Return to work of breast cancer survivors: a systematic review of intervention studies

Background  

Breast cancer management has improved dramatically in the past three decades and as a result, a population of working age women is breast cancer survivor. Interventions for breast cancer survivors have shown improvements in quality of life and in physical and psychological states. In contrast, efforts aimed at stimulating re-employment and return-to-work interventions for breast cancer survivors have not kept pace. The objective of this review was to study the effects and characteristics of intervention studies on breast cancer survivors in which the outcome was return to work.     

甲基强的松龙对嗅鞘细胞移植治疗受损视网膜神经节细胞的早期保护效应

目的:观察注射甲基强的松龙对嗅鞘细胞移植治疗受损视网膜节细胞的早期保护作用。方法:实验于2005-09/2006-09在北京大学医学部神经解剖实验室完成。实验动物分组:成年雄性SD大白鼠55只随机取出7只为正常对照组,不进行任何实验处理;其余48只为实验组,在手术显微镜下经动物的左侧眶上缘暴露视神经,然后将视神经鞘顺向划开,在距眼球后壁2mm处将视神经剪断。将实验组动物随机分成4组,每组12只:①损伤组。②静脉注射甲基强的松龙组,动物实施术后30min给予一次性尾静脉注射甲基强的松龙注射液(90mg/kg)。③嗅鞘细胞移植组,动物术后移植嗅鞘细胞组织层。④给药后嗅鞘细胞移植组,动物术后30min给予一次性尾静脉注射甲基强的松龙注射液(90mg/kg),然后移植嗅鞘细胞组织层。术后21d麻醉下处死各组大鼠。实验评估:通过视神经逆行荧光标记和蛋白免疫印迹方法观察视网膜神经节细胞存活状况以及热休克蛋白27表达情况。结果:55只SD大鼠均进入结果分析。①视网膜神经节细胞的存活数量:甲基强的松龙静脉注射组高于损伤组[(16.525±9.557),(9.889±5.585)个/视野,P<0.1],给药后嗅鞘细胞移植组明显高于甲基强的松龙静脉注射组和嗅鞘细胞移植组[(28.881±13.660),(16.525±9.557),(13.513±6.840)个/视野,P<0.1,<0.01]。②各组视网膜神经节细胞热休克蛋白27的表达:甲基强的松龙静脉注射组高于损伤组,给药后嗅鞘细胞移植组明显高于甲基强的松龙静脉注射组和嗅鞘细胞移植组。结论:早期注射甲基强的松龙使受损视网膜神经节细胞存活率升高,并使热休克蛋白27表达上调,同时亦表现出了对移植嗅鞘细胞移植治疗受损视网膜神经节细胞的显著保护效应。     

SEVENTY-TWO HOUR COMPARISON OF METHYLPREDNISOLONE SULEPTANATE AND METHYLPREDNISOLONE SODIUM SUCCINATE IN PATIENTS WITH ACUTE ASTHMA

SUMMARY The efficacy and safety of the methylprednisolone prodrugs methylprednisolone suleptanate and methylprednisolone sodium succinate were evaluated in a multicentre, randomised, double-blind, double-dummy parallel study of 88 patients hospitalised with acute asthma. Each study drug was administered as a bolus intravenous injection of 40mg methylprednisolone equivalents every 6 hours for 48 hours. Methylprednisolone 32mg was administered orally 6 hours after the last dose. Pulmonary function, medical events, and clinical laboratory values were assessed at predefined intervals before and during the 72-hour study. The primary response measure of pulmonary function was per cent predicted forced expiratory volume in one second (FEV₁) at 48 hours. Secondary response measures were peak expiratory flow rate (PEFR) and FEV₁/forced vital capacity (FVC) ratio. Although both drugs demonstrated within-group mean changes from baseline (starting at 6 hours) that were statistically significant for each response, there were no statistically significant differences between the two groups. The mean percent predicted FEV₁ at 48 hours and mean per cent change from baseline were 64% and 13% (p<0.0001) for the methylprednisolone suleptanate group and 67% and 17% (p<0.0001) for the methylprednisolone sodium succinate group, respectively. The mean PEFR and FEV₁/FVC ratio at 48 hours were 5.77 l/s and 73% for the methylprednisolone suleptanate group and 5.78 l/s and 76% for the methylprednisolone sodium succinate group, respectively. There were no clinically or statistically significant between-group differences in any of the safety parameters. In this study, methylprednisolone suleptanate and methylprednisolone sodium succinate have been shown to be therapeutically equivalent in the treatment of patients hospitalized with acute asthma.     

