Psychometric evaluation of the Taiwan version of the Disability of the Arm, Shoulder, and Hand (DASH) questionnaire.

BACKGROUND AND PURPOSE: To adapt the Taiwan version of the Disability of the Arm, Shoulder, and Hand (DASH) questionnaire and evaluate its psychometric properties. METHODS: The DASH questionnaire was adapted through the process of translation, back-translation, and expert review. Eighty two subjects with upper extremity disorders were recruited in a medical center and 46 of these patients could be followed up to assess retest reliability in less than 10 days. Cronbach alpha and intraclass correlation coefficient were used to evaluate the internal consistency and test-retest reliability. Principal axis factor analysis was performed to assess the factor-construct validity, while concurrent validity was tested with the Medical Outcomes Study Short Form-36 (SF-36) Taiwan version questionnaire. RESULTS: The internal consistency of the Taiwan version of the DASH questionnaire was high (Cronbach alpha = 0.96) and the test-retest reliability was satisfactory (intraclass correlation coefficient = 0.9). Principal axis factor analysis confirmed the 1-factor model. The Pearson correlation coefficients of the DASH questionnaire to the SF-36 showed a correlation with physical component summary scores rather than mental component summary scores. Bodily pain, physical function and role-physical scores among the SF-36 subscales were most significantly correlated with DASH disability/symptom scores. CONCLUSION: The Taiwan version of the DASH questionnaire is a valid and reliable measure of health status for patients with upper-extremity disorders.     

关于主诉定义和书写要点的讨论

文章提出了在医院医疗服务范围和项目不断拓宽的情况下,现行病历书写规章制度中有关“主诉”的定义和书写要求也应进一步修改和拓宽。作者根据多年做临床质量控制工作和住院病历检查的经验,结合国内医学文献中部分专家的意见,对主诉的书写要点和常见问题进行了分析、总结。     

解剖学实验室存在的三大问题与对策

根据对13所解剖学实验室的调查，阐述解剖学实验室存在的三大问题，并提出解决问题的对策。     

Recurrent corneal perforation and acute calcareous corneal degeneration in chronic graft-versus-host disease.

Keratoconjunctivitis sicca (KCS) is a common complication of graft-versus-host disease (GVHD), and may lead to corneal epithelial defect and melting. In contrast, recurrent corneal calcareous degeneration and perforation is rare. A 46-year-old woman developed chronic GVHD after bone marrow transplantation for aplastic anemia. Severe KCS with corneal melting and calcium deposits were noted in the left eye. Penetrating keratoplasty was performed because of corneal perforation, but poor re-epithelialization and calcium deposition recurred. Lamellar keratectomy and amniotic membrane transplantation (AMT) were performed, but acute calcareous degeneration developed with subsequent recurrence of corneal perforation. After regraft, AMT and tarsorrhaphy, the corneal graft remained clear for 3 months. However, breakdown of the corneal epithelium occurred 3 weeks after spontaneous separation of tarsorrhaphy. Six months later, corneal perforation recurred again along with exacerbation of GVHD. Regraft was performed, but the patient refused tarsorrhaphy and AMT. Poor re-epithelialization persisted after regraft. Corneal melting with impending corneal perforation ensued. Further corneal surgery was refused and the patient chose to undergo evisceration. This case demonstrates that the ocular complications of GVHD may be severe enough to lead to corneal perforation and calcareous degeneration that is recalcitrant to medical and surgical treatment.     

黄芪注射液对刀豆蛋白诱导的小鼠肝脏损伤的保护作用

目的：观察免疫损伤模型组与实验组小鼠外周血中T细胞亚群的变化情况，探讨黄芪注射液对小鼠肝脏损伤的保护作用。方法实验组小鼠每天腹腔注射黄芪注射液400μl，正常组与模型组小鼠每天给予等剂量的生理盐水。第7天在给药1小时后，模型组与实验组小鼠分别经尾静脉注射刀豆蛋白，正常组小鼠则给予等剂量的生理盐水。8小时后检测各组动物外周血中CD4^＋T、CD8^＋T细胞以及CD4^＋／CD25^＋T细胞所占比例，检测血浆转氨酶水平，制备肝脏病理标本，进行HE染色。结果尾静脉注射8小时后，实验组小鼠外周血的CD4^＋所占T细胞比例较模型组有所升高（P〈0．05），但仍低于正常组水平（P〉0．05）：而CD8^＋T细胞的比例则无明显变化（P〉0．05）。实验组ALT、AST水平明显低于模型组（P〈0．05）。实验组汇管区淋巴细胞浸润明显减少。结论黄芪注射液对刀豆蛋白诱导的小鼠肝损伤有确切的保护作用。     

