Objective To explore the correlation between the time course of disease and bone metabolism changes in patients with spinal cord injury. Methods Data on serum osteocalcin(SO)measured by radioimmunoassay(RIA)from a database on 167 patients with spinal cord injury(SCI)were analyzed retrospectively.The patients were divided into four groups according to the time post-injury:group A(＜3 months post-injury,n=44),group B(3-6 months post-injury,n=42),group C(7-12 months post-injury,n=37)and group D(＞12 months post-injury,n=44). Results The mean SO value in all 4 groups of patients was significantly higher than normal.The mean SO value of group B was significantly higher than that of group A,but not significantly different from that of group C.The mean SO value of group D was significantly lower than that of group C,but not significantly different from that of group A.Conclusion Serum osteocalcin is elevated in the early stages of SCI,and its subsequent de-cline is closely correlated with the time post-injury.

Objective To investigate the effects of locomotor training on improving locomotor function after spinal cord injury(SCI)and the mechanism of spinal cord plasticity.Methods A model of complete thoracic cord transection was established using 84 adult female rats divided into sham,SCI and treadmill training(BWSTT) groups.The hind limb locomotor function of all the rats was evaluated.The fluorescence intensities due to (EphA4),vesicular glutamate transporter 2(VGluT2)and EphA4/VGluT2 double-positive neurons in the ventromedial area of the anterior horn of the lumbar COrd were detected using immunofluorescence double labeling and laser confocal microscopy.Results The rats in the BWSTT group showed better functional recovery in their hind limbs than those in the SCI group.BWSTT was correlated with markedly increased EphA4.VGIuT2 and EphA4/VGluT2 intensities in the ventromedial area.Conclusion BWSTT improves hind limb locomotor function in rats with thoracic cord transections by elevating the expression of EphA4/VGluT2,promoting neuronal plasticity in the lumbar anterior horn.

ObjectiveTo investigate the characteristic of hindlimb movement recovery in adult rats after spinal cord injury and how to assess it.Methods 26 adult female rats were randomized in sham,completely midthoracic spinal cord transected(at T8 level) or body weight supported treadmill training(BWSTT) groups.Their motor function were assessed with Basso,Beattie,Bresnahan locomotor rating scale for open field(BBB scale) and average combined scores(ACOS).ResultsNone of the rats exhibited hindlimb movements after operation.30 d and 45 d after operation,BBB and ACOS score of rats in BWSTT group showed better than that in SCI group.There were significant differences in ACOS score among 15 d,30 d and 45 d after operation in both group.ConclusionPartial spontaneous hindlimb functional recovery can be found in chronic adult spinal cord injured rats and BWSTT would facilitate the recovery.Both semiquantitative and qualitative assessment were strongly correlated with locomotor recovery,but the semiquantitative assessment shows more sensitive.

Objective To explore the effect of body-weight support treadmill training(BWSTT)on lower extremity muscle atrophy and ambulatory capacity in complete spinal cord injured(SCI)patients.Methods 20 patients with complete SCI at the thoracic level were divided into control and BWSTT group.They all received comprehensive rehabilitation,and patients in BWSTT group also received BWSTT for 3 months when the physical condition was permitted.They were assessed before and after treatment with measurement of thigh girth,ambulatory capacity measure of Functional Independence Measure(FIM),10 meters ambulatory velocity and activity of daily living(ADL)evaluation.Patients in BWSTT group also received middle thigh MRI examination before and after BWSTT.Results The muscles at the mid-thigh of the BWSTT group looked larger after BWSTT than before.The scores of FIM ambulatory function,the 10 miters ambulatory velocity of BWSTT group improved significantly when compared with that of the control group(P<0.05).The thigh girth and the scores of ADL were no different between these two groups before and after treatment(P<0.05).Conclusion BWSTT may ameliorate lower extremities skeletal muscle atrophy and improve ambulatory capacity for SCI patients.

