Nausea and vomiting are physiological responses that react to various bodily conditions and play a protective function.Medicinal and nonmedicinal methods,including complementary medicine,treat nausea and vomiting.The ...Nausea and vomiting are physiological responses that react to various bodily conditions and play a protective function.Medicinal and nonmedicinal methods,including complementary medicine,treat nausea and vomiting.The current research aims to investigate the effectiveness of foot reflexology as a complementary medicine method for nausea and vomiting.Based on PRISMA 2020,PubMed,Web of Science,and Scopus were searched until October 2,2024,using a search strategy approved by two researchers.Only randomized controlled trial studies were included in this research.No limitations or filters were applied.The inclusion criteria were selected based on the PICOS framework,and the studies were evaluated according to the National Institutes of Health quality assessment tool,which is related to controlled intervention,and were evaluated by two researchers.Finally,six studies were included in this review.Eighty-four percent of studies were conducted in Asia.Three records are from Iran,and two are from Turkey,and one is from France.The results showed that nausea and vomiting improved in all studies.In most studies(67%),four sessions or less led to improved outcomes.Rhodes index of nausea,vomiting,and retching and visual analog scale were utilized to assess nausea and vomiting.The current systematic review indicated that foot reflexology as a noninvasive intervention could improve nausea and vomiting in patients with cancer problems,pregnancy,hemodialysis,and laparoscopic cholecystectomy。展开更多
BACKGROUND Pheochromocytoma,a rare catecholamine-secreting tumor,typically presents with the classic triad of headache,palpitations,and diaphoresis,often accompanied by cardiovascular manifestations.While vomiting occ...BACKGROUND Pheochromocytoma,a rare catecholamine-secreting tumor,typically presents with the classic triad of headache,palpitations,and diaphoresis,often accompanied by cardiovascular manifestations.While vomiting occurs in approximately 34.5%of cases,it is rarely the predominant and persistent presenting symptom.Pheochro-mocytoma-induced cardiomyopathy leading to heart failure is a recognized but uncommon complication.Due to its heterogeneous presentations,misdiagnosis and diagnostic delay are frequent.CASE SUMMARY A 53-year-old female presented predominantly with persistent and refractory vomiting as her chief complaint,accompanied by signs of acute heart failure[left ventricular ejection fraction(LVEF)30%].Initial evaluation at a primary hospital,including coronary angiography(revealing only mild stenosis),led to a misdia-gnosis of coronary artery disease.Despite standard anti-thrombotic,anti-heart failure,and anti-emetic therapy,her vomiting persisted and heart failure did not resolve.Subsequent hospitalization revealed dramatic paroxysmal hypertension(202/129 mmHg to 97/51 mmHg)and fever.Significantly elevated plasma meta-nephrines and normetanephrine,combined with abdominal computed tomogra-phy and magnetic resonance imaging,confirmed a right adrenal pheochromo-cytoma.This diagnosis was significantly delayed due to the atypical prominence of gastrointestinal symptoms masking the underlying endocrine crisis.CONCLUSION This case highlights a highly atypical presentation of pheochromocytoma domi-nated by refractory vomiting and complicated by acute catecholamine-induced cardiomyopathy.It emphatically underscores that pheochromocytoma must be considered in the differential diagnosis for patients presenting with unexplained,treatment-resistant vomiting,particularly when co-existing with acute heart failure.The presence of labile hypertension,even if not initially evident,provides a crucial diagnostic clue.Prompt biochemical screening(catecholamine metabolites)and adrenal imaging are essential to prevent diagnostic delay and enable timely,life-saving surgical intervention.展开更多
BACKGROUND Postoperative nausea-vomiting(PONV)occurs often after surgery performed under general anesthesia.Liberal fluid treatments are a low-cost and a low sideeffect alternative to pharmacological treatment in the ...BACKGROUND Postoperative nausea-vomiting(PONV)occurs often after surgery performed under general anesthesia.Liberal fluid treatments are a low-cost and a low sideeffect alternative to pharmacological treatment in the prevention of PONV.AIM To compare the effects of perioperative liberal and restrictive fluid therapy on PONV and recovery after laparoscopic cholecystectomy.METHODS A total of 160 patients were randomly allocated to two groups:Liberal fluid treatment group(group L),and restrictive fluid treatment group(group R).Three patients were excluded.Ringer’s lactate infusion was administered intravenously as follows:20 mL/kg/hour to group L,and 4 mL/kg/hour to group R.The primary outcomes were PONV incidence 24 hours postoperatively and the quality of recovery-15 scale at 24 hours postoperatively.RESULTS The incidence of PONV was significantly lower in group L(38.0%)compared with group R(70.5%)(relative risk:0.54,95%confidence interval:0.39-0.74,P<0.001).The quality of recovery-15 scale scores for overall satisfaction were significantly higher in group L compared with group R[137(135-141)vs 135(130-139),P=0.006].CONCLUSION Perioperative liberal fluid therapy reduced the incidence of PONV and improved the quality of postoperative recovery in patients undergoing laparoscopic cholecystectomy.展开更多
Chemotherapy-induced nausea and vomiting(CINV)is common in patients receiving moderately or highly emetogenic chemotherapy and is caused by the activation of peripheral and central nervous system pathways,with the neu...Chemotherapy-induced nausea and vomiting(CINV)is common in patients receiving moderately or highly emetogenic chemotherapy and is caused by the activation of peripheral and central nervous system pathways,with the neurokinin-1 receptor playing a central role in delayed CINV.Neurokinin-1 receptor antagonists(NK1RAs)in combination with other antiemetic agents are recommended in international and Chinese guidelines for the prevention of acute and delayed CINV.Therefore,a summary of current data for NK1RAs would be of great clinical utility.This article summarizes the available clinical and real-world data on the use of NK1RAs in CINV prophylaxis,with a focus on evidence from China,where three NK1RAs,aprepitant,fosaprepitant and netupitant,are currently approved.NK1RAs have demonstrated efficacy and favorable safety in the prevention of acute and delayed CINV.Further research is required to determine the optimal use of these drugs and to identify strategies for CINV management in specific patient populations.展开更多
