The influence of iliotibial tract thickness on clinical outcomes in women with patellofemoral pain

BackgroundThe assessment of iliotibial tract thickness by ultrasonography may help identify a key, previously unexplored factor that may contribute directly to the homeostasis imbalance of the femoropatellar joint in people with patellofemoral pain (PFP).ObjectivesTo compare the iliotibial tract thickness of people with PFP and asymptomatic people; and to correlate the iliotibial tract thickness with self-reported pain and function of people with PFP.MethodsEighty women, separated into two groups: PFP group (n = 40) and control group consisting of asymptomatic participants (CG; n = 40). The participants answered the Anterior Knee Pain Scale (AKPS) questionnaire, to identify the self-reported knee function; they evaluated the pain in millimeters by the Visual Analog Scale for pain (VAS). For the imaging evaluation, an ultrasound was used, with a linear transducer at the distal portion of the iliotibial tract (coronal plane), with the participants positioned in dorsal decubitus, with 20° of knee flexion. The iliotibial band was visualized in its long axis, and three sequential images were recorded between the lateral femoral condyle and the lateral tibial condyle. The measurements were normalized and correlated.ResultsThe groups had no differences (P > 0.001) between participants for: age/weight/height/IMC. Participants in the PFP group had moderate levels of pain (58 + 2.1 mm), considerable self-reported functional limitation (d = 3.05) and greater iliotibial tract thickness compared with the CG (d = 2.41).ConclusionThe iliotibial tract of women diagnosed with PFP have greater thickness compared with asymptomatic women. There was no association between iliotibial tract thickness and subjective measures of pain and function.     

Are risk factors necessary for pretest probability assessment of coronary artery disease? A patient similarity network analysis of the PROMISE trial

BackgroundPretest probability (PTP) calculators utilize epidemiological-level findings to provide patient-level risk assessment of obstructive coronary artery disease (CAD). However, their limited accuracies question whether dissimilarities in risk factors necessarily result in differences in CAD. Using patient similarity network (PSN) analyses, we wished to assess the accuracy of risk factors and imaging markers to identify ≥50% luminal narrowing on coronary CT angiography (CCTA) in stable chest-pain patients.MethodsWe created four PSNs representing: patient characteristics, risk factors, non-coronary imaging markers and calcium score. We used spectral clustering to group individuals with similar risk profiles. We compared PSNs to a contemporary PTP score incorporating calcium score and risk factors to identify ≥50% luminal narrowing on CCTA in the CT-arm of the PROMISE trial. We also conducted subanalyses in different age and sex groups.ResultsIn 3556 individuals, the calcium score PSN significantly outperformed patient characteristic, risk factor, and non-coronary imaging marker PSNs (AUC: 0.81 vs. 0.57, 0.55, 0.54; respectively, p ?< ?0.001 for all). The calcium score PSN significantly outperformed the contemporary PTP score (AUC: 0.81 vs. 0.78, p ?< ?0.001), and using 0, 1–100 and ?> ?100 cut-offs provided comparable results (AUC: 0.81 vs. 0.81, p ?= ?0.06). Similar results were found in all subanalyses.ConclusionCalcium score on its own provides better individualized obstructive CAD prediction than contemporary PTP scores incorporating calcium score and risk factors. Risk factors may not be able to improve the diagnostic accuracy of calcium score to predict ≥50% luminal narrowing on CCTA.     

痛情绪相关神经递质及神经环路研究进展＊

痛情绪是指因疼痛引发的情绪和情感体验，是疾病过程中最常见的一种情绪。痛情绪相关神经机制非常复杂，但主要与单胺类神经递质、神经肽和某些神经环路有关，笔者将结合目前研究现状分别从以上两方面展开，就痛情绪相关单胺类神经递质和神经肽在受体分类、脑区通路、共疾病以及各神经递质之间的联系和痛情绪相关神经环路中各个蛋白的作用机制等方面进行探讨。     

揿针疗法分经论治神经根型颈椎病的临床研究

目的:观察揿针疗法分经论治神经根型颈椎病的临床疗效及可行性.方法:将70例神经根型颈椎病患者随机分为观察组与对照组,每组35例.对照组采用常规取穴的揿针疗法,观察组采用分经辨证取穴的揿针疗法.在治疗前后对两组患者的视觉模拟量表(VAS)评分及临床症状评分进行评价,并观察两组治疗方案的临床疗效.结果:治疗后,两组患者的VAS评分均较治疗前降低(均P<0.01),且观察组患者VAS评分低于对照组(P<0.01);两组患者的临床症状评分均较治疗前降低(均P<0.01),且观察组患者的临床症状评分低于对照组(P<0.01);观察组的临床总有效率高于对照组(P<0.05).结论:分经辨证取穴的揿针疗法能够降低神经根型颈椎病患者的疼痛评分,改善患者的临床症状,疗效优于常规揿针疗法.     

