恶性心包积液16例误诊分析

 本文对我院内科16例误诊为"心包炎"的恶性心包积液病例进行了分析.本组癌性心包积液患者以中老年男性多见,平均年龄58岁,男性占68.75%,起病急骤,有急性心包填塞的表现,中毒症状不明显.14例患者心包积液呈血性,占87.5%,心包积液细胞学检查常能发现肿瘤细胞.     

Comparison of Euroqol EQ-5D and SF-36 in patients with chronic fatigue syndrome

The objective of the study was to compare the Euroqol EQ-5D (Euroqol) and short-form 36 (SF-36) health questionnaires in patients with chronic fatigue syndrome (CFS). One hundred and twenty-seven out-patients referred to a hospital-based infectious disease clinic with a diagnosis of CFS were contacted by post and asked to complete both questionnaires. Additional data were determined from hospital casenotes. Eighty-five patients returned correctly completed questionnaires. Euroqol health values and visual analogue scale (VAS) scores were strongly and significantly correlated with all dimensions of the SF-36, with the exception of physical limitation of role. SF-36 dimensions were in turn strongly and significantly correlated with each other, with the same exception. Patients reported a high degree of physical disability and a moderate degree of emotional or psychological ill-health. The Euroqol elements dealing with mobility and self-care referred to inappropriately severe degrees of disability for these patients with CFS. Similarly some dimensions in the SF-36 were oversensitive and did not discriminate between patients with moderate or severe disability. It was concluded that Euroqol scores correlated strongly with SF-36 scores and provided useful information about patients with CFS and that Euroqol would be a useful tool for the rapid assessment of health status in CFS. The current Euroqol instrument refers to inappropriately severe degrees of disability for patients with CFS and would need to be modified to be maximally useful in this situation.     

人参 陈皮及其配伍抗疲劳实验研究

目的 :人参陈皮及其配伍对小鼠游泳时间的影响 (耐疲劳实验 )。方法 :与治疗组螺旋藻组进行对比 ,从运动学和生理生化指标方面观察了人参陈皮及其配伍对小鼠游泳时间的影响。结果 :单味陈皮及单味人参均能显著延长小鼠游泳时间 ,人参陈皮配伍也能显著延长小鼠游泳时间。各组与空白对照组比较有显著性差异 (P <0 0 5 ) ,且单味陈皮和单味人参、人参陈皮配伍均能使小鼠运动后 5 0min血乳酸明显降低 ,与空白对照组比较有显著性差异 (P <0 0 5 )。结论 :人参陈皮及其配伍均具有抗疲劳作用 ,其作用机理是通过降低血乳酸产生抗疲劳作用 ,且单味陈皮、人参比人参陈皮及其配伍组效果要好     

The longitudinal relationship of hemoglobin, fatigue and quality of life in anemic cancer patients: results from five randomized clinical trials.

BACKGROUND: Anemia is common in cancer and has been associated with fatigue and reduced health-related quality of life (HRQOL). We report the association between hemoglobin and fatigue and the impact of reducing fatigue on several domains of HRQOL. PATIENTS AND METHODS: These analyses were based on five randomized trials. Patients completed the Functional Assessment of Cancer Therapy (FACT) Anemia scales and numeric rating scales of Energy, Activity and Overall Health at baseline and after the 12-week treatment period. t-tests and linear regression models were used to evaluate associations. Analyses were stratified into three groups: solid tumor chemotherapy patients, lymphoproliferative malignancy chemotherapy patients and non-chemotherapy patients. RESULTS: Adjusted mean differences (95% CI) in FACT Fatigue change scores between hemoglobin responders (> or =2 g/dl increase) and non-responders were 3.0 (1.2, 4.7), 2.8 (0.6, 5.0) and 5.8 (2.2, 9.5) among the solid tumor, lymphoproliferative malignancy and non-chemotherapy groups, respectively. Significantly greater improvements (P <0.01) were observed in the FACT well-being scales for patients with meaningful improvement in fatigue (FACT Fatigue change score > or =3 points). After controlling for other factors, patients whose fatigue improved reported substantially greater improvements in energy, ability to perform usual activities and overall health (P <0.0001). CONCLUSIONS: Across five trials of cancer patients on and off chemotherapy, hemoglobin response was associated with meaningful improvements in fatigue, which, in turn, was associated with improved physical, functional, emotional and overall well-being.     

Evaluation of the inner-surface morphology of an artificial heart by acoustic microscopy

The total artificial heart (TAH) is being developed for permanent replacement of the natural heart instead of heart transplantation. The need for detecting the material fatigue in the TAH is increasing in order to guarantee long-term use. In this study, the inner surface morphology of the TAH was evaluated by a specially developed scanning acoustic microscope (SAM) system operating in the frequency range of 100-200 MHz. The inner sac of our TAH consisted of polyvinylchloride coated with polyurethane, and the SAM investigations were performed before and after the implantations in goats. The amplitude images of the SAM demonstrated protein adhesion on the inner surface of the TAH after the animal experiment, and the phase images showed distortion of the wall with spatial resolution of 0.2 microm. These results suggest the feasibility of a high-frequency ultrasound for evaluating the material fatigue of TAH.     

