温针灸对功能性便秘患者临床症状及焦虑抑郁的改善作用

目的:探讨温针灸对功能性便秘(FC)患者临床症状及焦虑抑郁的改善作用。方法:选取2017年1月至2017年12月中国中医科学院广安门医院南区收治的FC患者70例作为研究对象,随机分为观察组和对照组,每组35例。对照组采用常规针刺治疗,观察组采用温针灸治疗,比较治疗前后2组患者便秘临床症状积分、首次排便时间、中医证候评分、焦虑自评量表(SAS)、抑郁自评量表(SDS)评分。结果:观察组有效率96. 00%,对照组有效率68. 00%,差异有统计学意义(P0. 05)。治疗后2组患者的周排便次数、粪便性状积分和排便困难程度均改善,中医证候评分、SAS和SDS评分下降,较治疗前差异有统计学意义(P 0. 05)。治疗后,观察组患者的周排便次数、粪便性状积分高于对照组,中医证候评分、SDS和SAS评分、首次排便时间以及排便困难程度积分小于对照组,差异有统计学意义(P 0. 05)。结论:温针灸治疗能调节胃肠道运动、润湿肠道、显著改善便秘等临床症状,对FC患者有显著临床效果。     

Efficacy of Topical Vibratory Stimulation for Reducing Pain During Trigger Point Injection to the Gastrocnemius: A Randomized Controlled Trial

ObjectiveTo evaluate the efficacy of topical vibratory stimulation for reducing pain during trigger point injection (TPI).DesignDouble-blind randomized placebo-controlled clinical trial.SettingTertiary care university hospital.ParticipantsA total of 136 participants were randomly recruited from among patients with myofascial pain syndrome who were scheduled for TPI. Of these, 65 were excluded because they met the exclusion criteria, and 11 because they refused to participate. Finally, 60 participants were enrolled. No participants dropped out of the study.InterventionParticipants were randomly assigned to the vibration group or control group. TPI was performed with 0.5% lidocaine using a 25-gauge needle. A vibrator was applied to the popliteal fossa for 3 to 5 seconds prior to and during TPI to the gastrocnemius; 100-Hz vibration was turned on for the vibration group and turned off for the control group.Main Outcome MeasuresPain intensity during TPI was assessed using a 100-mm visual analog scale (VAS) as a primary outcome, and participant satisfaction and preference for repeated use were measured using 5-point Likert scales as a secondary outcome. These parameters were evaluated immediately after TPI. The primary outcome was evaluated using analysis of covariance and secondary outcome using the Mann-Whitney U test.ResultsVAS scores for pain during TPI were significantly lower in the vibration group (30.30; 95% confidence interval [CI], 22.65-39.26) compared with the control group (47.58; 95% CI, 38.80-56.52; F=7.74; P< .01). The mean difference in VAS scores between the 2 groups was 17.27 (95% CI, 5.24-29.30). Participant satisfaction and preference for repeated use were significantly higher in the vibration group than in the control group (P<.05). No participant showed any side effects.ConclusionTopical vibratory stimulation significantly decreased pain during TPI of the gastrocnemius.     

Mechanical Thrombectomy in Acute Ischemic Stroke—The Role of Interventional Cardiologists: A Prospective Single-Center Study

ObjectivesThe aim of this study was to assess the safety and outcomes of mechanical thrombectomy (MT) performed at a stroke center by interventional cardiologists (ICs) compared with other interventionists. The primary endpoint was functional independence of stroke survivors (modified Rankin scale score 0-2) at 3 months. The secondary endpoints included recanalization rate, reduction in stroke severity, and 3-month mortality.BackgroundMT is a validated treatment for large vessel occlusion acute ischemic stroke. Incorporating ICs with their infrastructure into a comprehensive stroke team may increase the accessibility of this therapy.MethodsIn this single-center, prospective study, we included 248 ischemic stroke patients (mean age 68 ± 13 years, 48% women) with confirmed large vessel occlusion. The procedures were performed by ICs (n = 80), vascular surgeons (n = 116), and neuroradiologists (n = 52).ResultsFunctional independence after 3 months was similar between patients operated by cardiologists and other specialists (modified Rankin scale score 0-2 in 44% vs 55%; P = 0.275). Similarly, the mortality rate at 3 months did not differ (28% vs 31%; P = 0.585). Procedures performed by cardiologists took longer than those performed by other specialists (120 minutes vs 105 minutes; P = 0.020). A percentage of procedures with angiographic success (TICI [Thrombolysis In Cerebral Infarction] grade 2b or 3) was lower when performed by cardiologists (55.7% vs 71.7%; P = 0.013), but the change in stroke severity (National Institutes of Health Stroke Scale score after 24 hours) was similar.ConclusionsEndovascular treatment in stroke provided by interventional cardiologists in cooperation with noninvasive stroke specialists is noninferior to procedures performed by the other endovascular specialists. Mortality and functional independence after 3 months are similar regardless of an interventionist performing the procedure.     

