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Current Living Situation of Survival Patients with Spinal Cord Injury 40 Years after Tangshan Earthquake

Lili ZHAO ; Xicheng ZHANG ; Bin ZHENG ; Fang CHENG ; Jing ZHOU ; Yuxia YANG ; Rongxuan DONG ; Rongli MA ; Hongjun ZHOU

Chinese Journal of Rehabilitation Theory and Practice.2017;23(8):959-964. doi:10.3969/j.issn.1006-9771.2017.08.019

Objective To survey the survival status, functional status, marital status and the present situation of the survival patients with spinal cord injury 40 years after Tangshan earthquake. Methods From February to May, 2016, a total of 216 patients with spinal cord injury were surveyed with questionnaire, in which 139 cases lived centralized and 77 cases lived scattered. The questionnaire was self-designed and included eleven items and 51 questions, which related to ability of daily life, marital status, employment status and socioeconomic status and so on. Results A total of 960 (25.15%) patients with spinal cord injury survived 40 years after Tangshan earthquake. In 216 surveyed pa-tients, the employment rate was 9.3%, the married rate was 53.2%, and 44.9%earned less than 500 yuan every month. The incidence was 25.9%for pressure score, 50.50%for neuralgia (severe pain accounted for 23.51%), and 19.40%for urinary tract stones. 56%of patients could take their own basic self-care. Conclusion There were many problems such as high complication rate, low employment rate and poor economic condition in the spinal cord injury group 40 years after Tangshan earthquake.

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Effects of Aquatic Taiji Quan on Balance Function of Patients with Incomplete Spinal Cord Injury

Long JIN ; Fang CONG ; Guiyun SONG ; Fengshan SI ; Bin YAO ; Wei JIA ; Yao CUI

Chinese Journal of Rehabilitation Theory and Practice.2017;23(8):955-958. doi:10.3969/j.issn.1006-9771.2017.08.018

Objective To investigate the effects of aquatic Taiji Quan on balance function of patients with incomplete spinal cord injury. Methods From March to December, 2015, 30 patients with incomplete spinal cord injury received aquatic Taiji Quan exercise based on rou-tine rehabilitation, 30 minutes every day, five times a week for five weeks. They were assessed with Berg Balance Scale (BBS) before and after exercise. Dynamic balance function and static balance function were also assessed with Active Balancer assessment. Results The BBS score significantly improved after exercise (t=-9.652, P<0.001). The track length and area of gravity movement with eyes open and closed decreased (t>3.528, Z>-2.590, P<0.01). No improvement was observed in the deflection center displacement of X and Y axes (P>0.05). The dynamic stability limit range enlarged (t=-4.516, P<0.01), and the time to target significantly shortened (t=4.530, P<0.001). Conclusion Aquatic Taiji Quan can improve the balance function of patients with incomplete spinal cord injury.

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Expression and Role of CXCL1 in Patients with Severe Traumatic Brain Injury

Su LIU ; Liying SUN ; Li SUN ; Qinfeng WU ; Guangyu SHEN

Chinese Journal of Rehabilitation Theory and Practice.2017;23(8):937-941. doi:10.3969/j.issn.1006-9771.2017.08.014