Comparing the efficacy of different intra-articular injections for knee osteoarthritis: A network analysis

Background:The findings on the effectiveness of platelet-rich plasma, ozone, and hyaluronic acid in the treatment of osteoarthritis of the knee are controversial, and the existing original studies and meta-analyses are mostly comparisons of a single joint cavity injection method, lacking direct and indirect comparisons of different drugs in the joint cavity. The lack of direct and indirect comparisons of different drugs in the joint cavity makes it difficult to have a clearer and more comprehensive understanding of joint cavity injection methods. In this study, the efficacy of platelet-rich, ozone, sodium hyaluronate, and combined knee cavity injections were compared directly or indirectly using a reticulated meta-analysis in this field, and the efficacy of treatment measures was ranked to provide more comprehensive and reliable evidence-based clinical evidence for the selection of knee cavity injections in osteoarthritis of the knee.Objective:To compare the effects of platelet-rich plasma, ozone, and sodium glassate injection interventions on the efficacy of osteoarthritis of the knee through reticulated Meta-analysis, and to comprehensively compare the clinical effectiveness of platelet-rich plasma, ozone, and sodium glassate injection joint cavity injection for the treatment of osteoarthritis of the knee.Methods:The PubMed, CBM, CNKI, VIP, and Wan-Fang databases were searched for information on the effectiveness of platelet-rich plasma, ozone, and sodium vitrate injection for the comparative treatment of osteoarthritis of the knee, with a search time frame of each database from the date of creation to July 20, 2021. Two investigators independently screened the literature, extracted data according to inclusion and exclusion criteria, and evaluated the quality of the literature in parallel. Statistical analysis was performed using Stata 16.0 software to compare the differences in the efficacy of each treatment measure using the ratio and 95% confidence interval as effect indicators and to rank the efficacy.Results:Thirty-three RCTs with 7003 patients with osteoarthritis of the knee were included, involving 5 therapeutic measures. Meta-analysis showed that the efficacy of platelet-rich plasma injection was superior to both ozone and hyaluronic acid therapies. Hyaluronic acid+ozone and platelet-rich plasma+hyaluronic acid were both superior to ozone and hyaluronic acid monotherapy. The differences in efficacy between hyaluronic acid and ozone compared with platelet-rich plasma were statistically significant, and the differences in efficacy between the 2 combination therapies (platelet-rich plasma+hyaluronic acid, hyaluronic acid+ozone) and the 3 monotherapies (platelet-rich plasma, ozone, hyaluronic acid) were statistically significant. Platelet-rich plasma+hyaluronic acid, hyaluronic acid+ozone compared with 3 monotherapies (platelet-rich plasma, ozone, hyaluronic acid) were statistically significant, except for the difference in efficacy with platelet-rich plasma, which was not statistically significant, indicating that this platelet-rich plasma+hyaluronic acid and Hyaluronic acid+ozone combination therapy was superior to monotherapy. Also, the efficacy of platelet-rich plasma was better than hyaluronic acid and ozone and the difference was statistically significant, indicating that platelet-rich plasma was more effective than ozone and sodium glass in the treatment of osteoarthritis of the knee in monotherapy.Conclusion:It is believed that in the course of clinical practice, hyaluronic acid+ozone or platelet-rich plasma+hyaluronic acid combination therapy or platelet-rich plasma therapy can be preferred for patients with osteoarthritis of the knee.     

ZTA和Al2O3正畸托槽的研究

目的 分别评价ZTA(ZrO2增韧Al2O3)和Al2O3陶瓷的性能,探索一种适合制备正畸托槽的陶瓷材料.方法 选用ZrO2(3mol%Y2O3)和α-Al2O3粉体作为原料,利用热压铸成型工艺制备陶瓷托槽,在1600 ℃下烧结.将制得样品进行各方面的性能测试.结果 采用纯Al2O3制备的托槽抗弯强度远远低于ZTA复合陶瓷.结论 牙科正畸托槽可以选用具有较高抗弯强度的ZTA复合陶瓷作为原料.     

