Dental Treatment Using Quantum Mechanics for Knee Joint Pain

In clinical practice, dentists sometimes encounter phenomena that cannot be explained by modern western medical concepts;for example, the patient’s medical symptoms improve by bringing medicines or dentures close to the body. Although it seems difficult to completely elucidate the mechanism through modern western medicine, it can be explained using quantum mechanics. The quantum, the smallest unit of matter composition, exhibits wave-particle duality. The fact that symptoms can be improved simply by bringing dentures or medicines closer to the body indicates that the waves emitted by dentures or medicines interfere with the pathological waves emitted by the pathological site. Thus, the pathological waves are deformed and lead to a change in symptoms. In this way, quantum theory can explain phenomena that are difficult to elucidate in conventional medicine, which are encountered in clinical practice. So far, the author has presented a case of difficulty in raising the upper limb where the symptoms improved without the need for dentures in the mouth by adjusting the dentures outside the mouth. This time, the author would like to introduce a case which the patient’s knee pain improved by adjusting the dentures outside the mouth.

Joint Management of Shared Resources, Issues and Conflicts of the Nso and Oku Tribes in the Ngongbaa Montane Forest Area, NWR of Cameroon

Wherever people live together in or near homelands that harbour joint natural resources such as forest, water, minerals, oil etc., they must collaborate, co-exist and share these resources irrespective of their genetic, social, cultural, and political peculiarities. This is not always the case when self-interest, ethnic divisions, elitist politics, economic interest and power tussle set in. The Nso and Oku people who reside in the Ngongbaa Forest area constitute an example of joint management of resources where at one period, their relationship over the management of the Oku Mountain Forest was cordial and at another, the relationship became conflictive. This study was designed to study the influence of the KIFP forest management policies on the Nso indigenous forest Management system in Ngongbaa Forest, and its implications. The data collected for the study was secured through the administration of a questionnaire to residents of 10 villages adjacent to the Ngongbaa Forest, and forest users who carried out livelihood activities there between 1963 and 2015. These forest user groups include beekeepers, rat trappers, grazers, mushroom gatherers, ground honey/tree honey harvesters, carvers, etc. The investigation also extended to the traditional leaders of Nso and Oku who are in charge of the land tenure systems. The findings show that the Oku Mountain Forest is jointly owned by the Nso and Oku people. The Nso own the eastern half of the forest known as Ngongbaa Forest while the Oku own the western half, known as the Kilum Forest. The cordial relationship that existed between these people ensured the conservation of the forest. But the conflicts that later set in, especially due to the creation of the Kilum Mountain Forest Project in 1987 later changed to the Kilum Ijim Forest Project (KIFP) in 1992 sidelined the local communities which was contrary to the dispositions of the new Cameroon forest law enacted in 1994. Thus, the indigenous conservation practices became ignored which the local population never digested well. This seriously jeopardized the wellbeing of the forest in general.

Loose Body in the Knee Joint: A Case Report

Background: Loose bodies (LBs) within the knee joint are commonly encountered during clinical practice and are frequently observed during knee arthroscopy. The primary treatment involves the removal of loose bodies;however, their complete eradication is often challenging and may not address underlying diseases, leading to persistent symptoms and the risk of new loose body formation. Aim: This case report aims to present the findings and surgical management of a 52-year-old male with an unusually large osseous loose body in the knee joint and associated pathologies. Case Presentation: The patient, a 52-year-old male, experienced recurrent episodes of severe, sudden, and painful locking of the knee joint, leading to difficulties moving. A plain MRI study was conducted to evaluate the condition of the knee joint, which revealed various degenerative changes and the presence of a loose body. Subsequently, an arthroscopic examination was performed under general anesthesia, uncovering the presence of an abnormally large loose body, as well as other pathologies including chondropathy, meniscal degeneration, and Baker’s cyst. Conclusion: Loose bodies (LBs) in the knee joint pose significant challenges and may lead to debilitating symptoms. Timely diagnosis and appropriate surgical intervention are crucial for symptom relief and the prevention of further joint damage as arthroscopic excision. Comprehensive imaging has a vital role in guiding treatment decisions and optimizing patient outcomes. In this case, the removal of the loose body improved patient outcomes and helped prevent potential joint complications.

