烧伤对局部引流淋巴液致炎因子与抗炎因子影响的实验研究

目的 探讨大鼠烧伤创面引流淋巴液致炎因子(TNF-α)和抗炎因子(IL-4)水平变化.方法 大鼠单侧后腿(随机)浸于70 ℃热水30 s,造成约4%总体表面积(TBSA)深Ⅱ度烫伤,对侧后腿浸于22 ℃热水30 s,实验分为烧伤腿组(A 组)和对侧未烧伤腿组(B 组);单侧腿烧伤大鼠又称为烧伤组,正常组大鼠未做任何处理,实验分为3 个时间点:烧伤后6 h(10 只)、烧伤后24 h(10 只)、烧伤后72 h(10 只).收集双侧髂总淋巴结输出淋巴管内的淋巴液及动脉血.应用酶联免疫吸附法(ELISA)检测TNF-α、IL-4 浓度.结果 烧伤后6、24 和72 h 的TNF-α及IL-4 水平,A 组显著高于B组(P ＜0.05);血浆TNF-α及IL-4 水平,烧伤组与正常组比较差异无显著性.结论 烧伤能引起局部引流淋巴液致炎因子与抗炎因子水平升高,从而影响局部免疫.     

中医适宜技术在脑卒中后疲劳中应用的研究进展北大核心

对适用于脑卒中后疲劳病人的中医适宜技术进行综述,旨在为临床开展适合脑卒中后疲劳病人的中医适宜技术提供参考,为后续的相关研究提供依据和方向。     

脑卒中后疲劳危险因素及干预措施研究进展

就脑卒中后疲劳的危险因素和干预措施进行综述,以期为临床预防和治疗护理提供参考。     

脑卒中后疲劳相关因素与干预措施的研究进展

疲劳是脑卒中后常见症状,属于病理性疲劳,严重影响患者的康复训练和生活质量。其涉及的相关因素很多,主要包括生理和生化因素、睡眠障碍、脑卒中后抑郁、运动因素等,这些因素往往多个同时存在,相互影响,导致患者疲劳。目前干预措施主要包括营养支持、优化睡眠质量、适当运动、心理干预、健康教育、中医治疗等,其主要是针对相关因素而采取的干预措施,以达到缓解疲劳的目的,最终提高患者康复依从性和生活质量。     

全身炎症反应综合征患者致炎因子与抗炎因子的变化及相关性研究

目的 观察全身炎症反应综合征（SIRS）患者血浆中致炎因子肿瘤坏死因子－α（TNF-α）、白介素－6（IL－6）和抗炎因子转化细胞生长因子－β（TGF-β）、白介素－10（IL－10）的变化规律及其相关性。方法 符合SIRS诊断48例，分别在入院后第1、8小时和第2、3、4天清晨空腹抽肘静脉血3mL，测定TNF－α、IL－6、TGF－β和IL－10，并设对照组。结果 TNF－α和IL－6各监测点均比对照组显著升高（P＜0．05，P＜0．01），TGF－β和IL－10入院后第小时与对照组比较无显著差异，第8小时以后各监测点均比对照组显著升高（P＜0．05，P＜0．01），TNF－α和IL－6峰值出现早于TGF－β和IL－10，致炎因子与抗炎因子具有显著的相关性。结论 拮抗炎症因子的同时提高机体免疫功能，达到致炎因子与抗炎因子的平衡是治疗SIRS的新思路。     

脑卒中后疲劳的研究现状

疲劳是脑卒中常见症状,在康复过程中常表现为体力不足,不能坚持达到足够的时间和运动量,休息不能缓解,属慢性疲劳,伴有认知异常或过度。按病理学分类为生理、躯体、心理及精神疲劳,生理疲劳与肌肉力量相联系,躯体疲劳可由疾病引起,心理疲劳出现于认知过程,精神疲劳与缺乏兴趣和     

脑卒中后疲劳评估工具研究进展

介绍了脑卒中后疲劳(PSF)的评估研究进展,从常用的PSF评估量表、量表在国内PSF病人中的应用情况、量表选用的注意事项3个方面进行了综述.     

脑卒中后疲劳的研究现状分析

脑卒中是严重危害人类健康的常见病、多发病,为全球第二大致死性疾病,占全球死亡人数的11.8%,仅次于心脏病[1-2]。其并发症对患者后期功能恢复有显著影响,其中脑卒中后疲劳是最普遍、最直接的因素之一。疲劳是一种缺乏躯体和精神能量的主观感受和多维结构,常表现为精疲力竭,失去原本能完成活动或工作的能力,与个体的身体、情感和心理体验有关[3]。它是健康个体和患者都会存在的一种普通体验,但较之正常疲劳在休息后能够快速缓解不同,不正常的疲劳即使经过休息也不能得到缓解,通常被认为是病理性的[4]。而脑卒中后疲劳(Post-stroke fatigue,PSF)正是这种病理性、慢性、持续性的躯体乏力和精神乏力的综合征,是卒中后的幸存者中的一种常见且痛苦的经历,其发病率高居不下,持续时间可达2年以上,严重影响卒中患者的功能恢复及生活质量,并增加了卒中相关死亡率[5-6]。本文就卒中后疲劳评估方法、发病率、发病机制和治疗方法进行综述。     

