[Urodynamic effects of elongated needle on patients with urinary retention after spinal cord injury].

OBJECTIVE: To explore the clinical significance of elongated needle in the treatment of urinary retention after spinal cord injury. METHODS: From January 2016 to June 2018, 60 patients with urinary retention after spinal cord injury were divided into elongated needle acupuncture group and needle acupuncture group, 30 cases in each group. The Shuidao(ST28) and Zhibian(BL54) were selected as the treatment of acupoints. In the elongated needle group, there were 23 males and 7 females, with a mean age of(52±9) years old. The patients in this group were treated on both sides, and the electro-acupuncture apparatus was used for 30 minutes at frequencies of 3 Hz for 30 minutes. In needle group, there were 24 males and 6 females, with a mean age of (56±10) years old. After treatment, the needles were retained for 30 minutes. The treatment frequencies of both groups were once every other day and passed for 2 months. After 2 months of treatment, the clinical significances of the treatment of the disease were explored by analyzing the time between the two groups of patients to reach the equilibrium bladder, diary urinary diary, urodynamics and urinary tract infection between the two groups. RESULTS: (1)Time to reach the equilibrium bladder:(39.5±1.2) days in elongated needle group and (46.5±2.1) days in needle group; the time to reach the equilibrium bladder in the two groups was significantly different(P<0.05). (2)Comparison of urination diary between the two groups:the daily number of catheterization, the amount of each catheterization, the number of daily urination, and the amount of urine per urination after treatment were better than those before treatment by intra-group comparison(P<0.05); the number of daily catheterization, the amount of daily catheterization, the number of daily urination, and the amount of urine output per patient in elongated needle group were better than those in needle group by comparison between two groups(P<0.05). (3)Comparison of improvement of urinary tract infection between the two groups:the urinary tract infection were better than that before treatmant in each group by intra-group comparison; the improvement rate of urinary tract infection in awn needle group (1/3.3%) was higher than that in needle group(5/16.7%), with significantly differences. (4)Comparison of urodynamic index between two groups:by intra-group comparison, the VH2O, Pves, Pdet, Qave, Qmax, and BC of the two groups were better than those before treatment(P<0.05); By comparison between two groups, the improvement of VH2O, Pves, Pdet, Qave, Qmax and BC were better than those of the needle group (all P<0.05). CONCLUSIONS: The elongated needle is better than conventional needle in improving urinary retention, urinary tract infection and urodynamic index in patients with urinary retention after spinal cord injury. It has positive significance in improving patients' quality of life and is worth applying to clinical.

[Effects on urinary retention after spinal cord injury treated with acupuncture at Zhibian (BL 54) and Shuidao (ST 28) with elongated needle].

OBJECTIVE: To explore the clinical effects of acupuncture with elongated needle on urinary retention after spinal cord injury. METHODS: A total of 66 patients with urinary retention after spinal cord injury were randomized into an elongated needle group (34 cases) and a filiform needle group (32 cases). In both of the groups, the routine orthopedic treatment and the bladder function training were adopted. Additionally, in the elongated needle group, the acupuncture at Zhibian (BL 54) and Shuidao (ST 28) was used with the elongated needle. In the filiform needle group, the acupuncture with filiform needle was used at Zhibian (BL 54) and Shuidao (ST 28). In both of the groups, acupuncture treatment was provided once every two days, for 2 months consecutively. Separately, before treatment and after 1, 2 month treatment, the residual urine volume, urodynamic parameters (bladder capacity, peak urinary flow rate and bladder pressure) and safety indicators were observed in the patients of the two groups. The clinical therapeutic effects were compared between the two groups. RESULTS: As compared with the results before treatment, the residual urine volume was reduced obviously (all P<0.01), bladder capacity, peak urinary flow rate and bladder pressure were improved obviously (all P<0.01) after 1, 2 month treatment in the two groups. After 1, 2 month treatment, the residual urine volume in the elongated needle group was lower than the filiform needle group (both P<0.01). The improvements in bladder capacity, peak urinary flow rate and bladder pressure in the elongated needle group were superior to the filiform needle (all P<0.01). The total effective rate was 94.1% (32/34) in the elongated needle group, higher than 71.9% (23/32) in the filiform needle group (P<0.01). During treatment, there was no damage of kidney function, no fainting or broken needle happened in the two groups. CONCLUSION: Acupuncture with elongated needle achieves the significant effects on urinary retention after spinal cord injury. This therapy is better than acupuncture with filiform needle and safe in operation.

[The metabolic profilings study of serum and spinal cord from acute spinal cord injury rats ¹H NMR spectroscopy].

OBJECTIVE: To establish the rat model of acute spinal cord injury, followed by aprimary study on this model with ¹H NMR based on metabonomics and to explore the metabonomics and biomarkers of spinal cord injury rat. METHODS: Twenty eight-week-old adult male SD rats of clean grade, with body weight of (200±10) g, were divided into sham operation group and model group in accordance with the law of random numbers, and every group had 10 rats. The rats of sham operation group were operated without damaging the spinal cord, and rats of model group were made an animal model of spinal cord incomplete injury according to the modified Allen's method. According to BBB score to observate the motor function of rats on the 1th, 5th, and 7th days after surgery. Postoperative spinal cord tissue was collected in order to pathologic observation at the 7th day, and the metabolic profilings of serum and spinal cord from spinal cord injury rats were studied by ¹H NMR spectroscopy. RESULTS: The hindlimb motion of rats did not obviously change in sham operation group, there was no significant difference at each time point;and rats of model group occurred flaccid paralysis of both lower extremities, there was a significant difference at each time; there was significant differences between two groups at each time. Pathological results showed the spinal cord structure was normal with uniform innervation in shame group, while in model group, the spinal cord structure was mussy, and the neurons were decreased, with inflammatory cells and necrotic tissue. Analysis of metabonomics showed that concentration of very low density fat protein (VLDL), low density fat protein (LDL), glutamine, citric acid, dimethylglycine (DMG) in the serum and glutathione, 3-OH-butyrate, N-Acetyl-L-aspartic acid (NAA), glycerophosphocholine (GPC), glutamic acid, and ascorbate in spinal cord had significant changes(P<0.05). CONCLUSIONS: There are significant differences in metabolic profile from serum and spinal cord sample between model group and sham operation group, it conduces to explain the changes of small molecular substances in serum and spinal cord tissue after spinal cord injury, this provides the research basis for targeted research on the role of metabolic markers in patients with acute spinal cord injury.