Objective To investigate the analgesic effect of intrathecal(IT)human bone marrow mesenchymal stem cells(hMSC)genetically modified with human proenkephalin gene(PENK)in a rat model of neuropathic pain.Methods Forty male SD rats weighing 160-180 g in which IT catheters were successfully implanted without complication were randomly divided into 4 gorups(n = 10 each): group A normal control;group B neuropathic pain(NP);group C NP + hMSC-pBABE and group D NP + hMSC-PENK.Neuropathic pain was induced with chronic constrictive injury(CCI).Four loose ligatures were placed on the main stem of sciatic nerve with 4-0 chronic catgut.IT normal saline 10 μl,hMSC-pBABE cell suspension 10 μl(2 × 108-3 × 108/μl)and hMSCPENK cell suspension 10 μl(2 × 108-3 × 108/μl)were injected in group B,C and D respectively on the 3rd day after operation.Paw-withdrawal latency(PWL)to noxious thermal stimulation was measured before(baseline)and at 3,5,7,9 and 14 d after operation.The animals were killed on the 14th day after last PWL measurement.RNA was extracted from the spinal cord for determination of proenkephalin mRNA expression.Results PWL was significantly decreased after operation as compared with the baseline values before operation in group B,C and D.PWL was significantly longer at 7,9,14 d after operation in group D than in group B and C but there was no significant difference in PWL after operation between group B and C.PENK mRNA expression was significantly lower in group B and C than in group A,but was significantly higher in group D than in group B and C.There was no significant difference in PENK mRNA expression between group B and C.Conclusion Intratheccal human bone marrow mesenchymal stem cells genetically modified with human proenkephalin gene can relieve neuropathic pain in rats.

Objective To investigate the role of endoplasmic reticulum stress ( ERS) in human brain gliomas cell(SHG-44) apoptosis induced by proteasome inhibitor MG-132. Methods Human glioma cells were passage cultured. Glioma cells were treated by MG-132 with varying concentration(5, 10, 15 and 50 μmol/L) for 24 h. Compared with cells prior to the treatment (control group), cell viability was detected by MTT assay and the expression of ERS associated proteins GRP78 and apoptosis associated proteins Caspsse-12 was examined by PCR and Western-blotting. Results After MG-132 treatment for 24 h, SHG-44 cell viability was decreased significantly (39 %) (P <0.05), and continued to show a significant decline with the increasing concentration of MG-132 (P <0.05). RT-PCR results showed that the expression of ERS associated proteins GRP78 in SHG-44 cells were significantly increased after 5, 10, 15 and 50 μmol/L MG-132 treatment, and the expression of Caspase-12 was significantly increased after 5 μmol/L MG-132 treatment, slightly increased after 10 and 15 μmol/L treatment compared with that after 5 μmol/L treatment and reached the peak after 50 μmol/L treatment. Western-blotting results of GRP78 in SHG-44 cells were same as results of RT-PCR. Conclusion ERS may be involved in the apoptosis of gliomas cells induced by proteasome inhibitor MG-132.

