Objective To investigate the therapeutic effect of the new K+ channel blocker 4-aminopyridine-3-methanol (4-AP-3-MeOH) on chronic spinal cord injury in rats.Methods 18 adult male Sprague-Dawley rats were randomly divided equally into 3 groups as follows:4-AP-3-MeOH treatment group (A),normal saline control group (B) and sham operation group (C).T10 segment of spinal cord compression injury was applied in group A and group B.4 weeks later,the rats in group A were daily treated by injecting 4-AP-3-MeOH 1 μmol (1000 μmol/L× 1 ml) into the veins of the tails for 4 weeks.While the same volume of saline was administrated into the group B for 4 weeks.Lamina of vertebra of T10 was cut without spinal cord injury in the sham-operation group.After modeling,the locomotor functional recovery was assessed by using Basso Beattie Bresnahan (BBB) scores and inclined plane (IP) tests,and all rats were periodical inspected by the somatosensory evoked potential(SEP) and motor evoked potential(MEP) post-operatively.Results BBB scores of group A started to increase gradually and were higher than those of group B from the 6th week,but the 2 groups at each time point in BBB scores were less than group C.Until 8 weeks after surgery,the inclined-plated angles of group A and B did not show significantly difference,but the both groups were significantly lower compared with group C.Electrophysiology study found that the amplitude of SEP and MEP in group A was higher than group B from the fourth to 8 weeks,but less than in group C.Histological examination showed that the spinal cord of rats in group C were morphologically intact with a clear demarcation between the grey and white matter.The gray matter structures of rats in group A and B were gone and a big cavity appears in the center of the spinal cord injury,with varying degrees of demyelination in the white around.In addition,statistically significant differences were found in the percentage of residual myelin at the injury epicenter between group A and group B.Conclusion With a persistent demyelination change and poor motor function in chronic spinal cord injury,daily administration of 4-AP-3-MeOH can improve the sensory and motor functions.

Objective:To evaluate the endothelial functions and autoregulation capacity of cerebral blood flow in patients with Fabry disease .Methods:Brachial artery vasodilation was assessed in 8 pa-tients with Fabry disease and 14 healthy controls by means of flow-mediated dilation ( FMD) and Nitro-glycerin-mediated dilation ( NMD) .Cerebrovascular reactivity was calculated in terms of breath-holding index ( BHI) and vascular motor reactivity ( VMR) by TCD-CO2 test in 4 patients and 14 healthy con-trols.Results:Compared with the controls , brachial artery vasodilation experiment showed no difference (the patients:FMD 15.94%±5.03% and NMD 23.92%±7.23%, the controls: FMD 14.57%± 5 .84% and NMD 22 .64%±6 .96%) , there was no relationship between FMD or NMD and the age , course of disease , MSSI or enzyme activity .In respect of cerebrovascular autoregulation capacity , there was no difference in anterior circulation , while cerebrovascular reactivity tended to be impaired in posteri-or circulation .Conclusion:Endothelial function showed no decline in patients with Fabry disease , but cerebrovascular autoregulation capacity tended to be impaired in posterior circulation .

Objective To investigate the knowledge level of the caregivers about pressure ulcer in patients with high risk of pressure ulcer in rural community,and to provide the scientific basis for the prevention and treatment of pressure ulcer.Methods 216 caregivers for patients with high risk of pressure ulcer in rural community were chosen from Mar.2012 to May 2013.The investigation on the awareness of pressure ulcer was performed by using questionnaire survey.Results The awareness rate of pressure ulcer in caregivers was 41.5 ％.The caregivers had gender difference (174females and 42 males).Most of the caregivers were 41 to 50 years old (124 cases,57.4％).Most caregivers had 1 ～ 2 years work experience (94 cases,43.5％).Most of them had low level of education (170 cases,78.7％) and non-professional training (178 cases,82.4％).The questionnaire score was higher in young caregivers than in the olders(F=2.483,P＜0.05).The questionnaire score was higher in caregivers having a long working lifetime(F=3.624,P＜0.05),higher educationalbackground (F=5.139,P＜ 0.01) and discipline training (t=7.346,P＜ 0.01) than in caregivers not having them.Conclusions The awareness rate of the knowledge about pressure ulcer is low in caregivers for patient with high risk of pressure ulcer in rural community.It is necessary to strengthen the guidance and training in caregivers to reduce the incidence of pressure ulcers and the medical cost,and improve the quality of life in patients with high risk of pressure ulcer in rural community.

