Systemic Inflammation and the Breakdown of Intestinal Homeostasis Are Key Events in Chronic Spinal Cord Injury Patients

Our aim was to investigate the subset distribution and function of circulating monocytes, proinflammatory cytokine levels, gut barrier damage, and bacterial translocation in chronic spinal cord injury (SCI) patients. Thus, 56 SCI patients and 28 healthy donors were studied. The levels of circulating CD14^+highCD16⁻, CD14^+highCD16⁺, and CD14^+lowCD16⁺ monocytes, membrane TLR2, TLR4, and TLR9, phagocytic activity, ROS generation, and intracytoplasmic TNF-α, IL-1, IL-6, and IL-10 after lipopolysaccharide (LPS) stimulation were analyzed by polychromatic flow cytometry. Serum TNF-α, IL-1, IL-6 and IL-10 levels were measured by Luminex and LPS-binding protein (LBP), intestinal fatty acid-binding protein (I-FABP) and zonulin by ELISA. SCI patients had normal monocyte counts and subset distribution. CD14^+highCD16⁻ and CD14^+highCD16⁺ monocytes exhibited decreased TLR4, normal TLR2 and increased TLR9 expression. CD14^+highCD16⁻ monocytes had increased LPS-induced TNF-α but normal IL-1, IL-6, and IL-10 production. Monocytes exhibited defective phagocytosis but normal ROS production. Patients had enhanced serum TNF-α and IL-6 levels, normal IL-1 and IL-10 levels, and increased circulating LBP, I-FABP, and zonulin levels. Chronic SCI patients displayed impaired circulating monocyte function. These patients exhibited a systemic proinflammatory state characterized by enhanced serum TNF-α and IL-6 levels. These patients also had increased bacterial translocation and gut barrier damage.     

Botulinum Toxin: From Poison to Possible Treatment for Spasticity in Spinal Cord Injury

Botulism has been known for about three centuries, and since its discovery, botulinum toxin has been considered one of the most powerful toxins. However, throughout the 20th century, several medical applications have been discovered, among which the treatment of spasticity stands out. Botulinum toxin is the only pharmacological treatment recommended for spasticity of strokes and cerebral palsy. Although its use as an adjuvant treatment against spasticity in spinal cord injuries is not even approved, botulinum toxin is being used against such injuries. This article describes the advances that have been made throughout history leading to the therapeutic use of botulinum toxin and, in particular, its application to the treatment of spasticity in spinal cord injury.     

Perceived risk for influenza in veterans with spinal cord injuries and disorders.

Objective: Guided by the extended parallel process model (EPPM), the objective was to assess control processes dominant in influenza behavior decisions. Design: Cross-sectional survey. Results: Response rate was 31% (n=968). Regarding influenza risk, 59% were in danger control. Those in fear control were more likely to report influenza infection (p=.000). In the nonvaccinated, those in fear control were more likely to indicate not knowing where to get the vaccine (p=.016) and that it was unavailable (p=.027), and those in danger control believed they did not need it (p=.023). Zero critical values were more likely to indicate that no health provider recommended the shot (p=.002). Conclusions: Most perceived efficacy to be stronger than threat related to influenza; according to the EPPM, they are aware of their risk but recognize their ability to avert it. For those in danger control, messages should focus on increasing perceptions of severity and susceptibility to positively affect behavior change. For those in fear control, messages should focus on efficacy only. With a critical value of zero, no threat is induced, and a high-threat/high-efficacy approach should be taken. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

éditorial.

This issue begins with an invited paper by Ronald Melzack, continuing the "Distinguished Contribution Series" begun in 1990 by my predecessor, Gordon Winocur. Professor Melzack is known world-wide for his research on pain. In 1965, together with Patrick Wall, he proposed the gate control theory, an entirely new conception of pain. For the first time, there was an explicit physiological model emphasizing the role played by the brain as well as by the spinal cord, leading to a new integration of psychological and physiological contributions to pain, as well as to new avenues for the control of pain. This theory has been highly influential, as a quick look in virtually any textbook in biology or medicine will confirm. Professor Melzack's continuing development of his ideas is presented with remarkable clarity in his books and in his many journal articles. It is, therefore, especially exciting for CJEP to be the first to publish a sketch of his new neuromatrix theory. When the book developing this theory is published, it too will no doubt have an immediate and major impact. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Human-Induced Neural and Mesenchymal Stem Cell Therapy Combined with a Curcumin Nanoconjugate as a Spinal Cord Injury Treatment

We currently lack effective treatments for the devastating loss of neural function associated with spinal cord injury (SCI). In this study, we evaluated a combination therapy comprising human neural stem cells derived from induced pluripotent stem cells (iPSC-NSC), human mesenchymal stem cells (MSC), and a pH-responsive polyacetal–curcumin nanoconjugate (PA-C) that allows the sustained release of curcumin. In vitro analysis demonstrated that PA-C treatment protected iPSC-NSC from oxidative damage in vitro, while MSC co-culture prevented lipopolysaccharide-induced activation of nuclear factor-κB (NF-κB) in iPSC-NSC. Then, we evaluated the combination of PA-C delivery into the intrathecal space in a rat model of contusive SCI with stem cell transplantation. While we failed to observe significant improvements in locomotor function (BBB scale) in treated animals, histological analysis revealed that PA-C-treated or PA-C and iPSC-NSC + MSC-treated animals displayed significantly smaller scars, while PA-C and iPSC-NSC + MSC treatment induced the preservation of β-III Tubulin-positive axons. iPSC-NSC + MSC transplantation fostered the preservation of motoneurons and myelinated tracts, while PA-C treatment polarized microglia into an anti-inflammatory phenotype. Overall, the combination of stem cell transplantation and PA-C treatment confers higher neuroprotective effects compared to individual treatments.     

