Résumé
Spinal cord injury (SCI) is mostly caused by severe trauma,which often leads to motor,sensory,reflex and sphincter dysfunction from the injury plane.It is the main cause of paraplegia.With the development of transportation and industry in modern society,the incidence of SCI is increasing year by year,but there is still a lack of ideal treatment drugs.Therefore,finding effective,safe and reliable drug treatment for spinal cord injury is one of the hotspots in basic and clinical research.Traditional Chinese medicine(TCM)has the characteristics of cheapness and less side effects,and it has a long history to be used in clinical treatment of spinal cord injury. Recent studies have shown that some single TCM and their extracts can effectively alleviate or improve secondary spinal cord injury, such as local vascular dysfunction, inflammation, oxidative stress, cell apoptosis, axonal demyelination, glial scar formation, and confirm the scientific nature of their treatment of spinal cord injury.This paper summarized the mechanism of single TCM and its extracts in promoting the repair of spinal cord injury,including improving spinal cord edema,ischemia and hypoxia by regulating the expression of aquaporin-4(AQP-4),hypoxia-inducing factor(HIF)-1α,and vascular endothelial growth factor(VEGF),inhibiting inflammation by regulating tumor necrosis factor(TNF)-α,interleukin(IL)-1β,inhibiting anti-oxygen free radical damage and lipid peroxidation.Chemicals,inhibit neuronal apoptosis,promote nerve cell repair and regeneration,inhibit the formation of glial scars and other aspects to alleviate pathological damage of spinal cord and promote the recovery of nerve function. It shows that traditional Chinese medicine has unique advantages such as multi-target,multi-channel and multi- level.It has broad research prospects for treating SCI and improving prognosis.
Résumé
<p><b>OBJECTIVE</b>To study the effects of Jisuikang (Chinese characters) on Nogo-NgR gene expression, and to explore the protective effects and mechanism of Jisuikang (Chinese characters) on spinal cord injury in rats.</p><p><b>METHODS</b>One hundred eighty female rats were randomly assigned to 6 groups(30 rats per group). Sham group: T10 lamina was resected only and spinal cord was untreated. Model group: spine cord injury (SCI) was created with a modified impinger of Allen's by impacting on the T10 spinal cord. Prednisolone group: Prednisolone (0.06 g/kg) was given by intragastric administration at a time interval of 24 hours after operation. The Jisuikang (Chinese characters) high, moderate and low dose groups: Jisuikang (Chinese characters) was supplied with different dose (50 g/kg, 25 g/kg, 12.5 g/kg) by intragastric administration in rats after operation,for the first time at 30 min after surgery. Animals were killed 3, 7, 14 days after surgery. The expression levels of Nogo-A and NgR were observed by Western Blot and Real-time PCR.</p><p><b>RESULTS</b>The expression of Nogo-A and NgR was at the basic level at all time points in sham group. Compared with model group, the protein expression levels of Nogo-A and NgR in sham, prednisolone, Jisuikang (Chinese characters) moderate dose groups were statistically significant at all time points (P < 0.05). No difference was found in Jisuikang (Chinese characters) high and low dose groups (P > 0.05). Three days after surgery, the mRNA levels of Nogo-A and NgR in treatment group were significantly lower than that in model group (P < 0.01); 7 days after surgery,Nogo-A and NgR mRNA expression were dramatically upregulated and peaked; 14 days after operation, the expression was decreased, but still significantly higher than that in other treatment groups (P < 0.01). Prednisolone and Jisuikang (Chinese characters) moderate dose groups showed the most significant effects among all groups,but there was no statistically significant difference between two groups (P > 0.05).</p><p><b>CONCLUSION</b>The decoction Jisuikang (Chinese characters) can promote the nerve cell regeneration by regulating Nogo-A and NgR gene expression, activating Nogo- NgR signaling pathways after acute spinal cord injury.</p>
Sujets)
Animaux , Femelle , Rats , Protéines liées au GPI , Génétique , Physiologie , Médecine traditionnelle chinoise , Protéines de la myéline , Génétique , Physiologie , Régénération nerveuse , Protéines Nogo , Récepteur Nogo-1 , Rat Sprague-Dawley , Récepteurs de surface cellulaire , Génétique , Physiologie , Transduction du signal , Traumatismes de la moelle épinière , Traitement médicamenteux , MétabolismeRésumé
