Persistent fatigue in liver transplant recipients: a two-year follow-up study

Background:  Fatigue after liver transplantation (LTx) is a major problem that is associated with lower daily functioning and health-related quality of life (HRQoL). This study aimed to assess changes over time in fatigue following LTx. We also examined daily functioning and HRQoL changes over time and assessed the influence of fatigue and changes in fatigue on daily functioning and HRQoL. We determined whether sleep quality, anxiety, and depression were associated with fatigue.
Methods:  We identified 70 LTx recipients who had previously participated in a cross-sectional study and reassessed them after two yr to determine changes in level of fatigue, daily functioning, and HRQoL. We also assessed sleep quality, anxiety, and depression after two yr.
Results:  Level of fatigue and level of daily functioning were unchanged at follow-up. HRQoL domains remained stable or worsened. Fatigue was a significant predictor of daily functioning and all HRQoL domains (p < 0.01). Change in fatigue was a significant predictor of daily functioning and the HRQoL domains of "physical functioning,""vitality," and "pain" (p < 0.05). Sleep quality, anxiety, and depression were associated with fatigue severity (r = 0.35 to r = 0.60, p < 0.05).
Conclusion:  This longitudinal study shows that fatigue is a chronic problem after LTx and that daily functioning and HRQoL do not improve over time. This study supports the need for intervention programs to address fatigue after LTx.     

Changes in fatigability of the striated anal canal after childbirth

Aim Anal manometry is an established assessment tool for patients with faecal incontinence. Fatigue rate index (FRI) has been shown to discriminate between symptomatic patients and controls. The aim of this study was to compare manometry and fatigability of the anal canal in nulliparous women before and after childbirth. Method An air‐filled manometry device was used to record maximum resting and squeeze pressures, fatigue rate (recorded over 20 s) and FRI. Recordings were made before and after vaginal delivery. Results Nineteen women were studied. Resting anal canal pressure was not significantly different before and after delivery (57.1 ± 13.6 vs 51.1 ± 11.9 cmH₂O, P = 0.1). Squeeze pressure was significantly lower postpartum (106.5 ± 43.6 vs 75.5 ± 45.6 cmH₂O, P < 0.001). Fatigue rate was significantly reduced postpartum (?129.5 ± 74.7 vs?76.1 ± 54.8 cmH₂O/min, P = 0.001), but FRI was not significantly altered (1.23 ± 1.49 vs 1.41 ± 1.27 min, P = 0.09). Conclusion Maximal squeeze pressure and fatigue rate of the anal canal are significantly reduced after childbirth. Resting anal canal pressure and FRI are not significantly different.     

Stress fractures of the anklein the athlete

Stress fractures of the ankle in the athlete are related to one of several proposed theories. Athletes sustaining these injuries usually participate in impact loading activities. The most common locations for stress fractures involving the ankle joint are the supramalleolar region of the fibula and the medial malleolus. Stress fractures of the distal fibula are usually treated conservatively with rest, activity modifications, and a short period of immobilization. Healing times and return to activity may take up to 12 weeks. Stress fractures of the medial malleolus have a higher rate of delayed unions and nonunions and require a higher degree of monitoring. Operative management has become an accepted method of treating stress fractures of the medial malleolus.     

正念训练干预对乳腺癌患者化疗后癌因性疲乏的研究

目的：探讨正念训练对乳腺癌患者癌因性疲乏（CRF）的影响。方法将2015年1～6月该院收治的200例中青年乳腺癌化疗患者分为观察组和对照组（各100例）,对照组给予常规护理,观察组在对照组的基础上给予正念训练,并参照癌症疲乏量表（CFS）评价患者的疲乏状况,并比较干预前后两组CRF各维度及总疲乏评分。结果乳腺癌术后化疗患者绝大多数存在疲乏症状,CRF发生率为97．0％,以中度疲乏为主,其次为轻度疲乏,重度疲乏最少。在第2次化疗时,两组患者躯体疲乏、认知疲乏、情感疲乏及总疲乏评分比较,差异均无统计学意义（P＞0．05）;第4、6次化疗时,观察组躯体疲乏、认知疲乏、情感疲乏及总疲乏评分均低于对照组,差异均有统计学意义（P＜0．05）。结论正念训练干预可以明显缓解患者的疲乏状态,提高患者的生活质量。     

