OBJECTIVETo study the effect of Shenfu injection (SF) treating cancer-related fatigue (CRF) of the patients with advanced carcinoma.

METHODFrom September 2005 to June 2009, 113 patients with advanced carcinoma who was treated in our department were selected, and were divided into test group and control group. The test group was treated with SF and common method, while the control group only was treated with common method. Three weeks later, CRF, hemoglobin (Hb), immune function, cardiac function and blood viscosity were compared between the two groups. Meanwhile, the correlations between CRF and the other indicators were analyzed.

RESULTThe test group was treated more effectively than the control group in some ways, such as relieving CRF, improving hemoglobin, some immune indicators, and cardiac function, and reducing blood viscosity. Moreover, CRF had negative correlation with Hb and cell-mediated immune, and had positive correlation with cardiac disfunction degree.

CONCLUSIONSF could relieve CRF of the patients with advanced carcinoma effectively by treating anemia and improving cell-mediated immune and cardiac function.

Adult ; Aged ; Aged, 80 and over ; Blood Viscosity ; drug effects ; Case-Control Studies ; Drugs, Chinese Herbal ; administration & dosage ; pharmacology ; therapeutic use ; Fatigue ; blood ; complications ; drug therapy ; physiopathology ; Female ; Heart ; drug effects ; physiopathology ; Hemoglobins ; metabolism ; Humans ; Injections ; Male ; Middle Aged ; Neoplasms ; complications ; pathology

Objective To investigate the effect of integrated traditional Chinese ( TCM ) and western medicine fast-track surgery ( FTS) in the perioperative management of laparoscopic cholecystectomy ( LC) .Methods One hundred and fifty patients with acute cholecysititis undergoing LC from June 2012 to January 2015, were recruited and divided randomly into 3 groups.Patients in group A (n=30) were treated with routine method in perioperative period, patients in group B ( n=60) were treated with western medicine FTS, and patients in group C (n=60) were treated with integrated TCM and western medicine FTS.The first exhaust time after operation, length of stay, times of clinic visit, symptoms, levels of IL-6, CRP and ALB, postoperative complications, readmission rate, reoperation rate, and patient satisfaction were evaluated in three groups.Results The first exhaust time after operation of group B and group C was earlier than that of group A [(25.16 ±8.36)h and (21.61 ±6.52)h vs.(36.06 ±10.88)h, P<0.05], and the first exhaust time of group C was earlier than that of group B (P<0.05).The length of stay of group B and group C were shorter than that of group A [(4.30 ±1.07)d and (3.98 ±1.16)d vs.(6.11 ±1.26)d, P<0.05].The nausea and vomiting, and abdominal distension of group C were lighter than those of group B [(0.27 ±0.08) vs.( 0.31 ±0.09); (0.35 ±0.09 ) vs.(0.40 ±0.13), respectively].There were no difference of the level of IL-6, CRP and ALB between group B and group C [(57.12 ±16.29) ng/L vs. (53.91 ±17.15) ng/L, (53.93 ±17.18) mg/L vs.(51.16 ±16.67) mg/L,(40.50 ±4.65) g/L vs. (41.01 ±4.60)g/L, respectively, all P<0.05].There was no difference among the three groups in the complication rate, readmission rate and reoperation rate(all P>0.05).Conclusion Integrated traditional Chinese and western medicine FTS in the perioperative period of LC can promote recovery, reduce symptoms and operation stress and maintain albumin level.

