【摘要】 目的 評價SF-36量表在測量地震傷殘人員生存質量中的信度和效度。 方法 利用自填法及訪談相結合的方式調查201例綿竹市某鎮地震傷殘人員，用重測信度和Cronbach’s α系數分析SF-36信度；因子分析方法分析效度。 結果 SF-36各領域的重測信度分別為:生理功能（PF）0.78、生理問題對功能的限制（RP）0.85、軀體疼痛（BP）0.92、健康總體評價（GH）0.82、活力（VT）0.77、社會功能（SF）0.71、心理問題對功能的限制（RE）0.79、精神健康（MH）0.66；各領域的Cronbach’s α系數分別為:PF 0.89、RP 0.75、BP 0.84、GH 0.86、VT 0.78、SF 0.72、RE0.86、MH 0.50。因子分析共提取了6個主成分，基本反映了量表的8個維度，與量表的結構構思基本相符。 結論 自填法及面對面訪談相結合的方式，將SF-36量表用于該地地震傷殘人員生存質量測定具有較好的信度和效度。【Abstract】 Objective To evaluate the validity and reliability of the MOS-36-item Short Form of Health Survey (SF-36) measuring the quality of life (QOL) of disabled people injured in the earthquake. Methods A total of 201 disabled people injured in the earthquake in a town of Mianzhu city were investigated via questionnaire combined with a face-to-face interview. The reliability of the SF-36 was assessed by test-retest reliability and Cronbach’s α coefficient. The validity was assessed through factor analysis. Results The test-retest reliability of the SF-36 included: physical functioning (PF) 0.78, role limitation due to physical problems (RP) 0.85, body pain (BP) 0.92, general health (GH) 0.82, vitality (VT) 0.77, social functioning (SF) 0.71, role limitation due to emotional problems (RE) 0.79, and mental health (MH) 0.66. The Cronbach’s α coefficients were as the follows: PF 0.89, RP 0.75, BP 0.84, GH 0.86, VT 0.78, SF 0.72, RE 0.86, and MH 0.50. Six principal components were extracted by factor analysis and the constructs of the obtained instrument were consistent with the conceived concept in essence. Conclusion The SF-36 survey could measure the QOL in disabled people injured in the earthquake with better reliability and validity by questionnaire combined with a face-to-face interview.
Objective To provide evidence-based therapeutic schedule for an adult patient with Lumber Isthmic Spondylolisthesis grading II. Methods Based on fully assessing the patient’s conditions, the clinical problems were put forward according to PICO principles. Such database as The Cochrane Library (2005 to April 2011), DARE (April 2011), CENTRAL (April 2011), MEDLINE (April 2011), EMbase and CBM were searched to collect high quality clinical evidence, and then we told a patient information about treatment plans. The plan was chosen by the patient for she knew her conditions and the plans. Results We included 1 meta-analysis, 3 randomized controlled trials, 5 systematic reviews and 1 prospective study on the natural course of isthmic spondylolisthesis were included. Literature evidence indicated that the prognosis of isthmic spondylolisthesis was good. Surgery should be selected when there was neither no remission of symptom, nor progression of lumber olisthy with conservative treatment. The long-term effect of surgery may be good, but it cannot change the natural course of the disease. Based on literature evidence, the patient chose the conservative treatment. After one year’s treatment the patient recovered, her sciatica relieved, and CT showed no progression of lumber olisthy. Conclusion Patient with low grand isthmic spondylolisthesis chose conservative treatment may achieves good effects, whereas on the process of the treatment, regular follow-up to monitor the progression of lumber olisthy should be conducted.
