Study on the characteristics of microcirculation in the site of pressure ulcer in patients with spinal cord injury.

To investigate the characteristics of pressure ulcer microcirculation in SCI patients with pressure ulcer, and to provide evidence for the treatment of pressure ulcer in patients with SCI. Group 1 (n = 12) SCI patients with pressure ulcer, 23 pressure ulcers were included. Group 2 (n = 15) SCI patients without pressure ulcer and the control group (n = 16) healthy adults. The application of laser Doppler perfusion imaging system (Moor FLPI) detector to the microcirculation perfusion of the sacrum area of the control group, the observation group 2 and the pressure ulcer site of the observation group 1, record the microcirculation perfusion (PU), The data of microcirculation perfusion (PU) were compared and analyzed. The correlation between microcirculation perfusion and healing time of pressure ulcer was analyzed. (1) The microcirculation perfusion was highest in the pressure ulcer center. (2) SCI patients and healthy adults had no significant difference of microcirculation perfusion at sacrococcygeal skin. (3) The lower the microcirculation perfusion of the pressure ulcer center, the longer the healing time of pressure ulcer. The healing time and the microcirculation perfusion of pressure ulcer center was negatively correlated. Microcirculation perfusion detection is a noninvasive and effective method for the determination of the scope of pressure ulcer, detection and direction judgment of pressure ulcer sinus tract, monitoring and guidance of pressure ulcer treatment, and prediction of the healing time of pressure ulcer.

Long-term efficacy and complications of implantable diaphragm pacer in children with high cervical spinal cord injury: case report and literature review / 中华实用儿科临床杂志

The long-term efficacy and complications of implantable diaphragm pacer (IDP) in a child with cervical spinal cord injury (CSCI) in the Department of Spinal and Neural Functional Reconstruction, China Rehabilitation Research Center in September 2022 were retrospective analyzed.A male child had quadriplegia without an obvious cause at the age of 12 years, and he was then lived completely with the assistance of mechanical ventilation.At the age of 14 years, he could wean off the ventilator in unilateral diaphragmatic pacing mode.However, mechanical ventilation was re-given for months after 5 years due to pneumonia, and then the IDP was re-given with the self-felt decreased pacing effect.After hospitalization, the patient was examined with mild diaphragmatic atrophy, secondary flat chest, and mild scoliosis.After optimization of the transdiaphragmatic pacing threshold and rehabilitation, his respiratory function improved.IDP can be used in CSCI for long time, while flat chest and scoliosis that limited the expansion of the lungs should be considered.At the meantime, the increased abdominal spasm affected the abdominal compliance, leading to the decrease in the efficiency of the diaphragm.

MRI study of the relationship between the cerebral small vessel disease total burden and imaging markers and degree of middle cerebral artery stenosis / 中华放射学杂志

Objective:To investigate the relationship between the cerebral small vascular disease (CSVD) total burden and the imaging markers and the degree of unilateral middle cerebral artery (MCA) stenosis.Methods:The study was a cross-sectional study. Clinical and imaging data of patients with chronic unilateral MCA stenosis who underwent multimodal MRI from October 2015 to January 2019 in the First Medical Center of PLA General Hospital were retrospectively analyzed. A total of 261 patients were included, 187 males and 74 females. According to the degree of MCA stenosis, the patients were divided into 102 cases in severe stenosis-occlusion group (stenosis degree ≥70%) and 159 cases in mild-moderate stenosis group (stenosis degree <70%). CSVD imaging marker scores (including white matter hyperintensity, perivascular space, cerebral microbleed, and lacune of presumed vascular origin) were assessed according to the ?standards for reporting vascular changes on neuroimaging 1 in the 2 groups, and the CSVD total burden score was calculated. Mann-Whitney U test was used to compare the indicators between the two groups, and the CSVD total burden score and imaging marker scores were ultimately included in a multifactorial binary logistic regression to assess the association of CSVD imaging markers with severe stenosis-occlusion of the MCA after adjusting for vascular risk factors (age, gender, drinking, smoking, hypertension, hyperlipidemia, atrial fibrillation and coronary heart disease). Results:There were significant differences in the CSVD total burden, centrum semiovale perivascular space and lacune of presumed vascular origin score between the mild-to-moderate stenosis group and the severe stenosis-occlusion group (all P<0.05), and none of the differences in the remaining imaging marker scores were statistically significant (all P>0.05). Multivariate binary logistics regression analysis showed CSVD total burden score ( OR=1.300, 95% CI 1.047-1.613, P=0.017), centrum semiovale perivascular space score ( OR=2.099, 95% CI 1.540-2.860, P<0.001) and lacune of presumed vascular origin score ( OR=2.609, 95% CI 1.294-5.261, P=0.007) were independent associated with severe stenosis-occlusion of MCA. Conclusion:The higher CSVD total burden score, centrum semiovale perivascular space score and lacune of presumed vascular origin score are associated with severe stenosis-occlusion of MCA.