Objective To study the application value of traditional Chinese medical continuing nursing care in follow-up of patients with gastrointestinal carcinoma .Methods Sixty-four patients with advanced gastrointestinal carcinoma from September 2010 to January 2013 were randomly divided into the control group (n=31) and the experimental group (n =33).The control group received the routine follow-up, while the experimental group received routine follow-up plus traditional Chinese medical continuing nursing care including pressing the auricular point by magnetic beads , foot bath in the traditional Chinese medicine , massage at the plantar reflex zone and oral shiquandabu decoction .The quality of sleep , the intensity of pain , appetite and cancer-related fatigue ( CRF ) were evaluated before and four weeks after the follow-up in two groups. Results Before the follow-up, Pittsburgh sleep quality index (PSQI) was (10.39 ±3.84) in the control group, and (10.15 ±3.73) in the experimental group; the score of pain numerical rating scale was (2.26 ± 1.03) in the control group, and (2.21 ±1.05) in the experimental group;the cases of the mild, moderate and severe according to CRF score were respectively 8, 20, 3 cases in the control group , and respectively 10, 21, 2 cases in the experimental group , and the differences in the three indexes between two groups were not statistically significant (P>0.05).Four weeks after the follow-up, PSQI was (10.10 ±3.35) in the control group, and (8.48 ±2.50) in the experimental group, and the difference was statistically significant (t =2.170,P<0.05);the score of pain numerical rating scale was (2.19 ±0.83) in the control group, and (1.76 ±0.75) in the experimental group, and the difference was statistically significant (t =2.201,P <0.05);the cases of the mild, moderate and severe according to CRF score were respectively 11, 16, 4 cases in the control group , and respectively 20, 13, 0 cases in the experimental group , and the difference was statistically significant (Z =-2.330,P <0.05).Conclusions The traditional Chinese medical continuing nursing care can improve the symptoms in the follow-up of patients with advanced gastrointestinal carcinoma .

Objective:To investigate the value of abdominal ultrasound in the diagnosis of postpartum diastasis of the rectus abdominis muscle (DRA).Methods:A total of 300 pregnant women who received prenatal examination and finally gave birth in Wenzhou Hospital of Integrated traditional Chinese and Western Medicine between October 2018 and October 2020 were included in this study. All of them underwent finger test and high-frequency ultrasound to determine the degree of DRA. The occurrence of DRA was recorded. The efficacy of abdominal high-frequency ultrasound versus finger test in the diagnosis of DRA was analyzed. The high-frequency ultrasound outcomes regarding DRA distance at different positions and at different phases were compared between women with DRA and those without DRA. Results:The overall incidence of DRA among all women included in this study was 57.67% (173/300). The incidence of DRA in multiparae was significantly higher than that in primipara [73.38% (102/139) vs. 44.10% (71/160), χ2 = 26.20, P = 0.001). The incidence of DRA in women subjected to cesarean section was significantly higher than that in women subjected to vaginal delivery [68.52% (74/108) vs. 51.56% (99/192), χ2 = 8.14, P = 0.004). The sensitivity, specificity and accuracy of abdominal ultrasound in the diagnosis of DRA were 99.42%, 98.42% and 99.00%, respectively, which were significantly higher than those of finger test [80.35%,85.04%, 82.33%, χ2 = 34.61, 15.00, 49.23, all P < 0.01]. The DRA distances at different positions measured at 36 weeks of gestation and 2 weeks postpartum were significantly shorter in women with DRA than those without DRA ( t = 5.17-7.46, P < 0.001). Conclusion:Abdominal ultrasound is of high clinical application value in the early diagnosis and rehabilitation treatment of postpartum DRA.

