1.Effect of ultrasound-guided foraminal electroacupuncture on spinal cord injury based on the Wnt/β-catenin signaling pathway.
Weixian WU ; Bin CHEN ; Jing LIU ; Li WANG ; Feizhen CHEN ; Yanling WU
Chinese Acupuncture & Moxibustion 2025;45(10):1442-1449
OBJECTIVE:
To observe the effects of ultrasound-guided foraminal electroacupuncture on neuronal apoptosis and motor function in rats with spinal cord injury (SCI), and to explore the potential underlying mechanisms.
METHODS:
Thirty-six SPF-grade Sprague-Dawley rats were randomly assigned to a sham operation group, a model group, and an ultrasound-guilded electroacupuncture group (electroacupuncture group), with 12 rats in each group. In the sham operation group, the spinal cord was exposed and then the incision was sutured without contusion. In the other two groups, SCI models were established using a modified Allen's impact method. On days 1, 3, 7, and 14 after modeling, the electroacupuncture group received electroacupuncture intervention at the T9/T10 and T10/T11 intervertebral foramen under ultrasound guidance, avoiding spinal cord injury. Stimulation parameters were dense-disperse wave at 2 Hz/100 Hz and 1-2 mA for each session. Following interventions on days 1, 3, 7, and 14, the Basso-Beattie-Bresnahan (BBB) score was assessed; the inclined plane test was used to assess hindlimb grip strength in rats. After the intervention, HE staining was used to observe spinal cord morphology; TUNEL staining was used to detect neuronal apoptosis; ELISA was used to measure the serum levels of interleukin (IL)-6, IL-1β, and tumor necrosis factor-alpha (TNF-α); Western blot was used to analyze the protein expression of Wnt-4, β-catenin, c-Myc, Bax, Bcl-2, and NeuN in spinal tissue; quantitative real-time PCR was used to detect the mRNA expression of Wnt-4, β-catenin, c-Myc, Bax, Bcl-2, and NeuN.
RESULTS:
Compared with the sham operation group, the model group showed significantly reduced BBB scores (P<0.05), and reduced inclined plane angles (P<0.05) at all time points. Compared with the model group, the electroacupuncture group exhibited increased BBB scores on days 3, 7, and 14 (P<0.05), and higher inclined plane angles on days 1, 3, 7, and 14 (P<0.05). Compared with the sham operation group, the model group showed disorganized spinal cord structure with increased inflammatory cells and necrotic neurons, higher number of apoptotic neurons in spinal tissue (P<0.05), elevated serum IL-6, IL-1β, and TNF-α levels (P<0.05), increased protein and mRNA expression of Wnt-4, β-catenin, c-Myc, and Bax (P<0.05), and decreased protein and mRNA expression of Bcl-2 and NeuN in spinal tissue (P<0.05). Compared with the model group, the electroacupuncture group had fewer inflammatory cells and apoptotic neurons in spinal tissue (P<0.05), reduced serum IL-6, IL-1β, and TNF-α levels (P<0.05), increased protein and mRNA expression of Wnt-4, β-catenin, Bcl-2, and NeuN (P<0.05), and decreased protein and mRNA expression of c-Myc and Bax in spinal tissue (P<0.05).
CONCLUSION
Ultrasound-guided foraminal electroacupuncture could improve motor function in rats with SCI, potentially by regulating the expression of molecules related to the Wnt-4/β-catenin signaling pathway to inhibit neuronal apoptosis and inflammatory responses.
Animals
;
Electroacupuncture/methods*
;
Spinal Cord Injuries/physiopathology*
;
Rats, Sprague-Dawley
;
Rats
;
Wnt Signaling Pathway
;
Male
;
Humans
;
Female
;
beta Catenin/metabolism*
;
Apoptosis
;
Ultrasonography
;
Tumor Necrosis Factor-alpha/genetics*
;
Spinal Cord/metabolism*
2.Effect of moxibustion at "Shenque" (CV8) on the expression of BDNF and c-fos in the urinary control brain regions of rats with neurogenic bladder after spinal cord injury.