Related factors and prediction model for neurological outcome of dance-associated pediatric spinal cord injury without radiographic abnormality / 中国康复理论与实践

ObjectiveTo investigate the neurological outcome of children with dance-associated spinal cord injury without radiographic abnormality (SCIWORA) and explore its related factors and predictive model. MethodsFrom July, 2012 to January, 2022, 75 children with dance-associated SCIWORA hospitalized in Beijing Bo'ai Hospital were divided into improved group (n = 14) and non-improved group (n = 61) according to the American Spinal Injury Association Impairment Scale (AIS) grade a year later, and the related factors were analyzed. ResultsAll patients were girls aged four to ten years. Most of them were complete spinal cord injuries (52/75, 69%). The time of injury to rehabilitation (OR = 0.926, P = 0.046, 95%CI 0.858 to 0.999), the existing tendon reflex (OR = 46.915，P = 0.012, 95%CI 2.333 to 943.616) and muscle tension (OR = 8.932，P = 0.044，95%CI 1.063~75.067) were correlated with the AIS grade improvement. The combination of time of injury to rehabilitation, tendon reflex and muscle tone existing may predict the improvement of AIS (AUC = 0.953, P < 0.001，95%CI 0.878 to 0.989), the sensitivity and specificity were 100% and 83.61%, respectively. ConclusionThe neurological outcome of children with dance-associated SCIWORA is poor. Rehabilitation training as soon as possible is beneficial to the neurological recovery. Tendon reflexe and muscle tone existing at admission are closely related to improvement of neurological outcome, which could be used as potential indicators.

Application of fast susceptibility weighted imaging based on deep learning in assessment of acute ischemic stroke / 中华放射学杂志

Objective:To explore the value of fast susceptibility weighted imaging (SWI) generated by a deep learning model in assessment of acute ischemic stroke (AIS).Methods:From January 2019 to January 2021, 118 AIS patients [75 males and 43 females, aged 23-100 (66±14) years] who underwent MR examination and SWI sequence scanning within 24 h of symptom onset in the First Medical Center of PLA General Hospital were retrospectively analyzed. MATLAB ′s randperm function was used to divide 118 patients into a training set of 96 cases and a test set of 22 cases at a ratio of 8∶2. Fourty-seven AIS patients [38 males and 9 females, aged 16-75 (58±12) years] from one center of a multicenter study were selected to build the external validation set. SWI image and filtered phase image were combined into complex value image as full sampling reference image. Undersampled SWI images were obtained by retrospective undersampling of reference fully sampled images, and the undersampling multiple was five times which could save 80% of the scanning time, then the complex-valued convolutional neural network (ComplexNet) was used to develop reconstruct fast SWI. Interclass correlation coefficient (ICC) or Kappa tests were used to compare the consistency of image quality and the diagnostic consistency for the presence of susceptibility vessel sign (SVS), cerebral microbleeds and asymmetry of cerebral deep medullary veins (DMVs) in AIS patient on fully sampled SWI and fast SWI based on ComplexNet.Results:In test set, score of image quality was 4.5±0.6 for fully sampled SWI image and 4.6±0.7 for fast SWI based on ComplexNet, and coefficient was excellent (ICC=0.86, P<0.05). Full sampling SWI had good agreement with fast SWI based on ComplexNet in detecting SVS (Kappa=0.79, P<0.05), microbleeds (Kappa=0.86, P<0.05), and DMVs asymmetry (Kappa=0.82, P<0.05) in AIS patients. In the external validation set, score of image quality was 4.1±1.0 for fully sampled SWI image and 4.0±0.9 for fast SWI based on ComplexNet, and coefficient was excellent (ICC=0.97, P<0.05). Full sampling SWI had good agreement with fast SWI based on ComplexNet in detecting SVS (Kappa=0.74, P<0.05), microbleeds (Kappa=0.83, P<0.05), and DMVs asymmetry (Kappa=0.74, P<0.05) in AIS patients. Conclusions:Deep learning techniques can significantly accelerate the speed of SWI, and the consistency of image quality and detected AIS signs between fast SWI based on ComplexNet and fully sampled SWI is good. The fast SWI based on ComplexNet can be applied to the radiographic assessment of clinical AIS patients

