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Objective:To explore the curative effect of anterior cervical surgery for lower cervical dislocation combined with spinal cord injury.Methods:A retrospective case series study was carried out to analyze the clinical data of 72 patients with lower cervical dislocation and spinal cord injury admitted in Beijing Boai Hospital, China Rehabilitation Research Center from January 2011 to August 2018, including 55 males and 17 females, with an average age of 35.8 years (range, 18-63 years). The segments of injury were at C 3 in 2 patients, at C 4 in 16, at C 6 in 24 and at C 7 in 30. Bases on American Spinal Injury Association (ASIA) grade, there included grade A in 43 patients, grade B in 22, grade C in 6 and grade D in 1. All patients were treated with anterior decompression and fusion. Operation time, intraoperative hemorrhage, decompression and fusion, complications and ASIA grade were observed. Results:All patients were followed up for 3-72 months (average 24.2 months). Operation time was 90-180 months [(118±58)minutes] and intraoperative bleeding volume was 50-180 ml [(104±30)ml]. Spinal cord was decompressed in all patients. The reduction was excellent in 58 patients (81%) and fair in 14 patients (19%). Fusion was confirmed in 48 patients (67%). The complications were improved after timely treatment, including cervical edema in 1 patient, laryngeal edema in 1, cerebrospinal fluid leakage in 4 and axial pain in 2. ASIA grade change of spinal cord injury: grade A were recovered to grade B in 2 patients, grade A to grade C in 1, grade B to grade C in 1, grade C to grade D in 2 ( P>0.05). Conclusion:For dislocation of lower cervical spine combined with spinal cord injury, anterior surgery can obtain good decompression, reduction and fusion effect, but it has limited help for improvement of neurological function.
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Objective To identify the efficacy of granulocyte-macrophage colony-stimulating factor (GM-CSF) gargle in patients who had oral mucositis after allogeneic hematopoietic stem cell transplantation. Methods A total of 134 patients were enrolled in this study from 2014 to 2015. They were randomly divided into two groups:the experimental group (n=65) and the control group (n=69). Both groups received preventive measures for oral mucositis. But once oral mucositis occurred, the control group continued with the routine nursing measure, while the experimental group added GM-CSF gargle based on previous routine nursing measure. The effective rate and healing time were compared between two groups. Results The effective rate of the experimental group (81.54%, 53/65) was significantly higher than that of the control group (24.64%,17/69) (χ2=43.434, P=0.000). The median healing time in the experimental group was 4.5 days, shorter than 9.0 days in the control group (Z=-5.379, P< 0.01). Conclusions GM-CSF gargle can control the oral mucositis after allogeneic hematopoietic stem cell transplantation.
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Neurogenic detrusor overactivity (NDO) often occurs after spinal cord injury, which often causes urinary tract infection, vesi-coureteral reflux, or even renal failure, and seriously impacts on the patient's quality of life. This paper reviewed the mechanism, the com-mon treatment methods, and neuromodulation theray of NDO after spinal cord injury, and elaborated percutaneous posterior tibial nerve stimulation, pudendal nerve regulation and the sacral neuromodulation respectively.
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@#Objective To investigate the clinical characteristics of nontraumatic spinal cord injury, including the demographic characteristics,etiology and neurological function. Methods 44 patients with nontraumatic spinal cord injury in the past 4 years were reviewed. Results There were 27 males (61.3%) and 17 females (38.7%) with mean age of 39.85 years (3.5~78). They were followed up for mean of 13.3 (3~23) months. Myelitis (36%) and spinal tumor (including primary and metastatic tumor, 18.1%) were the most common causes, followed by intraspinal tumor (15.9%), vascular disease (13.6%), nontraumatic acute disc herination (6.8%), spinal cord ischemia after non-spinal surgery (4.5%) and hepatic myelopathy (4.5%). Neurological function at the initial admission included tetraplegia in 9 patients, paraplegia in 30 patients, conus medullaris syndrome in 2 patients and cauda equina syndrome in 2 patients. Neurological function of ASIA at the initial admission included A in 14 cases, B in 6, C in 13 and D in 11. 34% patients improved at least one ASIA grade when evaluated at final follow up. Conclusion Nontraumatic etiologies contribute to a significant proportion for spinal cord injury. Patients with nontraumatic spinal cord injury present the clinical characteristics different from traumatic spinal cord injury cases.