Finite Element Analysis of Tubular KK Joint under Compressive Loading

KK tubular joints are used to build jacket-type offshore structures. These joints are mostly made up of structural steel. These joints can withstand yield, buckling, and lateral loads depending on the structure’s design and environment. In this study, the Finite Element Model of the KK-type tubular joint has been created, and analysis has been performed under static loading using the Static Structural analysis system of ANSYS 19.2 commercial software and structural mechanics module of COMSOL Multiphysics. The KK tubular model is analyzed under compressive load conditions, and the resulting stress, strain, and deformation values are tabulated in both graphical and tabular form. This study includes a comparison of the outcomes from both commercial software. The results highlight that maximum stress, strain, and deformation values decrease as joint thickness increases. This study holds significant relevance in advancing the understanding of tubular KK joints and their response to compressive loading. The insights derived from the analysis have the potential to contribute to the development of more robust and reliable tubular KK joints in various engineering and structural applications. .

Numerical Optimization by Finite Element Method of Stainless Steel/Glass-Epoxy Composite Bolted Joint under Tension and Compression

The aim of this study was to optimize the geometry and the design of metallic/composite single bolted joints subjected to tension-compression loading. For this purpose, it was necessary to evaluate the stress state in each component of the bolted join. The multi-material assembly was based on the principle of double lap bolted joint. It was composed of a symmetrical balanced woven glass-epoxy composite material plate fastened to two stainless sheets using a stainless pre-stressed bolt. In order to optimize the design and the geometry of the assembly, ten configurations were proposed and studied: a classical simple bolted joint, two joints with an insert (a BigHeadR insert and a stair one) embedded in the composite, two “waved” solutions, three symmetrical configurations composed of a succession of metallic and composites layers, without a sleeve, with one and with two sleeves, and two non-symmetrical constituted of metallic and composites layers associated with a stair-insert (one with a sleeve and one without). A tridimensional Finite Element Method (FEM) was used to model each configuration mentioned above. The FE models taked into account the different materials, the effects of contact between the different sheets of the assembly and the pre-stress in the bolt. The stress state was analyzed in the composite part. The concept of stress concentration factor was used in order to evaluate the stress increase in the highly stressed regions and to compare the ten configurations studied. For this purpose, three stress concentration factors were defined: one for a monotonic loading in tension, another for a monotonic loading in compression, and the third for a tension-compression cyclic loading. The results of the FEM computations showed that the use of alternative metallic and composite layers associated with two sleeves gived low values of stress concentration factors, smaller than 1.4. In this case, there was no contact between the bolt and the composite part and the most stressed region was not the vicinity of the hole but the end of the longest layers of the metallic inserts.

Impact of Earthquake Action on the Design and Sizing of Jointed Masonry Structures in South Kivu, DRC

This article deals with the investigation of the effects of seismic impacts on the design and dimensioning of structures in South Kivu. The starting point is the observation of an ambivalence that can be observed in the province, namely the non-consideration of seismic action in the study of structures by both professionals and researchers. The main objective of the study is to show the importance of dynamic analysis of structures in South Kivu. It adopts a meta-analytical approach referring to previous researches on South Kivu and proposes an efficient and optimal method. To arrive at the results, we use Eurocode 7 and 8. In addition, we conducted static analysis using the Coulomb method and dynamic analysis using the Mononobe-Okabe method and compared the results. At Nyabibwe, the results showed that we have a deviation of 24.47% for slip stability, 12.038% for overturning stability and 9.677% for stability against punching through a weight wall.

