BACKGROUND: Studies in recent years have suggested the involvement of chemoattractant cytokines in the recruitment of peripheral blood cells to the injured spinal tissue. Monocyte chemoattractant protein-1(MCP-1) belongs to the CC-type chemokines and is capable of specific chemotactic attraction of the macrophages.OBJECTIVE: To observe MCP-1 expression in the serum of patients with acute spinal cord injury and explore the possible mechanism of secondary spinal cord injury.DESIGN: A non-randomized and controlled concurrent pilot study.SETTING and PARTICIPANTS: Eight patients with acute incomplete spinal cord injury and 8 with compression fracture of the spine were treated in the Department of Orthopaedics, Renmin Hospital of Wuhan University during the period from January 2001 to December 2002. Another 8 healthy subjects were included as the controls.METHODS: In the next morning after hospitalization, totally(8-10) mL of fasting peripheral venous blood was collected from the patients and the serum separated for determination of MCP-1 level with enzyme-linked immunosorbent assay(ELISA) . Serum MCP-1 level was also measured in the healthy subjects in the same manner.MAIN OUTCOME MEASURES: Serum level of MCP-1 in each group.RESULTS: Serum levels of MCP-1 in the healthy subjects, patients with compression fracture of the spine and those with acute incomplete spinal cord injury were(124 ± 15), (184 ±21) and(428 ± 11) ng/L, respectively, with significant differences between any two groups( P ＜ 0.01 ).CONCLUSION: MCP-1 may induce secondary inflammation by recruiting inflamnatory cells to the injury site and thus aggravate the spinal cord injury.

Objective To investigate the changes of TLR4 and nuclear factor kappa B(NF-κB) levels in peripheral blood mononuclear cells(PBMC) of the patients with ulcerative colitis(UC) and its possible pathogenesis mechanism.Methods In our hospital from January 2014 to January 2015,30 cases of UC were selected as the observation group,and other 10 individuals undergoing healthy physical examination in this hospital were selected as the control group.Flow cytometry was used to detect the positive expression rate of TLR4 on surface of peripheral blood CD14+ mononuclear cells.The levels of TLR4,MyD88,NF-κB(P65)mRNA expression were detected by RT-PCR.Western blot was adopted to detect the levels of TLR4,MyD88,NF-κB(P65) protein.Results The positive expression rate of TLR4 on the surface of peripheral blood CD14+ mononuclear cells in the observation group was significantly higher than that in the control group(P＜0.05);the levels of TLR4,MyD88 and NF-κB(P65) B mRNA and protein in the control group were significantly lower than those in the observation group(P＜0.05);the levels of TLR4,MyD88 and NF-κB(P65) protein were positively correlated with the severity of UC.Conclusion The levels of TLR4 and NF-κB in PBMC of the patients with UC are significantly increased,clinic can judge the UC development degree by detecting TLR4 and NF-κB levels.

Objective:To measure the expression of the MCP-1(Monocyte Chemoattractant Protein-1) in the serum of patients with acute spinal cord injury and explore the possible mechanism of secondary spinal cord injury.Methods:MCP-1 in the serum of patients with acute spinal cord injury,single spine compression and healthy subjects were detected by ELISA irrespectively.The MRI data of these patients were studied at the same time on a blind base.Results:MCP-1 in the serum of patients with acute spinal cord injury was correlated positively with the degree of spinal cord compression,which was elevated markedly(P

