癌痛及其处理对癌症患者生存质量的影响

目的 :探讨癌痛及其处理对癌症患者生存质量的影响。方法 :对 4 8例癌痛患者采用线段分级法(VAS)和 KPS评分法于治疗前后进行评估。结果 :无论是轻度、中度还是重度疼痛 ,均严重影响患者的日常生活、情绪、行走能力、工作、睡眠 ,且随着疼痛程度的加重 ,影响也逐渐加深 ;经三阶梯止痛法治疗后生存质量明显提高 ,治疗前后比较有显著的差异 (P<0 .0 5 )。结论 :疼痛是影响癌症患者生存质量的一个重要因素 ,对癌痛患者应给予必要的止痛治疗 ,以提高患者的生存质量     

美施康定对癌症疼痛的镇痛效果

本组５４例重度癌痛晚期病人,给予口服美施康定３０～９０ｍｇ每１２ｈ一次治疗,有效率达９６３％（５２／５４）,完全缓解率达８７％（４７／５４）,主要副作用为便秘、恶心、呕吐、嗜睡等     

愁——李清照咏花词的情感视点

李清照的咏花词,弥漫着浓浓的愁绪,贯注于词人的一生。有少女时的清愁,少妇时的怨愁,晚年时的苦愁。在体味词人凄清孤愁的女性情怀时,也寄寓着词人高洁的情趣和卓异的人格。     

测试稿件刘蔚霞周磊2 冯利2 张平2*

目的：研究益肾骨康方对骨转移癌疼痛大鼠脊髓背角GFAP、c-fos、P物质蛋白表达的调控作用。方法：在裸鼠肺腺癌溶骨性骨转移模型的基础上,采用免疫组织化学染色的方法,分别观察各组裸鼠脊髓背角GFAP、c-fos、P物质等蛋白的表达。并使用MIA4.0图像分析软件进行图像分析,每张切片取五个视野,显微镜放大倍数为400倍,统计每个高倍镜视野中表达的阳性物质的光密度值。结果：模型组裸鼠发生了100%的骨转移,免疫组织化学结果显示模型组脊髓背角GFAP、c-fos、P物质蛋白过表达；而“益肾骨康方”低剂量组与中 西药组裸鼠未发生骨转移,免疫组织化学结果显示GFAP、c-fos、P物质蛋白的表达处于较低的水平(P<0.01)；“益肾骨康方”中、高剂量组裸鼠也发生了骨转移,但是这两组裸鼠脊髓背角GFAP、c-fos、P物质蛋白等与疼痛相关的蛋白表达明显低于模型组(P<0.05)。结论：“益肾骨康方”可能通过抑制裸鼠脊髓背角GFAP、c-fos、P物质等蛋白的表达,从而抑制肺腺癌细胞的骨侵袭与转移所引起的疼痛,即“益肾骨康方”通过抑制裸鼠脊髓背角GFAP、c-fos、P物质蛋白的表达而起到一定的镇痛作用。     

一站式CT检查系统在急性胸痛患者干预方案中的应用

本研究探讨一站式CT检查系统在急性胸痛患者管理中干预方案的应用。将符合急性胸痛患者49例纳入研究,采用自动触发方式采集患者上胸部volume数据集和心胸部volume数据集,经过处理后获得胸主动脉、冠状动脉、肺动脉及全胸部图像。本研究中,测量结果发现平均CT值主动脉弓是(332±51)Hu,升主动脉是(435±53)Hu,肺动脉干是(491±93)Hu,降主动脉是(454±70)Hu,而左冠状动脉和右冠状动脉分别是(425±60)Hu、(415±62)Hu。病变鉴定发现,急性肺栓塞12例,主动脉弓动脉粥样硬化斑块破裂8例,肺组织实变4例,慢性肺栓塞伴右心衰竭2例,胸腔积液2例,左冠状动脉非关键性狭窄11例,右冠状动脉非关键性狭窄7例,心包积液2例,复合解剖畸形1例。总之,本研究通过一站式CT检查系统对急性胸痛患者干预方案的制定提供了重要指导。     

In Vitro Cytotoxic Protective Effect of Alginate-Encapsulated Capsaicin Might Improve Skin Side Effects Associated with the Topical Application of Capsaicin

Chronic neuropathic pain, particularly peripheral pain, is a cause of great concern for diabetic patients. Current treatments include numerous agents such as capsaicinoids, a known deterrent of neuropathic pain despite the inconvenience associated with local side effects. In this context, the current work aims to elucidate the potential mechanisms involved in cytotoxicity by capsaicin and proposes an efficient formulation of capsaicin in alginate microcapsules, which significantly reduces side effects from capsaicin topical administration. For this, human dermal fibroblast cells were treated with alginate-microencapsulated capsaicin extracts and screened for potential cytotoxic effects produced by the treatment. Cell viability and morphology were examined, as well as oxidative stress status and anti-inflammatory potential. Our results show that the alginate encapsulated formulation of capsaicin exerted lower cytotoxic effects on human dermal fibroblasts as measured by cell viability and reactive oxygen species (ROS) production. Furthermore, the expression profiles of inflammatory cytokines were significantly altered by the treatment as compared with the control culture.     