Electrochemical Corrosion Behaviour of X70 Steel under the Action of Capillary Water in Saline Soils

In this paper, the electrochemical corrosion behavior of X70 steel in saline soil under capillary water was simulated by a Geo-experts one-dimensional soil column instrument. A volumetric water content sensor and conductivity test were used to study the migration mechanism of water and salt (sodium chloride) under the capillary water. The electrochemical corrosion behavior of the X70 steel in the corrosion system was analyzed by electrochemical testing as well as the macroscopic and microscopic corrosion morphology of the steel. The test results showed that the corrosion behavior of X70 steel was significantly influenced by the rise of capillary water. In particular, the wetting front during the capillary water rise meant that the X70 steel was located at the three-phase solid/liquid/gas interface at a certain location, which worsened its corrosion behavior. In addition, after the capillary water was stabilized, the salts were transported with the capillary water to the top of the soil column. This resulted in the highest salt content in the soil environment and the most severe corrosion of the X70 steel at this location.     

Schisandra chinensis essential oil attenuates acetaminophen-induced liver injury through alleviating oxidative stress and activating autophagy

ContextSchisandra chinensis (Turcz.) Baill. (Magnoliaceae) essential oil (SCEO) composition is rich in lignans that are believed to perform protective effects in the liver.ObjectiveThis study investigates the effects of SCEO in the treatment of acetaminophen (APAP)-induced liver injury in mice.Materials and methodsC57BL/6 mice (n = 56) were randomly divided into seven groups: normal; APAP (300 mg/kg); APAP plus bicyclol (200 mg/kg); APAP plus SCEO (0.25, 0.5, 1, 2 g/kg). Serum biochemical parameters for liver function, inflammatory factors, and antioxidant activities were determined. The protein expression levels of Nrf2, GCLC, GCLM, HO-1, p62, and LC3 were assessed by western blotting. Nrf2, GCLC, HO-1, p62, and LC3 mRNA were detected by real-time PCR.ResultsCompared to APAP overdose, SCEO (2 g/kg) pre-treatment reduced the serum levels of AST (79.4%), ALT (84.6%), TNF-α (57.3%), and IL-6 (53.0%). In addition, SCEO (2 g/kg) markedly suppressed cytochrome P450 2E1 (CYP2E1) (15.4%) and attenuated the exhaustion of GSH (43.6%) and SOD (16.8%), and the accumulation of MDA (22.6%) in the liver, to inhibit the occurrence of oxidative stress. Moreover, hepatic tissues from our experiment revealed that SCEO pre-treatment mitigated liver injury caused by oxidative stress by increasing Nrf2, HO-1, and GCL. Additionally, SCEO activated autophagy, which upregulated hepatic LC3-II and decreased p62 in APAP overdose mice (p < 0.05).Discussion and conclusionsOur evidence demonstrated that SCEO protects hepatocytes from APAP-induced liver injury in vivo and the findings will provide a reliable theoretical basis for developing novel therapeutics.     

Early Age Shrinkage and Mechanical Effect of Ultra-High-Performance Concrete Composite Deck: A Case Study with In Situ Test and Numerical Simulation

For the Honghe Bridge project located in Yunnan Province, Southwest China, a steel/ultrahigh-performance concrete (UHPC) composite deck is used in the suspension bridge with a 700 m main span, and the steel stud connectors are used in the 50 mm–thick UHPC layer. To investigate the shrinkage behavior of UHPC and the relevant influence, the in situ time-dependent strain is measured continuously, and within the 20-day curing time, the material behavior is summarized based on test results. This paper proposes a prediction model for UHPC shrinkage which is refined from the widely used B3 model for normal concrete material, and the parameter values are modified and optimized by experimental comparison. Combining the numerical model and the finite element analysis model of the composite deck, the detailed mechanical state in structural parts is studied. For the practical construction, the simulation results indicate that the small thickness of UHPC above the stud and weak bond strength can influence the eventual structural performance greatly. In the discussion of stress distribution at different locations of the deck, the potential crack on the edge and the corner of the UHPC–steel interface and the mechanical damage on the stud connector around are also indicated.