Spinal cord injury causes motor dysfunction below the level of damage plane, that due to the interruption of descending tracts passing movement instruction from the brain to the spinal cord. The main tract is the corticospinal tract which dominate the extremity motor function. The regeneration of the corticospinal tract or functional remodeling after spinal cord injury is anatomical pathology basis of promoting recovery of extremity motor function. This article discussed the anatomical knowledge of the corticospinal tract and previous classic methods of promoting corticospinal tract axon regeneration and repair and the latest research progress, in order to help the clinical treatment.

To investigate the effects of brachial plexus block(BPB) and satellite ganglion block(SGB) on the blood flow of upper limb, 22 patients were randomly divided into two groups,and given BPB(group A,n=11) or SGB(group B,n=11) with 1% lidocaine 10 ml every other day for 5 times. Ulnar-radial artery blood flow was measured by using a TCD 30 minutes before and after the block. Finger pulse amplitude was measured by pulse oximeter 5,10,15,20,30 minutes after the block.The average increase in ulnar-radial artery blood flow was 13 cm/s in group A and 5 cm/s in group B. Finger pulse amplitude increased by (9.04±2.12)mm in group A and(3.54±1.42)mm in group B.A significant difference was observed between the two groups (P＜0.01).It suggested that BPB could induce more increase in blood flow of the upper limb than SGB.

Objective To observe the clinical efficacy of navel acupuncture in treating lumbar spinal stenosis. Method A total of 120 patients with lumbar spinal stenosis were randomized into a treatment group and a control group, 60 cases each. The treatment group was intervened by navel acupuncture based on syndrome differentiation of traditional Chinese medicine, while the control group was intervened by oral administration of Bulleyaconitine A tablets, 10 d as a treatment course, for successive 2 courses. The Visual Analogue Scale (VAS) was observed before and after the intervention, and the clinical efficacies were compared.Result The total effective rate was 98.3% in the treatment group versus 76.6% in the control group, and the between-group difference was statistically significant (P<0.01). The VAS scores were significantly changed after the intervention in both groups (P<0.05); the VAS score in the treatment group was significantly different from that in the control group after the treatment (P<0.05).Conclusion Navel acupuncture is an effective approach in treating lumbar spinal stenosis.

Objective To investigate the effect of various doses of dezocine on the prevention of emergence agitation after sevoflurane anesthesia in children .Methods 100 children aged from 1 to 3 years old were randomly divided into 4 groups with 25 cases each :the 0 .03 mg/kg dezocine group (group D1) ,the 0 .05 mg /kg dezocine group (group D2) ,the 0 .10 mg/kg dezocine group (group D3) and the control group .Anaesthesia was induced with 6% sevoflurane and 1 μg/kg remifentanil .Anaesthesia was maintained with 1 .5% - 2 .5% sevoflurane and remifentanil .Different doses of dezocine 0 .03 mg/kg ,0 .05 mg/kg ,0 .10 mg/kg ,and the same volume saline were administered before surgery .The incidence of emergence agitation was assessed with 5 points scale and the severity of emergence agitation was assessed with Pediatric Anesthesia Emergence Delirium (PAED) scale .The time to remove the laryngeal mask airway ,the time to be discharged from the post-anesthesia care unit (PACU) ,FLACC and Ramsey scores ,post-operative nausea and vomiting were recorded and considered .Results Compared with the control group ,the incidence of emergence agitation and PAED scales of D2 and D3 group were significantly lower than it (P < 0 .05) .Compared with the control group , FLACC scores of D2 and D3 group were lower than it(P< 0 .05) .At the same time ,Ramsey scores of D2 and D3 were higher than that of the control group(P < 0 .05) .Moreover ,Ramsey score of D3 was higher than D2(P < 0 .05) .The time span of being dis-charged from the PACU of D3 was significantly longer than that of the other groups(P< 0 .05) .Conclusion Dezocine of 0 .05 mg/kg and 0 .10 mg/kg both can reduce the incidence of emergence agitation effectively ,and there is no significant difference between the effect of the two doses .However ,the dose of 0 .05 mg/kg has a better performance in the time span for being discharged from the PACU .

