改良式正念减压法对头颈部鳞癌放疗患者自我效能和正念水平的影响

目的 探究改良式正念减压法对接受放疗的头颈部鳞状细胞癌患者自我效能和正念水平的影响。方法 选取2019年1—10月在本中心收治的首次接受单纯放疗的91例头颈部鳞状细胞癌患者为研究对象,按随机数字表法分为观察组（n=46）和对照组（n=45）。对照组采用常规心理护理,观察组采用常规心理护理+改良式正念减压法,比较2组患者干预前后的自我效能、正念水平评分及护理满意度的差异。结果 干预前,2组患者的自我效能和正念水平评分差异无统计学意义（均P>0.05）;干预6周末,观察组患者的自我效能与正念水平评分均显著高于对照组（均P<0.05）。其中,在自我效能量表中,2组的自我减压、正性态度维度分差异有统计学差异（均P<0.05）。结论 改良式MBSR可有效地提高头颈部鳞癌放疗患者的自我效能和正念水平。     

正念减压疗法对体外受精—胚胎移植失败患者心理弹性及正念注意觉知的影响

目的 探讨正念减压疗法对体外受精—胚胎移植失败患者心理弹性及正念注意觉知的影响。方法 采用方便抽样方法,选取2018年9月—2019年1月吉林大学第一医院生殖妇科住院的既往有移植失败史的体外受精—胚胎移植患者作为研究对象,接受8周正念减压疗法治疗,分别于干预前、干预后1周末及干预后3个月末采用心理弹性量表及正念注意觉知量表评估干预效果。结果 共有48例患者完成测评,干预后1周末、干预后3个月末,本组体外受精—胚胎移植失败患者心理弹性总分及正念注意觉知总分均高于干预前（P<0.001）。结论 对体外受精-胚胎移植失败患者实施正念减压疗法,可提高其心理弹性及正念注意觉知水平。     

基于遗忘规律健康教育对住院肺癌患者的效果观察

目的 探讨基于遗忘规律健康教育对住院肺癌患者自我效能感及自我管理行为的应用效果。方法 采用便利抽样法选取我院肿瘤科住院治疗的肺癌患者共80例,采用随机数字表法将所选患者分为对照组（n=40）和观察组（n=40）。对照组给予常规健康教育,观察组在对照组的基础上采用基于遗忘规律健康教育,比较2组患者干预前后自我效能感和自我管理行为的评分。结果 干预前2组肺癌患者自我效能感和自我管理行为得分比较差异无统计学意义（P>0.05）。干预后观察组正性态度、自我减压、自我决策及自我效能感总分高于对照组,差异有统计学意义（P<0.05）;干预后观察组饮食管理、日常生活管理、治疗相关管理、社会心理管理及自我管理总分高于对照组,差异有统计学意义（P<0.05）。结论 基于遗忘规律健康教育可有效提高肺癌患者的自我效能感及自我管理行为。     

门诊胃食管反流病患者应用正念减压腹式呼吸训练的效果观察

目的 探讨正念减压腹式呼吸训练在门诊胃食管反流病患者中的应用效果。方法 采用便利抽样法选择我院消化内科门诊就诊的胃食管反流病患者68例,予以正念减压腹式呼吸操训练3个月,比较干预前、干预4周末、8周末、12周末时68例患者的胃食管反流病症状、健康相关生活质量及焦虑抑郁状况。结果 胃食管反流病患者在干预前、干预4周末、干预8周末、干预12周末胃食管反流病状况比较,差异具有统计学意义（F=11.837,P<0.001）;胃食管反流病患者在干预前、干预4周末、干预8周末、干预12周末焦虑抑郁得分比较,差异具有统计学意义（P<0.01）,随着干预时间的延长,胃食管反流病患者焦虑、抑郁得分降低。胃食管反流病患者在干预前、干预4周末、干预8周末、干预12周末健康相关生活质量得分比较,差异具有统计学意义（P<0.01）,随着干预时间的延长,健康相关生活质量得分提高。结论 正念减压腹式呼吸训练能够缓解胃食管反流病患者症状,减轻其焦虑抑郁情绪,提高其生活质量。     