Objective To formulate an evidence-based nursing strategy of turning over for a patient with the risk of pressure ulcer. Methods The personalized clinical questions were put forward based on the PICO and patient’s condition, and the following databases such as NGC, The Cochrane Library of DARE, CDSR, CCTR, MEDLINE, PubMed and CBM were searched to collect the best clinical evidences of turning over for preventing pressure ulcer. Results One clinical guideline, one systematic review and three randomized controlled trials were included finally. According to the retrieval outcomes, patient’s clinical condition, and patients and their family members’ willingness, a reasonable nursing plan of turning over was formulated: lie on the visco-elastic foam decompression bed, turn over every 4 hours, and combine supine position with alternation of left-oblique 30° position and right-oblique 30° position. During hospitalization, the grade-I pressure ulcer in size of 4×6 cm2 on patient’s sacrococcygeal region was clear, dry and not broken, and the other part of body with pigmentation had no occurrence of pressure ulcer. Conclusion Evidence-based approaches are helpful to provide patient with a nursing plan that meets the needs of both scientificalness and individualization.
【Abstract】 Objective To establ ish a stable animal model for glucocorticoid-induced avascular necrosis of femoral head in rabbits. Methods Thirty-six adult New Zealand rabbits were randomly divided into four groups:ten were injected twice with l i popolysaccharide (group A), ten were treated with a combination of l i popolysaccharideand methylprednisolone (group B), ten were injected three times with methylprednisolone (group C), and six wereinjected normal sal ine as a control (group D). MR imaging was performed in the rabbits before the first injection ofl i popolysaccharide or methylprednisolone, and at 2, 4, and 6 weeks after the last injection of l i popolysaccharide ormethylprednisolone. Histopathological changes in the femoral heads were observed by l ight microscope and transmission electron microscope at the end of six weeks after the injection. Vascular infusion with Chinese ink was made to evaluate the morphological changes of blood vessels in the femoral head. The percentage of trabecular bone area and empty lacunae and microvascular density were measured. According to the histological and MR imaging appearance of the femoral heads in all groups, the incidence of osteonecrosis of every group was calculated. Results Listlessness, blepharal hyperemia,less activity and reduced diet were found in the rabbits of groups A and B after injected with l ipopolysaccharide. At 3 weeks after the final injection, the body weight of groups B and C was decreased. At 4 weeks after the final injection, the body weight of groups A and D was increased. No abnormal signal could be detected on MR images in rabbits of all groupsbefore injection and at 2 weeks after the injection. At 4 weeks and 6 weeks after the last injection, irregular low signal on T1-weighted images and irregular low or high signal on T2-weighted images could be detected on MR images in rabbits of groups B and C, no abnormal signal could be detected on MR images in rabbits of groups A and D. At 6 weeks after the last injection,the trabecular bone of group B became thin and sparse, some were broken. The percentages of empty lacunae were 11.8% ± 4.7%, 34.4% ± 6.2%, 20.0% ± 4.7% and 9.3% ± 4.6%; the percentages of trabecular bone area were 59.2% ± 6.8%, 40.1% ± 6.0%, 51.5% ± 5.6% and 63.2% ± 8.3%; and the microvascular densities were 14.3% ± 2.7%, 4.5% ± 2.1%, 10.2% ± 3.1% and 15.4% ± 4.1% in groups A, B, C and D respectively. There were statistically significant differences between group B and groups A, C, D (P lt;0.01). The fatty tamponade accumulated in the medullary cavity and intramedullary vascular sinusoids were pressed by the l ipocytes and became narrow. Limposomes were found in osteocytes and vascular endothel ia of group B and group C. Osteocytes of group B crimpled and pyknosis or karyolysis of chromatin were observed in these osteocytes, nuclearmembrane of the osteocytes was discontinous. Vascular endothel ia became swollen and the cell junctions widened or were destroyed in groups A and B. The incidence of osteonecrosis in group B (88.9%) was higher than that in group C (22.2%, P lt; 0.05). There was no osteonecrosis occurred in groups A and D . Conclusion Methylprednisolone combined with l ipopolysaccharide can induce typical rabbit model for early avascular necrosis of femoral head.