[Objective]To analyze the clinical characteristics and treatment methods of upper-middle thoracic fractures with spinal cord injury.[Method]Forty patients with upper-middle thoracic fracture were retrospectively reviewed.Hanley-Eskay classification was used:compression fractures in 4,burst fractures in 11,fracture-dislocations in 23,and burst dislocation in 2 cases.Neurologicall function(according to the ASIA classification):A in 29,B in 3,C in 4,D in 0,and E for 4 cases.Four cases without spinal cord injury received conservative treatment.Thity-six cases with spinal cord injury underwent laminectomy and reduction followed by posterior fusion with bone graft and pedicular screw instrumentation.All 36 cases received early rehabilitation.[Result]All 40 cases were evaluated clinically,radiographically,and functionally during the follow-up(mean,32 months).Conservative group:one case developed delayed kyphosis deformity with neurological deficit and underwent anterior-posterior surgical treatment 16 months tater.Surgical group:the correction in 3 patients was not complete on radiographs after operation.No loose screw or breakage was found,and the grafted bone was completely fused.Among the patients with spinal cord injury,one case in ASIA A improved to ASIA B,one case in ASIA B improved to ASIA C,two cases in ASIA C improved to ASIA D.All of the 4 cases with hemorrhage less than 4 mm(MIRI) increased 1 grade of ASIA.Activities of daily living(ADL)scores were increased (average,22.53?6.25)at early rehabilitation in all cases.[Conclusion]The upper-middle thoracic fractures are involved in multipla spine vertebral levels,high dislocation incidence,serious spinal cord injury(most cases were complete injury),poor prognosis.Presence of hemorrhage less than 4 mm (MRI) was associated with good prognosis.Posterior approach decompression and reduction followed by fusion with bone grafting and pedicle screws instrumentation are ideal surgical methods for patients with fresh fractures.Early rehabilitation may improve daily life ability and prevent complications.

[Objective]To compare the neurological improvement of the patients with spinal cord injury without radiographic abnormality (SCIWORA)after primary treatment including operation via anterior/posterior approach and conservative management,and to discuss about evaluating standard for this kind of patients.[Method]Eighty adult cervical SCIWORA patients,72 males and 8 females with an average age of 52.7 years(34 to 74 years)and a follow up period of 53 weeks (48 to 60 weeks),were retrospectively studied. They were divided into the anterior operated,posterior operated and conservative treated groups. The motor and sensory scores and impairment scale of each patient were obtained at least three times by international standard for the neurological classification of spinal cord injury (ASIA standard),and those of their first and final visits to the hospital were retrieved and analyzed. Mann-Whitney U Test and Wilcoxon Rank Sum Test were used in statistic study.[Result]All the patients achieved an average increase of 2 to 5 points of motor scores (P

To investigate the effects of brachial plexus block(BPB) and satellite ganglion block(SGB) on the blood flow of upper limb, 22 patients were randomly divided into two groups,and given BPB(group A,n=11) or SGB(group B,n=11) with 1% lidocaine 10 ml every other day for 5 times. Ulnar-radial artery blood flow was measured by using a TCD 30 minutes before and after the block. Finger pulse amplitude was measured by pulse oximeter 5,10,15,20,30 minutes after the block.The average increase in ulnar-radial artery blood flow was 13 cm/s in group A and 5 cm/s in group B. Finger pulse amplitude increased by (904?212)mm in group A and(354?142)mm in group B.A significant difference was observed between the two groups (P

Objective:To explore the effect of stage target intervention on mental state, quality of life and prognosis of spontaneous cerebral hemorrhage, so as to provide reference for improving the quality of life and prognosis of patients with spontaneous cerebral hemorrhage.Methods:A total of 261 patients with spontaneous cerebral hemorrhage from June 2017 to June 2019 in Beijing Union Hospital were selected as the research subjects. Patients were divided into the observation group (131 cases) and the control group (130 cases) by the random number table method. The control group was treated with routine nursing intervention, and the observation group applied stage target intervention based on the control group. The psychological state, quality of life and prognosis of the two groups were evaluated by Self-rating Anxiety Scale (SAS), Self-rating Depression Scale (SDS), modified Rankin Scale (mRS), Stroke Specific Quality of Life scale (SS-QOL).Results:There were no significant differences in SAS, SDS, mRS, SS-QOL before intervention between the two groups ( P >0.05) . After intervention, the scores of energy, family role, language, activity, emotion, personality, self-care ability, social role, upper limb function, work / labor and total scores of SS-QOL in the two groups were all increased ( P < 0.05), and the increase of energy, family role, language, activity, emotion, personality, self-care ability, social role, upper limb function, work / labor and total scores of SS-QOL in the observation group were higher than those in the control group, and the differences were statistically significant ( P < 0.05). After intervention, the scores of SAS, SDS and mRS were (42.07±4.14), (43.09±4.79), (3.06±0.42) points in the observation group and (51.83±4.65), (54.82±4.92), (3.57±0.50) points in the control group, and the differences were statistically significant ( t values were 17.912, 19.516, 8.925, P < 0.05). Conclusions:Stage target intervention can improve the anxiety and depression of patients with spontaneous cerebral hemorrhage, improve the quality of life, and reduce the incidence of poor prognosis.

