Spinal cord plasticity includes spontaneous neuronal plasticity and task-dependent plasticity which was respectively driven by spinal cord injury and special treatment.Spontaneous plasticity occurred at neuronal and synaptic sites,displaying various forms of axonal sprouting,unmasking of relatively ineffective functional connections and modification of synaptic efficacy.Task-dependent plasticity demonstrated reactivation of central generator pattern and functional reorganization of extensive spinal circuits.Exploration,induction and guidance of spinal cord plasticity will help determine the most optimal treatments and expand therapy methods to further promote function recovery of patients with spinal cord injury.

ObjectiveTo observe the effect of aerobic exercise training on plasma apolipoprotein in severe simple obese children.Methods7 severe simple obese children had 10 week exercise training and plasma apolipoprotein AⅠ(ApoAI) and B (ApoB) were tested before and after training. ResultsComparing with the control group, the ApoB in obese children increased significantly <0.01) and reduced after aerobic exercise training (P<0.05). The ApoAⅠ in obese children showed a decreasing intendcy (P>0.05). ConclusionThe aerobic exercise training may improve the plasma apolipoprotein.

OBJECTIVE:To reduce the error rate of inventory in the automated pharmacy of our hospital. METHODS:Activi-ties were designed and implemented by the management method of quality control circles(QCC)-PDCA(Plan,Do,Check and Ac-tion)cycle. The reasons for the errors of inventory in the automated pharmacy were analyzed to investigate and implement counter-measures. Visible and invisible achievements were evaluated,and then standardized processes were made. RESULTS:The errors of inventory in the automated pharmacy mainly included those of drug dispensing,drug shelving,drug return sheet,automatic medi-cine dispensing machine and system. In view of the above reasons,relevant standards were formulated and performed,including the process of warehouse-out check and shelving of drugs,drug dispensing process for the automated pharmacy,the process of sec-ondary check,etc. After the implementation of the activities,the error rate of inventory in the automated pharmacy reduced from 9.17% to 3.77%,which was visible achievement;and the above-mentioned standardized processes could ensure continuous run-ning of PDCA cycle. The practice,sense of responsibility,communication and coordination of management members in PDCA cy-cle namely invisible achievements were improved to some extent. CONCLUSIONS:The management method of QCC-PDCA cycle is feasible in reduction of the error rate of inventory in the automated pharmacy,which can provide a reference for automated phar-macy management.

Objective To investigate the effects of rolipram on neurofunction and the ultrastructure of the spinal cord in rats with spinal cord contusion.Methods Thirty adult,female Sprague-Dawley (SD) rats received spinal cord contusion at the T10 level.They were then randomited into an experimental group and a control group immediately after the operation.Rats in the experimental group received subcutaneous injections of 0.25mg/kg of rolipram twice daily for two weeks.Control rats received the same dosage of 0.9％ sodium chloride solution on the same schedule.The rats'functional recovery was evaluated using the open-field locomotion rating scale of Basso,Beattie and Bresnahan (BBB score),once a week within the 1st month after spinal cord injury (SCI),and once every two weeks subsequently.The morphology of the spinal cord tissue around the lesion site was observed under the light microscope with HE staining at the 8th week postoperation,and the ultrastructure of the spinal cord was observed under the transmission electron microscope at the 2nd,4th and 8th week postoperation.Results At the 2nd and 3rd week after SCI the experimental group exhibited significandy greater improvement in average BBB scores than the control group.However,the average BBB scores in the experimental and control groups were not significantly different at 8 weeks after SCI.Under the light microscope,cavities were observed in the posterior dorsal column near the SCI in both the experimental and control groups.However thick,condensed glial scars in the injured area were observed only in the control group.The density of glial cells decreased more in the experimental group than in the control group.Transmission electron microscopy revealed that,compared with the control group,inflammatory edema was attenuated and fewer axons were damaged at the 2nd week postoperation in the experimental group.That group also showed less axon degeneration as well as more angiogenesis at the 4th and 8th week.Conclusion Rolipram can reduce secondary neuron degeneration,inhibit gliosis and the formation of glial scars,and promote angiogenesis.

ObjectiveTo explore the migration, effect on axon growth of olfactory ensheathing cells (OECs) transplanted in contused spinal cord of rats. Methods8 adult female rats were induced spinal cord contusion at T10 cord by NYU impactor (H=25 mm), and received OECs transplantation in 1 mm rostral and caudal to injury site，or injury site. Other 4 adult female rats were uncovered the spinal cord at T8-10 cord, and injected GFP+OECs at T10 cord. 1 week after transplantation, all animals were executed and the T8-11 cord (15 mm long) contained the entire injury site were observed for the migration of OECs and immunostained for neurofilament (NF) and myelin basic protein (MBP). ResultsThe OECs injected in injury site largely migrate longitudinally and laterally from the injection site, OECs injected in 1 mm rostral and caudal to injury site of contused spinal cord, migrate longitudinally and laterally from the injection site to the injury site in white and gray matter, and some along the central canal. OECs injected in normal spinal cord migrated longitudinally and laterally from injection site, too. The transplanted OECs expressed a little NF and MBP. ConclusionThe transplanted OECs are able to migrate in spinal cord and promote axon regeneration and remyelination.

