Objective To observe the expression of autophagy-related genes and proteins in the smooth bladder muscle of rats after spinal cord injury (SPI).Methods Twenty-four male Wistar rats were randomly and evenly divided into a model group and a control group.The model group had SPI induced using the modified Allen's method,while the control group was only given laminectomy.Six hours after the operation,the Basso Beattle Bresnahan (BBB) locomotor rating scale was used to evaluate the rats' hindlimb locomotor function.Nissl staining was used to observe the morphological changes in their spinal cords,while Western blotting and immunofluorescence staining were employed to assess the expression of microtubule-associated protein 1 light chain 3 (LC3) and protein 62 (P62).The expression of autography gene Beclin1 mRNA was determined using a reverse transcription polymerase chain reaction (RT-PCR).Results The average BBB score in the model group was significantly lower than in the control group.After Nissl's staining,a decreased number of neurons and Nissl bodies was observed.Western blotting showed that the expression of LC3-Ⅱ had increased significantly and that of P62 had decreased significantly in the model group compared with the control group.The immunofluorescence staining showed LC3 and P62 dots in the bladders' smooth muscle cells.RT-PCR detected significantly higher LC3 and Beclinl mRNA levels in the model group than in the control group;in contrast the average P62 mRNA level was significantly lower.Conclusions Autophagy was activated in rats' bladder muscles after SPI.That may be related to the pathogenesis of a neurogenic bladder after spinal cord injury.

ObjectiveTo evaluate the Chinese guidelines and consensus of rehabilitation medicine published in the medical journals in 2022 using Scientific, Transparent and Applicable Rankings (STAR). MethodsGuidelines and consensus which were developed by Chinese institutions or led by Chinese scholars were retrieved in databases of CNKI, Wanfang Data, CBM, Chinese Medical Journal Network, PubMed and Web of Science, in 2022, followed by screening for rehabilitation medicine field. The literature were rated with STAR. ResultsSeven guidelines and eleven consensuses were included. The STAR scores ranged from 11.7 to 69.6, with a median score of 25.9 and mean score of 28.3. There was a significant difference in the total score between guidelines and consensus (U = 12.000, P = 0.014). The score ratio was high in the domains of recommendations (73.6%), evidence (39.5%) and others (33.3%), while it was low in the domains of protocol (1.4%), clinical questions (12.5%) and conflicts of interest (13.9%). The score ratio was high in the items of listing the institutional affiliations of all individuals involved in developing the guideline (94.4%), identifying the references for evidence supporting the main recommendations (94.4%), indicating the considerations (e.g., adverse effects) in clinical practice when implementing the recommendations (88.9%), and making the recommendations clearly identifiable, e.g., in a table, or using enlarged or bold fonts (75%); and it was low in the items of describing the role of funder(s) in the guideline development (0), indicating information about the evaluation and management of conflicts of interest (0), providing tailored editions of the guidelines for different groups of target users (0), presenting the guideline or recommendations visually, such as with figures or videos (0), providing details of the guideline protocol (2.8%), assessing the risk of bias or methodological quality of the included studies (2.8%), describing the responsibilities of all individuals or sub-groups involved in developing the guideline (5.6%), indicating how the clinical questions were selected and sorted (5.6%), formating clinical questions in PICO or other formats (5.6%), making the guideline accessible through multiple platforms (5.6%), and declaring that the funder(s) did not influence the guideline's recommendations (8.3%). ConclusionThe quality of current clinical practice guidelines and consensus of rehabilitation medicine is poor, which should be developed in accordance with the relevant standards.