Background Subjective assessment tools such as visual analog scales （VAS） or pain scores are commonly used to evaluate the intensity of chronic cancer-induced pain.However,their value is limited in some cases.We mea...Background Subjective assessment tools such as visual analog scales （VAS） or pain scores are commonly used to evaluate the intensity of chronic cancer-induced pain.However,their value is limited in some cases.We measured changes in VAS pain scores and salivary a-amylase （sAA） concentrations in cancer patients receiving radiotherapy for bone metastases to ascertain the correlation between these measures.Methods We enrolled 30 patients with bone metastases attending a single institution from June 2010 to March 2011.All patients with cancer-induced bone pain received radiation therapy （RT） at the same dose （30 Gy） and fractionation （3 Gy/ fraction,5 days/week） for palliative pain relief.We assessed heart rate （HR）,systolic and diastolic blood pressures （DBP/SBP） and VAS pain scores before （d0） and after five （d5） and ten fractions （d10） of irradiation,sAA and salivary cortisol （SC）concentrations were measured using a portable analyzer and automated chemiluminescence analyzer,respectively.Results Radiotherapy markedly decreased VAS scores from （82.93±9.29） to （31.43±t16.73） mm （P ＜0.001） and sAA concentrations from （109.40±26.38） to （36.03±19.40） U/ml （P ＜0.001）.Moreover,there was a significant correlation between these two indices （P ＜0.01,r=0.541）.HR decreased by 6.5％ after radiotherapy,but did not correlate with VAS scores （P ＞0.05）.SC concentrations and BP did not change significantly during the study （P ＞0.05）.Conclusions The significant correlation between sAA concentrations and VAS pain scores identified in these preliminary results suggests that this biomarker may be a valuable,noninvasive and sensitive index for the objective assessment of pain intensity in patients with cancer-induced bone pain.展开更多
目的 :自控式镇痛泵(patient controlled analgesia,PCA)联合持续鞘内药物输注系统(intrathecal drug delivery system,IDDS)用于肺癌骨转移性癌痛(bone metastasis cancer pain of lung cancer)的镇痛疗效观察。方法:选择2017年11月至2...目的 :自控式镇痛泵(patient controlled analgesia,PCA)联合持续鞘内药物输注系统(intrathecal drug delivery system,IDDS)用于肺癌骨转移性癌痛(bone metastasis cancer pain of lung cancer)的镇痛疗效观察。方法:选择2017年11月至2018年11月就诊于郑州中心医院康欣舒缓病区的肺癌骨转移性癌痛患者为研究对象。根据入组标准从中选择30例,随机数字表法分为2组。观察组:植入IDDS,并外接PCA,持续吗啡注射液泵注,泵注速度(m L/h)=日初始剂量(mg)/(浓度·24),不低于0.1 m L/h。对照组:口服吗啡缓释片为主,吗啡注射液皮下应用处理暴发痛。在所有患者入组后规范化镇痛治疗前(T1)、治疗后3 d(T2)及治疗后1周(T3),分别记录其数字评分法(numerical rating scale,NRS)得分和吗啡日用量,测定患者唾液α-淀粉酶(salivaryα-amylase,SAA)活性。同时观察2种镇痛方式的不良反应。结果:通过重复测量分析,2组病例的NRS、SAA活性均随治疗的进行而逐渐下降,观察组的吗啡日用量随治疗的进行而逐渐下降;且所有指标在相邻时间点的下降差异有统计学意义(P<0.05);不同治疗方式之间有统计学差异(P<0.05)。鞘内持续用药不良反应少(P<0.01)。结论:与口服吗啡相比,IDDS联合PCA吗啡泵注可使肺癌骨转移性癌痛更快速、更大程度地缓解,显著改善患者焦虑和应激状态,且吗啡用量小,不良反应少。展开更多
Background and Aims: This study examined the stress levels, the stressors and biomarker such as Alpha (α)-Amylase enzyme which is secreted under distress conditions. The aim was to determine the relationship between ...Background and Aims: This study examined the stress levels, the stressors and biomarker such as Alpha (α)-Amylase enzyme which is secreted under distress conditions. The aim was to determine the relationship between these three variables. Methods: The study respondents were made up of cancer outpatients from 3 hospitals namely the Hospital Kuala Lumpur, Seberang Jaya and Johor Baru, Pantai Ipoh and Putrajaya. The Personal Stress Inventory (PSI) questionnaire was used to identify stressors, while the Hospital Anxiety and Depression Scale (HADS) were used to determine the psychological distress levels. The Salimentary Oral Swab (SOS) Technique was used to collect the saliva and then the Salivary α-Amylase Assay Kit was used to analyse for α amylase. Results: The majority of respondents were stressed due to their sensitive emotion and nervousness in their daily lives (68.7%), they had poor memory and short attention spans of carrying out job tasks (67.3%) as well as they were emotionally depressed (65.3%). Their poor memory and short attention span (p = 0.037), heavy work load and poor task delivery (p = 0.008) were predictors for distress using HADS. The salivary α-amylase concentration was significantly related to the stress levels (p = 0.002). Conclusion: Breast cancer respondents with musculoskeletal system related symptoms, with heavy work load and poor task delivery, as well as had poor memory and short attention span were at higher risk of experiencing psychological distress. The salivary α-amylase which had significant relationships with psychological distress was therefore, a potential biological indicator for distress, while the musculoskeletal system related symptoms from the PSI questionnaire were predictors for distress.展开更多
