1, what is the function of the spinal cord The spinal cord consists of many bundles of nerves and nerve cells. It can conduct sensory (e.g. pain, temperature, touch) stimuli from the body to the center (brain), and can also conduct the instructions from the brain to the motor muscles to produce random movements. In addition, it is also responsible for some nerve reflexes to control the nerve function of the urinary and fecal sphincter. 2.What are the causes of spinal cord injury? Mainly traumatic and non-traumatic. Traumatic spinal cord injury: foreign incidence: 20-60/100,000, no accurate statistics in China. Most common: fall from height. Second: car accidents and heavy objects. Also: natural disasters (Tangshan and Wenchuan earthquakes). Non-traumatic spinal cord injury: ① Developmental diseases: spinal cord vascular malformation, congenital scoliosis, spina bifida, spondylolisthesis, etc. ② Acquired diseases: infections (spinal tuberculosis, spinal septic infection, transverse myelitis), spinal cord tumors, spinal degenerative diseases. 3.What are the consequences of spinal cord injury? Spinal cord injury can cause “quadriplegia” (refers to cervical spinal cord injury) or paraplegia and “paraplegia” (refers to thoracic and lumbar spinal cord injury) due to different parts of the injury. The main pathological changes are sensory and motor deficits below the injury level, abnormal reflexes and incontinence, etc. Spinal cord injuries can cause lifelong disabilities, and many people are unable to take care of themselves and need to be taken care of, and many comorbidities can arise from these injuries. For example, long-term bed-ridden, local skin pressure resulting in pressure sores (commonly known as bedsores), urinary tract infections due to urinary incontinence, osteoporosis caused by prolonged inactivity to the point of fracture, long-term immobility of the bone and joints caused by contracture fixation, muscular atrophy, as well as spinal cord nerve damage resulting in spasticity (commonly known as “cramps”) and pain, hip joints, hip joints, knee joints, and other dislocated bones around the knee joints. Heterotopic ossification around the knee joint, venous thrombosis of the lower extremities, etc. In addition, because the treatment of spinal cord injury is not yet effective, the above serious consequences will cause great psychological trauma to the patient, resulting in psychological imbalance, pessimism, disappointment, anxiety, depression may arise. 4, the scene of first aid, for the neck, chest, waist trauma patients should be how to deal with better? According to the medical investigation, about 1/4 of the patients’ conditions are aggravated due to improper on-site resuscitation, which makes the simple fracture that could have avoided the spinal cord injury appear to have fracture dislocation and produce spinal cord injury, and makes the original very slight spinal cord injury become serious spinal cord injury. Therefore, in the scene of first aid, if you suspect that the casualty may be injured in the spine, we must fix the head, especially can not lower the head or turn the head, the head and torso must be coaxial rotation, in addition, the best in-situ handling, can not easily change the position of the casualty, in particular, can not be used one person to lift the armpits, a person to lift the lower limbs of the method of handling, the casualty should be fixed in the hardwood stretcher to carry and fix the casualty can not be moved to avoid the scene! Do unnecessary checks, some people say; “Rehabilitation is from under the wheels.” There is some truth in it. 5, spinal cord injury patients should pay attention to the problems during hospitalization After spinal cord injury, patients should pay attention to the following problems during hospitalization: (1) should cooperate with doctors and nurses, according to the doctor’s instructions to complete the treatment tasks, do not go around to inquire about the treatment methods and effects elsewhere, put forward unreasonable requirements, so that the local doctors are at a loss, feel the loss of trust, and thus also disrupt the treatment process, but to the detriment of the patient. (2) To give the patient spiritual encouragement and comfort, not to blame people, not to be impatient, the patient due to sudden trauma, mental unpreparedness, often feel bewildered, do not know what to do, to help the patient at ease to recuperate, less mention of the adverse consequences of the prognosis. (3) Nutritional supplements should be provided to the patient. Patients with indwelling catheterization should drink more water, and patients after surgery should strengthen nutrition and eat more fruits. (4) If there is no bowel movement for more than a week, the doctor should be informed to give enema treatment. Patients with sweating, uncomfortable, flushed face