正念减压疗法对乳腺癌患者干预效果的Meta分析

目的 评价正念减压疗法对乳腺癌患者心理健康及生活质量的作用效果。方法 计算机检索Cochrane Library、PubMed、Web of Science、EMbase、CINAHL Complete、中国知网、万方数据库、维普数据库中研究正念减压疗法对乳腺癌患者焦虑、抑郁、压力及生活质量作用效果的随机对照试验。检索年限从建库到2018年11月31日。文献质量评价依照Cochrane Review Handbook 5.1.0质量评价标准,质量评价后运用RevMan 5.3软件进行Meta分析。结果 共检索文献615篇,经筛选后纳入12篇。Meta分析结果表明,正念减压疗法可以改善乳腺癌患者干预后的压力程度[MD=-4.81,95%CI(-5.25,-4.36),P<0.001],抑郁状况[SMD=-0.66,95%CI(-0.98,-0.33),P<0.001]以及焦虑情绪[SMD=-0.67,95%CI(-1.06,-0.29),P<0.001]。同时,随访后的压力程度[MD=-0.90,95%CI(-1.39,-0.42),P<0.001]和焦虑情绪[SMD=-0.30,95%CI(-0.57,-0.03),P=0.030]也有所缓解。结论 正念减压疗法可以有效缓解乳腺癌患者干预后及长期的压力程度和焦虑情绪,但对抑郁程度只有干预后的效果,而对生活质量的短期和长期效果均不显著。     

正念饮食察觉训练对糖尿病患者自我管理和饮食行为的影响

目的 探讨正念饮食察觉训练在糖尿病患者自我管理和饮食行为的影响。方法 2018年4月—2019年4月,随机选取吉林省某三级甲等医院120例糖尿病患者为研究对象,按随机数字表法分为观察组和对照组,每组各60例。对照组实施常规护理及心理护理,观察组在在对照组的基础上进行正念饮食察觉训练,训练频率每天1次,每次2 h,持续训练4周。干预前后比较2组患者的自我管理能力,对患者干预前、干预后的高糖零食行为、饮食规律情况、摄取能量适中情况例数、饮食方面的遵医嘱性行和饮食选择合理方面的进行记录、比较。结果 干预前,2组患者的自我管理能力得分比较,差异无统计学意义（P>0.05）;4周的正念饮食察觉训练后,观察组的自我管理能力在饮食控制、血糖监测、足部护理、预防及处理高/低血糖和总分方面得分均高于对照组（P<0.05）;观察组患者的饮食行为情况均显著优于对照组（P<0.05）。结论 正念饮食察觉训练可提高患者自我管理能力,有效改善糖尿病患者饮食行为,提高进食效率,增强遵医行为,对辅助治疗糖尿病患者具有显著疗效。     

住院康复期精神分裂症患者正念训练的效果观察

目的 探讨正念训练对住院康复期精神分裂症患者焦虑、抑郁及生活质量的影响。方法 选取2017年1—12月在江苏省扬州五台山医院精神科住院的62例住院康复期精神分裂症患者,采用抽签法随机分为观察组及对照组各31例,对照组给予常规的治疗及护理,观察组在此基础上进行为期8周的正念训练,采用世界卫生组织生存质量测定量表简表自评量表、汉密尔顿抑郁量表、汉密尔顿焦虑量表进行效果评价。结果 干预后,2组抑郁、焦虑总分均有下降,生活质量每项评分均增高;经组间比较,观察组抑郁、焦虑得分低于对照组（P<0.05）;观察组除社会关系维度评分外,生活质量评分各项评分均明显高于对照组（P<0.05）。结论 正念训练能够有效改善康复期精神分裂症患者抑郁、焦虑等情绪,调动患者的康复潜能,改善其生活能力,提高患者生活质量。     