Sleep quality in times of Covid-19 pandemic

BackgroundDue to the 2019 novel coronavirus (COVID-19) disease outbreak, social distancing measures were imposed to control the spread of the pandemic. However, isolation may affect negatively the psychological well-being and impair sleep quality. Our aim was to evaluate the sleep quality of respiratory patients during the COVID-19 pandemic lockdown.MethodsAll patients who underwent a telemedicine appointment from March 30 to April 30 of 2020 were asked to participate in the survey. Sleep difficulties were measured using Jenkins Sleep Scale.ResultsThe study population consisted of 365 patients (mean age 63.9 years, 55.6% male, 50.1% with sleep-disordered breathing [SDB]). During the lockdown, 78.9% of participants were confined at home without working. Most patients (69.6%) reported at least one sleep difficulty and frequent awakenings was the most prevalent problem. Reporting at least one sleep difficulty was associated with home confinement without working, female gender and diagnosed or suspected SDB, after adjustment for cohabitation status and use of anxiolytics. Home confinement without working was associated with difficulties falling asleep and waking up too early in the morning. Older age was a protective factor for difficulties falling asleep, waking up too early and non-restorative sleep. Notably, SDB patients with good compliance to positive airway pressure therapy were less likely to report sleep difficulties.ConclusionsHome confinement without working, female gender and SDB may predict a higher risk of reporting sleep difficulties. Medical support during major disasters should be strengthened and potentially delivered through telemedicine, as this comprehensive approach could reduce psychological distress and improve sleep quality.     

甲基丙二酸血症86例患儿的神经发育特征

目的分析甲基丙二酸血症患儿神经发育特征及可能影响因素。方法设计临床调查表,对2016年2月至2018年2月于河南中医药大学第一附属医院儿科就诊的86例甲基丙二酸血症患儿进行调查,采用Gesell发育量表进行神经发育评估。结果86例患儿中男45例,女41例;年龄2.4~62.5个月,中位数8.3个月。新生儿期筛查确诊的患儿33例,发病后临床诊断的患儿53例,患儿各能区多为轻到重度发育缺陷。其中,0~6月龄患儿28例,精细运动、大运动、适应性缺陷显著;>6~12月龄患儿24例,语言、适应性、个人-社交缺陷显著;>12~36月龄患儿23例,语言、适应性、大运动缺陷显著;>36~72月龄患儿11例,语言、个人-社交、适应性缺陷显著;新生儿筛查发现的患儿在精细运动、大运动、适应性、个人-社交和语言方面发育商均不同程度高于发病后临床诊断的患儿,差异均有统计学意义(均P<0.05)。结论虽经积极规范治疗,大多数发病后诊断的甲基丙二酸血症患儿仍存在神经发育障碍,各能区存在轻到重度发育缺陷。不同年龄段患儿神经发育能区损害稍有不同,6月龄以下的患儿精细运动、大运动、适应性发育缺陷显著,6月龄以上患儿语言、适应性、个人-社交缺陷显著。经新生儿筛查发现的患儿神经损害较轻。     

翁连解毒汤治疗浊毒内蕴型溃疡性结肠炎的疗效观察

目的：探究翁连解毒汤治疗浊毒内蕴型溃疡性结肠炎（Ulcerative Colitis，UC）临床疗效及可能的作用机制。方法：选取2016年2月至2018年12月在攀枝花学院附属医院收治的浊毒内蕴型UC患者130例作为研究对象，按照入院先后顺序分为对照组和观察组，每组65例。对照组常规西医治疗，观察组加用翁连解毒汤，观察2组治疗前、完成治疗后T细胞、NK细胞、炎性反应因子、凝血功能、生命质量变化，完成治疗后总结疗效。结果：观察组患者在NK细胞、T淋巴细胞组成、CR、TNF-α、IL-1 β、ESR、内毒素、IL-10、FIB、PLT、APTT改善方面的效果较对照组更优，组间差异有统计学意义（P<0.05）。观察组患者完成治疗后的生命质量量表各维度评分及总评分改善效果优于对照组患者（P<0.05），且临床总有效率和组织病理学疗效率均高于对照组患者（P<0.05）。结论：翁连解毒汤能抑制浊毒内蕴型UC炎性反应，改善高凝状态，提高机体免疫功能，从而提高疗效和生命质量。     

Measuring hope amongst Tanzanian women who participate in microfinance: An evaluation of the Snyder hope scale

ABSTRACT

Measuring hope reliably and accurately remains an important research objective, not least in less prosperous settings where ‘holding on to hope’ may be critically important in the struggle against adverse life conditions. The State Hope Scale was designed for use in the US. Despite reported application in diverse cultures and using translations the scale has not been extensively validated outside US populations. This study contributes to a larger project exploring the measurement of hope and provides a critique of Snyder’s scale as used in a Tanzanian female population of 1021 urban microfinance participants. We evaluate the scale’s validity through assessment of the empirical distribution of scores, item response profiles, internal consistency and discriminatory ability. Participants mostly scored very high and many reached very near the maximum attainable score. Hardly any endorsed the negative half of the response scale. Several problems are discussed including poor discrimination and strong evidence of acquiescence response bias. We also found little association of the scale scores with hypothesised correlates of hope. Future improvements on the measurement of hope are recommended, especially in studies outside the narrow Western context in which the scale was devised.