The integrity of the neuronal membrane is important for its specific physiological function.Spinal cord injury (SCI) can result in immediate disruption of neuronal membranes.Now,a novel treatment method for SCI is sealing the compromised membranes at the early stage of SCI.In this article,recent development of membrane repair agents in treating SCI is discussed,including polyethylene glycol(PEG),poloxamer 188(P188),chitosan and some nanomaterials.At the same time,problems remained in recent researches are reviewed and the prospect is discussed.

Objective To investigate the effect of repetitive transcranial magnetic stimulation(rTMS)on the spinal segmental excitability after spinal cord injury in adult rats.MethodsT 10 spinal cord injury models were made with weight-drop method.8 weeks later,rTMS were applied to the experimental group at 0.5 Hz suprathreshold stimulation,500 pulses daily for 4 weeks.Spinal cord injury rats without stimulation and normal rats were used as controls.At different time points,electronic evoked F-wave were measured.The ratio of F-wave amplitude to M-wave amplitude(F/M)were compared among these groups.Immunohistochemistry was used to detect the expression of 5-hydroxytryptamine(5-HT)in the rostral and caudal lesion segments.ResultsThe ratio of F/M increased significantly(P<0.01)8 weeks after spinal cord injury compared with baseline ratio and regressed significantly(P<0.01)after 4 weeks of rTMS.Expression of 5-HT in grey matter around lesion was decreased after spinal cord injury and increased significantly(P<0.01)both in the rostral and caudal lesion segments in rTMS treatment group.ConclusionThe increased spinal segmental excitability after spinal cord injury can be regressed by rTMS,which may be resulted in increased expression of 5-HT.

Objective To explore the effect of repetitive transcranial magnetic stimulation(rTMS)on spinal cord injured rats.Methods Weight-drop spinal cord injury model was made at thoracic 10 segments with NYU impactor device.Stimulated group received daily superthreshold rTMS continued for 4 weeks.BBB locomotor scores were recorded weekly.Growth associated protein 43(GAP43)and 5-hydroxytryptamine(5-HT)were detected with immunofluorescence staining in the area of rostral and caudal to the lesion.Results The BBB scores in stimulation group improved compared with that in the control(P<0.01).GAP43 and 5-HT markers increased in the stimulation group(P<0.01),and they increased in the rostral than in the caudal areas(P<0.01).Conclusion rTMS can improve the locomotor function of incomplete spinal cord injury rats,which may result from the increase of expression of GAP43 and 5-HT.

Objective To evaluate the novel hybrid liver and renal support system the safety and efficacy of the treatment of Tibet mini pig model of renal failure .Methods Five Tibet miniature pig bilateral renal artery ligation approached to construct the models of renal failure ,treatment group was treated with therapy (CRRT mode) of the novel hybrid liver and renal support system after modeling ,while the control group received no treatment .Drawning venous blood endotoxin ,biochemical tests and aerobic anae‐robic culture when in the treatment of 0 ,4 ,8 h;then we observed the changes of biochemical indicators in Tibet mini pigs before and after treatment ;we recorded machine pressure monitoring indicators every 2 hour during treatment .Results The model of renal failure of two experimental animals were successfully constructed .The general condition of treatment group was improved after treated by the novel hybrid liver and renal support system ,while the control groups continued to deteriorate .The experimental ani‐mals did not appear abnormal ECG during the experiment .Two groups of animals showed no statistics significant difference (P>0 .05) in the period of 0 h .In the remaining period ,heart rate and respiratory rate in treatment group was significantly reduced(P<0 .05) ,while oxygen saturation and mean arterial pressure were significantly increased compared to control group(P<0 .05) .There was no differences of biochemical indicators between two groups before modeling (P>0 .05);after modeling both groups biochemi‐cal indicators was significantly increased compared with baseline (P<0 .05);after treatment of the hybrid liver and renal support systems in the treatment group ,the biochemical parameters were significantly decreased compared with baseline ,the difference was statistically significant different(P<0 .05) ,while the control group did not change significantly .Blood endotoxin measured results were less than 0 .5 EU/mL ,arteriovenous end aerobic anaerobic culture showed no bacterial growth .Pathological examination showed significant swelling of the renal tubular epithelium and tubular necrosis .Conclusion The novel hybrid liver and renal sup‐port system for the treatment of Tibet mini‐pig model of renal failure is safe and effective ,and it can be further attempts for clinical trials .