脑卒中后疲劳评估工具研究进展

介绍了脑卒中后疲劳（PSF）的评估研究进展,从常用的PSF评估量表、量表在国内PSF病人中的应用情况、量表选用的注意事项3个方面进行了综述。     

电头针治疗闭塞性脑动脉炎的疗效及对致炎因子影响研究

目的:观察电头针治疗闭塞性脑动脉炎的临床疗效及对患儿致炎因子的影响.方法:选取2016年7月～2017年10月收治的闭塞性脑动脉炎患儿88例,随机分为对照组和研究组,各44例.对照组应用常规治疗,研究组应用电头针治疗.对比两组临床疗效,治疗前及治疗后Barthel指数评分、Fugl-Meyer运动功能评分、血清致炎因子...     

能量代谢在卒中后躯体疲劳中的应用进展

脑卒中患者常出现躯体疲劳的现象,导致康复训练积极性下降,影响恢复进程。本文介绍卒中后躯体疲劳产生的原因、临床表现和影响因素。脑卒中患者能量代谢升高,可能促进躯体疲劳,可通过一定干预加以改善。能量代谢在卒中后躯体疲劳中的应用有待进一步研究。     

Prevalence of Fatigue in Patients With Cancer: A Systematic Review and Meta-Analysis

ContextFatigue is a particularly common and troubling symptom that has a negative impact on quality of life throughout all phases of treatment and stages of the illness among patients with cancer.ObjectivesThe objective of this meta-analysis is to examine the present status of fatigue prevalence in patients with cancer.MethodsThe following databases were searched: PubMed, MEDLINE, EMBASE, PsycINFO, Cochrane Library, from inception up to February 2020. Prevalence rates were pooled with meta-analysis using a random-effects model. Heterogeneity was tested using I-squared (I²) statistics.ResultsA total of 129 studies (N = 71,568) published between 1993 and 2020 met the inclusion criteria. The overall prevalence of fatigue was 49% (34,947 of 71,656 participants, 95% CI = 45–53) with significant heterogeneity between studies (P < 0.000; τ² = 0.0000; I² = 98.88%). Subgroup analyses show that the prevalence of fatigue related to type of cancer ranged from 26.2% in patients with gynecological cancer to 56.3% in studies that included mixed types of cancer. In advanced cancer stage patients, the highest prevalence of fatigue (60.6%) was reported. Fatigue prevalence rates were 62% during treatment and 51% during mixed treatment status. The prevalence of fatigue decreased from 64% in studies published from 1996 to 2000 to 43% in studies published from 2016 to 2020. Metaregression identified female gender as a significant moderator for higher prevalence of fatigue, whereas mean age is not associated with fatigue.ConclusionThis meta-analysis highlights the importance of developing optimal monitoring strategies to reduce fatigue and improve the quality of life of patients with cancer.     

Fatigue and stroke.

Under disabling conditions such as stroke, fatigue may worsen other symptoms and impede full participation in a rehabilitation program. The functional improvement needed to regain mobility and independence may be impacted significantly by fatigue. This article explores the symptom of fatigue and its relation to stroke from a rehabilitation perspective. It examines theoretical models, operational definitions, fatigue as a response to stroke, assessment and measurement instruments, symptom management strategies, and future research directions.     

Fatigue in stroke rehabilitation patients: a pilot study

Background and Purpose. Stroke is the leading cause of adult disability. Rehabilitation is a vital component of post‐stroke care with two‐thirds of survivors requiring rehabilitation. Fatigue is a common issue affecting stroke patients and is a barrier to rehabilitation causing inefficient care provision and potential limitation to patient recovery. No study to date has investigated whether the experience of fatigue is different between the two main causes of ischemic stroke: small‐vessel (SVD) and large‐vessel disease (LVD). The aim of the present study is to complete a pilot study to inform the feasibility, design, magnitude of difference in experience of fatigue, and sample size for a definitive study to evaluate differences in fatigue between these two groups of stroke patients. The experimental hypothesis is that participants with LVD experience a significantly greater level of fatigue than those with SVD as assessed by the Fatigue Severity Scale (FSS). Methods. The study used a cohort observational design. Thirteen participants were recruited over a two‐month period from King's College Hospital. Participants were visited on average at the start of the second week of rehabilitation to complete the FSS. An independent t‐test and ANCOVA were performed. For all statistical analyses, a significance level of p < 0.05 was used. Results. The study demonstrated a trend towards LVD participants reporting higher fatigue scores than SVD participants, even when controlling for age, with gender having no confounding effect. Conclusions. Fatigue is common amongst ischemic stroke rehabilitation participants with 85% of the combined sample experiencing fatigue at the start of the second week. The results demonstrate a trend towards LVD participants experiencing greater fatigue. While the results were non‐significant, the study demonstrates a feasible methodology which could help lay the groundwork for future research. Copyright © 2010 John Wiley & Sons, Ltd.     