Aim: Whole body vibration (WBV) is thought to improve blood flow and autonomic balance and thereby induce a relaxation effect, which suggests its use for stress management. However, the relaxation effect of WBV traini...Aim: Whole body vibration (WBV) is thought to improve blood flow and autonomic balance and thereby induce a relaxation effect, which suggests its use for stress management. However, the relaxation effect of WBV training has not been objectively evaluated thus far. The purpose of this study was to determine the biological response to WBV training by measuring peripheral blood flow and salivary components using non-invasive techniques. Methods: Participants included 10 healthy volunteers (7 men, 3 women;mean age 33.8 ± 2.3) who provided oral consent and served as their own control. Each participant performed 15 types of stretching exercises for 10.5 min on the Power Plate? and cutaneous blood flow and salivary components were measured before and after the exercise. One week later, all participants performed the same exercise regimen for 10.5 min on a non-vibratory plate, and blood flow measurement and salivary tests were performed in a similar manner. Cutaneous blood flow was measured in the 4th digit for 1 min using the laser speckle flowgraphy. Saliva samples were evaluated for cortisol levels and α-amylase activity. To determine the effects of stretching exercises on the Power Plate? vs a non-vibratory plate, the differences in pre- and post-exercise peripheral blood flow, salivary cortisol levels, and salivary α-amylase activity were statistically evaluated by the t-test. Results: Mean blood flow before and after the exercise on the Power Plate? was 122.0 ± 54.2 and 156.7 ± 51.2, respectively;on a non-vibratory plate, blood flow was 136.6 ± 47.9 and 146.3 ± 38.3, respectively. The differences in pre-exercise and post-exercise values of the two training methods were not significant (p = 0.215). Mean cortisol levels before and after the exercise on the Power Plate? were 266.6 ± 125 and 204.9 ± 61.6, respectively;on a non-vibratory plate, the levels were 439.0 ± 121.7 and 425.8 ± 118.8, respectively. The differences in pre-exercise and post-exercise values of the two training methods were not significan展开更多
The psychological stress of most perioperative patients has been reduced by many interventions. In order to evaluate the effects of these interventions, biomarkers are being considered as objective assessment tools in...The psychological stress of most perioperative patients has been reduced by many interventions. In order to evaluate the effects of these interventions, biomarkers are being considered as objective assessment tools in addition to the subjective assessment tools. It has been thought that salivary α-amylase (sAA) activity is associated with sympathetic nervous system activity, which reflects psychological stress. We examined the relationship between sAA, self-reported data, and autonomic nervous system activity to assess the reliability of sAA as a marker for relaxing response in surgery-related stress. The sAA, the State anxiety, Visual Analogue Scale (VAS) of pain, and heart rate variability were used to assess prior to and after the relaxation on the day before surgery, and on postoperative days (POD) 1, 2, 3, and 7. A total of 75 patients participated and 301 relaxing response readings were obtained. We found that the sAA significantly decreased depending upon the pain and anxiety by relaxation, but they were unrelated to sympathetic nervous system activity. There was weak correlation between the change in sAA, and anxiety and VAS pain. Thus, sAA appears to be an easy-to-use, non-invasive and good marker for relaxing response within a short period in surgery-related stress patients.展开更多
基金This study was supported by grants from the Natural Science Foundation of Shandong Province （No. 2010ZRE27212）, Science and Technology Development Planning of Shandong Province （No. 2012GGE27122 and No. 2012GSF 11834）.
