Dysfunction after spinal cord injury mainly focused on the loss of motor function and sensory function and its complications instead of cognitive impairment. In this paper, the relevant reports of cognitive impairment in patients with spinal cord injury were collected. The influencing factors mainly contained emotion, traumatic brain injury, alcohol intake, drug abuse and educational level, etc. The possible mechanisms included traumatic brain injury, structure change of brain, brain damage and functional change, and inappropriate treatment, etc.

Aim Tostudythetherapeuticeffectof CJ016 on human lung cancer model and the mecha-nism.Methods Anexperimentalhumanlungadeno-carcinoma model of A549 was set up to investigate the anti-tumor effect of CJ016,while the effect of angio-genesis and apoptosis in tumor were detected.Results In vitro,the cell proliferation was inhibited signifi-cantly by CJ016,and the value of IC50 was 34. 22 nmol ·L-1 .In vivo,the tumor inhibition rate and T/C%value were 70. 08%and 27. 75%,respectively,at the dose of 20 mg·kg-1 .Meanwhile,CJ016 could reduce the expression of CD31 and promote the apoptosis of tumorcells.Conclusion CJ016caninhibitthegrowth of A549 cells,and the possible mechanism may be re-lated to the reduction of angiogenesis and inducing tumor cell apoptosis.

Objective To compare the effects of nonsurgical spinal decompression system (SDS) cervical traction and common cervical traction using surface electromyography (sEMG).Methods Twenty-two volunteers' sEMG signals were recorded before,during and after two modes of cervical traction:the conventional traction in sitting and SDS traction in supine.The interval between the two modes of traction was no shorter than 24 hours.The mean and peak amplitudes of their sEMG signals were observed before,during and after traction.The sEMG signals of the posterior cervical muscle while sitting or lying were compared at different stages of the traction.Results There was no statistically significant difference in sEMG signals between the subjects' right and left posterior cervical muscles.The sEMG signals decreased significantly during both traction trials.With common cervical traction the mean and peak amplitudes of the left posterior cervical muscle pre-and post-traction were higher than during traction,and the same as that of the right posterior cervical muscle.In the SDS trials the sEMG signals during traction and post-traction were significantly lower than those pre-traction.After traction the sEMG signals while sitting (common cervical traction) were significantly higher than those post-traction while lying (SDS cervical traction),and the sEMG signals post-traction while either lying or sitting were stronger than during traction while lying.The post-traction signals in sitting were stronger than those in lying.Conclusions Both nonsurgical SDS and common cervical traction can relax the posterior cervical muscles.The effect of nonsurgical SDS was better than that of common cervical traction.

Objective To explore the value of amplitude integrated electroencephalogram(aEEG)combined with electroencephalogram monitoring α percentage variation(PAV)in evaluating the short-term prognosis of patients with severe acute cerebral infarction(SACI).Methods A total of 212 SACI patients hospitalized in our ICU from January 2020 to December 2022 were recruited and then divided into poor prognosis group(93 cases)and good prognosis group(119 cases)ac-cording to the mRS score at 90 d.The differences in aEEG and PAV were observed between the two groups.Multivariate logistic regression analysis was used to observe the relationship of aEEG and PAV with poor prognosis.ROC curve was plotted to analyze the clinical value of aEEG and PAV in predicting the prognosis of SACI patients.Results The incidence of poor prognosis was 43.9％in 212 patients at the 90th day.The patients from the poor prognosis group had significantly higher aEEG score but lower PAV than those in the good prognosis group(P＜0.01).Multivari-ate logistic regression analysis showed that aEEG was a risk factor for poor prognosis(OR=1.403,95％CI:1.114-3.287,P=0.011),and PAV was a protective factor for poor prognosis(OR=0.714,95％CI:0.591-0.837,P=0.006).ROC curve results revealed that PAV had a high-er sensitivity,specificity and AUC value than aEEG in predicting poor prognosis of SACI pa-tients,and their combination obtained better sensitivity,specificity and AUC value than aEEG or PAV alone in the prediction(P＜0.01).Conclusion The combined use of aEEG and PAV has high clinical value in predicting the prognosis of SACI patients.

Objective To explore the correlation of nerve function and prognosis with serum uric acid(UA),homocysteine(Hcy)and low-density lipoprotein cholesterol(LDL-C)in patients with acute cerebral infarction(ACI)after alteplase intravenous thrombolysis.Methods A total of 220 ACI patients undergoing thrombolysis in Changsha First Hospital ICU between January 2020 and December 2022 were enrolled,and according to mRS score at 3 months after thrombolysis,they were divided into poor prognosis group(mRS score＞2,91 cases)and good prognosis group(mRS score ≤2,129 cases).The serum levels of UA,Hcy and LDL-C were compared between the two groups.The correlation between the three indexes and score of National Institutes of Health Stroke Scale(NIHSS),and their predictive value for poor prognosis were analyzed.Results At 1 and 3 d after thrombolysis,the serum levels of UA,Hcy and LDL-C and NIHSS score were sig-nificantly decreased in both groups,and the serum levels of UA and Hcy and NIHSS score at 3 d after thrombolysis were significantly lower than those at 1 d(P＜0.05).The poor prognosis group had obviously higher serum levels of UA,Hcy and LDL-C and NIHSS score at 1 and 3 d after thrombolysis than the good prognosis group(P＜0.05,P＜0.01).Pearson correlation analysis showed that the serum levels of UA,Hcy and LDL-C were positively correlated with NIHSS score at 1 and 3 d after thrombolysis(P＜0.01).ROC curve analysis indicated that the AUC values of UA,Hcy and LDL-C at 1 d after thrombolysis for predicting poor prognosis were 0.707(95％CI:0.639-0.776),0.800(95％CI:0.739-0.860)and 0.624(95％CI:0.550-0.698),respectively,while the values of them at 3 d after thrombolysis were 0.655(95％CI:0.583-0.726),0.730(95％CI:0.664-0.795)and 0.573(95％CI:0.497-0.649),respectively.Conclusion In ACI patients after thrombolysis,the serum levels of UA,Hcy and LDL-C are increased in those with poor prognosis,and are associated with the severity of nerve injury.The levels at 1 d after throm-bolysis have good predictive value for poor prognosis.

