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面向新世纪开创新局面
21世纪是人类生命科学时代(或者称健康科学时代),保护环境,保障安全,提高生命质量(the quality of life),促进健康,使人类社会进入可持续发展的知识经济时代.这表明人类即将告别为了发展经济而损害环境,导致环境病和职业病的工业革命时代.以研究人体中毒及其防治为主的毒理学开始转变为预防潜在毒性和提高健康机能的卫生毒理学(或称健康毒理学,health toxicology).
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中文版SF-36量表用于杭州市区居民生命质量研究
SF-36健康量表在欧美是一个普遍被认可的生命质量测评工具[1-4],它评价健康相关生命质量(health related quality of life,HRQoL)的8个方面,分属于“生理健康”和“心理健康”两个大类,即:生理功能(Physical functioning,PF)、生理职能(role-physical,RP)、躯体疼痛(bodily pain,BP)、总体健康(general health,GH)、活力(vitality,VT)、社会功能(social functioning,SF)、情感职能(role-emotional,RE)、精神健康(mental health,MH)。另外,SF-36量表还包括1项指标—健康变化(health transition,HT),用于评价过去1年内健康改变。作者将中文版SF-36健康调查量表用于杭州市区普通人群生命质量测定。
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Effect of Meridian Massage for Cancer Related Fatigue
The purpose of this study is to investigate the effectiveness of meridian massage in lessening the fatigue and improving both physical and mental quality of life of cancer patients. Settings and design: This study was conducted at the East-West Cancer Center at Daejeon University; Using a single-arm, waiting list and non-treatment control research design, we compared the results of control group and to that of the experimental group. Materials and methods: From July 2, 2007 to July 28, 2007, eighteen eligible cancer patients were recruited to participate in the experiment. Modified Chalder Fatigue Scale (CFS), Visual Analogue Scale (VAS) and active oxygen level were measured before and after treatment for both control and experimental groups. Lying on their back or stomach inside a room with a temperature of 18-2℃2, the patients received 30 minutes of meridian massages mainly around the trapezius muscles 5 times a week.Statistical analysis used: Data analysis was carried out using independent t-test, paired t-test and One-way ANOVA.Results: Data analysis of modified CFS showed statistically significant results for all groups between before and after treatment. Within CFS, results of physical and psychological analysis showed significant results for all groups except before and after no treatment and secondary treatment. In the analysis of VAS, the experimental group showed a greater decrease in score compared to that of the control group and the average difference was statistically significant (P<0.05). Although the results were not statistically significant (P>0.05), active oxygen levels for the control group showed little difference before and after no treatment (331.11 and 330.78, respectively) while the experimental group observed a decrease in active oxygen level before and after treatment (327.28 and 314.11, respectively). Conclusion: In conclusion, patients who received meridian massage showed decreased cancer related fatigue scores compared to the control. These results suggest that meridian massage may alleviate cancer-related fatigue and contribute to the improvement in quality of life among cancer patients.
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康莱特注射液结合中医辨证对晚期肺癌生存质量及免疫功能的影响
康莱特注射液是浙江康莱特药业有限公司生产的抗肿瘤中药制剂,临床主要用于肺癌及消化道肿瘤的治疗.我科近年来应用康莱特注射液治疗晚期肺癌取得了一定的疗效,现将观察结果报告如下.
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Chronic renal insufficiency is the result of renal injuries and progressive deterioration caused by various reasons. At the late stage, i.e. the period of uremia, it may be complicated with abnormalities of various systems. Along with the development and popularization of hemodialysis, the survival time of uremic patients can be prolonged, but uremic pruritus affects greatly the quality of life of the patients. For this purpose, we have treated 68 cases of the patients with acupuncture and western medicine respectively, and made clinical observations on the therapeutic results. A report follows.
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Primary osteoporosis, a commonly encountered metabolic bone disease in the postmenopausal women and the aged people, can be classified by modern medicine into postmenopausal osteoporosis (Type I) and senile osteoporosis (Type II). The disease seriously affects health and quality of life of the people as it often cause ostealgia, fracture and the secondary symptoms or diseases. Presently, the pharmacotherapy (including both Chinese herbal drugs and western drugs) remains the first among all other therapeutic methods which are mainly adopted in treatment of the disease at home and abroad. Studies related have been curried out quite early and systematically, and considerable progress has been made, but limit of the pharmacotherapy has also been found. Certain non-drug treatments (such as dietetic therapy, physical exercise, acupuncture and moxibustion, and qigong, especially acupuncture and moxibustion therapy, although with a late start, have been proved effective with satisfactory results. The following is a summary of all the contributions concerned.