BACKGROUND: Available evidence suggests that following spinal cord injury, obvious reduction of Mg2+ level occurs in both the serum and the injured spinal cord, which has significant effects on cell membrane permeability, vascular regulation as well as secondary spinal cord injury.OBJECTIVE: To investigate the protective effects of magnesium sulfate (Mg2SO4) administered via intraperitoneal injection on the injured spinal cord of SD rats.DESIGN: A randomized controlled experiment.SETTING: Department of Orthopedics, Renmin Hospital of Wuhan UniversityMATERIALS: Forty-eight adult male SD rats were allocated randomly into experiment group and control group with 24 rats in each.INTERVENTIONS: The experiment was conducted in the Laboratory of Department of Orthopedics, Renmin Hospital of Wuhan University from April to August 2002. One hour after establishment of spinal cord injury models, the rats in the controlled group were injected intraperitoneally with normal saline, while those in the experiment group were given intraperitoneal injection of 300 mg/kg Mg2SO4. At each time point of 4, 8 and 24 hours after the treatment, 6 rats were selected from each group for measuring free Ca2+ concentration in the cells at the site of injury with spectrofluorometer . The activities of superoxide dismutase (SOD) in the spinal cord were detected by means of xanthine oxidation and thiobarbituric acid was used to determine the concentration of malondialdehyde (MDA). Lowered SOD activity and decreased MDA level were considered to suggest the protective effect of Mg2SO4 against spinal cord injury. Inclined plane test was used to assess the spinal cord function at 8, 24 hours and 1 week after the injury, in which the rat was made to stand on an inclined plate covered by a piece of rubber and the plate was inclined gradually until the rat was no longer able to stay in the original position for 5 s, and the inclination of the plate was recorded. The test was performed 3 times for each rat and the plate inclinations were averaged. An increased inclination indicated improvement of the spinal cord function.MAIN OUTCOME MEASURES: ① Intracellular Ca2+ concentration at the injury site. ② Changes in SOD activity and MDA concentration in the spinal cord. ③ Results of spinal cord function evaluation of the rats.RESULTS: Intracellular Ca2+ concentration at 8 and 24 hours after the injury was significantly lower in the experimental group than in the control group [(376.5±36.2)×10-9vs (425.9±32.7)×10-9 mol/L and (316.3±13.9)×10-9vs (350.2±29.4)×10-9 mol/L, respectively, P ＜ 0.05]. Compared with the control group at each time point, MDA concentration was significantly decreased, while SOD activity of SOD was increased in the experiment group (P ＜ 0.01). The improvement of spinal cord injury was not obvious in the experiment group and was significantly higher than that in the control group until I week after the injury [(53.3±4.3)° vs (44.3±5.7)°, P ＜ 0.05].CONCLUSION: Intraperitoneal Mg2SO4 injection may significantly lower the concentration of intracellular Ca2+ at the injury site and alters the product of lipid peroxidation, suggesting its neuroprotective effect against spinal injury so as to lighten secondary spinal injury in rats.

Objective To evaluate the effect of free NgR-modified bone marrow stromal cell (BMSC) transplantation on axon regeneration in rats after spinal cord injury. Methods Genes encoding free NgR protein were cloned and transduced into BMSCs at passage 3 using a lentivirus vector.Indirect immunofluorescence was used to detect the expression of free NgR protein.Meanwhile a spinal cord contusion model was established in 36 adult Sprague-Dawley rats at the T10 segment.The rats were then divided randomly into an experimental group and a control group.NgR + BMSCs were transplanted into the injured site 1 week post-trauma in the experimental group.BMSCs were also transplanted at the same time into the control group.Expression of free NgR at the injury site was detected by immunohistochemical staining at 1 week post-transplantation.The functional recovery of both groups was evaluated at 4 and 6 weeks post-transplantation.Longitudinal sections of the spinal cord were studied for axon regeneration using horseradish peroxidase staining. Results Expression of free NgR was found in the cell plasma of BMSCs by indirect immunofluorescence post-transfection.Positive immunohistochemical staining for NgR was found at the transplant site in the experimental group 1 week post-transplantation.Better axon plasticity could be observed in the experimental group.The Basso-Beattie-Bresnahan scoring of the experimental group was significantly higher than that of the controls at both observation times. Conclusions Free NgR-modified BMSCs can prompt injured axons to regenerate and thus to promote the recovery of neurological function.This might provide a new strategy to treat spinal cord injury.

The outcome of spinal cord injury is related to many factors, such as mechanism and severity of injury, and differences of individual. The standard of clinical trial plays a very important role in the reliability of the research. especially the inclusion and exclusion criterias, ethical issues, treatment standardization, informed consent and other issues. The effect of these factors on the clinical trial of spinal cord injury was summarized in this article. The inclusion and exclusion criterias to control the consistency should be developed based on the specific research content. Informed consent for clinical trial is also necessary, especially to the clinical trials with uncertainly benefits and risks, as well as the standardization of the operation procedures and rehabilitation treatment.