卡通画与背景音乐在儿科穿刺室的应用

目的探讨一种服务方式,旨在减轻患儿痛苦,提高穿刺成功率,提升患者满意度。方法将儿科静脉穿刺的2 869例患者分成2组,在普通穿刺室静脉穿刺者为对照组(1 417例),在经过卡通画装饰墙面、播放儿歌背景音乐后的穿刺室中脉穿刺者为观察组(1 452例),比较两组患者一次穿刺成功率、头皮静脉穿刺疼痛程度、对护理工作的满意度。结果观察组一次穿刺成功率与患者对护士工作的满意度均高于对照组,观察组疼痛程度较轻,差异有统计学意义(P<0.05)。结论卡通画与背景音乐在儿科穿刺室的应用,可缓解静脉穿刺给患儿造成的疼痛,提高一次穿刺成功率,提升患者满意度。     

提高重症患者气管插管医护配合默契度的效果研究

目的:通过持续质量改进的实施与效果评价,提高重症患者气管插管医护配合默契度。方法:应用PDCA进行重症患者气管插管医护配合的现状分析、实施改进措施、数据查检,比较PDCA实施前后医护配合默契度及医生对护士操作配合的满意度。结果:实施PDCA后医护配合默契度(90.00±9.07)分,高于实施前(60.00±14.95)分(P<0.05);医生对护士操作配合的Likert scale 5分满意度评分,4分以上占97.14%,高于实施前77.14%(P<0.05)。结论:通过持续质量改进,可以增进医护沟通,对重症患者气管插管进行科学管理,提高医护配合默契度,提高抢救效率,保证患者生命安全。     

基于灰色关联度分析和聚类分析的3种滇产重楼抗肝癌作用谱效关系探索

目的:研究长柱重楼、滇重楼和南重楼的HPLC指纹图谱与其抗肝癌作用的谱效关系,为明确重楼抗肝癌作用的物质基础提供实验依据。方法:采用HPLC建立3种重楼提取物的指纹图谱,流动相乙腈(A)-水(B)梯度洗脱(0～10 min,20%A; 10～20 min,20%～25%A; 20～30 min,25%～30%A; 30～40 min,30%～35%A; 40～50 min,35%～40%A; 50～60 min,40%A; 60～75 min,40%～45%A; 75～80 min,45%～60%A),流速0. 9 m L·min~(-1),检测波长203 nm;利用噻唑蓝(MTT)比色法测定3种重楼提取物对肝癌HepG2细胞的增殖抑制作用,计算半数抑制浓度(IC_(50));运用聚类分析(HCA)和灰色关联度分析(GRA)研究3种重楼指纹图谱和抗肝癌作用的关系,找出对抗肝癌作用贡献较大的成分。结果:在3种重楼的HPLC指纹图谱中,确定其中11个色谱峰为共有峰。作用时间72 h时长柱重楼、滇重楼、南重楼的IC_(50)分别为148. 33,178. 87,208. 09 mg·L~(-1),其中长柱重楼的抗肝癌活性最强。灰色关联度结果显示,滇重楼共有峰中关联度较高的为1～10号峰,长柱重楼共有峰关联度较高的为1～7号峰,南重楼共有峰中关联度较高的为1～4,6～10,N1号峰,与IC_(50)关联度均0. 7。各重楼变量的聚类分析结果显示,可与IC_(50)聚为一类的色谱峰的关联度均 0. 7。结论:建立了3种重楼的HPLC指纹图谱,重复性良好。3种重楼中的1～4,6和7号色谱峰对抗肝癌药效贡献最大。     

曼月乐治疗子宫内膜异位症的效用分析

目的:探讨曼月乐对子宫内膜异位症的治疗效果。方法:选取98例我院在2015年12月—2018年12月收治的子宫内膜异位症患者进行研究,按照入院顺序分成对照组和观察组,各49例。对照组用妈富隆治疗,观察组用曼月乐治疗,比较两组治疗情况。结果:观察组疾病治疗总有效率高于对照组,不良反应发生率低于对照组(95.92%VS79.59%,6.12%VS22.45%)(P<0.05);两组治疗前疼痛程度、子宫内膜厚度、糖类抗原125水平对比差异无统计学意义(P>0.05),观察组治疗后痛程度、子宫内膜厚度、糖类抗原125水平低于对照组[(4.98±1.09)分VS(5.72±1.32)分,(0.58±0.15)cmVS(0.68±0.16)cm,(59.34±1.81)U/mLVS(60.28±1.76)U/mL](P<0.05)。结论:在子宫内膜异位症的治疗中使用曼月乐,可提高治疗效果,缓解疼痛感,降低不良反应发生风险,推广应用价值高。