癌性疼痛患者药物止痛治疗依从性调查

目的 了解癌性疼痛患者对药物治疗依从性情况,为规范三阶梯止痛治疗提供指导.方法 采用调查研究方法,应用自制的调查问卷方式对178例癌性疼痛患者药物治疗的遵医行为进行调查,并分析影响其行为的因素.结果 178例癌性疼痛患者均不能正确遵医嘱进行治疗,主要是对药物止痛治疗知识缺乏,如恐惧药物依赖成瘾、担心药物影响肿瘤治疗、害怕药物不良反应,其次是对医护人员不信任及经济问题等.结论 癌性疼痛患者药物止痛治疗依从性有待提高,需医务人员关心体贴患者,加强止痛药物知识的宣教,消除患者的依赖成瘾恐惧感,及时处理药物不良反应;家庭及社会提供经济支持.     

保守疗法治疗腰椎间盘突出症的短期临床疗效分析

目的:分析保守疗法治疗腰椎间盘突出症的短期临床疗效。方法:选取2013年1月~2013年12月来我科就诊并采取保守疗法治疗的69例腰椎间盘突出症患者,对其临床资料进行回顾性分析。其中,37例采用了电针、推拿、中频、牵引和功能锻练等综合疗法(综合疗法治疗组),32例仅采用了药物治疗(单纯药物对照组),比较两组治疗前后的JOA评分及VAS疼痛评分,并比较其临床疗效。结果:治疗后,两组患者的腰椎功能JOA评分均较治疗前明显改善(P0.05),且综合保守治疗组的JOA评分明显高于单纯药物对照组(p0.05);两组患者的VAS疼痛评分均较治疗前明显降低(P0.05),且综合保守治疗组患者的VAS疼痛评分降低程度明显高于单纯药物对照组(P0.05)。单纯药物对照组的总有效率为71.87%,而综合保守治疗组的总有效率为91.89%,较单纯药物对照组显著升高(P0.05)。结论:与单纯药物治疗相比,采用综合保守疗法治疗腰间盘突出症的短期临床疗效更好,可更有效改善患者的腰椎功能并缓解其疼痛。     

基于专家问卷反馈的头痛活血化瘀药物功效强度及用药情况初探

目的:以专家临床经验为积淀,对治疗头痛活血化瘀药物功效强度的量化及用药规律进行初步的探讨。方法:基于专家咨询及中医传承辅助平台软件,将筛选出的活血化瘀中药的专家意见集中程度、协调程度、药物功效强度及常用度,采用Kmeans聚类分析法进行统计分析。结果:对于治疗头痛中活血化瘀功效较强的药物,专家意见在川芎、红花、莪术等,川芎、赤芍、桃仁等协调程度较高,川芎、当归、赤芍等活血化瘀功效较强且临床治疗血瘀头痛中较常使用。结论:对于活血化瘀药物在治疗头痛中的应用,应以辨证论治为先,活血化瘀药物可选择川芎、当归、赤芍等,结合疼痛不同部位选用引经药。此外,虫类药物在治疗血瘀头痛中起不可替代的作用。     

氨酚曲马多片治疗骨科术后疼痛的疗效观察

目的:对氨酚曲马多片治疗骨科术后疼痛的效果进行分析探讨。方法:选取我院2014年2月至2015年3月收治的100例骨科术后表示存在严重疼痛的患者作为本次研究的对象,将其随机分为实验组与对照组两组,实验组采用氨酚曲马多片对组内患者进行治疗,对照组采用药物成分及功能与之相似的药物产品法对组内患者进行治疗,待4天后,对两组患者去痛起效时间、用药不良反应进行对比分析。结果:实验组患者在抑制疼痛的效果上与对照组一致,止痛率为100%。结论:氨酚曲马多对骨科术后疼痛患者的止痛效果明显,安全性有所保障,具有临床应用价值与推广价值。     

子宫腺肌病小鼠的药物疗效及其疼痛机制

目的了解腺肌病小鼠药物治疗疗效及疼痛机制。方法他莫昔芬法建模。以不同药物治疗后,监测小鼠动情周期,检测5-HT、GnRH-R、NGF、NF的水平。结果对照组5-HT水平明显高于造模组。GnRH-R及NGF在正常内膜、在位内膜的表达显著低于异位内膜。NF在正常内膜的表达显著低于在位内膜、异位内膜。结论与全量抑那通相似,半量抑那通可减缓腺肌病进展,但对动情周期影响无明显优势。全量抑那通后使用达英-35可巩固疗效。5-HT可能在腺肌病疼痛机制中发挥作用。     

