Adult neurogenesis is a highly dynamic process that leads to the production of new neurons from a population of quiescent neural stem cells(NSCs).In response to specific endogenous and/or external stimuli,NSCs enter a...Adult neurogenesis is a highly dynamic process that leads to the production of new neurons from a population of quiescent neural stem cells(NSCs).In response to specific endogenous and/or external stimuli,NSCs enter a state of mitotic activation,initiating proliferation and differentiation pathways.Throughout this process,NSCs give rise to neural progenitors,which undergo multiple replicative and differentiative steps,each governed by precise molecular pathways that coordinate cellular changes and signals from the surrounding neurogenic niche.展开更多
OBJECTIVE：To identify global trends in research on spinal cord injury-induced neurogenic bladder, through a bibliometric analysis using the Web of Science. DATA RETRIEVAL：We performed a bibliometric analysis of stud...OBJECTIVE：To identify global trends in research on spinal cord injury-induced neurogenic bladder, through a bibliometric analysis using the Web of Science. DATA RETRIEVAL：We performed a bibliometric analysis of studies on spinal cord injury-induced neurogenic bladder using the Web of Science.Data retrieval was performed using key words＂spinal cord injury＂,＂spinal injury＂,＂neurogenic bladder＂,＂neuropathic bladder＂,＂neurogenic lower urinary tract dysfunction＂,＂neurogenic voiding dysfunction＂,＂neurogenic urination disorder＂and ＂neurogenic vesicourethral dysfunction＂. SELECTION CRITERIA：Inclusion criteria：（a）published peer-reviewed articles on spinal cord injury-induced neurogenic bladder indexed in the Web of Science;（b）type of articles：original research articles and reviews;（c）year of publication：no limitation.Exclusion criteria：（a）articles that required manual searching or telephone access;（b）Corrected papers and book chapters. MAIN OUTCOME MEASURES：（1）Annual publication output;（2）distribution according to journals; （3）distribution according to subject areas;（4）distribution according to country;（5）distribution according to institution;and（6）top cited publications. RESULTS：There were 646 research articles addressing spinal cord injury-induced neurogenic bladder in the Web of Science.Research on spinal cord injury-induced neurogenic bladder was found in the Science Citation Index-Expanded as of 1946.The United States,Ireland and Switzerland were the three major countries contributing to studies in spinal cord injury-induced neurogenic bladder in the 1970s.However,in the 1990s,the United States,the United Kingdom,the Netherlands,Germany and Japan published more papers on spinal cord injury-induced neurogenic bladder than Switzerland,and Ireland fell off the top ten countries list.In this century,the United States ranks first in spinal cord injury-induced neurogenic bladder studies,followed by France,the United Kingdom,Germany,Switzerland and Japan.Subject categories including urology, nephrology and clinical neurology,as well as rehabilitation,are represented in spinal cord injury-induced neurogenic bladder studies. CONCLUSION：From our analysis of the literature and research trends,we conclude that spinal cord injury-induced neurogenic bladder is a hot topic that will continue to generate considerable research interest in the future.展开更多
Objectives:This study employed evidence mapping to systematically evaluate clinical practice guidelines(CPGs)for neurogenic bladder(NB)care.We aimed to identify research trends,evidence gaps,and consensus patterns to ...Objectives:This study employed evidence mapping to systematically evaluate clinical practice guidelines(CPGs)for neurogenic bladder(NB)care.We aimed to identify research trends,evidence gaps,and consensus patterns to inform evidence-based nursing practices and support the formulation of highquality CPGs.Methods:A systematic search of electronic databases and guideline repositories was conducted,included PubMed,Web of Science,Embase,Guidelines International Network(GIN),ect.Eligible NB guidelines underwent dual-researcher screening and extraction,and methodological and recommendation quality were assessed using the Appraisal of Guidelines for Research and Evaluation II(AGREE II)and Evaluation-Recommendations Excellence(AGREE-REX)instruments.Five researchers independently evaluated recommendation specificity,evidence grading systems,and implementation consistency.Discrepancies were resolved through consensus discussion or third-party arbitration.Results:Analysis of 19 CPGs(2006–2023)from 11 countries/regions revealed that 78.95%(15/19)incorporated evidence grading systems and 68.42%(13/19)specifiedrecommendation strength.The AGREE II evaluation identifiedcritical methodological deficiencies,with three domains scoring below the acceptable thresholds:Rigor of Development(41.70%),Editorial Independence(43.30%),and Applicability(30.00%).The AGREE-REX results showed moderate performance in Clinical Applicability(55.56%)and implantability(41.67%)but severe gaps in Values and Preferences(25.00%).A systematic synthesis identified40 recommendations:90%(36/40)demonstrated consensus and 10%(4/40)contradictions.These studies addressed the following six clinical themes:1)nursing assessment,2)manipulation-assisted voiding,3)behavioral therapy,4)intermittent catheterization,5)indwelling catheterization,and 6)other therapies.Conclusions:The methodologies and recommendations of the CPGs for NB in nursing demonstrated substantial variability.Therefore,there is an urgent need to improve the quality of the NB-related CPGs.More in-depth research and timely updates are required to enhance the practical utility of CPGs and narrow the gap between CPGs and clinical practice.展开更多
In healthy intervertebral discs(IVDs),nerves and blood vessels are present only in the outer annulus fibrosus,while in degenerative IVDs,a large amount of nerve and blood vessel tissue grows inward.Evidence supports t...In healthy intervertebral discs(IVDs),nerves and blood vessels are present only in the outer annulus fibrosus,while in degenerative IVDs,a large amount of nerve and blood vessel tissue grows inward.Evidence supports that neurogenic inflammation produced by neuropeptides such as substance P and calcitonin gene related peptide released by the nociceptive nerve fibers innervating the IVDs plays a crucial role in the process of IVD degeneration.Recently,non-neuronal cells,including IVD cells and infiltrating immune cells,have emerged as important players in neurogenic inflammation.IVD cells and infiltrating immune cells express functional receptors for neuropeptides through which they receive signals from the nervous system.In return,IVD cells and immune cells produce neuropeptides and nerve growth factor,which stimulate nerve fibers.This communication generates a positive bidirectional feedback loop that can enhance the inflammatory response of the IVD.Recently emerging transient receptor potential channels have been recognized as contributors to neurogenic inflammation in the degenerative IVDs.These findings suggest that neurogenic inflammation involves complex pathophysiological interactions between sensory nerves and multiple cell types in the degenerative IVDs.Clarifying the mechanism of neurogenic inflammation in IVD degeneration may provide in-depth understanding of the pathology of discogenic low back pain.展开更多
Clinical bladder evaluation is a cost-effective,non-invasive method for diagnosing and managing urinary dysfunction,particularly in patients with neurogenic bladder or other impairments.This process aims to assess bla...Clinical bladder evaluation is a cost-effective,non-invasive method for diagnosing and managing urinary dysfunction,particularly in patients with neurogenic bladder or other impairments.This process aims to assess bladder capacity,storage,and voiding functions through simple,realistic,and resource-friendly approaches.It involves a structured series of steps,from history-taking and physical examination to bladder-emptying procedures,monitoring urine leaks,assessing reflex voiding,measuring post-void residual(PVR),and calculating total bladder capacity.These evaluations help differentiate between upper motor neuron and lower motor neuron bladder dysfunction,providing critical insights for tailored management.The interpretation of findings focuses on identifying bladder type,assessing leak timing and volume,evaluating reflex voiding,and measuring PVR and total bladder capacity.The results guide interventions such as timing selfclean intermittent catheterization,adjusting fluid intake,and using bladder diaries to monitor patterns.Clinical bladder evaluation is particularly advantageous in low-resource settings,as it avoids the risks and costs associated with urodynamic studies while reflecting real-life patient conditions more effectively.Despite its benefits,no validation studies currently exist for clinical bladder assessment,and its parameters,like maximum voided volume,remain underexplored compared to urodynamic measures.Given the accessibility,affordability,and practicality of this approach,it holds promise for widespread application,especially in primary care settings and among economically disadvantaged populations.This editorial describes the process step-by-step and highlights its role in improving patient outcomes while minimizing complications.展开更多