Objective To investigate the effect of cisternostomy on the prognosis of patients with traumatic brain injury (TBI).Methods A retrospective case control study was conducted to analyze the clinical data of 46 patients with TBI admitted to Shanxi Dayi Hospital from May 2017 to September 2018.There were 37 males and nine females,aged 24-80 years [(49.8 ± 15.7)years].The injury severity score (ISS) was 6-42 points [(25.0 ± 8.2)points],and the Glasgow Coma score (GCS) was 3-14 points [(3.4 ± 1.7) points].Twenty-three patients underwent routine surgery only (control group),and 23 patients underwent cisternostomy (cisternostomy group) on the basis of routine surgery.Intracranial pressure monitoring was performed in both groups before surgery.The postoperative intracranial pressure,intracranial pressure 1 week after operation,postoperative mechanical ventilation time,neurosurgical ICU (NICU) time,postoperative dehydration dose,decompressive craniectomy rate,postoperative infection rate,mortality rate,length of hospital stay,GCS at discharge,and Glasgow outcome score (GOS) of 3 months of follow-up were compared between the two groups.Results Compared with the control group,the cistemostomy group had lower postoperative intracranial pressure [(7.1 ± 5.7) mmHg vs.(14.2 ± 12.0) mmHg)],intracranial pressure 1 week after operation [(11.8 ± 0.5) mmHg vs.(14.0 ± 0.7) mmHg],postoperative dosage of dehydrating agent [0 (0-500.0) ml vs.1 275 (787.5-3 812.5) ml] and decompression rate (57％ ∶ 91％) (P ＜ 0.05).There were no significant differences between the cistemostomy group and control group in postoperative mechanical ventilation time [120 (42.0-225.0)hours vs.89(65.5-203.5)hours],NICU time [236(182.0-340.5)hoursvs.281 (114-400)hours],postoperative infection rate (4％ vs.0),mortality rate (13％ vs.39％) and hospital stay [32 (20.0-44.5) hours vs.25 (12.0-30.5)hours] (P ＞ 0.05).The cisternostomy group had higher GCS score at discharge than the control group [(10.7 ± 4.2) points vs.(7.9 ± 4.2) points] (P ＜ 0.05).After 3 months of follow-up,18 patients in the cisternostomy group showed good prognosis,better than that in the control group (11 patients) (P ＜ 0.05).Conclusion For TBI patients,cisternostomy can clear the blood cerebrospinal fluid,reduce harmful metabolic products in the brain,reduce intracranial pressure and hence improve the prognosis of patients.

Objective:To analyze the effect of modified Banxia Baizhu Tianma Decoction combined with Nimodipine on cognitive dysfunction and changes on cerebral blood flows of the patients with chronic cerebral insufficiency (CCCI).Methods:A total of 91 patients with CCCI who received treatment in our hospital from March 2019 to March 2020 were selected and divided into the treatment group ( n=46) and the control group ( n=45), according to random number table method. The control group was treated with Nimodipine oral treatment, and the treatment group was treated with modified Banxia Baizhu Tianma Decoction on the basis of the control group treatment. Both groups were treated for 2 weeks. The Traditional Chinese Medicine (TCM) syndrome scores were performed before and after treatment, and transcranial Doppler ultrasound was used to detect the average blood flow of bilateral vertebral arteries (VA), basilar arteries (BA), internal carotid arteries (ICA) and middle cerebral arteries (MCA). The whole blood viscosity high shear (HS), whole blood low shear (LS), plasma viscosity (PV), fibrinogen (FIB) and hematocrit (HCT) were detected by automatic blood rheometerusing. The Montreal Cognitive Assessment Scale (MoCA) was used to assess the degree of cognitive impairment and evaluate the clinical efficacy. Results:The total effective rate was 91.3% (42/46) in the treatment group and 73.3% (33/45) in the control group, with a statistically significant difference between the two groups ( χ2=5.07, P=0.024). The scores of dizziness, headache, forgetfulness, insomnia and total scores in the treatment group were significantly lower than those in the control group after treatment ( t values were 8.59, 7.79, 3.92, 4.11, 5.01, all Ps<0.01), and the MoCA score (25.13±2.16 vs. 23.88±2.70; t=2.44, P=0.017) in the treatment group significantly higher than that in the control group. After treatment, VA [(35.49±4.08) cm/s vs. (32.17±4.25) cm/s, t=3.80], BA [(36.99±3.79) cm/s vs. (33.76±4.12) cm/s, t=3.89], ICA [(62.49±5.07) cm/s vs. (58.91±5.31) cm/s, t=3.29], MCA [(70.09±5.04) cm/s vs. (67.12±5.85) cm/s, t=2.60] in the treatment group was significantly higher than those in the control group ( P<0.01). After treatment, the levels of HS, LS, PV, Fg, and HCT in the treatment group were significantly lower than those in the control group ( t values were 2.37, 4.35, 2.23, 2.42, 2.20, P<0.05 or P<0.01). Conclusion:Modified Banxia Baizhu Tianma Decoction combined with Nimodipine tablets can relieve the clinical symptoms of CCCI patients, improve blood flow velocity, blood rheology level and cognitive function, and improve clinical efficacy.