| Background and Objective Spinal cord injury?SCI?is one of the most common clinical diseases,the global incidence of SCI is about 10.4-83/100 million.It shows a character of high incidence,high disability,high consumption and younger age.The current non-surgical treatment of spinal cord injury including braking,traction,drug therapy and hyperbaric oxygen therapy.Due to their own limitations,clinical hyperbaric oxygen and drug applications have many inconveniences and risks.Hydrogen is considered as a novel antioxidant and has protective effects in a variety of disease models.Its mechanism may be related to antioxidant,antiinflammatory,antiapoptotic and cell signaling pathways.The aim of this study is to investigate the protective effect of H2 on spinal cord injury,and conduct clinical trials to observe the clinical effect to provide a basis of H2 of clinical application in the future.Methods 1.high concentration of hydrogen inhalation treatment of spinal cord injury.75 male Sprague-Dawley?SD?rats were randomly divided into three groups:?1?control group: 175 kdynes weight was used to establish SCI model,and then treated with nitrogen and oxygen mixture?66.7%N2-33.3%O2;n=25?;?2?The experimental group: the same degree of SCI after the high concentration of hydrogen treatment?66.7%H2-33.3%O2,n=25?;?3?sham operation group: resection of spinous processes and partial lamina,given nitrogen oxygen mixture treatment?66.7%N2-33.3%O2;n=25?.One hour treatment was followed by breathing every 12 hours for 14 days.Hind limb motor function were observed before operation and at 1,4,7,10 and 14 days after operation.The levels of superoxide dismutase?SOD?and malondialdehyde?MDA?in serum were measured at 6,24,48 and 7,14 days after operation.The levels of serum tumor necrosis factor ??TNF-??and interleukin-1??IL-1??were measured.The morphology of spinal cord was observed by HE staining at 6 hours,7 days and 14 days after operation.Immunohistochemistry was used to observe the expression of glial fibrillary acidic protein?GFAP?and chondroitin sulfate polysaccharides?CSPGs?at 14 days after operation.2.Clinical study on the treatment of spinal cord injury with high concentration of hydrogen inhalation Thirty-six patients undergoing spinal cord injury were randomly divided into control group?18 cases?and experimental group?18 cases?.After admission,the control group was given routine comprehensive rehabilitation treatment,the experimental group increased daily H2 inhalation therapy,once a day for 1 hour each time,the other treatments measures were same to the control group.On the day of admission,2 weeks and 4 weeks,the patient's ASIA sensory and motor scores and daily living activities FIM were evaluated.Results 1.Compared with the control group,the BBB score of the hind limb function in the experimental group was higher than that in the control group.At 6,24 and 48 hours and 7d and 14 day,the SOD level was increased and the MDA level was decreased in serum.The release of TNF-? and IL-1? is reduced.Histological observation found that hydrogen can inhibit the inflammatory response,reduce gray matter and white matter degeneration,reduce neuronal apoptosis,inhibit the expression of GFAP and CSPGs.2.After 4 weeks of treatment,ASIA sensory score in the H2 treatment group increased compared with the control group?P <0.05?.There was no significant difference in motor function score and FIM score between the experimental group and the control group?P> 0.05?.Conclusion 1.High concentration of H2 inhalation has a protective effect on spinal cord injury,which can promote the recovery of neurological function after SCI.It may be related to anti-oxidation,inhibition of inflammatory reaction,inhibition of GFAP and CSPGs expression.It may be a means of treating spinal cord injury.2.High concentration of H2 in the treatment of spinal cord injury is safe and convenient,it can improve the patient's ASIA sensory score,but its effectiveness still needs further observation. |
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