Murine subarachnoid hemorrhage(SAH)induced using the filament perforation method is a useful in vivo experimental model to investigate the pathophysiological mechanisms in the brain underlying SAH.However,identifying ...Murine subarachnoid hemorrhage(SAH)induced using the filament perforation method is a useful in vivo experimental model to investigate the pathophysiological mechanisms in the brain underlying SAH.However,identifying mice with comorbid acute neurogenic pulmonary edema(NPE),a life-threatening systemic consequence often induced by SAH,in this model is difficult without histopathological investiga-tions.Herein,we present an imaging procedure involving dual-energy X-ray absorp-tiometry(DXA)to identify NPE in a murine model of SAH.We quantified the lung lean mass(LM)and compared the relationship between micro-computed tomography(CT)evidence of Hounsfield unit(HU)values and histopathological findings of PE.Of the 85 mice with successful induction of SAH by filament perforation,16(19%)had NPE,as verified by postmortem histology.The DXA-LM values correlate well with CT-HU levels(r=0.63,p<0.0001).Regarding the relationship between LM and HU in mice with post-SAH NPE,the LM was positively associated with HU values(r2=0.43;p=0.0056).A receiver operating characteristics curve of LM revealed a sensitivity of 87%and specificity of 57%for detecting PE,with a similar area under the curve as the HU(0.79±0.06 vs.0.84±0.07;p=0.21).These data suggest that confirming acute NPE using DXA-LM is a valuable method for selecting a clinically relevant murine NPE model that could be used in future experimental SAH studies.展开更多
The purpose of this study was to explore the application of TCM-appropriate technology in neurogenic bladder rehabilitation nursing.Firstly,the background and contents of the study were introduced.Then,it summarizes t...The purpose of this study was to explore the application of TCM-appropriate technology in neurogenic bladder rehabilitation nursing.Firstly,the background and contents of the study were introduced.Then,it summarizes the definition and development of TCM-appropriate technology and expounds the main therapy and application of TCM-appropriate technology in the rehabilitation nursing field.Besides,the pathophysiological characteristics,rehabilitation nursing measures,and rehabilitation difficulties of the neurogenic bladder are described.Then,the application method,effect and prospect of TCM-suitable technology in rehabilitation nursing of neurogenic bladder are described.In addition,the object,method,result analysis,and conclusion of the experimental study are introduced,the main results of this study are summarized,and the future research direction is prospected.In summary,this study aims to provide effective TCM-appropriate technology for neurogenic bladder rehabilitation nursing and provide a reference for clinical practice and theoretical research in related fields.展开更多
Exciting new features have been described concerning neurogenic bowel dysfunction,including interactions between the central nervous system,the enteric nervous system,axonal injury,neuronal loss,neurotransmission of n...Exciting new features have been described concerning neurogenic bowel dysfunction,including interactions between the central nervous system,the enteric nervous system,axonal injury,neuronal loss,neurotransmission of noxious and non-noxious stimuli,and the fields of gastroenterology and neurology.Patients with spinal cord injury,myelomeningocele,multiple sclerosis and Parkinson's disease present with serious upper and lower bowel dysfunctions characterized by constipation,incontinence,gastrointestinal motor dysfunction and altered visceral sensitivity.Spinal cord injury is associated with severe autonomic dysfunction,and bowel dysfunction is a major physical and psychological burden for these patients.An adult myelomeningocele patient commonly has multiple problems reflecting the multisystemic nature of the disease.Multiple sclerosis is a neurodegenerative disorder in which axonal injury,neuronal loss,and atrophy of the central nervous system can lead to permanent neurological damage and clinical disability.Parkinson's disease is a multisystem disorder involving dopaminergic,noradrenergic,serotoninergic and cholinergic systems,characterizedby motor and non-motor symptoms.Parkinson's disease affects several neuronal structures outside the substantia nigra,among which is the enteric nervous system.Recent reports have shown that the lesions in the enteric nervous system occur in very early stages of the disease,even before the involvement of the central nervous system.This has led to the postulation that the enteric nervous system could be critical in the pathophysiology of Parkinson's disease,as it could represent the point of entry for a putative environmental factor to initiate the pathological process.This review covers the data related to the etiology,epidemiology,clinical expression,pathophysiology,genetic aspects,gastrointestinal motor dysfunction,visceral sensitivity,management,prevention and prognosis of neurogenic bowel dysfunction patients with these neurological diseases.Embryological,morphological and experimental studies on animal models and humans are also taken into account.展开更多
Objective:To observe the effects of electroacupuncture on urodynamics and intramedullary apoptosis related factor B cell lymphoma gene-2(Bcl-2),Bcl-2 related protein X(Bax)and brain-derived neurotrophic factor(BDNF)in...Objective:To observe the effects of electroacupuncture on urodynamics and intramedullary apoptosis related factor B cell lymphoma gene-2(Bcl-2),Bcl-2 related protein X(Bax)and brain-derived neurotrophic factor(BDNF)in neurogenic bladder rats after supersacral spinal cord injury.Methods:A total of 60 female SD rats,SPF grade,were randomly selected,12 rats in the blank group and 12 rats in the sham operation group,and the remaining 36 rats were made models.Of these 36 rats,24 rats meeting the model standard were randomized into the model group and electroacupuncture group,with 12 rats in each group.The neurogenic bladder models after supracacral spinal cord injury were prepared by the Hassan Shaker spinal cord transection method,via combining the previous model study experience.At the end of spinal shock stage,"Dazhui(大椎GV14)""Zhongji(中极CV 3)""Ciliao(次髎BL 32)",and"Sanyinjiao(三阴交SP 6)"were selected for electroacupuncture.Observation on the histomorphological changes of bladder detrusor and spinal cord in rats was conducted by HE staining.The apoptosis rate of spinal cord cells was measured by TUNEL assay.The maximum bladder volume and compliance were measured by urodynamics test.The protein expressions of Bcl-2,Bax,and BDNF in spinal cord tissues were measured by Western blot assay.The expressions of Bcl-2,Bax,and BDNF mRNA were measured by RT-PCR assay.Results:(1)The results of HE staining showed that compared with the blank group and sham operation group,in the model group the bladder epithelial cell structure was destroyed,the detrusor muscle fibers proliferated,and there were severe bleeding changes,the spinal cord tissue was disordered,the structure was destroyed,the cell space was enlarged,and accompanied by a large number of inflammatory cell infiltration and cystic cavity formation.Compared with the model group,in the electroacupuncture group,the intact bladder epithelial cells increased,the detrusor muscle fiber proliferation decreased,the bleeding changes decreased,the complete structural area of spinal cord tissues increased,the cell space decreased,the levels were clearer,and the cystic cavity decreased.(2)The results of TUNEL assay indicated that the TUNEL positive rate of spinal cord cells in the model group was significantly higher than that in the blank group and sham group(both P<0.05).Compared with the model group,the TUNEL positive rate of spinal cord cells in the electroacupuncture group was significantly reduced(P<0.05).(3)The results of urodynamics test suggested that compared with the blank group and sham operation group,the maximum bladder volume and compliance of the model group were significantly reduced(all P<0.05).Compared with the model group,the maximum bladder volume and compliance were significantly increased in the electroacupuncture group(both P<0.05).(4)The results of Western blot assay indicated that,compared with the blank group and sham operation group,in the model group the protein contents of Bcl-2 and BDNF were significantly reduced(all P<0.05),while the protein content of Bax in the model group was significantly increased(both P<0.05).(5)The results of RT-PCR assay indicated that,compared with blank group and sham operation group,in the model group the intramedullary Bcl-2 and BDNF mRNA were significantly reduced(all P<0.05),and Bax mRNA was significantly increased(both P<0.05).Conclusion:Electroacupuncture at"GV14""CV3""BL32",and"SP6"can promote the repair of bladder detrusor,improve the maximum bladder volume and compliance of bladder,promote morphological repair of bladder detrusor,reduce spinal cord cell apoptosis rate,thus to restore the function of bladder.This is maybe related with the electroacupuncture’s two-way regulatory mechanism of increased expression of protein and gene of Bcl-2 and BDNF and decreased expression of protein and gene of Bax in spinal cord tissues.展开更多
The aim of this review is to offer dietary advice for individuals with spinal cord injury(SCI)and neurogenic bowel dysfunction.With this in mind,we consider health conditions that are dependent on the level of lesion ...The aim of this review is to offer dietary advice for individuals with spinal cord injury(SCI)and neurogenic bowel dysfunction.With this in mind,we consider health conditions that are dependent on the level of lesion including skeletal muscle atrophy,autonomic dysreflexia and neurogenic bladder.In addition,SCI is often associated with a sedentary lifestyle,which increases risk for osteoporosis and diseases associated with chronic low-grade inflammation,including cardiovascular and chronic kidney diseases.The Mediterranean diet,along with exercise and dietary supplements,has been suggested as an anti-inflammatory intervention in individuals with SCI.However,individuals with chronic SCI have a daily intake of whole fruit,vegetables and whole grains lower than the recommended dietary allowance for the general population.Some studies have reported an increase in neurogenic bowel dysfunction symptoms after high fiber intake;therefore,this finding could explain the low consumption of plant foods.Low consumption of fibre induces dysbiosis,which is associated with bothendotoxemia and inflammation.Dysbiosis can be reduced by exercise and diet in individuals with SCI.Therefore,to summarize our viewpoint,we developed a Mediterranean diet-based diet and exercise pyramid to integrate nutritional recommendations and exercise guidelines.Nutritional guidelines come from previously suggested recommendations for military veterans with disabilities and individuals with SCI,chronic kidney diseases,chronic pain and irritable bowel syndrome.We also considered the recent exercise guidelines and position stands for adults with SCI to improve muscle strength,flexibility and cardiorespiratory fitness and to obtain cardiometabolic benefits.Finally,dietary advice for Paralympic athletes is suggested.展开更多