Inhibition of Thiol-Mediated Uptake with Irreversible Covalent Inhibitors

Thiol-mediated uptake is emerging as method of choice to penetrate cells. This study focuses on irreversible covalent inhibitors of thiol-mediated uptake. High-content high-throughput screening of the so far largest collection of hypervalent iodine reagents affords inhibitors that are more than 250 times more active than Ellman’s reagent and rival the best dynamic covalent inhibitors. Comparison with other irreversible reagents reveals that inhibition within one series follows reactivity, whereas inhibition across series deviates from reactivity. These trends support that molecular recognition, besides dynamic covalent exchange, contributes significantly to thiol-mediated uptake. The most powerful inhibitors besides the best hypervalent iodine reagents were Fukuyama’s nosyl protecting group and super-cinnamaldehydes that have been introduced as irreversible activators of the pain receptor TRPA1. Considering that several viruses use different forms of thiol-mediated uptake to enter cells, the identification of new irreversible inhibitors of thiol-mediated uptake is of general interest for the discovery of new antivirals.     

两种药物膀胱灌注治疗间质性膀胱炎的临床疗效观察

目的 观察并比较透明质酸钠、碱化利多卡因联合肝素膀胱灌注治疗膀胱疼痛综合征/ 间质性膀胱炎（BPS/IC）的临 床疗效。方法 将63 例BPS/IC 患者按随机单盲的原则分成A、B 两组,A 组32 例,B 组31 例。A 组患者予膀胱灌注透明质酸钠40ml;B 组予膀胱灌注碱化利多卡因联合肝素治疗,即用5%碳酸氢钠10ml、2%利多卡因10ml、肝素钠2.5 万U 和0.9%氯化钠15ml的混合液行膀胱灌注。两组均保留40~60min,每周2 次,4周后改为每周1 次,共16 次。观察两组患者用药前及用药开始后4、12周时的O’Leary-Sant平均症状评分（ICPI）、问题评分（ICSI）及生活质量评分（QOL）,并记录不良反应。结果 两组患者治疗开始后4周和12 周ICPI、ICSI 及QOL评分均有明显改善,与治疗前比较均有统计学差异（均P＜0.05）。治疗4 周后两组的ICPI、ICSI 及QOL 评分下降分值比较均无统计学差异（均P＞0.05）,但治疗12 周后A 组的ICPI、ICSI 及QOL评分下降分值较B 组更为明显（均P＜0.05）。所有患者治疗过程中均未发生明显不良反应。结论 透明质酸钠及碱化利多卡因联合肝素膀胱灌注均能改善BPS/IC患者的临床症状,而透明质酸钠疗效更为显著。     

Effect of Interventions for Improving Lumbar Motor Control on Low Back Pain in Sedentary Office Workers: A Randomized Controlled Trials

Objective: To clarify the effect of intervention with dynamic motor control exercise (DMCE) for the lumbar region on low back pain in sedentary office workers (SOWs). Methods: The participants comprised 32 SOWs with low back pain who were randomly categorized into two groups: the DMCE group and the normal trunk exercise (NTE) group. Both groups performed each exercise for three days per week for 8 weeks. The primary endpoints were evaluated for the lumbar and hip flexion angles during trunk forward bending, effect of low back pain on activities of daily living (using the Oswestry Disability Index), and intensity of low back pain (using the Visual Analog Scale) pre- and post-intervention. The extent of changes was calculated by subtracting the pre-intervention value from the post-intervention value and was compared between the two groups using an unpaired t-test. Results: The extent of changes in the lumbar flexion and hip flexion angles at 10° of trunk forward bending were significantly greater in the DMCE group than in the NTE group, and no significant differences were noted between the two groups at other angles of trunk forward bending. The extent of changes in the Oswestry Disability Index and the Visual Analog Scale scores were significantly greater in the DMCE group than in the NTE group. Conclusion: DMCE is effective in improving motor control in the lumbar region and hip joints, thereby ameliorating low back pain in SOWs.     

Electromyography Activity of Vastus Medialis Obliquus and Vastus Lateralis Muscles During Lower Limb Proprioceptive Neuromuscular Facilitation Patterns in Individuals with and without Patellofemoral Pain Syndrome

Objective: Exercise therapy to strengthen quadriceps muscle is recommended in rehabilitation program for people with patellofemoral pain syndrome (PFPS). This study aimed to investigate the electromyography (EMG) activity of vastus medialis obliquus (VMO), vastus lateralis (VL) and VMO/VL ratio during PNF in individuals with and without PFPS. Methods: 26 persons with PFPS and 26 healthy subjects participated to study. All subjects performed PNF patterns (Flexion-Adduction-External Rotation (D₁FL), Extension-Adduction-External Rotation (D₂EX), D₁FL+ load, D₂EX+ load) and straight leg raise (SLR). The normalized EMG activity of VMO, VL and VMO/VL ratio were measured and analyzed using repeated measure ANOVA. Results: There were significant main effects of group and exercises for the both VMO and VL (p<0.05). It was found that except SLR and D₂EX, in the other motions PFPS group had lower VMO activity compared to healthy group (p<0.05). For VL except SLR, in the other motions PFPS group had lower VL activity too (p<0.05). The PNF patterns activated VMO more than SLR, however it was not significant (p>0.05). Also; there weren''t any significant difference between the two groups in VMO/VL activation ratios. Also, performing the PNF patterns with load increased VMO and VL muscles activity significantly (p<0.05). It also found that in PFPS group the VMO/VL ratio values in PNF patterns were significantly more than SLR and the highest VMO/VL ratio value (0.96) was found during D₂EX. Conclusion: The PNF patterns due to provide optimal VMO/VL ratio value than SLR and proper balance between these two muscles can be recommended in rehabilitation of individuals with PFPS.