Han YU ; Yuanbo FU ; Huilin LIU ; Yuzhuo ZHANG ; Yutong NI ; Qingdai LI ; Yi XU
Chinese Acupuncture & Moxibustion 2025;45(5):638-645
OBJECTIVE:
To observe the effects of moxibustion at "Shenque" (CV8) on urodynamics and the expression of brain-derived neurotrophic factor (BDNF) and immediate early gene (c-fos) in pontine micturition center (PMC), periaqueductal gray (PAG), medial prefrontal cortex (mPFC) of neurogenic bladder (NB) rats after spinal cord injury.
METHODS:
Twenty-four SPF female SD rats were randomly divided into a sham-operation group (6 rats) and a modeling group (18 rats). In the modeling group, T9 complete spinal cord transection method was used to establish a neurogenic detrusor overactivity model, and the 12 rats with successful modeling were randomized into a model group and a moxibustion group, with 6 rats in each group. The rats in the moxibustion group were treated with ginger/salt-insulated moxibustion at "Shenque" (CV8), and 4 consecutive moxa cones were delivered in one intervention. Moxibustion was operated once daily and for 14 days. After intervention completion, the urodynamic indexes of rats in each group were detected. Fluorescence quantitative PCR was used to detect the mRNA expression of BDNF and c-fos in PMC, PAG and mPFC in rats. Western blot was used to detect the protein expression of BDNF and c-fos in PMC, PAG and mPFC.
RESULTS:
The rats in the sham-operation group did not show phasic detrusor contraction during bladder filling. Compared with the model group, the frequency and amplitude of the phasic detrusor contraction were reduced 5 min before urine leakage in the rats of the moxibustion group (P<0.05), and the duration of the first phasic detrusor contraction during bladder filling was prolonged (P<0.05). Compared with the sham-operation group, the mRNA and protein expression of BDNF and c-fos in PMC, PAG and mPFC increased in the model group (P<0.05). Compared with the model group, the mRNA and protein expression of BDNF and c-fos in PMC, PAG and mPFC decreased in the moxibustion group (P<0.05).
CONCLUSION
Moxibustion at "Shenque" (CV8) can improve the phasic contraction during bladder filling in NB rats after spinal cord injury, possibly by down-regulating the mRNA and protein expression of BDNF and c-fos in PMC, PAG, and mPFC.
Animals
;
Moxibustion
;
Female
;
Rats
;
Brain-Derived Neurotrophic Factor/metabolism*
;
Rats, Sprague-Dawley
;
Acupuncture Points
;
Spinal Cord Injuries/metabolism*
;
Urinary Bladder, Neurogenic/etiology*
;
Proto-Oncogene Proteins c-fos/metabolism*
;
Humans
;
Urinary Bladder/physiopathology*
;
Brain/metabolism*
;
Urination
3.Acupuncture and moxibustion combined with umbilical therapy for 30 cases of anxiety and depression in patients with neurogenic bladder after spinal cord injury.
Dongli WANG ; Xueqian WANG ; Rui WANG ; Youzhi HAO ; Weiwei QIAO ; Chao LI ; Yinping ZUO
Chinese Acupuncture & Moxibustion 2025;45(7):923-926
OBJECTIVE:
To observe the clinical effect of acupuncture and moxibustion combined with umbilical therapy on anxiety and depression in patients with neurogenic bladder (NB) after spinal cord injury (SCI).
METHODS:
Thirty cases of NB after SCI with anxiety and depression were selected and treated with acupuncture and moxibustion combined with umbilical therapy. Acupuncture was applied at Baihui (GV20), Yintang (GV24+), Sanyinjiao (SP6), Shenmen (HT7), Hegu (LI4), Taichong (LR3), once a day, continuous treatment for 4 weeks. Ginger moxibustion was applied at the bladder meridian of foot taiyang and governor vessel, once a day, continuous treatment for 4 weeks. In treatment of umbilical therapy, Chaihu (Radix Bupleuri), Yujin (Radix Curcumae), Rougui (Cortex Cinnamomi) were ground and mixed with the same amount of honey, put into the application, and the application was placed on the navel after filling the navel with fine salt, once a day for 4 weeks. Hamilton anxiety scale (HAMA) score, Hamilton depression scale (HAMD) score, urodynamic indexes (maximum urinary flow rate [Qmax], maximum detrusor pressure [Pdet-max], residual urine volume [RUV]), neurogenic bladder symptom score (NBSS), urinary symptom distress scale (USDS) score were compared before and after treatment, and the clinical efficacy was evaluated.