Objective:To investigate the prevalence, risk factors and outcomes of diastasis recti abdominis (DRA) in multiparas after the second delivery.Methods:From June 2017 to September 2019, 300 multiparas with an average age of (31.7±4.0) years (26 to 43 years) after the second delivery were recruited at 6 weeks postpartum from two hospitals in Wenzhou. There were 171 multiparas with two natural births,36 multiparas with one natural birth and one caesarean delivery, and 93 multiparas with two caesarean deliveries. The interrectus distance (IRD) was measured with palpation at 6 weeks, 6 months and 12 months after delivery. Data on age, height, weight before pregnancy and delivery, baby′s birth weight, abdominal circumference before pregnancy and delivery, fetus number, delivery mode and occupation type were collected. Strength and endurance of abdominal muscle was assessed using manual muscle testing and curl-ups, low back pain was assessed using Oswestry disability index(ODI), urinary incontinence was assessed with International Consultation on Incontinence guestionnaire-incontinentia urinae (ICIQ-UI) short form (ICIQ-SF), and quality of life was assessed using 36-item short form health survey (SF-36).Results:Prevalence of DRA was 51.7%(155/300), 39.3%(116/295) and 27.7%(80/289) 6 weeks, 6 months and 12 months after delivery, respectively. Logistic regression analysis indicated that age ( OR=1.39, 95 %CI:1.02-1.91, P=0.38), abdominal circumference ratio ( OR=2.31, 95 %CI:1.23-4.33, P=0.01), twins ( OR=11.41, 95 %CI:2.15-60.76, P<0.01), and cesarean section ( OR=1.44, 95 %CI:1.06-1.95, P=0.02) were the risk factors of DRA at 12 months after delivery. At 12 months after delivery, the multiparas with DRA had weaker strength and endurance of abdominal muscle ( Z=-3.62, P<0.01; Z=-8.91, P<0.01), more serious low back pain ( Z=-2.10, P=0.04), and lower quality of life on physical health ( t=-3.34, P<0.01) than the multiparas without DRA. No difference in prevalence and severity of urinary incontinence and quality of life on psychological health was found when comparing multiparas with and without DRA (χ 2=0.66, P=0.42; Z=-1.18, P=0.24; t=0.91, P=0.36). Conclusion:Multipara after the second delivery has great likelihood for DRA.Age, abdominal circumference ratio, twins, and cesarean section are the risk factors of DRA. DRA is related to abdominal muscle dysfunction, low back pain, and quality of life.

Objective To investigate the expression level and correlation of β-catenin and neural cell adhesion molecule(NCAM) in thyroid carcinoma.Methods In this study,the expression levels of NCAM and β-catenin in thyroid carcinoma tissues (n=62) and thyroid adenoma tissues (n=44) collected from patients treated in Wenzhou Integrated Traditional Chinese and Western Medicine Hospital Affiliated to Zhejiang Chinese Medical University from Dec.2012 to Dec.2017 were detected by immunohistochemical staining,then its correlation with clinicopathological features was analyzed.Results The positive expression rate of NCAM in thyroid carcinoma tissues was significantly lower than that in thyroid adenoma tissues (12.90％ vs 90.91％,t=63.203,P=0.000).The positive expression rate of β-catenin protein in thyroid carcinoma tissues was significantly higher than that in thyroid adenoma tissues (82.26％ vs 6.82％,t=58.608,P=0.000).NCAM and β-catenin were negatively correlated in thyroid carcinoma tissues (r=-0.220,P=0.024).The difference of NCAM expression level was not significant among thyroid carcinoma patients with different gender,age,tumor diameter,histological type or pathological stage (t=1.960,0.054,3.335,0.807,0.218;P=0.162,0.816,0.069,0.848,0.641).The expression of NCAM in cancer tissues was significantly different in patients with different lymph node metastasis (t=8.373,P=0.004).The expression of β-catenin in cancer tissues was not significant in thyroid carcinoma patients with different gender,histological type,tumor diameter,age,lymph node metastasis or pathological stage (t=0.258,2.307,0.424,0.741,2.570,0.126;P=0.612,0.511,0.515,0.389,0.109,0.722).Conclusions In thyroid carcinoma patients,NCAM is down-regulated,and β-catenin is highly expressed.Moreover,the two indicators are negatively correlated.Additionally,NCAM expression is correlated with lymph node metastasis in thyroid carcinoma patients.

