Modified Chinese disabilities of arm, shoulder and hand tool: Validity and reliability for upper extremity injuries.

DESIGN: Clinimetric evaluation study. INTRODUCTION: The Chinese Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire has necessitated the development of a revised version to the specific needs of individuals with upper extremity injuries with the progress of times and lifestyle changes. PURPOSE OF THE STUDY: This research aimed to evaluate the reliability and validity of Modified Chinese Disability of Arm, Shoulder and Hand (MC-DASH) questionnaire in individuals with upper extremity injuries. METHODS: One hundred and one individuals with upper extremity injuries (UEI) were recruited. The function of upper extremity was measured using the electronic version of MC-DASH, and compared against the Chinese Disability of Arm, Shoulder and Hand. The MC-DASH was reassessed within three days in all individuals. We investigated the internal consistency, test-retest reliability, content validity, criterion validity, and construct validity of MC-DASH. RESULTS: The internal consistency was deemed sufficient, as indicated by a Cronbach's alpha of 0.986 and an intraclass correlation coefficient of 0.957. Moreover, the mean total scores of MC-DASH on the first-test and retest were 37.86 and 38.19, respectively (ICC: 0.957, 95 %CI: 0.937-0.971, p < 0.001). Furthermore, the MC-DASH version exhibited satisfactory content validity evidenced by its strong correlation (R= 0.903, p < 0.001) with the Chinese DASH. Three major influencing factors were identified from 37 items. The cumulative variance contribution rate of the MC-DASH questionnaire was 75.76 %, confirming its construct validity. CONCLUSION: The Modified Chinese Disability of Arm, Shoulder and Hand questionnaire has been shown to be a valid, reliable, and practical tool for use in patients with upper extremity injuries.

Effect of traumatic upper-limb injury on cognitive functions: A cross-sectional observational study.

OBJECTIVES: There is growing evidence of cognitive impairment after traumatic peripheral lesions. The purpose of this study was to explore the association between cognitive function and traumatic upper-limb injury. We assessed difference in cognitive function between participants with and without upper-limb injury, and explored the association between cognitive function and certain variables in injured individuals: gender, age, body mass index (BMI), educational level, and occupation. We sought to identify the factors associated with cognitive function in injured subjects: time since injury, injury side, nerve injury, hand function, pain, and finger sensation. MATERIAL AND METHODS: A cross-sectional observational study was conducted, with 2 groups: observational group (with traumatic upper-limb injury) and control group (uninjured). The 2 groups were matched for age, gender, BMI, educational level and occupation. Short-term memory and executive functions were assessed using the Rey Auditory and Verbal Learning Test (RAVLT) and Stroop Color and Word Test (SCWT), respectively. RESULTS: 104 participants with traumatic upper-limb injury and 104 uninjured control subjects were included. There was a significant inter-group difference only in RAVLT (p < 0.01; Cohen d, of 0.38). Regression analysis demonstrated an association of pain on VAS (beta = -0.16, p < 0.01) and touch-test (beta = 1.09, p < 0.05) with total RAVLT score (short-term memory) in injured subjects (R2 = 0.19, F (2, 82) = 9.54, p < 0.001). CONCLUSION: Traumatic upper-limb injury can impact short-term memory, which should be kept in mind during rehabilitation.

Professional Identity among New Rehabilitation Graduates in China: A Cross-Sectional Questionnaire-Based Survey.

Background: The rehabilitation industry suffered in a terrible economic climate caused by the coronavirus disease 2019 (COVID-19). Healthcare resources and the labor force were directed towards epidemic prevention of post-pandemic, which exacerbated the issue. This study evaluated the professional identity (PI) of new graduates majoring in rehabilitation therapy during the final harsh phase of COVID-19 and explored the factors influencing PI. Methods: A cross-sectional investigation with a questionnaire was used in this study. A convenience sample of new graduates who majored in rehabilitation were recruited from hospitals and universities nationwide. The data collected demographic information and scores of professional identities for students in the final phase of the strict COVID-19 control policy in 2022. Results: This study indicated that the average PI was quite a distance from the degree of 'agree' (3.84 on average), particularly for the fitness dimension (3.64 on average). The results identified two influencing variables: employment (Beta= -0.09, P< 0.05) and educational patterns (Beta= 0.12, P< 0.01). Conclusions: Higher education in rehabilitation should respond to the present shift in the structure of the rehabilitation industry post-COVID-19. Meanwhile, the occupational environment of rehabilitation therapists and the medical value of rehabilitation therapy deserves more attention. This study provides evidence for managers to improve organizational justice and adjust policies on the distribution of medical resources.