Objective To determine the effects of treadmill training on the structure of hippocampal myelin and cognitive function in rats exposed to acute plateau hypoxia.Methods With 30 SPF-grade female SD rats (aged 6-8 weeks,weighing 200-220 g),6 of them were used for observation of myelin structure after injury,and the remaining 24 rats were randomly divided into control group,hypobaric hypoxia group and treadmill training group (n=8).The rats in above experimental groups were placed in a low-pressure oxygen chamber at an altitude of 6000 m for 7 consecutive days,and the rats of the control group were placed in the confined chamber for the same period without hypoxia.Then,the rats of the treadmill training group received a 4-week treadmill training scheme since the day after hypoxia.Finally,all the rats were tested for cognitive function with open field test (OFT)and Morris water maze (MWM).Transmission electron microscopy (TEM) was used to observe the changes of demyelination in the hippocampus. The expression of oligodendrocyte transcription factor 2 (Olig2)and myelin basic protein (MBP )in the hippocampal CA1 and CA3 regions was measured by immunofluorescence staining and Western blotting.Results Behavioral tests showed that the number into the central area,total distance,distance ratio in OFT and the number of platform crossings and distance to the target area in MWM were reduced in the hypobaric hypoxia group than the control group (P<0.05 ),while these indexes were increased in the treadmill training group than in the hypobaric hypoxia group (P<0.05).Immunofluorescence staining indicated that the number of Olig2 positive cells per unit area and the mean fluorescence intensity of MBP in the CA1 and CA3 regions were significantly lessen in the hypobaric hypoxia group than the control group (P<0.05 ),while these indicators were higher in the treadmill training group than the hypobaric hypoxia group (P<0.05 ).Western blotting displayed that the expression levels of Olig2 and MBP in the hippocampus were obviously lower in the hypobaric hypoxia group than the control group (P<0.01 ),while the levels were increased in the treadmill training group than the hypobaric hypoxia group (P<0.01 ).Conclusion Treadmill training promotes the number of the oligodendrocyte spectrum cells in CA1 and CA3 regions,enhances the expression of myelin-related proteins and improves myelin repair in hippocampus of hypobaric hypoxia rats,and thereby ameliorates hypoxia-induced anxiety-like behaviors and memory dysfunction.

Objective To evaluates the impact of early application of neuromuscular electrical stimulation(NMES)on muscle strength,clinical outcomes,and long-term quality of life improvements in patients with severe acute pancreatitis(SAP)complicated with acute respiratory distress syndrome(ARDS).Methods A total of 75 patients diagnosed with SAP and ARDS admitted in Department of Critical Care Medicine of our hospital from September 2022 to August 2023 were recruited and then randomly divided into NMES group(n=37)and control group(n=38).After 16 patients were excluded,including 8 died during treatment,3 discharged and 5 received palliative care,there were finally 29 patients in the NMES group and 30 in the control group.Within 48 h after ICU admission,the NMES group received NMES 1 h per day,for 7 d in addition to standard rehabilitation intervention.While,the control group were given conventional interventions for rehabilitation.Assessments at baseline and post-treatment included the incidence of ICU-acquired weakness(ICU-AW),Medical Research Council(MRC)score,duration of mechanical ventilation,lengths of ICU and total hospital stays,and activity,thickness and thickening fraction of the diaphragm.Mortality rates and Barthel index(BI)for self-care ability in 1,3 and 6 months after discharge were recorded for follow-up assessments.Results The NMES group had significantly lower incidence of ICU-AW(P＜0.05),higher upper and lower limb MRC scores and overall MRC score at ICU discharge(P＜0.05),shorter durations of mechanical ventilation,ICU stay,and total hospital stay when compared with the control group(P＜0.05).There was no statistical difference in the BI at 1 month post-discharge between the 2 groups,but the indexes at 3 and 6 months were notably higher in the NMES group than the control group(P＜0.05).No obvious differences were observed between the 2 groups in terms of diaphragm activity,thickness,or thickening scores at enrollment,ICU discharge,or hospital discharge,nor in mortality rates at 1,3,and 6 months after discharge.Conclusion Combined NMES and early rehabilitation therapy can improve muscle strength and reduce length of hospital stay in SAP patients complicated with ARDS,and may enhance long-term quality of life.However,it does not significantly affect diaphragm function or mortality rates.