Complementary/alternative medicine for supportive cancer care: development of the evidence-base

Aim The aim of this article is to compare the evidence relating to the effectiveness of complementary/alternative medicine (CAM) in palliative cancer care as it existed in 2000 and 2005. Methods Our comparison is based on systematic reviews using the same methodology at these two points in time. Results The results reveal a buoyant research activity in this sector. Consequently, new evidence for 19 CAM modalities has emerged between 2000 and 2005. For some treatments, the evidence is encouraging but for very few, it is as yet fully convincing. Conclusion It follows that further research is warranted, particularly in areas where the data already looks encouraging.     

Benchmarks of Significant Change After Aphasia Rehabilitation

ObjectiveTo establish benchmarks of significant change for aphasia rehabilitation outcome measures (ie, Western Aphasia Battery-Aphasia Quotient [WAB-AQ], Communicative Effectiveness Index [CETI], Boston Naming Test [BNT]) and assess if those benchmarks significantly differ across subgroups (ie, time post onset, dose frequency, treatment type).Data SourcesA comprehensive literature search of 12 databases, reference lists of previous reviews, and evidence-based practice materials was conducted.Study SelectionRandomized controlled trials, quasi-experimental studies, single-subject design, and case studies that used a standardized outcome measure to assess change were included. Titles and full-text articles were screened using a dual review process. Seventy-eight studies met criteria for inclusion.Data ExtractionData were extracted independently, and 25% of extractions were checked for reliability. All included studies were assigned quality indicator ratings and an evidence level.Data SynthesisRandom-effects meta-analyses were conducted separately for each study design group (ie, within-/between-group comparisons). For within-group designs, the summary effect size after aphasia rehabilitation was 5.03 points (95% confidence interval, 3.95-6.10, P<.001) on the WAB-AQ, 10.37 points (6.08-14.66, P<.001) on the CETI, and 3.30 points (2.43-4.18, P<.001) on the BNT. For between-group designs, the summary effect size was 5.05 points (1.64-8.46, P=.004) on the WAB-AQ and 0.55 points (-1.33 to 2.43, P=.564) on the BNT, the latter of which was not significant. Subgroup analyses for the within-group designs showed no significant differences in the summary effect size as a function of dose frequency or treatment type.ConclusionsThis study established benchmarks of significant change on 3 standardized outcome measures used in aphasia rehabilitation.     

康复护理对神经根型颈椎病患者功能恢复的影响

目的:探讨康复护理对神经根型颈椎病患者功能恢复的影响。方法:将182例神经根型颈椎病患者随机分为对照组82例和观察组100例,对照组给予常规颈椎病非手术疗法治疗,观察组除给予常规颈椎病非手术疗法外,还实施了颈椎牵引、运动疗法等康复护理措施,3个疗程后采用神经根型颈椎病的症状与功能评定量表进行疗效评价。结果:对照组优32例,良26例,中18例,差6例,优良率70.7%;观察组优68例,良22例,中8例,差2例,优良率90.0%,观察组疗效明显优于对照组(P<0.01);对照组平均治愈天数为23.14±6.77d,观察组为17.58±7.11d,两组比较有显著性差异(P<0.05)。结论:康复护理对神经根型颈椎病有较好的疗效,值得临床推广。     

产时个性化基础按摩程序对促进自然分娩的影响

目的：探讨产时个性化基础按摩程序对促进自然分娩的影响。方法选取我院产科自然分娩产妇90例,随机分为观察组和对照组各45例。观察组在传统自然分娩的基础上辅以个性化基础按摩程序;对照组按照传统自然分娩流程进行。对比分析两组孕妇产程中的疼痛评分、镇痛药物使用量、产程时间、产后出血、尿潴留、中转剖宫产率及新生儿窒息情况。结果观察组产时疼痛程度评分及镇痛药物剂量均低于对照组,第一产程及第二产程时间短于对照组,差异均有统计学意义( P<0.05)。观察组中转剖宫产率、尿潴留发生率均低于对照组,差异有统计学意义( P<0.05)。两组在产后出血量、新生儿窒息方面比较,差异均无统计学意义( P﹥0.05)。结论产时个性化基础按摩程序有助于减轻产时疼痛,减少镇痛药物的使用,促进产程,降低中转剖宫产率,具有一定的临床应用和推广价值。     

前列地尔注射液治疗老年糖尿病性末梢神经炎的疗效观察及护理

目的探讨前列地尔注射液对老年糖尿病性末梢神经炎的临床疗效及护理的方法。方法对2008年6月～2009年6月82例老年糖尿病性末梢神经炎的患者,随机分为治疗组和对照组各41例,治疗组给予前列地尔注射液10ug加入生理盐水100ml中静脉点滴,1次/d,15d为一个疗程;同时控制血糖。对照组给常规内科治疗。结果治疗组和对照组总有效率分别为95.12%和68.30%,两组总有效率比较在统计学上差异有显著意义（P〈0.05）。结论前列地尔注射液治疗老年糖尿病性末梢神经炎有显著的疗效,值得临床推广应用。     

鹿泉市娱乐场所性服务者艾滋病综合干预效果评价

目的研究在娱乐场所性服务人员中如何开展艾滋病(AIDS)干预,为预防控制艾滋病提供依据。方法对鹿泉市所有娱乐场所的性服务人员进行综合干预,干预前后通过问卷方式进行干预效果评估。结果性服务人员的艾滋病知识知晓率由干预前72.10%,提高到干预后90.67%(x2=32.53,P0.01);最近1次商业性行为时,安全套使用比例从干预前的46.12%,增加到干预后的76.00%(x2=6.94,P0.01);最近1个月商业性行为时,安全套每次使用比例从干预前的49.23%,增加到干预后的61.00%(x2=1.17,P0.05)。结论AIDS综合干预措施能有效提高安全套使用率,降低HIV感染机会,但需要形成长效工作机制,才能取得更好的效果。     

大学生综合素质培养——医学院校推行大学生班主任助理制度的探索与思考

大学生素质培养是一个重要的理论和实践问题,本文通过医学院校推行大学生班主任助理制度对大学生综合素质培养的作用和效果提出了思考,对大学生班主任助理制度的方法进行了探讨。     

胶原酶溶解术联合硬膜外阻滞治疗腰椎间盘突出症疗效分析

目的 探讨胶原酶溶解术联合硬膜外阻滞治疗腰椎间盘突出症的疗效.方法 腰椎间盘突出症患者60例,分为3组,各20例：A组单纯行胶原酶溶解术;B组胶原酶溶解术联合硬膜外阻滞治疗;C组单纯行硬膜外阻滞治疗.治疗前1 d,治疗后3 d,2个月,6个月测定疼痛视觉模拟评分（VAS）、直腿抬高试验（SLRT）与治疗优良率以评估治疗效果.结果 三组患者治疗后3 dVAS值、SLRT值均较治疗前1 d明显改善（P〈0.01或P〈0.05）;A组与B组治疗后2个月、6个月VAS值、SLRT值均较治疗前明显降低和提高（P〈0.01或P〈0.05）,C组无明显变化;B组治疗后2个月、6个月较A组与C组的VAS值明显降低、SLRT值明显提高（P〈0.05）.A组治疗后3d、2个月、6个月时治疗优良率分别为：17/20,16/20,13/20;B组分别为：20/20,18/20,16/20;C组分别为：20/20,9/20,6/20;B组2个月,6个月优良率较A组与C组提高.结论 胶原酶溶解术联合硬膜外阻滞治疗腰椎间盘突出症,近期优良率100%,远期优良率达80%,均较单纯行胶原酶溶解术与单纯硬膜外阻滞的效果好.