The Effects Of Electroacupuncture On Urodynamics, Intramedullary Apoptosis And Neurotrophic Factors In Neurogenic Bladder Rats After Suprasacral Spinal Cord Injury

Objective: To observe the effect of electroacupuncture on B-cell lymphoma-2(Bcl-2),Bcl-2 associated x protein(Bax)and Brain-Derived Neurotrophic Factor(BDNF)in spinal cord tissues of rats after T10 level complete spinal cord injury,finally,this paper will provide research ideas for the mechanism of electroacupuncture treatment of neurogenic bladder after spinal cord injury.Methods: 60 SPF-grade SD female rats were randomly divided into the blank group(n=12)and the sham group(n=12).The remaining 36 rats received surgery for modeling,24 rats were randomly selected from which meeting the model standards and then divided into the model group(n=12)and the electroacupuncture group(n=12).The neurogenic bladder model after supracacral spinal cord injury was prepared by combining the previous model with the Hassan Shaker spinal cord transection method.After the end of the spinal cord shock stage,the electroacupuncture group received electroacupuncture therapy with density alternate wave(10/50Hz)for 20 minutes with selecting the points of Dazhui(DU14),Zhongji(RN03),Ciliao(BL32),Sanyinjiao(SP06)and once a day for 7 consecutive days.After the treatment,the bladder tissue morphological changes were observed by HE staining method,the maximum urine volume and the compliance of bladder were determined by urine flow dynamic,the spinal cord cell apoptosis rate was evaluated by TUNEL method,the protein and m RNA expression of Bcl-2,Bax and BDNF in the spinal cord tissue were determined by Western blot and RT-PCR method.Results:1.Comparison with the blank group: there was no significant difference in the index results of the sham operation group(p>0.05).Compared with the blank group and the sham group,the HE staining results of the model group showed that the structure of bladder epithelial cells was damaged,the space was enlarged,and the arrangement was disordered,accompanied by a large number of inflammatory cells,detrusor muscle fibers were proliferated,the layers were blurred,and some areas had bleeding changes.TUNEL positive rate of spinal cord cells was significantly increased(p< 0.01).The maximum bladder volume and bladder compliance were significantly decreased(p< 0.01).Protein and gene expression of apoptosis-related factor Bcl-2 were significantly decreased(p <0.01),protein and gene expression of Bax were significantly increased(p<0.01),protein and gene expression of neurotrophic factor BDNF were significantly decreased(p<0.01).2.Compared with the model group,the results of HE staining in the electroacupuncture group showed that there were more intact bladder epithelial cells,less inflammatory cell infiltration,less detrusor muscle fiber hyperplasia,less tissue edema and less bleeding.TUNEL positive rate of spinal cord cells was significantly decreased(p<0.01).The maximum bladder volume and bladder compliance were significantly increased(p<0.01).Both protein and gene expression of intramedullary apoptosis-related factor bcl-2 were significantly increased(p<0.01),Bax protein and gene expression were decreased(p<0.05),and neurotrophic factor BDNF protein and gene expression were increased(p<0.05).Conclusion: Electroacupuncture on Dazhui,Zhongji,Ciliao,Sanyinjiao,points can improve the bladder tissue structure of neurogenic bladder rats after T10 level complete spinal cord injury,increase the maximum bladder volume and compliance of bladder,then restore the function of bladder,which is related to the two-way regulatory mechanism of increased expression of Bcl-2 and BDNF and decreased expression of Bax in spinal cord tissues.