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transplantation and genetic enhancement of intrinsic growth capacities to promote CNS axon regeneration after spinalcord injury

Bin Yu, Xiaosong Gu

《医学前沿（英文）》 2019年第13卷第2期页码 131-137 doi: 10.1007/s11684-018-0642-z

摘要： The inhibitory environment that surrounds the lesion site and the lack of intrinsic regenerative capacity of the adult mammalian central nervous system (CNS) impede the regrowth of injured axons and thereby the reestablishment of neural circuits required for functional recovery after spinal cord injuries (SCI). To circumvent these barriers, biomaterial scaffolds are applied to bridge the lesion gaps for the regrowing axons to follow, and, often by combining stem cell transplantation, to enable the local environment in the growth-supportive direction. Manipulations, such as the modulation of PTEN/mTOR pathways, can also enhance intrinsic CNS axon regrowth after injury. Given the complex pathophysiology of SCI, combining biomaterial scaffolds and genetic manipulation may provide synergistic effects and promote maximal axonal regrowth. Future directions will primarily focus on the translatability of these approaches and promote therapeutic avenues toward the functional rehabilitation of patients with SCIs.

关键词： spinal cord injury biomaterial extrinsic barrier intrinsic regeneration capacity

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脊髓损伤后基因表达和分子调控的系统研究

苏国辉

《工程（英文）》 2020年第6卷第4期页码 389-390 doi: 10.1016/j.eng.2019.12.017

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Anterior cervical surgery methods for central cord syndrome without radiographic spinal fracture-dislocation

Chengwei JING, Qin FU, Xiaojun XU

《医学前沿（英文）》 2009年第3卷第1期页码 45-48 doi: 10.1007/s11684-009-0019-4

摘要： This study was aimed to explore the anterior cervical surgery methods to treat central cord syndrome without radiographic spinal fracture-dislocation (CCSWORFD), retrospectively analyze the cases of CCSWORFD, and evaluate the curative effect of anterior cervical surgery methods for CCSWORFD. Twenty four cases of CCSWORFD (19 males and 5 females), all suffering from cervical hyperextension injury, between 45-68 (average 59) years old, were operated on by anterior cervical surgery methods. Among these, 18 cases had been followed up for 6-24 (average 15) months; 18 cases, who had anterior decompression and plate fixation with titanium mesh bone grafting or iliac bone grafting achieved reliable effects based on the Japanese Orthopedics Association (JOA) evaluation (improved scores of cases with titanium mesh bone grafting, = 2.800, <0.05; improved scores of cases with iliac bone grafting, = 3.270, <0.05), and reliable reconstruction of cervical spine. The two groups obtained the same curative effect ( = 0.470, >0.05) Most of these cases had degeneration of cervical vertebra. The decompression which relieves the oppression to the spinal cord can help lessen edema of the spinal cord, and early fixation for stability of cervical vertebra is better for the recovery of spinal cord injury. Anterior operation with titanium mesh bone grafting or iliac bone grafting are both reliable curative methods for CCSWORFD, and titanium mesh bone grafting can avoid the trauma of the supplying graft. Mesh bone grafting can also shorten hospital stay.

关键词： central cord syndrome decompression surgical titanium mesh

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Primary spinal epidural non-Hodgkin’s lymphoma presented with spinal cord compression syndrome

Chunquan CAI MD, PhD, Qingjiang ZHANG BM, Changhong SHEN MD, PhD,

《医学前沿（英文）》 2009年第3卷第4期页码 499-502 doi: 10.1007/s11684-009-0075-9

摘要： The spinal epidural space is an uncommon presenting site in primary non-Hodgkin’s lymphomas, especially for children. A boy suffered spinal cord compression syndrome caused by primary spinal epidural non-Hodgkin’s lymphoma. Thoracolumbar magnetic resonance imaging (MRI) demonstrated an intraspinal mass. An operation was performed with gross total tumor removal. Histological examination revealed a non-Hodgkin’s B-cell lymphoma. Bone marrow aspiration was negative for lymphoma involvement. No other therapies (chemotherapy and/or radiotherapy) were performed according to the parents’ opinion. The patient died approximately one year after the operation due to brain metastases. The clinical course and imaging features were discussed with a review of literatures.

