Hydronephrosis after spinal cord injury (SCI) may result in renal insufficiency which ranks as the most common late cause of death in SCI patients. SCI may cause vesicourethral dysfunction of nerve regulation, which in turn brings about functional obstruction, high intravesical pressure, increase of the incidence and frequency of detrusor uninhibitory constractions, leading to hydronephrosis. The paramount principle of prevention and treatment of hydronephrosis is keeping low vesical pressure (storage pressure <40 cmH2O, voiding pressure <60 cmH2O). Oral anticholinergics combined with intermittent catheterization are the best choice for the slight hydronephrosis, urinary operations such as botulinum toxin injection into detrusor, transurethral sphincterotomy, ileocystoplasty may be needed for the moderate and severe hydronephrosis.

Objective To design and apply a kind of controllable enema input apparatus in patients with spinal cord injury (SCI). Methods 20 SCI patients with chronic constipation were included. Their defecation time, nature of defecation and usage of enema of 5 times of defecation were recorded before and after using the new apparatus. Results There were significant differences in the defecation time, nature of defecation and usage of enema before and after using the new apparatus (P<0.05). Conclusion The application of the new controllable enema input apparatus may shorten the defecation time, improve the nature of defecation, and reduce the usage of enema in SCI patients with chronic constipation.

Objective To investigate the relations between radiological findings and pathological classification of superficial depressed(Ⅱc type)early gastric cancer.Methods Radiological features in subtonic double contrast barium examination and the endoscopic pictures of early gastric cancer compared with the global pathological specimens and micro-pathological features were prospectively studied.Combined with the gastric endoscopic pictures,the sharpness of margin of the lesions,the changes of converging mucosal folds and the changes of the depressed surface on the film of double contrast barium examination were analyzed.The correlation between the radiological features and histological classification of gastric cancer including well differentiated tubular adenocarcinoma(tub1),moderately differentiated tubular adenocarcinoma(tub2),poorly differentiated adenocarcinoma(por)and signet-ring cell carcinoma(sig) were studied.Results In 102 cases of Ⅱc type early gastric cancer,there were tubl 27 cases,tub2 11, por 26 and sig 38 cases histologically.The margin of the depressed lesions of tub1(24 cases)and tub2 (9 cases)cancers were mostly unsharply demarcated or with fine spicular border,while the margin of lesions of por(15 cases)and sig(31 cases)were mostly clearly and sharply demarcated,with statistical significance (P

ObjectiveTo compare differences in life satisfaction, quality of life and mood between UK and Chinese tetraplegia patients after rehabilitation.MethodsThe sample consisted of 44 tetraplegics, 22 from UK and 22 from China, the survey about life satisfaction, quality of life, anxiety and depression was made and analyzed.ResultsPatients of UK group were significantly more satisfied with their situations of vocational and financial, and family life than that in Chinese group, and more active with their value of life, meaning of life and mood than that in Chinese group. No significant differences were identified between two groups in life as a whole, self care, leisure situation, sexual life, partnership relations, contact with friends and ratings of overall quality of life.ConclusionIt is very important to enhance the psychological adaptation of disability so as to improve the quality of life of the tetraplegics in China.

Objective:To discuss the methods and effects of clinical pharmacists in the Chinese and western medicine pharmaceu-tical care for one myelitis patient infected by brucellosis. Methods:Taking one myelitis patient infected by brucellosis as the example, clinical pharmacists provided Chinese and western medicine pharmaceutical care through making individualized drug regimen, perform-ing drug education and so on. Results:Clinical pharmacists participated in the therapeutic process actively, and performed Chinese and western medicine pharmaceutical care. As a result, the body temperature, look,tongue coating and excrement of the patient were obvi-ously improved. Conclusion:Performing Chinese and western medicine pharmaceutical care in clinics is very important for safety and effectiveness of drugs and improvement of drug use level.