This article reviews the research progress of rehabilitation treatment and nursing care of patients with neurogenic bladder after spinal cord injury,in order to provide reference for the rehabilitation treatment and n...This article reviews the research progress of rehabilitation treatment and nursing care of patients with neurogenic bladder after spinal cord injury,in order to provide reference for the rehabilitation treatment and nursing care of patients.We reviewed recent medical literature on patients with neurogenic bladder,focusing on neurogenic bladder caused by spinal cord injury.We analyzed 30 recent of publications in patients with neurogenic bladder after spinal cord injury,in addition to reviewing and evaluating the commonly used rehabilitation nursing methods for neurogenic bladder.Psychological counseling is a vital aspect which cannot be neglected in the process of neurogenic bladder rehabilitation.Hitherto,the commonly used drug and surgical treatments may have negatively impacted the mental health of patients in varying degrees.However,in clinical practice,applying intermittent catheterization in patients who have neurogenic bladder with spinal cord injury may help improve patients’life quality,mitigate psychological burden,and reduce negative emotions.展开更多
A complete spinal cord injury model was established in experimental rabbits using the spinal cord clip compression method. Urodynamic examination was performed 2 weeks later to determine neurogenic bladder status. The...A complete spinal cord injury model was established in experimental rabbits using the spinal cord clip compression method. Urodynamic examination was performed 2 weeks later to determine neurogenic bladder status. The rabbits were treated with anodal block stimulation at sacral anterior roots for 4 weeks. Electrical stimulation of sacral anterior roots improved urodynamic parameters of neurogenic bladder in rabbit models of complete spinal cord injury, effectively promoted urinary function, and relieved urinary retention. Immunohistochemistry results showed that a balance was achieved among expression of muscarinic receptor subunits M2, M3, ATP-gated ion channel P2X3 receptors, and 132-adrenergic receptor, and nerve growth factor expression decreased. These results suggested that long-term sacral anterior root stimulation of anodal block could＇be used to treat neurogenic bladder in a rabbit model of complete spinal cord injury.展开更多
Objective： To investigate the effect and mechanism of electroacupuncture（EA） in the intervention of neurogenic bladder（NB） caused by suprasacral spinal cord injury（SCI）.Methods： The total 60 female Sprague-Daw...Objective： To investigate the effect and mechanism of electroacupuncture（EA） in the intervention of neurogenic bladder（NB） caused by suprasacral spinal cord injury（SCI）.Methods： The total 60 female Sprague-Dawley（SD） rats were divided into blank group, sham operation group by adopting random number table method, with 12 rats in each group. The remaining rats were made into models through operation, and 24 successful model rats were randomly divided into model group and EA group, with 12 rats in each group. Since the 19 th day after modeling, EA was conducted at ＂Cìliào＂（次髎BL 32）, ＂Zhōngjí＂（中极CV 3）,＂Sānyīnjiāo＂（三阴交SP 6） and ＂Dàzhuī＂（大椎GV 14） in EA group, remaining the needle for 20 min every time. The intervention was performed for once a day, and7 consecutive days were needed. The rest of the three groups were only tied up for the same time. Urodynamics test was conducted after the intervention. The contents of PACAP-38 and PAC1 R of the spinal cord of the injury site were detected by Western blot.Results： Compared with the blank group. there were no significant differences in the bladder capacity,leak point pressure, bladder compliance and PACAP-38 and PAC1 R contents in spinal cord in sham operation group; compared with the sham operation group, the maximum bladder capacity and the bladder compliance in the model group were lower（both P〈0.05）, the leak point pressure was higher（P〈0.05）,the contents of PACAP-38 and PAC1 R were lower（both P〈0.05）; compared with the model group, the maximum bladder capacity and the bladder compliance in the EA group were higher（both P〈0.05）, the leak point pressure was lower（P〈0.05）, the contents of PACAP-38 and PAC1 R were higher（both P〈0.05）.Conclusion： EA at BL 32, CV 3, SP 6 and GV 14 can improve the bladder function of NB rats of suprasacral SCI, and its mechanism may be related to the increase expression of PACAP-38 and PAC1 R protein in the injured spinal cord tissue.展开更多
The aim of this research was to assess the antinociceptive activity of the transient receptor potential （TRP） channel TRPV1, TRPM8, and TRPA1 antagonists in neurogenic, tonic, and neuropathic pain models in mice. Fo...The aim of this research was to assess the antinociceptive activity of the transient receptor potential （TRP） channel TRPV1, TRPM8, and TRPA1 antagonists in neurogenic, tonic, and neuropathic pain models in mice. For this purpose, TRP channel antagonists were administered into the dorsal surface of a hind paw 15 min before capsaicin, allyl isothiocyanate （AITC）, or formalin. Their antiallodynic and antihyperalgesic efficacies after intraperitoneal ad- ministration were also assessed in a paclitaxel-induced neuropathic pain model. Motor coordination of paclitaxel- treated mice that received these TRP channel antagonists was investigated using the rotarod test. TRPV1 antagonists, capsazepine and SB-366791, attenuated capsaicin-induced nociceptive reaction in a concentration-dependent manner. At 8 pg/20 pl, this effect was 51% （P〈0.001） for capsazepine and 37% （P〈0.05） for SB-366791. A TRPA1 antagonist, A-967079, reduced pain reaction by 48% （P〈0.05） in the AITC test and by 54% （P〈0.001） in the early phase of the formalin test. The test compounds had no influence on the late phase of the formalin test. In paclitaxel-treated mice, they did not attenuate heat hyperalgesia but N-（3-aminopropyl）-2-{[（3-methylphenyl）methyl]oxy}-N-（2-thienylmethyl） benzamide hydrochloride salt （AMTB）, a TRPM8 antagonist, reduced cold hyperalgesia and tactile allodynia by 31% （P〈0.05） and 51% （P〈0.01）, respectively. HC-030031, a TRPA1 channel antagonist, attenuated tactile allodynia in the von Frey test （62%; P〈0.001）. In conclusion, distinct members of TRP channel family are involved in different pain models in mice. Antagonists of TRP channels attenuate nocifensive responses of neurogenic, tonic, and neuropathic pain, but their efficacies strongly depend on the pain model used.展开更多
Typically situated posterolateral in the spinal canal, intraspinal facet cysts often cause radicular symptoms. Rarely, the midline location of these synovial or ganglion cysts may cause thecal sac compression leading ...Typically situated posterolateral in the spinal canal, intraspinal facet cysts often cause radicular symptoms. Rarely, the midline location of these synovial or ganglion cysts may cause thecal sac compression leading to neurogenic claudication or cauda equina syndrome. This article summarizes the clinical presentation, radiographic appearance, and management of three intraspinal, midline facet cysts. Three patients with symptomatic midline intraspinal facet cysts were retrospectively reviewed. Documented clinical visits, operative notes, histopathology reports, and imaging findings were investigated for each patient. One patient presented with neurogenic claudication while two patients developed partial, subacute cauda equina syndrome. All 3 patients initially responded favorably to lumbar decompression and midline cyst resection; however, one patient required surgical stabilization 8 mo later. Following the three case presentations, we performed a thorough literature search in order to identify articles describing intraspinal cystic lesions in lateral or midline locations. Midline intraspinal facet cysts represent an uncommon cause of lumbar stenosis and thecal sac compression. Such entities should enter the differential diagnosis of midline posterior cystic lesions. Midline cysts causing thecal sac compression respond favorably to lumbar surgical decompression and cyst resection. Though laminectomy is a commonly performed operation, stabilization may be required in cases of spondylolisthesis or instability.展开更多
Neurogenic bladder is a dysfunction of the lower urinary tract caused by nervous system disor- der. We investigated the trends in publication of articles under the topic ＂neurogenic bladder＂ using bibliometric analy...Neurogenic bladder is a dysfunction of the lower urinary tract caused by nervous system disor- der. We investigated the trends in publication of articles under the topic ＂neurogenic bladder＂ using bibliometric analysis. Articles on neurogenic bladder, published between 1995 and 2014, were retrieved from the ISI Web of Science citation database. We analyzed the search results for authors, countries, institutions, journals, and top-cited papers. A total of 1,904 articles were re- trieved. There was a small increase in the number of articles on neurogenic bladder from 1995 （n = 43） to 2014 （n = 117）. The USA was the leading country in the total number of articles （n = 598）. However, the number of publications from China has rapidly increased, and China was ranked second in 2014. Emmanuel Chartier-Kastler （n = 65） was the most productive author, and University of Paris VI （Paris 6） （n = 61） was the most productive institution. The Journal of Urology published the greatest number of artides on this topic （n = 285）. Articles on neurogenic bladder were often published in a professional journal under the category Urology ＆ Nephrology, Neurosciences ＆ Neurology, or Rehabilitation. Visualization analysis based on co-citation networks was conducted using CiteSpace III. Visualization analysis revealed that the hot spots in neurogenic bladder were botulinum toxin-A, prazosin, bethanechol, and afferent pathways. These findings provide new insight into the publication trends and hot spots in neurogenic bladder.展开更多