综合护理干预对宫颈癌根治术后患者生活质量及癌因性疲乏的影响

目的：：探讨综合护理干预对宫颈癌患者行根治术后生活质量及癌因性疲乏的影响,促进患者康复。方法：选择符合标准的患者60例,随机分为观察组和对照组各30例,对照组给予常规护理,观察组行综合护理干预,采用癌症康复评价简表( CARES － SF)评估生活质量,Piper 疲乏评估量表(PFS)评价癌因性疲乏。结果：护理前,两组患者 CARES－SF 各维度评分比较,差异无统计学意义( P >0.05);护理后,观察组患者 CARES－SF 各维度评分均低于对照组,差异有统计学意义(P<0.05);较本组护理前,生理、心理社会、与医务人员的关系评分降低,性功能、婚姻关系评分增加,差异有统计学意义(P<0.05)。护理前,两组患者 PFS 各维度评分比较,差异无统计学意义(P >0.05);护理后,PFS 各维度评分较本组护理前均增加,但是观察组增加幅度低于对照组,差异有统计学意义(P<0.05)。结论：综合护理干预能改善宫颈癌根治术后患者生活质量,缓解癌因性疲乏程度。减轻了患者负性情绪,降低了不良反应发生率,缓解了患者癌因性疲乏,值得临床重视。     

舒适护理对结肠癌术后化疗患者康复效果及癌因性疲乏的影响研究

目的:探讨舒适护理对结肠癌术后化疗患者癌因性疲乏的影响. 方法:选择符合标准的患者60例,随机分为观察组和对照组各30例,两组患者均给予常规护理,观察组此基础上实施舒适护理,采用欧洲癌症研究与治疗组织( EORTC)编制的生活质量核心问卷( QLQ-C30)中的5个功能量表进行康复效果,癌因性疲乏采用简明疲乏量表( BFI )进行评价. 结果:术前,两组患者QLQ-C30功能量表各维度评分相似,差异无统计学意义( P>0.05);两个疗程化疗结束时,两组患者QLQ—C30功能量表各维度评分较术前增加,但是观察组各项指标评分明显高于对照组,差异有统计学意义( P<0. 05). 术前,两组患者BFI评分相似,差异无统计学意义( P>0.05);化疗第14天和第28天,两组患者BFI评分较术前均增加,但是观察组患者增加幅度小于对照组,差异有统计学意义( P<0.05). 结论:舒适护理可明显改善结肠癌术后化疗患者癌因性疲乏程度,促进患者术后康复,提高生活质量.     

中西医结合治疗脑卒中后疲劳疗效观察

目的:探讨运用中西医结合综合治疗脑卒中后疲劳的疗效。方法:对照组60例采用常规西医及康复治疗,治疗组60例在对照组基础上结合中医中药,治疗4周后分别观察巴塞尔指数(BI)、疲劳评定量表(FAI)改善情况,治疗前、后各评定1次BI和FAI,并比较其分值。结果:治疗后两种评分值均有改善,BI的分值治疗组治疗前后比较、治疗组与对照组比较均有非常高度显著性差异(P0.001);FAI的分值治疗组治疗前后比较有高度显著性差异(P0.01)、治疗组与对照组比较有显著性差异(P0.05)。结论:中西医结合综合治疗脑卒中后疲劳是有效的,能显著提高患者的日常生活能力并改善疲劳状态,值得进一步研究。     

王金贵教授从脏腑“左升右降”角度探讨津沽脏腑推拿治疗慢性疲劳综合征的相关性

慢性疲劳综合征(CFS)是以反复发作的持续疲劳为主症的一组证候群,西医认为其发病机制与心理因素、免疫功能失调、病毒感染等因素有关,主要依靠心理及生活方式干预进行治疗。中医认为慢性疲劳综合征属于"虚劳""郁证"范畴,其发病与五脏皆有关系。"左升右降"是在《内经》时期便初步萌芽的理论,其以五行思维总结了脏腑之间气机变化的关系以指导临床。王金贵教授以"左升右降"的气血运行方式为津沽脏腑推拿的指导理念,从整体治疗慢性疲劳综合征。     

近5年针灸推拿消除运动性疲劳研究进展

通过检索近5年来CNKI有关针灸推拿治疗运动性疲劳的研究报道,总结针灸推拿治疗运动性疲劳的疗效和机制,并阐明未来针灸推拿治疗运动性疲劳的研究方向.