Heat stroke (HS) is a life-threatening illness characterized by core body temperatures above 40 ℃ coupled with central nervous system (CNS) dysfunction, including delirium, convulsions, and/or coma. Its morbidity has increased dramatically in the past few decades. Multiple organ dysfunction syndrome (MODS) is not only the most serious complication of HS, but also the leading cause of deaths. Understanding the pathogenesis, characteristic and advancement pattern of MODS caused by HS will have a profound effect on the clinical treatment, research and mortality decrease. The pathogenesis, injury characteristic of each system and organ, and treatment methods were summarized in this review so as to deepen the clinical recognition of this disease.

Objective To evaluate the effect of combination transfer pump and single blood pump to 32 cases of renal failure patient who need blood purification therapy.Methods The combination transfer pump and single blood pump were used.According to the clinical requirement,the parameters of transfer pump were set such as therapy time,replacement liquid flow rate,dialysate flow rate,temperature of warmer and filtrate flow rate,etc.Results 32 patients with varying degrees of illness have been alleviated.Patients' acute left heart failure,water and electrolyte turbulences,acid intoxication and azotemia caused by liquid retention were corrected,which ensured a role for further treatment.Conclusion It is the functions of adjustable time and transfusion volume that are used in the combination transfer pump,the task of which is accomplished by several transfer pumps together.This method is easy to implement and can meet the clinical requirement largely without special CBP instrument.

The comprehensive and precise functional evaluation is imperative in finding the disabilities of patients with quadriplegia,and it is the basement of providing appropriate rehabilitation training.The predominant instruments which have been used to evaluate the functional capacity of the quadriplegics include Barthel Index,Functional Independence Measure,Quadriplegia Index of Function,a short-form of Quadriplegia Index of Function Scale and Spinal Cord Independence Measure.The purpose of this article is to introduce the characters of each instrument above in functional evaluation for quadriplegics and the comparison among them.

This article mainly introduced the basic strategy of rehabilitation of spinal cord injury,including maintaining and improving range of motor(ROM),enhancing the muscle strength,sitting and standing balance training,respiration training,application of splints and aids.The rehabilitation objectives and approaches of each level of spinal cord injuries were also involved.

The complications of spinal cord injury(SCI)affect not only the rehabilitation treatment,but also quality of the patients' living,even threaten to patients' life,including pressure sore,complications of urinary system and respiratory system,deep venous thrombosis,pulmonary embolism,spasm,pain,autonomic dysreflexia,osteoporosis,etc.The prevention and treatment of complications of SCI may be helpful to improve patients' health,and a premise of the rehabilitation.

BACKGROUND: Human transforming growth factor-β1 gene can be used for gene therapy of the degeneration of intervertebral discs, but the key to the experiment is to construct its effective vector.OBJECTIVE: To determine whether or not adult degenerated intervertebrai disc cells cultured in vitro after transfected by eukaryotic expression vector can express the product of human transforming factor-βl, and to provide the experimental basis of gene therapy for intervertebral disc degeneration.DESIGN: Single sample experiment. SETTING: Traumatic Orthopedic Institute of Shandong Province and the Orthopedic Department of Weihai Municipal Hospital.MATERIALS: The experiment was conducted at the laboratory of Traumatic Orthopedic Institute of Shandong Province between October 1999and January 2001. Intervertebral disc samples were from the operated patients with protrusion of irtervertebral disc after the patients were informed.Sample 1 was intervertebral disc at L4/5 from a 30-year-old woman; sample 2 was intervertebral disc at L5/S1from a 30-year-old woman.METHODS: ① Culture of adult degenerated intervertebral disc cells:Samples ex vivo were taken back to the laboratory within 30 minutes; fibrous ring cells and myelin nucleus cells cultured primarily were collected.② Transfection: Cells were put in the 24-well culture plate with 5.5×105cells in each well. Constructed PCI-hTGF-β1 eukaryotic expression vector was used to perform transfection, then transfected PCI group and nontransfected group were set. ③ The expression product of cells transfected for 48 hours was determined with immunohistochemical staining method.MAIN OUTCOME MEASURES: Comparison of absorbance of the positive cell product of eukaryotic expression vector PCI-hTGF-β1 in the primary fibrous ring cells and myelin nucleus cells in each group.RESULTS: ① Sample 1: The absorbance of positive cell product of eukary otic expression vector PCI-hTGF-β1 in the primary fibrous ring cells and myelin nucleus cells was 3.49 and 3.69 times that in PCI group, and 3.55times that in non-transfected group. ② Sample 2: The absorbance of positive cell product of eukaryotic expression vector PCI-hTGF-31 in the primary fibrous ring cells and myelin nucleus cells was 3.56 and 3.46 times that in PCI group, and 3.43 times and 3.33 times that in non-transfected group.CONCLUSION: PCI-hTGF-31, as the effective eukaryotic expression vector in the transfection of transforming growth factor-31 gene to culture degenerated intervertebral disc cells in vitro, can transfect adult degenerated intervertebral disc cells cultured in vitro and obtain the high expression of human transforming growth factorβ1 gene.