OBJECTIVE:To investigate the efficacy of active compounds of Chanqin(CQ)granules on PM2.5-induced airway neurogenic inflammation in vivo,and to elucidate the underlying mechanisms of action.METHODS:The Traditional Chi...OBJECTIVE:To investigate the efficacy of active compounds of Chanqin(CQ)granules on PM2.5-induced airway neurogenic inflammation in vivo,and to elucidate the underlying mechanisms of action.METHODS:The Traditional Chinese Medicine systems pharmacology(TCMSP)database was searched,and the results were combined with oral bioavailability and drug analysis to identify the compounds in CQ granules.The pharmacophore modeling approach was used to predict the compound targets,and the diseases corresponding to the targets were obtained by searching the therapeutic target database(TTD),pharmacogenomics knowledgebase(Pharm GKB)and Drug Bank databases.Cytoscape software was used to construct the network pharmacological charts for Component-Target and Target-Disease interactions of the CQ granules.Then,the mechanisms of action and effectiveness of CQ granules for the treatment of PM2.5-induced airway neurogenic inflammation were analyzed.RESULTS:A total of 195 compounds and 171 targets were obtained from the analyses.A total of569 corresponding diseases were identified for these targets.Component-target and target-disease networks were constructed.The possible mechanisms and effective components in CQ granules for treating airway neurogenic inflammation were analyzed.Quercetin,kaempferol and isorhamnetin,beta-sitosterol and sitosterol,which are typically found in the formulation,have extensive pharmacological activities,including anti-inflammatory,antioxidant and antiviral actions and neuroprotective properties.Among these targets,androgen receptor,estrogen receptor,prostaglandin G/H synthase 2,and inducible nitric oxide synthase play important pathological roles,including the induction of neurogenic inflammation.CQ granules may have therapeutic effectiveness for numerous diseases in addition to respiratory diseases,including neoplasms,digestive system diseases,cardiovascular diseases,respiratory tract diseases and nervous system diseases.In vivo,CQ granules are effective in treating pulmonary inflammation and downregulate neuropeptides in the bronchoalveolar lavage fluid after PM2.5 exposure.CQ granules significantly decreased the levels of neurokinin A,neurokinin B and calcitonin gene-related peptide in the lung and dorsal root ganglia.CQ also significantly suppressed the upregulation of p-extracellular regulated protein kinase 1/2 and p-methyl ethyl ketone 1/2 induced by PM2.5 exposure.CONCLUSION:CQ granules have potential for thetreatment of neurogenic inflammation induced by PM2.5 in vivo,and the mechanism might involve downregulation of neuropeptides in the BALF,lung and dorsal root ganglia.展开更多
AIM: To observe the curative effect of bandage contact lens in neurogenic keratitis.METHODS: Twenty cases of neurogenic keratitis were studied at the Department of Ophthalmology, the First Affiliated Hospital of China...AIM: To observe the curative effect of bandage contact lens in neurogenic keratitis.METHODS: Twenty cases of neurogenic keratitis were studied at the Department of Ophthalmology, the First Affiliated Hospital of China Medical University, between October 2012 and June 2013. These included 13 males and 7 females, aged from 35 to 88 y. Patients were voluntarily divided into an experimental group(lens wearing group, n =10) and control group(drug therapy,n =10). In experimental group patients wore silicone hydrogel bandage soft contact lens. Both groups used the following eyedrops: 0.5% levofloxacin TID; 0.5%Sodium carboxymethyl cellulose QID; fibroblast growth factor BID; ganciclovir BID [cases complicated with herpes simplex virus(HSV)]; compound tropicamide BID(cases concurrent hypopyon). The healing time of corneal ulcer and complication rates were observed in the two groups.RESULTS: The healing time of corneal ulcer in the experimental group was 10.80±4.44 d versus 46.70±13.88 d in the control group(P 【0.05). No complications occurred in the experimental group, except for the lens falling off twice in one case, the patient recovered eight days after rewearing the lens. While in the control group, all cases vascularized, 2 cases were complicated with descemetocele that recovered with amniotic membrane transplantation and 1 case was complicated with corneal perforation that recovered by autologous conjunctival flap covering.CONCLUSION: Bandage contact lens is a safe and effective method of treating neurogenic keratitis andsignificantly shortened the healing time of corneal ulcer.展开更多
BACKGROUND： Hand-foot-mouth disease has become a major public health issue in children in China. In the present prospective study we investigated the clinical characteristics and emergency management of children with...BACKGROUND： Hand-foot-mouth disease has become a major public health issue in children in China. In the present prospective study we investigated the clinical characteristics and emergency management of children with severe encephalitis associated with NPE caused by enterovirus 71.METHODS： The study was conducted in 2 pediatric intensive care units （PICUs） over a 2-month period. Clinical records were reviewed of critically ill children with severe encephalitis associated with NPE caused by EV71 who were admitted to PICUs during the period of May to June 2008 in Fuyang.RESULTS： We reviewed the complete records of 36 children, of whom 23 （63.9%） were male and 13 （36.1%） female. Their age ranged from 4 to 48 months, with an average of 15.8 months. All children except one were under 3 years of age. The overall mortality in these children was 19.4%. The average duration of critical life threatening signs and symptoms was 2.1 days （12 hours-5 days）. Nervous system diseases included brainstem encephalitis in 27 children （75%）, brainstem encephalitis associated with myelitis in 6 children （16.7%）, and general encephalitis in 3 chidren （8.3%）, respectively. In 12 patients of NPE （33.3%） pink or bloody bubble sputum and asymmetric pulmonary edema or hemorrhage was the primary manifestation but no typical exanthema was observed. Five children died of acute onset of NPE and / or pulmonary hemorrhage with rapid progression of cardiopulmonary failure within hours after admission. Therapeutic management consisted of mechanical ventilation and administration of mannitol, methylprednisolone, intravenous immunoglobulin （IVIG） and vasoactive drugs, associated with the need of fluid volume resuscitation in 9 （25%） of the 36 children.CONCLUSION： In children less than 3 years of age found to be affected by severe EV71 encephalitis associated with NPE, one fifth may die. The major organ systems infected by severe EV71 include the central nervous system, the respiratory system, and the cardiovascular system. Early diagnosis and evaluation, respiratory support, treatment of intracranial hypertension, and mainttenance of function of the cardiovascular system are the most important therapeutic measures.展开更多
OBJECTIVE:To evaluate the therapeutic effects and long-term efficacy of acupuncture for neurogenic dysphagia.METHODS:Subjects with neurogenic dysphagia undergoing routine swallowing management were randomized to recei...OBJECTIVE:To evaluate the therapeutic effects and long-term efficacy of acupuncture for neurogenic dysphagia.METHODS:Subjects with neurogenic dysphagia undergoing routine swallowing management were randomized to receive either 20 sessions of true acupuncture(experimental group) or sham acupuncture(control group 1) for approximately one and a half months.A third group(control group 2) comprised of non-randomized subjects with neurogenic dysphagia who received routine care were recruited from separate wards.The outcomes were assessed by the Royal Brisbane Hospital Outcome Measure for Swallowing(RBHOMS),as well as by the consistencies of ingested food and fluid.RESULTS:A total of 87 subjects(experimental group,n= 20;control group 1,n=19;control group 2,n=48) were recruited into the trial.The average RBHOMS score showed a greater improvement in the experimental group and in control group 1 than in control group 2.The average levels of foodand fluid consistencies displayed greater improvement in the experimental group than in the two control groups.CONCLUSIONS:This study demonstrates that acupuncture may have therapeutic effects and long-term efficacy for neurogenic dysphagia.However,due to an insufficient sample size and the lack of follow-up for control group 2,multi-centre trials employing a larger sample size may be required to draw concrete conclusions.展开更多
文摘Adult neurogenesis is a highly dynamic process that leads to the production of new neurons from a population of quiescent neural stem cells(NSCs).In response to specific endogenous and/or external stimuli,NSCs enter a state of mitotic activation,initiating proliferation and differentiation pathways.Throughout this process,NSCs give rise to neural progenitors,which undergo multiple replicative and differentiative steps,each governed by precise molecular pathways that coordinate cellular changes and signals from the surrounding neurogenic niche.