多尺度特征融合的脊柱X线图像分割方法

为了精确地从X线图像中分割脊柱,提出了一种基于深度学习的脊柱X线图像分割方法,使用基于多尺度特征融合的U-Net网络进行分割。将U-Net模型中的卷积层替换成类Inception网络来提取不同尺度的特征,并进行多尺度融合。同时在跳跃连接前增加残差连接层,并在首次上采样前添加卷积块注意力模块。该模型对20幅脊柱X线图像进行验证,Dice系数为0.845 7,与近期X线脊柱图像分割方法相比,提高了0.135 1。     

Cell Development Enhanced Bionic Silk Hydrogel on Remodeling Immune Pathogenesis of Spinal Cord Injury via M2 Polarization of Microglial

Due to the complex spatial-temporal pathophysiology of spinal cord injury (SCI), effective modulation of SCI-specific inflammatory pathogenesis to achieve desirable therapeutic effects on functional recovery still remains challenging. Herein, cell-enhanced photocrosslinked silk fibroin hydrogels with extracellular matrix-mimicking cues of mechanical properties and RGD (Arg-Gly-Asp) signals are gelled in situ to fill the lesion site to modulate injury-induced neuroinflammation and promote neurite regrowth after SCI. The bionic hydrogel system provides biomimetic mechanical cues to promote neuronal differentiation of neural stem/progenitor cells (NPCs) and neurite growth by activating YAP nuclear expression. Importantly, favored by the strong capacity of silk fibroin hydrogels on macrophage/microglia recruitment, NPCs encapsulated hydrogel (NPCs@SFRGD0.1) effectively promotes recruited macrophages/microglia to M2 polarization in the lesion site by releasing S100A4 and thereby remodels the inflammatory microenvironment after SCI. Moreover, NPCs@SFRGD0.1 successfully reduces glial scar formation and accelerates corticospinal tract axon regrowth to improve locomotor recovery. Overall, this work contributes to illustrating the therapeutic mechanism of NPCs development based biomaterial therapies on modulating inflammatory microenvironment and this NPCs enhanced silk fibroin hydrogel provides a promising therapeutic strategy for SCI.     

起爆索的概念及其特性

本文采用了新的导爆索芯药,得到了一种具有起爆特性的索,称之为起爆索。它能够被常规的电点火头、非电导爆管或延期体点火,并很快形成爆轰输出,对工业炸药实现引爆,因而具备工程雷管的功能。经过对起爆索爆速、殉爆距离、点火感度、起爆能力、轴向威力等的测定,反映出爆速与芯药线密度有关,其殉爆距离是普通导爆索的4倍多,对常规的电、非电导爆管和延期体点火方式则有较好的感度响应,爆速接近5 000 m/s时能够对粉状炸药、乳化炸药或水胶炸药实施引爆,而起爆索的轴向威力只达到2 mm厚铅板炸孔的合格水平。     

Multi-objective analysis for assessing simultaneous changes in regional spinal curvatures under backpack carriage in young adults

Change in sagittal spinal curvature from the neutral upright stance is an important measure of the heaviness and correctness of backpack use. As current recommendations, with respect to spinal profile, of backpack load thresholds were based on the significant curvature change in individual spinal region only, this study investigated the most critical backpack load by assessing simultaneously the spinal curvature changes along the whole spine. A motion analysis system was used to measure the curvature changes in cervical, upper thoracic, lower thoracic and lumbar regions with backpack load at 0, 5, 10, 15 and 20% of body weight. A multi-objective goal programming model was adopted to determine the global critical load of maximum curvature change of the whole spine in accordance with the maximum curvature changes of the four spinal regions. Results suggested that the most critical backpack load was 13% of body weight for healthy male college students.

Practitioner Summary: As current recommendations of backpack load thresholds were based on the significant curvature change in individual spinal region only, this study investigated the backpack load by considering simultaneously the spinal curvature changes along the whole spine. The recommendation, in terms of the global critical load, was 13% of body weight for healthy male college students.     

Three-dimensional spinal motion and risk of low back injury during sheep shearing

Sheep shearers are known to work in sustained flexed postures and have a high prevalence of low back pain (LBP). As sustained posture and spinal movement asymmetry under substantial loads are known risk factors for back injury our aim was to describe the 3D spinal movement of shearers while working. We hypothesised that thoraco-lumbar and lumbo-sacral movement would be tri-axial, asymmetric, and task specific. Sufficient retro-reflective markers were placed on the trunk of 12 shearers to define thoraco-lumbar and lumbo-sacral 3D motion during three tasks. Thoraco-lumbar movement consistently involved flexion, left lateral flexion, and right rotation. Lumbo-sacral movement consistently involved right lateral flexion in flexion with minimal rotation. Shearers therefore work in sustained spinal flexion where concurrent, asymmetric spinal movements into both lateral flexion and rotation occur. These asymmetric movements combined with repetitive loading may be risk factors leading to the high incidence of LBP in this occupational group.