BACKGROUND Cyclic vomiting syndrome(CVS)and its effect on nutritional status has not been well described.AIM To describe the clinical characteristics,treatment and outcomes of children with CVS in Singapore.METHODS Re...BACKGROUND Cyclic vomiting syndrome(CVS)and its effect on nutritional status has not been well described.AIM To describe the clinical characteristics,treatment and outcomes of children with CVS in Singapore.METHODS Retrospective cohort study of pediatric patients aged 1 to 18 years old with CVS diagnosed at KK Women’s and Children’s Hospital in Singapore from 2011 to 2021.RESULTS Thirty-two children(69%female)with CVS were included in the study,with mean age of onset of symptoms at 7(±4)years and mean follow up duration of 5 years.Forty percent(12/32)of patients were underweight at diagnosis with no other identifiable organic cause,with a median body mass index(BMI)z score-3.2(range-2 to-7.5).The incidence of systemic hypertension was 10%(3/32).The overall mean frequency of exacerbations in this cohort of patients was 4(±4)episodes per year.In total,16(50%)patients,who had mean baseline frequency of 6(±5)attacks per year,were commenced on prophylactic treatment.Twelve patients(75%)responded to first-line therapy,whereas 4(25%)required escalation to second-line treatment.With prophylactic treatment,there was an overall improvement in the frequency of attacks with a mean reduction of 5(±3)attacks per year.Also,there was improvement in the BMI z score of these patients from a median of-2.9 to-0.9.CONCLUSION Prophylactic treatment is effective in improving nutritional status as well as reducing symptom frequency and should be considered for patients with complications such as growth failure and significant hypertension.展开更多
Objective To preliminarily investigate the rules of acupoint selection of acupuncture and moxibustion for the treatment of chemotherapy-induced nausea and vomiting by retrospecting pertinent literature from 1986 to 20...Objective To preliminarily investigate the rules of acupoint selection of acupuncture and moxibustion for the treatment of chemotherapy-induced nausea and vomiting by retrospecting pertinent literature from 1986 to 2013. Methods Literature of clinical studies on acupuncture and moxibustion for the treatment of chemotherapy-induced nausea and vomiting published from 1986 to 2013 in CNKI, Wanfang and VlP databases and in PubMed database were retrieved. Data were analyzed statistically via Excel. Results One hundred and nineteen articles retrieved were related to the study. Based on the current literature analysis, meridians selected for acupuncture and moxibustion on chemotherapy-induced nausea and vomiting were mainly the stomach meridian, the pericardium meridian, the conception vessel, the spleen meridian and bladder meridian; point combination was applied more in prescription, accounting for 73.11%, while single point was applied less, only accounting for 26.89%. There were numerous methods for point combinations, but proximal and distal point combination was the most widely used method, accounting for 20.93%. Meanwhile, main acupoints selected were mostly Zusanli （足三里 ST 36）, Neiguan （内关 PC 6）, Zhongwan （中脘CV12）, Gongsun （公孙SP 4） and Taichong （太冲 LR 3） and point combinations were mainly Shenmen （神门 HT 7）, Geshu （膈俞 BL 17）, PishB （脾俞 BL 20）, Weishu （胃俞 BL 21） and Jianli （建里 CV 11）. Conclusion Acupoints selection on acupuncture and moxibustion for chemotherapy-induced nausea and vomiting shows a certain rules that the meridians selected are mainly stomach meridian, pericardium meridian and conception vessel and acupuncture points selected are normally ST 36, PC 6 and CV 12, proximal and distal point combination is applied more, while single point applied less.展开更多
Objective:To summarize and analyze the recommendations of acupuncture and moxibustion in the global guidelines/expert consensus of chemotherapy-and/or radiotherapy-induced nausea and/or vomiting,providing a basis for ...Objective:To summarize and analyze the recommendations of acupuncture and moxibustion in the global guidelines/expert consensus of chemotherapy-and/or radiotherapy-induced nausea and/or vomiting,providing a basis for the development of clinical practice guidelines on acupuncture and moxibustion for chemotherapy-and/or radiotherapy-induced nausea and/or vomiting.Methods:We systematically searched 7 comprehensive databases,7 guideline libraries and 4 websites of societies/associations.The retrieval period was from the inception to April 1,2023.Two researchers independently screened the literature,extracted data,and used the Scientific,Transparent,and Applicable Rankings(STAR)tool to evaluate the quality of guidelines/expert consensus that contained acupuncture and moxibustion recommendations,and analyzed acupuncture and moxibustion recommendations in guidelines/expert consensus and their evidence base.Results:A total of 56 guidelines/expert consensus related to the prevention and treatment of chemotherapy-and/or radiotherapy-induced nausea and/or vomiting were included,and 22 guidelines/expert consensus contained acupuncture and moxibustion recommendations,with a total of 34 recommendations on acupuncture and moxibustion(27 supports,4 neutrals,3 objections).The STAR evaluation(excluding 1 patient version of guideline)showed that none of the guidelines/expert consensus was with high quality,95.24%(20/21)with medium quality,and 4.76%(1/21)with low quality.Although there were many recommendations of acupuncture and moxibustion in the existing guidelines/expert consensus,there was great heterogeneity among the acupuncture and moxibustion treatment regimens.Moreover,most of the guidelines/expert consensus did not describe the details of acupuncture and moxibustion treatment regimens,such as acupuncture and moxibustion manipulation,acupoint selection,course and timing of treatment,which is difficult to guide the clinical practice of acupuncture and moxibustion.Conclusion:Developing clinical practice guidelines of acupuncture and moxibustion for chemotherapyand/or radiotherapy-induced nausea and/or vomiting according to the items of the STAR tool was urgent,so as to clarify the details of acupuncture and moxibustion regimens and provide standardized treatment regimens to guide the clinical practice of acupuncture and moxibustion.展开更多