Iron overload as a risk factor for poor graft function following allogeneic hematopoietic stem cell transplantation.

Hematological malignancies are increasingly treated with allogeneic hematopoietic stem cell transplantation (allo-HSCT). Unfortunately, iron overload is a frequent adverse effect of allo-HSCT and is associated with poor prognosis. In the present study, we investigated hematopoiesis in iron-overloaded mice and elucidated the effects of iron overload on the bone marrow (BM) microenvironment. Iron-overloaded BALB/C mice were generated by injecting 20 mg/mL saccharated iron oxide intraperitoneally. Hematoxylin-eosin staining was performed to evaluate the effects of an iron overload in mice. BM cells obtained from C57BL/6 mice were transplanted into irradiated BALB/C mice (whole-body irradiation of 4 Gy, twice with a 4-hours interval) by tail vein injection. Two weeks after allo-HSCT, the hematopoietic reconstitution capacity was evaluated in recipients by colony-forming assays. Histopathological examinations showed brown-stained granular deposits, irregularly arranged lymphocytes in the liver tissues, and blue-stained blocks in the BM collected from mice received injections of high-dose saccharated iron oxide (20 mg/mL). Iron-overloaded mice showed more platelets, higher-hemoglobin (HGB) concentration, fewer granulocyte-macrophage colony-forming units (CFU-GM), erythrocyte colony-forming units (CFU-E), and mixed granulocyte/erythrocyte/monocyte/megakaryocyte colony-forming units (CFU-mix) than healthy mice. Iron-overloaded recipients presented with reduced erythrocytes and HGB concentration in peripheral blood, along with decreased marrow stroma cells, CFU-GM, CFU-E, and CFU-mix relative to healthy recipients. Taken together, our findings demonstrate that iron overload might alter the number of red blood cells after transplantation in mice by destroying the BM microenvironment, thereby affecting the recovery of BM hematopoietic function.

Bone marrow-derived mesenchymal stem cells overexpressing MiR-21 efficiently repair myocardial damage in rats.

OBJECTIVE: We investigated the ability of bone marrow derived mesenchymal stem cells (BMSCs) overexpressing microRNA-21 (miR-21) to repair cardiac damage induced by anthracyclines in rats. METHODS: Sprague-Dawley (SD) rats of 2~3 weeks old were selected to isolate and culture BMSCs. A lentivirus harboring pLVX-miR-21 was generated and transfected into rat BMSCs. The rats were assigned into an untreated negative control group, and groups injected with adriamycin alone or with adriamycin followed by BMSCs, pLVX-BMSCs or pLVX-miR-21-BMSCs (n = 10 each). Proliferation and migration of cells were detected by cholecystokinin-8 (CCK- 8) and transwell. MiR-21 expression, mRNA expressions of B cell lymphoma 2 (Bcl2), BAX (BCL-2-associated X protein) and vascular endothelial growth factor (VEGF) were tested by qRT-PCR. Western blotting was applied to detect protein expressions of Bcl-2, Bax and VEGF. RESULTS: Using CCK- 8 and transwell assays, we found that pLVX-miR-21-BMSCs, which overexpressed miR-21, exhibited greater proliferation and migration than untransfected BMSCs or pLVX-BMSCs. Ultrasonic cardiograms and immunohistochemical analysis demonstrated that among the five groups, the pLVX-miR-21-BMSC group exhibited the most improved heart function and enhanced angiogenesis. Moreover, the pLVX-miR-21-BMSC group showed enhanced expression of Bcl-2, VEGF and Cx43 and reduced expression of Bax, BNP and troponin T. CONCLUSION: These findings suggest miR-21 overexpression enhanced the proliferation, invasiveness and differentiation of BMSCs as well as expression of key factors (Bcl-2, VEGF and Bax) essential for repairing the cardiac damage induced by anthracyclines and restoring heart function.

