Home-based exercise: promising rehabilitation for symptom relief,improved functional status and quality of life for post-surgical lung cancer patients

Background

Post-thoracotomy non-small cell lung cancer (NSCLC) patients report cancer-related fatigue (CRF) as a severe symptom that may increase the occurrence and severity of other symptoms while decreasing functional status and quality of life (QOL). The aim of this pilot study was to describe the effects of a home-based rehabilitative exercise intervention on CRF, other symptoms, functional status, and QOL for post-surgical NSCLC patients starting within days after hospital discharge.

Methods

Seven post-thoracotomy NSCLC patients completed the Brief Fatigue Inventory (BFI) measuring CRF severity, and the M.D. Anderson Symptom Inventory measuring symptom severity at pre- and post-surgery, and at the end of each week of the six-week intervention. Additionally, the Medical Outcomes Short-Form-36 measuring physical and mental functional status; and the Quality of Life Index (QLI) measuring QOL were completed pre- and post-surgery, after week 3, and at the end of the intervention (week 6).

Results

Participants had a mean age of 65 years, a mean of 6 co-morbid conditions, and initiated the intervention within 4 days after hospital discharge. Participants’ CRF severity scores were reduced to mild levels while the mean number of symptoms decreased from 10.4 post-surgery to 7.0 at week 6 with lower levels of severity and interference. Likewise, participants’ post-intervention functional status and QOL improved to near or above pre-surgical levels.

Conclusions

The exercise intervention for post-surgical NSCLC patients showed promising preliminary efficacy in improving CRF, other symptom severity, functional status, and QOL. Further testing via a two-arm randomized controlled trial is being conducted.     

Pulmonary hypertension in end-stage renal disease and post renal transplantation patients

Background

Information regarding lung function parameters and functional capacity in renal failure and post renal transplantation patients with pulmonary hypertension (PH) is limited. The purpose of this study was to examine the clinical characteristics of patients with PH who were receiving hemodialysis (HD) or peritoneal dialysis (PD) or who had undergone renal transplantation.

Methods

A prospective study was performed on 116 patients (HD =55, PD =17, and post renal transplantation =44) who underwent Doppler echocardiography. PH was defined as systolic pulmonary artery pressure (SPAP) ≥40 mmHg. Demographic information, clinical characteristics, pulmonary function tests (PFTs) and the six-minute walk test (6MWT) were collected and compared between the patients with and without PH.

Results

Twelve (21.8%) patients receiving HD, four (23.5%) patients receiving PD, and eight (18.2%) post renal transplantation patients had PH. In the HD group, the physiological indicators (including pulmonary function test parameters, the final Borg score, and walking distance during the 6MWT) were all significantly lower in the patients with PH compared with those without PH (all P<0.0001). However, in the PD and post renal transplantation groups, no significant differences were noted in the demographic characteristics or in the physiological parameters when the PH patients were compared with those without PH (all P>0.05).

Conclusions

Among HD patients, marked aberrations in PFT results or walking distance may identify a subset of patients suffering from PH.     

Altered Brain Regional Homogeneity Following Contralateral Acupuncture at Quchi (LI 11) and Zusanli (ST 36) in Ischemic Stroke Patients with Left Hemiplegia: An fMRI Study

Objective: To study the effect of contralateral acupuncture (CAT) at acupoints of Quchi (LI 11) and Zusanli (ST 36) on the unaffected limbs of ischemic stroke patients with left hemiplegia based on regional homogeneity (ReHo) indices. Methods: Ten ischemic stroke patients with left hemiplegia received CAT on right side at LI 11 and ST 36. Functional magnetic resonance imaging (fMRI) was performed before and after acupuncture. A ReHo analytical method was used to compare brain responses of patients before and after CAT operated by REST software. Results: The stimulation at both LI 11 and ST 36 on the unaffected limbs produced significantly different neural activities. CAT elicited increased ReHo values at the right precentral gyrus and superior frontal gyrus, decreased ReHo value at right superior parietal lobule, left fusiform gyrus and left supplementary motor area. Conclusions: Acupuncture at one side could stimulate bilateral regions. CAT could evoke the gyrus which was possibly related to motor recovery from stroke. A promising indicator of neurobiological deficiencies could be represented by ReHo values in post-stroke patients.     

持续被动运动机辅助功能锻炼在胫骨平台骨折术后的应用

目的 探讨持续被动运动（CPM）机辅助功能锻炼在胫骨平台骨折术后的应用。方法 选择2017年1月～2019年1月在我院创伤骨科收住的胫骨平台骨折患者92例,采用抛银币法分为CPM组与对照组,每组各46例。两组患者均行胫骨平台骨折切开复位内固定术。对照组术后患肢主动运动训练,CPM组术后第2天开始进行CPM机辅助功能锻炼,两组患者均治疗6个月。观察两组患者治疗后膝关节及胫骨平台后倾角（PA）恢复情况。结果 治疗6个月后,两组患者ROM、膝关节Harris评分和BI评分均较治疗前明显上升（P＜0.05或P＜0.01）,且CPM组上升幅度较对照组更高,差异有统计学意义（P＜0.05）;两组患者PA较治疗前明显上升（P＜0.05或P＜0.01）,且CPM组上升幅度较对照组更更高,差异有统计学意义（P＜0.05）。结论 CPM机辅助功能锻炼用于胫骨平台骨折术后的疗效确切,能增加患者关节活动度,能有效矫正PA,改善膝关节功能,从而提高患者独立活动能力。     

基于静息态脑功能网络特征的额叶癫痫评价基础研究

目的本文旨在利用静息态功能磁共振成像技术,对额叶癫痫(Frontal Lobe Epilepsy,FLE)影响下的脑功能网络特征进行分析,寻找可能的FLE脑损伤客观评价指标。方法利用图论分析方法中的边、节点度、节点效率和介数中心度参数,获得患者组和对照组的这些参数计算结果并进行两样本t检验,分析FLE影响下的脑功能网络变化特征,并进一步研究这种变化特征与发作频率和病程之间的相关性。结果FLE患者组与对照组相比,边、节点度、节点效率和介数中心度参数均有重要统计学差异结果,且发现差异结果中与发作频率和病程存在一定的相关性。结论基于图论分析方法的静息态脑功能网络特征参数有可能作为FLE的评估指标,为FLE的评价提供依据。     

体育运动对孤独症谱系障碍的干预

孤独症谱系障碍是以社会交往障碍、兴趣狭隘和重复刻板行为为特征的神经发育疾病。目前,其发病机制还没有被完全认知,临床上采用多种方法进行治疗与干预,其中体育运动干预也有明显的效果。针对体育运动对孤独症谱系障碍症状的改善做一综述,为后续研究提供理论支持。     

沙棘糖浆联合枸橼酸莫沙必利片治疗儿童功能性消化不良的临床研究

目的 探讨沙棘糖浆联合枸橼酸莫沙必利片治疗儿童功能性消化不良的临床疗效。方法 选取功能性消化不良患儿为研究对象。对照组给予枸橼酸莫沙必利片,观察组给予口服沙棘糖浆,比较两组患儿治疗效果。结果 经治疗4周后,观察组的总有效率显著高于对照组。结论 沙棘糖浆联合莫沙必利可改善临床症状,其机制可能与提高血清NPY和LEP水平有关。     

五种治疗阿尔茨海默病药物分子结构与性质的密度泛函计算分析

目的：在模拟大脑油性环境下对五种抗阿尔茨海默病药物进行整体和局部性质计算比较分析。方法：采用密度泛函B3LYP/TZVP计算方法,对五种抗阿尔茨海默病药物的几何结构、电子结构、紫外光谱和概念密度泛函分析,利用环己烷模拟大脑油性环境。结果：共轭效应使得极性键键长缩短;静电势差异决定了分子间作用位点的不同,在酶反应中,与蛋白质构象的改变密切相关;溶剂效应对紫外光谱产生影响,其中溶剂的极性越大红移越大。由福井函数结合相对亲电指数与相对亲核指数,表明多奈哌齐和卡巴拉汀亲电、亲核能力都很强,加兰他敏亲核能力强,美金刚和石杉碱甲亲电、亲核能力均比较弱。结论：五种药物分子的结构差异、电性差异影响药物的理化性质并决定了药物不同的作用机制。四种抗胆碱酯酶抑制剂活性略有差异但明显高于N-甲基-D-天冬氨酸受体拮抗剂,其中多奈哌齐药理作用最强。