In recent years,the occurrence of medical unsafe incidents in hospital has seriously affected the construction of a harmonious relationship between doctors and patients.In view of this,specialized research on the patient safety culture has become one of the focuses of attention.The United States is the country that carried out research on patient safety culture earlier.Through the retrieval of relevant website,case and literature about patient safety culture,this paper scientifically defined the connotation of patient safety culture,introduced the research progress of patient safety culture in United States,and had the localization research and reference to it,in order to help the research on patient safety culture in our country.

Objective To investigate the effect of home diabetes care platform based on internet and family fixed partner on the continuous care of diabetes patients outside the hospital.Methods A total of 150 out-patients with diabetes were collected from June 2016 to November 2016,divided into family fixed partner group(group A),smart phone APP home diabetes care platform group(group B),family fixed partner combination with smart phone APP home diabetes care platform group(group C)with 50 cases each by random digits table method.The three groups received the same health education during their stay in hospital,patients in group A and group C were required to have family fixed partners,patients in group B and group C were required to receive the home diabetes care platform for smart phones APP after they left the hospital,the intervention time was six months,and the indexes of blood glucose metabolism,self-management ability of diabetes were assessed at the end of six months after intervention and before intervention.Results Fasting blood glucose and postprandial blood glucose and glycosylated hemoglobin values of the three groups after intervention were lower than those before intervention.The postprandial blood glucose and glycosylated hemoglobin values was(9.96±4.23)mmol/L,(7.16±1.47)%in group C,(13.78±3.34),(11.46±4.85)mmol/L and(8.46±2.21)%,(8.07±2.45)%in group A and B,the difference was significant(F=10.57,3.92,P＜0.05).The scores of self-management ability of diabetes of the three groups after intervention were all higher than those before intervention.The score of self-management ability of diabetes of item 1-6 was(6.45±1.65),(4.87±2.23),(6.17±2.12),(5.24±1.65),(4.67±2.13),(6.27±2.02)points in group C,(5.78±1.96),(3.63±2.14),(5.25±2.34),(4.12±1.97),(3.65±1.34),(5.26±2.21)points in group B,(5.04±1.78),(3.37±1.64),(4.63±1.87),(4.03±2.17),(3.32±1.74),(5.30±1.97)points in group A,the difference was statistically significant(F=3.82-7.94,P＜0.05).Conclusions Home diabetes care platform based on internet,combined with family fixed partner education,are more conductive to patient blood sugar control,and enhance self-management ability and account ability.

OBJECTIVE:To explore losses and gains (L&G) and L&G ratio induced by Essential Medicine System in a county. METHODS:By choosing a county in western China as sample area,field investigation was used to collect outpatient and inpatient visits,outpatient and inpatient income,drug income,total length of stay and medical insurance reimbursement criteria in primary medical institutions (township health centers,village health rooms) of the county during 2009-2015. By setting the year 2009 as the baseline year,the drug cost reimbursed by medical insurance was simulated and calculated when Essential Medicine System were not implemented;L&G and L&G ratio of medical insurance were calculated by comparing with actual drug cost reimbursed by medical insurance. RESULTS:The year 2012,in which the sample county fully implemented the Essential Medicine System was the turning year. Medical insurance funds lost in primary medical institutions of the county during 2010-2011(lost 437000,915000 yuan,respectively),but gained during 2012 to 2015(gained 199000,494000,858000,1290000 yuan, respectively);the L&G ratio increased from -0.67％ to 1.21％. For reimbursed outpatient drug cost and inpatient cost,L&G of medical insurance were different. For reimbursed drug cost of village health room and township health center,L&G of medical insurance were also different. CONCLUSIONS:The implementation of Essential Medicine System benefits to medical insurance within the county and Medical insurance funds can be saved.

