Objective To explore the reliability of the modified Penn spasm frequency scale (MPSFS),the spinal cord assessment tool for spasticity (SCATS),the spinal cord injury spasticity evaluation tool (SCI-SET) and visual analogue scales (VASs) and their inter-correlation so as the provide evidence for clinical application.Methods The spasticity of thirty-five patients with spinal cord injury was assessed by 2 raters using the 4 scales with an interval of half an hour between assessments.Three days later,all of the subjects were again evaluated by one of the 2 raters in the same environment.The intra-class correlation coefficient (ICC),standard error of measurement (SEM) and minimal detectable difference (MDD95) were calculated,and the correlations among the 4 scales were analyzed.Results The test-retest ICC for the MPSFS was 0.94 and the inter-rater reliability ICC was 0.90.For the SCATS they were 0.948 and 0.939 respectively.,For the VAS they were 0.962 and 0.974,and for the SCI-SET they were 0.969 and 0.989.There was significant inter-correlation among all four scales,with negative correlation between the SCI-SET and the others.The observed correlations were all of medium strength (r=-0.421 to-0.5),except for a high correlation between the SCI-SET and VAS results (r=0.55 to 0.94).Conclusion The MPSFS,SCATS,VAS and SCI-SET are all reliable tools for evaluating spasticity among people with spinal cord injury.All can be applied in clinical practice.

Objective To observe the clinical efficacy of pestle acupuncture at Yao Yang Guan Ba Zhen and He Che Ming Qiang Duan in treating lumbago due to cold and damp. Methods Totally sixty-two patients with lumbago due to cold and damp were randomized into a treatment group and a control group, 31 in each group. The two groups were both intervened by medicinal fumigation, while the treatment group was additionally treated with pestle acupuncture at Yao Yang Guan Ba Zhen and He Che Ming Qiang Duan and the control group was additionally with ordinary acupuncture. Visual Analogue Scale (VAS) was observed before and after intervention, and the clinical efficacies were compared. Results The total effective rate was 90.3%in the treatment group versus 87.1% in the control group, and the difference was statistically significant (P<0.05). The VAS scores were significantly changed after intervention in both groups (P<0.01). After intervention, there was a significant difference in comparing VAS score between the two groups (P<0.05). Conclusions Pestle acupuncture is an effective method in treating lumbago due to cold and damp, and it doesn’t cause any injury or pain.

Objective: To observe the clinical effect of pestle needle combined with Chinese herbal fumigation on cervical spondylosis and provide a safe effective therapy for this condition. Methods: A total of 54 cases were randomly allocated into two groups (27 cases in each group) according to their sequence of consultation. Patients in both groups were treated with the same Chinese herbal fumigation. Patients in the treatment group were additionally treated with pestle needle therapy on a unique set ofBa Zhen points around Dazhui (GV 14), Fengfu (GV 16) and the distance between Naohu (GV 17) and Dazhui (GV 14) along theHe Chepathway, whereas patients in the control group were additionally treated with routine acupuncture therapy. Then the short-term and long-term efficacies were observed and compared after treatment using the visual analog scale (VAS) and pain rating index (PRI). Results: At the end of treatment, VAS scores were significantly decreased in both groups, and the VAS score in the treatment group was lower than that in the control group (P<0.05). The intra-group differences were statistically significant in VAS scores 1 month, 3 and 6 months after treatment (allP<0.05). At the end of treatment, the sensory and total PRI scores in the treatment group were significantly lower than those in the control group, showing statistically significant differences (both P<0.01); and there was no significant between-group difference (P>0.05) in the affective PRI score. At the end of treatment, the total effective rate was 85.2% in the treatment group, versus 65.4% in the control group, showing a statistical significance (P<0.05). The follow-up six months later showed that the total effective rate was 92.6% in the treatment group, versus 76.9% in the control group, showing a statistical significance (P<0.05). Conclusion: Pestle needle therapy is a stable and positive therapy for cervical spondylosis.

Objective: To investigate the relationships of intracranial compartment volumes with the severity of clinical symptoms before surgery, and the degree of symptom improvement one year after cerebrospinal fluid(CSF)shunt surgery in patients with idiopathic normal pressure hydrocephalus(iNPH). Methods: Twenty-one patients meeting the diagnosis criteria of international guidelines of iNPH and undergoing CSF shunt surgery in Department of Neurosurgery in our hospital from 2016 to 2017 were included.All patients underwent brain MRI measurement before surgery, and were evaluated by using 3-meter timed up and go test(TUG), minimum mental state examination(MMSE), idiopathic normal pressure hydrocephalus grading scale(iNPHGS)and modified Rankin scale(mRS)before and one year after CSF shunt procedures.The ventricular volume, brain volume, pericerebral CSF volume, total intracranial volume and Evans' index were measured in the pre-operative imaging of the brain.The following four pre-operative intracranial compartment volumes were calculated: the relative ventricular volume, brain volume ratio, pericerebral CSF volume ratio and the ratio of ventricular volume to pericerebral CSF volume. Results: The scores of gait, cognitive function and urinary function were improved after surgery in iNPH patients(all P<0.05). There were no significant difference in the correlation of intracranial compartment volumes(the relative ventricular volume, brain volume ratio, pericerebral CSF volume ratio and the ratio of ventricular volume to pericerebral CSF volume)and Evans' index with the severity of clinical symptoms including gait, cognitive function and urinary function before surgery, and with the degree of symptom improvement one year after surgery in iNPH patients(all P>0.05). There was no significant difference in intracranial compartment volumes between patients having improvement in mRS, TUG, MMSE and iNPHGS and patients having no improvement one year after surgery in iNPH patients(all P>0.05). Conclusions Patients with iNPH can benefit from CSF shunt surgery and have improvements of clinical symptoms including gait, cognitive function and urinary function.Preoperative intracranial compartment volumes(the relative ventricular volume, brain volume ratio, pericerebral CSF volume ratio and the ratio of ventricular volume to pericerebral CSF volume)and Evans' index have no correlations with the severity of clinical symptoms before surgery, and have no correlations with the degree of symptom improvement one year after surgery in iNPH patients.For this reason, preoperative intracranial compartment volumes and Evans' index cannot be used to predict whether or not CSF shunt surgery can improve specific clinical symptoms.