Risk factors for calf muscle vein thromboses after spinal cord injury / 中华物理医学与康复杂志

Objective:To analyze the clinical data on hospitalized spinal cord injury patients with calf muscle vein thromboses (MCVTs) seeking prevention and treatment techniques.Methods:The medical records of 423 patients with spinal cord injury were collected. Those with MCVT constituted the observation group, while those without served as controls. Their clinical data were compared.Results:The risk factors for MCVT were screened in logistic regression analyses. The results showed that age, an ASIA grade of A or B, spinal fusion, preventive anticoagulation, physiotherapy treatment and a homocysteine level >15μmol/L were risk factors for the occurrence of a MCVT.Conclusions:Age, an ASIA grade of A or B, spinal fusion or an elevated serum homocysteine level are all risk factors for MCVT. Active anticoagulation and physical therapy may reduce the risk.

Repair of eyelids deformities caused by trauma with cosmetic surgery incisions / 中华医学美学美容杂志

Objective:To explore the effectiveness of repairing eyelids deformities caused by trauma with cosmetic surgery incisions.Methods:Retrospective analysis was conducted in 17 patients with eyelids deformities caused by trauma in Plastic and Cosmetic Center, School and Hospital of Stomatology, China Medical University from January 2016 to October 2018. The deformities included lower eyelid ectropion, scar contracture of endocanthion, displacement of the medial canthus ligament, displacement of external canthus. We used the incisions of blepharoplasty, modified Z-epicanthoplasty, and the cosmetic lateral canthoplasty. The surgeries included grafting of full-thickness skin from blepharoplasty to repair the defects after scar ectomy, anchoring of medial canthal ligament, suspending of lateral canthal ligament.Results:All the 17 patients had good appearance and normal functions of eyelids.Conclusions:It deserves well recommended for using cosmetic surgery incisions to repair eyelids deformities.

Efficacy of Autogenous Tooth Bone Graft Material for Patients with Alveolar Bone Deficiency in Orthodontic Treatment / 中国医科大学学报

Objective To evaluate the clinical effect of alveolar bone augmentation by applying autogenous tooth bone graft material to patients with alveolar bone deficiency in orthodontic treatment. Methods Four patients with a stable periodontal condition managed with fixed orthodontic treatment were included, and the number of graft sites was 17. Cone beam computed tomography (CBCT) showed labial alveolar bone deficiency. The treatment plan included extraction, and the extracted teeth were used to prepare autogenous tooth bone material. The alveolar bone width was measured at the same site at multiple heights prior to operation and at 3 and 6 months post-operation.Results The alveolar bone width was higher at both 3 and 6 months post-operatively (P ＜ 0.05) than that pre-operatively. The alveolar bone width at 6 months post-operation was lower than that at 3 months post-operation (P ＜ 0.05). Conclusion Applying autogenous tooth bone graft material to patients with alveolar bone deficiency in orthodontic treatment can expand the range of tooth movement and result in good clinical outcomes.