Osteocalcin is one of the biochemical markers of bone metabolism, produced by mature osteoblasts. It has been shown that serum osteocalcin is a marker of osteoblastic activity, and the levels reflect the rate of bone formation and bone turnover. Bone metabolism after spinal cord injury (SCI) initially reflects a disproportion between highly bone resorption and almost normal or lightly elevated bone formation, indicating an increase in bone turnover. Osteocalcin and other biochemical markers may be helpful to know the bone metabolism after SCI and to evaluate the effect of all kinds of methods in treating and preventing osteoporosis after SCI.

Objective To survey the situation of spinal cord injuries (SCI) in Beijing.Methods China Rehabilitation Research Center and Information Center of Beijing Health Bureau sponsored the surveillance of 86 hospitals in Beijing which had hospitalized SCI patients in 2002. The faculty of surveillance was composed of trained professionals. The number of registered SCI patients in 2002 was 1077, and 264 patients in 11 hospitals were chosen to be investigated in detail according to stratified sampling result.Results There were 1077 registered patients with a neurological deficit and the annual SCI incidence was 60 per million. The ratio of male to female was 3:1 and the ratio of cervical, thoracic, lumbar injuries and others is 4.9%, 28%, 66.7%, 0.4% respectively. The mean age at the time of injury was 41 years. The causes most frequently seen were falls from a height and traffic accidents. The mean time of hospitalization was 18.9 days and the mean expenditure of hospitalization was 27819.3 RMB. Four patients were transferred to rehabilitation hospitals, and others went homes directly after discharge.Conclusion There are many reasons for the high annual SCI incidence in Beijing and the first SCI cause was falling from a height, which should be pay special attention when the prevention measures are taken into account. The rate of SCI patients who received systemic medical rehabilitation was low.

Objective:To evaluate the efficacy of compatibility of different opioids for postoperative patient-controlled intravenous analgesia (PCIA) in the patients undergoing gastrointestinal surgery.Methods:A total of 6 556 patients undergoing PCIA after gastrointestinal surgery in the first affiliated Hospital of Air Force military Medical University from May 2018 to March 2022 were retrospectively collected and divided into sufentanil plus nalbuphine group (SN group), hydromorphine plus nalbuphine group (HN group) and sufentanil group (S group). In SN, HN and S groups, the PCIA solutions contained sufentanil 100 μg+ nalbuphine 40 mg, hydromorphone 10 mg+ nalbuphine 40 mg, sufentanil 200 μg, respectively, in 100 ml of normal saline, and the PCA pump was set up with a background infusion at a rate of 1 ml/h, bolus dose 0.5 ml, and lockout interval 10 min.The demographic data, the number of patients with insufficient analgesia at rest and during activity (visual analog scale score≥4) at 24 and 48 h after operation, adverse reactions, time to first flatus and first postoperative off-bed time were collected.Results:Compared with S group, the incidence of insufficient analgesia at rest and during activity, dizziness, nausea and vomiting, effective pressing times of PCA and consumption of drugs in the analgesic pump were significantly decreased at 24 and 48 h after operation in HN group and SN group, the incidence of drowsiness was decreased at 24 h after operation, and the time to first flatus and first postoperative off-bed time were shortened in HN group, and the incidence of somnolence was increased at 48 h after operation in SN group ( P<0.05). Compared with SN group, the incidence of insufficient analgesia at rest at 24 and 48 h after operation was significantly increased, the incidence of insufficient analgesia during activity, dizziness, nausea and vomiting, effective pressing times of PCA and consumption of drugs in the analgesic pump were decreased, the incidence of drowsiness was increased at 24 h after operation, the incidence of somnolence was decreased at 48 h after operation, and the time to first flatus and first postoperative off-bed time were shortened in HN group ( P<0.05). Conclusions:Hydromorphine mixed with nalbuphine provides better efficacy than sufentanil mixed with nalbuphine and sufentanil and is helpful in shortening the recovery time of gastrointestinal function when used for postoperative PCIA in the patients undergoing gastrointestinal surgery.