RESULTS:
After treatment, the scores of HAMA, HAMD, NBSS, USDS and RUVwere lower than those before treatment (P<0.05), and Qmax and Pdet-max were higher than those before treatment (P<0.05). The total effective rate was 93.3 (28/30).
CONCLUSION
Acupuncture and moxibustion combined with umbilical therapy can effectively relieve anxiety and depression symptoms, improve urination disorders in patients with NB after SCI.
Humans
;
Moxibustion
;
Male
;
Female
;
Adult
;
Middle Aged
;
Acupuncture Therapy
;
Spinal Cord Injuries/psychology*
;
Depression/etiology*
;
Anxiety/etiology*
;
Urinary Bladder, Neurogenic/etiology*
;
Young Adult
;
Aged
;
Combined Modality Therapy
;
Acupuncture Points
4.A simulation study of nerve fiber activation in the lumbar segment under kilohertz-frequency transcutaneously spinal cord stimulation.
Qi XU ; Xinru LI ; Zhixin LU ; Yongchao WU
Journal of Biomedical Engineering 2025;42(2):300-307
Clinical trials have demonstrated that kilohertz-frequency transcutaneous spinal cord stimulation (TSCS) can be used to facilitate the recovery of sensory-motor function for patients with spinal cord injury, whereas the neural mechanism of TSCS is still undetermined so that the choice of stimulation parameters is largely dependent on the clinical experience. In this paper, a finite element model of transcutaneous spinal cord stimulation was used to calculate the electric field distribution of human spinal cord segments T 12 to L 2, whereas the activation thresholds of spinal fibers were determined by using a double-cable neuron model. Then the variation of activation thresholds was obtained by varying the carrier waveform, the interphase delay, the modulating frequency, and the modulating pulse width. Compared with the sinusoidal carrier, the usage of square carrier could significantly reduce the activation threshold of dorsal root (DR) fibers. Moreover, the variation of activation thresholds was no more than 1 V due to the varied modulating frequency and decreases with the increased modulating pulse width. For a square carrier at 10 kHz modulated by rectangular pulse with the frequency of 50 Hz and the pulse width of 1 ms, the lowest activation thresholds of DR fibers and dorsal column fibers were 27.6 V and 55.8 V, respectively. An interphase delay of 5 μs was able to reduce the activation thresholds of the DR fibers to 20.1 V. The simulation results can lay a theoretical foundation on the selection of TSCS parameters in clinical trials.
Humans
;
Spinal Cord Stimulation/methods*
;
Nerve Fibers/physiology*
;
Finite Element Analysis
;
Spinal Cord/physiology*
;
Computer Simulation
;
Spinal Cord Injuries/physiopathology*
;
Lumbosacral Region
;
Lumbar Vertebrae
;
Transcutaneous Electric Nerve Stimulation/methods*
;
Models, Neurological
5.Analysis of demographic and clinical characteristics of 744 inpatients with osteoporotic vertebral compression fractures.
Bo ZHANG ; Wenlong MA ; Weihua FENG ; Yanjin WANG ; Hanjie ZHUO ; Yihang QIAO ; Haobo LIANG ; Zhenjie ZHAO
Chinese Journal of Reparative and Reconstructive Surgery 2025;39(3):354-361
OBJECTIVE:
To analyze the demographic and clinical characteristics of inpatients with osteoporotic vertebral compression fractures (OVCF) and provide a basis for clinical prevention and treatment.