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家属同步健康教育对帕金森病患者生活质量的影响
帕金森是好发于老年人的神经系统变性疾病,病理基础为中脑黑质多巴胺能神经元变性坏死导致患者慢性运动功能障碍,以静止性震颤、肌强直、步态障碍、动作迟缓和非运动症状为主要表现,严重影响其心理状态、生活能力和生活质量,也给家属带来沉重经济负担和精神压力[1]。健康教育是在常规治疗和康复的基础上给予患者医疗知识支持和更多人性化关怀以帮助其获得更好的治疗、康复效果,改善生活质量。由于帕金森患者生活自理能力部分丧失,家属陪护需承担更多的康复辅助责任,因而对帕金森护理和康复相关知识的需求很高[2]。本研究采用家属与帕金森患者同步健康教育的干预方式,探讨家属同步健康教育对提高帕金森患者康复效果和生活质量的作用。
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继发性残疾对康复和生活质量的影响
In this paper, we will discuss the consequences of secondary conditions and their impact on rehabilitation outcomes and quality of life for persons with disabilities. Health promotion as a preventive method for secondary conditions for persons with disabilities has not been a significant area of interest on the part of the general health care and rehabilitation services community in Western societies. In the U.S., after years of careful evaluation a shift in scientific and advocacy thinking has encouraged researchers, funding agencies, health care providers, rehabilitation professionals and persons with disabilities, as well as the consumers of health care services to prioritize future studies in this specific area and establishing quality health care and the best possible rehabilitation outcomes for millions of individuals with disabilities.
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创伤性脑损伤对儿童健康相关生存质量的研究进展
健康相关生存质量(health-related quality of life,HRQOL)是指在不同文化和价值体系中.个体由其生存的标准、期望、追求的目标所决定的、对目前生命状况的认知和满意程度[1].
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运动疗法在2型糖尿病并发症中的应用进展
随着肥胖的不断普遍化,2型糖尿病(type 2 diabetes mellitus,T2DM)也进入了一个空前流行的阶段,而由其引发的并发症也随之普及开来.有研究表明,近50%的成年糖尿病患者和近60%的老年糖尿病患者至少并发一种慢性疾病[1],而这类患者的健康状况往往不容乐观,其中的一些慢性疾病,如周围神经病变、骨质疏松、视网膜病变等,会直接影响患者的健康生活水平(health related quality of life,HRQL).另一方面,糖尿病患者与健康人群相比,更容易因患心血管疾病、肾病等并发症而增加死亡率.目前,糖尿病已经成为世界第四大致死疾病,如果不采取相应的行动,那么在下一个十年,与糖尿病相关的死亡率将增加50%[2].与此同时,糖尿病给个人、家庭、医疗机构和国家都带来了巨大的经济负担.2010年的报告指出,我国作为全球糖尿病患者(9240万)多的国家之一,用于糖尿病治疗的医疗经费开支占医疗总开支的13%,即达到了1734亿人民币[3],而且这个数字还会随着其他由并发症而引起的额外治疗费用而增加.因此,对于糖尿病及其并发症的治疗方法的开发与普及,已成为包括医学、人文社会学、经济学等在内的多学科领域迫切解决的问题.
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Effects of Standardized Rehabilitation on Quality of Life of Stroke Patients at Convalescence and Sequelae Stages
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晚期胰腺痛减黄术后化疗加肠外营养支持的随机对照研究
目的探讨营养支持在晚期胰腺癌姑息减黄术后化疗病人中的作用,及对病人的营养、免疫、生活质量及肿瘤疗效的影响.方法1996年1月至1999年1月,对有病理学诊断和术中临床分期的40例姑息减黄术后的进展期胰腺癌病人进行随机分组,.术后给予联合化疗(FCMP/A),或加用干扰素γ.联合化疗方案:5氟尿嘧啶300~400mg/m2,甲酰四氢叶酸钙200mg/次,24小时持续静脉滴注,分别在3、5、10、12天给予,丝裂霉素4~6mg/m2、顺铂或表阿霉素20~30mg/m2第一天静注.以上药物可根据病人化疗中反应情况适当调整.每21天为1周期,间歇1周重复,完成至少2个周期.干扰素γ300万IU/天,每周3次,共6周.评定疗效标准按WHO实体瘤疗效标准分为CR(完全缓解)、PR(部分缓解)、NC(无变化)、PD(进展).40例病人随机分为治疗组和对照组,治疗组为联合化疗加营养支持,共20例,其中男12例,女8例,中位年龄57.8(43~69)岁.对照组为联合化疗加常规治疗,共20例,其中男13例,女7例,中位年龄58.2(45~69)岁.肠外营养方案:每日静脉供给非蛋白(NPC)热量20Kcal·k8-1·d-1,热氮比125Kcal·kg-1·d-1,糖脂比6:4,治疗组接受肠外营养平均11.5天(8~15天).检验两组病人的营养、免疫状态,生活质量及化疗效果.结果治疗组的前白蛋白,转铁蛋白,视黄醇结合蛋白,外周淋巴细胞总数,自然杀伤细胞活性,白介素-2受体阳性细胞,生活质量评分,化疗药物毒性作用消失时间和生存时间均不同程度的优于对照组(P<0.05或P<0.01).非随机性对照使用干扰素未发现差异(P>0.05).结论对进展期胰腺癌姑息减黄术后的病人进行联合化疗,同时给予合理的营养支持能够提高营养、免疫水平,改善生活质量,延长生存时间,提高化疗效果.但是病人未能达到长期的无瘤生存.