Objective To explore the cellular localization of chemokine (C-X-C motif) ligand 1 (CXCL1) in brain tissue and its expres-sion in brain tissue and blood in patients with severe traumatic brain injury (TBI), as well as its correlation with the injury severity. Methods From September, 2013 to October, 2015, 78 cases of TBI with craniotomy admitted to our hospital were involved as TBI group. A total of 78 peripheral blood samples and 19 brain tissue samples were studied. According to the scores of Glasgow Coma Scale (GCS) at admission, the TBI group was classified as severe TBI group (6~8, n=35) and particularly severe TBI group (3~5, n=43). Ten cases of control brain tissue were taken from patients with cerebral aneurysms or benign tumor and also undergoing craniotomy during the same time. Peripheral blood from ten healthy people were involved as the healthy control group. Immunofluorescent double staining was used to detect the cellular local-ization of CXCL1 in brain tissues, and ELISA was used to detect the expression of CXCL1 in brain tissue and blood. The relationship be-tween the level of CXCL1 in peripheral blood at different time and the score of Glasgow Outcome Scale (GOS) was analyzed with Spear-man correlation analysis. Results In normal brain tissue, CXCL1 mainly localized in astrocytes. For severe TBI, CXCL1 mainly expressed in neurons and astrocytes. The level of CXCL1 was higher in brain tissue in the particularly severe TBI group than in the severe TBI group (t=-12.58, P<0.05). In the severe TBI group, the level of CXCL1 in blood reached a peak before surgery, then gradually decreased, and was still higher than that in the healthy control group 14 days after surgery (P<0.05), however, no significant difference was found 30 days after surgery compared to the healthy control group (P>0.05). In the particularly severe TBI group, the level of CXCL1 in blood reached a peak before and one day after surgery, then gradually decreased, and was still higher than that in the healthy control group 30 days after surgery (P<0.05). The level of CXCL1 in blood was higher in the particularly severe TBI group than in the severe TBI group at all time points (P<0.05), and the level before surgery was negatively correlated with the score of GOS in the particularly severe TBI group (r=-0.351, P<0.05). Conclusion The CXCL1 protein of injury brain tissue was mainly colocalized in neurons and astrocytes in severe TBI patients, and the ex-pression was associated with injury severity and outcome.

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Risk Factors and Outcome of Stroke-associated Pneumonia in Emergency Ward

Na WANG ; Fengrong WANG ; Lushan LIU

Chinese Journal of Rehabilitation Theory and Practice.2017;23(8):932-936. doi:10.3969/j.issn.1006-9771.2017.08.013

Objective To explore the risk factors and outcome of stroke-associated pneumonia (SAP) in emergency ward. Methods The baseline characteristics and laboratory data of 306 patients with stroke in emergency ward of our hospital from April, 2014 to December, 2016 were reviewed. Patients were allocated into SAP group (n=120) and non-SAP group (n=186). The multivariable Logistic regression was applied to investigate risk factors for the progression and death of SAP. Results Totally, 120 (39.2%) patients developed SAP, in which 34 (28.3%) cases died. There were significant differences in age, the scores of Glasgow Coma Score (GCS), Sequential Organ Failure As-sessment (SOFA) and National Institute of Health Stroke Scale (NIHSS), and mechanical ventilation, dysphagia, antiacid and tube feeding (P<0.05). The multivariable Logistic regression analysis revealed that age over 65 years, hypertension, GCS<9, NIHSS, dysphagia and anti-acid were the risk factors for the development of SAP;the SOFA, NIHSS>15 and mechanical ventilation were the risk factors for 30-day mortality in SAP group. Conclusion SAP is a severe complication of stroke, it is associated with a variety of risk factors that affect its out-come in emergency ward.

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Advance in Measurement Methods of Intramedullary Pressure after Spinal Cord Injury (review)

Xin ZHANG ; Jianjun LI ; Degang YANG ; Changbin LIU ; Wenhao ZHANG ; Mingliang YANG ; Liangjie DU ; Feng GAO ; Dapeng LI ; Yun GUO ; Chang CAI

Chinese Journal of Rehabilitation Theory and Practice.2017;23(8):919-923. doi:10.3969/j.issn.1006-9771.2017.08.010

The measurement of intramedullary pressure is particularly important in the research of spinal cord injury. This article ana-lyzed the influence factors and the measurement methods of intramedullary pressure. The influence factors included edema, vascular regula-tion and bleeding, spinal dural, pia mater spinalis, cerebrospinal fluid, canalis vertebralis and body position, etc. The measurement methods included direct measurement methods, as the sensor placed in the parenchyma of spinal cord, intradural extramedullary or lumbar catheter, and measuring in vitro, and indirect measurement methods, as computer modeling and intraocular pressure measuring.