携带LacZ的腺病毒载体在牵引骨痂局部转染成纤维细胞和成骨细胞的表达

目的:利用小鼠胫骨牵引成骨动物模型,在牵引成骨过程中局部给予携带了LacZ的腺病毒载体后观察其表达情况,以探讨基因治疗促进骨折愈合的可行性。方法:实验于2004-10/2006-01在中南大学湘雅三医院完成。①实验分组:取雄性8周龄CD-1小鼠20只,随机数字表法分为实验组和对照组,每组各10只。②实验方法:所有小鼠接受左胫骨中上段骨干横行截骨安置特制延长外固定架,胫骨牵引过程包括5d静止期,10d牵引期,牵引速率为0.1mm/次,2次/d,共0.2mm/d。牵引期第7天实验组牵引骨痂局部注射5μL携带了LacZ的腺病毒载体,对照组局部注入等量未含LacZ腺病毒液。③实验评估:注射后第3天麻醉后杀取动物,采集左胫骨标本,分别作组织学检查和组织化学分析。结果:纳入小鼠20只,均进入结果分析。在牵引第10天,牵引骨痂中纤维间区形成,两端的新生骨由骨折两端中心生长延伸。骨髓腔内外可见大量新生骨形成。X-Gal底物染色显示,在实验组新生骨组织内可见大量细胞呈阳性染色;而对照组未发现阳性染色细胞。结论:在牵引成骨过程中,骨痂局部注射携带LacZ的腺病毒,能成功转染局部的成纤维细胞及成骨细胞,并表达LacZ基因,为临床应用基因治疗促进骨牵引延长或骨折愈合提供可行性。     

脑功能磁共振成像在针刺合谷、足三里与内关、三阴交穴位后的影像学特征变化比较

目的:利用功能磁共振技术观察针刺不同经脉的两组穴位后,人脑运动功能区的活动情况。方法:试验于2004-10/2006-06在中山大学附属第二医院进行。选取健康右利手志愿者11名,均为医学院学生。试验采用多组块设计,包括静息期和针刺期。每个受试者接受4次针刺,针刺穴位依次取右侧合谷、内关、三阴交、足三里穴,针刺同时采用荷兰飞利浦公司生产的Philips Intera1.5T超导型MR扫描仪进行功能磁共振扫描,两穴位刺激成像的间隔时间为15min。采用统计参数图进行数据统计学分析,用t检验分析,P<0.01的象素构成针刺激活的特异性脑区图。结果:11名受试者均进入结果分析。①针刺合谷穴引起平均信号强度升高脑区主要为双侧额中回,中央前后回、颞中上回,同侧楔前叶、岛盖以及对侧舌回、脑岛、顶下小叶。②针刺内关穴引起平均信号强度升高脑区主要为双侧额中回、尾状核、中央前后回、扣带回、颞中上回及对侧岛盖、缘上回、下丘脑、顶下小叶。③针刺足三里穴引起平均信号强度升高脑区主要为双侧颞中回、额中上回,同侧岛叶、枕上回以及对侧中央前后回、岛盖、角回。④针刺三阴交穴引起平均信号强度升高脑区主要为双侧颞中回、额下回、中央后回,同侧顶上小叶、岛叶及对侧中央前后回、顶下小叶。结论:在同一受试者,针刺不同穴位可引起相同部位脑功能区激活,不同人针刺相同穴位激活的脑功能区有一定差异,针刺效果可能并非通过单一脑功能区,而是通过有功能联系的多个脑功能区所形成的一个复杂的流动性网络的相互作用而实现的。