Excretory dysfunction and quality of life after a spinal cord injury: A cross-sectional study

Effects of comprehensive functional nursing on functional recovery and quality of life in patients with spinal cord injury

This study evaluated the effects of comprehensive functional nursing on functional recovery and quality of life in patients with spinal cord injuries (SCIs). A total of 214 patients with SCIs treated in our hospital from October 2019 to October 2021 were included in the retrospective analysis and divided into a general care group (n = 107) and a comprehensive care group (n = 107), based on the care that they received. Patients in the general care group received general functional nursing, whereas those in the comprehensive care group received a comprehensive functional nursing intervention. The Rivermead Mobility Index (RMI), Barthel Index (BI), and Berg Balance Score (BBS) were used to evaluate patient neurobehavioral ability before and after nursing. Changes in cardiopulmonary function indexes, left ventricular end-diastolic dimension (LVEDD), left ventricular end-systolic dimension (LVESD), vital capacity (VC), forced expiratory volume in 1 second (FEV1), FEV1/FVC, and maximal voluntary ventilation (MVV) were measured before and after nursing. The number of micturition, maximum micturition volume, bladder volume, residual urine volume, and lower urinary tract symptom (LUTS) score were recorded, and the improvement in bladder function were measured before and after nursing. The Hamilton Anxiety Scale (HAMA) and Beck Depression Inventory (BDI) scores were used to evaluate patients' emotional state. After nursing, the RMI, BI, BBS score, FEV1, FEV1/FVC, MVV, maximum micturition volume, bladder volume, and SF-36 scores of the comprehensive care group were significantly higher than those of the general care group, and the LVEDD, LVESD, micturition time, residual urine volume, and LUTS, HAMA, and BDI scores of the comprehensive care group were significantly lower than those of the general care group. In patients with SCIs, comprehensive functional nursing can promote the recovery of neurocognition, bladder function, and cardiorespiratory function, and improve their quality of life. Comprehensive functional nursing is worthy of clinical application.

Treadmill training improves respiratory function in rats after spinal cord injury by inhibiting the HMGB1/TLR-4/NF-κB signaling pathway

OBJECTIVE

To investigate the effects of treadmill training on lung injury and HMGB1/TLR4/NF-κB after spinal cord injury (SCI) in rats.

METHODS

A total of 108 female SD rats were randomly divided into three groups: sham operation group, SCI brake group, and SCI exercise group. The rats in the SCI exercise group began treadmill running training on the 3rd day after the operation. The rats in the SCI brake group underwent braking treatment. The lung tissues were obtained on the 3rd, 7th, and 14th days after exercise. Locomotor functional recovery was determined using the BBB scores and inclined plane test. Respiratory function was determined via abdominal aortic blood gas analysis. HE staining was used to detect pathological changes in rat lung tissue. RNA sequencing was used to identify differentially expressed genes at different phases in each group of lung tissues. HMGB1, TLR4, and NF-κB in lung tissue were detected using immunohistochemistry and immunofluorescence. Detection of HMGB1 levels in serum, spinal cord tissues and lung tissues by ELISA. HMGB1, TLR4, NF-κB, IL-1β, IL-6, TNF-α mRNA, and protein expression levels were detected via qRT PCR and western blot.

RESULTS

Motor and respiratory functions significantly decreased after SCI (P<0.05). However, locomotion and respiratory functions were significantly improved after treadmill training intervention (P < 0.05). HE staining showed that interstitial thickening, inflammatory cells, and erythrocyte infiltration occurred in lung tissue of rats after SCI (P<0.05). Moreover, inflammatory reaction in lung tissue was significantly reduced after treadmill training intervention (P<0.05). A total of 428 differentially expressed mRNAs [(|log2(FC)| > 2, P < 0.05)] were identified in the intersection of the three groups. KEGG analysis identified five enriched signal pathways, including NF-kappa B. ELISA results showed that treadmill training could significantly reduce the levels of HMGB1 in serum, spinal cord tissue and lung tissue that were elevated after SCI (P < 0.05). Immunohistochemistry, immunofluorescence, qRT PCR, and Western blot showed that HMGB1, TLR4, IL-1β, IL-6, TNF-α, and NF-κB expressions were significantly up-regulated at the 3rd, 7th and 14th days after SCI, compared with the sham operation group. Besides, inflammatory cytokines were significantly lower in the SCI exercise group than in the SCI brake group at all time points after intervention (P < 0.05).

CONCLUSION

Treadmill training alleviates lung tissue inflammation and promotes recovery of motor and respiratory functions by inhibiting the HMGB1/TLR4/NF-κB signaling pathway after SCI in rats.

Factors Influencing Social Participation Among Persons With Neuromyelitis Optica Spectrum Disorders: A Cross-Sectional Study

Background

Neuromyelitis optica spectrum disorders seriously hinder social participation. Only clarifying the status of social participation and the factors most strongly influencing it can promote better-targeted support for those with neuromyelitis optica spectrum disorders.

Objectives

To explore the factors influencing social participation among persons with neuromyelitis optica spectrum disorders.

Methods

138 persons with neuromyelitis optica were recruited by convenience sampling. They completed the Impact on Participation and Autonomy Questionnaire, and were rated using the Barthel index, the Beck Anxiety Inventory and the Beck Depression Inventory. The data were used to evaluate a generalized linear model predicting social participation.

Results

The respondents mostly perceived good or very good possibilities of social participation, but participation outdoors and in social relations were considered more restricted. Ability in the activities of daily living, education level, bladder and bowel dysfunction, and depression were four significant predictors of social participation.

Conclusions

Strengthening training in the activities of daily living, continuing education, giving positive psychological support and helping with bladder and bowel problems may help to promote social participation among those with neuromyelitis optica spectrum disorders.