METHODS:
A retrospective analysis was performed on the clinical data of 744 inpatients diagnosed with OVCF between January 2017 and December 2021 who met the inclusion criteria. Among them, 146 were male and 598 were female, with age ranging from 50 to 95 years (mean, 69.37 years). The demographic characteristics (gender, age, ethnicity, occupation, regional distribution, urban-rural distribution, and seasonal incidence) and clinical features [causes of injury, history of vertebral fractures, smoking and drinking history in males, comorbidities (hypertension, diabetes, coronary atherosclerotic heart disease, cerebral infarction), body mass index (BMI), blood lipid levels, menopausal age in females, vertebral bone mineral density T-value, number of vertebral fractures, and fracture segment distribution] of OVCF patients were analyzed. Multiple linear regression was used to analyze the independent risk factors of vertebral osteoporosis.
RESULTS:
The demographic analysis indicated that female patients with OVCF were significantly younger than male patients ( P<0.05). Significant differences were observed in the age distribution of OVCF between males and females ( P<0.05), with the highest proportion of male patients in the 70-79 years group (37.0%) and the highest proportion of female patients in the 60-69 years group (40.0%). From 2017 to 2021, the age of onset for OVCF gradually increased, with a similar trend observed for both genders. The distribution of occupations between genders also showed significant differences ( P<0.05); with the top three occupations for males being farmers (48.6%), retirees (24.7%), and workers (13.7%), while for females, the leading occupations were farmers (51.5%), retirees (19.4%), and service workers (10.0%). Female OVCF patients had higher BMI, vertebral bone mineral density T-value, history of vertebral fractures, hypertension prevalence, and blood lipid levels compared to male patients ( P<0.05). No significant difference between the males and the females was found in ethnicity, seasonal distribution, regional distribution, urban-rural distribution, causes of injury, number of vertebral fractures, or prevalence of comorbidities (except hypertension) ( P>0.05). Among the 744 OVCF patients, a total of 1 309 vertebrae were involved, with 628 thoracic vertebrae (48.0%) and 681 lumbar vertebrae (52.0%). The most common fracture segments were L 1 (22.5%), T 12 (21.2%), followed by L 2 (12.2%) and T 11 (10.2%). No significant gender difference was observed in the distribution of fracture segments ( P>0.05). Multiple linear regression analysis indicated that older age, female, and lower BMI were independent risk factors for vertebral osteoporosis ( P<0.05).
CONCLUSION
The age of onset of OVCF patients is increasing year by year. The number of fractured vertebral bodies, age distribution of morbidity, occupational distribution, BMI, history of vertebral fracture, hypertension, and blood lipid levels are related to gender. The occurrence of OVCF is mainly in the thoracolumbar segment. The female, older age, and lower BMI are independent risk factors of osteoporosis.
Humans
;
Male
;
Female
;
Aged
;
Middle Aged
;
Retrospective Studies
;
Spinal Fractures/etiology*
;
Aged, 80 and over
;
Osteoporotic Fractures/etiology*
;
Fractures, Compression/etiology*
;
Risk Factors
;
Bone Density
;
China/epidemiology*
;
Osteoporosis/epidemiology*
;
Comorbidity
;
Inpatients
;
Sex Factors
;
Age Factors
6.Comparative study on effectiveness of different puncture methods of flexible bone cement delivery device in treatment of osteoporotic vertebral upper 1/3 compression fractures.
Tangbo LI ; Kun LIU ; Nan ZHANG ; Guobing HAO ; Zexing ZHU ; Lin QIAO ; Diyu SONG
Chinese Journal of Reparative and Reconstructive Surgery 2025;39(4):470-477
OBJECTIVE:
To compare the effectiveness of different puncture methods of the flexible bone cement delivery device in unilateral percutaneous curved vertebroplasty for osteoporotic vertebral upper 1/3 compression fractures.