Objective:This review aimed to map and summarize published studies that tested non-pharmacological management for chemotherapyinduced nausea and vomiting(CINV).Methods:We searched for eligible studies in 5 electronic ...Objective:This review aimed to map and summarize published studies that tested non-pharmacological management for chemotherapyinduced nausea and vomiting(CINV).Methods:We searched for eligible studies in 5 electronic databases and screened the retrieved studies using the inclusion and exclusion criteria.Data were then collated according to the types of interventions,measurement tool,and outcomes.Results:The search yielded 2343 records,of which 11 were included.Four categories of non-pharmacological CINV management were made;manipulative and body-based therapy(n=5 studies);mind–body therapy(n=3 studies);biologically based practice(n=1 study),and energy therapy(n=2 studies).Seven different scales were used to measure CINV.Nine studies repor ted improvement in CINV.Conclusions:This scoping review demonstrates the breadth of non-pharmacological management to address CINV.Various types of CINV scales were used to measure CINV severity.The management and scale can be utilized to improve nursing care,par ticularly in cancer care.展开更多
Background： Few studies have attempted to evaluate the use of antiemetic therapy for chemotherapyinduced nausea and vomiting （CINV） at a national level in China or to assess how treatment regimens adhere to current...Background： Few studies have attempted to evaluate the use of antiemetic therapy for chemotherapyinduced nausea and vomiting （CINV） at a national level in China or to assess how treatment regimens adhere to current guidelines. Methods： We searched the China Health Insurance Research Association （CHIRA） Database to identify patients with cancer who were 〉 18 years old and received either moderately or highly emetogenie chemotherapy （MEC and HEC, respectively） between 2008 and 2012. Patients＇ characteristics as well as usage of specific antiemetic regimens were analyzed using descriptive statistics. Results： Of the 14,548 patients included in the study, 6,477 received HEC while 8,071 were treated with MEC. Approximately 89.9% used antiemetics prophylactically to prevent acute CINV and 71.5% for delayed CINV while 9.0% were prescribed antiemetics as rescue therapy. A significantly lower proportion of patients treated with HEC received prophylactic antiemetic therapy for delayed CINV as compared to those treated with MEC （59.4% vs. 81.3 %; P〈0.001）. The HEC group had a slightly lower proportion of patients using a mixed regimen containing a 5-HT3 antagonist to prevent both acute and delayed CINV than the MEC group （P〈0.012）; however, a higher proportion received a mixed regimen containing eorticosteroids （P≤0.007）. Although more than half of the patients in the HEC group took three antiemeties to prevent acute and delayed CINV, these rates were significantly lower than those of the MEC group （both P〈0.001）. Finally, analysis of the regimens used revealed that there is over-utilization of drugs within the same class of antiemetic. Conclusions： These findings indicate that more attention is needed for treatment of delayed CINV, in terms of both overall use and the components of a typical treatment regimen.展开更多
Background: Chemotherapy?induced nausea and vomiting adversely affects the quality of life of patients who receive chemotherapy via intravenous infusion or transcatheter arterial chemoembolization(TACE). This study ai...Background: Chemotherapy?induced nausea and vomiting adversely affects the quality of life of patients who receive chemotherapy via intravenous infusion or transcatheter arterial chemoembolization(TACE). This study aimed to investigate the clinical effects of transcutaneous electrical acupoint stimulation(TEAS) on nausea and vomiting after TACE.Methods: A total of 142 patients who received TACE with cisplatin for primary or metastatic liver cancer were assigned to the active?acupuncture(n = 72) or placebo?acupuncture(n Hegu(LI4), Neiguan(P6), an= 70) groups using a covariate?adaptive randomization at a ratio of 1:1. The acupointsd Zusanli(ST36) were stimulated twice daily for 6 days. The effects of TEAS on nausea and vomiting were assessed by using occurrence rate and severity of these symptoms. Anorexia scale and M. D. Anderson Symptom Inventory(MDASI) scores were secondary endpoints and were used to assess the effect of TEAS on patient appetite and quality of life. The safety of the treatments was also monitored.Results: Between the two groups, the differences in occurrence rates and severities of nausea and vomiting after TACE were not significant(all P > 0.05). From the second day after TACE, anorexia scores were significantly lower in the active?acupuncture group than in the placebo?acupuncture group and continued to decrease over time with treat?ment(all P values less than 0.01). On days 0, 1, and 2, the mean MDASI scores for the active?acupuncture group were slightly lower than those for the placebo?acupuncture group, but the differences were not statistically significant(all P > 0.05). No significant differences were found between the two groups in the occurrence rate of any adverse event(P > 0.05).Conclusion: TEAS appears to be a safe and effective therapy to relieve patients' gastrointestinal discomfort after chemotherapy.展开更多
