled, directly applied to the upper body, completely known and results in small fluctuations around the working point.     

大鼠放射性脊髓损伤脊髓血流量变化规律

目的:放射性脊髓损伤(Radiation spinal cord injury,RSCI)是头颈部、胸部及上腹部肿瘤放射治疗和射线意外照射时的常见并发症,一般认为,白质坏死、脱髓鞘为其主要的病理学变化.然而,越来越多的证据表明血-脊髓屏障破裂和血管通透性增加等血管损伤远早于白质坏死和脱髓鞘改变.所以本文阐明大鼠放射性脊髓损伤病理生理过程中脊髓血流量变化规律.方法:将60只Sprague-Dawley (SD)大鼠随机分为12组,1组为对照,其余11组采用60Co放射治疗机行30 Gy大鼠颈髓C2-T2单次照射,剂量率为153 cGy/min,源皮距为80 cm,照射时长为1153 s,照射范围为2.0× 1.0 cm,对照组大鼠于麻醉后置于60Co放射治疗机下,佯照,照射前及照射后分别采用激光多普勒法测量脊髓血流量,11组大鼠于照射前以及照射后1、3、7、14、21、30、60、90、120、150、180天进行测量,以照射前测量值为基数,各时间点以基数的百分比表示该时间点脊髓血流量.结果:大鼠放射性脊髓损伤后,脊髓血流量在照射早期即有降低,照射后90天达到最低,随后脊髓血流量进入平台期.结论:阐明了大鼠放射性脊髓损伤后脊髓血流量的变化规律.大鼠放射性脊髓损伤可影响脊髓血流量,导致脊髓长期处于持续低灌流、缺血缺氧状态,最终导致脊髓不可逆性损伤.临床上放射性脊髓损伤的病人感到疲乏无力,出现神经系统的症状体征,通常死于脑疝.本文为临床上疲乏无力,出现神经系统的症状体征,死于脑疝放射性脊髓损伤的病人的早期防治提供病理生理基础.     

脊柱融合的实验研究进展

脊柱融合是脊柱外科研究重点之一,脊柱融合的动物实验研究也是方兴未艾,有关脊柱融合的实验动物选择、实验方法、实验材料、评价方法是研究的重点。本文通过大量文献进行系统回顾,对脊柱融合动物实验的上述方面进行了总结。     

脊柱损伤的法医临床学鉴定研究进展

随着社会和现代交通、建筑事业的发展,脊柱损伤的病人发病率呈上升趋势,尤其道路交通事故为其损伤的首要原因。脊柱损伤的现场急救、临床诊断与治疗为人们所关注。然而,伴随着事件的进一步处理,对病人的损伤进行渗医学鉴定显得尤为重要。目前,有关脊柱损伤的鉴定标准仅仅是确定的标准,没有规定标准的适用条件。同时,也易导致鉴定人对标准的理解与应用存在差异,由此导致了鉴定结论的争议。本文对脊柱损伤的法医临床学应用研究进展作一综述。     

Paradoxical variation of strength determinants with different rotation axes in trunk flexion and extension strength tests

The aim of this study was to illustrate the influence of different levels of the fulcrum (the axis of sagittal rotation) on measured trunk flexion and extension strength and compare force and torque as a unit of measure. The isometric trunk strength was measured in 16 healthy female subjects. The dynamometer was kept at the shoulder level and the moment arm was lengthened step by step by moving the fulcrum caudally from the level of the posterior superior iliac spine to the level of the gluteal fold. The moment of force (torque) increased from 117.0 to 208.5 N · m in flexion and from 182.2 to 292.5 N · m in extension,P < 0.0001. An attempt to quantify this change was made. Paradoxically, the measured force remained at a constant level (in flexion) or slightly decreased (in extension). We concluded that torque as a measure of trunk flexion and extension strength is highly dependent on the level of the rotation axis and force appears to be less sensitive for variations with the height of the fulcrum. We would suggest that the observed increase in torque is physiological and reflects to what extent hip flexor or extensor muscles are recruited. The force, on the other hand, may better characterize a person's capability to perform functional tasks. Force and torque should strictly be distinguished from one another.     