文摘OBJECTIVE：To identify global trends in research on spinal cord injury-induced neurogenic bladder, through a bibliometric analysis using the Web of Science. DATA RETRIEVAL：We performed a bibliometric analysis of studies on spinal cord injury-induced neurogenic bladder using the Web of Science.Data retrieval was performed using key words＂spinal cord injury＂,＂spinal injury＂,＂neurogenic bladder＂,＂neuropathic bladder＂,＂neurogenic lower urinary tract dysfunction＂,＂neurogenic voiding dysfunction＂,＂neurogenic urination disorder＂and ＂neurogenic vesicourethral dysfunction＂. SELECTION CRITERIA：Inclusion criteria：（a）published peer-reviewed articles on spinal cord injury-induced neurogenic bladder indexed in the Web of Science;（b）type of articles：original research articles and reviews;（c）year of publication：no limitation.Exclusion criteria：（a）articles that required manual searching or telephone access;（b）Corrected papers and book chapters. MAIN OUTCOME MEASURES：（1）Annual publication output;（2）distribution according to journals; （3）distribution according to subject areas;（4）distribution according to country;（5）distribution according to institution;and（6）top cited publications. RESULTS：There were 646 research articles addressing spinal cord injury-induced neurogenic bladder in the Web of Science.Research on spinal cord injury-induced neurogenic bladder was found in the Science Citation Index-Expanded as of 1946.The United States,Ireland and Switzerland were the three major countries contributing to studies in spinal cord injury-induced neurogenic bladder in the 1970s.However,in the 1990s,the United States,the United Kingdom,the Netherlands,Germany and Japan published more papers on spinal cord injury-induced neurogenic bladder than Switzerland,and Ireland fell off the top ten countries list.In this century,the United States ranks first in spinal cord injury-induced neurogenic bladder studies,followed by France,the United Kingdom,Germany,Switzerland and Japan.Subject categories including urology, nephrology and clinical neurology,as well as rehabilitation,are represented in spinal cord injury-induced neurogenic bladder studies. CONCLUSION：From our analysis of the literature and research trends,we conclude that spinal cord injury-induced neurogenic bladder is a hot topic that will continue to generate considerable research interest in the future.
文摘Objectives:This study employed evidence mapping to systematically evaluate clinical practice guidelines(CPGs)for neurogenic bladder(NB)care.We aimed to identify research trends,evidence gaps,and consensus patterns to inform evidence-based nursing practices and support the formulation of highquality CPGs.Methods:A systematic search of electronic databases and guideline repositories was conducted,included PubMed,Web of Science,Embase,Guidelines International Network(GIN),ect.Eligible NB guidelines underwent dual-researcher screening and extraction,and methodological and recommendation quality were assessed using the Appraisal of Guidelines for Research and Evaluation II(AGREE II)and Evaluation-Recommendations Excellence(AGREE-REX)instruments.Five researchers independently evaluated recommendation specificity,evidence grading systems,and implementation consistency.Discrepancies were resolved through consensus discussion or third-party arbitration.Results:Analysis of 19 CPGs(2006–2023)from 11 countries/regions revealed that 78.95%(15/19)incorporated evidence grading systems and 68.42%(13/19)specifiedrecommendation strength.The AGREE II evaluation identifiedcritical methodological deficiencies,with three domains scoring below the acceptable thresholds:Rigor of Development(41.70%),Editorial Independence(43.30%),and Applicability(30.00%).The AGREE-REX results showed moderate performance in Clinical Applicability(55.56%)and implantability(41.67%)but severe gaps in Values and Preferences(25.00%).A systematic synthesis identified40 recommendations:90%(36/40)demonstrated consensus and 10%(4/40)contradictions.These studies addressed the following six clinical themes:1)nursing assessment,2)manipulation-assisted voiding,3)behavioral therapy,4)intermittent catheterization,5)indwelling catheterization,and 6)other therapies.Conclusions:The methodologies and recommendations of the CPGs for NB in nursing demonstrated substantial variability.Therefore,there is an urgent need to improve the quality of the NB-related CPGs.More in-depth research and timely updates are required to enhance the practical utility of CPGs and narrow the gap between CPGs and clinical practice.
文摘In healthy intervertebral discs(IVDs),nerves and blood vessels are present only in the outer annulus fibrosus,while in degenerative IVDs,a large amount of nerve and blood vessel tissue grows inward.Evidence supports that neurogenic inflammation produced by neuropeptides such as substance P and calcitonin gene related peptide released by the nociceptive nerve fibers innervating the IVDs plays a crucial role in the process of IVD degeneration.Recently,non-neuronal cells,including IVD cells and infiltrating immune cells,have emerged as important players in neurogenic inflammation.IVD cells and infiltrating immune cells express functional receptors for neuropeptides through which they receive signals from the nervous system.In return,IVD cells and immune cells produce neuropeptides and nerve growth factor,which stimulate nerve fibers.This communication generates a positive bidirectional feedback loop that can enhance the inflammatory response of the IVD.Recently emerging transient receptor potential channels have been recognized as contributors to neurogenic inflammation in the degenerative IVDs.These findings suggest that neurogenic inflammation involves complex pathophysiological interactions between sensory nerves and multiple cell types in the degenerative IVDs.Clarifying the mechanism of neurogenic inflammation in IVD degeneration may provide in-depth understanding of the pathology of discogenic low back pain.
文摘Clinical bladder evaluation is a cost-effective,non-invasive method for diagnosing and managing urinary dysfunction,particularly in patients with neurogenic bladder or other impairments.This process aims to assess bladder capacity,storage,and voiding functions through simple,realistic,and resource-friendly approaches.It involves a structured series of steps,from history-taking and physical examination to bladder-emptying procedures,monitoring urine leaks,assessing reflex voiding,measuring post-void residual(PVR),and calculating total bladder capacity.These evaluations help differentiate between upper motor neuron and lower motor neuron bladder dysfunction,providing critical insights for tailored management.The interpretation of findings focuses on identifying bladder type,assessing leak timing and volume,evaluating reflex voiding,and measuring PVR and total bladder capacity.The results guide interventions such as timing selfclean intermittent catheterization,adjusting fluid intake,and using bladder diaries to monitor patterns.Clinical bladder evaluation is particularly advantageous in low-resource settings,as it avoids the risks and costs associated with urodynamic studies while reflecting real-life patient conditions more effectively.Despite its benefits,no validation studies currently exist for clinical bladder assessment,and its parameters,like maximum voided volume,remain underexplored compared to urodynamic measures.Given the accessibility,affordability,and practicality of this approach,it holds promise for widespread application,especially in primary care settings and among economically disadvantaged populations.This editorial describes the process step-by-step and highlights its role in improving patient outcomes while minimizing complications.