AIM： To evaluate the clinical presentation, response to prophylactic therapy and outcome of children with cyclic vomiting syndrome （CVS） in Shiraz, Iran. METHODS： During a period of 11 years （March 1994 to March ...AIM： To evaluate the clinical presentation, response to prophylactic therapy and outcome of children with cyclic vomiting syndrome （CVS） in Shiraz, Iran. METHODS： During a period of 11 years （March 1994 to March 2005）, 181 consecutive children with a final diagnosis of CVS were evaluated, treated and followed in our center. Patients were randomized to receive either amitriptyline or propranolol as prophylactic treatments. RESULTS： There were 88 boys and 93 girls with mean age of onset of symptoms of 4.9 ± 3.3 years （range, neonatal period to 14 years）, the mean age at final diagnosis was 6.9 years （range, 1.5 to 14）, and the mean duration between the onset of the first attack and the final diagnosis of CVS was 2 ± 1.81 years （range, 1/6 to 8）. The mean duration of each attack was 4.26 days （range, from few hours to 10 d） and the mean interval between the attacks was 1.8 mo （range, 1 wk to 12 too）. The time of onset of the attacks was midnight to early morning in about 70% of cases. Amitriptyline was effective in 46 out of 81 （56%） patients （P 〈 0.001）. Propranolol appeared to have a superior action and was effective in 74 out of 83 （92%） patients （P 〈 0.0001）. CONCLUSION： There is a significant lag time between the onset of clinical symptoms and the final diagnosis of CVS in our area. In patients with typical clinical presentations of CVS, who are examined by an experienced physician, invasive workup is not necessary. Propranolol appears more effective than arnitriptyline for prophylactic use in children with CVS.展开更多
AIM： To establish a new, reliable vomit model of minks METHODS： Adult male minks were randomly divided into 8 groups （n=6）： cisplatin （7.5 mg/kg） intraperitoneal injection （ip） group, copper sulfate （40 mg/k...AIM： To establish a new, reliable vomit model of minks METHODS： Adult male minks were randomly divided into 8 groups （n=6）： cisplatin （7.5 mg/kg） intraperitoneal injection （ip） group, copper sulfate （40 mg/kg） intragastric injection （ig） group, apomorphine （1.6 mg/kg） subcutaneous injection （sc） group, and 18 Gy whole-body X-irradiation group, ondansetron injection group （2 mg/kg ip） 30 min later followed by cisplatin （7.5 mg/kg） ip, normal saline （NS） ip injection control group, metoclopramide injection group （4 mg/kg ip） 30 rain later followed by apomorphine （1.6 mg/kg） sc, NS ig control group. The frequency of retching and vomiting was calculated. After behavioral experiment, distribution of 5-HT in the ileum was detected by immunohistologic method. RESULTS： Cisplatin, apomorphine, copper sulfate and X-irradiation administered to minks evoked a profound emetic response in the animals. However, retching and vomiting were significantly inhibited by pretreatment with ondansetron and metoclopramide in cisplatin and copper sulfate groups （P=0.018）. Immunohistologic result showed that 5-HT released from enterochromaffin cells （EC cells） was involved in vomiting mechanism. CONCLUSION： Mink vomit model has a great value in studying the vomiting mechanism and screening new antiemetic drugs.展开更多
BACKGROUND Ganglioneuroma (GN) is a rare neurogenic tumor that accounts for about 0.1%- 0.5% of all tumors of the nervous system.It originates from neural crest cells.GN has no specific clinical symptoms or laboratory...BACKGROUND Ganglioneuroma (GN) is a rare neurogenic tumor that accounts for about 0.1%- 0.5% of all tumors of the nervous system.It originates from neural crest cells.GN has no specific clinical symptoms or laboratory findings,which leaves it easily overlooked and misdiagnosed as other tumors.Retroperitoneal GN with very large volume and vascular penetration is extremely rare.CASE SUMMARY We present the imaging and pathological findings of a giant retroperitoneal GN in a child.A 4-year-old boy had suffered from postprandial vomiting for more than 6 mo with no precipitating factors.Abdominal computerized tomographic examination showed a giant cystic mass in the retroperitoneal area.After injection of contrast agent,the mass showed heterogeneous enhancement.Surgery with local excision of the mass was performed to address the embedded abdominal blood vessels,and the histopathological and immunohistochemical diagnosis of the mass was GN.Postprandial vomiting was relieved,and no complications occurred after the operation.CONCLUSION In the diagnosis of giant retroperitoneal hypodense masses in children,GN should be considered if the mass presents delayed enhancement,punctate calcification,and vascular embedding but no invasion.Pathology is the golden standard for the diagnosis of GN,and surgical excision is the optimal treatment for GN.展开更多
Objective:To analyze the acupoint selection rules in acupuncture treatment for chemotherapy-induced nausea and vomiting(CINV)in China through data mining technology.Methods:The relevant literature on acupuncture treat...Objective:To analyze the acupoint selection rules in acupuncture treatment for chemotherapy-induced nausea and vomiting(CINV)in China through data mining technology.Methods:The relevant literature on acupuncture treatment for CINV were searched from SinoMed,China National Knowledge Infrastructure(CNKI),Wanfang,VIP and Pubmed databases from the establishment to January 3,2021 and the worksheet was set up for the information extraction of acupuncture-moxibustion prescriptions.Using IBM SPSS Statistics 25.0 and SPSS Modeler 18.0 software,cluster analysis and association rule analysis were conducted to explore the rules of acupoint selection.Results:A total of 179 articles were eligible,including 206 acupuncture prescriptions and 64 acupoints.The total use frequency of acupoints was 784 times.The acupoints with the highest use frequency were Zúsānlǐ(足三里ST36),Zhōngwǎn(中脘CV12)and Nèiguān(内关PC6).The commonly used meridians included stomach meridian of foot-yangming,conception vessel,pericardium meridian of hand-jueyin and bladder meridian of foot-taiyang.The acupoints located on the chest,the abdomen and the lower limbs were mostly selected.Five-shu points and crossing points were highly involved in terms of the specific points.The most common combination was ST36,CV12 and PC6.Conclusion:In treatment of acupuncture for CINV,the acupoints were generally selected from stomach meridian of foot-yangming,conception vessel,pericardium meridian of hand-jueyin.Front-mu points on the chest and the abdomen,the he-sea points and lower he-sea points in the lower limbs are commonly used.The core acupoint prescription of acupuncture for CINV included ST36,CV12 and PC6.展开更多