Objective:To investigate the protective effects of levosimendan combined with lyophilized recombinant human brain natriuretic peptide (rhBNP) on myocardium in patients with acute myocardial infarction complicated by heart failure.Methods:140 patients with acute myocardial infarction complicated by heart failure who received treatment in Changxing People's Hospital from June 2018 to June 2020 were included in this study. They were randomly assigned to receive either routine treatment (control group, n = 70) or routine treatment, levosimendan combined with rhBNP (study group, n = 70). Serum levels of creatine kinase (CK)-MB, cardiac troponin I (cTnI), lactate dehydrogenase (LDH), high-sensitivity C-reactive protein (hs-CRP), which were associated with myocardial injury, were measured in each group. In addition, the changes in cardiac ultrasound indexes left ventricular end diastolic diameter (LVEDD), left ventricular end systolic diameter (LVESD) and left ventricular ejection fraction (LVEF) were observed. Clinical effects on heart failure were evaluated. Adverse drug reactions were monitored during the treatment. Results:After treatment, CK-MB, cTnI, LDH and hs-CRP levels in the study group were (56.73 ± 12.15) U/L, (0.41 ± 0.19) μg/L, (126.83 ± 15.26) U/L and (1.59 ± 0.27) mg/L, respectively, which were significantly lower than those in the control group [(78.52 ± 14.07) U/L, (0.68 ± 0.21) μg/L, (187.25 ± 23.04) U/L, (2.84 ± 0.41) mg/L, t = 5.569-12.418, all P < 0.05]. LVEDD and LVESD in the study group were significantly lower than those in the control group, while LVEF in the study group was significantly higher than that in the control group ( t = 4.435-6.426, all P < 0.05). Total effective rate in the study group was significantly higher than that in the control group [88.57% (62/70) vs. 72.86% (51/70), χ2 = 5.552, P < 0.05]. There was no significant difference in total incidence of adverse drug reactions between study and control groups [11.43% (8/70) vs. 8.57% (6/70), χ2 = 0.317, P > 0.05]. Conclusion:Levosimendan combined with rhBNP can effectively alleviate myocardial injury in patients with acute myocardial infarction complicated by heart failure, improve myocardial function, is highly safe, and thereby deserves clinical application.

Purpose To explore the changes of structure of cerebellum,frontal lobe and limbic system(cingulate gyrus,hippocampus and amygdala)in poststroke depression(PSD)via diffusion tensor imaging,and to confirm that cerebellum was involved in the occurrence of PSD,and to study the correlation between cerebellum and traditional depression-related areas such as frontal lobe,limbic system(cingulate gyrus,hippocampus and amygdala).Materials and Methods A total of 39 patients with basal ganglia infarction for the first time from October 2020 to October 2021 in the First Affiliated Hospital of Jinzhou Medical University were evaluated by Hamilton depression scale(HAMD),and all subjects were divided into PSD group(19 cases)and non-PSD group(20 cases),and 20 people with no statistical difference in basic information were randomly selected as the normal control group.The fractional anisotropy(FA)values and apparent diffusion coefficient in region of interest via diffusion tensor imaging were measured.The FA values of lesion and contralateral region of interest were compared among the three groups,and the correlation between FA value and HAMD score was analyzed.Results The FA values of ROI in the prefrontal lobe,hippocampus,cingulate gyrus,corpus callosum,middle cerebellar peduncle,and inferior cerebellar crus in the PSD group were significantly different from those in the non-PSD group and normal control group(t=-0.12--0.06,all P<0.05).The FA values of cerebellum,frontal lobe and limbic system were significantly negatively correlated with HAMD scores(R2adjust=0.954,P<0.05).There was a positive correlation between the FA value of contralateral foot in the cerebellum of PSD patients and that of prefrontal lobe,hippocampus,cingulate gyrus and knee of corpus callosum(r=0.977,0.752,0.637 and 0.539,all P<0.05),respectively.Conclusion PSD patients may have changes in the white matter fiber tracts of the cerebellum,which are associated with traditional depressions.

BACKGROUNDThe purpose of this retrospective study was to compare the surgical outcomes of simple discectomy and instrumented posterior lumbar interbody fusion (iPLIF) in patients with lumbar disc herniation and Modic endplate changes. Our hypothesis was that iPLIF could provide better outcome for patients with refractory lumbar disc herniation and Modic changes (LDH-MC).

METHODSNinety-one patients with single-segment LDH-MC were recruited. All patients experienced low back pain as well as radicular leg pain, and low back pain was more severe than leg pain. Forty-seven patients were treated with discectomy and 44 were treated with iPLIF. The outcomes of both low back pain and radicular leg pain using visual analogue scale (VAS) as well as the clinical outcome related to low back pain using Japanese Orthopaedic Association (JOA) score were assessed before and 18 months after surgery, respectively.

RESULTSBoth low back and leg pain were significantly improved 18 months after simple discectomy and iPLIF. Compared to patients undergoing simple discectomy, low back pain was significantly reduced in patients undergoing iPLIF, but there was no significant difference in leg pain between two groups. Solid fusion was achieved in all patients who underwent iPLIF.

CONCLUSIONSIn patients with LDH-MC, iPLIF can yield significantly superior outcome on the relief of low back pain compared to simple discectomy. Simple discectomy can relieve radicular leg pain as efficient as iPLIF. Accordingly, iPLIF seems to be a reliable treatment for patients with LDH-MC and predominant low back pain.

Adult ; Diskectomy ; standards ; Female ; Humans ; Intervertebral Disc Displacement ; surgery ; Low Back Pain ; surgery ; Lumbar Vertebrae ; surgery ; Middle Aged ; Retrospective Studies ; Spinal Fusion ; standards