Under the new mode of training clinical post-graduate students, it is enhanced to train the clinical competence in rehabilita-tion medicine. As high level professionals, the scientific research ability is very important for the post-graduate students, too.

On the basis of previous classification of lower urinary dysfunction, the author developed a new classification of the comprehensive urinary tract dysfunction for neurogenic bladder, which included a new grading standard for the hydronephrosis and ureter dilatation. This classification can provide with comprehensive, scientific and objective basis for the evaluation, description and recording the pathphysical changes of lower and upper urinary tract dysfunction.

Underactive bladder is the main part of lower urinary tract symptoms. As a conservative treatment, intravesical electrical stimulation can improve the function of bladder sensation, and promote micturition. Intravesical electrical stimulation is effective and safe on underactive bladder, both idiopathic and neurogenic. Rectilinear biphasic waveform, low frequency and short pulse width stimulation was recommended.

Objective To evaluate if replication-defective herpes simplex virus mediated kynurenine aminotransferase Ⅱ (HSV-KAT Ⅱ) could inhibit detrusor overactivity (DO) in rats with spinal cord injury by bladder wall injection.Methods From June 2012 to July 2013,48 male Wistar rats with T10 spinal cord transection (SCT) were randomly divided into normal saline group,HSV group and HSV-KAT Ⅱ group (n=16 each group).Normal saline (40 μl),HSV or HSV-KAT Ⅱ (40 μl,1×107 plaque forming unit viruses) was injected into the rat bladder wall of according group by 1 week after SCT.Three weeks after injection,cystometry was performed and the virus transfected efficiency,expression of KAT Ⅱ in L6-S1 dorsal root ganglia were examined.Results The DO number,DO amplitude,maximum voiding pressure and volume inducing voiding were decreased significantly by 59.6％-61.1％,21.6％-24.2％,30.3％-34.4％ and 44.1％-46.5％ (P＜0.01),while voiding efficiency,the time to first DO were increased significantly by 40.7％-47.7％ and 30.1％-49.0％ (P＜0.01) in the HSV-KAT Ⅱ group compared with normal saline group and HSV group.However,the leaking volumes were no significantly different among the 3 groups (P＞0.05).The relative intensity of KAT Ⅱ protein (0.50±0.13 versus 0.28±0.07,P＜0.05) and mRNA (0.78±0.06 versus 0.51±0.08,P＜0.01) were increased significantly in HSV-KAT Ⅱ group than those in HSV group.Conclusion HSV-KATⅡ bladder wall injection inhibits DO and may improve detrusor-sphincter dyssynergia in rats with spinal cord injury.

Objective To investigate the video-urodynamics indication of upper urinary tract dilation secondary to neurogenic bladder that may be resolved only by intermittent catheterization. Methods From January, 2008 to August, 2016, twelve cases of upper urinary dila-tion secondary to neurogenic bladder were treated by intermittent catheterization only. Their clinical data was reviewed. Results The mor-phology and function index of upper urinary tract were improved gradually during the regular follow-ups. The common video-urodynamics characteristics include no detrusor overactivity, no vesicoureteral reflux, cysctometry volume larger than 300 ml and detrusor presser at the capacity lower than 40 cmH2O, poor voiding efficiency with residual volume larger than 150 ml. Conclusion For upper urinary tract dilation secondary to neurogenic bladder characterized as passable storage and poor voiding, intermittent catheterization may be enough to resolve the dilation.