Scalene Muscle Injections for Neurogenic Thoracic Outlet Syndrome: Case Series

Abstract: Scalene muscle injections are used to confirm the diagnosis of neurogenic thoracic outlet syndrome and predict the response of patients to surgery. We performed a retrospective study to determine if relief of pain was related to brachial plexus blockade in these patients. Methods: We reviewed the charts of 12 patients who had anterior and middle scalene muscle injections, for neurogenic thoracic outlet syndrome, between April 2009 and September 2010. The injections were performed under ultrasound guidance wherein 2 to 5 mL of 0.25% bupivacaine was injected into the belly of the anterior and scalene muscles. The following were noted: (1) sites of preprocedure pain; (2) volume injected into each of the anterior and middle scalene muscles; (3) presence of numbness after injection; and (4) presence and duration of pain relief. Results: All 12 patients had relief of their pain. Six of the twelve patients developed numbness, which ranged from blockade of the C4‐5, C6‐7, and C4‐T1 dermatomes. In the patients who developed numbness, there was no relationship between the duration of numbness and the duration of pain relief or the location of numbness and the location of pain relief. Conclusions: The relief from scalene muscle injections in patients with neurogenic thoracic outlet syndrome is not related to blockade of the brachial plexus. ?     

Ease of use of two autoinjectors in patients with multiple sclerosis treated with interferon beta-1a subcutaneously three times weekly: results of the randomized,crossover REDEFINE study

Background: For interferon beta-1a subcutaneously three times weekly (IFN β-1a SC tiw), administration options include manually injected prefilled syringes; a preassembled, single-use autoinjector; and a reusable autoinjector. This study evaluated patient-perceived ease of use of two injection devices.

Research design and methods: REDEFINE, a Phase IV, multicenter crossover study, randomized patients with multiple sclerosis and ≥5 weeks’ IFN β-1a 44 μg SC tiw use to 4 weeks using a single-use autoinjector, then 4 weeks using a reusable autoinjector, or vice versa. The primary endpoint was the proportion rating each ‘easy’ or ‘very easy’, with/without regard to previous device experience.

Results: Of 97 randomized patients, 29 had most recent experience with manual injection; 23 with single-use autoinjector; and 45 with reusable autoinjector. 68.4% found using the single-use autoinjector very easy or easy, versus 77.9% for the reusable device (difference ?9.5%; p = 0.200). 40.0% versus 29.5% found the respective devices very easy (difference 10.5%; p = 0.203).

Conclusions: Most patients found both autoinjectors easy or very easy to use. Having two viable options may help accommodate patient preferences. Ease of administration and patient satisfaction relates to adherence; satisfied patients may more likely be adherent.

Trial registration: The trial is registered at ClinicalTrials.gov (CT.gov identifier: NCT02019550).     

Ephedra alkaloid contents of Chinese herbal formulae sold in Taiwan

Consumption of Ephedra alkaloids is prohibited in‐competition by the World Anti‐Doping Agency (WADA). In Taiwan, colds are often treated with Chinese herbal formulae containing Herba Ephedrae. We screened products sold in Taiwan and preliminarily assessed their relationships with WADA threshold violations. Fifty‐six concentrated powder products, including 19 Chinese herbal formulae that contained Herba Ephedrae, were collected. The content of Ephedra alkaloids, namely ephedrine (E), methylephedrine (ME), norpseudoephedrine (NPE; cathine), pseudoephedrine (PE), and norephedrine (NE; phenylpropanolamine), was determined using a validated high‐performance liquid chromatography method. The results revealed that the phenotypic indicators of the collected products, E/PE and E/total ratios, were 1.52–4.70 and 0.49–0.72, respectively, indicating that the Herba Ephedrae species in these products was probably E. sinica or E. equisetina, but not E. intermedia. The contents of E, ME, NPE, PE, and NE and the total alkaloid contents in the daily doses of the products were 0.45–34.97, 0.05–4.87, 0.04–3.61, 0.15–12.09, and 0.01–2.00 mg and 0.68–53.64 mg, respectively. The alkaloid contents followed a relatively consistent order (E > PE > ME ≈ NPE > NE), even for products from different manufacturers. We calculated that single doses of 50.0% and 3.6% of the products would result in the WADA thresholds of E and NPE being exceeded, respectively. Our data provide critical information for athletes and medical personnel, who should be wary of using complex Chinese herbal formulae in addition to over‐the‐counter products.     

Quality Control in Foodservice and the Possibility for Developing a Quality Control Program for Chinese Restaurants

No abstract available for this article.     

中医药防治椎动脉型颈椎病研究思路探讨

椎动脉型颈椎病(CSA)是颈椎病中常见的一种类型,为中老年人的常见病、多发病,近年来其发病率呈上升趋势,严重危害人类健康。本文旨在结合国内外研究进展,通过对CSA发病机制、临床研究、实验研究等方面进行回顾、归纳与分析,探讨中医药防治本病研究的物质基础,以期明确研究思路与方法。     

中西医结合康复干预在脑卒中后偏瘫患者功能恢复中的作用

目的探讨中西医结合康复干预在脑卒中后偏瘫患者功能恢复中的作用。方法选择2015年7月~2017年4月脑卒中后偏瘫患者76例,随机分为中西医组和西医组。两组患者予控制血糖、血压和颅压、脑神经营养和增加脑血供等治疗。西医组予以西医康复干预治疗,中西医组在西医组基础上予以中医康复干预,两组均干预8周。观察两组干预前后神经、肢体运动及日常生活能力变化,并比较其生活质量。结果干预8周后,两组CSS评分较前明显下降、FMA评分和BI评分较前明显上升(P0.05或P0.01),且中西医组干预后变化幅度与西医组比较更显著(P0.05);同时两组躯体、心理、社会和物质等各项评分较前上升(P0.05或P0.01),且中西医组干预后上升幅度与西医组比较更显著(P0.05)。结论中西医结合康复干预在脑卒中后偏瘫患者功能恢复中的效果明显优于单纯的西医康复干预,能加快神经和肢体运动功能恢复,提高其日常生活自理能力,促进其早日康复,提高其生活质量。     

中西医结合治疗新生儿呕吐51例

目的:观察中西医结合治疗新生儿呕吐的临床疗效。方法:选择2012年4月—2014年4月本院收治的102例患儿,随机分为观察组与对照组,每组各51例。对照组行西医常规治疗,观察组在对照组的基础上服用生大黄水,比较两组患儿的临床疗效。结果:观察组有效率为90.20%,对照组有效率为60.78%,两组有效率比较,差异具有统计学意义(P0.05)。观察组患儿呕吐停止时间与鼻饲停止时间分别为(51.67±30.02)h、(63.32±31.30)h,均显著优于对照组患儿的(74.35±30.22)h、(85.32±31.28)h,差异均有统计学意义(P0.05)。结论:中西医结合治疗新生儿呕吐可明显提高临床疗效,缩短疗程。     

结直肠早癌及癌前病变内镜治疗和中医论治

结直肠癌大多起源于结直肠早癌及腺瘤等癌前病变,若在发展到浸润癌之前发现并予以切除,即可取得预防或根治效果。随着内镜技术的发展,尤其是EMR/ESD技术的不断成熟,从早期诊断到治疗及预后,与传统开腹手术相比优点突出,但要严格把握其适应症,由于技术难度大,出血、穿孔等是常见并发症。EMR/ESD是经济、安全、可靠的治疗结直肠早癌及癌前病变的方法,同时中药治疗疗效肯定。     

胆囊炎并发胆结石保守疗法与护理配合

老年胆囊疾病患者多数为慢性结石性胆囊炎,该病临床表现无特异性,起病缓慢,大多由急性胆囊炎反复发作迁延而至。由于年岁所限患者多采取保守疗法。如消炎利胆片、舒胆通、等口服药,起到了缓解病情的作用,但难根治。我院内科在治疗上加用了中药制剂,起到了疏肝理气、利胆通腑的药物疗效。同时护理人员注意调节好患者情志,使患者气血调和、气体通畅,加上规律饮食,确保患者及早康复。