and fast heartbeat should be thought of as having poor bowel movement, which should be handled by the doctor and nurses in time, so don’t be careless! (5) To assist the patient to move each big and small joints every day, to protect the normal range of motion of the joints, in order to facilitate the future rehabilitation training and completion of daily life movements. (6) Assist the nurse to turn the patient over every 2 hours, the bone protruding part should be padded with foam cushion to prevent pressure sores. If the skin color is abnormal, notify the nurse in time, and give massage with the nurse’s consent to promote blood circulation of the skin. Do not put pressure on the part where pressure sores have appeared, and pad up around it, but make sure not to use the circle-shaped air cushion, otherwise it will block the circulation and aggravate the condition. (7) Drink water regularly, limit the amount of intake, drink water once an hour, not more than 125ml each time, do not drink a lot of water at a time. Some patients once the urinary tract is blocked, it will make the bladder dilated for a short time, is damaging. 6, spinal cord injury rehabilitation can play what role? It is the application of modern medical technology, so that the disabled with spinal cord injury to maximize the mobilization of the remaining limb function to compensate for the loss of function, to eliminate and reduce the patient’s functional impairment, to help the patient in the scope of its physical permit, the maximum recovery of its ability to live and work, and to rejoin the social life, self-reliance, to become a disabled but not invalid, a person with the ability to lead an independent life. 7.When should the rehabilitation of spinal cord injury start? Spinal cord injury rehabilitation should start at an early stage. There are two kinds of situation after the injury: one is surgery and the other is conservative treatment (i.e. no surgery). As long as the condition is stable and there are no other co-injuries, rehabilitation should begin. Of course, early activities are not allowed to be too wide, and should not affect the effect of surgery. The main activity should be to move all the joints of the body, to maintain the normal mobility of the joints, 2 to 3 times a day, each joint activity should be less than 1 minute. In addition, in the case of doctor’s permission, under the guidance of the nurse for position change, that is, turn over regularly to prevent pressure sores, generally once every 2 hours, protruding part of the bone (such as the scapula, heel, back, sacrococcygeal, double limbs) with a soft cushion padded, pay attention to the urinary and fecal discharge, pay attention to the changes in body temperature, pay attention to comforting the patient, to improve the patient’s psychology, and what abnormal changes in a timely manner to notify the doctor, the nurse, pay attention to the meal Pay attention to the nutrition of the food and drink water regularly. If early rehabilitation is done well, it will create a good foundation for comprehensive rehabilitation training in the future. 8.The main methods of rehabilitation treatment for spinal cord injury (1) Physiotherapy: It is mainly to improve the activities of all joints of the whole body and enhance the training of residual muscle strength, as well as the balance and coordination of movements and position exchange and transfer movements (e.g.: lying down to sitting, turning over, moving from bed to wheelchair, from wheelchair to toilet, etc.), as well as physiotherapy: the use of hydrotherapy, light therapy, biofeedback, etc., targeted to promote rehabilitation. (2) Occupational therapy: It focuses on daily life movements (such as basic skills in clothing, food, housing, and transportation), occupational labor movements, and craft labor movements (such as knitting, etc.), so that the patients can adapt to their personal life, family life, social life, and labor after being discharged from the hospital. In addition, the homework department provides patients with simple aids to facilitate the successful completion of home life movements. (3) Psychotherapy: A psychotherapy plan is formulated to address changes in different stages of the psyche (e.g., various stages of denial, anger, depression, and opposition to independence for adaptation, etc.), and a variety of methods can be carried out both individually and collectively, in the family, and in behavior. (4) Rehabilitation works: some necessary supports can be customized to practice standing and walking, and some special tools such as walkers can also be equipped to compensate for functional deficiencies by these tools. (5) Clinical rehabilitation: Nursing care and medication can be used to prevent the occurrence of various comorbidities, and some therapeutic clinical treatments can also be carried out to alleviate