Cerebrospinal Fluid Cytokines and Neurotrophic Factors in Human Chronic Pain Populations: A Comprehensive Review

Chronic pain is a prevalent and debilitating condition, conveying immense human burden. Suffering is caused not only by painful symptoms, but also through psychopathological and detrimental physical consequences, generating enormous societal costs. The current treatment armamentarium often fails to achieve satisfying pain relief; thus, research directed toward elucidating the complex pathophysiological mechanisms underlying chronic pain syndromes is imperative. Central neuroimmune activation and neuroinflammation have emerged as driving forces in the transition from acute to chronic pain, leading to central sensitization and decreased opioid efficacy, through processes in which glia have been highlighted as key contributors. Under normal conditions, glia exert a protective role, but in different pathological states, a deleterious role is evident—directly and indirectly modulating and enhancing pain transmission properties of neurons, and shaping synaptic plasticity in a dysfunctional manner. Cytokines and neurotrophic factors have been identified as pivotal mediators involved in neuroimmune activation pathways and cascades in various preclinical chronic pain models. Research confirming these findings in humans has so far been scarce, but this comprehensive review provides coherent data supporting the clear association of a mechanistic role of altered central cytokines and neurotrophic factors in a number of chronic pain states despite varying etiologies. Given the importance of these factors in neuropathic and inflammatory chronic pain states, prospective therapeutic strategies, and directions for future research in this emerging field, are outlined.     

The Relationship Between Fatigue and Quality of Life in Children With Chronic Health Problems: A Systematic Review

PURPOSE: This systematic review synthesized the literature regarding fatigue in children with chronic health problems and examined the relationship to quality of life. CONCLUSIONS: Most studies that have examined fatigue and its relationship to quality of life in children with chronic health problems have focused on children with cancer. Studies found that children often reported fatigue and that it decreased quality of life. PRACTICE IMPLICATIONS: Quantifying fatigue in children with chronic illnesses and disabilities is critical for pediatric nursing assessment. Understanding the impact of fatigue on children with chronic health problems is a first step in improving their quality of life.     

补中益气汤对卒中后疲劳的疗效观察

目的探讨补中益气汤加减治疗卒中后疲劳的疗效.方法对60例卒中后疲劳患者给予补中益气汤加减连续治疗4周,参照<中药新药临床指导原则>制定疗效评定标准,根据症状改善情况对其进行疗效评价.结果 60例患者中,显效47例(78.33%),有效10例(16.67%),无效3例(5%),总有效率95%,全身乏力、纳差、肌肉酸痛等症状均有明显改善.结论补中益气汤加减治疗卒中后疲劳疗效显著,有利于康复治疗的顺利进行.     

囊性纤维化累及多系统一例

目的提高对囊性纤维化的认识。方法 2011年11月收治1例自幼有临床表现的囊性纤维化患者,回顾其诊断及治疗经过,复习相关文献总结其临床特征、诊疗进展及预后评价。结果囊性纤维化起病年龄较早,患者自幼年起即反复出现肺、消化道、肝脏等多系统病变,最终导致多器官功能衰竭。结论应提高对囊性纤维化的识别度,对于发病年龄过早、反复发作的严重支气管扩张,伴随生长发育延迟、肝硬化等临床征象应注意对囊性纤维化的筛查。     

异丙酚对高血压脑出血手术患者血清炎性细胞因子的影响

目的明确异丙酚对于高血压脑出血患者血清炎性细胞因子的影响。方法将2008年3月2009年3月收治的高血压脑出血患者47例分为两组,异丙酚组采用异丙酚、芬太尼、维库溴铵以及异氟醚诱导和维持麻醉;对照组采用依托咪酯、芬太尼、维库溴铵以及异氟醚诱导和维持麻醉。比较两组患者手术中不同时段血清白细胞介素（IL-6）、肿瘤坏死因子（TNF）、血栓素、内皮素、前列腺素E和降钙素水平。结果患者麻醉过程中生命体征平稳,无麻醉相关死亡。术前异丙酚组患者血清IL-6、TNF、血栓素、内皮素、前列腺素E和降钙素水平与对照组比较均无差异（P〉0.05）,而麻醉诱导后差异有统计学意义（P〈0.05）,而且差异随时间延长增大。结论采用异丙酚麻醉能降低术中血清炎性细胞因子水平。     

脑卒中后疲劳与康复

脑卒中后疲劳（PoSF）是脑卒中后的常见症状,表现为病理性疲劳,常常影响患者的日常生活活动和生活质量.PoSF是一个独立的、复杂的症状,与抑郁、年龄、病情等无必然联系.在康复过程中,应尽量避免生理因素和心理因素等诱因,正确评估PoSF,通过药物、饮食、提高睡眠质量、适当运动、健康教育等手段,调整和改善机体状况,为康复创造良好的条件.