土豆片联合热敷对预防肌注后硬结的疗效观察

目的比较单用热敷法与热水袋＋土豆片湿热敷法预防肌注后硬结发生的疗效,寻找预防长期肌注后硬结的最有效方法。方法选择120例肌注黄体酮的患者,采用自身对照,在每例患者的两侧臂大肌首次注射后,分别用热敷法（热敷组）和热水袋＋土豆片湿热敷（联用组）,观察患者注射局部硬结的发生率,疼痛程度。结果联用组较热敷组局部硬结的形成及疼痛发生率低,两者比较差异有统计学意义（P〈0．001）。结论联用法预防肌注后硬结的发生,减轻患者疼痛效果优于单用热敷法。     

Cardiovascular autonomic responsiveness in postmenopausal women with and without hot flushes

Objectives

During menopausal transition autonomic balance is known to shift towards sympathetic dominance, but the role of vasomotor hot flushes in this phenomenon is not understood. We compared cardiovascular autonomic responsiveness between women with and without hot flushes.

Study design and main outcome measures

One hundred fifty recently postmenopausal healthy women with varying degree of hot flushes (none, mild, moderate, severe) underwent comprehensive cardiovascular autonomic nervous testing (controlled and deep breathing, active orthostatic test, Valsalva manoeuvre and handgrip test) assessing both sympathetic and parasympathetic activity. The responses of heart rate, heart rate variability and blood pressure in these tests were evaluated.

Results

Responses in heart rate showed differences between the study groups only in the Valsalva manoeuvre where the tachycardia ratio in all symptomatic women was lower (p = 0.041) than in women without hot flushes. Neither change in the heart rate variability analyses nor the blood pressure responses were affected by hot flush status. However, there was a non-significantly higher maximum systolic (140 (112–182) mmHg vs. 135 (102–208) mmHg) and diastolic blood pressure (94 (72–112) mmHg vs. 90 (66–122) mmHg) following the handgrip test in women without hot flushes vs. all the symptomatic women.

Conclusions

Menopausal hot flushes seem to be associated with a possibly increased sympathetic preponderance without an effect on parasympathetic activity in cardiovascular autonomic responses. This may imply a potentially negative impact on cardiovascular health in women experiencing hot flushes.     

Management of menopausal symptoms in breast cancer patients

In breast cancer patients, menopausal symptoms such as hot flashes, urogenital problems, musculoskeletal symptoms and cognitive dysfunction are common, regardless of age at diagnosis. They affect quality of life and systemic therapy will worsen this. Endocrine and/or chemotherapy may induce temporary or permanent ovarian failure and can exacerbate these symptoms. Hormone therapy (HT) has been studied in breast cancer survivors, but safety has been questioned. The HABITS trial investigating estrogen-based HT, as well as the LIBERATE trial investigating tibolone, found a reduction in disease-free survival for those treated. Alternative strategies are needed, as menopause symptoms may reduce compliance with breast cancer treatments. This article reviews recently published strategies to tackle menopausal problems in breast cancer patients. Antidepressants may help with hot flashes. Acupuncture and hypnosis can also be used but the evidence is conflicting. For urogenital problems vaginal moisturizers or topical estrogens can be employed. A musculoskeletal syndrome induced by aromatase inhibitors (AIs) is frequently encountered and currently there are no effective treatment strategies. Bisphosphonates reduce AI-induced bone resorption and can also increase disease-free and overall survival. Standard-dose endocrine and chemotherapy are associated with a decline in cognitive function.     

A critical view of the effects of phytoestrogens on hot flashes and breast cancer risk

The increased risk of breast cancer recently observed with some specific estro-progestin associations has raised concerns about the harmful effects of menopausal hormone replacement therapy (HRT). It has been proposed that phytoestrogens (PEs), which have a similar chemical structure to estrogens, could be used as HRT. The main selling points of these preparations concern the management of hot flashes and their potential beneficial effects on breast tissue. In this review, we will address the effects of PE on hot flashes and breast cancer risk as well as the questions raised on a chemical point of view. We conclude that the efficacy of a PE rich diet or nutritional supplements is not clearly established. The use of PE as an alternative for HRT cannot be advocated for now, due to insufficient and conflicting data on efficacy and safety. Moreover, due to the hormone dependence of breast cancer, PE use must be contraindicated in breast cancer survivors.     