基于Smooth-Joint模型的层状页岩力学特性研究

普光气田陆相页岩气资源潜力巨大,侏罗系千佛崖组一段页岩气大面积分布,埋深适中,页岩气资源量为4239.5亿m^(3)。为实现页岩气的高效开发,在室内页岩单轴压缩力学试验的基础上,利用颗粒离散元法建立页岩的单轴压缩模型和Smooth-Joint节理模型,探讨宏观各向同性页岩单轴压缩破坏、变形及强度特征,以及不同Smooth-Joint节理倾角对岩石力学特性的影响。数值试验与室内试验分析结果表明,节理面的存在降低了岩石的抗压强度;岩体的抗压强度随着节理倾角的改变而改变,随着节理倾角的增大,岩体的强度先降低随后增大;当节理面与潜在破坏面的方向相近时,即节理面倾角θ=45°+φ_(s)/2时,岩体受压破坏沿节理面发生,岩体强度下降得最多;层状页岩单轴压缩全应力-应变曲线可以分为5个阶段,阶段Ⅰ岩样内部裂纹闭合体积减小、阶段Ⅱ弹性变形过程(总体积应变增量等于弹性体积应变增量)、阶段Ⅲ裂纹稳定扩展(弹性变形)、阶段Ⅳ裂缝非稳定扩展(塑性变形阶段)、阶段Ⅴ试件裂缝继续扩展延伸直至达到峰后强度σ_(p)停止。该研究结果为普光陆相千佛崖组页岩气的开发提供了一定参考,以普光气田页X井为例,该井成功压裂,压后产气量较高,储层改造应用效果较好。

装配式混凝土剪力墙结构接缝连接研究进展

装配式剪力墙结构拼装时存在大量的水平接缝和竖向接缝,由于剪力墙的刚度较大,接缝连接处易存在刚度不足引起的损伤集聚问题,成为影响结构整体性和抗震性能的决定性因素。总结了国内外正在发展的预制装配式剪力墙结构水平和竖向接缝的连接形式,并对各类连接形式的构造特点、抗震性能、应用优势和技术瓶颈进行了系统阐述和分析,在此基础上探讨了装配式剪力墙结构接缝连接技术的发展方向。结果表明:目前湿式连接技术已较为成熟且被广泛应用,但仍存在现场湿作业量大、质量不易检测和控制等问题;干式连接技术工业化程度高,但对施工精度的要求也高,可能产生的螺栓松动、锈蚀以及磨损问题限制了其工程应用;将消能减震技术融入竖向接缝连接,利用超高性能混凝土实现水平接缝连接,并结合可恢复功能防震技术,是未来装配式剪力墙结构高质量发展的新增长点。

隧道不良地质识别:方法、现状及智能化发展方向

随着隧道施工对于不良地质识别精度要求的不断提高以及人工智能技术的发展,融合多源信息的不良地质智能化识别已成为发展趋势。本文首先阐述了常见的6种隧道不良地质类型及其地质成因,回顾分析了隧道主要的不良地质识别方法及现状,详细介绍了笔者在不良地质智能化识别方面的探索性研究:基于机器学习利用图像识别技术对隧道围岩岩性与裂隙特征进行智能识别;融合图像和光谱特征进行不良地质识别;将地化分析融入到传统的超前钻探中,融合随钻参数和地化信息进行不良地质随钻识别,既可以发挥超前钻探在感知岩体质量和地层信息变化方面的优势,又可以发挥地化分析在岩性和不良地质异常识别方面的优势;基于地质与物探联合反演进行不良地质识别,旨在实现掌子面前方不良地质体“形”(位置、形态、规模)和“性”(性质和类型)的精确识别。最后,对隧道不良地质智能化识别的发展趋势进行了展望。

关节镜下自体骨软骨移植对膝关节局限性软骨损伤的临床疗效评价

目的探讨关节镜下自体骨软骨移植术对膝关节局限性软骨损伤的临床疗效,并以磁共振成像(MRI)检查对疗效进行评价。方法选取2018年6月至2021年6月诊治的100例膝关节局限性软骨损伤患者,按随机数字表法分为研究组和对照组,每组各50例。研究组采取关节镜下自体骨软骨移植术,对照组采取微骨折术治疗。采用MRI评估其手术疗效,并记录其术后膝关节软骨愈合时间;采用Lysholm膝关节功能评分表、国际膝关节文献委员会(IKDC)膝关节评估表,评估患者治疗前后膝关节功能变化;统计患者术后并发症发生率。结果研究组关节软骨愈合优良率98.00%,高于对照组84.00%(P<0.05)。两组术前和术后3个月的Lysholm评分、IKDC评分比较差异无统计学意义(P>0.05);术后6、12、24个月,研究组Lysholm评分、IKDC评分均高于对照组(P<0.05)。两组患者术后均无严重并发症,且并发症发生率差异无统计学意义(P>0.05)。研究组术后膝关节软骨愈合时间短于对照组(P<0.05)。结论关节镜下自体骨软骨移植术对膝关节局限性软骨损伤的远期治疗效果显著,可有效改善患者术后膝关节功能,缩短膝关节软骨愈合时间,安全性高。