To evaluate the cl inical results of less invasive stabil ization system (LISS) for femur supercondylar and intercondylar fractures. Methods From March 2004 to November 2005, 47 patients with 49 intercondylar and supercondylar fractures were treated. Of all the patients, there were 34 males and 13 females with an average of 39.7 years (range 19-56 years). The locations were left side in 21 cases and right side in 28 cases. Fracture was caused by traffic accident in 31 cases, fall ing in 8 cases, violence in 6 cases and others in 2 cases. Forty-nine fractures included 14 intercondylar fractures, 21supercondylar fractures and 14 intercondylar and supercondylar fractures; 32 closed fractures and 17 open fractures. According to the AO typing, there were 6 type 33-A1, 8 type 33-A2 , 10 type 33-A3, 7 type 33-C1, 3 type 33-C2 and 15 type 33-C3. The disease course was 30 minutes to 6 days. Articular surface reduction was first performed, then the LISS plate was inserted via two incisions and locking screws were used later. Results The average operation time was 126 minutes (range 48-248 minutes). The blood loss was 180 mL(range 60-1 200 mL). The average follow-up time was 18.6 months (range 12-23 months). There were 4 patients with AP angular deformity and 5 patients with lateral angular deformity (range 2-5°). External rotation deformity was presented in 2 patients. There were no plate breakage, screw loosen and fixation failure. Average bone union time was 5.6 months (range 3-8 months) without infection case. Six cases were treated with il iac bone transplantation for delayed union. Conclusion LISS is one kind of effective treatment to femoral intercondylar and supercondylar fractures.
Objective To analyze the incidence and mortality of liver cancer in China between 1992 and 2021, in order to provide data support for the prevention and treatment of liver cancer in the country. MethodsUsing the Global Burden of Disease (2021) database, we analyzed the trends and performed an age-period-cohort model analysis on the incidence and mortality of liver cancer by gender in China between 1992 and 2021. An autoregressive integrated moving average model was employed to forecast the age-standardized incidence and mortality rates of liver cancer in China from 2022 to 2030. ResultsCompared with 1992, the number of incident cases and deaths from liver cancer in China in 2021 increased significantly in the total population, males, and females. The percentage changes in the number of cases were 93.98% (101 400→196 700), 94.06% (74 100→143 800), and 93.41% (27 300→52 800), respectively. The corresponding percentage changes in the number of deaths were 75.25% (98 200→172 100), 72.29% (71 100→122 500), and 83.70% (27 000→49 600). The rate of change in incidence for the total population, males, and females in 2021 was 64.33% (8.41 per 100 000→13.82 per 100 000), 66.11% (11.89 per 100 000→19.75 per 100 000), and 62.61% (4.68 per 100 000→7.61 per 100 000), respectively; the rate of change in mortality was 48.53% (8.14 per 100 000→12.09 per 100 000), 47.41% (11.41 per 100 000→16.82 per 100 000), and 53.88% (4.64 per 100 000→7.14 per 100 000), respectively. The standardized incidence rates decreased compared to 1992, with changes of –9.16% (10.48 per 100 000→9.52 per 100 000), –4.14% (14.96 per 100 000→14.34 per 100 000), and –17.54% (5.93 per 100 000→4.89 per 100 000) for the total population, males, and females, respectively; the standardized mortality rates decreased by –20.32% (10.48 per 100 000→8.35 per 100 000), –16.61% (14.87 per 100 000→12.40 per 100 000), and –24.84% (6.08 per 100 000→4.57 per 100 000), respectively. The age effect showed significant variations in liver cancer risk with age, with the highest incidence risk in the 65–69 age group for the total population and females, and the 60–64 age group for males. The period effect overall showed an upward trend, with the most significant increase occurring from 2017 to 2021. The cohort effect indicated significant variations in liver cancer risk across different birth cohorts, with an overall increasing trend for the total population and females born between 1907 and 1981, and the most significant risk increase for males born between 1952 and 1956. The incidence and mortality risk for those born between 2017 and 2021 showed a significant downward trend. The prediction results indicated a continuous decline in liver cancer incidence and mortality rates for the total population, males, and females in China from 2022 to 2030. ConclusionsFrom 1992 to 2021, the incidence and mortality rates of liver cancer in China increased, while the standardized incidence and mortality rates showed a decreasing trend. Age, period, and cohort are significant factors influencing liver cancer. It is essential to further strengthen liver cancer prevention and control strategies and vaccine implementation.