BACKGROUND Chemotherapy is the primary treatment for patients with advanced gastrointestinal cancer,but it has many adverse reactions,particularly nausea and vomiting.Music therapy can reduce anxiety symptoms,avoid th...BACKGROUND Chemotherapy is the primary treatment for patients with advanced gastrointestinal cancer,but it has many adverse reactions,particularly nausea and vomiting.Music therapy can reduce anxiety symptoms,avoid the response to the human body under various stress conditions through psychological adjustment,and improve the adverse reactions of chemotherapy.AIM To investigate the impact of music therapy on relieving gastrointestinal adverse reactions in chemotherapy for patients with digestive tract cancer by metaanalysis.METHODS EMBASE,PubMed,OVID,WoS,CNKI,CBM,and VIP database were all used for searching relevant literature,and the efficacy after treatment was combined for analysis and evaluation.RESULTS This study included seven articles.The results of meta-analysis indicated that music therapy could reduce the nausea symptom score of patients after chemotherapy[mean difference(MD)=-3.15,95%confidence interval(CI):-4.62 to-1.68,Z=-4.20,P<0.0001].Music therapy could reduce the vomiting symptom score of patients after chemotherapy(MD=-2.28,95%CI:-2.46 to-2.11,Z=-25.15,P<0.0001).Furthermore,music therapy could minimize the incidence of grade I and above nausea or vomiting in patients after chemotherapy(odds ratio=0.38,95%CI:0.26-0.56,Z=-4.88,P<0.0001).Meta-regression analysis found that publication year was not a specific factor affecting the combined results.There was no significant publication bias(P>0.05).CONCLUSION Music therapy can significantly improve the scores of nausea and vomiting symptoms in patients with digestive system cancer during chemotherapy and reduce the incidence of grade I and above nausea and vomiting after chemotherapy,making it an effective psychological intervention method worthy of clinical promotion.展开更多
Objective:To observe the influence of wrist-ankle acupuncture(WAA)on postoperative nausea and vomiting(PONV)undergoing radiofrequency ablation(RFA)in thyroid nodule and its analgesic effect.Methods:A total of 66 patie...Objective:To observe the influence of wrist-ankle acupuncture(WAA)on postoperative nausea and vomiting(PONV)undergoing radiofrequency ablation(RFA)in thyroid nodule and its analgesic effect.Methods:A total of 66 patients with thyroid nodule and undergoing RFA were randomized into a WAA group and a sham-acupuncture(SA)group,33 cases in each one.Acupuncture was exerted after the patients entering operation room.In the WAA group,WAA was applied on the bilateral Upper 1,2 and 3 areas.In the SA group,the sham-acupuncture was given on the same areas.In 30 min after needle insertion,the routine RFA started in the patients of the two groups.All the needles were removed when the operation was finished.The proportion of intraoperative sufentanil supplementation,the incidence of24 h PONV and the proportion of intraoperative intravenous injection of urapidil were recorded in the patients of the two groups.Results:In the WAA group,sufentanil was supplemented by 12.90%,obviously less than 36.36%in the SA group.The incidence of 24 h PONV was 9.68%in the WAA group,remarkably lower than 27.27%in the SA group,indicating statistical significances(both P<0.05).The intravenous injection of urapidil was not applied during operation in the two groups,without statistical difference between the groups(P>0.05).Conclusion:Wrist-ankle acupuncture reduces the intraoperative demand of sufentanil in radiofrequency ablation of thyroid nodule and this therapy is preventive for PONV.展开更多
Objective: To describe the prescribing trends of antiemetics in chemotherapy-induced nausea and vomiting (CINV), assess adherence to American Society of Clinical Oncology (ASCO) guidelines, and evaluate the effectiven...Objective: To describe the prescribing trends of antiemetics in chemotherapy-induced nausea and vomiting (CINV), assess adherence to American Society of Clinical Oncology (ASCO) guidelines, and evaluate the effectiveness of prescribed antiemetics. Additionally, we also sought to explore barriers that hinder clinical practice guideline (CPG) implementation. Methods: One hundred fifty-five patients between the ages of 18 and 60 who were admitted to the haematology/oncology department/clinic to receive intravenous chemotherapy, either as in-patients or outpatients, were enrolled in a prospective observational study. Relevant patient demographic data, chemotherapy protocols and antiemetics were collected. Chemotherapies were classified according to their emetogenic potential. This information was used to assess whether the antiemetic prescribed matched the emetogenic risk of treatment. The analysis of outcomes was performed using the MASCC antiemetic assessment tool. Key Findings: The results showed that 95% of antiemetic prescription pre-chemotherapy regimens did not adhere to the guidelines. The findings were use of twice the recommended dose of granisetron (87.7%), overuse granisetron (16%) and metoclopramide (62.6%), and underuse dexamethasone (27%) and corticosteroid duplication (7.7%). With respect to post-chemotherapy antiemetic prescriptions, 91% of prescriptions were not adherent to guidelines, with overuse of granisetron (81.9%) and metoclpramide (34.2%) and underuse of dexamethasone (66.5%) being the most frequently reported trends. Conclusion: This study shows a lack of conformity to antiemetic guidelines, resulting mainly in overtreatment. Although vomiting was well-managed, nausea remains under controlled and requires additional medical attention. The lack of knowledge and motivation are considered barriers to CPG implementation.展开更多