<p><b>BACKGROUND</b>Left ventricular (LV) dyssynchrony has been described to occur in patients with myocardial infarction. Dyssynchrony of left ventricular mechanical contraction produces adverse hemodynamic consequences. This study aimed to test the capacity of geometric rebuilding by aneurysm plication to restore a more synchronous contractile pattern after a mechanical, rather than electrical, intervention.</p><p><b>METHODS</b>A total of sixty patients with anterior myocardial infarction, QRS duration < 120 ms, electively undergoing operation between January 2008 and January 2010 were included for analysis. Real-time 3-dimensional echocardiography was performed to assess LV function, LV systolic and diastolic dyssynchrony by measuring ejection fraction (EF), peak ejection rate (PER), peak filling rate (PFR) and LV dyssynchrony. LV dyssynchrony was defined as the systolic dyssynchrony of the time to reach the minimum systolic volume for 16 LV segments, expressed in percent cardiac cycle, systolic dyssynchrony index (SDI). We compared changes of LV dyssynchrony at different interval times.</p><p><b>RESULTS</b>LV contraction was significantly asynchronous because preoperative SDI was higher, EF, PER and PFR were lowered. Compared with function after operation, LV mechanical intraventricular resynchronization was improved with decreased SDI ((8.7 ± 0.5)% vs. (14.3 ± 1.6)%, P = 0.01); LV function was improved with EF increasing ((43 ± 9)% vs. (37 ± 7)%, P = 0.001), and LV systolic and diastolic dyssynchrony was improved with more rapid PFR (199.4 ± 15.6 vs. 148.4 ± 21.2, P = 0.002) and PER (212.4 ± 14.5 vs. 156.3 ± 26.2, P = 0.001).</p><p><b>CONCLUSIONS</b>Systolic and diastolic dyssynchrony was highly prevalent in patients with aneurysm, irrespective of QRS duration. Aneurysm plication produces a mechanical intraventricular resynchronization.</p>
Sujets)
Sujet âgé , Femelle , Humains , Mâle , Adulte d'âge moyen , Anévrysme , Chirurgie générale , Échocardiographie tridimensionnelle , Infarctus du myocarde , Imagerie diagnostique , Chirurgie générale , RadiographieRésumé
<p><b>BACKGROUND</b>The temporal response to off-pump anteroapical aneurysm plication has not been well defined. We have evaluated the long-term clinical and functional results of this technique and compared the efficacy with the patch modeling repair.</p><p><b>METHODS</b>From March 2005 to May 2010, 163 (115 men and 48 women) consecutive patients were operated on for post-infarction left ventricular aneurysm (LVA), 54 patients underwent patch remodeling (group A) and 109 patients underwent off-pump anteroapical aneurysm plication repair (group B). All patients had simultaneous coronary revascularization, other operative procedures included septoplasty in eight and ablation of ventricular tachycardia in six. Follow-up ranged from 1 to 5 years, short-term and mid-term outcomes, including complications, cardiac function, and mortality, were assessed.</p><p><b>RESULTS</b>Early mortality was 1.8% for all patients (group A 1 death vs. group B 2 deaths, not significant (NS)). Peri-operative support included intraaortic balloon pumping in 16 (9.8%), (group A 6 patients vs. group B 10 patients, NS) and inotropic drugs in 84 (51.5%), (group A 34 vs. group B 50, NS). During a mean follow-up of (3.7±0.8) years, eight patients died, with four due to cardiac-related causes. No patient required transplantation, and two required use of an implantable cardioverter-defibrillator for ventricular tachycardia. Survival at 1 and 5 years was 95% and 86%, respectively. It did not differ significantly between group A and group B. Functional class improved from 2.90 ± 0.59 to 1.65 ± 0.54 among the mid-term survivors (P < 0.001), with no significant difference between the two groups. Pre-operative risk factors for mortality or poor function were ejection fraction (EF) < 0.35 (OR = 7.9, 95%CI 1.6 - 40.0); congestive heart failure (CHF) (OR = 4.4, 95%CI 1.0 - 19.0); end-systolic volume index (ESVI) > 80 ml/m(2) (OR = 3.7, 95%CI 1.0 - 14.0); and advanced age > 70 years (OR = 2.4, 95%CI 1.0 - 12.0).</p><p><b>CONCLUSIONS</b>The technique of off-pump anteroapical aneurysm plication associated with coronary grafting can be performed with low operative mortality, providing good symptomatic relief and long-term survival, and similar results can be achieved with patch modeling repair.</p>
Sujets)
Sujet âgé , Femelle , Humains , Mâle , Adulte d'âge moyen , Procédures de chirurgie cardiaque , Méthodes , Pontage aortocoronarien , Échocardiographie , Anévrysme cardiaque , Chirurgie générale , Infarctus du myocarde , Chirurgie générale , Études rétrospectives , Facteurs de risqueRésumé
