[Clinical observation of prophylactic lactulose for prevention of oral morphine-induced constipation].

OBJECTIVE: To evaluate the effects of different doses of lactulose on preventing oral morphine-induced constipation. METHODS: From January 2011 to May 2012, a total of 112 patients received oral lactulose solution to prevent morphine-induced constipation at our hospital and their clinical data were retrospectively analyzed. The doses of morphine were adjusted according to the pain scores and lactulose was taken simultaneously. There were 52 males and 60 females. They were randomized into Group 30 ml/d (n = 40), Group 60 ml/d (n = 43) and Group 90 ml/d (n = 29). The incidences of constipation and adverse reactions were obtained at 1 week after the start of medicine. The measurement data were analyzed with analysis of variance. And the enumeration data were analyzed with χ(2), Kruskal-Wallis and Mann-Whitney U tests. RESULTS: The incidence of constipation was 67.5% (27/40) in Group 30 ml/d, 46.5% (20/43) in Group 60 ml/d, and 37.9% (11/29) in Group 90 ml/d. And there were statistical differences (P = 0.036). The incidence of constipation in Group 30 ml was significantly higher than Group 90 ml/d (P = 0.015). No statistical difference existed in the incidence of constipation between Groups 30 ml/d and 60 ml/d (P = 0.054) or Groups 60 ml/d and 90 ml/d (P = 0.471). The incidence of vomiting was 34.5% (10/29) in Group 90 ml/d and it was significantly higher than 10.0% (4/40) in Group 30 ml/d (P = 0.013) and 9.3% (4/43) in Group 60 ml/d (P = 0.009). No statistical difference existed in the incidence of vomiting between Groups 30 ml/d and 60 ml/d (P = 0.915). The incidence of diarrhea was 17.2% (5/29) in Group 90 ml/d and it was significantly higher than 0 (0/40) in Group 30 ml/d (P = 0.007). No statistical difference existed in the incidence of diarrhea between Groups 30 ml/d and 60 ml/d (4.7% (2/43), P = 0.170) or Groups 60 ml/d and 90 ml/d (P = 0.072). CONCLUSION: The correct dosage of lactulose for the prevention of oral morphine-induced constipation is 60 ml/d.

[Cryosurgical ablation for 23 cases of prostate cancer guided by rectal ultrasound].

OBJECTIVE: To detect the short-term clinical and side effects of cryosurgical ablation for prostate cancer. METHODS: The ENDOCAm cryosurgical system with 2 mm Cryo-probes was used to treat the prostate cancer guided by rectal ultrasonic. 1. Completeness of freeze; 2. Complications; 3. The changes of PSA and PSMA before and after operation were observed respectively. RESULTS: 1. The completeness of freeze rate and non-completeness of freeze rate were 34.8% (8/23) and 65.2% (15/23) showed by MRI 3 weeks later after operation; the biopsy results showed that tumor positive rates in completeness of freeze group and non-completeness of freeze group were 0 and 20% (3/15) respectively after 6 months. 2. The incontinence rate was 13%, and all recovered during 1 month; and the erectile dysfunction rate post-operation was 56.2% (9/16). 3. The levels of PSA before and after cryosurgical ablation were (32.98 +/- 35. 50) microg/L, (11.65 +/- 26. 51) microg/L respectively (P < 0.05). PSMA increased significantly after the cryosurgical ablation. CONCLUSION: The short-term curative effects of cryosurgical ablation, which guided by rectal ultrasound for prostate cancer is satisfied with low complication rate and minor vulnus.

[Study on factors affecting the quality of life to cancer patients at the community level in Shanghai].

OBJECTIVE: A survey on cancer patients at the community level in Shanghai was performed, in order to study the factors affecting the quality of life (QOL) on them. METHODS: To evaluate the QOL of cancer patients, self-administered Functional Assessment of Cancer Therapy-General (FACT-G) questionnaire and personal interview methods were used. Data analysis was performed by SPSS software (SPSS,Chicago, IL), including one-way ANOVA and linear regression methods. RESULTS: There were 7580 valid questionnaires retrieved. Many factors were certificated to have significant relationship with QOL of cancer patients,such as family incomes, education, occupation, awareness of disease, physical exercise, cost of health care and pain (P < 0.01). Some factors however, only affecting certain aspects of the QOL, of which age, marriage state, type of tumor and stage were also noticed. KPS had strong Linear correlation with every aspect of FACT-G (P < 0.000). CONCLUSION: Patients having a poor KPS, metastasis, low educational level, divorced or lost of spouse, pain, poor income, little exercise and old age would tend to have a poor QOL outcome.