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BACKGROUND: Our previous findings have shown that anodic block electrical stimulation of sacral nerve root can adjust urine storage and urination, but the specific molecular mechanism is unknown. OBJECTIVE: To analyze the expression of neurotransmitter receptors and nerve growth factor in the bladder detrusor using immunohistochemistry from the perspective of protein function and to explore the mechanism of anodic block electrical stimulation of sacral nerve root on bladder function reconstruction. METHODS: Thirty New Zealand rabbits were randomly divided into control group (n=10), spinal cord injury group (n=10) and electrical stimulation group (n=10). In the latter two groups, animal models of post-spinal cord injury neurogenic bladder were made using spinal cord clippings. In the electrical stimulation group, the sacral nerve root was subjected to an intermittent electrical stimulation (300 μs, 1.05 mA, 20 Hz), 5 seconds on and 10 seconds off for 120 hours. Then, the bladder detrusor was harvested. The expression of nerve growth factor and neurotransmitter receptor in neurogenic bladder detrusor was analyzed qualitatively and quantitatively by immunohistochemistry from the perspective of protein function RESULTS AND CONCLUSION: In the spinal cord injury group, there was a significantly smaller, dark-brown bladder, with reduced number of vessel plexuses on the tissue surface. The bladder boundary was blurred, with some adhesion to the surrounding tissue, and partial fibrosis and tissue necrosis on the section surface were observed. The morphology of the control group and the electrical stimulation group was relatively consistent, both with enlarged bladder volume and light red in color. Abundant arteriovenous networks were visible on the surface of the tissue. The boundary was clear. Residual urine amount was increased in the tissue. The color was yellowish and transparent. There was no abnormality in the section compared with the surrounding tissues. Immunohistochemical findings shown that the expression of M2 receptor, P2X3 receptor and nerve growth factor receptor in bladder detrusor muscle in the spinal cord injury group was significantly higher than that in the electric stimulation group and control group (P < 0.05), while the expression of M3 receptor and β2-AR receptor in bladder detrusor muscle in spinal cord injury group was significantly lower than that in the electric stimulation group and control group (P < 0.05). To conclude, electrical stimulation of the sacral nerve root by anodic block can adjust the expression of nerve growth factor and neurotransmitters in neurogenic bladder, thereby influencing the systolic and diastolic function of bladder detrusor, improving bladder compliance and remodeling the function of neurogenic bladder after spinal cord injury. [ABSTRACT FROM AUTHOR]

BACKGROUND: Traumatic spinopelvic dissociation severely damages the stability of the lumbosacral region, with many treatment complications, poor prognosis and many influencing factors. OBJECTIVE: To analyze the influencing factors of clinical efficacy of lumbopelvic internal fixation with nail-rod system treatment of traumatic spinopelvic dissociation. METHODS: Complete data of 16 patients with traumatic spinopelvic dissociation from Tianjin Ninghe Hospital between September 2009 and September 2018 were analyzed retrospectively. All patients received lumbopelvic internal fixation with nail-rod system. There were 12 cases with nerve injury, of which 10 cases were treated with sacral nerve decompression. Two cases had no responsible fracture block on imaging and were not treated. Postoperative effect of treatment was evaluated according to the evaluation criterion of Japanese Orthopaedic Association and radiographic measurements of pelvic incidence and British Medical Research Council neurological function. Univariate statistical analysis was performed in the correlation between age, gender, timing of surgery, reduction quality, comorbid injury, degree of nerve injury and postoperative functional score. Among them, linear correlation analysis was conducted between age and Japanese Orthopaedic Association score. The correlation of gender, timing of surgery, reduction quality, comorbid injury, and degree of nerve injury with Japanese Orthopaedic Association score was analyzed with the Chi-square test. RESULTS AND CONCLUSION: (1) All patients were followed up for 17-38 months. (2) Postoperative evaluation results of Japanese Orthopaedic Association score showed that 4 cases were rated excellent, 5 good, 4 fair and 3 poor. (3) Imaging measurements showed that the pelvic incidence improvement rate of flexion sacral fracture was 78%, and the neutral type and extension type did not improve. (4) British Medical Research Council results demonstrated that neurological injuries were recovered of “excellent” in 5 cases, “good” in 4 and “no changes” in 3 patients. Clinical recovery rate of neurological injury was 75%. (5) Statistical analysis showed that the degree of nerve injury and accompanying anterior pelvic ring injury affected the surgical outcome. (6) It is indicated that the efficacy of surgical treatment of traumatic spinopelvic dissociation is affected by many factors. Based on the treatment of combined injury, the traumatic spinopelvic dissociation should be treated operatively with lumboiliac fixation early to maintenance the stability of spin-pelvic and pelvic ring, and exact decompression for neurological injuries is the key to achieve a satisfactory curative effect. [ABSTRACT FROM AUTHOR]