The long-term efficacy and complications of implantable diaphragm pacer (IDP) in a child with cervical spinal cord injury (CSCI) in the Department of Spinal and Neural Functional Reconstruction, China Rehabilitation Research Center in September 2022 were retrospective analyzed.A male child had quadriplegia without an obvious cause at the age of 12 years, and he was then lived completely with the assistance of mechanical ventilation.At the age of 14 years, he could wean off the ventilator in unilateral diaphragmatic pacing mode.However, mechanical ventilation was re-given for months after 5 years due to pneumonia, and then the IDP was re-given with the self-felt decreased pacing effect.After hospitalization, the patient was examined with mild diaphragmatic atrophy, secondary flat chest, and mild scoliosis.After optimization of the transdiaphragmatic pacing threshold and rehabilitation, his respiratory function improved.IDP can be used in CSCI for long time, while flat chest and scoliosis that limited the expansion of the lungs should be considered.At the meantime, the increased abdominal spasm affected the abdominal compliance, leading to the decrease in the efficiency of the diaphragm.

ObjectiveTo investigate the neurological outcome of children with dance-associated spinal cord injury without radiographic abnormality (SCIWORA) and explore its related factors and predictive model. MethodsFrom July, 2012 to January, 2022, 75 children with dance-associated SCIWORA hospitalized in Beijing Bo'ai Hospital were divided into improved group (n = 14) and non-improved group (n = 61) according to the American Spinal Injury Association Impairment Scale (AIS) grade a year later, and the related factors were analyzed. ResultsAll patients were girls aged four to ten years. Most of them were complete spinal cord injuries (52/75, 69%). The time of injury to rehabilitation (OR = 0.926, P = 0.046, 95%CI 0.858 to 0.999), the existing tendon reflex (OR = 46.915，P = 0.012, 95%CI 2.333 to 943.616) and muscle tension (OR = 8.932，P = 0.044，95%CI 1.063~75.067) were correlated with the AIS grade improvement. The combination of time of injury to rehabilitation, tendon reflex and muscle tone existing may predict the improvement of AIS (AUC = 0.953, P < 0.001，95%CI 0.878 to 0.989), the sensitivity and specificity were 100% and 83.61%, respectively. ConclusionThe neurological outcome of children with dance-associated SCIWORA is poor. Rehabilitation training as soon as possible is beneficial to the neurological recovery. Tendon reflexe and muscle tone existing at admission are closely related to improvement of neurological outcome, which could be used as potential indicators.

BACKGROUND: LY01005 (Goserelin acetate sustained-release microsphere injection) is a modified gonadotropin-releasing hormone (GnRH) agonist injected monthly. This phase III trial study aimed to evaluated the efficacy and safety of LY01005 in Chinese patients with prostate cancer. METHODS: We conducted a randomized controlled, open-label, non-inferiority trial across 49 sites in China. This study included 290 patients with prostate cancer who received either LY01005 or goserelin implants every 28 days for three injections. The primary efficacy endpoints were the percentage of patients with testosterone suppression ≤50 ng/dL at day 29 and the cumulative probability of testosterone ≤50 ng/dL from day 29 to 85. Non-inferiority was prespecified at a margin of -10%. Secondary endpoints included significant castration (≤20 ng/dL), testosterone surge within 72 h following repeated dosing, and changes in luteinizing hormone, follicle-stimulating hormone, and prostate specific antigen levels. RESULTS: On day 29, in the LY01005 and goserelin implant groups, testosterone concentrations fell below medical-castration levels in 99.3% (142/143) and 100% (140/140) of patients, respectively, with a difference of -0.7% (95% confidence interval [CI], -3.9% to 2.0%) between the two groups. The cumulative probabilities of maintaining castration from days 29 to 85 were 99.3% and 97.8%, respectively, with a between-group difference of 1.5% (95% CI, -1.3% to 4.4%). Both results met the criterion for non-inferiority. Secondary endpoints were similar between groups. Both treatments were well-tolerated. LY01005 was associated with fewer injection-site reactions than the goserelin implant (0% vs . 1.4% [2/145]). CONCLUSION: LY01005 is as effective as goserelin implants in reducing testosterone to castration levels, with a similar safety profile. TRIAL REGISTRATION ClinicalTrials.gov, NCT04563936.
Humans ; Male ; Antineoplastic Agents, Hormonal/therapeutic use* ; East Asian People ; Gonadotropin-Releasing Hormone/agonists* ; Goserelin/therapeutic use* ; Prostate-Specific Antigen ; Prostatic Neoplasms/drug therapy* ; Testosterone

Objective:To analyze the factors influencing dysphagia after an injury to the cervical spinal cord (CPCI) to provide a basis for clinical screening and intervention.Methods:A total of 110 CPCI patients with dysphagia were divided into a severe dysphagia group ( n=19), a mild dysphagia group ( n=35), and a control group ( n=56) according to their functional oral intake scale scores. Data on gender, age, level of injury, degree of damage, duration of injury, causes of injury, surgical mode, tracheotomy status, occurrence of pneumonia and pharynx swelling were collected. Univariate and multivariate logistic regressions were evaluated to identify factors affecting swallowing. Results:The regressions highlighted age, the severity of the spinal cord injury, tracheotomy status, and the occurrence of pneumonia and pharyngeal swelling during hospitalization as the best predictors of swallowing difficulties. Multifactoral logistic regression analysis revealed that undergoing tracheotomy and catching pneumonia during hospitalization were major risk factors for severe dysphagia.Conclusions:Tracheotomy and pneumonia during hospitalization are useful predictors of severe dysphagia after a cervical spinal cord injury.

