Health Care Resource Utilization and Medical Costs of Spinal Cord Injury With Neuropathic Pain in a Commercially Insured Population in the United States

ObjectiveTo evaluate health care resource use, costs, and cost drivers among patients with neuropathic pain (NeP) after spinal cord injury (SCI) in a commercially insured population.DesignRetrospective longitudinal cohort study comparing SCI patients with and without NeP.SettingTruven Health MarketScan commercial claims database from 2005 through 2012.ParticipantsCommercially insured SCI patients with NeP (n=3524) propensity score matched to SCI patients without NeP (n=3524).InterventionsNot applicable.Main Outcomes MeasuresHealth care resource utilization and expenditures for the 12 months after NeP onset (index event; identified through International Classification of Diseases, 9th Revision, Clinical Modification diagnosis 338.0x or use of NeP-specific antiepileptic drugs or NeP-specific antidepressants) in patients with SCI compared with matched patients without NeP.ResultsUtilization over 12 months postindex among patients with SCI-associated NeP was higher than among SCI-only patients for inpatient admissions (27.4% vs 22.1%), emergency department visits (36.7% vs 26.4%), and office visits per patient (mean ± SD: 13.0±9.5 vs 9.5±8.3); all P values were <.001. All-cause expenditures showed adjusted incremental costs of $22,545 (95% confidence interval, $19,010–$26,168) per patient with SCI-associated NeP during the 12-month postindex period.ConclusionsPatients with evidence of NeP secondary to SCI have significantly higher health care utilization and total costs compared with SCI patients without evidence of NeP. Factors contributing to NeP in patients with SCI need to be clinically assessed to determine the optimal approach for treating these individuals.     

SCI数据库中地址信息著录的差异与错误

以苏州大学附属第二医院论文为例,分析了SCI在收录我国作者论文产生漏检和误检的原因,主要包括作者地址与单位名称不规范、拼写错误、合作论文单位署名位次颠倒等,并提出了相应的防范措施.     

医学博士生英文SCI论文写作课程的开设

在医学院校博士生中开设英文SCI论文写作课十分必要。第三军医大学在该课的课程设置上以学习者的需求为导向,确立了符合学习者实际情况的课程目标、课程内容、教学模式等。同时,采取了＂以写促学＂的课堂教学模式和＂课堂教学＂与＂课外讲座＂相结合的立体化研究生英文SCI论文写作课程体系,为医学院校优化该课程的设置提供了借鉴。     

Repeated Baclofen treatment ameliorates motor dysfunction,suppresses reflex activity and decreases the expression of signaling proteins in reticular nuclei and lumbar motoneurons after spinal trauma in rats

The interruption of supraspinal input to the spinal cord leads to motor dysfunction and the development of spasticity. Clinical studies have shown that Baclofen (a GABA_B agonist), while effective in modulating spasticity is associated with side-effects and the development of tolerance. The aim of the present study was to assess if discontinued Baclofen treatment and its repeated application leads antispasticity effects, and whether such changes affect neuronal nitric oxide synthase (nNOS) in the brainstem, nNOS and parvalbumin (PV) in lumbar α-motoneurons and glial fibrillary acidic protein in the ventral horn of the spinal cord. Adult male Wistar rats were exposed to Th9 spinal cord transection. Baclofen (30 mg/b.w.) diluted in drinking water, was administered for 6 days, starting at week 1 after injury and then repeated till week 4 after injury. The behavior of the animals was tested (tail-flick test, BBB locomotor score) from 1 to 8 weeks. Our results clearly indicate the role of nitric oxide, produced by nNOS in the initiation and the maintenance of spasticity states 1, 6 and 8 weeks after spinal trauma. A considerable decrease of nNOS staining after Baclofen treatment correlates with improvement of motor dysfunction. The findings also show that parvalbumin and astrocytes participate in the regulation of ion concentrations in the sub-acute phase after the injury.     

Expression pattern of Nogo‐A,MAG, and NgR in regenerating urodele spinal cord

Background: The mammalian central nervous system is incapable of substantial axon regeneration after injury partially due to the presence of myelin‐associated inhibitory molecules including Nogo‐A and myelin associated glycoprotein (MAG). In contrast, axolotl salamanders are capable of considerable axon regrowth during spinal cord regeneration. Results: Here, we show that Nogo‐A and MAG, and their receptor, Nogo receptor (NgR), are present in the axolotl genome and are broadly expressed in the central nervous system (CNS) during development, adulthood, and importantly, during regeneration. Furthermore, we show that Nogo‐A and NgR are co‐expressed in Sox2 positive neural progenitor cells. Conclusions: These expression patterns suggest myelin‐associated proteins are permissive for neural development and regeneration in axolotls. Developmental Dynamics 242:847–860, 2013. © 2013 Wiley Periodicals, Inc.     

