| Background:Spinal Cord Injury (SCI) is a severe injury of the cerebrospinal nervous system. There isusually severe damage and loss of nervous functions after SCI. Besides, the dyskinesia is themost main reason which causes loss of self-help ability in the life time of patients. It is a focusconcerned by both patients and doctors to restore the movement function. What’s more, thepractice of the movement function is an important method for restoration of movementfunctions for patients with clinical spinal cord injury. Existing research shows that clinicalearly and constant nursing intervention of the movement function after SCI may promote partrestoration of the movement function. But the mechanism is still not clear to us. It needs morefoundational research for support. Therefore, this research intervenes the movement functionof rat after SCI. Methods such as Basso, Beattie and Bresnahan score (BBB Score), Inclined-plane score, myoelectricity response and wet muscle weight test, regular Hematoxiline-eosin(HE) staining, Immunohistochemistry (IHC) staining method etc. are used in this research toassess the movement function change of two hind legs, myoelectricity response ofgastrocnemius muscle and wet muscle weight change of rat with SCI after nursingintervention. The optical microscope is used to observe the morphological change of injuredspinal cord section to find effects and strong supporting evidence for roles of nursingintervention in function restoration of injured spinal cord.Objective:Observe the restoration degree and change of movement function of rat with SCI afternursing intervention to discuss the role of nursing intervention in function restoration ofinjured spinal cord and provide evidence and basis for clinical nursing.Materials and methods:1. Grouping: randomly group60SD adult rat (about250g, sex unlimited) into threeexperimental groups of A for normal comparison, B for experimental comparison and C for experiment (n=20for each group). Group B and C are divided as four time phase points1day,7days,30days and60days after SCI (n=5for each time phase point).2. Methods:2.1Preparation of animal models: Model for animals of SCI in Group B and C isprepared by cutting and extruding the L4plane of cross spinal cord section.2.2Measures of nursing intervention: No treatment is carried out for rat of Group A.Regular nursing is carried out for rat of Group B after SCI. Nursing intervention is carried outfor rat of Group C after SCI. Both Group B and C are injected with200thousand U ofpenicillin sodium in enterocoelia once a day1day after SCI, and are injected for continuousthree days to prevent infection. Regular nursing like assisting the rat in urination, cacation etc.is carried out twice a day; besides regular intervention, passive movement practices such asbladder and abdomen massage, joint motion range practice, muscle massage practice etc. arecarried out for Group C. The nursing intervention for all groups is carried out immediatelyafter injury. It shall be carried out twice a day and for10min for each rat at each time.Specific passive movement practices of hind legs of rat include passive flexion and extensionhip, knee and passive dorsiflexion and flexion practice of ankle to maintain and improve themotion degree of joints; practices on muscle compression mainly include central and annularalternative massage of muscle groups in feet, calves, thighs to decrease edema and promoteblood circulation of hind legs.2.3BBB score and Inclined-plane score: the movement function of hind legs of eachgroup is scored with the BBB score and inclined-plane score at four same time phase points1day,7days,30days and60days respectively after SCI to assess the behavioral change of ratwith SCI after nursing intervention.2.4Myoelectricity response and wet muscle weight test: this test is carried out toobserve the myoelectricity response and wet gastrocnemius muscle weight change of rat1day,7days,30days and60days after SCI and compare the denervation gastrocnemius muscleatrophy of rat with SCI after nursing intervention.2.5Regular HE staining: histology biopsy HE staining is carried out to observe thetissue repair situation of injured spinal cord of each group at each corresponding time phasepoint. 2.6Immunohistochemistry method: this method is applied to display changes of NF-200(Neurofilament-200) and GFAP (Glial fibrillary acidic protein) of each group at eachtime phase point to observe the positive immunoreaction change of NF-200for central neureand GFAP for neurogliocyte of each group at each time phase point.Main results:Part I: Ethology effects of nursing intervention on movement function restorationof rat after SCI.1. The result of BBB score is basically in line with that of the Inclined-plane score. Atthe time phase point1day and7days after SCI, there is no apparent difference in results ofBBB score and Inclined-plane score for the experimental group and the experimentalcomparison group after nursing intervention (P＞0.05); at the time phase point30days and60days after SCI, that of the experimental group is higher than the experimental comparisongroup (P<0.05). The hind leg function of rat in the experimental group is improved apparently.However, the scores for both the experimental group and experimental comparison group arelower than the normal comparison group and fail to reach the normal level.2. The myoelectricity response result of gastrocnemius muscle shows that fibrillationpotential appears in both the experimental group and experimental comparison group at thetime phase points30days and60days after SCI, and fibrillation potential amplitude ofgastrocnemius muscle of the experimental group is higher than the experimental comparisongroup (P<0.05). It is of statistical significance.3. Wet muscle weight result of gastrocnemius muscle