六味地黄汤加减治疗糖尿病疼性周围神经病变34例临床疗效分析

目的:探讨六味地黄汤加减治疗糖尿病疼性周围神经病变的临床疗效。方法:随机将我科68例糖尿病疼性周围神经病变患者随机分为对照组和治疗组,对照组常规使用降糖药、神经营养药等常规西药治疗,治疗组在对照组的基础上配合六味地黄汤加减治,两组患者均治疗2周为一疗程,三个疗程后对比疗效。结果:疗组总显效率为41.18%,明显优于对照组17.65%,P0.05;治疗组总有效率为94.12%明显优于对照组67.65%,P0.01(P=0.00551)。结论:六味地黄汤加减治疗糖尿病疼性周围神经病变明显改善了患者的症状,缓解了疼痛,解除了痛苦,缩短了治疗期,较大程度地控制了疾病的发展。     

Anti-Diarrheal Activity and Toxicity of Learng Pid Samud Recipe

Learng Pid Samud (LPS) recipe is a traditional remedy in Thai folk medicine to ease the common diarrhea. The anti-diarrheal potential of LPS recipe was herein examined in vitro using a guinea-pig ileum model. The LPS exerted an inhibitory effect on acetylcholine-induced smooth muscle contraction in the guinea pig ileum. Significantly, not only did the LPS reduce the total amount of feces in the induced diarrhea rats, but also the intestinal transit in the charcoal meal test. A single oral administration with the recipe at 5,000 mg/kg did not cause acute toxicity and the daily oral administration (1,000, 2,000 and 4,000 mg/kg) for 90 days in rats did not produce any toxic signs and symptoms. In conclusion, the Learng Pid Samud recipe remedy is evidently safe and effective for the anti-diarrheal treatment which supports its therapeutic uses in the alternative medicine.     

祛瘀消痛贴膏治疗癌性腹痛疗效观察

目的:观察祛瘀消痛贴膏治疗癌性腹痛的临床疗效及意义。方法:采用活血化瘀、散结止痛的中药止痛膏治疗癌性腹痛110例,观察患者止痛起效时间、持续时间、疗效和副作用。结果:用药7天,110例中CR 21例(19.09%),PR47例(42.73%),MR 30例(27.27%),NR 12例(10.91%),总有效率89.09%;起效时间最短1h,最长3h,平均起效时间1.5h。每副贴膏持续止痛时间最长可达24h,总无痛持续时间最短为4天,最长为7天。结论:祛瘀消痛贴膏治疗癌性腹痛副作用小、疗效可靠,值得进一步推广。     

预见性护理在慢性心力衰竭中的作用

目的探讨预见性护理在减少慢性心力衰竭(CHF)患者反复发作的应用效果.方法将90例在我科住院的CHF患者随机分为干预组和对照组各45例,对照组给予常规护理措施,干预组在此基础上给予包括饮食、卧位、用药、病情观察等综合的预见性护理,比较两组患者并发症的发生率和夜间阵发性呼吸困难发作次数、住院天数.结果干预组并发症发生率明显低于对照组,且住院天数及夜间阵发性呼吸困难发作次数差异有统计学意义(P<0.05).结论预见性护理可以减少CHF患者的反复发作次数,缩短住院天数,提高生活质量.     

Pain response measured with arterial spin labeling

The majority of functional MRI studies of pain processing in the brain use the blood oxygenation level‐dependent (BOLD) imaging approach. However, the BOLD signal is complex as it depends on simultaneous changes in blood flow, vascular volume and oxygen metabolism. Arterial spin labeling (ASL) perfusion imaging is another imaging approach in which the magnetically labeled arterial water is used as an endogenous tracer that allows for direct measurement of cerebral blood flow. In this study, we assessed the pain response in the brain using a pulsed‐continuous arterial spin labeling (pCASL) approach and a thermal stimulation paradigm. Using pCASL, response to noxious stimulation was detected in somatosensory cortex, anterior cingulate cortex, anterior insula, hippocampus, amygdala, thalamus and precuneus, consistent with the pain response activation patterns detected using the BOLD imaging approach. We suggest that pCASL is a reliable alternative for functional MRI pain studies in conditions in which blood flow, volume or oxygen extraction are altered or compromised. Copyright © 2013 John Wiley & Sons, Ltd.     

The traditional Japanese medicine hangeshashinto alleviates oral ulcer-induced pain in a rat model

ObjectiveRecent studies have demonstrated that mouthwash made with the traditional Japanese medicine hangeshashinto exhibits anti-inflammatory action and alleviates oral mucositis scores, including pain complaints, in patients undergoing chemoradiotherapy. However, no study has demonstrated the mechanism underlying how hangeshashinto provides pain relief in oral ulcers.DesignThe analgesic effects on pain-related behaviors following the topical application of hangeshashinto were evaluated in an oral ulcer rat model treated with acetic acid using recently developed methods. Indomethacin, the representative anti-inflammatory agent, was intraperitoneally administered. The tissue permeability of the oral mucosa was histologically evaluated after applying the fluorescent substance FluoroGold.ResultsThe topical application of hangeshashinto in ulcerative oral mucosa suppressed mechanical pain hypersensitivity over 60 min, without any effects on healthy mucosa. The same drug application also inhibited oral ulcer-induced spontaneous pain. Indomethacin administration failed to block the mechanical pain hypersensitivity, though it did largely block spontaneous pain. Topical anesthesia with lidocaine showed hyposensitivity to mechanical stimulation in healthy mucosa. In the ulcer regions in which the oral epithelial barrier was destroyed, deep parenchyma was stained with FluoroGold, in contrast to healthy oral mucosa, in which staining was limiting to the superficial site.ConclusionsHangeshashinto leads to long-lasting analgesic effects, specifically in the ulcer region by destroying the epithelial barrier. Hangeshashinto alleviates oral ulcer-induced pain in inflammation-dependent and/or independent manner.     