曲马多代谢相关基因多态性研究进展

盐酸曲马多是临床中常用的弱阿片类药物,用于治疗中度疼痛,其镇痛效果介于弱罂粟碱和吗啡之间,临床中用于术后疼痛、牙痛、和其他疼痛,镇痛效果明显,安全性好。但是由于曲马多各基因型对其药物代谢行为的影响,在临床使用中,曲马多的镇痛效果和不良反应个体差异大。为了研究对比不同种族之间曲马多代谢等位基因的分布情况,作者通过检索,对不同的人种CYP2D6的不同活性,不同人种决定该酶活性的等位基因频率,不同基因型对曲马多代谢行为的影响进行综述。     

风湿骨痛胶囊结合康复锻炼治疗早期骨关节炎的临床疗效

[目的]探究风湿骨痛胶囊结合康复训练治疗早期骨关节炎的临床疗效。[方法]本研究选取社区卫生服务中心收治的60例骨关节炎病例作为研究对象,将其分为三组,分别采用药物治疗、康复治疗、联合治疗等不同的措施实施干预。比较干预前后各组在疼痛、肌力、Womac评分方面的差异,比较不同干预措施的效果。[结果]三组患者治疗前、后都有显著差异,药物组与康复锻炼组之间无明显差异,但二者与联合组之间有明显差异。[结论]对于早期其膝关节炎患者,采取风湿骨痛胶囊结合康复训练方案进行治疗,效果显著,值得在社区医院加以推广应用。     

多瑞吉在带状疱疹疼痛治疗阿片类药物转换中的应用

目的:探讨多瑞吉在带状疱疹疼痛治疗阿片类药物转换中的应用。方法:选择37例住院治疗的带状疱疹疼痛患者,年龄>45岁、VAS评分≥4分、所有病人常规抗病毒治疗、增加免疫力等常规治疗,予硬膜外腔置管间断注入消炎镇痛药物并持续泵吗啡,根据疼痛调整至止痛剂量,转换为多瑞吉贴剂后出院。疼痛控制后逐渐减药,每半个月减量半贴多瑞吉,对病人的疼痛评分、生活质量及并发症进行评估。结果:有1例病人应药物副反应出组,其余病人硬膜外泵吗啡后均在一周左右控制疼痛,等效转换为多瑞吉,定时定量减药,无疼痛反复,成瘾戒断等情况。结论:带状疱疹疼痛采用硬膜外间断注药持续泵吗啡迅速达到无痛后,转换为等效剂量的多瑞吉,定时定量减药,安全有效。     

帕金森病衣架样疼痛及治疗策略

目的:衣架样疼痛(coat-hanger ache,CHA)是帕金森病(Parkinson disease,PD)疼痛的一个少见类型,本文研究帕金森病合并衣架样疼痛的血压状况及治疗策略。方法:本文以15例伴有CHA的PD患者为研究对象,以不伴有CHA年龄、性别大致匹配的PD病人为对照,观察两组病人卧立位血压的变化及CHA组直立后出现疼痛的时间和评分,找到相应的治疗措施。结果:CHA组伴有体位性低血压(orthostatic hypotension,OH)的比例为80%,明显高于对照组(33%),站立后出现疼痛的时间为7.2±1.2,疼痛评分为3.5±2.1,给予改善OH的物理及药物治疗,大部分DHA病人有效。结论:PD病人伴有CHA可能与OH有关,改善血压状况后部分有效。     

浅谈癌症疼痛的临床护理

本文探讨了肿瘤患者疼痛的有效护理措施。对癌症疼痛患者加强非药物止痛、药物止痛护理,心理护理以及控制疼痛的用药指导做了论述。指出加强癌症患者的心理护理及药物指导能有效的控制癌症疼痛,更好的配合治疗。     

Induction of dominant lethals with ethyl methane-sulfonate in male germ cells of mulberry silkwork, Bombyx mori l.