Advance in Measurement Methods of Intramedullary Pressure after Spinal Cord Injury (review) / 中国康复理论与实践

The measurement of intramedullary pressure is particularly important in the research of spinal cord injury. This article ana-lyzed the influence factors and the measurement methods of intramedullary pressure. The influence factors included edema, vascular regula-tion and bleeding, spinal dural, pia mater spinalis, cerebrospinal fluid, canalis vertebralis and body position, etc. The measurement methods included direct measurement methods, as the sensor placed in the parenchyma of spinal cord, intradural extramedullary or lumbar catheter, and measuring in vitro, and indirect measurement methods, as computer modeling and intraocular pressure measuring.

Research Progress of Two-photon Microscopy in Small Animals in Vivo Imaging (review) / 中国康复理论与实践

@#Two­photon microscopy is a new technique which combines laser scanning con-focal microscopy and two-photon excitation technique. Two-photon fluorescence microscopy has the advantages of little light damage, small bleaching area, strong penetrability, high resolution, high fluorescence collection efficiency, and high image contrast. It is suitable for dark field imaging and multi-labeled compound measurement, and has been widely used in small animals in vivo optical imaging, such as research for tumour, gene therapy, stem cells, drug development, spinal cord injury, etc.

Survey on Awareness of Upper Limb Function Reconstruction in Patients with Cervical Spinal Cord Injury / 中国康复理论与实践

@#Objective To survey the attitudes and acceptance level of upper limb function reconstruction in patients with cervical spinal cord injury and analyze the related factors. Methods From October, 2013 to June, 2014, a total of 104 patients with cervical spinal cord injury were surveyed with self-designed questionnaire. Results There were 81 valid questionnaires, in which 3 patients (3.7%) heard of upper-extremity reconstructive surgery. The patients longed for upper limb function improvement most. After they had a understanding of the surgery, their willingness improved (P<0.01). No significant difference was found in the satisfaction degree and operation willingness between different hand function groups (P>0.05). The patients focused on the operation cost, the operation risk, recovery time after operation and the satisfaction of assistive devices, however, they were not correlated with the willingness of upper limb function reconstruction (P>0.05). Conclusion There is a clear gap between strong desire for functional improvement of upper limb and surgery awareness. It is important to communicate upper limb among patients with cervical spinal cord injury.

Progress of Wearable Technology in Rehabilitation Medicine (review) / 中国康复理论与实践

With the development of science and technology, and the emergence of artificial intelligence, wearable technology is becom-ing a hot topic in the field of rehabilitation medicine. Wearable technology is characterized by miniaturization, intelligency and convenience, and has been widely researched and applied in many fields, such as neurological rehabilitation, orthopaedic rehabilitation, spinal cord injury rehabilitation and rehabilitation for senile degenerative diseases. The further research may focus on the reliability of signals under dynamic monitoring, the comfortable feeling during long-term use of wearable devices, the data security based on personal privacy, and so on.

Research Progress of MicroRNA in Spinal Cord Injury (review) / 中国康复理论与实践

@#MicroRNAs are short non-coding RNAs that regulate and control the translation of target genes, and play an important role in gene expression involved in the development of spinal cord and spinal cord injury, which constitute novel targets for therapeutic intervention to promote repair and regeneration of the spinal cord, also they are the potential biomarkers of spinal cord injury. This article reviewed the mechanism of microRNAs and listed several microRNAs in spinal cord injury area.

Research Progress of Model Establishment for Tethered Cord Syndrome (review) / 中国康复理论与实践

@# Tethered cord syndrome (TCS) is a progressive neurodevelopmental disorder. The TCS model was established mainly using physical and chemical Methods and surgery, but remained problems in failing to fully reflect the progressive course of the human TCS. In the future, it may select a single etiological factor to analyze, and gradually add other factors until we have deeper understanding of this disease.

Expert Consensus on Evaluation, Treatment and Rehabilitation of Traumatic Spinal Cord Injury / 中国康复理论与实践

Spinal cord injury is a catastrophic injury causing lifelong severe disabilities, and poses a great burden to the individuals, families and society. In order to promote the standardization in treatment of traumatic spinal cord injury, the consensus on the evaluation, treatment and rehabilitation of traumatic spinal cord injury was suggested by experts, who came from authoritative multicenter in China. The expert consensus, which formed a standardization process from the first aid clinical treatment to rehabilitation of spinal cord injury, shall give a better practical guide for clinic and rehabilitation physicians.

