Spinal cord injury is a serious and disabling injury and has a high incidence. The annual incidence of spinal cord injury worldwide is about 15-40 cases per million. With the development of our transportation and industrial economy, the number of spinal cord injury patients has increased significantly. In addition to causing physical paralysis, spinal cord injury can also lead to other neurological dysfunctions, with neurogenic bladder being one of the most common complications, occurring in the vast majority of spinal cord injury patients. In a study of the U.S. Standard Spinal Cord Injury System, 81% of patients reported some degree of bladder function impairment 1 year after injury. The type of bladder and sphincter dysfunction varies depending on the injured segment and produces a range of urinary complications. Furthermore, renal impairment due to neurogenic bladder is the leading cause of death in patients with spinal cord injury. A study of spinal cord injury patients from the 1976 Tangshan earthquake in China found that spinal cord injury with neurogenic bladder resulted in up to 49% of deaths from renal failure 15 years after the earthquake. After a diagnosis of rheumatoid arthritis, patients are randomly confronted with treatment options, for which a series of questions arise, such as, “I’ve seen a lot of pictures of deformed joints on the Internet, am I going to look like that even if I receive treatment?” “The medicine my doctor told me to take has hormones in it, and rumor has it that hormones have especially many side effects, so I don’t want to take them!” “I heard that biologics are very effective, is it that biologics treatment does not require medication? Is it that biologics can cure the disease and guarantee no recurrence?” ”How long does it take to get better with these treatments? Is it possible to stop the medication once the joint pain is gone?” “I’ve seen many advertisements on the Internet saying that rheumatoid arthritis can be cured, do you have such drugs in your hospital?” In view of these problems, we briefly introduce the treatment and effects of rheumatoid arthritis: 1. The disability rate of rheumatoid arthritis has been significantly reduced in recent years. Patients see online pictures of deformed joints and even disabilities are mostly cases of late treatment or without standardized treatment. In recent years, with increased health awareness and the promotion of standardized treatment for rheumatic diseases, the effectiveness of rheumatoid arthritis treatment has improved significantly. Among the many people who strictly follow their doctor’s treatment plan, a significant number of patients are no different from healthy people in both activity and appearance. 2, rheumatoid arthritis is a chronic disease that requires long-term treatment, do not stop the medication or reduce the dosage on your own. For most cases, doctors often develop a program of drug therapy. For example, hormones or non-steroidal anti-inflammatory drugs with slow-acting anti-rheumatic drugs (such as methotrexate, leflunomide, etc.), sometimes with some plant preparations (such as tretinoin), the specific drug regimen to be adjusted according to individual circumstances. Drug therapy has been in the history of treatment in the field of rheumatic diseases for decades, and the treatment experience has been relatively mature. Although the drugs for rheumatoid arthritis have more or less some side effects, such as liver and kidney function damage, lowering of white blood cells and platelets, high blood pressure, high blood sugar, etc., rheumatologists will take into account the occurrence of these conditions throughout the treatment process and make corresponding adjustments to the medication at any time in response to the blood test results at the patient’s follow-up. Therefore, as long as the patient adheres to regular treatment and regular review, there is no need to have too much psychological burden, and there is no need to overly panic about the use of hormones. 3, biological agents are “new weapons” for the treatment of rheumatoid arthritis, but not “all-purpose weapons”. Biological agents are one of the biggest advances in the field of rheumatism and immunity in the last decade or so, mainly targeting certain key aspects of rheumatism pathogenesis for targeted treatment. It can control disease progression faster and has more significant effects, but also has corresponding side effects, such as infection, local reflection at the injection site, allergic reactions and so on. At present, in rheumatoid treatment, the more used are classical gram, Xumel, Ixep, Enzyme, Yamiro and so on. Adding slow-acting anti-rheumatic drugs such as methotrexate or leflunomide to the use of biological agents is more effective. It should be noted that biological agents do not cure rheumatoid arthritis, after the disease is stable, still need the maintenance treatment of drugs. 4, so far, there is no radical treatment for rheumatoid arthritis. There are many rheumatoid treatment prescriptions circulating on the Internet or among the people, claiming that they can cure the disease. In fact, the world’s most cutting-edge research has not yet developed a treatment to fundamentally end this disease, in other words, rheumatoid arthritis is still not a curable disease. In other words, rheumatoid arthritis is still not curable. Therefore, it is also recommended that patients should consult a regular hospital as early as possible to avoid delaying their condition by seeking the so-called “miracle drugs”. Therefore, spinal cord injury neurogenic bladder not only leads to a serious decline in the quality of life of patients, but also directly affects the lives of patients, and should be given great attention. For the rehabilitation of spinal cord injury, there is a lack of sufficient attention to neurogenic bladder in China. It is not wrong to focus on the recovery of somatic motor function, but the neurogenic bladder should be given the same or even more attention, for the reasons mentioned above. In addition to the importance placed on the treatment of neurogenic bladder in spinal cord injury, colleagues in rehabilitation medicine should also be aware of the principles of treatment and its new ideas and techniques. One important principle is to ensure that bladder pressure is within a safe range during the storage and voiding periods, which is generally considered to be no more than 40 cm of water column, especially during the storage period. This is to ensure that urine does not reflux into the upper urinary tract during storage and voiding, which is one of the major causes of kidney damage and renal failure in patients with spinal cord injury. How do you know what the intravesical pressure is during urine storage and voiding? It is necessary to introduce the concept of urodynamic testing. The urodynamic testing system can provide us with data on intravesical pressure, urinary flow rate, bladder capacity, sphincter condition, and imaging of the bladder during voiding, which is currently the gold standard test for accurately assessing neurogenic bladder and developing the best bladder management plan for patients. During the rehabilitation of neurogenic bladder with urinary retention, we have to pay attention to the fact that we cannot just focus on helping the patient to urinate, but more importantly, we have to see whether the urination and urine storage are safe, whether there is any threat to the upper urinary tract and whether there is any upper urinary tract reflux, otherwise, although the patient urinates, his life is threatened. Therefore, the abdominal pressure voiding, breath-holding voiding including trigger point voiding that we commonly use in rehabilitation may have to draw a question mark. The specific feasibility and safety of these methods in a particular patient depends on whether the pressure in his bladder is in the safe range and whether there is urine reflux. The gold standard test is imaging urodynamics, but what if there is none? You can use the Simple Urodynamic Examination and Training System, which requires only a few simple devices such as a catheter, a feeding tube and a ruler, and can be made and carried out by yourself. In our clinical practice this has proven to be simple and practical, and Professor Wyndaele, editor-in-chief of Spinal Cord magazine, also advocates the use of this simple method in places where conditions are limited. In addition, early detection of upper urinary tract reflux can be achieved by regular ultrasound examination of the bladder and upper urinary tract. If a patient has upper urinary tract dilatation after voiding with abdominal pressure, breath-holding or trigger point voiding, this method of voiding should be abandoned immediately. There is also a relatively new concept concerning the retention of catheterization in the early stages of spinal cord injury. Most hospitals in China still follow the textbook practice of clamping and opening the urinary catheter at regular intervals, mainly to preserve bladder sensory stimulation and to prevent bladder atrophy. However, the new concept is to open the urinary catheter without clamping. The reason is that short-term retention of catheterization in early spinal cord injury will not lead to bladder atrophy, and if the catheter is clamped, there is a risk of urinary reflux during the bladder storage period. Although there are now a variety of treatments for neurogenic bladder in spinal cord injury, the accepted method of choice is intermittent clean catheterization. This has been largely agreed upon in the rehabilitation medicine community, but in other related disciplines, such as orthopedics, this concept needs to be promoted.