Sensitivity of male germ cells in the mulberry silkworm, Bombyx mori L., to ethyl methanesulfonate (EMS) was determined by treating newly emerged 5th- instar larvae, and 2-day- and 7-day-old pupae with 3 concentrations, 0.05, 0.1 and 0.15%, of the mutagen. The frequency of dominant-lethal mutations induced by EMS treatment was used as the parameter for the study. Spermatids and spermatozoa were markedly sensitive to EMS. Statistical analysis confirmed that differences in respect of percentage of egg hatch among the 3 different treatments as well as the interactions between the 3 factors, e.g. stages, hatchability and EMS treatment, were highly significant.     

EMS对三个玉米自交系的诱变效应分析

EMS诱变玉米花粉是玉米化学诱变的主要技术。该研究以生产上3个常用的玉米自交系K305、21-ES、R08为材料,对其花粉用不同浓度的EMS诱变处理,探讨其EMS诱变的最佳浓度范围,明确其诱变效应。结果表明：3个自交系经过不同浓度的EMS诱变后,其结实率随着浓度的增大表现出减小的趋势,从其半致死剂量来看,EMS诱变花粉的适宜浓度范围自交系K305和R08均为0.67~1.0 mL?L-1,21-ES在1.67 mL?L-1附近。 M1代不同性状其变异幅度和变异系数与对照相比主要表现出增大的趋势,其不同性状的生物学效应在材料间表现不一致,表明性状在不同材料间对EMS的敏感性不一样,生育期表现为21-ES>K305>R08;主要株型性状表现为R08>21-ES>K305;主要雄穗性状K305和21-ES比R08敏感;主要果穗性状表现为21-ES>K305>R08。 M2代整体表现为变异谱扩大,其株高、穗位高和叶面积以及主要果穗性状的变异表现复杂,主要雄穗性状中除K305的M2株系雄穗分枝数呈双向变异外,其余M2株系整体偏向于雄穗变短,雄穗分枝数减小。该研究结果为后续研究和应用打下了基础。     

环境监测植物豌豆根尖细胞的研究

本文通过不同浓度的甲基磺酸乙脂（ＥＭＳ）对豌豆根尖细胞微核的诱导,结果表明,豌豆根尖用作检测诱变剂是可行的。     

Fitness Effects of Ems-Induced Mutations on the X Chromosome of DROSOPHILA MELANOGASTER. I. Viability Effects and Heterozygous Fitness Effects

Drosophila melanogaster X chromosomes were mutagenized by feeding males sucrose solutions containing ethyl methanesulfonate (EMS); the concentrations of EMS in the food were 2.5 mM, 5.0 mM, and 10.0 mM. Chromosomes were exposed to the mutagen up to three times by treating males in succeeding generations. After treatment, the effective exposures were 2.5, 5.0, 7.5, 10.0, 15.0, and 30.0 mM EMS. X chromosomes treated in this manner were tested for effects on fitness in both hemizygous and heterozygous conditions, and for effects on viability in hemizygous and homozygous conditions. In addition, untreated X chromosomes were available for study. The viability and heterozygous fitness effects are presented in this paper, and the hemizygous fitness effects are discussed in the accompanying one (MITCHELL and SIMMONS 1977). Hemizygous and homozygous viability effects were measured by segregation tests in vial cultures. For hemizygous males, viability was reduced 0.5 percent per mM EMS treatment; for homozygous females, it was reduced 0.7% per mM treatment. The decline in viability appeared to be a linear function of EMS dose. The viabilities of males and females were strongly correlated. Heterozygous fitness effects were measured by monitoring changes in the frequencies of treated and untreated X chromosomes in discrete generation populations which, through the use of an X-Y translocation, maintained them only in heterozygous condition. Flies that were heterozygous for a treated chromosome were found to be 0.4% less fit per mM EMS than flies heterozygous for an untreated one.     

Cell transplantation for diabetes

For 30 years there has been experimental work aimed at transplanting islets for the treatment of diabetes with a view to curing the disease and preventing the secondary complications. Many technical difficulties were experienced, first in isolating the islets without damaging them, and second in finding a suitable place to inject them, but until recently the results of a vascularized pancreas transplant have been superior to islet transplantation. In 2000, the group in Edmonton, headed by Shapiro, published encouraging results using a different immunosuppression in transplanting patients earlier in the course of their disease than had been attempted previously. The results were excellent at a year and good at 2 years in patients with Type I diabetes, however there was the rather worrying attrition at five years. Nevertheless, the Edmonton observations were proof of concept and have intensified interest in treating diabetes and other diseases where a specific protein synthesis was required by cell transplantation and/or genetic engineering. The recent interest in embryonic stem cells extenuated these efforts and progress is being made in defining the difficulties, which are greater than most workers would have predicted.In this review, the subject is discussed explaining where progress needs to be made in order to provide treatment that would be of value to patients.     