Effects of Celebrity Role Models on Teaching of Rehabilitation Medicine / 中国康复理论与实践

Objective To evaluate the effects of celebrity role models on the teaching of rehabilitation medicine. Methods The teaching program of rehabilitation medicine based on the effect of celebrity role models was designed and given to the college students of Capital Medical University School of Rehabilitation Medicine. The students in grades 2014 (group A) and 2015 (group B) were taught by the same teachers with celebrity and general roles, respectively. The learning attitude, immediate test following the teaching and the final exam were carried out to determine the teaching effects. Results The incidence of using mobile phones was higher in group B than in group A (χ2=8.22, P0.05). Nobody left early in the class. The scores of the evaluated chapters and the total score in the immediate test were higher in group A than in group B (t>2.048, P0.05). Conclusion The teaching program of rehabili-tation medicine based on the effect of celebrity role models could improve the short-term teaching effect.

Correlation between Serum Phosphorylated High-molecular-weight Neurofilament and Severity of Spinal Cord Injury in Rats / 中国康复理论与实践

Objective To investigate the level of phosphorylated high-molecular-weight neurofilament (pNF-H) after spinal cord injury (SCI), and explore the relationship between pNF-H and severity of SCI. Methods 20 Sprague-Dawley rats were equally divided into control group (group A), mild SCI group (group B), moderate SCI group (group C) and severe SCI group (group D). The level of pNF-H in serum, BBB score and remaining area of white matter were obtained at different time points. Results The level of serum pNF-H in groups B, C and D arrived at peaks 12 hours and 3 days after SCI, and there was significant difference among them (P<0.05). Both BBB score and remaining area of white matter 14 days after SCI negatively correlated with the level of pNF-H 3 days after SCI (r=-0.987 and r=-0.978, respective-ly). Conclusion The pNF-H increases twice after SCI in rats, and may be associated with the severe of SCI, which can be considered as a biomarker.

The effect of Laminaria japonica polysaccharides on the recovery of the male rat reproductive system and mating function damaged by multiple mini-doses of ionizing radiations.

To evaluate the radiation-protect effects of Laminaria japonica polysaccharides (LJP) on male reproductive system damage and mating dysfunction induced by multiple mini-dose ionizing radiations, male rats were administrated with radiation and/or LJP. Results showed that mating function (such as erection, mount and ejaculation), sperm count and survival rate in LJP group were significantly better than the corresponding model group after the radiation. The testis organ coefficient, GSH (glutathione) content, serum sex hormones (luteinizing hormone, follicle-stimulating hormone, testosterone and estradiol) levels improved while MDA (malondialdehyde) content decreased. In addition, SOD (superoxide dismutase), GSH-PX (glutathione peroxidase), LDH (lactate dehydrogenase) activities were enhanced while testicular tissue damage was reduced, 14 days after the cessation of radiation; all indicators in the LJP group were similar to the control group. Our results suggest that, LJP has some promoting effects on the recovery of the reproductive system and mating dysfunction induced by radiation.

Neuromuscular Functional Remodeling of Knee after Anterior Cruciate Ligament Reconstruction (review) / 中国康复理论与实践

Either injury or reconstruction of anterior cruciate ligament (ACL) may damage proprioceptive sense, remodel central ner-vous system and impair motor control. It is necessary to systematically remodel neuromuscular function, including proprioceptive sense cor-rection, central nervous system remodeling and motor control strengthening etc., for patients after ACL reconstruction.

Rehabilitation Medicine Teaching for International Medical Students / 中国康复理论与实践

With the continuous expansion of the enrollment of international medical students and the improvement of teaching quality, as well as the rapid development of rehabilitation medicine in China, rehabilitation medicine has become one of the required courses for in-ternational medical students. In view of the main problems suffered by the international medical undergraduate students in the study of reha-bilitation medicine, we mainly focused on the education concepts, teaching management and quality evaluation system, curriculum setting, construction of teaching materials, teacher training, teaching mode, teaching research and so on. The aim is to provide reference for improv-ing education quality in the course of rehabilitation medicine for the international medical students.