接纳与承诺疗法对永久性肠造口患者造口接受度和社会心理适应的影响

目的 探讨接纳与承诺疗法在结直肠癌永久性肠造口术后的应用效果,为促进永久性肠造口患者造口接受度和社会心理适应水平提供依据。方法 选取2019年1月—2020年5月郑州大学第二附属医院进行肠造口术后的结直肠癌患者72例,按照住院号分为对照组36例和观察组36例,对照组给予肠造口术后专科护理及心理护理,观察组在对照组的基础上进行接纳与承诺疗法,干预前、干预完成时及干预完成3个月观察比较2组患者造口接受度及社会心理适应得分。结果 干预前,2组患者造口接受度、社会心理适应各维度得分及总分比较,差异无统计学意义（P>0.05）;干预完成时及干预完成3个月,2组患者造口接受度、社会心理适应各维度得分及总分比较,差异有统计学意义（P<0.05）;观察组患者造口接受度、社会心理适应各维度得分及总分均高于对照组（P<0.05）。不同时间点造口接受度、社会心理适应总分差异有统计学意义（P<0.05）,组与时间具有较互效应（P<0.05）。结论 接纳与承诺疗法可以提高结直肠癌肠造口患者的造口接受度和社会心理适应水平。     

基于信息-动机-技巧模型对脑卒中患者健康教育的效果观察

目的 探讨信息-动机-技巧模型干预在脑卒中患者健康教育中的应用效果。方法 选取2017年1月—2018年1月入本院治疗脑卒中患者120例为研究对象,采用信息-动机-技巧模型的健康教育,评估干预前和干预3个月末患者自我效能和日常生活能力。结果 脑卒中患者干预前和干预3个月末比较,自我效能各维度得分和自我效能总分高于干预前（P<0.05）;干预3个月末日常生活自理能力得分高于干预前（t=18.673,P<0.001）。结论 基于信息-动机-技巧模型健康教育可改善脑卒中患者自我效能,提升日常生活自理能力。     

正念认知疗法对喉癌术后患者癌因性疲乏及情绪感受的影响

目的 探讨正念认知疗法对喉癌术后患者癌因性疲乏及焦虑、抑郁、幸福感指数的影响。方法 采用便利抽样方法,2018年6月—2019年10月选取在武汉市某三级甲等医院耳鼻喉科住院手术且拔除胃管的70例喉癌患者为研究对象,采用随机数字表将其分为对照组和观察组,2组各脱落 1例,最终2组各34例喉癌患者。对照组喉癌术后患者仅给予耳鼻喉头颈外科的常规护理,观察组喉癌术后患者在此基础上进行6周的正念认知疗法干预,在干预前和干预6周末采用简短疲乏评估表、焦虑自评量表、抑郁自评量表和幸福感指数量表对2组喉癌术后患者进行评估。结果 干预6周末,观察组12例喉癌术后患者无疲乏,对照组2例无疲乏,组间比较差异有统计学意义（P<0.01）;观察组喉癌术后患者焦虑总分、抑郁总分低于对照组（P<0.001）,幸福感指数量总分高于对照组（P<0.05）。结论 正念认知疗法能减轻喉癌患者的癌因性疲乏程度,改善癌喉术后患者的焦虑、抑郁情绪,提升喉癌术后患者的幸福感。     

Evaluation of radical scavenging properties of shikonin

With the aim of developing effective anti-inflammatory drugs, we have been investigating the biochemical effects of shikonin of “Shikon” roots, which is a naphthoquinone with anti-inflammatory and antioxidative properties. Shikonin scavenged reactive oxygen species like hydroxyl radical, superoxide anion (O₂^•−) and singlet oxygen in previous studies, but its reactivity with reactive oxygen species is not completely understood, and comparison with standard antioxidants is lacking. This study aimed elucidation of the reactivity of shikonin with nitric oxide radical and reactive oxygen species such as alkyl-oxy radical and O₂^•−. By using electron paramagnetic resonance spectrometry, shikonin was found unable of reacting with nitric oxide radical in a competition assay with oxyhemoglobin. However, shikonin scavenged alkyl-oxy radical from 2,2''-azobis(2-aminopropane) dihydrochloride with oxygen radical absorbance capacity, ORAC of 0.25 relative to Trolox, and showed a strong O₂^•−-scavenging ability (42-fold of Trolox; estimated reaction rate constant: 1.7 × 10⁵ M⁻¹s⁻¹) in electron paramagnetic resonance assays with CYPMPO as spin trap. Concerning another source of O₂^•−, the phagocyte NADPH oxidase (Nox2), shikonin inhibited the Nox2 activity by impairing catalysis when added before enzyme activation (IC₅₀: 1.1 µM; NADPH oxidation assay). However, shikonin did not affect the preactivated Nox2 activity, although having potential to scavenge produced O₂^•−. In conclusion, shikonin scavenged O₂^•− and alkyl-oxy radical, but not nitric oxide radical.     