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Temporal and Spatial Variation of ski-interacting Protein Expression in Rats after Spinal Cord Injury and its Role

Yandong ZHU ; Kaisheng ZHOU ; Yongqiang GUO ; Long JIANG ; Liqiang ZHENG ; Jing WANG ; Sen LI ; Zaiyun LONG ; Yamin WU ; Haihong ZHANG

Chinese Journal of Rehabilitation Theory and Practice.2017;23(8):912-918. doi:10.3969/j.issn.1006-9771.2017.08.009

Objective To explore the expression and change of ski-interacting protein (SKIP) in rats after spinal cord injury. Methods A total of 60 adult female Sprague-Dawley rats were randomly divided into sham group (n=30) and spinal cord injury (SCI) group (n=30), each group was further divided into five time points including one day, three days, five days, seven days, and 14 days with six rats in each time points. The model was established at T10 with modified Allen's technique, and the sham group only bit the lamina of rats. The hindlimbs behavior was assessed with Basso-Beattie-Bresnahan (BBB) score at each time point. The pathological changes of spinal cord neurons were detected with Nissl staining. The expression of SKIP were observed with immunofluorescence staining. Results The BBB scores were signif-icantly lower in each time point in SCI group than in the sham group (t>48.267, P<0.001). Compared with the sham group, Nissl bodies in the cytoplasm of spinal cord neurons began to disintegrate, coalesce and irregularly distribute, the neurons began to degenerate and die on the fifth day, and the damage deteriorated on the 14th day. Immunofluorescence staining showed that SKIP expression was mainly expressed in the gray matter of the spinal cord and little expressed in the white matter. The expression of SKIP gradually increased after SCI, and reached a peak on the fifth day (t=-17.035, P<0.001) and decreased significantly on the 14th day (t=3.853, P<0.05). Conclusion SKIP may be a new signaling molecule, which play an important role in neuronal apoptosis after SCI.

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Service of Institutional Care for People with Disabilities in Shanghai, China

Zhao PEI ; Jun Lü ; Huijiong YU ; Pei LIU ; Jinghua WU ; Mei SUN ; Lianding XUE ; Xiaohong LI

Chinese Journal of Rehabilitation Theory and Practice.2017;23(8):895-899. doi:10.3969/j.issn.1006-9771.2017.08.006

Objective To analyze the current situation of institutional care for people with disabilities in Shanghai, China. Methods Sec-ondary data were collected from the synthetical information platform of Shanghai Disabled Persons' Federation, including data about the res-idential institutions and people with disabilities living in the institutions from 2004 to 2015. Results The number of residential institutions and people with disabilities showed an increasing tendency from 2004 to 2015. At the end of 2015, there was 368 residential institutions in Shanghai, providing institutional care for 5821 people with disabilities. People in the institutions were mainly with intelligence disability and mental disability, and mainly in 35 to 59 years old. Conclusion The institutional care for people with disabilities was generally in a good condition in Shanghai and met people's needs.

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Realization of Rehabilitation Needs and its Influential Factors of Adults with Physical Disability in Shanghai, China

Baosong LIU ; Zhao PEI ; Yongjun GUO ; Biping HE ; Huijiong YU ; Ping XU ; Jun Lü

Chinese Journal of Rehabilitation Theory and Practice.2017;23(8):883-886. doi:10.3969/j.issn.1006-9771.2017.08.004

Objective To explore the rehabilitation needs and its influential factors of adults with physical disability in Shanghai, and to provide evidence for decision-making of the precise rehabilitation service. Methods From November to December, 2016, the rehabilitation demands, utilization rate and its influential factors of 390 registered people with physical disability were investigated with a questionnaire. Results The service of occupational rehabilitation met 62.34%and educational rehabilitation met 52.00%of the needs of adults with physi-cal disability at the age of 18 to 40 years. The service of occupational rehabilitation met 38.71%and educational rehabilitation met 35.29%of the needs of adults with physical disability of grade two. The main obstacle to the service utilization wasDo not know(67.34%). As a part ofotherreason, the cumulative frequency oftemporarily not neededaccounted for 16.41%in all reasons. Conclusion The rehabili-tation service should focus unmet needs to complete the community rehabilitation and health governance, and optimize the service system.