颞下颌关节紊乱病的MRI临床应用进展

随着颞下颌关节影像检查手段的发展,磁共振成像逐渐成为颞下颌关节紊乱病的首选检查方法,由于其无电离辐射暴露风险且为非侵入性检查,可清晰显示关节盘、关节腔积液、髁突水肿、咀嚼肌、双板区及滑膜病变,在临床有较大应用价值。本文从关节盘位置及形态改变、关节腔积液、髁突水肿和翼外肌的磁共振成像表现及其相关性研究现状进行探讨,以期为颞下颌关节紊乱病影像诊断提供思路。

东海OBN和三维DAS-VSP数据的联合采集与处理方法研究

近年来,光纤传感技术已经应用于地面地震数据、海洋地震数据、井中地震数据和井地联合地震数据的采集,推动了光纤传感技术在地球物理特别是地震数据采集中的应用。井地或井海联合地震勘探是陆地或海洋三维地震与三维DAS-VSP勘探相结合形成的三维立体地震勘探方法,利用井海联采的三维DAS-VSP数据,可以获得地下井周围准确的时深关系、地层速度、反褶积算子、球面扩散补偿因子、吸收衰减因子、各向异性参数和井筒周围的高分辨率构造成像,这些参数可以基于井驱处理提高陆地或海洋三维地震数据的处理质量。在中国东海某OBN数据勘探中首次开展了井下套管内铠装光缆同步采集的三维DAS-VSP数据的处理方法研究以及成像处理。首先,采用常规的三维VSP数据成像处理技术对三维DAS-VSP数据进行常规处理,具体处理流程包括:观测系统定义、预处理、初至拾取、静校正、振幅补偿、反褶积、波场分离、速度分析与建模和利用上行反射波进行井周围地层的构造成像;然后,再根据海上三维DAS-VSP数据下行多次波的特点,研发了海上三维DAS-VSP数据的下行多次波成像技术,扩展了三维DAS-VSP数据成像范围,提高了三维DAS-VSP数据成像的整体质量。与本工区早期的三维OBC数据成像结果相比,本次三维DAS-VSP数据的下行多次波成像结果表明,井周围三维构造成像质量得到了显著改进,大幅度扩展了成像范围;新采集的OBN数据和三维DAS-VSP数据的成像结果展示了更为详细和较高分辨率的构造成像,基于新的成像资料,对储层顶部和储层内流体的识别与追踪变得更加容易和清晰。井海联采技术生产效率高且成本低,既能快速获得三维DAS-VSP数据及成像,还能对三维海洋地震数据进行井驱提高分辨率处理。此外,三维OBN或OBC数据和三维DAS-VSP数据还能够进行融合处理,实现井地或井海同步采集数据的联合偏移成像,可以大幅度提高三维海洋地震数据的成像品质,值得在有条件的地方推广应用。

浮针治疗早中期膝骨关节炎对软骨厚度的影响

目的观察浮针疗法治疗早中期膝骨关节炎对关节软骨厚度的影响。方法将60例早中期膝骨关节炎患者随机分为治疗组和对照组,每组30例。治疗组采用浮针治疗,对照组采用电针治疗。观察两组治疗前后疼痛视觉模拟量表(visual analog scale,VAS)评分、疼痛开始缓解时间、Lysholm膝关节功能评分、平衡功能及股骨内侧和外侧髁软骨厚度的变化。结果治疗组疼痛开始缓解时间短于对照组(P<0.05)。治疗后,两组VAS评分以及平衡功能的横向标准差和前后标准差均较治疗前降低(P<0.05),Lysholm膝关节功能评分、平衡功能的稳定极限均较治疗前升高(P<0.05)。治疗后3个月,两组VAS评分较治疗前降低(P<0.05),Lysholm膝关节功能评分较治疗前升高(P<0.05),膝关节内外侧髁软骨厚度均较治疗前增加(P<0.05)。治疗后和治疗后3个月,治疗组VAS评分均低于对照组(P<0.05),Lysholm膝关节功能评分均高于对照组(P<0.05)。治疗后,治疗组横向标准差低于对照组(P<0.05),稳定极限高于对照组(P<0.05)。结论浮针治疗早中期膝骨关节炎起效速度优于电针治疗,能有效缓解疼痛症状及提高膝关节功能,可改善软骨损伤。