关键词： non-Hodgkin’ s lymphoma primary spinal cord compression syndrome epidural space

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成年哺乳类神经发生在脊髓损伤修复方面的研究进展

杨朝阳, 赵文, 高钰丹, 段红梅, 郝鹏, 郝飞, 李晓光

《工程（英文）》 2021年第7卷第12期页码 1713-1714 doi: 10.1016/j.eng.2021.09.009

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Developmental expression of CAPON and Dexras1 in spinal cord of rats

LI Xin, CHENG Chun, CHEN Mengling, GAO Shangfeng, ZHAO Jian, NIU Shuqiong, SHEN Aiguo

《医学前沿（英文）》 2008年第2卷第1期页码 75-81 doi: 10.1007/s11684-008-0014-1

摘要： To study the expression of the carboxy-terminal PSD-95/DLG/ZO-1 ligand of nNOS (CAPON) and Dexras1 mRNA during development in the spinal cord of rats, real-time polymerase chain reaction (Real-time PCR), as a quantitative method, was used to study the developmental expression of CAPON and Dexras1 mRNA level in the spinal cord. The spatial expression of CAPON and Dexras1 mRNA was examined by a combination of hybridization (ISH) and immunofluorescence. During the development of the spinal cord, CAPON mRNA was expressed in low levels from embryo day 14 to day 18. At postnatal day 1, it reached the peak and was expressed in the part which will become the dorsal horn when mature. It then decreased gradually until postnatal week 12, when it presented in the ventral horn. At embryo day 14, Dexras1 mRNA was expressed at low levels, increased during embryo day 16 to day 18 and peaked at postnatal day 1. Spatiotemporal expression of Dexras1 mRNA was similar to CAPON as confirmed by correlation analysis and colocalization. CAPON and neuronal nitric oxide synthase (nNOS) was expressed within the same cells of the dorsal horn at postnatal day 1 but had different subcellular localizations. Co-expression of CAPON and Dexras1 mRNA in myeloid tissue during development process of rat indicates that the adaptor protein, CAPON may play a probable role in differentiation of neurons, synaptic plasticity and synaptogenesis by regulating nNOS to activate Dexras1.

关键词： CAPON ISH differentiation postnatal different subcellular

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大鼠脊髓发育过程中时序转录组的发育时间模式和分子网络特征 Article

杨建, 赵莉莉, 易晟, 丁斐, 杨宇民, 刘炎, 王勇军, 刘梅, 薛成斌, 许莲, 龚蕾蕾, 王星辉, 张愉, 于彬, 明国丽, 顾晓松

《工程（英文）》 2021年第7卷第11期页码 1592-1602 doi: 10.1016/j.eng.2021.10.001

摘要：

目前对胎盘哺乳动物脊髓发育的分子网络特征我们知之甚少。这些特征对深入理解与再生相关的重要生物过程和组织工程研究非常必要。现在，借助于从胚胎期到成年期大鼠脊髓的大规模时序转录组分析取得了一些新的进展。研究发现发育早期波动的RNA表达水平反映了脊髓活跃的转录调控并可能启动了脊髓的早期模式发育。脊髓发育过程中由microRNA (miRNA)和转录因子（TF）构成的宏观调控网络在新生期前后存在切换现象（即“镶嵌模型”）。差异可变剪接事件提示了可变剪接可能是郎飞结发育的驱动力之一。我们的研究也支持了脊髓中先天免疫的发育与其内在生长能力之间存在负相关性。发育过程中的一些表观遗传学修饰很可能在不同发育阶段发挥各自的调控功能。G蛋白偶联受体（包括嗅觉受体）可能在发育的轴突生长中发挥多效性作用。该研究为脊髓发育领域提供了有价值的资源，并与越来越多的单细胞数据形成互补，也为开发新的脊髓损伤组织工程策略提供了组学基础。

关键词：发育基因表达模式先天免疫脊髓转录组

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Advances in tissue state recognition in spinal surgery: a review

Hao Qu, Yu Zhao

《医学前沿（英文）》 2021年第15卷第4期页码 575-584 doi: 10.1007/s11684-020-0816-3

摘要： Spinal disease is an important cause of cervical discomfort, low back pain, radiating pain in the limbs, and neurogenic intermittent claudication, and its incidence is increasing annually. From the etiological viewpoint, these symptoms are directly caused by the compression of the spinal cord, nerve roots, and blood vessels and are most effectively treated with surgery. Spinal surgeries are primarily performed using two different techniques: spinal canal decompression and internal fixation. In the past, tactile sensation was the primary method used by surgeons to understand the state of the tissue within the operating area. However, this method has several disadvantages because of its subjectivity. Therefore, it has become the focus of spinal surgery research so as to strengthen the objectivity of tissue state recognition, improve the accuracy of safe area location, and avoid surgical injury to tissues. Aside from traditional imaging methods, surgical sensing techniques based on force, bioelectrical impedance, and other methods have been gradually developed and tested in the clinical setting. This article reviews the progress of different tissue state recognition methods in spinal surgery and summarizes their advantages and disadvantages.