文摘Background Subjective assessment tools such as visual analog scales （VAS） or pain scores are commonly used to evaluate the intensity of chronic cancer-induced pain.However,their value is limited in some cases.We measured changes in VAS pain scores and salivary a-amylase （sAA） concentrations in cancer patients receiving radiotherapy for bone metastases to ascertain the correlation between these measures.Methods We enrolled 30 patients with bone metastases attending a single institution from June 2010 to March 2011.All patients with cancer-induced bone pain received radiation therapy （RT） at the same dose （30 Gy） and fractionation （3 Gy/ fraction,5 days/week） for palliative pain relief.We assessed heart rate （HR）,systolic and diastolic blood pressures （DBP/SBP） and VAS pain scores before （d0） and after five （d5） and ten fractions （d10） of irradiation,sAA and salivary cortisol （SC）concentrations were measured using a portable analyzer and automated chemiluminescence analyzer,respectively.Results Radiotherapy markedly decreased VAS scores from （82.93±9.29） to （31.43±t16.73） mm （P ＜0.001） and sAA concentrations from （109.40±26.38） to （36.03±19.40） U/ml （P ＜0.001）.Moreover,there was a significant correlation between these two indices （P ＜0.01,r=0.541）.HR decreased by 6.5％ after radiotherapy,but did not correlate with VAS scores （P ＞0.05）.SC concentrations and BP did not change significantly during the study （P ＞0.05）.Conclusions The significant correlation between sAA concentrations and VAS pain scores identified in these preliminary results suggests that this biomarker may be a valuable,noninvasive and sensitive index for the objective assessment of pain intensity in patients with cancer-induced bone pain.
文摘目的 :自控式镇痛泵(patient controlled analgesia,PCA)联合持续鞘内药物输注系统(intrathecal drug delivery system,IDDS)用于肺癌骨转移性癌痛(bone metastasis cancer pain of lung cancer)的镇痛疗效观察。方法:选择2017年11月至2018年11月就诊于郑州中心医院康欣舒缓病区的肺癌骨转移性癌痛患者为研究对象。根据入组标准从中选择30例,随机数字表法分为2组。观察组:植入IDDS,并外接PCA,持续吗啡注射液泵注,泵注速度(m L/h)=日初始剂量(mg)/(浓度·24),不低于0.1 m L/h。对照组:口服吗啡缓释片为主,吗啡注射液皮下应用处理暴发痛。在所有患者入组后规范化镇痛治疗前(T1)、治疗后3 d(T2)及治疗后1周(T3),分别记录其数字评分法(numerical rating scale,NRS)得分和吗啡日用量,测定患者唾液α-淀粉酶(salivaryα-amylase,SAA)活性。同时观察2种镇痛方式的不良反应。结果:通过重复测量分析,2组病例的NRS、SAA活性均随治疗的进行而逐渐下降,观察组的吗啡日用量随治疗的进行而逐渐下降;且所有指标在相邻时间点的下降差异有统计学意义(P<0.05);不同治疗方式之间有统计学差异(P<0.05)。鞘内持续用药不良反应少(P<0.01)。结论:与口服吗啡相比,IDDS联合PCA吗啡泵注可使肺癌骨转移性癌痛更快速、更大程度地缓解,显著改善患者焦虑和应激状态,且吗啡用量小,不良反应少。
文摘Background and Aims: This study examined the stress levels, the stressors and biomarker such as Alpha (α)-Amylase enzyme which is secreted under distress conditions. The aim was to determine the relationship between these three variables. Methods: The study respondents were made up of cancer outpatients from 3 hospitals namely the Hospital Kuala Lumpur, Seberang Jaya and Johor Baru, Pantai Ipoh and Putrajaya. The Personal Stress Inventory (PSI) questionnaire was used to identify stressors, while the Hospital Anxiety and Depression Scale (HADS) were used to determine the psychological distress levels. The Salimentary Oral Swab (SOS) Technique was used to collect the saliva and then the Salivary α-Amylase Assay Kit was used to analyse for α amylase. Results: The majority of respondents were stressed due to their sensitive emotion and nervousness in their daily lives (68.7%), they had poor memory and short attention spans of carrying out job tasks (67.3%) as well as they were emotionally depressed (65.3%). Their poor memory and short attention span (p = 0.037), heavy work load and poor task delivery (p = 0.008) were predictors for distress using HADS. The salivary α-amylase concentration was significantly related to the stress levels (p = 0.002). Conclusion: Breast cancer respondents with musculoskeletal system related symptoms, with heavy work load and poor task delivery, as well as had poor memory and short attention span were at higher risk of experiencing psychological distress. The salivary α-amylase which had significant relationships with psychological distress was therefore, a potential biological indicator for distress, while the musculoskeletal system related symptoms from the PSI questionnaire were predictors for distress.