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Objective To summarize the experience in management of main hepatic vein injury due to hepatectomy for hepatic neoplasm of segment Ⅷ. Methods Clinical data of 64 patients suffering from main hepatic vein injury due to hepatectomy of hepatic neoplasm of segment Ⅷ in our hospital from October 1996 to October 2008 were retrospectively analyzed. Results Both the main trunks of the middle and right hepatic vein were injured in 34 patients, single right hepatic vein in 13 and middle hepatic vein in 17. In these patients with hepatic vein injury, the main trunk of the hepatic vein was repaired in 39, vessels ligated in 12 and direct liver wound surfaces sutured in 12. The hepatectomy and hemostasis were successfully performed during operation in all patients. After operation, 3 patients had active bleeding and 2 patients were reoperated on to sew up the bleeding points by wadding with the gelatin sponge and discharged after rehabilitation. One patient gave up treatment and was discharged automatically. Conclusion Main hepatic vein injury in hepatectomy of hepatic neoplasm of segment Ⅷ can be managed effectively by hepatic vein repair, hepatic vein ligation and suture of the liver section that can be chosen to control the bleeding of hepatic vein injury according to the actual conditions.
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@#This paper would discuss the concepts about motor imagery and differences to motor execution. The application of motor imagination in rehabilitation was described. The problem of the way to observe the motor imagery and executing task of motor imagery effectively are emphasized. Finally we provide an addressing on motor imagery questionnaires.
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@#Objective To explore the application values of effect on the expression of growth associated protein-43 (GAP-43) and myelin basic protein(MBP) by electrical stimulation in different sites of spinal cord injured rats after the human umbilical cord blood stem cells transplantation. Methods In this study the subjects adopted are clean grade rats, which were performed with Allen's method by NYU blow device, resulting in SCI models. 192 rats successfully modeled were divided into groups according to the random table. Group A received electric stimulation in the scalp surface projection area of motor area: Group A1 received electric stimulation and transplantation of umbilical cord blood stem cell, while Group A2 only received electric stimulation; Group B received local electric stimulation at damaged site: Group B1 received electric stimulation and transplantation of umbilical cord blood stem cell, while Group B2 only received electric stimulation; Group C received electric stimulation in the scalp surface projection area of motor area and local electric stimulation at damaged site: Group C1 received electric stimulation and transplantation of umbilical cord blood stem cell, while Group C2 only received electric stimulation; Group D are just the SCI models: Group D1 received transplantation of umbilical cord blood stem cell without electric stimulation, while Group D2 neither received cell transplantation nor electric stimulation. The sacrifice time of rats was the 1st week, 2nd week, 3rd week, 4th week, 8th week, and 12th week after operation respectively. The distribution of the remained or regenerative neurons at damaged areas by corticospinal tract anterograde tracer with Biotinylated dextran amine (BDA), and we also detected the content changes of GAP-43, MBP and the MAB1281 specific expression of the human nucleus of human umbilical cord blood stem cells. Results 1). NYU is a blow device for Allen's rat model of SCI, which could quantify the crash potential energy, and gain a stable and repeated model with high successful rate. 2). At each time site in this study, the factors that benefit for the neurofunction restoration after electric stimulation in the microenvironment into which the stem cells have been transplanted are GAP-43 and MBP, and they are all positive; the effects of the combination of head acupuncture with body acupuncture are much better than single head acupuncture or body acupuncture. 3). At each time site in this study, the factors that benefit for the neurofunction restoration after injury are GAP-43 and MBP, and the effects of them are all positive, which do not depend on whether the stem cell transplantation has been done. Conclusion 1). After the stem cell transplantation have been done, the changes of the microenvironment develops in the direction of benefiting for restoring neurofunction, which means that stem cell transplantation can promote the restoration of neurofunction and the stem cell transplantation is successful in this study. 2). Electric stimulation is significantly positive for the factors (GAP-43, MBP) which benefit for restoring neurofunction in the microenvironment after stem cell transplantation, the effects of the combination of head acupuncture with body acupuncture is better than single head acupuncture or body acupuncture. The significantly positive effects of the electric stimulation on microenvironment after injuries are independent, which do not depend on whether the stem cell transplantation has been done. Electric stimulation and stem cell transplantation are significantly synergistic at the microenvironment.
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@# Central pain (CP) following spinal cord injury (SCI) challenges the health care community. A number of pain syndromes associated with SCI are based on the nature of the lesion, neurological structure damage and secondary pathophysiological changes. The hyperresponsiveness of neurons following SCI is the key factor of the mechanisms of CP. And several treatments have received some effects. So it is very important to study the mechanisms and therapies of CP.