关键词： spinal surgery tissue state recognition image force sensing bioelectrical impedance

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Implantation of human umbilical cord mesenchymal stem cells for ischemic stroke: perspectives and challenges

null

《医学前沿（英文）》 2015年第9卷第1期页码 20-29 doi: 10.1007/s11684-014-0371-x

摘要：

Ischemic stroke is a focal cerebral insult that often leads to many adverse neurological complications severely affecting the quality of life. The prevalence of stroke is increasing throughout the world, while the efficacy of current pharmacological therapies remains unclear. As a neuroregenerative therapy, the implantation of human umbilical cord mesenchymal stem cells (hUC-MSCs) has shown great possibility to restore function after stroke. This review article provides an update role of hUC-MSCs implantation in the treatment of ischemic stroke. With the unique “immunosuppressive and immunoprivilege” property, hUC-MSCs are advised to be an important candidate for allogeneic cell treatment. Nevertheless, most of the treatments are still at primary stage and not clinically feasible at the current time. Several uncertain problems, such as culture conditions, allograft rejection, and potential tumorigenicity, are the choke points in this cellular therapy. More preclinical researches and clinical studies are needed before hUC-MSCs implantation can be used as a routinely applied clinical therapy.

关键词： cellular therapy transplantation human umbilical cord mesenchymal stem cells ischemic stroke

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第十四届全国脊柱脊髓学术大会 The 14th Congress of Chinese Association of Spinal Cord

会议日期： 2019年08月30日

会议地点：中国/湖北/武汉

主办单位：中国康复医学会

Umbilical cord-derived mesenchymal stem cells: strategies, challenges, and potential for cutaneous regeneration

null

《医学前沿（英文）》 2012年第6卷第1期页码 41-47 doi: 10.1007/s11684-012-0175-9

摘要：

Umbilical cord mesenchymal stem cells (MSCs) are a unique, accessible, and non-controversial source of early stem cells that can be readily manipulated. As the most common pluripotent cell, bone marrow-derived MSCs display limitations with the progress of stem cell therapy. By contrast, umbilical cord-derived cells, which have plentiful resources, are more accessible. However, several uncertain aspects, such as the effect of donor selection or culture conditions, long-term therapeutic effects, product consistency, and potential tumorigenicity, are the bottleneck in this clinical therapy. MSCs are predicted to undergo an unprecedented development in clinical treatment when a generally acknowledged criterion emerges. In the current paper, we highlight the application of umbilical cord-derived MSCs in skin therapies based on our previous studies, as well as the achievements of our peers in this field. This paper focuses on the strategies, challenges, and potential of this novel therapy.

关键词： umbilical cord mesenchymal stem cells cutaneous regeneration

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Bile duct injury repair — earlier is not better

null

《医学前沿（英文）》 2015年第9卷第4期页码 508-511 doi: 10.1007/s11684-015-0418-7

摘要：

Bile duct injury is a common complication of cholecystectomy. The timing of bile duct injury repair remains controversial. A recent review conducted in France reported 39% complications and 64% failure after immediate repair in 194 patients compared with 14% complications and 8% failure after late repair in 133 patients. A national review of 139 consecutive early repairs conducted at five hepatopancreaticobiliary centers in Denmark reported 4% mortality, 36% morbidity, and 42 restrictures (30%) at a median follow-up of 102 months, and only 64 patients (46%) demonstrated uneventful short-term and long-term outcomes. Most patients with bile duct injury present with bile leak and sepsis; thus, early repair is not recommended. Percutaneous drainage of bile and endoscopic stenting are the mainstays of treatment of bile leak because they convert acute bile duct injury into a controlled external biliary fistula. The ensuing benign biliary stricture should be repaired by a biliary surgeon after a delay of 4–6 weeks once the external biliary fistula has closed.