Influence of muscle activity on musculotendinous stiffness quantification in stunted,prepubertal children

The quick-release technique to estimate musculotendinous (MT) stiffness has been extensively used over the last years, in both animals and humans, to gain insights in the adaptive process of the series elastic component (SEC). Recently, MT stiffness quantification, i.e., SEC behavior, has been revisited for subjects not able to fully activate their muscles (effects of long-term spaceflight or non-mature muscles). Such a phenomenon can also be encountered in stunted children. So, the aim of the present study was to analyze the effect of stunting on MT stiffness taking into account possible defect in muscle activation. For this study, 20 eutrophic children (EU) with an average age of 9 years ± 4 months were compared to 11age matched stunted children (S) evaluated by the height-to-age index. The MT stiffness index was obtained with regard to stiffness–torque and stiffness–soleus EMG relationships. The children of the S group presented a significantly lower Maximal Voluntary Contraction (MVC) in plantar flexion in comparison with children of the EU group (?37.8%). The significantly lower MT stiffness index for S children (?42.6%) was evidenced only when quantified with regard to the stiffness–soleus EMG relationship (66.5 ± 42.8 vs. 38.2 ± 19.9 Nm rad^?1%^?1). Possible delay in fiber type differentiation or tendinous structure maturation can account for the lower MT stiffness index in S children. In conclusion, stunting during early childhood delays the differentiation and maturation processes of musculotendinous structures as shown by the lower MT stiffness quantified with regards to muscle activity, also altered for stunted prepubertal children.     

大鼠坐骨神经结扎后脊髓钙结合蛋白PV的表达变化

目的:研究大鼠坐骨神经结扎模型钙结合蛋白Parvalbumin(PV)在脊髓的时空变化规律,为探讨其在神经再生中的作用与机制提供实验依据。方法:SD大鼠随机分为假手术对照组和坐骨神经结扎组,实验组结扎后分别存活1,3,7,14或21d,采用免疫组化结合图像分析技术观察PV在脊髓的表达变化。结果:在对照组,PV免疫阳性神经元主要分布于腰髓背角Ⅱ层,Ⅲ～Ⅵ层只观察到少量散在分布的PV样阳性神经元,脊髓前角Ⅷ层和Ⅸ层内也可见少量多极的大型阳性神经元。术后各时间点PV样阳性神经元表达下降,14d下降最显著,21d表达有所上升,但还是低于7d组。脊髓后角PV免疫阳性产物灰度值测定结果显示:术后14d后角PV表达最低,与对侧和对照组以及1、3d组相比有统计学意义(P<0.05)。结论:坐骨神经结扎后PV表达变化呈现一定的时空模式,为进一步揭示PV在神经系统疾病中的作用提供实验依据。     

Evidence for a role of antagonistic cocontraction in controlling trunk stiffness during lifting

Activity of the abdominal muscles during symmetric lifting has been a consistent finding in many studies. It has been hypothesized that this antagonistic coactivation increases trunk stiffness to provide stability to the spine. To test this, we investigated whether abdominal activity in lifting is increased in response to destabilizing conditions.

Ten healthy male subjects lifted 35 l containers containing 15 l of water (unstable condition), or ice (stable condition). 3D-kinematics, ground reaction forces, and EMG of selected trunk muscles were recorded. Euler angles of the thorax relative to the pelvis were determined. Inverse dynamics was used to calculate moments about L5S1. Averaged normalized abdominal EMG activity was calculated to express coactivation and an EMG-driven trunk muscle model was used to estimate the flexor moment produced by these muscles and to estimate the L5S1 compression force.