the symptoms and promote functional recovery. (6) Traditional Chinese medicine rehabilitation: Using traditional Chinese medicine, acupuncture, massage, electroacupuncture, and ionic introduction of traditional Chinese medicine to promote rehabilitation; in addition, for the treatment of comorbidities, traditional Chinese medicine can also be widely used internally and externally. (7) Nutritional therapy: formulate reasonable recipes and strengthen nutrition to meet the needs of rehabilitation training. (1) Pay attention to the general condition of the patient, such as in the acute stage, should be hospitalized (generally within 1 to 4 weeks). Should observe the patient’s breathing, pay attention to whether the fever, trembling, sweating, irritability, urine and feces are unobstructed. If the infusion, more attention should be paid to whether the urine volume increases, if there is a wound, pay attention to whether the dressing is dry, there is no blood seepage, seepage, there is drainage to pay attention to the flow of fluid, there are abnormalities in a timely manner to notify the doctor or nurse. (2) Prevention of pressure sores. Our rehabilitation center is currently using anti-pressure sore air cushion, the effect is very good. If there is no turn over every 2 hours, neck injuries or surgical patients to axial turning (i.e., the head and torso at the same time turning, can not cause head rotation when turning over). To prevent pressure sores, bone protrusions should be padded (head back occiput, scapula, sacrococcygeal, both hips, both internal and external ankles, ankles, both knee joints), but be careful not to use a round air cushion, because such a cushion will cause poor venous blood flow. The bone protrusion should be gently massaged with hands, and any color change should be shown to the doctor. (3) patients need to move to a different bed, out of the wheelchair, need to be 3 to 4 people work together to lift the patient (standing on one side), to complete the transfer, if the transfer of their own will not be, the need for two people to lift the patient from the bedside transfer to the wheelchair. In the manpower shortage can also be a person in accordance with a special position to transfer the patient, that is, both knees against the patient’s knees, the upper body moved to the patient’s back, both hands pulling the patient’s back side belt or pants, the upper body backward force, the patient’s upper body leaning on the back side of the assistant’s upper body, the two points of anterior and posterior (when the left turn, the right foot in the front, when the right turn, the left foot in the front), slowly moving, a person can also complete the transfer of action. Of course, the patient can not sit in a stable position can not perform this transfer mode, in the patient after formal rehabilitation training, such as self-transfer, but also in the early stage should be protected to prevent falls and trauma. (4) eat more nutritious food and fruits, pay attention to the stool situation, more than 3 to 7 days without stool, to be in the anus quickly injected into the Keserol 2, too dry to wear gloves (latex) digging out, the hand to be gentle, to prevent anal fissure, at the same time, you can orally some honey, laxative (such as senna bubble water or traditional Chinese medicine ma ren lun intestinal pills, etc.). (5)Move all the joints, especially the paralyzed part of the following large and small joints need to move, be gentle, each joint activity for 2 times a day, each time 1 ~ 2 minutes, according to the normal range of joint activity. (6) Pay attention to the swelling of both lower limbs, such as swelling for deep vein thrombosis bleeding, do not in the activities, to slightly elevate the affected limbs, and ask the doctor to check. (7) If the limbs are swollen and purplish after activity, there may be tendon crack or fracture, stop the activity and ask the doctor to check. (8) Comfort the patient with peace of mind and encourage the patient’s confidence in overcoming the disability. (9) When covered, put a soft pillow under the foot to keep the joints at 90°, and do not press the foot with the blanket to prevent foot drop. (910) The patient’s body position is generally lateral, supine, or prone if there are pressure sores on the sacrococcygeal area. Of course, the patient’s condition is stabilized can also be used sitting position. Any change of position must be guided by the doctor and nurse to follow. Generally speaking, the head, neck, chest and waist should not be twisted, and all kinds of positions should be supported by soft cushion and protect the bone protrusion, which should make the posture stable. 10.How is the rehabilitation effect of spinal cord injury? The effect of spinal cord injury rehabilitation is called “rehabilitation goal” in medicine. This goal may vary depending on the degree of disability caused by the different planes of injury. Quadriplegia caused by cervical injuries is less effective than thoracolumbar injuries. In general, patients with neck 4 injuries are dependent on others for basic living assistance, but can rely on self-help utensils for eating and can control a long-back power wheelchair by their head. Patients with neck 5 injury can take care of their own movements on the table, but they still need to be assisted by other people, and they can use a long back manual wheelchair. For patients with neck 6 injury, most of the daily life movements can be done by themselves, and they can move horizontally and push the manual wheelchair. Patients with neck 7 injury can take care of their daily life movement, can turn over and sit up, can support their body to do transfer movement. They can use manual wheelchair freely. Patients with neck 8 and chest 1 injuries can use long lower limb supports and crutches to walk to a small extent. Patients with thoracic 1 and 2 injuries do not need assistance from others at all, and are otherwise better than thoracic 1, and are basically similar to thoracic 11. Patients with chest 12 injuries have good trunk balance and can walk and go up and down stairs with long supports and crutches. Patients with lumbar 1 injuries are basically the same as those with chest 12 injuries, but the pelvis can be lifted. Patients with lumbar 2 injuries can use a brace to complete a functional walk. Patients with lumbar 4 and sacral 1 injuries can walk with short lower extremity supports. As for how long it takes to train to achieve the above goals, it takes about 8 to 12 months for neck injuries and 4 to 6 months for thoracolumbar injuries if the patient is in a specialized rehabilitation hospital. Of course, the above goals can also be achieved in the community or at home under the guidance of a doctor, and the time taken is relatively longer. In general, the training time is relatively short for young and physically fit patients, and relatively longer for old and frail patients. In addition to physical training, a certain amount of money has to be spent to equip with supports and wheelchairs, otherwise it is difficult to achieve the above goals. 11. Can stem cell transplantation make patients stand up? Stem cell transplantation is one of the current research directions, and it is hoped that patients can really stand up through this method. However, the whole medical world is still in the exploration and experimental stage, and there is not a single successful case, especially for patients with complete spinal cord injury. Therefore, many medical professionals put their hope on Chinese medicine. 12.What is the role of Chinese medicine, especially acupuncture, in the recovery of spinal cord injury? Chinese medicine has made fruitful achievements in the treatment and research of spinal cord injury, especially in improving urinary and defecation function, sensory and motor function, controlling symptoms, improving quality of life, and decreasing the rate of disease and death, etc. The effectiveness of Chinese medicine in the treatment of spinal cord injury has been remarkable. 13.What is the characteristic treatment of Chinese medicine in our rehabilitation center? Acupuncture and Chinese medicine are used together. Especially, the moxibustion in acupuncture is a method that we improve the traditional moxibustion method for the treatment of spinal cord injury patients. There are several kinds of moxibustion methods: ① “With years of strength” moxibustion method: it is a kind of moxibustion method which combines the traditional heavy moxibustion “Guanyuan” method and “refining umbilical cord method” and improves it. With years of strength, first seen in the “Yellow Emperor’s Classic of Internal Medicine”, the Jin Dynasty Ge Hong Zhi, medical practitioner Chen Yanzhi, is one of the pioneers who advocated moxibustion therapy, the application of “with years of strength”. From the Tang Dynasty to the Ming and Qing Dynasties, “Thousand Golden Wings”, “Thousand Golden Essentials”, “General Records of the Holy Spirit”, “Secret Essentials of the Wai Tai”, “Acupuncture and Moxibustion Zi Sheng Jing” and other important medical writings are included as important content, which are rich in acupoints and involve a wide range of diseases, including first aid, miscellaneous internal medicine, surgical diseases, gynecological, men’s, pediatric diseases and psychiatric symptoms, etc.. The term “with years of strong”, moxibustion, refers to the age of the size of the decision of the number of strong moxibustion, different age has a different constitution, its yin and yang, qi and blood and tolerance of moxibustion therapy is different, this quantitative method is simple, taking into account the individual differences, for the quantification of moxibustion therapy to provide