METHODS:
A retrospective analysis was conducted on the clinical data of 67 patients with osteoporotic vertebral upper 1/3 compression fractures who were admitted and met the selection criteria between January 2023 and April 2024. The patients were divided into two groups based on the puncture method of the flexible bone cement delivery device: the oblique puncture group ( n=37) and the parallel puncture group ( n=30). There was no significant difference ( P>0.05) between the two groups in terms of gender, age, bone mineral density (T value), distribution of fractured vertebrae, time from injury to operation, and preoperative visual analogue scale (VAS) score for pain, Oswestry disability index (ODI), anterior vertebral height of the fractured vertebra, and Cobb angle of the fractured vertebra. The following parameters were compared between the two groups: operation time, incidence of secondary puncture, incidence of bone cement leakage, volume of injected bone cement, bone cement distribution score, as well as VAS score, ODI, anterior vertebral height of the fractured vertebra, and Cobb angle of the fractured vertebra at 1 day after operation and at last follow-up.
RESULTS:
Two cases in the oblique puncture group and 7 cases in the parallel puncture group underwent secondary puncture during operation, and the difference in the incidence of secondary puncture was significant ( P<0.05). No complications such as bone cement hypersensitivity, bone cement embolism, nerve injury, or epidural hematoma occurred in both groups. There was no significant difference in operation time, volume of injected bone cement, incidence of bone cement leakage, distribution score and rating of bone cement between the two groups ( P>0.05). All patients were followed up 6-18 months (mean, 12.0 months), and there was no significant difference in the follow-up time between the two groups ( P>0.05). No further fracture collapse or compression occurred in the fractured vertebra during follow-up. Both groups exhibited significant improvements in VAS score, ODI, anterior vertebral height, and Cobb angle of the fractured vertebra after operation compared to baseline ( P<0.05). There were also significant differences between the two time points after operation ( P<0.05). However, there was no significant difference in the above indicators between the two groups ( P>0.05).
CONCLUSION
For osteoporotic vertebral upper 1/3 compression fractures treated with unilateral percutaneous curved vertebroplasty, both oblique and parallel puncture methods of the flexible bone cement delivery device can effectively relieve pain, but the former is more conducive to reducing the incidence of secondary puncture.
Humans
;
Bone Cements/therapeutic use*
;
Fractures, Compression/surgery*
;
Retrospective Studies
;
Vertebroplasty/instrumentation*
;
Osteoporotic Fractures/surgery*
;
Spinal Fractures/surgery*
;
Female
;
Male
;
Aged
;
Middle Aged
;
Treatment Outcome
;
Punctures/methods*
;
Aged, 80 and over
7.Clinical and therapeutic analysis of 22 patients with traumatic spinopelvic dissociation.
Min WU ; Jianzhong GUAN ; Xiaotian CHEN ; Xiaopan WANG ; Peishuai ZHAO ; Yongsheng WANG ; Jiaqiang CHEN ; Leyu LIU ; Renjie LI
Chinese Journal of Reparative and Reconstructive Surgery 2025;39(6):692-700
OBJECTIVE:
To review the clinical characteristics of patients with traumatic spinopelvic dissociation (SPD) and explore the diagnostic and therapeutic methods.
METHODS:
A clinical data of 22 patients with SPD who underwent surgical treatment between March 2019 and August 2024 was retrospectively analyzed. There were 13 males and 9 females, with an average age of 35.5 years (range, 14-61 years). The causes of injury included falling from height in 16 cases, traffic accidents in 5 cases, and compression injury in 1 case. Sacral fractures were classified based on morphology into "U" type (9 cases), "H" type (7 cases), "T" type (4 cases), and "λ" type (2 cases). According to the Roy-Camille classification, there were 4 cases of type Ⅰ, 12 cases of type Ⅱ, 2 cases of type Ⅲ, and 4 cases of type Ⅳ. The Cobb angle was (35.7± 22.0)°. Sixteen patients were accompanied by lumbosacral trunk and cauda equina nerve injury, which was classified as grade Ⅱ in 5 cases, grade Ⅲ in 5 cases, and grade Ⅳ in 6 cases according to the Gibbons grading. The time from injury to operation was 2-17 days (mean, 5.7 days). Based on the type of sacral fracture and sacral nerve injury, 6 cases were treated with closed reduction and minimally invasive percutaneous sacroiliac screw fixation, 16 cases were treated with open reduction and lumbar iliac fixation (8 cases)/triangular fixation (8 cases). Among them, 11 patients with severe fracture displacement and kyphotic deformity leading to sacral canal stenosis or bony impingement within the sacral foramen underwent laminectomy and sacral nerve decompression. X-ray films and CT were reviewed during followed-up. The Matta score was used to evaluate the quality of fracture reduction. At last follow-up, the Majeed score was used to assess the functional recovery, and the Gibbons grading was used to evaluate the nerve function.
