Objective To evaluate content validity and construct validity of International Classification of Functioning,Disability and Health(ICF)Core Set for patients with organ transplantation.Methods Patients with kidney,liver,heart,or lung transplantation were assessed with ICF Core Set questionnaire,Functional Independence Measure(FIM)and Barthel Index(BI).Content validity was evaluated with frequency and percentage of patients with a problem for each ICF category,while construct validity was evaluated with Spearman correlation between ICF categories with FIM and BI.Results A consecutive sample of 102 patients completed this study.In body functions,10 categories were reported as a problem by more than 30% of the patients,of which 22 categories correlated significantly with FIM or BI.In body structures,structure areas of skin(s810)were reported as a problem by 30% of the patients,of which 3 categories correlated significantly with FIM or BI.In activities and participation,3 categories were reported as a problem by 30% of the patients,of which 15 categories correlated significantly with FIM and BI.In environmental factors,8 categories were reported as a facilitator by 30% of the patients,of which 8 categories correlated significantly with FIM or BI.Conclusion The content validity and construct validity of ICF Core Set for patients early after organ transplantation were good.

BACKGROUND: The autonomous neurogenic bladder(ANB) is one of the common problems and difficulty in rehabilitation of patients with spine injury. Having the advantages of safety, non-invasion and no side-effects,functional magnetic stimulation(FMS) has been applied in central nervous system(CNS) neurotransmission, recovery from nervous exhaustion, bone healing, treatment of neural disorders and research of brain function, and so on. But the studies on treatment of ANB after spine injury are not as profound and systematic as they were needed.OBJECTIVE: To investigate the therapeutic effect of FMS in patients with ANB caused by spine injury.DESIGN: A longitudinal observation based on patients.SETTING: Department of Rehabilitative Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology.PARTICIPANTS: From May 2003 to May 2004, 12 patients with ANB hospitalized in the Rehabilitative Medicine Department of Tongji Hospital,Tongji Medical College, Huazhong University of Science and Technology were selected, 9 were male and 3 were female.METHODS: By using MagLite FMS Devices(made by Dantec, Danmark),a FMS therapy was employed at the sacral 3(S3) nerve root region and the bladder region, twice a day, 5 days a week, and a duration of 4 - 8 weeks.MAIN OUTCOME MEASURES: The pre-and post-treatment dynamics of urine flow variables(such as, residual urine volume, maximum urethral closure pressure(MUCP), the maximum bladder capacity, the bladder pressure, and the maximum urine flow rate), the frequency of urination, the average daily amount of urine, the maximum urine volume(V max), influence of urinary symptoms on the quality of life scale and the symptom score of lower urinary tract syndrome(LUTS) were selected as main outcomes measurements.RESULTS: Nearly all of the pre-and post-treatment dynamics of urine flow variables(such as, residual urine volume, MUCP, the maximum bladder capacity, the bladder pressure and the maximum urine flow rate) exhibited significant difference( P ＜ 0. 01 - 0. 001 ), except for the bladder pressure ( P ＞ 0.05); After FMS therapy, the frequency of urination decreased and the daily amount of urine and the V max increased significantly(P ＜ 0.01-0. 001); Also, the influence of urinary symptoms on the quality of life scale and the symptom score of LUTS changed significantly( P ＜ 0. 001 ).CONCLUSION: FMS therapy can greatly and partly ameliorate the bladder function of the patients with ANB after spine injury, and it can also improve their quality of life significantly.

[Objective] To evaluate the efficacy of reinforcing short-segment pedicle screw fixation with posterior morselized bone grafting in vertebrae for spinal fusion in patients with thoracolumbar vertebrae fractures.[Method]Seventy patients with thoracolumbar vertebrae fractures were treated with short-segment pedicle screw fixation.Fractures in Group A(n =20) were reinforced with posterior morselized bone grafting in vertebrae for spinal fusion.Group B patients(n =50) were not treated with morselized bone grafting.Kyphotic deformity,anterior vertebral height,instrument failure rates,and neurological function outcomes were compared between the two groups.[Result]Kyphosis correction was achieved in Group A(morselized bone grafting) and Group B(Group A,6.4 degrees,Group B,5.4 degrees).At the end of the follow-up period,kyphosis correction was maintained in Group A but lost in Group B(Group A,0.33-degree loss,Group B,6.20-degree loss)(P=0.0001).After surgery,greater anterior vertebral height was achieved in Group A than in Group B(Group A,12.9%,Group B,2.3%)(P

Objective To assess the efficacy of functional magnetic stimulation (FMS) in treatment of neurogenic dysfunction of bladder and urethra in patients with spinal cord injury. Methods A total of 12 patients accepted FMS to the sacral nerves at S 3 and bladder area. The study variables included urodynamic parameters,the quality of life and international lower urinary tract syndrome (LUTS)symptoms. Results There were significant improvements in 10 patients with respect to the number of voiding,volume voided and degree of frequency,urgency and incontinence. Only 2 patients were failed to make any progress. Conclusion FMS is an effective,safe therapy for the spinal cord injury patients complicated with neurogenic dysfunction of bladder and urethra and improve the patients' quality of life.