Thyrotoxicosis may present in many ways;severe vomiting as a prominent symptom of thyrotoxicosis is uncommon.In this paper,we report a 24-year-old Chinese male with hyperthyroidism who presented with recurrent severe ...Thyrotoxicosis may present in many ways;severe vomiting as a prominent symptom of thyrotoxicosis is uncommon.In this paper,we report a 24-year-old Chinese male with hyperthyroidism who presented with recurrent severe vomiting.The patient had had intermittent vomiting for seven years and had lost approximately 15 kg of weight.Gastroscopic examinations revealed chronic gastritis and one occasion peptic ulcer.He was treated with antacid and proton pump inhibitors,but his symptoms had no relief.His presenting symptoms suggested hyperthyroidism and were confirmed by laboratory data.After a month of propylthiouracil therapy,his symptoms were relieved.It should be noted that hyperthyroidism patients can have unexplained vomiting,and that hyperthyroidism may coexist with peptic ulcer in rare cases.Awareness of such atypical presentations of hyperthyroidism may help to make a correct diagnosis.展开更多
OBJECTIVE: To observe the effect of transcutaneous electroacupuncture(TEA) at Neiguan(PC 6) on refractory vomiting in critically ill patients in intensive care(ICU) setting.METHODS: Ten patients admitted in ICU and pr...OBJECTIVE: To observe the effect of transcutaneous electroacupuncture(TEA) at Neiguan(PC 6) on refractory vomiting in critically ill patients in intensive care(ICU) setting.METHODS: Ten patients admitted in ICU and presenting vomiting refractory to one or more antiemetic drugs were prospectively included in the study. TEA was applied at acupoint of Neiguan(PC6) during 30 min with a neuromuscular transmission monitor(single-twitch stimulation with 1 Hz at a constant current of 10 m A). Nausea and Vomiting were evaluated at the following intervals: immediately after 30 min of TEA at Neiguan(PC 6),30 min-6h and 6-24 h. The presence of nausea and/or vomiting throughout the observational period was defined as the primary end point.RESULTS: The presence of nausea or vomiting throughout the observational period was 10% at the end of TEA, 40% between 30 min and 6 h, and50% between 30 min and 24 h(P < 0.001, P = 0.01 and P = 0.03 vs pre-TEA, respectively). There were no complications or side effects related to TEA.CONCLUSION: TEA at Neiguan(PC 6) seems effective in reducing refractory vomiting in the patients in ICU setting, even if larger trials are needed to define optimal modalities.展开更多
Background:Postoperative nausea and vomiting(PONV)refers to a problem commonly occurring after surgery.Acupuncture is considered a critical complementary alternative therapy for PONV.The acupoints selection critically...Background:Postoperative nausea and vomiting(PONV)refers to a problem commonly occurring after surgery.Acupuncture is considered a critical complementary alternative therapy for PONV.The acupoints selection critically determines the efficacy of acupuncture,whereas the selection rules remain unclear.The objective of the present study was to delve into the principles of acupoints selection for PONV using data mining technology.Methods:The clinical trials assessing the acupuncture effect for PONV were searched with the use of computer in PubMed,China National Knowledge Infrastructure,and Chinese Biomedical Database;the time span was confined as 2009–2019.The database of acupuncture prescriptions for PONV was built using Excel 2016;the description and association were analyzed by IBM SPSS modeler 18.Result:Eighty-three relevant literatures were screened out.The number of specific acupoints took up 72.5%of all acupoints;specific acupoints exhibited the frequency taking up 91.30%of the total frequency.As revealed from the result,Neiguan(PC 6),Zusanli(ST 36),Hegu(LI 4),and Zhongwan(CV 12)were most frequently applied,suggesting the tightest associations.Most acupoints were taken from the stomach meridian and pericardium meridian.The common acupoints were concentrated in the lower limbs,chest,as well as abdomen.Conclusion:Data mining acts as a feasible method to identify acupoints selection and compatibility characteristics.As suggested from our study,the acupoints selection for PONV prioritizes specific acupoints and related meridians.The selection and combination of acupoints comply with the theory of traditional Chinese medicine.展开更多
文摘Nausea and vomiting are physiological responses that react to various bodily conditions and play a protective function.Medicinal and nonmedicinal methods,including complementary medicine,treat nausea and vomiting.The current research aims to investigate the effectiveness of foot reflexology as a complementary medicine method for nausea and vomiting.Based on PRISMA 2020,PubMed,Web of Science,and Scopus were searched until October 2,2024,using a search strategy approved by two researchers.Only randomized controlled trial studies were included in this research.No limitations or filters were applied.The inclusion criteria were selected based on the PICOS framework,and the studies were evaluated according to the National Institutes of Health quality assessment tool,which is related to controlled intervention,and were evaluated by two researchers.Finally,six studies were included in this review.Eighty-four percent of studies were conducted in Asia.Three records are from Iran,and two are from Turkey,and one is from France.The results showed that nausea and vomiting improved in all studies.In most studies(67%),four sessions or less led to improved outcomes.Rhodes index of nausea,vomiting,and retching and visual analog scale were utilized to assess nausea and vomiting.The current systematic review indicated that foot reflexology as a noninvasive intervention could improve nausea and vomiting in patients with cancer problems,pregnancy,hemodialysis,and laparoscopic cholecystectomy。
基金Supported by National Natural Science Foundation of China,No.82200353Jiangsu Province Double Innovation Doctoral Program,No.JSSCBS20221948+4 种基金Suzhou Gusu Health Talent Program,No.(2022)043Suzhou Gusu Health Talent Plan Talent Research Project,No.GSWS2022014Suzhou Science and Technology Innovation Policy Funding Projectthe Jiangsu Province College Students’Innovation and Entrepreneurship Training Program Project,No.202410285087Z“Bo Xi”Talent Casting Plan of the First Affiliated Hospital of Soochow University.