<p><b>BACKGROUND</b>Off-pump coronary artery bypass surgery (OPCAB) has been widely applied in recent years as a less invasive method of myocardial revascularization. This study evaluated the sequential bilateral internal mammary artery grafting combined with selective arterialization of the coronary venous system during OPCAB.</p><p><b>METHODS</b>From April 2004 to August 2010, patients with diffuse right coronary lesions were studied retrospectively and divided into two groups. Group 1 included seventeen patients who underwent this surgery while group 2 included twenty-one patients without right coronary artery surgical therapy. All patients presented with symptoms of angina. Blood flow of bridged vessels was measured. The perioperative ventricular parameters including left ventricular ejection fraction and end diastolic diameter were compared. During follow-up, myocardial nuclide imaging and coronary angiography were carried out.</p><p><b>RESULTS</b>Off-pump coronary artery bypass was performed with an average of 3.6 grafts per patient. Hospital mortality was zero. At the time of follow-up, the patients in group 1 recovered better than in group 2 (P < 0.05). In both groups, the mean New York Heart Association (NYHA) class and ejection fraction increased significantly (P < 0.001) and the mean left ventricular end-diastolic diameter decreased significantly (P < 0.05). Myocardial blood supply of inferior wall in group 1 was obviously improved by myocardial nuclide imaging. Coronary angiography for eight patients in group 1 verified that there was blood flow to myocardium in the arterialized vein.</p><p><b>CONCLUSIONS</b>Sequential bilateral internal mammary artery grafting combined with selective arterialization of the coronary venous system can be performed during OPCAB. A postoperative improvement in the cardiac functions and the quality of life was documented, increasing our expectation for extensive application.</p>
Sujets)
Femelle , Humains , Mâle , Adulte d'âge moyen , Coronarographie , Pontage coronarien à coeur battant , Méthodes , Vaisseaux coronaires , Chirurgie générale , Artères mammaires , Transplantation , Études rétrospectives , Résultat thérapeutiqueRésumé
<p><b>OBJECTIVE</b>To investigate the effect of infrasound therapy on the proliferation, apoptosis and ultrastructure of human B lymphoma Raji cells.</p><p><b>METHODS</b>Human B lymphoma Raji cells were exposed to infrasound treatment for 15, 30, 60, 90 and 120 min and cultured subsequently for 24 or 48 h. MTT assay, flow cytometry analysis, and electron microscopy were performed to examine the proliferative status, cell apoptosis and ultrastructural changes of the exposed cells, respectively.</p><p><b>RESULTS</b>MTT assay revealed no significant changes in the proliferation of the cells exposed to infrasound treatment (P>0.05), nor did flow cytometry analysis identified significant variation in the cell apoptosis (P>0.05). Scanning electron microscopy, however, identified shortened or reduced cell processes and microvilli on the surface of the cells with infrasound exposure and a subsequent 24-hour culture, and the cell membrane surface became smooth. Under transmission electron microscope, the cells with infrasound treatment presented with significantly reduced microvilli, and the cell nuclei appeared homogeneous, with cytoplasmic budding and losses after a 48-hour culture.</p><p><b>CONCLUSION</b>Infrasound less than 90 dB does not obviously affect the proliferation and apoptosis of Raji cells, but may directly cause cell ultrastructural changes such as reduction of the cell processes.</p>
Sujets)
Humains , Apoptose , Physiologie , Lignée cellulaire tumorale , Prolifération cellulaire , Cytométrie en flux , Lymphome B , Anatomopathologie , Microscopie électronique à balayage , Microscopie électronique à transmission , Son (physique)Résumé
<p><b>OBJECTIVE</b>To improve the early and late benefits (the patency and total myocardium revascularization) of coronary artery bypass grafting, stimulate us using only bilateral internal mammary artery (BIMA) composite Lima (left internal mammary artery)-Rima (right internal mammary artery) Y graft with off-pump, here is the early evaluation.</p><p><b>METHODS</b>From October 2002 to December 2005, 125 patients underwent off-pump coronary artery bypass grafting with the only composite grafts. The bilateral semi-skeletonization internal mammary artery pedicles composed the Y graft, the free Rima was anastomosed to the in situ Lima. The operation was performed off-pump and sequential anastomosis.</p><p><b>RESULTS</b>Four hundred and thirteen grafts for 125 patients, average number of grafts per patient was 3.3. Graft flow was measured with Transit time flowmeter during operation time. All grafts were patent during operation. There was no death perioperative period.</p><p><b>CONCLUSION</b>Off-pump coronary artery bypass grafting with only bilateral internal mammary artery composite Lima-Rima Y graft is secure and feasible. The technique could achieve total arterial myocardium revascularization and avoiding any procedure on the ascending aorta.</p>