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Research on Unmet Needs and Services of Rehabilitation for People with Physical Disabilities in Rural Areas in Henan, China

Xin LI ; Fengbo LIU ; Zhuoying QIU ; Ruofei DU ; Muchun YANG ; Ning LIU

Chinese Journal of Rehabilitation Theory and Practice.2017;23(8):879-882. doi:10.3969/j.issn.1006-9771.2017.08.003

Objective To research the unmet needs and services of rehabilitation for people with physical disabilities in rural areas in Henan, China. Methods The data of 2016 Basic Service Status and Unmet Needs for People with Disabilities in Henan, China were ana-lyzed. Results A total of 1,028,598 people with physical disabilities from all 19 cities had been surveyed, accounting for 61.7% male. In terms of rehabilitation needs, there were 19,348 (1.9%) responsed surgery, 202,855 (19.7%) responsed medical treatment, 197,592 (19.2%) responsed functional training, 360,754 (35.1%) responsed assistive products, and 158,012 (15.4%) responsed nursing, there were significant differences in the number of people who needed rehabilitation among different disability levels (χ2>18.080, P<0.001). For rehabilitation ser-vice, there were 6061 (0.6%) reported surgery, 93,905 (9.1%) reported medicine, 62,967 (6.1%) reported function training, 81,437 (7.9%) reported assistive products, and 34,595 (3.4%) reported nursing, there were significant differences in the number of people who got rehabili-tation among different disability levels (χ2>15.920, P<0.01). For the people without rehabilitation services, there were 165,172 (20.3%) per-son-times lack of understanding of rehabilitation policy, 151,448 (18.6%) reported lack of rehabilitation financial support, 20,369 (2.5%) re-ported not to access rehabilitation institutions, 540,971 (66.5%) reported lack of rehabilitation professionals or services, there were signifi-cant differences in the number of people who did not get rehabilitation services among different disability levels (χ2>19.182, P<0.001). Con-clusion The unmet needs and services of rehabilitation for people with physical disabilities in rural areas in Henan were explicated. It recom-mended to train rehabilitation professionals and improve the service delivery capacity, to raise awareness, increase investment in rehabilita-tion services and provide reasonable accommodation for people with disabilities.

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Research on Unmet Needs and Service Development of Rehabilitation for People with Disabilities in China

Zhuoying QIU ; Xin LI ; Qinyi LI ; Jianxun GUO ; Xianguang WU ; Di CHEN ; Lun LI ; Fengbo LIU

Chinese Journal of Rehabilitation Theory and Practice.2017;23(8):869-874. doi:10.3969/j.issn.1006-9771.2017.08.001

Objective To explore the unmet needs and service of rehabilitation for Chinese people with disabilities. Methods The unmet needs and services of rehabilitation data from the Second National Sample Survey of Disability and 2006-2016 Statistical Bulletin on the De-velopment of People with disabilities in China issued by China Disabled Persons Federation had been analyzed. Results The unmet needs of rehabilitation for people with disabilities in China were mainly included health care and support, assistive devices, rehabilitation therapy and services, poverty alleviation, accessible facilities, accessible information, and other rehabilitation needs. The highest rate of unmet needs of rehabilitation was in the fields of health care (34.84%) and poverty alleviation (33.25%). There were significant differences in unmet needs of rehabilitation among people with different types of disabilities (χ2=40322.1, P<0.01). For all the types of disabilities, 41.46%had not re-ceived any service and support, 30.45%received health care and support, and 0.55%received accessible information. The main approaches recommended by professionals for people with disabilities were institutional rehabilitation, and community and family based services. The main services recommended by professionals to people with psychiatric (68.18%) or visual disabilities (60.28%) were health care, to people with hearing disability (51.67%) were assistive device, and to people with intellectual (57.36%) and speech disability (47.06%) were rehabil-itation therapy and training. There were significant differences both in rehabilitation approaches and contents among people with different types of disabilities preferred by professionals (χ2=12489.9,χ2=52528.93, P<0.01). Conclusion The unmet needs of rehabilitation for people with different types of disabilities were mainly included health care and assistance, assistive devices, rehabilitation training and services, and poverty alleviation. There were significant differences among people with different types of disabilities. For service delivery, the highest rate was in health care and assistance. The gap between the service and unmet needs of poverty alleviation for people with disabilities in China was the highest. There were significant differences in rehabilitation approaches and contents recommended by professionals among people with different types of disabilities. It was recommended to construct the national and local system of policy support system and rehabilita-tion service governance, to provide precision rehabilitation services based on the unmet needs of rehabilitation, to develop the comprehen-sive rehabilitation service delivery to achieve the goal of rehabilitation for all, and to conduct scientific research on rehabilitation by using International Classification of Functioning, Disability and Health to provide evidence and support for the development of rehabilitation.

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