ABSTRACT
We provided the palliative care of a multiple disciplinary team care mode to a patient diagnosed with advanced head and neck cancer and her caregivers.People-centered integrated health services were provided according to the specific needs and preferences of individuals.The team-based palliative care relieved the suffering and improved the quality of life of the patient and that of her family who were facing challenges associated with life-threatening illness.
Subject(s)
Humans , Female , Palliative Care , Quality of Life , Head and Neck Neoplasms/therapyABSTRACT
End-stage patients experience unbearable pain because of refractory symptoms.Palliative sedation is a form of palliative care which relieves patients' agony by lowering their consciousness.Standard palliative sedation can help patients die with dignity.It is distinct from euthanasia and does not alter the survival of patients.Sufficient palliative care is the premise of palliative sedation.Repeated and detailed clinical evaluation,as well as multidisciplinary involvement,is necessary for the standardized implementation of palliative sedation.Here,we proposed the standard process and specifications of palliative sedation in Peking Union Medical College Hospital.Furthermore,we reported a case of palliative sedation for an advanced cancer patient with refractory delirium and living pain to demonstrate its application in clinical practice.
Subject(s)
Humans , Anesthesia , Pain , Hospitals , Palliative Care , UniversitiesABSTRACT
<strong>Objective</strong> To evaluate the effects of ultrasound-guided transversus abdominis plane (TAP) block on postoperative analgesia and early recovery in patients undergoing retroperitoneoscopic urologic surgeries. <strong>Methods</strong> This was a randomized, controlled, double-blinded trial. Eligible patients scheduled for retroperitoneoscopic urologic surgeries were randomly assigned to two groups. Group TAP received ultrasound-guided TAP block with 0.5% ropivacaine 20 ml at 30 minutes before surgery, and Group C received TAP sham block with normal saline. All patients received retroperitoneoscopic urologic surgeries under general anesthesia. The primary outcome was the severity of pain after surgery. Secondary outcomes included opioids consumption, analgesics, postoperative nausea and vomiting, time to Foley catheter removal and to passage of flatus, length of post-anesthesia care unit stay and hospital stay. <strong>Results</strong> Eighty patients completed the study, forty cases in each group. Compared to the Group C, the Group TAP had lower visual analogue scale pain scores within two postoperative days (all P<0.05). They also had less consumption of intraoperative fentanyl (2.0±0.5 vs. 3.8±0.7 μg/kg, P<0.05), reduced incidence of postoperative rescue analgesic usage (12.5% vs. 45.0%, P<0.05), and lower incidence of postoperative nausea and vomiting within postoperative 48 hours (12.5% vs. 25.0%, P<0.05) when compared to the Group C. In addition, Group TAP had a shortened post-anesthesia care unit stay (25±8 vs. 49±12 minutes, P<0.05), and a greater proportion of patients discharged within postoperative three days (57.5% vs. 35.0%, P<0.05). <strong>Conclusion</strong> Preoperative ultrasound-guided TAP block is an effective technique to improve postoperative analgesia and early recovery in patients undergoing retroperitoneoscopic urologic surgeries.
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Abdominal Muscles , Diagnostic Imaging , Adrenalectomy , Double-Blind Method , Length of Stay , Nephrectomy , Nerve Block , Methods , Pain, Postoperative , Therapeutics , Ultrasonography, InterventionalABSTRACT
Objective To evaluate the effects of ultrasound-guided transversus abdominis plane (TAP) block on postoperative analgesia and early recovery in patients undergoing retroperitoneoscopic urologic surgeries. Methods This was a randomized, controlled, double-blinded trial. Eligible patients scheduled for retroperitoneoscopic urologic surgeries were randomly assigned to two groups. Group TAP received ultrasound-guided TAP block with 0.5% ropivacaine 20 ml at 30 minutes before surgery, and Group C received TAP sham block with normal saline. All patients received retroperitoneoscopic urologic surgeries under general anesthesia. The primary outcome was the severity of pain after surgery. Secondary outcomes included opioids consumption, analgesics, postoperative nausea and vomiting, time to Foley catheter removal and to passage of flatus, length of post-anesthesia care unit stay and hospital stay. Results Eighty patients completed the study, forty cases in each group. Compared to the Group C, the Group TAP had lower visual analogue scale pain scores within two postoperative days (all P<0.05). They also had less consumption of intraoperative fentanyl (2.0±0.5 vs. 3.8±0.7 μg/kg, P<0.05), reduced incidence of postoperative rescue analgesic usage (12.5% vs. 45.0%, P<0.05), and lower incidence of postoperative nausea and vomiting within postoperative 48 hours (12.5% vs. 25.0%, P<0.05) when compared to the Group C. In addition, Group TAP had a shortened post-anesthesia care unit stay (25±8 vs. 49±12 minutes, P<0.05), and a greater proportion of patients discharged within postoperative three days (57.5% vs. 35.0%, P<0.05). Conclusion Preoperative ultrasound-guided TAP block is an effective technique to improve postoperative analgesia and early recovery in patients undergoing retroperitoneoscopic urologic surgeries.