四黄水密冷敷联合扶他林治疗急性痛风性关节炎的疗效观察

目的：探讨中西医结合治疗急性痛风性关节炎的疗效。方法：63例符合急性痛风性关节炎患者随机分为治疗组与对照组,治疗组以四黄水密局部冷敷并口服扶他林治疗,对照组以秋水仙碱口服,进行为期一周的治疗观察。结果：治疗组总有效率90.3%,对照组总有效率87.5%,差异有显著意义（P〈0.05）,且治疗组不良反应的发生率明显低于对照组。结论：四黄水密冷敷联合扶他林治疗急性痛风性关节炎疗效确切,不良反应少。     

Reversible attenuation of neuropathic-like manifestations in rats by lesions or local blocks of the intralaminar or the medial thalamic nuclei

BACKGROUND AND AIM: Thalamic somatosensory nuclei have been classified into medial and lateral systems based on their role in nociception. An imbalance between these two systems may result in abnormal somatic sensations and spontaneous pain. This study aims to investigate the effects of transient or permanent block of the medial and intralaminar nuclear groups on the neuropathic-like behavior in a rat model for mononeuropathy. METHODS: Neuropathy was induced on one hind paw in different groups of rats following the spared nerve injury model. When the resulting hyperalgesia and allodynia (tactile and cold) reached a maximum plateau, the rats received either chemical or electrolytic lesion or lidocaine (2%) microperfusion, placed in the various thalamic nuclear groups. RESULTS: All procedures produced transient but significant decrease of neuropathic manifestations. The magnitude and duration of decrease depended on the type and the site of the block. These effects can be ranked in increasing order as follows, electrolytic相似文献   

放射性碘125粒子植入联合体外高频热疗治疗恶性肿瘤的护理研究

目的探讨放射性碘125粒子植入联合体外高频热疗治疗恶性肿瘤的一系列完善的护理程序及有效护理措施。方法对30例晚期恶性肿瘤患者直视或CT、B超引导下经皮穿刺,按照治疗计划将放射性碘125粒子永久性植入肿瘤内持续照射,术后于患者病变区域行体外高频热疗治疗。进行实例的观察与护理,制定完善的一整套护理程序。结果30例患者中:CR1例,PR26例,NC2例,PD1例,完成全程治疗的29例,1例热疗3次后需停止(不能完成)。结论放射性碘125粒子植入联合体外高频热疗,二者合一的护理比单一的放射性碘125粒子植入或高频热疗的护理难度更大,需要完善的护理程序。     

Menopausal symptoms following breast cancer treatment: A qualitative investigation of cognitive and behavioural responses

Objectives

Menopausal symptoms – hot flushes and night sweats (HF/NS) – are particularly troublesome for women who have undergone breast cancer treatment. Non-medical treatments, such as cognitive behaviour therapy, are being developed but there is a lack of information about cognitive and behavioural reactions to HF/NS in breast cancer patients.

Methods

Thirty-five women who had completed active breast cancer treatment with at least 10 HF/NS per week completed questionnaires assessing HF/NS, mood and beliefs, and took part in interviews to elicit cognitive and behavioural reactions and a thematic content analysis used to analyse the data.

Results

The mean weekly frequency of HF/NS was 76 (SD = 46) (57 HF and 19 NS). Smokers reported significantly more night sweats, but BMI and mood were not associated with HF/NS frequency. Cognitive and behavioural responses were varied but broadly similar to those of well women. The main cognitive themes were: embarrassment/social anxiety, loss of control, beliefs about NS, sleep and tiredness, and the main behaviours were: carry on and ignore them, cool down, avoidance, communication with others.

Conclusions

The results are discussed within a cognitive behavioural framework and might inform the development of psychological interventions for these treatment related symptoms.     

手部热压伤后临床治疗

目的 总结38例手部热压伤创面治疗方法选择的临床体会.方法 对38例手部热压伤患者,根据临床伤情特点使用相应的治疗方法.结果 33例皮瓣手部功能完全或部分恢复,5例无功能.结论 根据不同外伤程度、部位,选择适当的治疗方法是手部热压伤治疗的关键.适合的治疗可以确保手部最大程度的功能恢复.