Objective To investigate the effect of dezocine on emergence agitation (EA) during recovery from sevoflurane-based anesthesia in children.Methods Ninety ASA Ⅰ or Ⅱ children,aged 3-6 yr,weighing 14-31 kg,were randomized into 3 groups (n =30 each):fentanyl group (group F),dezocine group (group D)and control group (group C).Anesthesia was induced with inhalation of 8 ％ sevoflurane and iv injection of atracurium 0.5 mg/kg and remifentanil 1 μg/kg and maintained with inhalation of 2％-3 ％ sevoflurane and infusion of remifentanil at 0.1-1.0 μg· kg-1 · min-1.In groups F,D and C,fentanyl 2 μg/kg,dezocine 0.05 mg/kg and the equal volume of normal saline were injected intravenously 10 min before the end of surgery,respectively,and inhalation of sevoflurane was stopped at the end of operation.The extubation time and length of stay in the postanesthesia care unit (PACU) were recorded.Agitation and the duration were recorded when the children were in PACU.The degree of EA was assessed using the Pediatric Anesthesia Emergence Delirium (PAED) scale.Pain was evaluated using the Children' s Hospital of Eastern Ontario Pain Scale (CHEOPS) and sedation was measured with Ramsay score.The complications such as respiratory depression,postoperative nausea and vomiting were recorded within 24 h after operation.Results Compared with group C,the incidence of EA and PAED scores were significantly decreased and the duration of EA was shortened in groups F and D,CHEOPS scores were decreased at each time point after operation and Ramsay scores were increased at T1 in group F,and CHEOPS scores were decreased and Ramsay scores were increased at each time point after operation in group D (P ＜ 0.05).Compared with group F,the incidence of EA and PAED scores were significantly decreased,CHEOPS scores were decreased at each time point after operation,and Ramsay scores were increased at T2 (P ＜ 0.05),and no significant change was found in the duration of EA in group D (P ＞ 0.05).There was no significant difference in the extubation time and length of stay in the PACU between the three groups (P ＞ 0.05).Conclusion Dezocine 0.05 mg/kg can safely and effectively prevent EA during recovery from sevoflurane-based anesthesia in children and produces better efficacy than fentanyl.

Objective To observe the clinical efficacy of Shiwei Longdanhua Capsule combined with western medicine on patients with mild acute exacerbation of chronic obstructive pulmonary disease (COPD) with phlegm-heat obstructing lung syndrome. Methods Totally 192 cases of COPD with mild acute exacerbation (phlegm-heat obstructing lung syndrome) were recruited. They were randomly divided into the treatment group (96 cases) and the control group (96 cases). Patients in the control group were treated in line with the regular Western treatment, while patients in the treatment group were additionally treated by Shiwei Longdanhua Capsule. After 10-day treatment, the changes of TCM syndrome score, symptom integral and the lung function before and after treatment were compared. Results After treatment, 14 patients withdrew from the treatment group and 15 patients withdrew from the control group. The total efficiency rate of TCM syndrome was 80.49% (66/82) in the treatment group, while it was 56.79% (46/81) in the control group, with statistical difference between the two groups (P<0.05). The severity and frequency of cough and expectoration of the treatment group were better than the control group (P<0.05). The breathing symptom and pulmonary function of patients in the two groups improved, with similar efficacy. Conclusion The efficiency of Shiwei Longdanhua Capsule combined with Western medicine in the treatment of acute exacerbation of COPD is superior to that of simple Western medicine treatment, especially in terms of relieving cough and expectoration.