Objective:To elucidate the underlying mechanism and effect of electroacupuncture(EA)on the neurogenic bladder following suprasacral spinal cord injury(ssCI).A rat model of detrusor hyperreflexia after SsCI was established to examine the urodynamics,detrusor muscle tissue morphology,the protein and mRNA expression levels of pituitary adenylate cyclase activating peptide(PACAP)and its receptor PAC1R,and cyclic adenosine monophosphate(cAMP)content in the detrusor muscle with a focus on the PACAPcAMP signaling pathway.Method:A total of 72 female SD rats were randomized into control group and sham operation group(n=12 per group)by using a random number table.The remaining 48 rats were established into the model of detrusor hyperreflexia after SsCI.After successful modeling,these rats were randomly assigned to model,EA,and EA+PACAP6-38 groups(n=12 per group).The unsuccessful modeled rats were used for exploratory observation.For the rats in EA group,"Ciliao(BL32)""Zhongji(CV3)",and"Sanyinjiao(SP6)"were needled and stimulated by EA.The PACAP receptor antagonist PACAP6-38 was administered intraperitoneally in the EA+PACAP6-38 group before EA,and EA was applied for seven consecutive days.After treatment,the urodynamics of the rats were analyzed,and hematoxylin and eosin staining was used to examine rat bladder detrusor tissue morphology.The expressions of PACAP-38 and PAC1R were detected by immunohistochemistry and Western blot.The mRNA expression levels of PACAP-38 and PAC1R were examined by RT-qPCR,while cAMP content was detected by ELISA.Results:(1)Compared with sham operation group,it was exhibited disarray in the transitional epithelium cells of the bladder in the modeled rats.The intercellular space was significantly widened,accompanied by inflammatory cell infiltration and noticeable tissue edema.Both the bladder initial pressure and leak point pressure of the rats were higher(P<0.01),whereas the maximum cystometric capacity and bladder compliance were lower(P<0.01).The protein and mRNA expression levels of PACAP-3
目的观察重复经颅磁刺激技术(repetitive transcranial magnetic stimulation,rTMS)和托特罗定治疗脊髓损伤后逼尿肌反射亢进的临床疗效。方法收集2019年1月至12月在温州医科大学附属第二医院脊柱外科和康复医学科住院的符合要求的脊髓损伤后逼尿肌反射亢进患者共40例,采用随机数字表法分为A、B两组,每组各20例,A组患者行rTMS治疗8周,B组患者行托特罗定治疗8周,治疗前、治疗8周后、停止治疗1个月后采用排尿日记、尿动力学指标、生存质量评分和国际下尿路症状评分进行疗效评估。结果两组患者治疗前的日均单次排尿量、日单次最大排尿量、日均排尿次数、日均残余尿量比较,差异均无统计学意义(P>0.05);两组患者治疗8周后日均单次排尿量、日单次最大排尿量、日均排尿次数、日均残余尿量分别较治疗前均有所改善(P<0.05);但经A组患者停止治疗1个月后的日均单次排尿量、日单次最大排尿量、日均排尿次数、日均残余尿量较治疗前均有所改善(P<0.05),而经B组患者停止治疗1个月后的日均单次排尿量、日单次最大排尿量、日均排尿次数、日均残余尿量与治疗前比较,差异均无统计学意义(P>0.05)。两组患者治疗前的膀胱容量、膀胱顺应性、膀胱开口压力、最大膀胱压力、最大逼尿肌压力比较,差异均无统计学意义(P>0.05);A组患者治疗8周后及停止治疗1个月后的膀胱容量、膀胱顺应性、膀胱开口压力、最大膀胱压力、最大逼尿肌压力均较治疗前明显改善(P<0.05);B组患者治疗8周后膀胱容量、膀胱开口压力、最大膀胱压力、最大逼尿肌压力较治疗前有所好转(P<0.05),但停止治疗1个月后,仅膀胱开口压力和最大逼尿肌压力较治疗前有所改善(P<0.05);两组患者治疗前的生存质量评分和国际下尿路症状评分比较,差异均无统计学意义(P>0.05),治疗8周后及停止治疗1个月后两组患者�
