How long does the recovery of corneal sensitivity in different corneal regions take after LASEK?

AIM:To determine the corneal sensitivity recovery period after laser-assisted sub-epithelial keratectomy(LASEK)refractive surgery and investigate the effects of ablation depth on it.METHODS:In this study examinations were performed on 90 right eyes of 90 people(34 males and 56 females)with an age range of 20-35 and an average of 22.26±3.8 years old.A sensation of 5 corneal regions,including the center and 4 mid-peripheral regions,i.e.,nasal,inferior,temporal,and superior,each at a distance of 2 mm from the center of the cornea were measured with a Cochet-Bonnet esthesiometer device in 3-time points including before LASEK,1 and 3mo after the surgery,respectively.LASEK was performed on individuals with stabilized myopia of -1.00 to -7.00 diopters and astigmatism of less than 2.00 diopters.Furthermore,the individuals were divided into three groups regarding ablation depth.RESULTS:The highest level of corneal sensitivity before surgery was related to the center of the cornea(59.1±7.76),and the highest level of corneal sensitivity loss was also related to this region.The sensation of all measured corneal regions significantly reduced 1mo postoperatively and returned to their preoperative levels 3mo after surgery(mean of 5 corneal regions in levels of preoperation:58.2±6.48,1mo postoperation:57.3±5.84,3mo postoperation:58.2±5.49;P<0.05).A significant relationship was found between ablation depth and corneal sensitivity changes in the center and temporal regions(P<0.05).CONCLUSION:Corneal sensitivity in myopia and low astigmatism decreases after LASEK and reaches the preoperative level within 3mo.The depth of ablation during surgery affected the recovery of corneal sensitivity.

Enhancing recovery and sensitivity studies in an unconventional tight gas condensate reservoir

The recovery factor from tight gas reservoirs is typically less than 15%, even with multistage hydrauhc tractunng stimulation. Such low recovery is exacerbated in tight gas condensate reservoirs, where the depletion of gas leaves the valuable condensate behind. In this paper, three enhanced gas recovery （EGR） methods including produced gas injection, CO2 injection and water injection are investigated to increase the well productivity for a tight gas condensate reservoir in the Montney Formation, Canada. The production performance of the three EGR methods is compared and their economic feasibility is evaluated. Sensitivity analysis of the key factors such as primary production duration, bottom-hole pressures, and fracture conductivity is conducted and their effects on the well production performance are analyzed. Results show that, compared with the simple depletion method, both the cumulative gas and condensate production increase with fluids injected. Produced gas injection leads to both a higher gas and condensate production compared with those of the CO2 injection, while waterflooding suffers from injection difficulty and the corresponding low sweep efficiency. Meanwhile, the injection cost is lower for the produced gas injection due to the on-site available gas source and minimal transport costs, gaining more economic benefits than the other EGR methods.

Improvement in Sensitivity and Recovery of Single-Walled Carbon Nanotube-Based Gas Sensors

In this paper,an improvement in sensitivity and recovery of the single-walled carbon nanotube (SWNT)-based gas sensors was reported.The sensors were fabricated from SWNT powder by a screen-printing method,followed by annealing for 2 h in open-air at various temperatures.The Raman spectra of the SWNT bundles and the response to ammonia (NH_3) exposure of the sensors indicated that the annealing at a relevant temperature improved the sensor sensitivity.The sensor annealed at 200℃exhibited a high sensitivity in NH_3 detection.After 20 min of exposure to NH_3 at room temperature,the resistance of the sensor increased up to 12% in comparison with its initial value.By evacuating combined with maintaining the flux of carrier gas at 300 sccm,the sensor recovery was significantly speeded.The sensor resistance retrieved to its initial value after only 25 min degassing. These results would be considered in the development of the SWNT-based gas sensors.

Activation of cerebral Ras-related C3 botulinum toxin substrate(Rac) 1 promotes post-ischemic stroke functional recovery in aged mice

Brain functional impairment after stroke is common;however,the molecular mechanisms of post-stroke recovery remain unclear.It is well-recognized that age is the most important independent predictor of poor outcomes after stroke as older patients show poorer functional outcomes following stroke.Mounting evidence suggests that axonal regeneration and angiogenesis,the major forms of brain plasticity responsible for post-stroke recovery,diminished with advanced age.Previous studies suggest that Ras-related C3 botulinum toxin substrate(Rac)1 enhances stroke recovery as activation of Rac1 improved behavior recovery in a young mice stroke model.Here,we investigated the role of Rac1 signaling in long-term functional recovery and brain plasticity in an aged(male,18 to 22 months old C57BL/6J)brain after ischemic stroke.We found that as mice aged,Rac1 expression declined in the brain.Delayed overexpression of Rac1,using lentivirus encoding Rac1 injected day 1 after ischemic stroke,promoted cognitive(assessed using novel object recognition test)and sensorimotor(assessed using adhesive removal tests)recovery on days 14–28.This was accompanied by the increase of neurite and proliferative endothelial cells in the periinfarct zone assessed by immunostaining.In a reverse approach,pharmacological inhibition of Rac1 by intraperitoneal injection of Rac1 inhibitor NSC23766 for 14 successive days after ischemic stroke worsened the outcome with the reduction of neurite and proliferative endothelial cells.Furthermore,Rac1 inhibition reduced the activation of p21-activated kinase 1,the protein level of brain-derived neurotrophic factor,and increased the protein level of glial fibrillary acidic protein in the ischemic brain on day 28 after stroke.Our work provided insight into the mechanisms behind the diminished plasticity after cerebral ischemia in aged brains and identified Rac1 as a potential therapeutic target for improving functional recovery in the older adults after stroke.

Risk Factors Asscociated with Hypokalemia during Postanesthesia Recovery and Its Impact on Outcomes in Gynecological Patients:A Propensity Score Matching Study

Objective:This study aimed to explore the risk factors and outcomes of hypokalemia during the recovery period from anesthesia in the gynecological population.Methods:This retrospective cohort study included 208 patients who underwent gynecological surgery at our institution between January 2021 and March 2022.Data were collected for each patient,including demographics,disease status,surgical data,and clinical information.Preoperative bowel preparation,postoperative gastrointestinal function,and electrolyte levels were compared between the two groups using propensity score matching(PSM).Results:The incidence of hypokalemia(serum potassium level<3.5 mmol/L)during the recovery period from anesthesia was approximately 43.75%.After PSM,oral laxative use(96.4%vs.82.4%,P=0.005),the number of general enemas(P=0.014),and the rate of≥2 general enemas(92.9%vs.77.8%,P=0.004)were identified as risk factors for hypokalemia,which was accompanied by decreased PaCO_(2) and hypocalcemia.There were no significant differences in postoperative gastrointestinal outcomes,such as the time to first flatus or feces,the I-FEED score(a scoring system was created to evaluate impaired postoperative gastrointestinal function),or postoperative recovery outcomes,between the hypokalemia group and the normal serum potassium group.Conclusion:Hypokalemia during postanesthesia recovery period occurred in 43.75%of gynecological patients,which resulted from preoperative mechanical bowel preparation;however,it did not directly affect clinical outcomes,including postoperative gastrointestinal function,postoperative complications,and length of hospital stay.

Characterizing permeability-porosity relationships of porous rocks using a stress sensitivity model in consideration of elastic-structural deformation and tortuosity sensitivity

Clarifying the relationship between stress sensitivities of permeability and porosity is of great significance in guiding underground resource mining.More and more studies focus on how to construct stress sensitivity models to describe the relationship and obtain a comprehensive stress sensitivity of porous rock.However,the limitations of elastic deformation calculation and incompleteness of considered tortuosity sensitivity lead to the fact that the existing stress sensitivity models are still unsatisfactory in terms of accuracy and generalization.Therefore,a more accurate and generic stress sensitivity model considering elastic-structural deformation of capillary cross-section and tortuosity sensitivity is proposed in this paper.The elastic deformation is derived from the fractal scaling model and Hooke's law.Considering the effects of elastic-structural deformation on tortuosity sensitivity,an empirical formula is proposed,and the conditions for its applicability are clarified.The predictive performance of the proposed model for the permeability-porosity relationships is validated in several sets of publicly available experimental data.These experimental data are from different rocks under different pressure cycles.The mean and standard deviation of relative errors of predicted stress sensitivity with respect to experimental data are 2.63%and 1.91%.Compared with other models,the proposed model has higher accuracy and better predictive generalization performance.It is also found that the porosity sensitivity exponent a,which can describe permeability-porosity relationships,is 2 when only elastic deformation is considered.a decreases from 2 when structural deformation is also considered.In addition,a may be greater than 3 due to the increase in tortuosity sensitivity when tortuosity sensitivity is considered even if the rock is not fractured.

Research progress and potential of new enhanced oil recovery methods in oilfield development

This paper reviews the basic research means for oilfield development and also the researches and tests of enhanced oil recovery(EOR)methods for mature oilfields and continental shale oil development,analyzes the problems of EOR methods,and proposes the relevant research prospects.The basic research means for oilfield development include in-situ acquisition of formation rock/fluid samples and non-destructive testing.The EOR methods for conventional and shale oil development are classified as improved water flooding(e.g.nano-water flooding),chemical flooding(e.g.low-concentration middle-phase micro-emulsion flooding),gas flooding(e.g.micro/nano bubble flooding),thermal recovery(e.g.air injection thermal-aided miscible flooding),and multi-cluster uniform fracturing/water-free fracturing,which are discussed in this paper for their mechanisms,approaches,and key technique researches and field tests.These methods have been studied with remarkable progress,and some achieved ideal results in field tests.Nonetheless,some problems still exist,such as inadequate research on mechanisms,imperfect matching technologies,and incomplete industrial chains.It is proposed to further strengthen the basic researches and expand the field tests,thereby driving the formation,promotion and application of new technologies.

High-Precision Flow Numerical Simulation and Productivity Evaluation of Shale Oil Considering Stress Sensitivity

Continental shale oil reservoirs,characterized by numerous bedding planes and micro-nano scale pores,feature significantly higher stress sensitivity compared to other types of reservoirs.However,research on suitable stress sensitivity characterization models is still limited.In this study,three commonly used stress sensitivity models for shale oil reservoirs were considered,and experiments on representative core samples were conducted.By fitting and comparing the data,the“exponential model”was identified as a characterization model that accurately represents stress sensitivity in continental shale oil reservoirs.To validate the accuracy of the model,a two-phase seepage mathematical model for shale oil reservoirs coupled with the exponential model was introduced.The model was discretely solved using the finite volume method,and its accuracy was verified through the commercial simulator CMG.The study evaluated the productivity of a typical horizontal well under different engineering,geological,and fracture conditions.The results indicate that considering stress sensitivity leads to a 13.57%reduction in production for the same matrix permeability.Additionally,as the fracture half-length and the number of fractures increase,and the bottomhole flowing pressure decreases,the reservoir stress sensitivity becomes higher.

Does enhanced recovery after surgery programs improve clinical outcomes in liver cancer surgery?

Enhanced recovery after surgery(ERAS)programs have been widely applied in liver surgery since the publication of the first ERAS guidelines in 2016 and the new recommendations in 2022.Liver surgery is usually performed in oncological patients(liver metastasis,hepatocellular carcinoma,cholangiocarcinoma,etc.),but the real impact of liver surgery ERAS programs in oncological outcomes is not clearly defined.Theoretical advantages of ERAS programs are:ERAS decreases postoperative complication rates and has been demonstrated a clear relationship between complications and oncological outcomes;a better and faster posto-perative recovery should let oncologic teams begin chemotherapeutic regimens on time;prehabilitation and nutrition actions before surgery should also improve the performance status of the patients receiving chemotherapy.So,ERAS could be another way to improve our oncological results.We will discuss the literature about liver surgery ERAS focusing on its oncological implications and future investigations projects.

近红外无创血糖浓度的Label Sensitivity算法和支持向量机回归

近红外光谱分析技术在生物医学工程领域具有广阔应用前景。无创且持续性地测量能实时监控人体血糖水平,给糖尿病患者带来极大便利性、提高生存质量、降低糖尿病并发症发生率具有很大的社会效益。无创血糖监测的想法提出较早,但仍然存在预测精度低、预测值与标签值相关性不高等难点,至今没有达到临床要求。近年来,光谱检测技术发展迅猛且机器学习技术在智能信息处理方面具有明显优势,两者结合可以有效提高人体无创血糖医学监测模型的精度和普适性。提出了一种标签敏感度算法(LS),并结合支持向量机方法建立了人体血糖含量预测模型。使用近红外光谱仪采集了4名志愿者食指处动态血液光谱数据(每名志愿者28组数据),并使用多元散射矫正(MSC)方法消除了部分光散射的影响。考虑血糖对不同波长光的吸收有差异,提出了基于血糖浓度标签差的特征波长挑选方法,并构建了标签敏感度支持向量机(LSSVR)预测模型。设计实验,对比该模型与偏最小二乘回归(PLSR)和区分度支持向量机(FSSVR)算法。结果表明,LS算法的最佳特征波长数为32,经特征波长选择后的LSSVR表现最佳,其均方误差降低至0.02 mmol·L^(-1),明显优于全谱段PLSR模型,血糖浓度的预测值与标签值的相关系数提升至99.8%,预测值全部位于可容许误差的克拉克网格A区内。LSSVR模型的优异表现为早日实现血糖的无创监测提供了新思路。

Optimizing postsurgical recovery for elderly patients with gastric cancer

Based on a recent study by Li et al,this editorial examines the significance of enhanced recovery after surgery(ERAS)protocols for elderly patients with gastric cancer.Cancer-related mortality,which is overwhelmingly caused by gastric cancer,calls for effective treatment strategies.Despite advances in the field of oncology,conventional postoperative care often results in prolonged hospital stays and increased complications.The aim of ERAS is to expedite recovery,reduce surgical stress,and improve patient satisfaction.The study of Li et al showed that,compared to traditional care,ERAS significantly reduces mortality risk,shortens hospital stays,and decreases postoperative complications.These findings support the widespread implementation of ERAS protocols in surgical practice to enhance patient outcomes and healthcare value.

Study on the Application Effect of Enhanced Recovery After Surgery (ERAS) in Patients Undergoing Spinal Fracture Surgery

Objective:To study the application effect of the Enhanced Recovery After Surgery(ERAS)model in patients undergoing spinal fracture surgery.Methods:A randomized controlled trial was designed,and 86 patients undergoing spinal fracture surgery were randomly divided into the ERAS group and the conventional care group.Postoperative recovery outcomes of the two groups were compared.Results:The ERAS group showed better outcomes in terms of postoperative pain scores,activities of daily living,length of hospital stay,and adherence to rehabilitation training compared to the conventional care group,with shorter hospital stays and lower medical expenses(P<0.05).Conclusion:The ERAS model significantly improves the postoperative recovery quality of patients undergoing spinal fracture surgery,reduces hospital stay and medical costs,and increases patient satisfaction.

Promoting Ethical Sensitivity in Nursing Education:A Systematic Review of Case Study-Based Health Education

Introduction: Nursing ethical sensitivity refers to a nurse’s capacity for thoughtful consideration of ethical issues when faced with dilemmas. In the nursing domain, ethical dilemmas arise when nurses face challenges in making sound ethical decisions during clinical practice. These challenges may stem from conflicts between personal values and professional responsibilities. Methodology: Articles downloaded from Pub Med, CNKI, and Google Scholar were reviewed. Results: After rigorous screening, a meticulous analysis was conducted, encompassing 10 articles and involving a substantial cohort of 2863 participants. Existing literature revealed variations in the ethical dilemmas faced by nurses across different departments. The ethical sensitivity of nurses also varies, with higher ethical sensitivity correlating with stronger empathetic abilities. Zhen et al. classified the causes of ethical dilemmas into four main categories: (1) Ethical dilemmas arising from personal reasons of nursing students;(2) Ethical dilemmas stemming from the actions of teachers;(3) Ethical dilemmas triggered by patients;(4) Ethical dilemmas resulting from miscellaneous reasons. Conclusion: According to literature findings, nursing ethical sensitivity was positively linked to the nurse’s ethical decision-making ability. A case study-oriented teaching program has proven effective in enhancing ethical sensitivity among nursing students.

Is recovery enhancement after gastric cancer surgery really a safe approach for elderly patients?

BACKGROUND This study aimed to evaluate the safety of enhanced recovery after surgery(ERAS)in elderly patients with gastric cancer(GC).AIM To evaluate the safety of ERAS in elderly patients with GC.METHODS The PubMed,EMBASE,and Cochrane Library databases were used to search for eligible studies from inception to April 1,2023.The mean difference(MD),odds ratio(OR)and 95%confidence interval(95%CI)were pooled for analysis.The quality of the included studies was evaluated using the Newcastle-Ottawa Scale scores.We used Stata(V.16.0)software for data analysis.RESULTS This study consists of six studies involving 878 elderly patients.By analyzing the clinical outcomes,we found that the ERAS group had shorter postoperative hospital stays(MD=-0.51,I2=0.00%,95%CI=-0.72 to-0.30,P=0.00);earlier times to first flatus(defecation;MD=-0.30,I²=0.00%,95%CI=-0.55 to-0.06,P=0.02);less intestinal obstruction(OR=3.24,I2=0.00%,95%CI=1.07 to 9.78,P=0.04);less nausea and vomiting(OR=4.07,I2=0.00%,95%CI=1.29 to 12.84,P=0.02);and less gastric retention(OR=5.69,I2=2.46%,95%CI=2.00 to 16.20,P=0.00).Our results showed that the conventional group had a greater mortality rate than the ERAS group(OR=0.24,I2=0.00%,95%CI=0.07 to 0.84,P=0.03).However,there was no statistically significant difference in major complications between the ERAS group and the conventional group(OR=0.67,I2=0.00%,95%CI=0.38 to 1.18,P=0.16).CONCLUSION Compared to those with conventional recovery,elderly GC patients who received the ERAS protocol after surgery had a lower risk of mortality.

Transplantation of fibrin-thrombin encapsulated human induced neural stem cells promotes functional recovery of spinal cord injury rats through modulation of the microenvironment

Recent studies have mostly focused on engraftment of cells at the lesioned spinal cord,with the expectation that differentiated neurons facilitate recovery.Only a few studies have attempted to use transplanted cells and/or biomaterials as major modulators of the spinal cord injury microenvironment.Here,we aimed to investigate the role of microenvironment modulation by cell graft on functional recovery after spinal cord injury.Induced neural stem cells reprogrammed from human peripheral blood mononuclear cells,and/or thrombin plus fibrinogen,were transplanted into the lesion site of an immunosuppressed rat spinal cord injury model.Basso,Beattie and Bresnahan score,electrophysiological function,and immunofluorescence/histological analyses showed that transplantation facilitates motor and electrophysiological function,reduces lesion volume,and promotes axonal neurofilament expression at the lesion core.Examination of the graft and niche components revealed that although the graft only survived for a relatively short period(up to 15 days),it still had a crucial impact on the microenvironment.Altogether,induced neural stem cells and human fibrin reduced the number of infiltrated immune cells,biased microglia towards a regenerative M2 phenotype,and changed the cytokine expression profile at the lesion site.Graft-induced changes of the microenvironment during the acute and subacute stages might have disrupted the inflammatory cascade chain reactions,which may have exerted a long-term impact on the functional recovery of spinal cord injury rats.

Identification, pathogenicity, and fungicide sensitivity of Eutiarosporella dactylidis associated with leaf blight on maize in China

Maize(Zea mays L.) is an economically vital grain crop that is cultivated worldwide. In 2011, a maize foliar disease was detected in Lingtai and Lintao counties in Gansu Province, China. The characteristic signs and symptoms of this disease include irregular chlorotic lesions on the tips and edges of infected leaves and black punctate fruiting bodies in dead leaf tissues. Given favourable environmental conditions, this disease spread to areas surrounding Gansu. In this study, infected leaves were collected from Gansu and Ningxia Hui Autonomous Region between 2018and 2020 to identify the disease-causing pathogen. Based on morphological features, pathogenicity tests, and multilocus phylogenetic analysis involving internal transcribed spacer(ITS), 18S small subunit rDNA(SSU), 28S large subunit rDNA(LSU), translation elongation factor 1-alpha(TEF), and β-tubulin(TUB) sequences, Eutiarosporella dactylidis was identified as the causative pathogen of this newly discovered leaf blight. Furthermore, an in vitro bioassay was conducted on representative strains using six fungicides, and both fludioxonil and carbendazim were found to significantly inhibit the mycelial growth of E. dactylidis. The results of this study provide a reference for the detection and management of Eutiarosporella leaf blight.

Future changes in precipitation and water availability over the Tibetan Plateau projected by CMIP6 models constrained by climate sensitivity

Precipitation projections over the Tibetan Plateau(TP)show diversity among existing studies,partly due to model uncertainty.How to develop a reliable projection remains inconclusive.Here,based on the IPCC AR6–assessed likely range of equilibrium climate sensitivity(ECS)and the climatological precipitation performance,the authors constrain the CMIP6(phase 6 of the Coupled Model Intercomparison Project)model projection of summer precipitation and water availability over the TP.The best estimates of precipitation changes are 0.24,0.25,and 0.45 mm d^(−1)(5.9%,6.1%,and 11.2%)under the Shared Socioeconomic Pathway(SSP)scenarios of SSP1–2.6,SSP2–4.5,and SSP5–8.5 from 2050–2099 relative to 1965–2014,respectively.The corresponding constrained projections of water availability measured by precipitation minus evaporation(P–E)are 0.10,0.09,and 0.22 mm d^(−1)(5.7%,4.9%,and 13.2%),respectively.The increase of precipitation and P–E projected by the high-ECS models,whose ECS values are higher than the upper limit of the likely range,are about 1.7 times larger than those estimated by constrained projections.Spatially,there is a larger increase in precipitation and P–E over the eastern TP,while the western part shows a relatively weak difference in precipitation and a drier trend in P–E.The wetter TP projected by the high-ECS models resulted from both an approximately 1.2–1.4 times stronger hydrological sensitivity and additional warming of 0.6℃–1.2℃ under all three scenarios during 2050–2099.This study emphasizes that selecting climate models with climate sensitivity within the likely range is crucial to reducing the uncertainty in the projection of TP precipitation and water availability changes.

Synergistic anionic/zwitterionic mixed surfactant system with high emulsification efficiency for enhanced oil recovery in low permeability reservoirs

Emulsification is one of the important mechanisms of surfactant flooding. To improve oil recovery for low permeability reservoirs, a highly efficient emulsification oil flooding system consisting of anionic surfactant sodium alkyl glucosyl hydroxypropyl sulfonate(APGSHS) and zwitterionic surfactant octadecyl betaine(BS-18) is proposed. The performance of APGSHS/BS-18 mixed surfactant system was evaluated in terms of interfacial tension, emulsification capability, emulsion size and distribution, wettability alteration, temperature-resistance and salt-resistance. The emulsification speed was used to evaluate the emulsification ability of surfactant systems, and the results show that mixed surfactant systems can completely emulsify the crude oil into emulsions droplets even under low energy conditions. Meanwhile,the system exhibits good temperature and salt resistance. Finally, the best oil recovery of 25.45% is achieved for low permeability core by the mixed surfactant system with a total concentration of 0.3 wt%while the molar ratio of APGSHS:BS-18 is 4:6. The current study indicates that the anionic/zwitterionic mixed surfactant system can improve the oil flooding efficiency and is potential candidate for application in low permeability reservoirs.

Problem identification and revitalization strategies for the recovery and reconstruction of traditional villages in the Ms 6.8 Luding Earthquake

Post-disaster reconstruction is a topic of global concern,and traditional villages have special heritage attributes and need to face more requirements and obstacles in post-disaster reconstruction.This paper summarizes four concepts based on the research on post-disaster reconstruction both domestically and internationally,as well as the recovery and reconstruction of cultural heritage.Through a field survey of traditional villages in the Ms 6.8 Luding earthquake-stricken area,it is found that there are problems such as insufficient awareness of heritage value,misalignment of scientific reconstruction technology,and insufficient protection of reconstruction elements during the reconstruction process.Traditional villages face the risk of declining or even loss of heritage value.In order to effectively protect traditional villages and inherit the carrier of regional culture,four targeted reconstruction response strategies are proposed,i.e.,to"establish special planning for traditional village preservation","emphasize recovery of the authenticity of village heritage","ensure elements for village heritage recovery"and"promote the activation and utilization of village heritage",based on the problems discovered during the survey and the four concepts summarized in the research on post-disaster reconstruction of traditional villages.The research results hope to provide useful reference for ancient cultural areas affected by earthquakes on how to protect cultural heritage during the post-disaster reconstruction process.

Surgical intervention combined with weight-bearing walking training promotes recovery in patients with chronic spinal cord injury:a randomized controlled study

For patients with chronic spinal cord injury,the co nventional treatment is rehabilitation and treatment of spinal cord injury complications such as urinary tract infection,pressure sores,osteoporosis,and deep vein thrombosis.Surgery is rarely perfo rmed on spinal co rd injury in the chronic phase,and few treatments have been proven effective in chronic spinal cord injury patients.Development of effective therapies fo r chronic spinal co rd injury patients is needed.We conducted a randomized controlled clinical trial in patients with chronic complete thoracic spinal co rd injury to compare intensive rehabilitation(weight-bearing walking training)alone with surgical intervention plus intensive rehabilitation.This clinical trial was registered at ClinicalTrials.gov(NCT02663310).The goal of surgical intervention was spinal cord detethering,restoration of cerebrospinal fluid flow,and elimination of residual spinal cord compression.We found that surgical intervention plus weight-bearing walking training was associated with a higher incidence of American Spinal Injury Association Impairment Scale improvement,reduced spasticity,and more rapid bowel and bladder functional recovery than weight-bearing walking training alone.Overall,the surgical procedures and intensive rehabilitation were safe.American Spinal Injury Association Impairment Scale improvement was more common in T7-T11 injuries than in T2-T6 injuries.Surgery combined with rehabilitation appears to have a role in treatment of chronic spinal cord injury patients.