基金supported by the Grants-in-Aid for Scientific Research from Japan Society for the Promotion of Science KAKENHI 22K09110.
文摘Murine subarachnoid hemorrhage(SAH)induced using the filament perforation method is a useful in vivo experimental model to investigate the pathophysiological mechanisms in the brain underlying SAH.However,identifying mice with comorbid acute neurogenic pulmonary edema(NPE),a life-threatening systemic consequence often induced by SAH,in this model is difficult without histopathological investiga-tions.Herein,we present an imaging procedure involving dual-energy X-ray absorp-tiometry(DXA)to identify NPE in a murine model of SAH.We quantified the lung lean mass(LM)and compared the relationship between micro-computed tomography(CT)evidence of Hounsfield unit(HU)values and histopathological findings of PE.Of the 85 mice with successful induction of SAH by filament perforation,16(19%)had NPE,as verified by postmortem histology.The DXA-LM values correlate well with CT-HU levels(r=0.63,p<0.0001).Regarding the relationship between LM and HU in mice with post-SAH NPE,the LM was positively associated with HU values(r2=0.43;p=0.0056).A receiver operating characteristics curve of LM revealed a sensitivity of 87%and specificity of 57%for detecting PE,with a similar area under the curve as the HU(0.79±0.06 vs.0.84±0.07;p=0.21).These data suggest that confirming acute NPE using DXA-LM is a valuable method for selecting a clinically relevant murine NPE model that could be used in future experimental SAH studies.
文摘The purpose of this study was to explore the application of TCM-appropriate technology in neurogenic bladder rehabilitation nursing.Firstly,the background and contents of the study were introduced.Then,it summarizes the definition and development of TCM-appropriate technology and expounds the main therapy and application of TCM-appropriate technology in the rehabilitation nursing field.Besides,the pathophysiological characteristics,rehabilitation nursing measures,and rehabilitation difficulties of the neurogenic bladder are described.Then,the application method,effect and prospect of TCM-suitable technology in rehabilitation nursing of neurogenic bladder are described.In addition,the object,method,result analysis,and conclusion of the experimental study are introduced,the main results of this study are summarized,and the future research direction is prospected.In summary,this study aims to provide effective TCM-appropriate technology for neurogenic bladder rehabilitation nursing and provide a reference for clinical practice and theoretical research in related fields.
文摘Exciting new features have been described concerning neurogenic bowel dysfunction,including interactions between the central nervous system,the enteric nervous system,axonal injury,neuronal loss,neurotransmission of noxious and non-noxious stimuli,and the fields of gastroenterology and neurology.Patients with spinal cord injury,myelomeningocele,multiple sclerosis and Parkinson's disease present with serious upper and lower bowel dysfunctions characterized by constipation,incontinence,gastrointestinal motor dysfunction and altered visceral sensitivity.Spinal cord injury is associated with severe autonomic dysfunction,and bowel dysfunction is a major physical and psychological burden for these patients.An adult myelomeningocele patient commonly has multiple problems reflecting the multisystemic nature of the disease.Multiple sclerosis is a neurodegenerative disorder in which axonal injury,neuronal loss,and atrophy of the central nervous system can lead to permanent neurological damage and clinical disability.Parkinson's disease is a multisystem disorder involving dopaminergic,noradrenergic,serotoninergic and cholinergic systems,characterizedby motor and non-motor symptoms.Parkinson's disease affects several neuronal structures outside the substantia nigra,among which is the enteric nervous system.Recent reports have shown that the lesions in the enteric nervous system occur in very early stages of the disease,even before the involvement of the central nervous system.This has led to the postulation that the enteric nervous system could be critical in the pathophysiology of Parkinson's disease,as it could represent the point of entry for a putative environmental factor to initiate the pathological process.This review covers the data related to the etiology,epidemiology,clinical expression,pathophysiology,genetic aspects,gastrointestinal motor dysfunction,visceral sensitivity,management,prevention and prognosis of neurogenic bowel dysfunction patients with these neurological diseases.Embryological,morphological and experimental studies on animal models and humans are also taken into account.
基金National Natural Science Foundation of China:81473753,81874510"Domestic First-class Cultivation Discipline"of Integrated Traditional Chinese and Western Medicine in Colleges and Universities of Hunan Province。
文摘Objective:To observe the effects of electroacupuncture on urodynamics and intramedullary apoptosis related factor B cell lymphoma gene-2(Bcl-2),Bcl-2 related protein X(Bax)and brain-derived neurotrophic factor(BDNF)in neurogenic bladder rats after supersacral spinal cord injury.Methods:A total of 60 female SD rats,SPF grade,were randomly selected,12 rats in the blank group and 12 rats in the sham operation group,and the remaining 36 rats were made models.Of these 36 rats,24 rats meeting the model standard were randomized into the model group and electroacupuncture group,with 12 rats in each group.The neurogenic bladder models after supracacral spinal cord injury were prepared by the Hassan Shaker spinal cord transection method,via combining the previous model study experience.At the end of spinal shock stage,"Dazhui(大椎GV14)""Zhongji(中极CV 3)""Ciliao(次髎BL 32)",and"Sanyinjiao(三阴交SP 6)"were selected for electroacupuncture.Observation on the histomorphological changes of bladder detrusor and spinal cord in rats was conducted by HE staining.The apoptosis rate of spinal cord cells was measured by TUNEL assay.The maximum bladder volume and compliance were measured by urodynamics test.The protein expressions of Bcl-2,Bax,and BDNF in spinal cord tissues were measured by Western blot assay.The expressions of Bcl-2,Bax,and BDNF mRNA were measured by RT-PCR assay.Results:(1)The results of HE staining showed that compared with the blank group and sham operation group,in the model group the bladder epithelial cell structure was destroyed,the detrusor muscle fibers proliferated,and there were severe bleeding changes,the spinal cord tissue was disordered,the structure was destroyed,the cell space was enlarged,and accompanied by a large number of inflammatory cell infiltration and cystic cavity formation.Compared with the model group,in the electroacupuncture group,the intact bladder epithelial cells increased,the detrusor muscle fiber proliferation decreased,the bleeding changes decreased,the complete structural area of spinal cord tissues increased,the cell space decreased,the levels were clearer,and the cystic cavity decreased.(2)The results of TUNEL assay indicated that the TUNEL positive rate of spinal cord cells in the model group was significantly higher than that in the blank group and sham group(both P<0.05).Compared with the model group,the TUNEL positive rate of spinal cord cells in the electroacupuncture group was significantly reduced(P<0.05).(3)The results of urodynamics test suggested that compared with the blank group and sham operation group,the maximum bladder volume and compliance of the model group were significantly reduced(all P<0.05).Compared with the model group,the maximum bladder volume and compliance were significantly increased in the electroacupuncture group(both P<0.05).(4)The results of Western blot assay indicated that,compared with the blank group and sham operation group,in the model group the protein contents of Bcl-2 and BDNF were significantly reduced(all P<0.05),while the protein content of Bax in the model group was significantly increased(both P<0.05).(5)The results of RT-PCR assay indicated that,compared with blank group and sham operation group,in the model group the intramedullary Bcl-2 and BDNF mRNA were significantly reduced(all P<0.05),and Bax mRNA was significantly increased(both P<0.05).Conclusion:Electroacupuncture at"GV14""CV3""BL32",and"SP6"can promote the repair of bladder detrusor,improve the maximum bladder volume and compliance of bladder,promote morphological repair of bladder detrusor,reduce spinal cord cell apoptosis rate,thus to restore the function of bladder.This is maybe related with the electroacupuncture’s two-way regulatory mechanism of increased expression of protein and gene of Bcl-2 and BDNF and decreased expression of protein and gene of Bax in spinal cord tissues.