Spinal cord stimulation (SCS) for pain is usually implanted as an open loop system using unchanged parameters. To avoid the under and over stimulation caused by lead migration, evoked compound action potentials (ECAP) is used as feedback signal to change the stimulating parameters. This study established a simulation model of ECAP recording to investigate the relationship between ECAP component and dorsal column (DC) fiber recruitment. Finite element model of SCS and multi-compartment model of sensory fiber were coupled to calculate the single fiber action potential (SFAP) caused by single fiber in different spinal cord regions. The synthetized ECAP, superimposition of SFAP, could be considered as an index of DC fiber excitation degree, because the position of crests and amplitude of ECAP corresponds to different fiber diameters. When 10% or less DC fibers were excited, the crests corresponded to fibers with large diameters. When 20% or more DC fibers were excited, ECAP showed a slow conduction crest, which corresponded to fibers with small diameters. The amplitude of this slow conduction crest increased as the stimulating intensity increased while the amplitude of the fast conduction crest almost remained unchanged. Therefore, the simulated ECAP signal in this paper could be used to evaluate the degree of excitation of DC fibers. This SCS-ECAP model may provide theoretical basis for future clinical application of close loop SCS base on ECAP.
Action Potentials ; Computer Simulation ; Electric Stimulation ; Evoked Potentials ; Spinal Cord ; Spinal Cord Stimulation

Bioartificial liver support system (BALSS) provides a new way to treat liver failure and leaves more time for patients who are waiting for liver transplantation. It has detoxification function as well as the human liver, at the same time it can provide nutrition and improve the internal environment inside human body. Bioreactors and hepatocytes with good biological activity are the cores of BALSS which determine the treatment effect. However, in the course of prolonged treatment, the function and activity of hepatocytes might be greatly changed which could influence the efficacy. Therefore, it is very important to detect the status of the hepatocytes in BALSS. This paper presents some common indicators of cell activity, detoxification and synthetic functions, and also introduces the commonly detection methods corresponding to each indicator. Finally, we summarize the application of detection methods of the hepatocyte status in BALSS and discuss its development trend.

Electric field stimulation (EFS) can effectively inhibit local Ca ²⁺ influx and secondary injury after spinal cord injury (SCI). However, after the EFS, the Ca ²⁺ in the injured spinal cord restarts and subsequent biochemical reactions are stimulated, which affect the long-term effect of EFS. Polyethylene glycol (PEG) is a hydrophilic polymer material that can promote cell membrane fusion and repair damaged cell membranes. This article aims to study the combined effects of EFS and PEG on the treatment of SCI. Sprague-Dawley (SD) rats were subjected to SCI and then divided into control group (no treatment, n = 10), EFS group (EFS for 30 min, n = 10), PEG group (covered with 50% PEG gelatin sponge for 5 min, n = 10) and combination group (combined treatment of EFS and PEG, n = 10). The measurement of motor evoked potential (MEP), the motor behavior score and spinal cord section fast blue staining were performed at different times after SCI. Eight weeks after the operation, the results showed that the latency difference of MEP, the amplitude difference of MEP and the ratio of cavity area of spinal cords in the combination group were significantly lower than those of the control group, EFS group and PEG group. The motor function score and the ratio of residual nerve tissue area in the spinal cords of the combination group were significantly higher than those in the control group, EFS group and PEG group. The results suggest that the combined treatment can reduce the pathological damage and promote the recovery of motor function in rats after SCI, and the therapeutic effects are significantly better than those of EFS and PEG alone.
Animals ; Electric Stimulation ; Polyethylene Glycols/therapeutic use* ; Rats ; Rats, Sprague-Dawley ; Recovery of Function/physiology* ; Spinal Cord ; Spinal Cord Injuries/therapy*