Objective To evaluate the effect of high-level spinal cord injury(SCI)on the expression of mitochondrial voltage-dependent anion channel 2(VDAC2)in rat cardiomyocytes.Methods Forty-eight pathogen-free healthy adult male Sprague-Dawley rats,weighing 200-250 g,were divided into 2 groups(n=24 each)using a random number table:sham operation group(group S)and high-level SCI group(group H).The animals were anesthetized with intraperitoneal chloral hydrate and subjected to SCI using the modified Allen weight-drop method in group H.The spinal cord was only exposed in group S.At 6,12,24 and 48 h after SCI(T1-4),6 rats in each group were randomly selected and sacrificed,and myocardial specimens were collected from the cardiac apex for microscopic examination of the cell morphology(with a transmission electron microscope) and for determination of cell apoptosis(by TUNEL assay),expression of Bax,Bcl-2 and VDAC2 protein and mRNA in cardiomyocytes(by Western blot and real-time polymerase chain reaction,respectively).The apoptosis rate and ratios of Bax/Bcl-2 protein and mRNA were calculated.Results Compared with group S,the apoptosis rate and ratios of Bax/Bcl-2 protein and mRNA were significantly increased at T1-4,the expression of VDAC2 protein and mRNA was significantly down-regulated at T2-4(P<0.05 or 0.01),and the pathologic changes of cardiomyocytes were aggravated in group H.Conclusion The mechanism of myocardial damage is related to down-regulation of mitochondrial VDAC2 expression in cardiomyocytes and promotion of cell apoptosis in rats with high-level SCI.

Objective To evaluate the effect of high-level spinal cord injury (SCI) on the myocardial energy metabolism in rats.Methods Sixty healthy male Sprague-Dawley rats,weighing 250-300 g,were randomly divided into 2 groups (n=30 each) using a random number table:sham operation (group S) and SCI group.SCI was induced in anesthetized rats by dropping a 10 g weight onto C7 spinal cord from 5 cm height falling freely inside a vertical hollow glass tube.At 6,12,24,48 and 72 h after SCI,6 rats in each group were chosen and arterial blood samples were taken for measurement of serum creatine kinase (CK) and creatine kinase isoenzyme-MB (CK-MB) activities.The rats were then sacrificed and myocardial specimens were obtained for examination of myocardial ultrastructure and for determination of ATP weight ratio,levels of Na+-K+-ATPase,Ca2+-Mg2+-ATPase,non-esterified fatty acids (NEFA) and lactic acid (LD),and expression of peroxisome proliferator-activated receptor alpha (PPARα) mRNA and protein (using fluorescent quantitative PCR and Western blot).Results Compared with group S,the serum CK and CK-MB activities were significantly increased,the ATP weight ratio,activities of Na+-K+-ATPase and Ca2+-Mg2+-ATPase and levels of NEFA and LD were decreased,and the expression of PPAR-α mRNA and protein was down-regulated in SCI group.No pathological changes of myocardium were found in group S,and the pathological changes of myocardium were obvious in SCI group.Conclusion High-level SCI can lead to decrease in the myocardial energy metabolism in rats,and down-regulated expression of PPARα is involved in the mechanism.

Objective To investigate the risk factors of incisional wound infection and put forward prevention measures to control the incision infection in patients under craniectomy.Methods Seventy patients with infection and 70 without infection of incisional wound among 1756 patients undergoing craniectomy from January 2011 to December 2013 were chosen in our study;and their clinical data were retrospective analyzed;etiological examination was performed on the secreta of these patients;the high risk factors of incisional wound infection were analyzed using multivariable Logistic regression.Results As compared with those in the non-infection group,patients in the infection group had significantly older age,lower albumin and Glasgow coma scale (GCS) scores,higher blood glucose level and APACHE Ⅱ scores,and higher percentages of surgical access station,microscopy applications,duration of surgery＞4 h and blood transfusion (P＜0.05).Pathogenic bacteria was positive in 88.57％ patients (62/70),including 45.71％ gram negative bacilli,40.00 ％ gram positive coccus and 2.86％ fungus.Multivariate Logistic regression analysis further showed that albumin,blood glucose,microscopy applications,duration of surgery＞4 h,blood transfusion,APACHE Ⅱ scores and GCS scores were significantly associated with incision infection,being the independent risk factors for incision infection.Conclusions To aim directly at the high-risk factors of incision wound infection,such as albumin,blood glucose,microscopy applications,duration of surgery,blood transfusion,APACHE Ⅱ and GCS,we should develop reasonable and effective preventive measures to reduce the incidence of incision infection and improve patient prognosis.