Evaluation of intervention strategy of thalassemia for couples of childbearing ages in Centre of Southern China

BackgroundTo describe the free intervention strategy of thalassemia for childbearing couples in Guangzhou.MethodsRoutine hematology examinations were conducted for 137,222 couples. Among them, 37,501 couples who had mean corpuscular volume (MCV) <82 fL or mean corpuscular hemoglobin <27 pg were elected for Hb analysis and the deletions of four common α‐thalassemia mutation. Reverse dot blot for common nondeletional α‐thalassemia and β‐thalassemia was selectively used. Three thousand twenty‐two couples randomly selected were offered all those tests as a control group. Sanger sequencing, multiplex ligation‐dependent probe amplification and next‐generation sequencing were used for rare thalassemia. High‐risk couples were offered prenatal diagnosis at 10–13 weeks’ gestation based on informed consent.ResultsThe carrier rates of α‐, β‐, and αβ‐thalassemia and δβ thalassemia/deletional HPFH were 7.7%, 3.02%, 0.5% and 0.059% respectively. Of them, 1.37% were identified as at‐risk couples and 345 couples terminated the pregnancy. No severe α‐ and β‐thalassemia births were observed. In the control group, two β‐ thalassemia carriers and one case with −α^3.7/αα^QS were misdiagnosed, but all at‐risk couples were found, and we could save 1,523,774 ¥ using our strategy. The cut‐off points of 73.46 fL and 23.25 pg would be useful to find −α⁺/α^T thalassemia.ConclusionThe intervention strategy was cost‐effective and offered reference in population thalassemia screening.     

Development of the Measure of Experiential Aspects of Participation for People With Physical Disabilities

Objectives

To create a parsimonious, psychometrically sound measure of experiential aspects of participation (MeEAP) for people with physical disabilities.

Validation of the Japanese Version of the Functional Assessment of Cancer Therapy-Cognitive Function Version 3

ContextCancer therapy–induced cognitive impairment adversely affects the quality of life of patients with cancer but cannot be detected by neuropsychological tests.ObjectivesThis study aimed to validate a Japanese version of the Functional Assessment of Cancer Therapy-Cognitive Function (FACT-Cog) version 3, which is a self-report measure of the cognitive concerns of patients with cancer.MethodsThe FACT-Cog was translated into Japanese and pilot tested with five patients with breast cancer and five patients with hematologic malignancy. Study participants were recruited in Hiroshima University Hospital and Kagawa Breast Clinic in Hiroshima, Japan. Patients with breast cancer (N = 236) responded to the resultant assessment and Functional Assessment of Cancer Therapy-General version 4. The internal consistency and concurrent and construct validity of the FACT-Cog were examined.ResultsThe Cronbach's alphas of the four FACT-Cog subscales, namely, CogPCI, CogOth, CogPCA, and CogQOL, were 0.95, 0.73, 0.93, and 0.88, respectively. The item-to-domain correlations ranged from 0.211 to 0.920. Most of the FACT-Cog subscales were significantly correlated with other subscale and total scores (r = 0.133–0.425). Structural equation modeling was barely acceptable (χ2 = 1361.8, df = 489, P < 0.001; goodness of fit index = 0.731, adjusted goodness of fit index = 0.691, comparative fit index = 0.848, root-mean-square error of approximation = 0.087).ConclusionThe Japanese version of the FACT-Cog is a valid and reliable self-report measure of the cognitive function of patients with breast cancer. Its utility to clinicians and researchers in measuring the cognitive concerns of patients with cancer in Japan will serve as a further test of its validity.     

The effect of foam rollers of varying densities on range of motion recovery

ObjectiveThis study aimed to compare the effect of different density foam rollers on range of motion recovery.MethodTen active men completed two, 3-day trials in random order. During the experimental trials, all participants performed 2 min of foam rolling (FR) using a medium-density (medium trial) or hard-density (hard trial) foam roller on the right posterior thigh after completing the 90-min Loughborough Intermittent Shuttle Test (LIST). The hip joint range of motion (ROM), muscle hardness, and muscle soreness were assessed before and after the LIST and at 0 min, 20 min, 60 min, 24 h, and 48 h after FR intervention. Serum creatine kinase (CK) concentrations were assessed before the LIST and at 60 min, 24 h, and 48 h after FR intervention. The contralateral leg in each trial was used as a control.ResultsThe ROM at 0 min, 20 min, 60 min, 24 h, and 48 h after FR intervention were higher in the right leg (the massage leg) than in the left leg (the contralateral leg) (p < 0.05). In the right leg, the ROM at 0 min after FR intervention was higher than after the LIST (p < 0.05). There were no significant differences between the medium and hard trials for ROM. Muscle hardness, muscle soreness, and serum CK concentration were not affected by FR.ConclusionFR has a positive effect on ROM recovery. Moreover, the two roller densities provided similar ROM recovery.     

Patterns of pain: meta-analysis of microarray studies of pain

Existing microarray gene expression profiling studies of tonic/chronic pain were subjected to meta-analysis to identify genes found to be regulated by these pain states in multiple, independent experiments. Twenty studies published from 2002 to 2008 were identified, describing the statistically significant regulation of 2254 genes. Of those, a total of 79 genes were found to be statistically significant “hits” in 4 or more independent microarray experiments, corresponding to a conservative P < 0.01 overall. Gene ontology-based functional annotation clustering analyses revealed strong evidence for regulation of immune-related genes in pain states. A multi-gene quantitative real-time polymerase chain reaction experiment was run on dorsal root ganglion (DRG) and spinal cord tissue from rats and mice given nerve (sciatic chronic constriction; CCI) or inflammatory (complete Freund’s adjuvant) injury. We independently confirmed the regulation of 43 of these genes in the rat-CCI-DRG condition; the genetic correlates in all other conditions were largely and, in some cases, strikingly, independent. However, a handful of genes were identified whose regulation bridged etiology, anatomical locus, and/or species. Most notable among these were Reg3b (regenerating islet-derived 3 beta; pancreatitis-associated protein) and Ccl2 (chemokine [C-C motif] ligand 2), which were significantly upregulated in every condition in the rat.     

Assessment of the reproducibility of the indirect ultrasound method of measuring diaphragm mobility

The aim of this study was to assess the reproducibility of the ultrasound (US) measurement of craniocaudal displacement of the left branch of the portal vein as an indirect method of measuring right hemidiaphragm mobility in healthy young adults. Forty‐one healthy participants were selected, ranging from 20 to 30 years of age. The US tests were conducted and interpreted by two observers (A and B) on two separate occasions (Test 1 and Test 2). Intra‐observer and interobserver reproducibility and repeatability of US measurements were determined by the intraclass correlation coefficient (ICC_[2,1]) using a 95% confidence interval (CI). Interobserver reproducibility assessment showed ‘high correlation’ for Test 1 and Test 2 (ICC_[2,1] = 0·83, 95% CI = 0·70–0·91, and ICC_[2,1]  = 0·79, 95% CI = 0·61–0·89, respectively). Intra‐observer reproducibility assessment showed ‘moderate correlation’ for observer A (ICC_[2,1]  = 0·69, 95% CI = 0·45–0·84) and for observer B (ICC_[2,1]  = 0·65, 95% CI = 0·39–0·81). Repeatability assessment showed ‘high correlation’ for all tests performed (ICC_[2,1]  = 0·86, 0·80, 0·74, 0·79, P<0·001). In conclusion, US measurement of craniocaudal displacement of the left branch of the portal vein is a reproducible method of measuring right hemidiaphragm mobility in healthy young adults.     

Brazilian versions of the Measure of Processes of Care-20 and Measure of Processes of Care-Service Providers: translation,cross-cultural adaptation and reliability

BackgroundThe Measure of Processes of Care (MPOC) questionnaires evaluate Family-Centered Practice (FCP) in services for children with developmental disorders. The MPOC-20 and MPOC-SP are completed by parents and by rehabilitation professionals, respectively, and are widely used in several countries.ObjectivesTo translate and cross-culturally adapt the MPOC-20 and MPOC-SP to Brazilian Portuguese and evaluate their reliability and internal consistency.Methodsthis study included translation, back-translation, cognitive interviews, testing of the pre-final versions, analysis of reliability and of internal consistency of the final versions. Respondents included parents and rehabilitation professionals from rehabilitation centers in four capital cities in Brazil.ResultsTranslation and cultural-adaptation procedures ensured the Brazilian versions were understandable and semantically equivalent to the original MPOC-20 and MPOC-SP. Pre-final and final versions were analyzed and vetted by the original authors. The MPOC-20 internal consistency Cronbach's alpha varied between 0.61 and 0.91 (n = 107), the test-retest reliability ICC varied between 0.44 and 0.83 and the standard error of measurement varied between 0.66 and 0.85 (n = 50). The MPOC-SP internal consistency Cronbach's alpha varied between 0.52 and 0.83 (n = 92), the test-retest reliability ICC between 0.83 and 0.90, and the standard error of measure between 0.34 and 0.46 (n = 62).ConclusionThe Brazilian versions of the MPOC-20 and the MPOC-SP are in general stable and sufficiently reliable. They are relevant to the evaluation of FCP and provide information that can improve health services and ensure better care.     

超声评价放疗对颈动脉溃疡斑块形成的影响

目的 探讨超声在评价放疗对颈动脉溃疡斑块形成的影响的价值。方法 回顾性收集经病理学证实为头颈部肿瘤、放疗前后的颈动脉超声资料以及其他基线资料完整的患者93例,比较放疗前后放疗侧颈动脉和非放疗侧颈动脉粥样硬化斑块和溃疡斑块的总数量、平均内膜-中膜厚度、最大斑块面积、最大溃疡斑块的面积、最大溃疡口的面积。结果 放疗前后颈动脉超声检查的平均间隔时间为（6.1±1.9）年;放疗前放疗侧斑块总数量、平均内膜-中膜厚度、最大斑块面积、溃疡斑块的总数量、最大溃疡斑块的面积、最大溃疡口的面积与非放疗侧比较差异均无统计学意义（P均>0.05）;放疗后放疗侧斑块总数量、平均内膜-中膜厚度、最大斑块面积、溃疡斑块的总数量、最大溃疡斑块的面积、最大溃疡口的面积均较非放疗侧加重,差异有统计学意义（P均<0.05）。结论 放疗可导致头颈部肿瘤患者颈动脉粥样硬化斑块的形成和进展,且斑块具有易损性特点。     

Effects of foot orthoses on the work of friction of the posterior tibial tendon

Background

Posterior tibial tendon dysfunction is a significant contributor to flatfeet. Non-operative treatments, like in-shoe orthoses, have varying degrees of success. This study examined changes to the work of friction of the posterior tibial tendon under three conditions: intact, simulated flatfoot, and flatfoot with an orthosis. It was hypothesized that work of friction of the posterior tibial tendon would significantly increase in the flatfoot, yet return to normal with an orthosis. Changes to bone orientation were also expected.

Methods

Six lower limb cadavers were mounted in a foot simulator, that applied axial and a posterior tibial tendon load. Posterior tibial tendon excursion, gliding resistance, and foot kinematics were monitored, and work of friction calculated. Each specimen moved through a range of motion in the coronal, transverse, and sagittal planes.

Findings

Mean work of friction during motion in the coronal plane were 0.17 N cm (SD 0.07 N cm), 0.25 N cm (SD 0.09 N cm), and 0.23 N cm (SD 0.09 N cm) for the intact, flatfoot, and orthosis conditions, respectively. Motion in the transverse plane yielded average WoF of 0.36 N cm (SD 0.28 N cm), 0.64 N cm (SD 0.25 N cm), and 0.57 N cm (SD 0.38 N cm) in the same three conditions, respectively. The average tibio-calcaneal and tibio-metatarsal valgus angles significantly increased in the flatfoot condition (5.8° and 9°, respectively). However, the orthosis did slightly correct this angle.

Interpretation

The prefabricated orthosis did not consistently restore normal work of friction, though it did correct the flatfoot visually. This implies that patients with flatfeet may be predisposed to developing posterior tibial tendon dysfunction due to abnormal gliding resistance, though bone orientations are restored.