ABSTRACT
<p><b>OBJECTIVE</b>To explore the relationship between contractile characteristics and fiber type conversion in hind-limb unloading mice soleus.</p><p><b>METHODS</b>After 28-day hind-limb unloading and muscle atrophy, we used the method of isolated muscle perfusion with different stimulated protocols to determine the changes in contractile characteristics including the isometric twitch force and tetanus force and fatigue index of slow twitch muscle in mice. The muscle myofibrillar composition and fiber type conversion were detected by immunofluorescence staining and real-time PCR.</p><p><b>RESULTS</b>The isometric twitch force and the tetanus force and fatigue index were decreased progressively in 28-day unloaded mice soleus, with the increase in fast twitch fiber subtype and the decrease in slow twitch fiber subtype.</p><p><b>CONCLUSION</b>The alteration of contractile characteristics is relevant to the slow-to-fast fiber conversion in mice soleus after 28-day hind-limb unloading.</p>
Subject(s)
Animals , Mice , Hindlimb Suspension , Physiology , Mice, Inbred C57BL , Muscle Contraction , Physiology , Muscle Fatigue , Physiology , Muscle Fibers, Fast-Twitch , Physiology , Muscle Fibers, Slow-Twitch , Physiology , Muscle, Skeletal , Pathology , Physiology , Muscular AtrophyABSTRACT
<p><b>OBJECTIVE</b>To investigate molecular mechanisms underlying in the treatment of inflammatory bowel disease by Pulsatilla decoction.</p><p><b>METHODS</b>Wistar male rats were randomly divided into control group, model group, model + positive control group (mesalazine), traditional Chinese medicine treatment group, in addition, the Chinese medical treatment group was divided into middle and high dose group ( n = 8). Intragastric administration was used in the positive control group and traditional Chinese medicine treatment group. The expression of Smad7 and p-Smad3 in the colons were detected by immunohistochemistry and Western blot.</p><p><b>RESULTS</b>Compared with the model group, positive medicine and traditional Chinese medicine group, especially high-dose group, could effectively inhibit the expression of Smad7, while enhancing the p-Smad3 expression.</p><p><b>CONCLUSION</b>The activation of TGF-beta1/Smad3 signaling pathway may be the molecular mechanism underlying in the anti-inflammatory effect of inflammatory bowel disease by Pulsatilla decoction.</p>
Subject(s)
Animals , Male , Rats , Drugs, Chinese Herbal , Therapeutic Uses , Inflammatory Bowel Diseases , Drug Therapy , Phytotherapy , Pulsatilla , Chemistry , Rats, Wistar , Signal Transduction , Smad3 Protein , Metabolism , Smad7 Protein , Metabolism , Transforming Growth Factor beta1 , MetabolismABSTRACT
<p><b>OBJECTIVE</b>To investigate the molecular mechanisms underlying in the treatment of inflammatory bowel disease by Pulsatilla Decoction.</p><p><b>METHODS</b>Forty Wistar male rats were randomly divided into 5 groups( n = 8)control group, model group, model + positive control group (mesalazine), Pulsatilla Decoction treatment group, in addition, the Pulsatilla Decoction treatment group was divided into middle and high dose group. Intragastric administration was used in the positive control group and Pulsatilla Decoction treatment group. The expression of interleukin-1beta (IL-1beta), interleukin-6(IL-6) and tumor necrosis factor-alpha (TNF-alpha) were detected by real time PCR after extraction of RNA from colons.</p><p><b>RESULTS</b>Compared with the model group, positive medicine and Pulsatilla Decoction group, especially high-dose group, could effectively inhibit the expression of IL-1beta, IL-6 and TNF-alpha.</p><p><b>CONCLUSION</b>Pulsatilla Decoction could exert its effect in the treatment of inflammatory bowel disease by inhibiting the expression of proinflammatory cytokines.</p>
Subject(s)
Animals , Male , Rats , Drugs, Chinese Herbal , Pharmacology , Therapeutic Uses , Inflammatory Bowel Diseases , Drug Therapy , Metabolism , Interleukin-1beta , Genetics , Metabolism , Interleukin-6 , Genetics , Metabolism , Phytotherapy , Pulsatilla , Chemistry , RNA, Messenger , Genetics , Metabolism , Rats, Wistar , Tumor Necrosis Factor-alpha , Genetics , MetabolismABSTRACT
<p><b>OBJECTIVE</b>To study on visible display of Meridian on the dummy human body.</p><p><b>METHODS</b>Tube model-building method and computer technique were used, and data came from Voxel-Man dummy human body development platform.</p><p><b>RESULTS</b>The visual effect of re-building Meridian is very good and it can display the different layers of anatomic structures on the Meridian lines.</p><p><b>CONCLUSION</b>The visible display of Meridian on the dummy human body is preliminary realized, which provides data carriers for establishing the platform of Meridian study.</p>
Subject(s)
Humans , Human Body , MeridiansABSTRACT
<p><b>OBJECTIVE</b>To study the difference in the pharmacokinetics of emodin in Zhiganning capsules and Rhizoma Polygontum Cuspidatum by nonaqueous RP-HPLC.</p><p><b>METHOD</b>The rats were orally administered with the extraction of Rhizoma Polygontum Cuspidatum and Zhiganning capsules. After hydrolysis and extraction, the content of emodin in the plasma is determined by Nonaqueous RP-HPLC.</p><p><b>RESULT</b>The concentration-time profiles of emodin fit two-compartment model. The pharmacokinetics parameters including, t1/2alpha, AUC(0-infinity), CL(s) and C(max) of emodin in the group of Rhizoma Polygontum Cuspidatum were significantly different from these in the group of its compounds.</p><p><b>CONCLUSION</b>There is a significant difference in pharmacokinetics of emodin between zhiganning capsules and the extraction of Rhizoma Polygontum Cuspidatum.</p>