关键词： bile duct injury cholecystectomy laparoscopic cholecystectomy

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Loss of monocarboxylate transporter 1 aggravates white matter injury after experimental subarachnoid

《医学前沿（英文）》 2021年第15卷第6期页码 887-902 doi: 10.1007/s11684-021-0879-9

摘要： Monocarboxylic acid transporter 1 (MCT1) maintains axonal function by transferring lactic acid from oligodendrocytes to axons. Subarachnoid hemorrhage (SAH) induces white matter injury, but the involvement of MCT1 is unclear. In this study, the SAH model of adult male Sprague-Dawley rats was used to explore the role of MCT1 in white matter injury after SAH. At 48 h after SAH, oligodendrocyte MCT1 was significantly reduced, and the exogenous overexpression of MCT1 significantly improved white matter integrity and long-term cognitive function. Motor training after SAH significantly increased the number of ITPR2⁺SOX10⁺ oligodendrocytes and upregulated the level of MCT1, which was positively correlated with the behavioral ability of rats. In addition, miR-29b and miR-124 levels were significantly increased in SAH rats compared with non-SAH rats. Further intervention experiments showed that miR-29b and miR-124 could negatively regulate the level of MCT1. This study confirmed that the loss of MCT1 may be one of the mechanisms of white matter damage after SAH and may be caused by the negative regulation of miR-29b and miR-124. MCT1 may be involved in the neurological improvement of rehabilitation training after SAH.

关键词： microRNAs monocarboxylate transporter 1 motor training subarachnoid hemorrhage white matter injury

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Risk factors of prognosis after acute kidney injury in hospitalized patients

null

《医学前沿（英文）》 2017年第11卷第3期页码 393-402 doi: 10.1007/s11684-017-0532-9

摘要：

The risk factors, especially laboratory indicators, of prognosis after acute kidney injury (AKI) remain unclear. We conducted a retrospective survey of Chinese People’s Liberation Army General Hospital from January 1, 2012 to December 31, 2012 according to the AKI diagnosis standard issued by Kidney Disease Improving Global Outcomes. The epidemiological features and factors influencing hospital mortality and renal function recovery were evaluated through logistic regression analysis. Among 77 662 cases of hospitalized patients, 1387 suffered from AKI. The incidence rate and mortality of AKI were 1.79% and 14.56%, respectively. Multivariate logistic regression analysis revealed that high AKI stage, age greater than 80 years, neoplastic disease, low cardiac output, increased white blood cell count, and decreased platelet count and serum albumin levels were the risk factors affecting the mortality of AKI patients. Conversely, body mass index between 28 and 34.9 was a protective factor. Increased AKI stage, tumor disease, post-cardiopulmonary resuscitation, and RRT were the risk factors of renal function recovery upon discharge. In addition to traditional risk factors, white blood cell count, platelet count, albumin, and BMI were the predictors of the mortality of AKI patients. No laboratory indicators were found to be the risk factors of renal function recovery in AKI patients.

关键词： acute kidney injury risk factors prognosis

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Capacity of human umbilical cord-derived mesenchymal stem cells to differentiate into sweat gland-like

null

《医学前沿（英文）》 2013年第7卷第3期页码 345-353 doi: 10.1007/s11684-013-0282-2

摘要：

Human umbilical cord-derived mesenchymal stem cells (hUC-MSCs) possess various advantageous properties, including self-renewal, extended proliferation potential, multi-lineage differentiation potential and capacity for differentiating into sweat gland-like cells in certain conditions. However, little is known about the effect of clinical-grade culture conditions on these properties and on the differentiative potential of hUC-MSCs. In this study, we sought to investigate the properties of hUC-MSCs expanded with animal serum free culture media (ASFCM) in order to determine their potential for differentiation into sweat gland-like cells. We found that primary cultures of hUC-MSCs could be established with ASFCM. Moreover, cells cultured in ASFCM showed vigorous proliferation comparable to those of cells grown in classical culture conditions containing fetal bovine serum (FBS). Morphology of hUC-MSCs cultured in ASFCM was comparable to those of cells grown under classical culture conditions, and hUC-MSCs grown in both of the two culture conditions tested showed the typical antigen profile of MSCs—positive for CD29, CD44, CD90, and CD105, and negative for CD34 and CD45, as expected. Chromosomal aberration assay revealed that the cells were stable after long-term culture under both culture conditions. Like normal cultured MSCs, hUC-MSCs induced under ASFCM conditions exhibited expression of the same markers (CEA, CK14 and CK19) and developmental genes (EDA and EDAR) that are characteristic of normal sweat gland cells. Taken together, our findings indicate that the classical culture medium used to differentiate hUC-MSCs into sweat gland-like cells can be replaced safely by ASFCM for clinical purposes.

关键词： umbilical cord mesenchymal stem cells sweat gland preclinical