Objective To study the role of gene Fas and FasL expression in apoptosis of plcenta with ICP. Methods TUNEL (TdT-mediated dUTP nick end labeling) and immuno-hisochemistry methods were used for 31 placental samples with ICP and 31 normal placental samples to detect apoptosis index (AI) and the expression of Fas and FasL in placental tissues. Results AI of cytotrophoblast, syncytotrophoblast, decidual cells and mediate cell(49.09?9.13,t=13.41;46.64?9.77,t=12.16;35.09?9.49,t=8.43;38.74?9.70,t=11.28) in ICP group was significantly higher than that of control group (P

To enhance the fusion of graft bone in thoracolumbar vertebrae and minimize the postoperative loss of correction, short-segment pedicle screw fixation was reinforced with posterior moselizee bone grafting in vertebrae for spinal fusion in patients with thoracrolumbar vertebrate fractures. Seventy patients with thoracrolumbar vertebrate fractures were treated by short-segment pedicle screw fixation and were randomly divided into two groups. Fractures in group A (n=20) were reinforced with posterior morselized bone grafting in vertebrae for spinal fusion, while patients group B (n=50) did not receive the morselized bone grafting for bone fusion. The two groups were compared in terms of kyphotic deformity, anterior vertebral height, instrument failure and neurological functions after the treatment. Frankel grading system was used for the evaluation of neurological evaluation and Denis scoring scale was employed for pain assessment. The results showed that the kyphosis correction was achieved in both group A and group B (group A: 6.4 degree; group B: 5.4 degree)/ At the end of follow-up, kyphosis correction was maintained in group A but lost in group B (P=0.0001). Postoperatively, greater anterior height was achieved in group A than in group B (P<0.01). During follow-up study, anterior vertebral height was maintained only in Group A (P<0.001). Both group A and group B showed good Denis pain scores (P1 and P2) but group A outdid group B in terms of control of severe and constant pain (P4 and P5). By Frankel criteria, the changes in neurological functions in group A was better than those of group B (P<0.001). It is concluded that reinforcement of short-segment pedicle fixation with morselized bone grafting for the treatment of patients with thoracolumbar vertebrae fracture could achieve and maintain kyphosis correction, and it may also increase and maintain anterior vertebral height. Morselized bone grafting in vertebrae offers immediate spinal stability in patients with thoracolumbar vertebrate fractures, decreases the instrument failure and provides better postoperative pain control than without the morselized bone grafting.
Bone Screws ; Bone Transplantation/*instrumentation ; Bone Transplantation/*methods ; Kyphosis/etiology ; Kyphosis/*surgery ; Lumbar Vertebrae/pathology ; Lumbar Vertebrae/surgery ; Nervous System Diseases/etiology ; Postoperative Complications ; Spinal Fractures/*surgery ; Spinal Fusion

Objective To compare the functional profiles of organ transplant patients using the International Classification of Functioning,Disability,and Health (ICF) core set.Methods The patients were enrolled 5 to 10 days after discharge following an organ transplant.The Functional Independence Measure (FIM),Barthel Index (BI) and the ICF core set were used to assess them.Analysis was conducted by grouping the kidney transplant patients (group A) separately from the heart,lung and liver transplant patients (group B).The prevalence of sevcre impairment in each group was calculated and compared.Results Average FIM and BI secores were both significantly higher in group A than in group B.No severe or total impairment was observed in group A,but in group B,the prevalence of 5 categories (ie.b455,b730,s430,d415 and d450) was significantly greater than in group A.The most prevalent were poor exercise tolerance (b455,56.8％),low muscle power (b730,54.5％),difficulty in maintaining a body position (d415,54.5％),and impaired walking (d450,45％) With regard to the environment factors,the prevalence of e110 (products or substances for personal consumption) and e120 (products and technology for personal use in daily living) were both significantly different in the two groups.Conclusion Heart,lung and liver transplant patients transplant demonstrated more impairments than the kidney transplant patients.All the organ transplant patients deserve early evaluation for detecting any possible impairment.