RESULTS:
All operations were successfully completed. All patients were followed up 8-64 months (mean, 20.4 months). Two patients developed deep vein thrombosis of the lower limbs, 2 had incision infections, and 1 developed a sacral pressure ulcer; no other complications occurred. Radiological examination showed that the Cobb angle was (12.0±6.8)°, which was significantly different from the preoperative one ( t=6.000, P<0.001). The Cobb angle in 16 patients who underwent open reduction was (14.9±5.5)°, which was significantly different from the preoperative one [(46.8±13.9)° ] ( t=8.684, P<0.001). According to the Matta scoring criteria, the quality of fracture reduction was rated as excellent in 8 cases, good in 7 cases, fair in 5 cases, and poor in 2 cases, with an excellent and good rate of 68.2%. Bone callus formation was observed at the fracture site in all patients at 12 weeks after operation, and bony union achieved in all cases at last follow-up, with a healing time ranging from 12 to 36 weeks (mean, 17.6 weeks). At last follow-up, the Majeed score was rated as excellent in 7 cases, good in 10 cases, fair in 4 cases, and poor in 1 case, with an excellent and good rate of 77.3%. One patient experienced a unilateral iliac screw breakage at 12 months after operation, but the fracture had already healed, and there was no loss of reduction. Among the 16 patients with preoperative sacral nerve injury, 11 cases showed improvement in nerve function (6 cases) or recovery (5 cases).
CONCLUSION
SPD with low incidence, multiple associated injuries, and high incidence of sacral nerve injury, requires timely decompression of the sacral canal for symptomatic sacral nerve compression, fractures reduction, deformities correction, and stable fixation.
Humans
;
Adult
;
Female
;
Male
;
Retrospective Studies
;
Middle Aged
;
Spinal Fractures/diagnostic imaging*
;
Adolescent
;
Sacrum/diagnostic imaging*
;
Fracture Fixation, Internal/methods*
;
Young Adult
;
Pelvic Bones/surgery*
;
Treatment Outcome
;
Bone Screws
8.Effect of removing microglia from spinal cord on nerve repair after spinal cord injury in mice.
Qi JIANG ; Chao QI ; Yuerong SUN ; Shiyuan XUE ; Xinyi WEI ; Haitao FU
Chinese Journal of Reparative and Reconstructive Surgery 2025;39(6):754-761
OBJECTIVE:
To investigate the effects of removing microglia from spinal cord on nerve repair and functional recovery after spinal cord injury (SCI) in mice.
METHODS:
Thirty-nine 6-week-old female C57BL/6 mice were randomly divided into control group ( n=12), SCI group ( n=12), and PLX3397+SCI group ( n=15). The PLX3397+SCI group received continuous feeding of PLX3397, a colony-stimulating factor 1 receptor inhibitor, while the other two groups were fed a standard diet. After 14 days, both the SCI group and the PLX3397+SCI group were tested for ionized calcium binding adapter molecule 1 (Iba1) to confirm that the PLX3397+SCI group had completely depleted the spinal cord microglia. The SCI model was then prepared by clamping the spinal cord in both the SCI group and the PLX3397+SCI group, while the control group underwent laminectomy. Preoperatively and at 1, 3, 7, 14, 21, and 28 days postoperatively, the Basso Mouse Scale (BMS) was used to assess the hind limb function of mice in each group. At 28 days, a footprint test was conducted to observe the gait of the mice. After SCI, spinal cord tissue from the injury site was taken, and Iba1 immunofluorescence staining was performed at 7 days to observe the aggregation and proliferation of microglia in the spinal cord. HE staining was used to observe the formation of glial scars at the injury site at 28 days; glial fibrillary acidic protein (GFAP) immunofluorescence staining was applied to astrocytes to assess the extent of the injured area; neuronal nuclei antigen (NeuN) immunofluorescence staining was used to evaluate neuronal survival. And 5-hydroxytryptamine (5-HT) immunofluorescence staining was performed to assess axonal survival at 60 days.