Abdominal coactivation was significantly higher when lifting the unstable load. This coincided with significant increases in estimated moments produced by the antagonist muscles and in estimated compression forces on the L5S1 disc, except at the instant of the peak moment about L5S1. The lifting style was not affected by load instability as evidenced by the absence of effects on moments about L5S1 and angles of the thorax relative to the pelvis. The data support the interpretation of abdominal cocontraction during lifting as subserving spinal stability. An alternative function of the increased trunk stiffness due to cocontraction might be to achieve more precise control over the trajectory of lifted weight in order to avoid sloshing of the water mass in the box and the consequent perturbations.     

The role of trunk muscles in sitting balance control in people with low back pain

The purpose of this study was to examine the muscular activities and kinetics of the trunk during unstable sitting in healthy and LBP subjects. Thirty-one healthy subjects and twenty-three LBP subjects were recruited. They were sat on a custom-made chair mounted on a force plate. Each subject was asked to regain balance after the chair was tilted backward at 20°, and then released. The motions of the trunk and trunk muscle activity were examined. The internal muscle moment and power at the hip and lumbar spine joints were calculated using the force plate and motion data. No significant differences were found in muscle moment and power between healthy and LBP subjects (p > 0.05). The duration of contraction of various trunk muscles and co-contraction were significantly longer in the LBP subjects (p < 0.05) when compared to healthy subjects, and the reaction times of the muscles were also significantly reduced in LBP subjects (p < 0.05). LBP subjects altered their muscle strategies to maintain balance during unstable sitting, but these active mechanisms appear to be effective as trunk balance was not compromised and the internal moment pattern remained similar. The changes in muscle strategies may be the causes of LBP or the result of LBP with an attempt to protect the spine.     

Spinal mechanisms of electric organ discharge synchronization in Gymnotus carapo

Summary The duration of the electric organ discharge (EOD) in Gymnotus carapo is brief and independent of fish size. Spinal mechanisms involved in electrocyte synchronization were explored by recording spontaneous action potentials of single fibers from the electromotor bulbospinal tract (EBST). Using the field potential of the medullary electromotor nucleus (MEN) as a temporal reference we calculated the orthodromic conduction velocity (CV) of these fibers (range: 10.7–91 m/s).The CVs (in m/s) of fibers recorded at the same level of the spinal cord were significantly different in small and large fish; this difference disappeared when CV were expressed as percentage of body length/ms. Plotting these values against conduction distance (also in %) showed that low CV fibers predominate in the rostral cord while only fast fibers are found at distal levels. Moreover, antidromic stimulation of the distal cord was only effective on high CV fibers. The orthodromic CVs in the distal portion of the recorded fibers were calculated by collision experiments; no significant differences were found between proximal and distal portions.The spatial distribution of CV values within the EBST is proposed to play the main role in synchronizing the electromotoneurons' activity along the spinal cord.Abbreviations EOD electric organ discharge - EO electric organ - EBST electromotor bulbospinal tract - MEN medullary electromotor nucleus - CV conduction velocity - EMN electromotoneuron     

Combination of Dexamethasone and Aminoguanidine Reduces Secondary Damage in Compression Spinal Cord Injury

The study was performed to investigate the effect of combination therapy with aminoguanidine (AG) and dexamethasone (DEX) on the compression spinal cord injury (SCI) in rat. Compared to the control group, the combination therapy group with AG (75 mg/kg) and DEX (0.025 mg/kg) significantly reduced the degree of (1) spinal cord edema, (2) the permeability of blood spinal cord barrier (measured by ^99mTc-Albumin), (3) infiltration of neutrophils (MPO evaluation), (4) cytokines expression (tumor necrosis factor-α and interleukin-1β), and (5) apoptosis (measured by Bax and Bcl-2 expression). In addition, we have also clearly demonstrated that the combination therapy significantly ameliorated the recovery of limb function (evaluated by motor recovery score). Taken together, our results clearly indicated for the first time that strategies targeting multiple proinflammatory pathways may be more effective than a single effector molecule for the treatment of SCI.