BACKGROUND: Functional magnetic stimulation (FMS) is characterizedby safe, unwounded and non-side effect. At present, it has been used incentral nervous conduction, recovery from nervous exhaustion, bone healing, treatment of neural disorder, research of brain function, and so on;meanwhile, it also can improve urination dysfunction.OBJECTIVE: To pursue investigating the effect of FMS on the treatment of neurogenic bladder.DESIGN: Self controlled study pre- and post-treatment.SETTING: Department of Rehabilitation Medicine, Tongji Hospital,Tongji Medical College, Huazhong University of Science and Technique.PARTICIPANTS: Twenty patients with neurogenic bladder were recruited in the Department of Rehabilitation Medicine, Tong ji Hospital, Tongji Medical College, Huazhong University of Science and Technique from June 2003 to June 2004. Of them, 12 patients with neurogenic bladder were caused by spinal cord injury and 8 by other reasons under urinary dynamic examinations.METHODS: Twenty patients with neurogenic bladder underwent S3 never root and bladder FMS by MagLite magnetic stimulation system (Dantec Company, Denmark), for 20 successive times, twice a day, five days a week and 4-6 weeks as a course. The interval was 2 seconds and the frequency was 5 minutes for once. Parameters were designed as the following: intensity: 70％-80％maximal magnetic intensity; frequency: 5 Hz; impulse length: 1 ms.MAIN OUTCOME MEASURES: Parameters were observed pretreatment, post-treatment immediately and at 1 and 3 months: ① Urine frequency: the mean voided volume and the maximal voided volume; ②Scores of quality of life (QOL): Scores ranged from 0 to 6 points. The higher the scores were, the poorer the QOL was. ③ International lower urinary tract symptoms (LUTS) scores: There were 7 questions with the scores of 0-35. The higher the scores were, the severer the symptoms were.RESULTS: All 20 patients were involved in the final analysis. ① Effect of urination on QOL scores: Scores were decreased post-treatment as compared with those pretreatment (3.17±1.53, 4.58±1.00, P ＜ 0.01), and scores were increased within 1 and 3 months post treatment but were still lower than those pretreatment (P ＜ 0.01). ② LUTS scores: Scores were decreased post-treatment as compared with those pretreatment (21.42±5.00,28.08±1.51, ,P ＜ 0.01), and scores were increased within 1 and 3 months post-treatment but were still lower than those pretreatment (P ＜ 0.01). ③Times of urination were decreased, but the mean voided volume and themaximal voided volume were increased (P ＜ 0.05); in 1 month post-treatment, each parameter was decreased but was still superior to that pretreatment (P ＜ 0.05); at 3 months post-treatment, each parameter was still decreased, but there was no significant difference of mean voided volume from that pretreatment (P ＞ 0.05), and other parameters were superior to those pretreatment (P ＜ 0.05); there was no significant difference at eachtime point post-treatment (P ＞ 0.05).CONCLUSION: FMS can partly improve the symptoms of voiding dys-function and improve the quality of life.

Considering the modern features and requirement of our medical education, we tried some exploration and reforms of the clinical practice training on students of clinical medicine major(7-year program). By strengthening the training of clinical practice while learning subjects, we came to the conclusion that students got their study’s aim much more positively and actively in their study, and the teaching goals are more direct and the teaching effects are better.

Objective To evaluate the distribution of Modic changes of cervical endplate in patients with cervical spondylotic myelopathy and its related factors.Methods All of 426 patients with cervical spondylotic myelopathy were examined by MRI scan and X-ray.According to the criteria of Modic changes,the distribution feature of Modic changes in cervical endplate on age,course of disease,segment and grade of intervertebral disc degeneration were retrospectively analyzed.Results Among 2556 intervertebral discs in 426 cases of patients,54 (12.7 ％) patients and 69 (2.3 ％) intervertebral discs were involved with Modic changes.22 (0.8％) discs in 15 (3.5％) cases were type Ⅰ; 34(1.2％) discs in 31 (7.3％) cases were type Ⅱ ; 13 (0.3％) discs in 8 (1.9％) cases were type Ⅲ.There were 0 (0) lesion in C2-3 disc,5 (0.2％) in C3-4,16 (0.6％) in C4-5,26 (1.0％) in C 19 (0.7％)in C6-7 and 3 (0.1％) in C7T1.Modic changes were distributed mainly over the age of 40 and correlated with disc degeneration,disc level,condition of cervical curve,course of disease and ages,moreover,disc degeneration played the most important role in the occurrence of Modic changes.Conclusion Modic changes of cervical endplate mainly occur in C5-6,and type Ⅱ is the most and type Ⅲ is the least.Modic changes are distributed mainly over the age of 40 and correlated with disc degeneration,disc level condition of cervical curve,course of disease and ages,moreover,disc degeneration plays an important role in the occurrence of Modic changes.