The effect of core stability and general exercise on abdominal muscle thickness in non-specific chronic low back pain using ultrasound imaging

Background: There is a controversy regarding whether core stability exercise (CSE) is more effective than general exercise (GE) for chronic LBP. To compare different exercises regarding their effect on improving back strength and stability, performance of abdominal muscles is a useful index. Ultrasound imaging for measuring muscle thickness could be used to assess muscle performance. Objective: The aim of this study was to compare CSE and GE in chronic LBP using ultrasound imaging for measurement of thickness of the deep stabilizing and main global trunk muscles in non-specific chronic LBP. Methods: Each program included 16 training sessions three times a week. Using ultrasound imaging, four transabdominal muscle thickness were measured before and after the intervention. Disability and pain were measured as secondary outcomes. Results: After the intervention on participants (n = 43), a significant increase in muscle thickness (hypertrophy) was seen only in right and left rectus abdominis in the GE group, but significant difference to the CSE group was only on the right side. Disability and pain reduced within the groups without a significant difference in the change between them. Conclusions: The present results provided evidence that only GE increased right and left rectus muscle thickness. The only significant difference between CSE and GE groups was the right rectus thickness. As rectus is a global muscle, the effect of GE on strength improvement (one side stronger than the other) may have a negative effect on motor control of lumbopelvic muscles and possibly increase the risk of back pain occurring or becoming worse, though this was not observed in the present study.     

小剂量舒芬太尼在剖宫产术麻醉中预防寒战和牵拉痛的临床观察

目的：观察小剂量舒芬太尼在剖宫产术麻醉中预防寒战和牵拉痛的临床效用。方法选择2012年1月~2013年1月在我院行剖宫产术的产妇52例作为研究对象。随机分为两组：舒芬太尼组和常规麻醉组，每组26例。舒芬太尼组用药情况为：0.75%布比卡因1 mL、舒芬太尼5μg、10%葡萄糖0.5 mL；常规麻醉组用药为0.75%布比卡因1 mL、10%葡萄糖0.5 mL。观察两组产妇术前术后的心率、新生儿Apgar评分、寒战和牵拉痛情况。结果两组产妇术前、术后心率、新生儿Apgar评分比较无统计学意义；寒战和牵拉痛发生率比较有统计学意义。结论小剂量舒芬太尼在剖宫产术麻醉中可降低寒战和牵拉痛的发生率，并且是安全的。     

Neighbourhood characteristics and 10-year risk of depression in Canadian adults with and without a chronic illness

The neighbourhood environment could play a role in the risk of depression in adults and those with a chronic illness. We investigated the effects of a range of neighbourhood characteristics on the 10-year risk of depression in a representative sample of 9026 Canadian adults and subsamples with a chronic condition. Characteristics of neighbourhoods were not significantly related to the risk of depression in the general sample and subsamples with a chronic condition. However, residing near a park was significantly associated with a lower risk of depression for people living in crowded households, and having a local health service nearby was protective for those living in materially deprived neighbourhoods. Living in a neighbourhood that was both socially advantaged and offered cultural services was also associated with lower risk of depression. Additional research is needed for smaller effect size detection. Future intervention research is warranted for health policy recommendations.     

The effects of dynamic hyperinflation on CT emphysema measurements in patients with COPD

ObjectivesDynamic hyperinflation (DH) significantly affects dyspnea and intolerance to exercise in patients with chronic obstructive pulmonary disease (COPD). Quantitative computed tomography (QCT) of the chest is the modality of choice for quantification of the extent of anatomical lung damage in patients with COPD. The purpose of this article is to assess the effects of DH on QCT measurements.MethodsThe study sample comprised patients with Global initiative for Chronic Obstructive Lung Disease (GOLD) stages III and IV COPD referred for chest CT. We examined differences in total lung volume (TLV), emphysema volume (EV), and emphysema index (EI) determined by QCT before and after DH induction by metronome-paced tachypnea (MPT). Initial (resting) and post-MPT CT examinations were performed with the same parameters.ResultsImages from 66 CT scans (33 patients) were evaluated. EV and EI, but not TLV, increased significantly (p < 0.0001) after DH induction.ConclusionQCT showed significant increases in EV and EI after MPT-induced DH in patients with GOLD stages III and IV COPD. For longitudinal assessment of patients with COPD using QCT, we recommend the application of a pre-examination rest period, as DH could mimic disease progression. QCT studies of the effects of DH-preventive therapy before exercise could expand our knowledge of effective measures to delay DH-related progression of COPD.