Protective effects of melatonin against spinal cord injury induced oxidative damage in rat kidney: A morphological and biochemical study

Spinal cord injury (SCI) induced oxidative stress affects multiple organ systems including the kidney. We studied the possible protective effects of melatonin on SCI-induced oxidative damage in renal tissues of rats. Wistar albino rats (n = 24) were exposed to SCI and divided into vehicle- or melatonin-treated SCI groups. Melatonin was administred intraperitoneally at a dose of 10 mg/kg for seven days. Renal tissues were investigated by light and electron microscopy. Furthermore, tissue malondialdehyde (MDA) and glutathione (GSH) levels and myeloperoxidase (MPO) and superoxide dismutase (SOD) activities were also determined. In the vehicle-treated SCI group, the renal histology was disturbed compared to controls, whereas the melatonin-treated SCI group showed significantly reduced degeneration of renal tissue as seen by both light and electron microscopy. MDA levels, MPO and SOD activities were increased and GSH levels were decreased in the vehicle-treated SCI group compared to controls. On the other hand, decreased MDA levels and MPO activities and increased GSH levels were observed in the melatonin-treated SCI group compared to vehicle-treated SCI group. These results showed that experimentally induced SCI caused oxidative stress in the rat kidney, whereas melatonin treatment reduced oxidative stress, suggesting that it may be used as a complementary therapy of renal problems occurring following SCI.     

我国医学领域不同学科作者合作度与论文影响力的关系

探讨1990-2010年中国在医学领域8个学科SCI/SSCI收录期刊发表论文的作者合作度分布规律和不同合作模式与论文影响力的关系。结果表明,目前医学领域几乎不存在单作者论文,免疫学和分子生物学与遗传学等基础学科的合作度较高,各学科论文的作者合作度近似符合Zipf(齐普夫)定律,且分布具有不均匀性,多作者、国际、机构间合作论文的被引次数分别显著高于单作者、国内和机构内合作(p0.01)。国内合作论文中,机构内合作和机构间合作的论文被引次数没有显著差异,作者数、机构数和国家数的增多均会导致论文影响力的升高,多作者、多机构和国际合作对论文影响力的促进作用逐渐增强。研究作者数与论文影响力的关系,应考虑不同学科的合作水平。     

1991-2011年山西医科大学科研成果引文分析

以山西医科大学1991-2011年被SCI收录的论文为研究对象,从论文数量、学科分布、被引频次、作者等方面,分析与评价学校的科研水平和发展趋势、学科建设和发展方向、科研力量分布和结构、论文质量和学术水平、科技成果和学术交流能力等,以促进本校科研工作的快速发展.     

2003-2007年SCI收录SARS相关文献的分析研究

利用PubMed数据库检索2003—2007年SCI收录的SARS相关文献,对其年度文献数量变化、国家和地区分布、主要研究机构等进行分析研究,探讨SARS文献的分布规律、研究现状和发展趋势,以期为我国的SARS相关研究工作提供参考。     

中药髓复康对恒河猴脊髓损伤后神经再生的影响

目的髓复康对恒河猴脊髓损伤后神经再生的影响。方法成年雄性恒河猴14只,其中10只用于制备T12胸髓左侧半横断损伤模型,并将其随机分为髓复康组（S）和模型组（M）,每组5只,另外4只设为正常对照组（N）。通过改良Tarlov法评估恒河猴脊髓神经功能恢复情况;采用原位杂交法检测各组髓鞘相关生长抑制因子（Nogo-A）和生长相关蛋白（GAP-43）的表达量。结果给药30 d后,髓复康组患肢神经功能恢复优于模型组（P〈0.01）;脊髓损伤后各手术组Nogo-A mR-NA的阳性细胞数及阳性产物的OD值均明显升高,其中髓复康组Nogo-A mRNA的阳性细胞数和其阳性产物的OD值都明显低于模型组（P〈0.05）。各手术组GAP-43 mRNA的阳性细胞数及其阳性产物的OD值均明显高于正常组（P〈0.01）;其中髓复康组GAP-43 mRNA的阳性细胞数和其阳性产物的OD值最高,与模型组比较,差异有统计学意义（P〈0.05或P〈0.01）。结论中药髓复康能够对脊髓损伤后恒河猴脊髓中Nogo-A的表达有一定的抑制作用,同时能够上调GAP-43的表达,促进了脊髓损伤后恒河猴运动神经功能的恢复。