基金Supported by the Project AMAMP(2019-2021),No.M_D GCOM REG2019002167303-12-2019funded by Ministero della Difesa,Italyfunded as a visiting professor by Sapienza,University of Rome,No.Prot.n.008164526-09-2019。
文摘The aim of this review is to offer dietary advice for individuals with spinal cord injury(SCI)and neurogenic bowel dysfunction.With this in mind,we consider health conditions that are dependent on the level of lesion including skeletal muscle atrophy,autonomic dysreflexia and neurogenic bladder.In addition,SCI is often associated with a sedentary lifestyle,which increases risk for osteoporosis and diseases associated with chronic low-grade inflammation,including cardiovascular and chronic kidney diseases.The Mediterranean diet,along with exercise and dietary supplements,has been suggested as an anti-inflammatory intervention in individuals with SCI.However,individuals with chronic SCI have a daily intake of whole fruit,vegetables and whole grains lower than the recommended dietary allowance for the general population.Some studies have reported an increase in neurogenic bowel dysfunction symptoms after high fiber intake;therefore,this finding could explain the low consumption of plant foods.Low consumption of fibre induces dysbiosis,which is associated with bothendotoxemia and inflammation.Dysbiosis can be reduced by exercise and diet in individuals with SCI.Therefore,to summarize our viewpoint,we developed a Mediterranean diet-based diet and exercise pyramid to integrate nutritional recommendations and exercise guidelines.Nutritional guidelines come from previously suggested recommendations for military veterans with disabilities and individuals with SCI,chronic kidney diseases,chronic pain and irritable bowel syndrome.We also considered the recent exercise guidelines and position stands for adults with SCI to improve muscle strength,flexibility and cardiorespiratory fitness and to obtain cardiometabolic benefits.Finally,dietary advice for Paralympic athletes is suggested.
文摘This article reviews the research progress of rehabilitation treatment and nursing care of patients with neurogenic bladder after spinal cord injury,in order to provide reference for the rehabilitation treatment and nursing care of patients.We reviewed recent medical literature on patients with neurogenic bladder,focusing on neurogenic bladder caused by spinal cord injury.We analyzed 30 recent of publications in patients with neurogenic bladder after spinal cord injury,in addition to reviewing and evaluating the commonly used rehabilitation nursing methods for neurogenic bladder.Psychological counseling is a vital aspect which cannot be neglected in the process of neurogenic bladder rehabilitation.Hitherto,the commonly used drug and surgical treatments may have negatively impacted the mental health of patients in varying degrees.However,in clinical practice,applying intermittent catheterization in patients who have neurogenic bladder with spinal cord injury may help improve patients’life quality,mitigate psychological burden,and reduce negative emotions.
文摘A complete spinal cord injury model was established in experimental rabbits using the spinal cord clip compression method. Urodynamic examination was performed 2 weeks later to determine neurogenic bladder status. The rabbits were treated with anodal block stimulation at sacral anterior roots for 4 weeks. Electrical stimulation of sacral anterior roots improved urodynamic parameters of neurogenic bladder in rabbit models of complete spinal cord injury, effectively promoted urinary function, and relieved urinary retention. Immunohistochemistry results showed that a balance was achieved among expression of muscarinic receptor subunits M2, M3, ATP-gated ion channel P2X3 receptors, and 132-adrenergic receptor, and nerve growth factor expression decreased. These results suggested that long-term sacral anterior root stimulation of anodal block could＇be used to treat neurogenic bladder in a rabbit model of complete spinal cord injury.
文摘Objective： To investigate the effect and mechanism of electroacupuncture（EA） in the intervention of neurogenic bladder（NB） caused by suprasacral spinal cord injury（SCI）.Methods： The total 60 female Sprague-Dawley（SD） rats were divided into blank group, sham operation group by adopting random number table method, with 12 rats in each group. The remaining rats were made into models through operation, and 24 successful model rats were randomly divided into model group and EA group, with 12 rats in each group. Since the 19 th day after modeling, EA was conducted at ＂Cìliào＂（次髎BL 32）, ＂Zhōngjí＂（中极CV 3）,＂Sānyīnjiāo＂（三阴交SP 6） and ＂Dàzhuī＂（大椎GV 14） in EA group, remaining the needle for 20 min every time. The intervention was performed for once a day, and7 consecutive days were needed. The rest of the three groups were only tied up for the same time. Urodynamics test was conducted after the intervention. The contents of PACAP-38 and PAC1 R of the spinal cord of the injury site were detected by Western blot.Results： Compared with the blank group. there were no significant differences in the bladder capacity,leak point pressure, bladder compliance and PACAP-38 and PAC1 R contents in spinal cord in sham operation group; compared with the sham operation group, the maximum bladder capacity and the bladder compliance in the model group were lower（both P〈0.05）, the leak point pressure was higher（P〈0.05）,the contents of PACAP-38 and PAC1 R were lower（both P〈0.05）; compared with the model group, the maximum bladder capacity and the bladder compliance in the EA group were higher（both P〈0.05）, the leak point pressure was lower（P〈0.05）, the contents of PACAP-38 and PAC1 R were higher（both P〈0.05）.Conclusion： EA at BL 32, CV 3, SP 6 and GV 14 can improve the bladder function of NB rats of suprasacral SCI, and its mechanism may be related to the increase expression of PACAP-38 and PAC1 R protein in the injured spinal cord tissue.
基金supported by the National Science Centre Grant(No.DEC-2012/05/B/NZ7/02705),Poland
文摘The aim of this research was to assess the antinociceptive activity of the transient receptor potential （TRP） channel TRPV1, TRPM8, and TRPA1 antagonists in neurogenic, tonic, and neuropathic pain models in mice. For this purpose, TRP channel antagonists were administered into the dorsal surface of a hind paw 15 min before capsaicin, allyl isothiocyanate （AITC）, or formalin. Their antiallodynic and antihyperalgesic efficacies after intraperitoneal ad- ministration were also assessed in a paclitaxel-induced neuropathic pain model. Motor coordination of paclitaxel- treated mice that received these TRP channel antagonists was investigated using the rotarod test. TRPV1 antagonists, capsazepine and SB-366791, attenuated capsaicin-induced nociceptive reaction in a concentration-dependent manner. At 8 pg/20 pl, this effect was 51% （P〈0.001） for capsazepine and 37% （P〈0.05） for SB-366791. A TRPA1 antagonist, A-967079, reduced pain reaction by 48% （P〈0.05） in the AITC test and by 54% （P〈0.001） in the early phase of the formalin test. The test compounds had no influence on the late phase of the formalin test. In paclitaxel-treated mice, they did not attenuate heat hyperalgesia but N-（3-aminopropyl）-2-{[（3-methylphenyl）methyl]oxy}-N-（2-thienylmethyl） benzamide hydrochloride salt （AMTB）, a TRPM8 antagonist, reduced cold hyperalgesia and tactile allodynia by 31% （P〈0.05） and 51% （P〈0.01）, respectively. HC-030031, a TRPA1 channel antagonist, attenuated tactile allodynia in the von Frey test （62%; P〈0.001）. In conclusion, distinct members of TRP channel family are involved in different pain models in mice. Antagonists of TRP channels attenuate nocifensive responses of neurogenic, tonic, and neuropathic pain, but their efficacies strongly depend on the pain model used.
文摘Typically situated posterolateral in the spinal canal, intraspinal facet cysts often cause radicular symptoms. Rarely, the midline location of these synovial or ganglion cysts may cause thecal sac compression leading to neurogenic claudication or cauda equina syndrome. This article summarizes the clinical presentation, radiographic appearance, and management of three intraspinal, midline facet cysts. Three patients with symptomatic midline intraspinal facet cysts were retrospectively reviewed. Documented clinical visits, operative notes, histopathology reports, and imaging findings were investigated for each patient. One patient presented with neurogenic claudication while two patients developed partial, subacute cauda equina syndrome. All 3 patients initially responded favorably to lumbar decompression and midline cyst resection; however, one patient required surgical stabilization 8 mo later. Following the three case presentations, we performed a thorough literature search in order to identify articles describing intraspinal cystic lesions in lateral or midline locations. Midline intraspinal facet cysts represent an uncommon cause of lumbar stenosis and thecal sac compression. Such entities should enter the differential diagnosis of midline posterior cystic lesions. Midline cysts causing thecal sac compression respond favorably to lumbar surgical decompression and cyst resection. Though laminectomy is a commonly performed operation, stabilization may be required in cases of spondylolisthesis or instability.