Nicotinamide mononucleotide (NMN) is an important precursor in conversing nicotinamide adenine dinucleotide (NAD +) in the body. By elevating NAD + level in the body, NMN enhances the hydrogen transfer function of NAD + in biological processes, promotes the synthesis of proteins and polysaccharides, improves substance transportation and regulatory efficiency, and enhances metabolic functions. Specifically, in central nervous system disease, NMN exerts neuroprotective effect through antioxidation, anti-inflammation, mitochondrial protection, and prevention of neuronal and axonal degeneration. This review focuses on the therapeutic role of NMN in common central nervous system diseases and their neuroprotective mechanisms, so as to further understand the role of NMN in central nervous system diseases, and provide references for predicting therapeutic targets and screening therapeutic drugs for central nervous system diseases.

Objective: To explore the relationship among jogging risk perception, jogging risk behavior and the incidence of jogging risk, so as to provide a feasible way to reduce the risk of college students extracurricular jogging exercise. Methods: The method of convenience sampling was used to conduct a follow up survey among 470 college students at a university in Beijing participating in extracurricular jogging exercise and the sports world campus app was used to record and monitor jogging exercise. During the tracking period, the jogging related information was counted once a month, a total of 6 times. At the same time, three questionnaires were distributed in three stages to collect relevant information. SPSS 26.0 was used for the descriptive analysis, and AMOS 22.0 was used for correlational analysis. Results: The risk rate of extracurricular jogging exercise of college students during the past academic year was 71.06 %, score of knowledge on jogging risk was(3.68±0.59), was (3.25±0.91)for jogging injury, and was( 3.23± 0.96)for jogging related disease. Significant negative correlation between college students jogging risk perception and jogging risk behavior ( r =-0.34), negative correlation between jogging risk perception and the incidence of jogging injuries ( r =-0.27), and positive correlation between jogging risk behavior and the incidence of jogging injuries ( r =0.28) were observed( P <0.01). PE(physical education) class was the main way of obtaining the knowledge about jogging risks among college students(43.40%). Conclusion College students show high vulnerability for extracurricular jogging related risks, and low level of perception of jogging risks and jogging injuries. Relevant measures need to be taken to improve the cognitive level of running risk among college students, so as to reduce the incidence of running risk.

Frailty is the clinical syndrome that occurs due to an increase in personal vulnerability and a decline in the ability to maintain one′s internal balance, which is closely related to the development of bladder cancer in the elderly. The research on frailty of elderly patients with bladder cancer in China is still in its infancy. This article discussed the risks of bladder cancer and frailty, the necessity of preoperative frailty assessment in patients with bladder cancer, commonly used assessment tools, and summarized the limitations of the existing evaluation tools to provide reference for further developing and improving the frailty evaluation tools and applications for bladder cancer patients research provides reference.

Objective:To analyze the clinical data on hospitalized spinal cord injury patients with calf muscle vein thromboses (MCVTs) seeking prevention and treatment techniques.Methods:The medical records of 423 patients with spinal cord injury were collected. Those with MCVT constituted the observation group, while those without served as controls. Their clinical data were compared.Results:The risk factors for MCVT were screened in logistic regression analyses. The results showed that age, an ASIA grade of A or B, spinal fusion, preventive anticoagulation, physiotherapy treatment and a homocysteine level >15μmol/L were risk factors for the occurrence of a MCVT.Conclusions:Age, an ASIA grade of A or B, spinal fusion or an elevated serum homocysteine level are all risk factors for MCVT. Active anticoagulation and physical therapy may reduce the risk.

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.

Objective To introduce a novel femoral distractor which is applied in close reduction and internal fixation (CRIF) with antegrade intramedullary nail for femoral shaft fractures.Methods From September 2010 to March 2015,85 patients with femoral shaft fracture were treated by CRIF with antegrade intramedullary nail in which our self-designed novel distractor was used.They were 64 males and 21 females,with an average age of 36.6 years.By AO classification,we had 32 cases of type 32-A,40 cases of type 32-B,and 13 cases of type 32-C.The intervals between injury and surgery averaged 7.5 days (range,from 1 to 16 days).The fracture was located at the upper shaft in 26 cases,at the middle shaft in 57 cases,at the middle shaft and ipsilateral neck in one,and at the lower shaft and ipsilateral intertrochanteric site in one.Their operation time,intraoperative blood loss,intra-and post-operative complications,and fracture union time were recorded and analyzed.Results Successful close reduction was achieved in all the 85 patients with no iatrogenic injury to major vessels or nerves.Operation time averaged 105.5 minutes;time for X-ray exposure averaged 25.8 seconds;intraoperative blood loss averaged 209.2 mL.The 85 patients received follow-ups from 8 to 24 months (mean,16.3 months).Fracture union was achieved in 83 cases after an average duration of 7.8 weeks (range,from 4 to 12 weeks),but nonunion occurred in 2 cases.One-year follow-ups revealed recovery of normal function of the affected knee in all,with no limb shortening ＞ 10 mm,rotational angulation ＞ 15°,or lateral or anteroposterior angulation ＞ 10°.No incision infection,deep vein thrombosis or pulmonary embolism happened during the entire follow-up.Conclusion Our self-designed novel distractor can facilitate CRIF with antegrade intramedullary nail for femoral shaft fractures,and avoid the complications and inconvenience associated with a traction table.