| Objective SCI is not only a threat to human health, but also brings heavy burden for family and society. The main therapies for SCI are surgery, drugs, rehabilitation training and so on, but their effects are limited currently . In recent years, stem cells therapy for SCI brings a light for SCI and it attracts more attention. Some studies have indicated that MSCs have a therapeutic effect on neurological deficit caused by SCI, meanwhile autologous MSCs without immunity rejection and ethic problem are more available therefore, it has become a focused research field. However, adequate clinical data of its effects are still lack.In this study we first report the autologous marrow mesenchymal stem cells transplantation through root artery and subarachnoid spaceto treat patients with SCI, and through observation we investigate the short-term curative effect and the safety of the two therapies.METHODS 26 SCI patients were enrolled in this study. They were diagnosed by CT or MRI and received surgical or conservative treatment, caused by violence, within 1-month to 2-year of SCI onset, age between 15 years to 60 years, with no coma or other complications, being able to get at least 1-month of standard rehabilitation, and were informed and had signed the informed consent document. Among the 26 enrolled patients, 16 received the stem cells transplantation as well as standard rehabilitation training (8 cases are the transplantation group through abbreviated as subarachnoid space group; another 8 are the transplantation group through root artery abbreviated as root artery group), and 10 patients were control group with standard rehabilitation therapy. The duration of standard rehabilitation treatment for all the enrolled patients was one month. Sensory and motor function assessments adopted the American Spinal Injury Association (ASIA) classification and degree of SCI were evaluated by International Standards for Neurological Classification of Spinal Cord Injury (Sixth Edition, 2006). There were no differences of age, duration of disease, degree of injury between the two groups (p>0.05). Both subarachnoid space group and root artery group were given autologous marrow mesenchymal stem cells transplantation therapy on the basis of comprehensive rehabilitation treatment. The autologous marrow was collected from iliac bone marrow puncture and injected through subarachnoid space and root artery after separation and extraction. The control group was given only conventional rehabilitation treatment. Both groups were received assessment of motor and sensory function and assessment of activities of daily living (ADL) on admission and one month after transplantation respectively; the control group received those assessments on admission and one month after rehabilitation treatment. The study was evaluated independently by two professional doctors who were not involved in the treatment.RESULTS 1)Change of neurological function scores: compared with admission,the root artery group had improvement in superficial, deep sensory and motor function scores in one month after transplantation, and there was a significant difference(p<0.01); The subarachnoid space group only had improvement in motor function scores, and there was a significant difference(p<0.01); The control group had improvement in superficial sensory function scores in one month after treatment, and there was a significant difference(p<0.05).2) Activities of daily living (ADL) score: The ADL scores of stem cells therapy group were all improved between on admission and one month after transplantation , and there was a significant difference (p<0.05); The ADL scores of control group had no significant difference (P>0.05).3) Comparisons on effect of different therapies: one month after treatment , to compare the different effects of subarachnoid space group, root artery group and control group, scores of superficial and deep sensory as well as motor functions patients in subarachnoid space group and root artery group looked like a better results than that of control group, but no significant difference (P>0.05); on ADL scores, patients in the three groups were nearly the same, and there was no significant difference (P>0.05); Compared between the two transplantation groups, patients had no significant difference on scores of superficial and deep sensory as well as motor functions(P>0.05).4) The adverse effects of stem cells transplantation: 1 patient got fever after transplantation through subarachnoid space, and the cause was unclear. The symptom relieved after giving intramuscular dexamethasone and there was no recurrence. No adverse effect was found in root artery group.CONCLUSION Using autologous MSCs transplantation through subarachnoid space and root artery to treat patients with SCI which was first reported, one month after operation the superficial and deep sensory, motor function as well as ADL scores of patients were improved, and there is no serious side effect. Autologous marrow stem cells transplantation has some short-term clinical effects for patients with SCI, and can be easily operated, it is safe and feasible, however, large sample, double-blind, multi-center clinical trials are further needed for evidence based medicine . Objective To explore the efficacy and clinical problems of autologous transplantation of marrow mesenchymal stem cells (MSCs) for treating patients with cranial nerve damage.METHODS 2 patients with cranial nerve damage treated by autologous transplantation of marrow mesenchymal stem cells were enrolled, who was volunteered and had signed the informed consent document. One was suffering from cerebral infarction,and the other was brainstem contusion and laceration. At first, extract autologous marrow cells suspension, and after isolation, make it as MSCs suspension; inject it into subarachnoid space through L4-5. The rest isolated blood was transfused back to patients through vein immediately. After operation, patients received conventional rehabilitation treatment. The grade of muscle strength was evaluated by MMT, ADL was assessed by Barthel, and hemiparalysis grade was evaluated by standard Brunnstrom stage.RESULTS The patient with cerebral infarction (case one) had no apparent change in functional evaluation one month after transplanting autologous MSCs. At the same time, one month after transplanting autologous MSCs the ADL score of the patient with brainstem contusion and laceration (case two) raised 10 points and Brunnstrom stage of right lower extremity raised 1 grade; in 3 month after operation, his ADL score raised 15 points, the muscle strength of right upper extremity increased 1 grade, and Brunnstrom stage of right upper extremity also raised 1 grade.CONCLUSION Autologous transplantation of marrow mesenchymal stem cells could be an effective method to treat patients with cranial nerve damage. The manual muscle, scores of ADL and Brunnstrom stage of the patient in case two of this report were equally improved, but it still needs to be identified whether the functional improvement was actually gotten from the stem cells therapy. Further studies are needed to explore the timing, paths, individual differences, clinical effects and so on of MSCs transplantation.
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