Objective To investigate the risk and prediction factors for tracheotomy after cervical spinal injuries. Methods A retrospective analysis was done on 1 064 cases suffering from cervical spinal injuries, of which, according to nerve function evaluation criteria of American Spinal Injury Association (ASIA), there were 243 cases at Grade A,327 at Grade B, 306 at Grade C and 188 at Grade D. Except for seven cases with brain injuries, trachea injuries, with a tracheotomy before hospitalization, a total of 106 cases needed tracheotomy during their hospitalization. The following factors were evaluated to predict the possible causes for tracheotomy: segment of injury, ages, smoking history, past diseases (such as diabetes mellitus, hypertension and coronary heart disease) and complicated chest or lung injuries. Results The highest rate of tracheotomy for cervical spinal injury at Grade A was 35.0% (85/243), while the rate of tracheotomy for incomplete injury at Grades B, C and D was only 2.6% (21/814). Of cervical spinal injury at Grade A, all C_3 segment injuries needed tracheotomy. Of all, the percentage for C_4 and C_5 segment injuries accounted for 43.2% (105/243),of which the percentage for tracheotomy was 74% (63/85). The possibility of tracheotomy decreased gradually from below C_5. Besides C_3 segment injuries, C_4 segment injuries had the highest possibility of tracheotomy, with statistical difference compared with other segments (P

Background/Aims: It is a common belief that constipated patients have hard feces that contributes to the difficulties defecating. To the best of our knowledge, no studies had been published on controlled evacuation of simulated feces with different consistencies. Methods: Twelve normal subjects were recruited for studies with the simulated feces device “Fecobionics” of different consistency (silicone shore 0A-40A corresponding to Bristol stool form scale types 2-4). The subjects filled out questionnaires and had the balloon expulsion test and anorectal manometry done for reference. The Fecobionics probes were inserted in rectum in random order with +20 minutes between insertions. The bag was filled to urge-to-defecate and evacuations took place in privacy. Non-parametric statistics with median and quartiles are provided. Results: One subject was excluded due to technical issues, and another had abnormal anorectal manometry–balloon expulsion test. The 4 females/6 males subjects were aged 23 (range 20-48) years. Most differences were observed between the 0A and 10A probe (duration, maximum bag pressure, duration x maximum bag pressure, and relaxation of the front pressure and the bend angle during evacuation), eg, the duration was 9 (8-12) seconds at 0A and 18 (12-21) seconds at 10A (P < 0.05), and maximum bag pressure was 107 (96-116) cmH 2 O at 0A and 140 (117-162) cmH 2 O at 10A (P < 0.05). The bend angle before evacuation differed between the probes whereas only the 10A differed from 40A during defecation. The 10A was harder to evacuate than the 0A probe. Except for the bend angles, no further significant change was observed from 10A to 40A. Conclusion Fecal consistency affects defecatory parameters.