ObjectiveTo investigate the characteristic changes of expression of the genes related to inflammation response after injury of rubrospinal tract（RST）. Methods18 Sprague Dawley（SD）female rats were randomly divided into 2 groups: RST injury group (n=9) and Sham group (n=9). RST injury models were established, and the rats were killed 24 hours after injury. 5 mm length spinal cord was harvested from the epicenter and total RNA was extracted. Affymetrics Gene Chips for rats, representing 28000 genes, were used for mRNA expression profiling.Results153 transcripts were observed to differ (2.0 fold; 136 up-regulated and 17 down-regulated) after injury of RST, compared with sham group. Most of genes related to inflammation response were up-regulated (except Scn9α). 8 genes related to Toll-like receptor signaling pathway were also up-regulated.ConclusionSignificant changes related to inflammation response occur in acute phase after injury of RST.

Objective To explore neural plasticity around an injured region of the spinal cord and the effects of step training on functional recovery after incomplete spinal cord injury (SCI). Methods Adult female Sprague-Dawley rats ( n = 24) were induced with spinal cord contusion at T10 and divided into a step training group and a control group ( 12 rats in each). Training started from the 7th day post-injury and lasted for (20 ± 10)min per day, 5 days per week, for 9 weeks. Treadmill speeds were 3 m/min at the beginning, and adjusted daily according to each rat's tolerance up to 11 m/min or more. The functional recovery was measured weekly with the open-field locomotor rating scale of Basso, Beattie and Bresnahan (BBB score). The expression of glial fibrillary acidic protein (GFAP), neurofilament protein (NF) and growth-associated protein-43 (GAP-43) in the spinal cord around the injured region were detected. Results After 70 days of step training, the average BBB score of the step training group reached ( 12.86 ± 0.94 ), significantly higher than that of the control group ( 10.71 ± 0.95 ). The expression of NF and GAP-43 around the injured region increased significantly more in the step training group than among the controls. Conclusions Step training can promote functional recovery and neural plasticity in rats after incomplete SCI.

Objective To explore the methods and standards of catastrophic health expenditure for China,and improve the operability in defining those impoverished due to diseases.Methods 600 households with inpatients were randomly sampled from 12 villages of three townships in City M in Hubei province for household survey.Literature review and expert consultation methods were used to measure and determine the threshold of catastrophic health expenditure( CHE) of City M,with improvements made by grouping.Results In a uniform standard,the CHE occurrence of the income method and expenditure method is lower than the non-existence expenditure method and WHO method,verifying theoretically that the standard set for the former should be higher than the latter.In addition,the income method and expenditure method present differently in China.Standards set should vary with different measurement methods,maintaining approximate CEH expenditure for the same region.For the income method and expenditure method,the recommended benchmark reference is 25%,with an adjustable range of 35%~45%.Mutual verifications of these methods can further determine a rational CHE value.Conclusions The CHE methods support the definition of people impoverished due to diseases beyond their household payment capacity.Different thresholds however should be set for different methods,and the relative standards should be translated into absolute standards by grouping.

Objective:To understand the current situation and problems of the supervision of individual clinics in China , and put forward some reform suggestions .Methods:Two cities were selected from typical provinces in east-ern, central and western regions by typical sampling .The investigation was conducted by semi-structured interviews and typical clinic participant observation method .Results:There were serious problems in the regulation of the pri-vate clinics and it was necessary to build efficient regulation mechanism .Conclusions:We should strengthen the su-pervision of private clinics .In the future , we should improve the access threshold for the private clinic; strengthen inter-sector cooperation and joint law enforcement; promote information exchange and information network construc-tion;use economic incentives and punitive measures at the same time and make the association itself and social su -pervision work .

Objective To investigate the epidemiology of spinal cord injuries (SCI) in hospital. Methods 423 patients with SCI were reviewed. esults The ratio of male to female was 15.3∶ 1, aged (40±11) years. The coal mine-related staff was the most (61.7%), mainly aused from coal blocks dropping (53.26%). 135 cases (31.91%) injured in cervical vertebra, and 187 cases (44.21%) in lumbar. There were 92 (45.39%) cases were complete injury. The most frequent complication of SCI were urinary tract infection, pressure sore and pulmonary nfection. The factors correlated with the complication were the degree of ASIA Impairment Scale, the period of admitted to hospital after injury, nd the surgery (P<0.05). The expenditure of hospitalization was mainly provided by oneself (73%). Conclusion It is important to improve he occupation prevention, enlarge the coverage of medical insurance, and promote pre-hospital care to prevent SCI.