文摘Aim: Whole body vibration (WBV) is thought to improve blood flow and autonomic balance and thereby induce a relaxation effect, which suggests its use for stress management. However, the relaxation effect of WBV training has not been objectively evaluated thus far. The purpose of this study was to determine the biological response to WBV training by measuring peripheral blood flow and salivary components using non-invasive techniques. Methods: Participants included 10 healthy volunteers (7 men, 3 women;mean age 33.8 ± 2.3) who provided oral consent and served as their own control. Each participant performed 15 types of stretching exercises for 10.5 min on the Power Plate? and cutaneous blood flow and salivary components were measured before and after the exercise. One week later, all participants performed the same exercise regimen for 10.5 min on a non-vibratory plate, and blood flow measurement and salivary tests were performed in a similar manner. Cutaneous blood flow was measured in the 4th digit for 1 min using the laser speckle flowgraphy. Saliva samples were evaluated for cortisol levels and α-amylase activity. To determine the effects of stretching exercises on the Power Plate? vs a non-vibratory plate, the differences in pre- and post-exercise peripheral blood flow, salivary cortisol levels, and salivary α-amylase activity were statistically evaluated by the t-test. Results: Mean blood flow before and after the exercise on the Power Plate? was 122.0 ± 54.2 and 156.7 ± 51.2, respectively;on a non-vibratory plate, blood flow was 136.6 ± 47.9 and 146.3 ± 38.3, respectively. The differences in pre-exercise and post-exercise values of the two training methods were not significant (p = 0.215). Mean cortisol levels before and after the exercise on the Power Plate? were 266.6 ± 125 and 204.9 ± 61.6, respectively;on a non-vibratory plate, the levels were 439.0 ± 121.7 and 425.8 ± 118.8, respectively. The differences in pre-exercise and post-exercise values of the two training methods were not significan
文摘The psychological stress of most perioperative patients has been reduced by many interventions. In order to evaluate the effects of these interventions, biomarkers are being considered as objective assessment tools in addition to the subjective assessment tools. It has been thought that salivary α-amylase (sAA) activity is associated with sympathetic nervous system activity, which reflects psychological stress. We examined the relationship between sAA, self-reported data, and autonomic nervous system activity to assess the reliability of sAA as a marker for relaxing response in surgery-related stress. The sAA, the State anxiety, Visual Analogue Scale (VAS) of pain, and heart rate variability were used to assess prior to and after the relaxation on the day before surgery, and on postoperative days (POD) 1, 2, 3, and 7. A total of 75 patients participated and 301 relaxing response readings were obtained. We found that the sAA significantly decreased depending upon the pain and anxiety by relaxation, but they were unrelated to sympathetic nervous system activity. There was weak correlation between the change in sAA, and anxiety and VAS pain. Thus, sAA appears to be an easy-to-use, non-invasive and good marker for relaxing response within a short period in surgery-related stress patients.