The elimination of mutagenic lesions induced by alkylating agents and UV in V79 Chinese hamster cells

The mutagenicity of MNU, EMS, BMS and UV light was compared by analyzing the dose-response curve just before and after the replicative process of the HGPRT gene in synchronized V79 Chinese hamster cells. This system makes it possible to compare a 10-h period for repair of different mutagenic lesions with no time for repair. Additional time for repair in synchronized V79 cells resulted in a reduced response for MNU and UV, but not for EMS and BMS. This result suggests that an error-free repair process operates on mutagenic lesions in methylated DNA and on thymine dimers, but not on ethylated and butylated DNA. Based on these results, it is concluded that the repair capacity of V79 cells to remove mutagenic lesions is characterized as low for UV, moderate for MNU and not detectable for the mutagenic lesions induced by EMS and BMS.     

降血糖药物治疗对糖尿病动物模型及患者肠道菌群的影响

随着人们生活方式和饮食结构的改变,我国糖尿病的发病率呈逐年上升趋势。如何预防并有效治疗糖尿病成为医疗工作者们重要的研究课题。目前,药物治疗是糖尿病最常用、安全以及经济的治疗手段。近年来,肠道菌群成为人们研究的焦点,越来越多证据表明它与糖尿病的发生发展存在密切的联系。本文总结了双胍类、噻唑烷二酮胰岛素增敏剂类、α糖苷酶抑制剂类、二肽基肽酶-4抑制剂(DPP-4)和胰高血糖素样肽-1(GLP-1)类似物、促胰岛素分泌剂和中药及其制剂等降血糖药物对糖尿病动物模型及患者肠道菌群的影响,以期为糖尿病的预测、预防及治疗提供参考。     

Enhancing effects of cytosine arabinoside on ethyl methanesulfonate-induced 6-thioguanine resistance mutations in Chinese hamster V79 cells

We studied the synergistic enhancement effects of two chemicals which are different in their mechanism of action on DNA in cells. The test chemicals used were ethyl methanesulfonate (EMS) as an alkylating agent and cytosine arabinoside (Ara-C) as an analogue of cytidine. For determination of mutagenesis we measured the induction of resistance to 6-thioguanine (6-TG) in Chinese hamster V79 cells. EMS had a strong mutagenic effect on V79 cells, but for Ara-C the results were less clear. In this study, Ara-C had no detectable effect in inducing mutation up to a concentration of 5 X 10(-4) M. The mutation frequency of combined treatment with EMS and Ara-C was significantly higher than that obtained with EMS alone. These results indicate that Ara-C had an enhancing effect on mutations induced by EMS.     

Contaminants in biotechnologically manufactured l-tryptophan

The epidemic outbreak of a new disease, the eosinophilia-myalgia syndrome (EMS), was traced back to the intake of l-tryptophan (Trp) of certain lots from a single manufacturer. Since some trace contaminants were related to EMS, it appeared to be necessary to identify and find the origin of most trace contaminants in the EMS related Trp in order to apply this knowledge to a prospective manufacturing practice. Seventeen contaminants were determined in an implicated Trp lot by a single reversed-phase high-performance liquid chromatography run using UV and fluorescence detection. Most of these contaminants were classified as Trp metabolites, non-physiological oxidation or carbonyl condensation compounds of Trp. The amount and the pattern of contaminants were compared with recently manufactured Trp and Trp-containing preparations.     

Effect of ethylmethanesulfonate on Chlamydomonas reinhardi

Summary Ethylmethane sulfonate (EMS) is known to cause a considerably high mutation rate in higher plants. In our experiments with Chlamydomonas reinhardi however, the mutagenic effect was unexpectedly low, whereas the toxic effect was quite remarkable. It is supposed that the reason for the low rate of mutants is the high toxicity, since non-toxic EMS concentrations induce no mutants. The toxic effect on Chlamydomonas cells is caused not only by the products of hydrolysis of the EMS, but also by the EMS itself. The damaged cells begin to bleach, furthermore they are not able to deliver their daughter cells. To a certain degree both effects are reversible. Finally it was found that the sensivity to EMS was higher in cells of the mating type — than it was in those of the+mating type.