Are voice endurance tests able to assess vocal fatigue?

Voice endurance tests are often used to evaluate vocal fatigue or to test the suitability of an individual for voice demands. It is assumed that these tests help to identify subjects with laryngeal or vocal fatigue out of a population of persons with complaints of discomfort in the throat, recurrent hoarseness and decreased voice power. In this study we evaluated the Voice Interval Test with respect to its discriminative power by comparison of voice performances in 20 patients with a history of vocal fatigue with that in 12 healthy subjects. Voice performance was studied during the Voice Interval Test as well as during regular use of the voice on a working day by electroglottography (EGG), acoustic analysis and a self-rating scale for pain and fatigue. Despite the number of tests the data did not reveal any significant difference between the patients and the healthy subjects. Voice fatigue could therefore not be identified and the clinical relevance of the Voice Interval Test appears to be questionable.     

白细胞介素Ⅱ联合加温化疗治疗癌性腹腔积液

１９９５年始采用随机分组方法，比较白细胞介素Ⅱ与加温顺铂、５－氟尿嘧啶联合（治疗组）及单用顺铂、５－氟尿嘧啶（对照组）腹腔内灌注治疗癌性腹腔积液４３例，结果显示：治疗组有效率为９０．９％，对照组有效率为６１．９％，Ｐ＜０．０５。生存质量方面治疗组明显提高，Ｐ＜０．０５。两组毒副反应均较轻，Ｐ＞０．０５无显著性差异，结论：白细胞介素Ⅱ与加温顺铂、５－氟尿嘧啶联合腹腔灌注治疗癌性腹腔积液，可能有协同、相加作用，是有效、简便、毒副反应小的治疗手段     

疲劳和紧张应激导致老年前期大鼠自由基损伤及中药五参方防治作用的实验研究

目的:研究社会心理因素对老年前期人群衰老的影响及寻求中医药防治措施。方法:采用较长期的疲劳和紧张应激手段作用于老年前期大鼠,中药治疗组在刺激的同时灌喂五参方煎剂,观察动物血自由基浓度、肝脏 LPO 含量、心肌和脑组织脂褐素含量以及血红细胞 SOD 含量。结果:与同龄空白对照组比较,造模组大鼠血中自由基浓度、肝组织 LPO含量明显升高,心、脑组织脂褐素含量显著增加,红细胞 SOD 含量降低(P<0.05,P<0.01),而中药五参方可明显减轻上述损伤性变化。结论:长期疲劳和紧张应激可加重自由基损伤从而加速衰老,而五参方可通过减轻自由基损伤而达到抗衰老的目的。     

扶正、理气类中药“体复康”改善运动性疲劳的骨骼肌形态计量学研究

为了探讨运动性疲劳的中医学机理以及寻求安全有效的改善运动性疲劳的中药复方制剂，本文设计了强化训练导致疲劳的大鼠模型，用形态计量学方法，研究了运动疲劳状态下，大鼠骨骼肌线粒体、肌原纤维和毛细血管超微结构的变化，以及应用理气扶正中药复方对改善运动性疲劳的作用。结果表明：扶正理气类中药“体复康”能有效地改善骨骼肌的供血和供氧功能，并有效地减少运动应激对肌肉超微结构的损伤     

体复康对运动性疲劳大鼠脑组织中阿黑皮素原基因表达动态变化的影响

目的 :从基因转录水平阐明运动性疲劳产生及药物调节的机理。方法 :采用生物素标记阿黑皮素原 (POMC)cRNA探针 (Bio cRNA)原位杂交法结合图像分析 ,观察中药复方体复康对运动性疲劳大鼠不同脑区POMCmRNA表达。结果 :对于慢性运动应激 ,体复康能增强POMC在海马CA1 区、下丘脑部位的基因表达 ,而能降低POMC在额叶皮层的基因表达。长时期 (共 7周 )大强度的跑台运动 (速度由 1 5m/min递增至 3 5m/min ,运动时间为每天 2 0～2 5min)的大鼠 ,末次运动后POMC基因表达在额叶皮层、海马CA1 下降 (前者至运动结束后 3h仍未恢复 ,后者至运动结束后 3 0min即恢复 ) ,在下丘脑则增强 ;体复康能增强末次运动后POMC在额叶皮层、海马CA1 区、下丘脑等脑区的基因表达 ,尤其是在运动结束后 3h最为显著。结论 :POMCmRNA表达在运动性疲劳大鼠不同脑区呈现不同的动态变化趋势 ,体复康对其POMCmRNA表达有重要动态调节作用。