文摘BACKGROUND Pheochromocytoma,a rare catecholamine-secreting tumor,typically presents with the classic triad of headache,palpitations,and diaphoresis,often accompanied by cardiovascular manifestations.While vomiting occurs in approximately 34.5%of cases,it is rarely the predominant and persistent presenting symptom.Pheochro-mocytoma-induced cardiomyopathy leading to heart failure is a recognized but uncommon complication.Due to its heterogeneous presentations,misdiagnosis and diagnostic delay are frequent.CASE SUMMARY A 53-year-old female presented predominantly with persistent and refractory vomiting as her chief complaint,accompanied by signs of acute heart failure[left ventricular ejection fraction(LVEF)30%].Initial evaluation at a primary hospital,including coronary angiography(revealing only mild stenosis),led to a misdia-gnosis of coronary artery disease.Despite standard anti-thrombotic,anti-heart failure,and anti-emetic therapy,her vomiting persisted and heart failure did not resolve.Subsequent hospitalization revealed dramatic paroxysmal hypertension(202/129 mmHg to 97/51 mmHg)and fever.Significantly elevated plasma meta-nephrines and normetanephrine,combined with abdominal computed tomogra-phy and magnetic resonance imaging,confirmed a right adrenal pheochromo-cytoma.This diagnosis was significantly delayed due to the atypical prominence of gastrointestinal symptoms masking the underlying endocrine crisis.CONCLUSION This case highlights a highly atypical presentation of pheochromocytoma domi-nated by refractory vomiting and complicated by acute catecholamine-induced cardiomyopathy.It emphatically underscores that pheochromocytoma must be considered in the differential diagnosis for patients presenting with unexplained,treatment-resistant vomiting,particularly when co-existing with acute heart failure.The presence of labile hypertension,even if not initially evident,provides a crucial diagnostic clue.Prompt biochemical screening(catecholamine metabolites)and adrenal imaging are essential to prevent diagnostic delay and enable timely,life-saving surgical intervention.
文摘BACKGROUND Postoperative nausea-vomiting(PONV)occurs often after surgery performed under general anesthesia.Liberal fluid treatments are a low-cost and a low sideeffect alternative to pharmacological treatment in the prevention of PONV.AIM To compare the effects of perioperative liberal and restrictive fluid therapy on PONV and recovery after laparoscopic cholecystectomy.METHODS A total of 160 patients were randomly allocated to two groups:Liberal fluid treatment group(group L),and restrictive fluid treatment group(group R).Three patients were excluded.Ringer’s lactate infusion was administered intravenously as follows:20 mL/kg/hour to group L,and 4 mL/kg/hour to group R.The primary outcomes were PONV incidence 24 hours postoperatively and the quality of recovery-15 scale at 24 hours postoperatively.RESULTS The incidence of PONV was significantly lower in group L(38.0%)compared with group R(70.5%)(relative risk:0.54,95%confidence interval:0.39-0.74,P<0.001).The quality of recovery-15 scale scores for overall satisfaction were significantly higher in group L compared with group R[137(135-141)vs 135(130-139),P=0.006].CONCLUSION Perioperative liberal fluid therapy reduced the incidence of PONV and improved the quality of postoperative recovery in patients undergoing laparoscopic cholecystectomy.
基金provided technical help and editorial assistance for this manuscriptsupport for this manuscript was also provided by Dr.Sharon Gladwin(Rude Health Consulting Limited)and funded by MSD Chinafunded by MSD China.
文摘Chemotherapy-induced nausea and vomiting(CINV)is common in patients receiving moderately or highly emetogenic chemotherapy and is caused by the activation of peripheral and central nervous system pathways,with the neurokinin-1 receptor playing a central role in delayed CINV.Neurokinin-1 receptor antagonists(NK1RAs)in combination with other antiemetic agents are recommended in international and Chinese guidelines for the prevention of acute and delayed CINV.Therefore,a summary of current data for NK1RAs would be of great clinical utility.This article summarizes the available clinical and real-world data on the use of NK1RAs in CINV prophylaxis,with a focus on evidence from China,where three NK1RAs,aprepitant,fosaprepitant and netupitant,are currently approved.NK1RAs have demonstrated efficacy and favorable safety in the prevention of acute and delayed CINV.Further research is required to determine the optimal use of these drugs and to identify strategies for CINV management in specific patient populations.
文摘BACKGROUND Cyclic vomiting syndrome(CVS)and its effect on nutritional status has not been well described.AIM To describe the clinical characteristics,treatment and outcomes of children with CVS in Singapore.METHODS Retrospective cohort study of pediatric patients aged 1 to 18 years old with CVS diagnosed at KK Women’s and Children’s Hospital in Singapore from 2011 to 2021.RESULTS Thirty-two children(69%female)with CVS were included in the study,with mean age of onset of symptoms at 7(±4)years and mean follow up duration of 5 years.Forty percent(12/32)of patients were underweight at diagnosis with no other identifiable organic cause,with a median body mass index(BMI)z score-3.2(range-2 to-7.5).The incidence of systemic hypertension was 10%(3/32).The overall mean frequency of exacerbations in this cohort of patients was 4(±4)episodes per year.In total,16(50%)patients,who had mean baseline frequency of 6(±5)attacks per year,were commenced on prophylactic treatment.Twelve patients(75%)responded to first-line therapy,whereas 4(25%)required escalation to second-line treatment.With prophylactic treatment,there was an overall improvement in the frequency of attacks with a mean reduction of 5(±3)attacks per year.Also,there was improvement in the BMI z score of these patients from a median of-2.9 to-0.9.CONCLUSION Prophylactic treatment is effective in improving nutritional status as well as reducing symptom frequency and should be considered for patients with complications such as growth failure and significant hypertension.
基金Supported by the National Basic Research Program of China:2014 CB 543201
文摘Objective To preliminarily investigate the rules of acupoint selection of acupuncture and moxibustion for the treatment of chemotherapy-induced nausea and vomiting by retrospecting pertinent literature from 1986 to 2013. Methods Literature of clinical studies on acupuncture and moxibustion for the treatment of chemotherapy-induced nausea and vomiting published from 1986 to 2013 in CNKI, Wanfang and VlP databases and in PubMed database were retrieved. Data were analyzed statistically via Excel. Results One hundred and nineteen articles retrieved were related to the study. Based on the current literature analysis, meridians selected for acupuncture and moxibustion on chemotherapy-induced nausea and vomiting were mainly the stomach meridian, the pericardium meridian, the conception vessel, the spleen meridian and bladder meridian; point combination was applied more in prescription, accounting for 73.11%, while single point was applied less, only accounting for 26.89%. There were numerous methods for point combinations, but proximal and distal point combination was the most widely used method, accounting for 20.93%. Meanwhile, main acupoints selected were mostly Zusanli （足三里 ST 36）, Neiguan （内关 PC 6）, Zhongwan （中脘CV12）, Gongsun （公孙SP 4） and Taichong （太冲 LR 3） and point combinations were mainly Shenmen （神门 HT 7）, Geshu （膈俞 BL 17）, PishB （脾俞 BL 20）, Weishu （胃俞 BL 21） and Jianli （建里 CV 11）. Conclusion Acupoints selection on acupuncture and moxibustion for chemotherapy-induced nausea and vomiting shows a certain rules that the meridians selected are mainly stomach meridian, pericardium meridian and conception vessel and acupuncture points selected are normally ST 36, PC 6 and CV 12, proximal and distal point combination is applied more, while single point applied less.