Objective To explore the appropriate frequency of ventilator tube replacement by researching the influence of different ventilator circuit change frequency on ventilator-associated pneumonia (VAP).Methods A prospective randomized sampling study was conducted.The patients undergoing invasive mechanical ventilation over or equal to 3 days admitted to emergency intensive care unit (EICU) of the First Affiliated Hospital of Kunming Medical University from December 2012 to December 2015 were enrolled.The patients were divided into 3,7 and 10 days group according to the frequency of ventilator tube replacement.Bacteriology of ventilator tube and the incidence of VAP were compared among the groups.Results Ninety-eight patients were enrolled,mainly with the artificial airway of endotracheal intubation or tracheotomy,with 56 male and 42 female,aging 8 to 86 years with mean of (51.97 ± 17.56) years.There were no statistical differences in gender,age,Glasgow coma scale (GCS) score,cough function and application of glucocorticoid,enteral nutrition,atomization and sedative therapy among three groups,indicating that the risk factors among three groups were consistent.The bacteria detection rates of extension tube,breathe out tube,breathe in tube,and hydrops collection cup were 36.7％,36.7％,33.3％,and 33.3％ respectively in 3 days group,and they were 73.0％,67.6％,62.2％,and 62.2％ in 7 days group respectively,and were all 90.3％ in 10 days group.It was showed that the bacteria detection rate in different pipe parts was almost the same with the same change frequency,and the rate was higher with the longer usage of ventilator tube (x2 values were 20.599,19.879,21.975,21.975,all P =0.000).The longer of the tube used time,the higher incidence of VAP.The incidence of VAP in 3,7,10 days groups were 26.7％,59.5％ and 77.4％,respectively,but there was statistically significant difference among all groups (x2 =30.486,P ＜ 0.001).Based on the value of 3 days group,the incidence of VAP in the 7 days group was 15.950 folds of 3 days group,and the incidence of VAP in the 10 days group was 18.333 folds of the 3 days group (both P ＜ 0.001).Conclusion This study suggests that the longer of pipeline using time,the more serious degree of bacterial contamination of pipeline,the higher incidence of VAP.

Objective To establish HPLC method for the simultaneous detgrmination of 9 effective components ofTanreqing injection.Methods The Agilent TC-C18 (2) (250 mm×4.6 mm, 5μm) column was used, the mobile phase consisted of acetonitrile (A) acetonitrile-0.1% formic acid aqueous solution (B) in a gradient mode, the flow rate was 1.0 ml/min,the column temperature was 30℃, the injection volume was 10μl, and the detecting wavelength was at 280 nm.Results All the 9 effective components showed a good linear relationship. TheRSDof the precision, reproducibility and stability tests were less than 2%. The average recoveries of the 9 effective components were in the range of 99.3%-103.1%.Conclusion This analysis method is simple, accurate and has a good specificity, which can be suitable for controlling the quality of Tanreqing injection.

Objective To understand the clinic usage of TCM decoction pieces in the First Affiliated Hospital of Xi’an Jiaotong University (hereinafter referred to as our hospital).Methods By using Microsoft Office Excel software, the medicine doses, classification of functions and clinic application of the TCM decoction pieces, which were among the top 50 most frequently used TCM decoction pieces were analyzed.Results In 2014, 60% of the top 50 most frequently used TCM decoction pieces in our hospital exceed the medicine dosage inChinese Pharmacopoeia. According to the functions, the top 3 TCM decoction pieces were medicine for reinforcing deficiency, clearing heat and promoting qi, respectively. Medicine for reinforcing deficiency was mainly used in gastroenteropathy, menopathy and nephropathy. Medicine for clearing heat was mainly used in gastroenteropathy, menopathy and infection of the upper respiratory tract. Medicine for promoting qi was mainly used in gastroenteropathy, tumor and disease of cardiovascular system.Conclusion TCM decoction pieces in our hospital exceed the medicine dosage in Chinese Pharmacopoeia, which requires attention. The top 3 TCM decoction pieces are respectively medicine for reinforcing deficiency, clearing heat and promoting qi, whose clinic applications are basically rational.

Most of the individuals with spinal cord injury (SCI) have nutritional problems in metabolism in energy, glucose, fat and vitamin after injury, which would influence the quality of life. Nutrition intervention program includes personalized nutrition consultation, correcting the imbalance of energy and lipid, supply of creatine and vitamins associated with energy metabolism, monitoring, and health promotion, are helpful to reduce the risk of complications related with metabolism.