文摘Neurogenic bladder is a dysfunction of the lower urinary tract caused by nervous system disor- der. We investigated the trends in publication of articles under the topic ＂neurogenic bladder＂ using bibliometric analysis. Articles on neurogenic bladder, published between 1995 and 2014, were retrieved from the ISI Web of Science citation database. We analyzed the search results for authors, countries, institutions, journals, and top-cited papers. A total of 1,904 articles were re- trieved. There was a small increase in the number of articles on neurogenic bladder from 1995 （n = 43） to 2014 （n = 117）. The USA was the leading country in the total number of articles （n = 598）. However, the number of publications from China has rapidly increased, and China was ranked second in 2014. Emmanuel Chartier-Kastler （n = 65） was the most productive author, and University of Paris VI （Paris 6） （n = 61） was the most productive institution. The Journal of Urology published the greatest number of artides on this topic （n = 285）. Articles on neurogenic bladder were often published in a professional journal under the category Urology ＆ Nephrology, Neurosciences ＆ Neurology, or Rehabilitation. Visualization analysis based on co-citation networks was conducted using CiteSpace III. Visualization analysis revealed that the hot spots in neurogenic bladder were botulinum toxin-A, prazosin, bethanechol, and afferent pathways. These findings provide new insight into the publication trends and hot spots in neurogenic bladder.
基金Supported by Natural Science Foundation of China(No.81904127/H2708)Study on Mechanism of Chanqin Granules Inhibiting TRPV1 Channel Activity in Relieving the Airway Neurogenic Inflammation of Post-Infectious Cough Based on Inos/NO-Cgmp-PKG Signal Pathway
文摘OBJECTIVE:To investigate the efficacy of active compounds of Chanqin(CQ)granules on PM2.5-induced airway neurogenic inflammation in vivo,and to elucidate the underlying mechanisms of action.METHODS:The Traditional Chinese Medicine systems pharmacology(TCMSP)database was searched,and the results were combined with oral bioavailability and drug analysis to identify the compounds in CQ granules.The pharmacophore modeling approach was used to predict the compound targets,and the diseases corresponding to the targets were obtained by searching the therapeutic target database(TTD),pharmacogenomics knowledgebase(Pharm GKB)and Drug Bank databases.Cytoscape software was used to construct the network pharmacological charts for Component-Target and Target-Disease interactions of the CQ granules.Then,the mechanisms of action and effectiveness of CQ granules for the treatment of PM2.5-induced airway neurogenic inflammation were analyzed.RESULTS:A total of 195 compounds and 171 targets were obtained from the analyses.A total of569 corresponding diseases were identified for these targets.Component-target and target-disease networks were constructed.The possible mechanisms and effective components in CQ granules for treating airway neurogenic inflammation were analyzed.Quercetin,kaempferol and isorhamnetin,beta-sitosterol and sitosterol,which are typically found in the formulation,have extensive pharmacological activities,including anti-inflammatory,antioxidant and antiviral actions and neuroprotective properties.Among these targets,androgen receptor,estrogen receptor,prostaglandin G/H synthase 2,and inducible nitric oxide synthase play important pathological roles,including the induction of neurogenic inflammation.CQ granules may have therapeutic effectiveness for numerous diseases in addition to respiratory diseases,including neoplasms,digestive system diseases,cardiovascular diseases,respiratory tract diseases and nervous system diseases.In vivo,CQ granules are effective in treating pulmonary inflammation and downregulate neuropeptides in the bronchoalveolar lavage fluid after PM2.5 exposure.CQ granules significantly decreased the levels of neurokinin A,neurokinin B and calcitonin gene-related peptide in the lung and dorsal root ganglia.CQ also significantly suppressed the upregulation of p-extracellular regulated protein kinase 1/2 and p-methyl ethyl ketone 1/2 induced by PM2.5 exposure.CONCLUSION:CQ granules have potential for thetreatment of neurogenic inflammation induced by PM2.5 in vivo,and the mechanism might involve downregulation of neuropeptides in the BALF,lung and dorsal root ganglia.
文摘AIM: To observe the curative effect of bandage contact lens in neurogenic keratitis.METHODS: Twenty cases of neurogenic keratitis were studied at the Department of Ophthalmology, the First Affiliated Hospital of China Medical University, between October 2012 and June 2013. These included 13 males and 7 females, aged from 35 to 88 y. Patients were voluntarily divided into an experimental group(lens wearing group, n =10) and control group(drug therapy,n =10). In experimental group patients wore silicone hydrogel bandage soft contact lens. Both groups used the following eyedrops: 0.5% levofloxacin TID; 0.5%Sodium carboxymethyl cellulose QID; fibroblast growth factor BID; ganciclovir BID [cases complicated with herpes simplex virus(HSV)]; compound tropicamide BID(cases concurrent hypopyon). The healing time of corneal ulcer and complication rates were observed in the two groups.RESULTS: The healing time of corneal ulcer in the experimental group was 10.80±4.44 d versus 46.70±13.88 d in the control group(P 【0.05). No complications occurred in the experimental group, except for the lens falling off twice in one case, the patient recovered eight days after rewearing the lens. While in the control group, all cases vascularized, 2 cases were complicated with descemetocele that recovered with amniotic membrane transplantation and 1 case was complicated with corneal perforation that recovered by autologous conjunctival flap covering.CONCLUSION: Bandage contact lens is a safe and effective method of treating neurogenic keratitis andsignificantly shortened the healing time of corneal ulcer.
文摘BACKGROUND： Hand-foot-mouth disease has become a major public health issue in children in China. In the present prospective study we investigated the clinical characteristics and emergency management of children with severe encephalitis associated with NPE caused by enterovirus 71.METHODS： The study was conducted in 2 pediatric intensive care units （PICUs） over a 2-month period. Clinical records were reviewed of critically ill children with severe encephalitis associated with NPE caused by EV71 who were admitted to PICUs during the period of May to June 2008 in Fuyang.RESULTS： We reviewed the complete records of 36 children, of whom 23 （63.9%） were male and 13 （36.1%） female. Their age ranged from 4 to 48 months, with an average of 15.8 months. All children except one were under 3 years of age. The overall mortality in these children was 19.4%. The average duration of critical life threatening signs and symptoms was 2.1 days （12 hours-5 days）. Nervous system diseases included brainstem encephalitis in 27 children （75%）, brainstem encephalitis associated with myelitis in 6 children （16.7%）, and general encephalitis in 3 chidren （8.3%）, respectively. In 12 patients of NPE （33.3%） pink or bloody bubble sputum and asymmetric pulmonary edema or hemorrhage was the primary manifestation but no typical exanthema was observed. Five children died of acute onset of NPE and / or pulmonary hemorrhage with rapid progression of cardiopulmonary failure within hours after admission. Therapeutic management consisted of mechanical ventilation and administration of mannitol, methylprednisolone, intravenous immunoglobulin （IVIG） and vasoactive drugs, associated with the need of fluid volume resuscitation in 9 （25%） of the 36 children.CONCLUSION： In children less than 3 years of age found to be affected by severe EV71 encephalitis associated with NPE, one fifth may die. The major organ systems infected by severe EV71 include the central nervous system, the respiratory system, and the cardiovascular system. Early diagnosis and evaluation, respiratory support, treatment of intracranial hypertension, and mainttenance of function of the cardiovascular system are the most important therapeutic measures.
文摘OBJECTIVE:To evaluate the therapeutic effects and long-term efficacy of acupuncture for neurogenic dysphagia.METHODS:Subjects with neurogenic dysphagia undergoing routine swallowing management were randomized to receive either 20 sessions of true acupuncture(experimental group) or sham acupuncture(control group 1) for approximately one and a half months.A third group(control group 2) comprised of non-randomized subjects with neurogenic dysphagia who received routine care were recruited from separate wards.The outcomes were assessed by the Royal Brisbane Hospital Outcome Measure for Swallowing(RBHOMS),as well as by the consistencies of ingested food and fluid.RESULTS:A total of 87 subjects(experimental group,n= 20;control group 1,n=19;control group 2,n=48) were recruited into the trial.The average RBHOMS score showed a greater improvement in the experimental group and in control group 1 than in control group 2.The average levels of foodand fluid consistencies displayed greater improvement in the experimental group than in the two control groups.CONCLUSIONS:This study demonstrates that acupuncture may have therapeutic effects and long-term efficacy for neurogenic dysphagia.However,due to an insufficient sample size and the lack of follow-up for control group 2,multi-centre trials employing a larger sample size may be required to draw concrete conclusions.
