Early neurosurgical intervention of spinal cord contusion: an analysis of 30 cases / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>The incidence of spinal injury with spinal cord contusion is high in developed countries and is now growing in China. Furthermore, spinal cord injury happens mostly in young people who have a long life expectance. A large number of patients thus are wheelchair bound for the rest of their lives. Therefore, spinal cord injury has aroused great concern worldwide. Despite great efforts, recovery from spinal cord injury remains unsatisfactory. Based on the pathology of spinal cord contusion, an idea of early neurosurgical intervention has been formulated in this study.</p><p><b>METHODS</b>A total of 30 patients with "complete" spinal cord injury or classified as American Spinal Injury Association (ASIA)-A were studied. Orthopedic treatment of the injured vertebra (e), internal fixation of the vertebral column, and bilateral laminectomy for epidural decompression were followed directly by neurosurgical management, including separation of the arachnoid adhesion to restore cerebrospinal fluid flow and debridement of the spinal cord necrotic tissue with concomitant intramedullary decompression. Rehabilitation started 17 days after the operation. The final outcome was evaluated after 3 months of rehabilitation. Pearson chi-square analysis was used for statistical analysis.</p><p><b>RESULTS</b>All the patients recovered some ability to walk. The least recovered patients were able to walk with a wheeled weight support and help in stabilizing the weight bearing knee joint (12 cases, 40%). Thirteen patients (43%) were able to walk with a pair of crutches, a stick or without any support. The timing of the operation after injury was important. An optimal operation time window was identified at 4 - 14 days after injury.</p><p><b>CONCLUSIONS</b>Early neurosurgical intervention of spinal cord contusion followed by rehabilitation can significantly improve the locomotion of the patients. It is a new idea of a therapeutic approach for spinal cord contusion and has been proven to be very successful.</p>

Acupuncture for treatment of depressive neurosis: a multi-center randomized controlled study / 中国针灸

<p><b>OBJECTIVE</b>To observe the clinical therapeutic effect of acupuncture on depressive neurosis.</p><p><b>METHODS</b>With a multi-center randomized controlled study, 440 cases were randomly divided into an acupuncture group, a prozac group, a non-acupoint needling group. In the acupuncture group, Hegu (LI 4) and Taichong (LR 3) were selected, and the Prozac group were treated with administration of 20 mg/d and the non-acupoint needling group were treated with needling the points deviating from the acupoints. The therapeutic effect was evaluated by HAMD score reduction rate, and Asberg's anti-depressant side-effect rating scale (SERS) and severe adverse reaction were used for safety evaluation, and the data were analyzed with ITT.</p><p><b>RESULTS</b>The total effective rate was 86. 4% in the acupuncture group, which was better than 59.1% in the non-acupoint needling group and 72.7% in the prozac group; HAMD score in the acupuncture group was similar to that in the Prozac group, which was better than that in the non-acupoint needling group; the SERS scores in the acupuncture group and the non-acupoint needling group were significantly lower than that in the Prozac group, with no severe side-effects found for acupuncture.</p><p><b>CONCLUSION</b>Acupuncture is an effective and safe therapy for depressive neurosis; therapeutic effect of acupuncture on depressive neurosis possibly is better than or similar to that of Prozac, but with less side-effects.</p>