目的 探討音樂療法在兒童青少年情緒障礙患者中的應用效果。 方法 2011年1月－7月，將70例兒童青少年情緒障礙患者隨機分為試驗組和對照組，每組各35例，對照組給予常規藥物治療和護理，試驗組除給予常規治療和護理外，結合音樂治療。用漢密爾頓抑郁量表、漢密爾頓焦慮量表對其情緒進行評價。 結果 兩組在療程結束后，漢密爾頓焦慮量表和抑郁量表評分差異具有統計學意義（P＜0.01）。 結論 音樂治療在改善兒童青少年情緒障礙方面具有顯著作用。
Objective To reveal the worldwide research status and hot topics of sleep apnea syndrome ( SAS) . Methods Articles were searched from Web of Science ( SCI) , Essential Science Indicator ( 2000 to 2010) database using sleep apnea syndrome or apnea as keywords. Retrieved documents were analyzed using the database with its own statistical functions and histcite software ( version 8.12. 16) .Results Since 1992 the international scientific papers on the SAS study showed a gradual upward trend.The United States is a world leader in this field. Recent research has focused on vascular endothelial barrier function and repair, oxidative stress, inflammation, cognitive function, special populations such as the elderlyor children patients with SAS. Conclusion Clinical researchers have paid more attention to SAS than before, but there are still many important issues unresolved.
Objective To investigate the surgical techniques and the cl inical outcomes of treating severe pronationexternal rotation ankle fractures combined with deltoid l igament injuries. Methods Between July 2005 and April 2007, 17 patients with grade-IV pronation-external rotation ankle fractures combined with deltoid l igament injuries were treated by open reduction and internal fixation with l igament repair by using suture anchors. There were 13 males and 4 femaleswith an average age of 36.5 years (21-56 years). All cases were closed injuries with l imitation of motion after initial physical examination. The X-ray and CT showed that all patients were characterized with lateral and posterior malleolus fractures and significant lateral shift of talus, but without medial malleous fracture before operation. All fractures were classified into grade-IV pronation- external rotation or type C according to Lauge-Hansen criterion and Danis-Weber standard respectively. The disease course was from 4 days to 7 days with an average of 5.6 days. Results All incisions healed by first intention Seventeen patients were followed up 11-24 months (mean 15.6 months). The X-ray films showed that all patients achieved bony heal ing. The heal ing time was 11-16 weeks (mean 14.8 weeks). According to the Baird-Jackson’s scoring system, the results were excellent in 5 cases, good in 9 cases, fair in 2 cases and poor in 1 case, the excellent and good rate was 82.4%. No operation compl ication occurred. Medial clear space was significantly decreased postoperatively compared with that before operation [(3.16 ± 0.37) mm vs. (4.87 ± 0.43) mm] (P lt; 0.01). In gravity stress radiographs, there was no significant difference in medial clear space between collateral ankle and injured ankle after operation [(3.47 ± 0.43) mm vs. (3.55 ± 0.44) mm] (P gt; 0.05). Conclusion It is emphasized that full attention should be given to reconstruction of medial l igament structures as well as open reduction and internal fixation in treating grade-IV pronation-external rotation ankle fractures combined with deltoid l igament injuries.
Objective To discuss the authenticity of reconstructing the anterior cruciate l igament (ACL) threedimensional digital model of normal adult knee joint by use of MRI. Methods The double knee joint specimens were selected from 20 fresh normal adult corpses and double knee joint of 20 normal adult volunteers, and were scanned with MRI; continuous image data of level thick 1.0 mm were acquired, and then these data were imported into Mimics 10.01 software for three-dimensional reconstruction; and full three-dimensional digital models were built, including the corpse specimens (corpsemodel group) and normal adult (normal model group). The relevance anatomy index of ACL were measured with easuring tool of Mimics 10.01 software, and double knee joint specimens of 20 fresh normal adult corpses were dissected, and the relevance data were measured (corpse specimens group). Results There was no significant difference in all indexes between corpse model group and corpse specimen group (P gt; 0.05), and between corpse model group and normal model group (P gt; 0.05). Conclusion The image data gathered by MRI could reconstruct the ACL three-dimensional digital model of normal adult knee joint, which has authenticity.