ObjectiveTo observe the efficacy and tolerability of tolterodine on spinal cord injured (SCI) patients with detrusor hyperreflexia.Methods39 cases were treated with tolterodine administration for at least two weeks (8.31±6.47 months in average), the range of drug dosage was 1 mg to 12 mg per day, 5.82±3.13 mg in average. Twelve of them have taken the drug (1-8 mg per day) for one year.ResultsAfter two weeks of treatment, 37 cases (94.87%) had a good effect, and the bladder volume increased 74.36±35.32 ml (P<0.001), the mean frequency of micturition decreased 3.85±2.38 times (P<0.001), urine of each micturition increased 49.74±41.20 ml (P<0.001), the residual urine increased 64.62±41.98 ml(P<0.001).Additionally, hydronephrosis of two cases was remitted. The adverse events: 8 cases of thirsty, 1 case of tachycardia and 1 case of urine retention.ConclusionTolterodine has a good effect and limited side effects on SCI patients with detrusor hyperreflexia.

ObjectiveTo explore the effect and limitation of α1 adrenergic recepter blockers used in bladder management of spinal cord injured patients.Methods70 patients were divided into two groups who received intermittent catheterization and intermittent catheterization combined with Alfuzosin respectively. After 4 months of treatment, the residual urine and the time to reduce the residual urine were compared.ResultsThere was no differences in deducing the residual urine and the time to reduce the residual urine between the two groups.ConclusionAlfuzosin has limited effect in reducing the residual urine in bladder management.

ObjectiveTo investigate the clinical manifestation, mechanism and optimal treatment of hydronephrosis after spinal cord injury. Methods58 slight and moderate cases were retrospectively analyzed. ResultsThere were no differences in the remitted time among the therapies of indwelling catheter, intermittent catheterization and medicine, mixed therapy. 56 (96.55%) SCI hydronephrosis remitted after treatment, 28(48.28%) recurred within 3 months. The recurrence rate of the patients with detrusor sphincter dyssynergia (57.14%) was higher than that of the detrusor hyperreflexia (28.57%) and the detrusor hyporeflexia (14.29%). The recurrence was associated with the fact that many patients couldn't keep up with the systematic therapy.ConclusionThe onset of SCI hydronephrosis is indistinct and recurrent easily. Keeping up with intermittent catheterization and taking medicine can prevent SCI hydronephrosis recurrence effectively.

Adult ; Decompression, Surgical ; Diskectomy, Percutaneous ; Female ; Humans ; Intervertebral Disc Displacement ; surgery ; Laser Therapy ; Male ; Middle Aged

AIMTo examine the liver mechanism with which clenbuterol is explained how to affect growth metabolism.

METHODSTwenty-four adult SD rats were randomly divided into three groups, a control and two treatment groups. The technique of isolated perfused rat liver in vitro was used to study the effects of clenbuterol on urea nitrogen concentration of perfused medium, GPT activity and synthesis and secretion of IGF-I in isolated perfused rat liver.

RESULTSUrea-nitrogen concentration of perfused medium was significantly affected by clenbuterol in a dose-dependent and time-dependent manner. The urea-nitrogen level was decreased by 15.02% (P > 0.05),17.97% (P > 0.05), 26.76% (P < 0.05) and 30.08% (P < 0.01) for 1 h, 2 h, 3 h, 4 h after administering clenbuterol at the dose of 1 x 10(-6) mol/L, respectively, compared to that of control. 1 x 10(-8) mol/L CL had the similar effect on urea-nitrogen level. GTP activity of isolated perfused rat liver was inhibited by clenbuterol. The enzyme activity was decreased by 24.65% (P < 0.05) at the dose of 1 10(-6) mol/L CL in clenbuterol-treated 4h. The production and secretion of IGF-I were also influenced by clenbuterol in isolated perfused rat liver. IGF-I concentration of rat liver was increased by 19.77% (P < 0.05) in 4 h clenbuterol treatment (1 x 10(-6) mol/L). Meanwhile, IGF-I concentration of perfusion medium was also elevated though the difference was not significant compared with control.

CONCLUSIONIt is suggested that clenbuterol may improve growth metabolism by means of increasing nitrogen retention and enhancing IGF-I production and secretion of rat liver.

Animals ; Clenbuterol ; pharmacology ; In Vitro Techniques ; Insulin-Like Growth Factor I ; metabolism ; Liver ; drug effects ; metabolism ; Nitrogen ; metabolism ; Rats ; Rats, Sprague-Dawley