| BackgroundSpinal cord injury is(English name for spinal cord injury, commonly abbreviated as SCI) by a variety of pathogenic factors in spinal cord tissue damaged, mainly in physical damage in a flat feeling, limited motion or total dysfunction as its clinical presentation, and along with the size of incontinence. It belongs to the category of central nervous system damage. Composition of spinal cord injury for a variety of reasons: clinical mainly associated virus infection, sepsis in invasion and spinal cord and spinal cord tissue of benign and malignant lesions, other systems in the body lesions in spinal cord tissue hypoxia or ischemia internal environment disorder. However, the most common cause of acute injury in the spinal cord is the most common cause of spinal cord injury. In anatomy, spinal cord tissue located in the rugged bony tissue and tough and close connection of the connective tissue layer upon layer bag around, and in parts of the central axis of the trunk, alter ego is subjected to external forces directly. Only the higher energy of the external violence, through the destruction of the spinal cord tissue around the bone structure or tough ligament tissue, it may cause the spinal cord tissue itself is an effective blow. In recent years, with the rapid development of the transportation industry, and led to the real estate industry, the construction industry made great progress, coupled with the driving safety, safety in production safety consciousness and profound changes in the economic and social growth of acute traumatic spinal cord injury patients provided for a hotbed. In the past, it was thought that no matter what causes of spinal cord injury, the process are not reversible, that spinal cord tissue is very difficult to restore to the state before the injury, which resulted in the prognosis of pain in patients with spinal cord injury.It has both direct disability and lethality of indirect, lack of the most basic quality of life, but also to a significant drag patients family, resulting in synchronised decline in the quality of life of family members, compared with other wound, will be doubled from the consumption of social resources. Indeed, after the development of modern medicine for more than one hundred years, for spinal cord injury, especially for traumatic spinal cord injury, it has been the emergence of a variety of treatment technology, but the intervention has always lagged behind, in clinical practice, for the diagnosis of spinal cord injury, in addition to the subjectivity of the physical examination to extreme dependence of image, especially the magnetic resonance, the application of neurophysiological, human first can learned in preoperative patients with spinal cord injury. The ancients cloud: cheyousuoduan, cunyousuochang, magnetic resonance imaging and electrophysiological examination has great limitations, time-consuming, high cost and need to patients with a higher coordination. In the center of the hospital to carry out this check, most institutions do not 24 hours patients, they are not objective and effective identification of spinal cord injury can only range survey and so on. Modern and mature treatment methods require us to carry out early internal and external intervention. This requires us to have a convenient and accurate laboratory objective indicators for the identification of acute traumatic spinal cord injury.The regeneration of spinal cord tissue has been the frontier of trauma surgery. In the study of spinal cord regeneration, there are many studies on the molecular mechanisms of spinal cord injury and repair, especially for the two spinal cord injury. MicroRNAs(English name for the Micro-ribonucleic-acid(micro RNA(miRNA) is a class about by 21- 25 nucleotide composition of the endogenous expression of single chain of non coding small RNA by inhibition of target messenger RNA(English name for the Messenger-ribonucleic-acid, generally referred to as mRNA translation or cause the degradation of gene expression regulation. Among the numerous related molecules, microRNA-124 is expressed in the central nervous system, which is a key part in the interpretation of spinal cord injury and its repair process in a large number of animal experiments.ObjectiveThe purpose of this study was to investigate the clinical data of patients with acute traumatic spinal cord injury and related molecules in peripheral blood, and to explore the application of RNA-124 in the diagnosis and treatment of acute traumatic spinal cord injury.MethodA total of 45 patients with acute spinal fractures and complete data were selected from the First Affiliated Hospital of Zhengzhou University from September 2014 to September 2015. These patients were divided into three groups: spinal cord complete injury group(AIS grade A) 15 cases, incomplete spinal cord injury group(AIS grading B, C, d) in 15 patients and neurologically normal group(AIS Grade E) in 15 cases, in accordance with the international standards for neurological classification of American Spinal Injury association with spinal cord injury will impairment scale(AIS grading).Another 15 cases of acute limb fracture in the same period were selected as control group. Patients with peripheral blood is extracted in 24 hours after the trauma occurred, and the plasma miRNA-124 level and serum TNF-alpha level were measured.Statistical data were analyzed by SPSS 21 software, and the continuous variables were tested for normality. Those who meet the measurement data of normal distribution with mean standard deviation(x s) said, the qualitative data among multiple groups were compared using ?2 test. The quantitative data among multiple groups of compared with single factor variance analysis. peripheral blood of miR-124 and TNF alpha two indexes plotted on receiver operating characteristic curve(ROC), and calculate the area under the curve(AUC); P < 0. 05 for statistical significance.Results1 clinical dataThere were no significant differences in age, sex, height, weight and other aspects of the patients in each group(both P > 0.05).2 the expression level of miR-124 in peripheral blood of each groupComplete injury group, injury group and normal nerve function group, limbs fracture patients with peripheral blood miR-124 expression levels were(0.48 0.06),(0.47 0.07),(0.39 0.07),(0.34 0.04), the differences among the groups have statistical significance(F=27.28, P < 0.01). In multiple comparisons, there was no significant difference in the total injury group, the normal group, the normal group and the limbs fracture group(both P > 0.05). The miR-124 expression level of complete injury group and incomplete injury group were higher than those in the other two groups(all P<0.05).3 The expression level of TNF- in peripheral blood of 3 groups outside.Complete injury group, injury group and normal nerve function group, limbs fracture patients with peripheral blood TNF alpha expression levels were(197 0.22) ng ml-1,(1.85 0.43) ng ml-1,(1.78 0.21) ng?ml-1,(1.69 0.19) ng?ml-1. The differences between the groups were statistically significant(F=3.51, P<0.05). In multiple comparisons, there was no significant difference in the total injury group, the normal group, the normal group and the limbs fracture group(both P > 0.05). The expression level of complete injury group, incomplete injury group TNF- alpha were higher than those of the other two groups(P<0.05).4 ROC analysis of 4 peripheral blood miR-124 and TNF- levels.The ROC curve of outside week blood miR-124 and TNF alpha levels in diagnosis of spinal cord injury area were 0.894(95% CI:0.828- 0.961,P < 0.01)and 0.758(95% CI:0.651-0.865,P < 0.01). Peripheral blood of miR-124 and TNF alpha levels can guide the diagnosis of spinal cord injury and miR-124 compared with TNF alpha has greater value in clinic.ConclusionThe present study showed that miRNA-124 was highly expressed in peripheral blood of patients with acute spinal cord injury, and had a certain value in early diagnosis of acute spinal cord injury.We hope to collect more basic clinical data and information on the postoperative patients were transferred out of track, especially to be prospective experimental design, in order to further explore the diagnosis means in the diagnosis of spinal fracture with spinal cord injury value.. |
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