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炎症性肠病患者的健康相关生存质量
健康相关生存质量(health-related quality of life,HRQOL)是一个多维的概念,包括生理、心理和社会功能,涉及到人们在生存中的文化和价值体系所反映出与其生存的目的、期望、标准及关注的关系[1].炎症性肠病(IBD)多发于青年人,病程冗长,长期的肠道和全身症状势必影响到患者的情感和社会能力.近年来国外文献中有数百篇关于IBD患者HRQOL的报道.主要集中于IBD患者HRQOL评价的工具,即IBD问卷(IBDQ)的制定及其信度和效度评价、IBD患者的HRQOL和各种治疗方法对IBD患者HRQOL的影响3方面.研究证实HRQOL是一个很好的指标,可用于临床科研中评价IBD患者生存的质量,指导临床医生对IBD患者的决策.国内目前尚未见相关报道.
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评估生命质量逐渐成为临床试验的新标准
把健康相关生命质量(health-related quality of life,以下简称生命质量)的评估作为一项重要的观察指标,日益成为随机对照临床试验和其他临床研究的新标准.临床试验不仅要回答治疗是否有效、花费效益比、佳治疗手段,还要回答治疗对生命质量的影响.
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Many institutions in Japan perform PCI via the radial artery(TRI), due to the adility of TRI to improve the quality of life of patients. However, this procedure involves the significant problem of causing narrowing of the radial artery or occlusion by trans-radial approach.
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强直性脊柱炎患者生存质量研究进展
强直性脊柱炎(ankylosing spondylitis,AS)是一种慢性炎症性脊柱关节炎,以骶髂关节的结构改变和脊柱受累为特征,早期以骶髂关节严重疼痛为主要症状,晚期会引起脊柱的疼痛、胸腰椎后凸畸形以及严重的功能障碍,随着疾病的进展还会引起社交功能以及心理健康的问题[1~3].对AS患者慢性功能损害及生存质量(quality of life,QoL)的评估能够指导临床资源分配、治疗策略的制定以及药物的使用[4~5].有研究使用通用量表和特定疾病量表来探讨AS患者的生存质量,而且发现有一些参数和QoL相关,甚至有一些可以用来预测QoL,这些参数包括:人口统计学参数、疾病参数、社会心理学因素以及AS诊疗的进展.笔者通过对AS患者QoL的文献回顾,总结AS患者QoL的影响因素以及分析与AS患者QoL相关或可以预测QoL的因素[6].
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肝移植受者健康相关生存质量评价
肝移植是治疗终末期肝病的主要手段[1].随着肝移植技术的日趋完善及医学模式的转变,人们对肝移植提出了更高的要求.简明健康调查量表(medical outcomes study short form 36,SF-36)是目前使用较多且普遍适用的生命质量量表之一[2].SF-36量表在20世纪90年代就已进入我国,并应用于普通人群及某些患者群.而针对我国肝移植受者健康相关生存质量(health-related quality of life,HRQOL)的研究报道较少.因此,我们从移植受者的临床特征、生存质量方面,重新审视肝移植的适应证以及医疗护理措施,为更好地开展临床肝移植提供一定的理论基础.
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儿童恶性实体瘤远期生存质量评估研究进展
近年来,我国部分地区报道儿童恶性肿瘤的发病率逐渐增高~([1-2]),其中很大部分是儿童恶性实体瘤患者.儿童常见的恶性实体肿瘤包括中枢神经系统肿瘤、神经母细胞瘤、肾母细胞瘤、横纹肌肉瘤、尤文肉瘤、生殖细胞瘤、骨肉瘤、视网膜母细胞瘤、肝母细胞瘤等.
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应用儿科哮喘生命质量调查问卷评估儿童哮喘吸入疗法
支气管哮喘是一种严重影响人们生活质量的慢性身心疾病.目前该病对生命质量的影响在国外备受关注,但国内此方面研究尚少.我们于2001年1~12月应用儿科哮喘生命质量调查问卷(pediatric asthma quality of life questionnaire,PAQLQ)对儿童哮喘治疗效果进行评估.