Extracellular vesicles (EVs) are vesicles like body of phospholipid bilayer membrane, which are able to mediate the transfer of genetic material. There are receptors, proteins and nucleic acids in the body, with carrying tumor genetic material, regulating tumor microenvironment, promoting tumor angiogenesis and mediating tumor cell metastasis. At present, it is found that there is a close re-lationship between the secretion and the metastasis of lung cancer. The main aspects of the brain metastasis of the lung cancer medi-ated by the exocrine body include the regulation of the microenvironment of the brain, the destruction of the blood-brain barrier, and the regulation of tumor cell pathology. The study on the relationship between the tumor and the metastasis of lung cancer may pro-vide more molecular targets for the development, diagnosis and treatment of lung cancer.

Presented in this Paper is a preliminary report on inter-observer agreement study of comprehensive function evaluation(CFE). one hundred and three normal persons were evaluated by two observers individually. The result revealed significant statistical difference,Kappa = 0. 75,demonstrating the substantial agreement of these two evaluations. The result suggests that the scale has substantial inter-observer agreement and high reliability. The personal comprehensive function could be evaluated completely in the scale. It would be significant not only in practice but also in theory to improve the rehabilitation evaluation.

The comprehensive and precise functional evaluation is imperative in finding the disabilities of patients with quadriplegia,and it is the basement of providing appropriate rehabilitation training.The predominant instruments which have been used to evaluate the functional capacity of the quadriplegics include Barthel Index,Functional Independence Measure,Quadriplegia Index of Function,a short-form of Quadriplegia Index of Function Scale and Spinal Cord Independence Measure.The purpose of this article is to introduce the characters of each instrument above in functional evaluation for quadriplegics and the comparison among them.

Objective To investigate the effects of locomotor training on improving locomotor function after spinal cord injury(SCI)and the mechanism of spinal cord plasticity.Methods A model of complete thoracic cord transection was established using 84 adult female rats divided into sham,SCI and treadmill training(BWSTT) groups.The hind limb locomotor function of all the rats was evaluated.The fluorescence intensities due to (EphA4),vesicular glutamate transporter 2(VGluT2)and EphA4/VGluT2 double-positive neurons in the ventromedial area of the anterior horn of the lumbar COrd were detected using immunofluorescence double labeling and laser confocal microscopy.Results The rats in the BWSTT group showed better functional recovery in their hind limbs than those in the SCI group.BWSTT was correlated with markedly increased EphA4.VGIuT2 and EphA4/VGluT2 intensities in the ventromedial area.Conclusion BWSTT improves hind limb locomotor function in rats with thoracic cord transections by elevating the expression of EphA4/VGluT2,promoting neuronal plasticity in the lumbar anterior horn.

This article mainly introduced the basic strategy of rehabilitation of spinal cord injury,including maintaining and improving range of motor(ROM),enhancing the muscle strength,sitting and standing balance training,respiration training,application of splints and aids.The rehabilitation objectives and approaches of each level of spinal cord injuries were also involved.

The complications of spinal cord injury(SCI)affect not only the rehabilitation treatment,but also quality of the patients' living,even threaten to patients' life,including pressure sore,complications of urinary system and respiratory system,deep venous thrombosis,pulmonary embolism,spasm,pain,autonomic dysreflexia,osteoporosis,etc.The prevention and treatment of complications of SCI may be helpful to improve patients' health,and a premise of the rehabilitation.

Objective To identify differences in the anal sphincter surface electromyography (sEMG)variables in spinal cord injury (SCI) subjects with different severities. Methods One hundred and ten SCI patients' impairments were classified as ASIA A,B,C or D using the International Standards for the Neurological Classification of Spinal Cord Injury.The evaluation was pedormed using sEMG equipment with an inserted anal sensor electrode and the Glazer pelvic floor muscle sEMG protocol.The sEMG variables were recorded and compared. Results There was no significant difference in sEMG variables between groups A and B,but the mean and maximum sEMG values of groups C and D in flick contractions ( 1 s),tonic contractions ( 10 s),and endurance contractions (60 s) were significantly higher than those of group A.Compared with group C,the mean and maximum sEMG values of group D were all significantly higher. Conclusions The sEMG data from the anal sphincter during contractions decreases significantly after SCI.Glazer's pelvic floor muscle sEMG protocol is a noninvasive and convenient real-time assessment.It is a useful complementary tool for quantitative assessment of the pelvic floor muscles of SCI patients.

Objective To explore the correlation between the time course of disease and bone metabolism changes in patients with spinal cord injury. Methods Data on serum osteocalcin(SO)measured by radioimmunoassay(RIA)from a database on 167 patients with spinal cord injury(SCI)were analyzed retrospectively.The patients were divided into four groups according to the time post-injury:group A(＜3 months post-injury,n=44),group B(3-6 months post-injury,n=42),group C(7-12 months post-injury,n=37)and group D(＞12 months post-injury,n=44). Results The mean SO value in all 4 groups of patients was significantly higher than normal.The mean SO value of group B was significantly higher than that of group A,but not significantly different from that of group C.The mean SO value of group D was significantly lower than that of group C,but not significantly different from that of group A.Conclusion Serum osteocalcin is elevated in the early stages of SCI,and its subsequent de-cline is closely correlated with the time post-injury.

ObjectiveTo search for the optimal treatment of hydronephrosis after spinal cord injury .Methods46 cases were treated by indwelling catheter, intermittent catheterization and drug therapy, and comprehensive therapy respectively. The course of treatment and the recurrence rate were observed after hydronephrosis remitted. Results There were no differences in the course of treatment among the three different kinds of therapy. The recurrence rate of the detrusor sphincter dyssynergia(85.7%) was higher than that of the detrusor hyperreflexia (35%) and the detrusor hyporeflexia(25%).ConclusionsThe optimal therapy on slight and moderate hydronephrosis should be intermittent catheterization and drug therapy to avoid the complications of long term indwelling catheter. SCI hydronephrosis is indistinct and recurrent easily. B ultrasound for kidneys is helpful in discovering SCI hydronephrosis on early stage. The earlier the treatment, the better the prognosis. Urodynamics plays an important role in the management of SCI hydronephrosis.

ObjectiveTo investigate the characteristic of hindlimb movement recovery in adult rats after spinal cord injury and how to assess it.Methods 26 adult female rats were randomized in sham,completely midthoracic spinal cord transected(at T8 level) or body weight supported treadmill training(BWSTT) groups.Their motor function were assessed with Basso,Beattie,Bresnahan locomotor rating scale for open field(BBB scale) and average combined scores(ACOS).ResultsNone of the rats exhibited hindlimb movements after operation.30 d and 45 d after operation,BBB and ACOS score of rats in BWSTT group showed better than that in SCI group.There were significant differences in ACOS score among 15 d,30 d and 45 d after operation in both group.ConclusionPartial spontaneous hindlimb functional recovery can be found in chronic adult spinal cord injured rats and BWSTT would facilitate the recovery.Both semiquantitative and qualitative assessment were strongly correlated with locomotor recovery,but the semiquantitative assessment shows more sensitive.