RESULTS:
All mice survived until the end of the experiment. Immunofluorescence staining revealed that the microglia in the spinal cord of the PLX3397+SCI group decreased by more than 95% compared to the control group after 14 days of continuous feeding with PLX3397 ( P<0.05). Compared to the control group, the BMS scores in the PLX3397+SCI group and the SCI group significantly decreased at different time points after SCI ( P<0.05). Moreover, the PLX3397+SCI group showed a further decrease in BMS scores compared to the SCI group, and exhibited a dragging gait. The differences between the two groups were significant at 14, 21, and 28 days ( P<0.05). HE staining at 28 days revealed that the SCI group had formed a well-defined and dense gliotic scar, while the PLX3397+SCI group also developed a gliotic scar, but with a more blurred and loose boundary. Immunofluorescence staining revealed that the number of microglia near the injury center at 7 days increased in the SCI group than in the control group, but the difference between groups was not significant ( P>0.05). In contrast, the PLX3397+SCI group showed a significant reduction in microglia compared to both the control and SCI groups ( P<0.05). At 28 days after SCI, the area of spinal cord injury in the PLX3397+SCI group was significantly larger than that in SCI group ( P<0.05); the surviving neurons significantly reduced compared with the control group and SCI group ( P<0.05). The axonal necrosis and retraction at 60 days after SCI were more obvious.
CONCLUSION
The removal of microglia in the spinal cord aggravate the tissue damage after SCI and affecte the recovery of motor function in mice, suggesting that microglia played a neuroprotective role in SCI.
Animals
;
Spinal Cord Injuries/surgery*
;
Microglia/pathology*
;
Female
;
Mice
;
Mice, Inbred C57BL
;
Nerve Regeneration/drug effects*
;
Spinal Cord/pathology*
;
Pyrroles/administration & dosage*
;
Aminopyridines/administration & dosage*
;
Recovery of Function
;
Disease Models, Animal
;
Calcium-Binding Proteins/metabolism*
;
Receptors, Granulocyte-Macrophage Colony-Stimulating Factor/antagonists & inhibitors*
;
Microfilament Proteins/metabolism*
;
Glial Fibrillary Acidic Protein/metabolism*
9.Disease burden of spinal fractures in China from 1990 to 2021 and temporal trends: A comparative analysis based on the Global Burden of Disease Study 2021.
Hao WANG ; Hua LIU ; Tianyun SHI ; Huaixi FAN ; Songkai LI
Chinese Journal of Reparative and Reconstructive Surgery 2025;39(6):762-768
OBJECTIVE:
To analyze the current status and temporal trends of the disease burden of spinal fractures in China from 1990 to 2021 based on data from the Global Burden of Disease Study 2021 (GBD 2021), aiming to provide evidence for developing prevention and treatment strategies.
METHODS:
Epidemiological data on spinal fractures in China, the United States of America (USA), and globally were extracted from the GBD 2021 database. Joinpoint regression models were applied to analyze temporal trends. Age-standardized incidence, prevalence, and disability-adjusted life years (DALYs) rates were calculated, with comparisons of gender- and age-group disparities.
RESULTS:
In 2021, the number of incident cases, prevalent cases, and DALYs of spinal fractures in China increased by 52.28%, 113.68%, and 106.98%, respectively, compared to 1990. The age-standardized incidence, prevalence, and DALYs rates rose by 11.80%, 16.11%, and 14.79%, respectively. The disease burden escalated significantly with age, peaking in individuals aged ≥75 years. Males exhibited higher age-standardized incidence and DALYs rates than females. Comparative analysis revealed that the age-standardized DALYs rate in China (4.19/100 000) was lower than that in globally (6.62/100 000) and USA (15.92/100 000). However, China showed an upward trend [annual average percentage change (AAPC)=0.19%], contrasting with a declining trend in the USA (AAPC=-0.08%).