Objective To study the value of cooperative training for general hospital and community hospital based on network in improving the cancer pain management ability of community health care workers. Methods From January 2015 to May 2016, 60 community health workers were recruited as research subjects and randomly divided into experimental group and control group. The experimental group received the general hospital-community hospital cooperative network training, the control group accepted the traditional training methods. After the training, 180 cancer patients who were in the charge of the relevant community from June 2015 to December 2016 were selected as the study subjects. Patients in the control group and experimental group were randomly assigned to cancer pain management for 6 months. After 6 months, the pain management knowledge of two group nursing staff was compared. The NRSscores of two groups of patients, the satisfaction of medical staff and the quality of life of the patients were compared. Results In the aspect of cancer pain knowledge, the score of experimental group was significantly higher than that of control group (P＜0. 05). In both groups, NRSscore of experimental group was significantly lower than that of control group (P＜0. 05). The Chinese version of QLT-C30 V3. 0 in both groups showed that the experimental group was better than the control group(P＜0. 05) except for three aspects: shortness of breath, diarrhea and economic difficulty (P＞0. 05). Conclusion Cooperative training based on Internet can better improve cancer care management in community health care.

Objective To study the information need in early period and its influencing factors of craniocerebral injury patients′relatives. Methods A total of 180 patients′relatives from three general hospitals in Wenzhou were selected by stratified random sampling. Their information need was investigated by an original scale. The results were analyzed by statistical methods. Results The score of the scale was (21. 28 ± 2. 27). Within the dimensions, the highest and the lowest scores were (3. 56 ± 0. 31) and (2. 61 ± 0. 48), which were injury state and hospital rules, respectively. The relatives of patients who had been in hospital for less than three days had more information need on injury state, therapeutic measure, examination method, family cooperation and hospital rules than those of patients who had been in hospital for more than three days. The differences were statistically significant (P < 0. 05). The relatives of patients with severe craniocerebral injury had more information need on injury state, therapeutic measure, examination method, doctor and nurse competency, treatment cost and family cooperation than those of patients with mild and moderate craniocerebral injury. The differences were statistically significant (P < 0. 05). The relatives with high education degree had more information need on therapeutic measure, doctor and nurse competency and family cooperation than those with low education degree. The differences were significant ( P < 0. 05 ). The relatives′ satisfaction with the information provided by doctors and nurses was positively related to their satisfaction with total work of doctors and nurses (r=0. 495, P<0. 01). Conclusions The relatives of patients with craniocerebral injury have much information need. Patients′length of hospital stay and injury degree, and relatives′education degree may be the influencing factors of information need. Providing the relatives with the information need can improve their satisfaction with total work of doctors and nurses.

Objective To explore the effects of transitional care based on network cooperation in patients with gastrointestinal tumors surgery treated with nursing care according to fast track surgery (FTS). Methods A total of 120 patients with gastrointestinal tumors surgery were recruited as the study subjects from January 2012 to March 2015. They all received nursing care according to FTS in duration of hospital stay. They were divided into experimental group (transitional care based on network cooperation) and control group (traditionally transitional care by telephone of the general hospital + traditional community follow-up of the community hospital) in accordance with the random number table according to 1:1 proportions. The visit times,readmission rates,symptoms,anxiety,depression and satisfaction at the thirtieth day after surgery were compared between two groups.Results At the thirtieth day after surgery,the visit times of experimental group was less than that of control group with a significant difference (Z=-2.730,P=0.006). There was no significant difference in readmission rates between two groups (χ2=0.158,P=0.691). There was no significant differences in the incidence rates of pain,nausea and vomiting,the degree of abdominal distension between two groups (Z=-0.655,-0.356,-0.785;P=0.513,0.722,0.433). The scores of anxiety and depression of patients in experimental group were significantly lower than those in control group (t=-2.580,-2.380;P=0.011,0.019). The satisfaction with the general hospital and community hospital of experimental group was higher than those of control group with significant differences (Z=-2.133,-2.331;P=0.033,0.020).Conclusions The application of transitional care based on network cooperation after FTS on the stomach and intestine can nicely make patients to avoid unnecessary return visit in outpatient and emergency department,can meet the requirements of patients for social and mental support so as to make the general hospital and community hospital be recognised by patients.