The Construction and Identification of Induced Pluripotent Stem Cells Derived from Acute Myelogenous Leukemia Cells.

OBJECTIVE: The present study aimed to establish an induced pluripotent stem cell (iPSC) line from acute myelogenous leukemia (AML) cells in vitro and identify their biological characteristics. METHODS: Cells from the AML-infiltrated skin from an M6 patient were infected with a lentivirus carrying OCT4, SOX2, KLF4 and C-MYC to induce iPSCs. The characteristics of the iPSCs were confirmed by alkaline phosphatase (ALP) staining. The proliferation ability of iPSCs was detected with a CCK-8 assay. The expression of pluripotency markers was measured by immunostaining, and the expression of stem cell-related genes was detected by qRT-PCR; distortion during the induction process was detected by karyotype analysis; the differentiation potential of iPSCs was determined by embryoid body-formation and teratoma-formation assays. ALP staining confirmed that these cells exhibited positive staining and had the characteristics of iPSCs. RESULTS: The CCK-8 assay showed that the iPSCs had the ability to proliferate. Immunostaining demonstrated that iPSC clones showed positive expression of NANOG, SSEA-3, SSEA-4, TRA-1-60 and TRA-1-81. qRT-PCR results revealed that the mRNA expression of Nanog, Lin28, Cripto, FOX3, DNMT3b, DPPA2, and DPPA4 significantly increased in iPSCs. Karyotype analysis found no chromosome aberration in the iPSCs. The results of the embryoid body-formation and teratoma-formation assays indicated that the iPSCs had the potential to differentiate into all three germ layers. CONCLUSION: Our study provided evidence that an iPSC line derived from AML cells was successfully established.

Effects of Blood Purification on Serum Levels of Inflammatory Cytokines and Cardiac Function in a Rat Model of Sepsis.

OBJECTIVE: The study aimed to explore the effects of blood purification (BP) on serum levels of inflammatory cytokines and cardiac function in a rat model of sepsis. METHODS: A rat model of sepsis was established by cecal ligation and puncture. All rats were divided into the normal control, sham operation, model, sham treatment, and BP treatment groups. Cardiac functions, inflammatory cytokines, myocardial enzymes, pathological score of cardiac muscle tissue, and myocardial apoptosis of rats in each group were compared. RESULTS: Sepsis rats had higher serum levels of inflammatory cytokines and lower cardiac function than those in the normal control and sham operation groups. Compared with the model and sham treatment groups, improved cardiac functions, decreased inflammatory cytokines, myocardial enzymes, pathological score, and myocardial apoptosis and mortality were observed in the BP treatment group. CONCLUSION: BP may reduce serum levels of inflammatory cytokines and improve cardiac function of sepsis rats.

Association between improved trunk stability and walking capacity using ankle-foot orthosis in hemiparetic patients with stroke: evidence from three-dimensional gait analysis.

BACKGROUND: Restoration of both normal movement of the pelvis and centre of mass is a primary goal of walking rehabilitation in post-stroke patients because these movements are essential components of effective gait. The aim of this study is to quantitatively analyze the effect of ankle-foot orthosis on walking ability, and to investigate the correlation between improvements in trunk motion and walking capacity. METHODS: Walking speed, centre of mass displacement, and pelvic movements were examined in 20 post-stroke hemiparetic patients with and without ankle-foot orthosis using three-dimensional motion analysis. RESULTS: Using ankle-foot orthosis improved walking speed, pelvic rotation and tilt, and lateral and vertical displacements of the centre of mass (P < 0.01). Moreover, the gait asymmetry index was significantly decreased (P < 0.01), and the Functional Ambulation Categories score improved significantly when patients used an ankle-foot orthosis (P < 0.05). There was significant correlation between improvements in the walking capacity and the displacement of the centre of mass in both vertical and lateral directions (P < 0.01). CONCLUSIONS: Using ankle-foot orthosis improves the walking capacity by improving the stability and concordant of the trunk in hemiplegic patients. The improvement in the walking capacity from using an ankle-foot orthosis may be attributed to its prevention of foot drop and compensation for the instability of the ankle joint.