CONCLUSION
The escalating disease burden of spinal fractures in China is closely linked to population aging, gender disparities, and insufficient targeted prevention policies. Future strategies should integrate age- and gender-specific interventions, including strengthened osteoporosis prevention, trauma risk control, and big data-driven precision measures, to mitigate this burden.
Humans
;
China/epidemiology*
;
Global Burden of Disease/trends*
;
Male
;
Female
;
Spinal Fractures/epidemiology*
;
Middle Aged
;
Aged
;
Disability-Adjusted Life Years
;
Prevalence
;
Incidence
;
Adult
;
Young Adult
;
Adolescent
;
Aged, 80 and over
;
United States/epidemiology*
;
Cost of Illness
;
Quality-Adjusted Life Years
;
Child
10.Establishment of a canine model of vascularized allogeneic spinal cord transplantation and preliminary study on spinal cord continuity reconstruction.
Jiayang CHEN ; Rongyu LAN ; Weihua ZHANG ; Jie QIN ; Weijun HU ; Jiaxing WANG ; Xiaoping REN
Chinese Journal of Reparative and Reconstructive Surgery 2025;39(9):1196-1202
OBJECTIVE:
To explore the construction of a canine model of vascularized allogeneic spinal cord transplantation (vASCT) and preliminarily evaluate its therapeutic efficacy for spinal cord injury (SCI).
METHODS:
Sixteen female Beagle dogs aged 8-12 months were randomly selected, with 8 dogs serving as donors for the harvesting of spinal cord tissue with a vascular pedicle [dorsal intercostal artery (DIA) at the T10 level and accompanying vein]. The remaining 8 dogs underwent a 1.5-cm-length spinal cord defect at the T10 level, followed by transplantation of the donor spinal cord tissue for repair. Polyethylene glycol (PEG) was applied to both ends to spinal cord graft; then, using a random number table method, the dogs were divided into an experimental group (n=4) and a control group (n=4). The experimental group received immunosuppressive intervention with oral tacrolimus [0.1 mg/(kg∙d)] postoperatively, while the control group received no treatment. The operation time and ischemia-reperfusion time of two groups were recorded. The recovery of hind limb function was estimated by Olby score within 2 months after operation; the motor evoked potentials (MEP) was measured through neuroelectrophysiological examination, and the spinal cord integrity was observed through MRI.
RESULTS:
There was no significant difference in the operation time and ischemia-reperfusion time between the two groups (P>0.05). All dogs survived until the completion of the experiment. Within 2 months after operation, all dogs in the control group failed to regain the movement function of hind limbs, and Olby scores were all 0. In the experimental group, the movement and weight-bearing, as well as walking abilities of the hind limbs gradually recovered, and the Olby scores also showed a gradually increasing trend. There was a significant difference between the two groups from 3 to 8 weeks after operation (P<0.05). Neuroelectrophysiological examination indicated that the electrical signals of the experimental group passed through the transplanted area, and the latency was shortened compared to that at 1 month after operation (P<0.05), showing continuous improvement, but the amplitude did not show significant improvement (P>0.05). The control group was unable to detect any MEP changes after operation. MRI examination showed that the transplanted spinal cord in the experimental group survived and had good continuity with normal spinal cord tissue, while no relevant change was observed in the control group.
CONCLUSION
The vASCT model of dogs was successfully constructed. This surgical procedure can restore the continuity of the spinal cord. The combination of tacrolimus anti-immunity is a key factor for the success of transplantation.
Animals
;
Dogs
;
Female
;
Spinal Cord/blood supply*
;
Spinal Cord Injuries/surgery*
;
Transplantation, Homologous
;
Disease Models, Animal
;
Recovery of Function
;
Plastic Surgery Procedures/methods*
;
Tacrolimus
;
Immunosuppressive Agents

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