an excellent program. This moxibustion has the function of warming the dantian, strengthening the yang, cultivating the energy and tonifying the marrow. At present, it is mainly used in the treatment of stroke, spinal cord injury, poor control of urination and defecation, and lumbar pain caused by various reasons, and it has a lot of miraculous effects. Plain and healthy people can be applied to strengthen the body, delay aging, life extension. ② Ren Chakra Moxibustion: Self-created moxibustion. The method of applying moxibustion on the Ren vein. The moxibustion site from the tail point to the middle pole point, the umbilical cord filled with our national invention of drugs, nourishing kidney yin, warm kidney yang, covered with the bottom of the width of 5cm, high 2, 5cm of ginger, on top of the moxa velvet strips, lighting moxibustion, the whole moxa cones burned out for a strong, each time according to the individual situation can be moxibustion 3, 5, 7 strong. The Ren Chakra is the sea of yin veins, which can nourish blood and promote digestion, nourish yin and supplement the deficiency, maintain the female uterus, ovaries, delay menopause, and health care for the male prostate function. This moxibustion method is very widely used in the treatment of a variety of diseases, Yang evidence, false evidence, cold evidence is particularly effective, can play: health care, anti-aging, anti-aging; warming the yang and replenish the deficiency, back to the yang and fixed off; tonifying the middle and benefiting the qi, Yang lift the trap, warming menstruation, cold, qi, pain, qi and blood, dissipation of lumps and swellings, support the right to fight against cancer, calm the liver to reduce the rebelliousness of the qi, lead the downward movement of the role of the qi. (iii) Improved acupuncture and moxibustion: the original folk therapy, is in the back of the human body on the ducal vein, to treat the disease of a special method of moxibustion, its moxibustion, from the large vertebrae point to the lumbar yu, along the spine on the midline of the powder (I developed their own formulations), and then the powder on the bottom of the bottom of the store width of 5cm, high 2, 5cm of ground ginger, the top of the store moxa velvet strips, and then the fire will be the two ends of the middle of the fire to ignite the moxibustion, so that the whole moxa cones burned out slowly! The whole cone of moxa will be burned out slowly, and each time you can moxibustion 1-3 strong. The acupuncture and moxibustion set of the dui chi, drugs, ginger and moxibustion therapeutic effect in one, ginger pungent and warm to go away, moxibustion warm and penetrating, can enhance the permeability of the skin, and promote the body’s absorption of the drug ingredients. Including meridians, acupoints, drugs, moxibustion and other factors of the integrated advantage, can be described as the law in the yin and yang, and in the number of techniques, multi-pronged, straight to the disease of the whole body to adjust, play the warm yang dispersal of cold, tonifying the kidneys, through the governor, the strong bone through the muscle, the blood, break the stasis, paralysis, pain, and to achieve the tonification of the kidney and through the stagnation of the governor, the “symptomatic treatment of the root of the problem” effect. ④ Anointed Vital Point Moxibustion: from the ancient method. Everyone knows that the idiom of “sick to the vertiginous” originates from a passage in Zuo Zhuan (左传). It is often used to refer to a serious illness that is difficult to treat, such as “the disease is in the vitals” or “the disease of the vitals”. The Anointing Vessel Point on the back of the human body is located three inches (about four cross fingers) away from the fourth and fifth thoracic vertebrae, belonging to the foot solar bladder meridian, and is a key point for treating various kinds of fatigue and chronic diseases. Anointed Vitality Yu is named for its unique therapeutic effect. “This is one of the lines in the song of acupuncture and moxibustion. In the Thousand Gold Formula, it is said that “Anointing and Vermiculosity can be used for treating deficiency and thinness, five labors and seven injuries, dreaming and loss of semen, coughing, phlegm and fire, forgetfulness, prenatal and postnatal period, and so on, and it can treat all kinds of diseases”. Anointing point is widely used in the treatment of deficiency labor syndrome. When the disease is not cured for a long time and the body is weak and thin, it is most suitable to take the Anointed Vermicula point to apply moxibustion, which can play a preventive and therapeutic role for the “sick in the vitals”. It can play a role in supporting yang and solidifying the guards, helping the yin and camping, and harmonizing the qi and blood of the whole body, so that the body can be restored to a strong state.