多区域注意力的细粒度图像分类网络

目前细粒度图像分类的难点在于如何精准定位图像中高度可辨的局部区域以及其他辅助判别特征。提出一种多区域注意力的细粒度图像分类网络来解决这个问题。首先使用Inception-V3对图像特征进行提取,通过重复使用注意力擦除的方法使模型关注次要特征;然后通过背景去除以及上采样的方法获取图像更精准的局部图像,对提取到的局部特征进行位置统计,并以矩形框的方式获取图像整体,减少细节信息丢失;最后对局部与整体图像进行更加细致的学习。此外,设计联合损失函数,通过动态平衡难易样本和缩小类内差距的方法改善模型的识别效果。实验结果表明,该方法在公开的细粒度图像数据集CUB-200-2011、Stanford-Cars和FGVC-Aircraft上的准确率分别达到89.2%、94.8%、94.0%,相较于对比方法性能更优。

颞下颌关节紊乱病的分类、诊断及治疗进展

近年来关于颞下颌关节紊乱病的分类和诊断已基本取得共识。颞下颌关节紊乱病是一种具有明显生物-心理-社会模式特点的心身疾病,除了临床诊断外,还要评价疼痛相关的功能丧失和心理状况。尽管外科手术治疗的水平有了很大的进步,但仍要强调治疗首选是非手术的保守治疗。相当一部分患者症状体征轻微或完全没有任何症状体征,颞下颌关节紊乱病治疗应充分考虑其症状体征对患者的影响程度,而不是仅仅根据临床诊断和影像检查结果而作出是否需要治疗的结论。

基于多维Copula函数的澜沧江-湄公河流域气象干旱特征分析

为全面揭示变化环境下澜湄流域多维气象干旱特征,采用标准化降水蒸散指数SPEI表征流域气象干旱,基于游程理论分别提取澜沧江段和湄公河段上、中、下游流域1901—1960年和1961—2021年两个时段的干旱事件,利用Copula函数分别构建两个时段不同子流域二维和三维干旱特征变量联合分布,计算不同干旱特征变量组合条件下的干旱联合发生概率,对比分析不同子流域多维气象干旱特征的时空变化。结果表明:时间上,1961—2021年各子流域平均干旱程度均较1901—1960年更严峻,尤其是极端干旱事件(单变量累积频率为25%、50%)的多维干旱联合发生概率增幅最大;空间上,1961—2021年,随着干旱历时、烈度和烈度峰值的增加,“或”情况下多维干旱联合发生概率最高值区自北向南转移,“且”情况下多维干旱联合发生概率最高值区自南向北转移。

人工关节集采对DRG IC29组病例住院费用的影响分析

[目的]研究集中带量采购对人工关节置换术患者住院费用的影响,为深化高值耗材持续改革提供依据。[方法]收集某三级医院集采前后DRG分组IC29组病例的DRG结算数据和医保信息系统的相关信息,进行倾向得分匹配后,采用描述性分析、非参数检验、结构变动度进行费用变化分析。[结果]集采政策实施后的各项费用中位数显示,IC29组病例次均费用下降了33445元,其中材料费下降了34835元;DRG统筹金额下降了13705元,个人自付金额下降了24550元。集采前后的结构变动度为60.52%,材料费呈负向变动,医疗服务费、检查化验费、药品费及其他费呈正向变动。结构变动贡献率前三位为材料费50.00%、医疗服务费26.04%、检查化验费16.36%。[结论]集采后IC29组病例的次均费用、材料费、医保支付和个人负担费用均明显降低,费用结构得到优化,人工关节集中带量采购成效明显。建议持续进行高值耗材集采工作,并协同推进医疗服务价格和医院薪酬制度等其他医改配套政策。

