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针对脊髓损伤后的皮质脊髓束的综合治疗方法。

Comprehensive therapeutics targeting the corticospinal tract following spinal cord injury.

机构信息

Department of Orthopedics, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou 310009, China.

Orthopedics Research Institute of Zhejiang University, Hangzhou 310009, China.

出版信息

J Zhejiang Univ Sci B. 2019;20(3):205-218. doi: 10.1631/jzus.B1800280.

Abstract

Spinal cord injury (SCI), which is much in the public eye, is still a refractory disease compromising the well-being of both patients and society. In spite of there being many methods dealing with the lesion, there is still a deficiency in comprehensive strategies covering all facets of this damage. Further, we should also mention the structure called the corticospinal tract (CST) which plays a crucial role in the motor responses of organisms, and it will be the focal point of our attention. In this review, we discuss a variety of strategies targeting different dimensions following SCI and some treatments that are especially efficacious to the CST are emphasized. Over recent decades, researchers have developed many effective tactics involving five approaches: (1) tackle more extensive regions; (2) provide a regenerative microenvironment; (3) provide a glial microenvironment; (4) transplantation; and (5) other auxiliary methods, for instance, rehabilitation training and electrical stimulation. We review the basic knowledge on this disease and correlative treatments. In addition, some well-formulated perspectives and hypotheses have been delineated. We emphasize that such a multifaceted problem needs combinatorial approaches, and we analyze some discrepancies in past studies. Finally, for the future, we present numerous brand-new latent tactics which have great promise for curbing SCI.

摘要

脊髓损伤(SCI)是公众关注的焦点,但仍是一种影响患者和社会福祉的难治性疾病。尽管有许多方法可以处理损伤,但仍缺乏涵盖这一损伤所有方面的综合策略。此外,我们还应该提到被称为皮质脊髓束(CST)的结构,它在生物体的运动反应中起着至关重要的作用,这将是我们关注的焦点。在这篇综述中,我们讨论了针对 SCI 后不同方面的各种策略,强调了一些对 CST 特别有效的治疗方法。近几十年来,研究人员已经开发了许多有效的策略,涉及五种方法:(1)解决更广泛的区域;(2)提供再生微环境;(3)提供神经胶质微环境;(4)移植;和(5)其他辅助方法,例如康复训练和电刺激。我们回顾了这种疾病的基本知识和相关的治疗方法。此外,还提出了一些经过精心制定的观点和假设。我们强调,这种多方面的问题需要综合方法,并分析了过去研究中的一些差异。最后,我们提出了许多新的潜在策略,这些策略有望抑制 SCI。

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