Objective To investigate the reliability of Assessment of Activities of Daily Living of Chinese Quadriplegics. Methods The scale was administered to 20 patients with quadriplegia twice within one week interval by the same rater, and was administered to the same patients by another rater within 2 days after the first assessment. Results The intraclass correlation coefficient (ICC) of the test-retest reliability was 0.994 (P<0.01); the ICC of the inter-observer reliability was 0.971 (P<0.01). Conclusion Assessment of Activities of Daily Living of Chinese Quadriplegics is an instrument with high test-retest reliability and inter-observer reliability.

Study design Survey of expert opinion, feedback and final consensus. Objective To describe the development and the variables included in the International Spinal Cord Injury (SCI) Spinal Interventions and Surgical Procedures Basic Data set. Setting International working group. Methods A committee of experts was established to select and define data elements. The data set was then disseminated to the appropriate committees and organizations for comments. All suggested revisions were considered and both the International Spinal Cord Society and the American Spinal Injury Association endorsed the final version. Results The data set consists of nine variables: (1) Intervention/ Procedure Date and start time (2) Non-surgical bed rest and external immobilization, (3) Spinal intervention-closed manipulation and/or reduction of spinal elements, (4) Surgical procedure-approach, (5) Date and time of the completion of the intervention or surgical closure; (6) Surgical procedure-open reduction, (7) Surgical procedure-direct decompression of neural elements, and (8 and 9) Surgical procedure- stabilization and fusion (spinal segment number and level). All variables are coded using numbers or characters. Each spinal intervention and procedure is coded (variables 1 through 7) and the spinal segment level is described (variables 8 and 9). Sample clinical cases were developed to illustrate how to complete it. Conclusion The International SCI Spinal Interventions and Surgical Procedures Basic Data Set was developed to facilitate comparisons of spinal interventions and surgical procedures among studies, centers and countries.

Objective To compare the characteristics of traumatic and non-traumatic spinal cord injury (SCI). Methods 226 patientswere reviewed. Results 73.4% of patients were traumatic SCI, who aged (33.96± 12.18) years, younger than non-traumatic (43.98± 11.4)years; 65.4% were complete injury, more than non-traumatic 38.7%; stayed in hospital for (189.74±157.88) d, longer than non-traumatic(142.53±85.72) d; spent (55270.39±47967.59) yuan, more than non-traumatic (40838.94±34786.85) yuan. The score of activities of daily livingwhen discharged (ADL2) was (54.25±24.16), poorer than non-traumatic (74.88±25.61). Conclusion Trauma is the major cause of SCI.The patients with traumatic SCI were younger, stayed in hosptital for longer time, spent more for hospitalization, and with poor ADL2.

Urodynamic data studying is universal for evaluating the lower urinary tract function after spinal cord injury. Urodynamic Basic Data Set for Spinal Cord Injury (SCI) is designed to standardize the collection and reporting of a minimal amount of information from the urodynamic study in daily practice in accordance with purpose and vision of the International Spinal Cord Injury Data Sets.