Study design: Lithium has attracted much attention as a neuroregenerative agent for spinal cord injury in animal models. We hypothesized that the lithium can be beneficial to patients with spinal cord injury. The safety and pharmacokinetics of lithium has been studied in our earlier phase I clinical trial, indicating its safety. This is a phase II clinical trial to evaluate its efficacy on chronic spinal cord injury patients. Objectives: The aim of this study was to investigate the efficacy of lithium on chronic spinal cord injury patients. Setting: A major spinal cord injury rehabilitation center in Beijing, China. Methods: Randomized, double-blind, placebo-controlled 6-week parallel treatment arms with lithium carbonate and with placebo. A total of 40 chronic spinal cord injury subjects were recruited. Oral lithium carbonate was titrated or placebo was simulated to maintain the serum lithium level of 0.6-1.2 mmol l À1 for 6 weeks, followed by a 6-month follow-up. The functional outcomes and the neurological classifications, as well as the safety parameters, adverse events and pharmacokinetic data were carefully collected and monitored. Results: No significant changes in the functional outcomes and the neurological classifications were found. The only significant differences were in the pain assessments using visual analog scale comparing the lithium and the placebo group. No severe adverse event was documented in the study. Conclusion: The lithium treatment did not change the neurological outcomes of patients with chronic spinal cord injury. It is worth to investigate whether lithium is effective in the treatment of neuropathic pain in chronic spinal cord injury. Sponsorship: China Spinal Cord Injury Network Company Limited.
Background To assess the relationship between peripheral anterior chamber depth and anthropomorphic measurements. Methods The Beijing Eye Study 2006 included 3251 (73.2%) subjects who returned for a followup examination after a baseline examination including 4335 subjects in 2001. The peripheral anterior chamber depth was estimated by slit lamp-assisted biomicroscopy using van Herick's method. Measurements of the body height and weight and assessment of the anterior chamber as inclusion criterion for this study were available for 3191 (98.2%) subjects.Results In a multivariate analysis, a shallow peripheral anterior chamber was significantly associated with higher age (Po0.001), female gender (Po0.001), and shorter height (Po0.001), whereas weight (P ¼ 0.97) and body mass index (P ¼ 0.82) were not significantly associated. Conclusions The peripheral anterior chamber depth was inversely correlated with height, ie, a shallow peripheral anterior chamber may be expected with a higher frequency in short subjects than in tall subjects. Height, in addition to higher age and female gender, may be taken as one of the parameters for screening of subjects being at risk for primary angleclosure glaucoma.
Study design: A prospective study. Objectives: To evaluate the effect of the surgery to reconstruct thoracic breathing in patients with high cervical spinal cord injury (CSCI). Setting: China Rehabilitation Research Center, Beijing, China. Methods: The posterior ribs (from the fifth to the eighth) were suspended on the inferior angle of the scapula on each side using titanium cables, as well as muscles and myofascial tissue in the subscapular area. After the surgery, the patients were trained for synchronous contraction of the trapezius and diaphragm muscles, and electromyography (EMG) was performed to evaluate the synchronization. The clinical symptoms and pulmonary function were assessed within 1 week before surgery and at 2, 12 and 24 postoperative weeks. Results: Six patients with complete high CSCI received rib suspension surgery 84±26.7 days after spinal cord injury. Before the surgery, all of the patients presented with weakened cough, retention of respiratory secretions and dyspnea, while these symptoms alleviated postoperatively. The vital capacity (VC) was enhanced to be 1680 ± 282 ml at 2 weeks after the surgery, compared with 1085±92 ml (P ¼ 0.013). The EMG showed a synchronous muscle electrical activity between the trapezius muscles and diaphragm during deep breaths. Conclusion: The rib suspension surgery partially restored the thoracic breathing of the patients with high CSCI, thereby improving VC, cough and expectoration.
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