shows that the wet weight ofgastrocnemius muscle of both the experimental group and experimental comparison group isapparently lower than the normal comparison group (P<0.01). Comparing the experimentalgroup with the experimental comparison group, the wet weight decreasing of the experimentalgroup is lower than the experimental comparison group (P<0.05). It is of statisticalsignificance. Part II: Morphology effects of nursing intervention on movement functionrestoration of rat after SCI1. HE staining resultsOne day after SCI, bleeding and light inflammatory response appear in the injured spinalcord area of both the experimental group and experimental comparison group in HE staining;fragment of tissue might be found in injured lacuna;7days after SCI, the spinal cord tissuestructure in the injured area is in disorder, large amount of inflammatory cells infiltrate, theinflammatory reaction is intensified; various hyperplastic cells and blood capillary might beseen; neure swelling and necrosis, protuberance disappear;30days after SCI, theinflammatory reaction in both the experimental group and experimental comparison group isrelieved or disappeared, cysts cavity change or bow cavity appears. The hyperplasia is veryapparent in tissue filling; proliferating cells present a cluster form of certain direction. Largeamount of hyperplastic blood capillary can be seen in hyperplastic tissue;60days after SCI,the spinal cord tissue at the injured part is improved. There is no apparent difference betweenthe experimental group and experimental comparison group. It can be seen that the cavity issurrounded by compact tissue centering the injured area. The tissue cells are arrangedregularly. Its direction is basically in line with the vertical axis of the spinal cord.2. Immunohistochemistry staining result2.1It is shown in the GFAP IHC staining result that the GFAP positive responding cellsand fibers are clear and small in the spinal gray matter of the normal comparison group. Thereare dense positive cells and fibers of GFAP immunoreactions in spinal white matter. It can beseen that positive cells of GFAP immunoreactions have apparent star shaped protuberanceand usually present in irregular polygon. In the experimental group and experimentalcomparison group, positive cells of GFAP immunoreactions increase as time goes by. Thereis no apparent different in positive GFAP immunoreactions at the same time phase point. Oneday after SCI, the tissue structures of injured spinal area of the experimental group and theexperimental comparison group are in disorder. Scattered positive cells and fibers of GFAPimmunoreactions can be seen. Positive cells and fibers of GFAP immunoreactions might beseen in tissue fragment of injured lacuna. Seven days after SCI, scattered positive cells andfibers of light staining of GFAP immunoreactions can be seen in injured area of theexperimental group and experimental comparison group. There are large amount of inflammatory cell infiltration. Thirty days after SCI, positive GFAP immunoreactions oftissue in injured area of the experimental group and experimental comparison group is creasedthan7days after SCI. Positive cellular expression and fiber expression of GFAPimmunoreactions is increased. Besides, positive fiber of GFAP immunoreactions interweavesinto a net. Sixty days after SCI, disorder tissue structure in injured spinal cord of theexperimental group and experimental comparison group is improved. The injured area isfilled by tissues. Positive cells and fibers of GFAP immunoreactions in the hyperplasia areaare increased apparently. The staining is deepened and present into sepia and form glial scar.There is no apparent different between the experimental group and experimental comparisongroup.2.2It is shown in the NF-200IHC staining result that the positive fiber of NF-200immunoreactions of both the experimental group and experimental comparison group firstlydecreases and them increases as time goes by; one day after SCI, positive cells and fibers ofNF-200immunoreactions can be seen in tissue blocks of injured spinal cord area and gap ofboth the experimental group and experimental comparison group; seven days after SCI,positive cells and fibers of NF-200immunoreactions in injured spinal cord tissue ofexperimental group and experimental comparison group are apparently decreased than oneday after SCI, there are small amount of scattered positive fibers and cells of NF-200immunoreactions; thirty days after SCI, positive NF-200immunoreactions of theexperimental group and experimental comparison group increases as time goes by. Sixty daysafter SCI, positive fibers of NF-200immunoreactions of the experimental group andexperimental comparison group increases as time goes by. Positive fibers of NF-200immunoreactions near the normal spinal cord interweave into a net. There are small amountof positive fibers of NF-200immunoreactions can be seen in the hyperplasia tissue.Result presentation:1. Nursing intervention may delay amyotrophy, improve movement function andpromote function restoration of injured spinal cord. This might be relevant to earlyintervention of stimulating nursing intervention of related function, continuous skincompression and muscle movement to promote blood stimulating and reduce edema of hindlegs of rat and try to keep the flexibility of hind leg joints to prevent ankylosis at the hind legjoints of rat. 2. There is no apparent change in morphological study of tissue in injured spinal areaafter nursing intervention. This might be relevant to insufficient nursing intervention toimprove secondary injury in tissue structure of spinal cord after SCI, such as inflammatoryresponse, bleeding, wide neurogliocyte hyperplasia, very difficult regeneration after neurondamage. |
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