考虑环间接头影响的盾构隧道纵向变形简化解

为反映外荷载下盾构隧道相邻环间张开和错台,提出考虑环间接头影响的盾构隧道纵向变形简化解答。首先,引入纵向梁-弹簧模型模拟盾构隧道纵向受力变形,其中采用Timoshenko短梁考虑隧道环段变形,引入转动和剪切弹簧分别模拟环间接头转动与错台。其次,构建弹性地基上纵向梁-弹簧模型的有限差分方程,以解决环间接头-管环非连续变形求解问题,并推导外荷载下既有盾构隧道的纵向变形公式。最后,建立新建隧道上穿和下穿引起既有盾构隧道的纵向变形解答,并与新建隧道上、下穿越工程案例及现有理论方法对比验证。研究结果表明:所提方法预测的隧道位移与Timoshenko连续梁模型,协同变形模型和实测数据均具有较好的一致性,但所提方法得到的环间错台略低于Timoshenko梁模型和协同变形模型;所提方法可考虑环间接头的影响,得到的隧道位移曲线呈现既不光滑也不连续的特征,其中环段变形以刚体位移为主,而环间接头主要发生转动和错台;而基于现有理论所得盾构隧道纵向位移均为连续曲线,无法反映环间接头的真实转动与错台位移。

隐形矫治器矫治Ⅱ类错[牙合]畸形对颞下颌关节相关角度、间隙变化值的影响

目的 探讨隐形矫治器矫治Ⅱ类错[牙合]畸形对颞下颌关节的影响。方法 选取Ⅱ类错[牙合]畸形患者70例,采用信封法将患者分为观察组(n=35)和对照组(n=35),观察组给予隐形矫治器矫治,对照组给予自锁托槽矫治器矫治。观察两组颞下颌关节相关角度、间隙变化值等。结果 观察组矫治前后上中切牙长轴与前颅底平面相交的下内角(U1-SN)变化值、上中切牙长轴与鼻根点-上牙槽座点连线交角(U1-NA)变化值分别为(11.05±1.01)°和(4.75±0.76)°,明显高于对照组(P <0.05);观察组矫治前后上颌中切牙、上颌侧切牙、下颌中切牙、下颌侧切牙变化值分别为(0.51±0.21)、(0.40±0.15)、(0.40±0.13)、(0.20±0.05)mm,明显低于对照组(P <0.05);观察组矫治前后菌斑指数(PLI)、牙龈指数(GI)和探诊深度(PD)变化值分别为(0.44±0.19)分、(0.41±0.13)分、(0.38±0.10)mm,明显低于对照组(P <0.05)。结论 隐形矫治器矫治Ⅱ类错[牙合]畸形有较好的应用价值,有利于患者颞下颌关节改善。

138例全膝关节置换患者术前护患信任度现状及影响因素分析

目的旨在调查全膝关节置换患者术前护患信任度现状,并对其影响因素进行分析。方法采用便利抽样法,选取2020年10月—2021年9月期间在我科在行全膝关节置换术的138例患者为研究对象,采用一般资料调查量表、焦虑自评量表、膝关节美国特种外科评分表、护患关系信任度量表对患者进行调查,并进行多元线性回归分析,探讨全膝关节置换患者术前护信任度现状及其影响因素。结果本组患者术前护患信任度总分为(136.75±7.93)分;Pearson相关性分析结果显示,本组全膝关节置换患者术前1 d护患信任度总分与其焦虑评分总分呈负相关(r=-0.419,P<0.01),与膝关节功能评分无相关性(r=0.063,P>0.05)。多元线性回归分析结果显示,既往有无住院经历、文化程度及术前焦虑评分进入回归方程(P<0.05),共解释总变异的66.9%。结论本组全膝关节置换患者术前护患信任度处于中等偏上水平,且受文化程度、既往有无住院经历、术前焦虑程度的影响,护理人员应重点关注文化水平低、无既往住院经历、焦虑程度高的患者,针对性的对以上患者进行干预,以减少患者术后焦虑及改善术后功能,促进医患关系,减少医疗纠纷,帮助患者尽早康复。