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@#Earthquake is one of the sudden major natural disasters,with a serious threat to human life and property safety,and also an enormous challenge to public health security.During earthquake the collapse of the houses and falling of heavy objects often resulted in a large number of patients with spinal fractures,which would create different levels of spinal cord injury(SCI),contributing to permanent disability.Those are closely related to the first aid of spinal fractures,clinical treatment and comprehensive rehabilitation post-earthquake.However,after earthquake,how to reduce the degree of disabilities of SCI patients and to improve their quality of life is not only a medical problem,but also a social problem.
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@#In the field of artificial muscle(AM) research,it is very difficult for humans to make the biological muscles,but there are experiments trying to put the function of muscles into practice of technology.With the development of materials and models of mathematics theories,people have made the AM of different materials and models true,however,as far as the characteristics of them and the widely used are concerned,they need deeply scientific research.And,in the near future,AM will play an important role in medical equipments,rehabilitation medicine,bionics,intelligent robots,military weapons,aerospace,etc.The authors review the types,characteristics,application in rehabilitation,as well as the function evaluation of AM.
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Objective To study the method and nursing measurements of the detection of portal venous pressure. Method The implantable drug delivery system was performed during the operation in 31 patients with liver cancer. The direct dynamic observation was performed by using the system and the corresponding nursing measurement was given. Result The measurement of portal venous pressure was successful performed 251 times in 31 cases with liver cancer and no complications were taken place. Conclusions The dynamic observation of portal venous of pressure by using the implantable drug delivery system was simple. Safety and could be repeated and could easily be receipted by the cases, the nurses skilled measured the key points of nursing and actively prevented the complications was taken implant role in increasing the rate of success of detection .
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Objective To investigate the feasibility,curative effect and problems of combined ultrasound-guided percutaneous radiofrequency ablation and ethanol injection(PRFA+EI) on small liver cancer located in first porta hepatis.Methods Twenty-six patients,who diagnosed as primary and metastatic liver cancer that located in first porta hepatis and was less than 5 cm in diameter by clinical evidence or pathology,were performed PRFA+EI between Jan 2001 and Oct 2004.The necrosis of the tumors was determined by MRI,Doppler ultrasound or CT after the treatment for one month and the regular examinations were tested every 3 months.The primary tumor recurrence rate and cumulative survival rate were calculated.Results The seroconversion rate of AFP was 76.9%(10/13).The complete necrosis rate of liver cancer in first porta hepatis was 84.6%(22/26) by MRI and CT.The primary tumor recurrence rate of 6 months and 1 year were 23.1%(6/26) and 26.9%(7/26),respectively.The 1-,2-,3-year cumulative survival rate were 92.3%(24/26),82.3% (14/17),75.0%(9/12),respectively.There was no occurrence of bile ducts stenosis.Conclusion The small live cancer located in first porta hepatis is not the contraindication of PRFA+EI.If the puncture point and route is selected properly,electrodes deployed exactly using ultrasound guidance and the size of heating area controlled appropriately,the PRFA+EI is an effective treatment for small liver cancer located in first porta hepatis.
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Objectives To investigate the diagnostic value and safety of needle cutting biopsy for the primary and metastatic hepatic cancer during the treatment of percutaneous radiofrequency ablation and ethanol injection guided by ultrosound or CT. Methods The clinical data of 48 patients underwent the treatment of percutaneous radiofrequency ablation and ethanol injection as well as biopsy were analyzed. Results Among 48 patients,46 case(95.8%) were diagnosed by pathological examination and 2 cases (4.2%) failed to be diagnosed. There were no serious complications in all the patients. Conclusion Detachable needle cutting biopsy was safe and effective for the diagnosis of the primary and metastatic hepatic cancer during the treatment of percutaneous radiofrequency ablation and ethanol injection guided by ultrasound or CT.
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Objective To investigate the effect and safety of the application of radiofrequency ablation(RFA) and ethanol injectionunder the different guidance means for105 patients with primary and metastatic hepatic cancer.Methods Aretrospective study was accom-plished on the radiofrequency ablation and ethanol injection for105 patients with primary and metastatic hepatic cancer under the guidance ofultrasound(56 cases),CT(12 cases),laparoscope(9 cases),open surgery(26 cases) and ultrasound associated with laparoscopic(2cases).Results The operations of RFA with the shortest time were guided by ultrasound(0.8?0.3) h,while the longest operations wereguided by open surgery(3.6?2.5) h(P