基金Supported by China Academy of Chinese Medical Sciences(CACMS)Innovation Fund:CI2021A03503National Key Research and Development Program:2022YFC3500705Fundamental Research Funds for the Central Public Welfare Research Institutes:ZZ20211810。
文摘Objective:To summarize and analyze the recommendations of acupuncture and moxibustion in the global guidelines/expert consensus of chemotherapy-and/or radiotherapy-induced nausea and/or vomiting,providing a basis for the development of clinical practice guidelines on acupuncture and moxibustion for chemotherapy-and/or radiotherapy-induced nausea and/or vomiting.Methods:We systematically searched 7 comprehensive databases,7 guideline libraries and 4 websites of societies/associations.The retrieval period was from the inception to April 1,2023.Two researchers independently screened the literature,extracted data,and used the Scientific,Transparent,and Applicable Rankings(STAR)tool to evaluate the quality of guidelines/expert consensus that contained acupuncture and moxibustion recommendations,and analyzed acupuncture and moxibustion recommendations in guidelines/expert consensus and their evidence base.Results:A total of 56 guidelines/expert consensus related to the prevention and treatment of chemotherapy-and/or radiotherapy-induced nausea and/or vomiting were included,and 22 guidelines/expert consensus contained acupuncture and moxibustion recommendations,with a total of 34 recommendations on acupuncture and moxibustion(27 supports,4 neutrals,3 objections).The STAR evaluation(excluding 1 patient version of guideline)showed that none of the guidelines/expert consensus was with high quality,95.24%(20/21)with medium quality,and 4.76%(1/21)with low quality.Although there were many recommendations of acupuncture and moxibustion in the existing guidelines/expert consensus,there was great heterogeneity among the acupuncture and moxibustion treatment regimens.Moreover,most of the guidelines/expert consensus did not describe the details of acupuncture and moxibustion treatment regimens,such as acupuncture and moxibustion manipulation,acupoint selection,course and timing of treatment,which is difficult to guide the clinical practice of acupuncture and moxibustion.Conclusion:Developing clinical practice guidelines of acupuncture and moxibustion for chemotherapyand/or radiotherapy-induced nausea and/or vomiting according to the items of the STAR tool was urgent,so as to clarify the details of acupuncture and moxibustion regimens and provide standardized treatment regimens to guide the clinical practice of acupuncture and moxibustion.
基金supported by the Institute of Research and Innovation of Universitas Muhammadiyah Yogyakarta(No.034/PEN-LP3M/II/2021)。
文摘Objective:This review aimed to map and summarize published studies that tested non-pharmacological management for chemotherapyinduced nausea and vomiting(CINV).Methods:We searched for eligible studies in 5 electronic databases and screened the retrieved studies using the inclusion and exclusion criteria.Data were then collated according to the types of interventions,measurement tool,and outcomes.Results:The search yielded 2343 records,of which 11 were included.Four categories of non-pharmacological CINV management were made;manipulative and body-based therapy(n=5 studies);mind–body therapy(n=3 studies);biologically based practice(n=1 study),and energy therapy(n=2 studies).Seven different scales were used to measure CINV.Nine studies repor ted improvement in CINV.Conclusions:This scoping review demonstrates the breadth of non-pharmacological management to address CINV.Various types of CINV scales were used to measure CINV severity.The management and scale can be utilized to improve nursing care,par ticularly in cancer care.
基金supported by MSD Holding Co.,Ltd.The funding was only for the payment of using CHIRA database
文摘Background： Few studies have attempted to evaluate the use of antiemetic therapy for chemotherapyinduced nausea and vomiting （CINV） at a national level in China or to assess how treatment regimens adhere to current guidelines. Methods： We searched the China Health Insurance Research Association （CHIRA） Database to identify patients with cancer who were 〉 18 years old and received either moderately or highly emetogenie chemotherapy （MEC and HEC, respectively） between 2008 and 2012. Patients＇ characteristics as well as usage of specific antiemetic regimens were analyzed using descriptive statistics. Results： Of the 14,548 patients included in the study, 6,477 received HEC while 8,071 were treated with MEC. Approximately 89.9% used antiemetics prophylactically to prevent acute CINV and 71.5% for delayed CINV while 9.0% were prescribed antiemetics as rescue therapy. A significantly lower proportion of patients treated with HEC received prophylactic antiemetic therapy for delayed CINV as compared to those treated with MEC （59.4% vs. 81.3 %; P〈0.001）. The HEC group had a slightly lower proportion of patients using a mixed regimen containing a 5-HT3 antagonist to prevent both acute and delayed CINV than the MEC group （P〈0.012）; however, a higher proportion received a mixed regimen containing eorticosteroids （P≤0.007）. Although more than half of the patients in the HEC group took three antiemeties to prevent acute and delayed CINV, these rates were significantly lower than those of the MEC group （both P〈0.001）. Finally, analysis of the regimens used revealed that there is over-utilization of drugs within the same class of antiemetic. Conclusions： These findings indicate that more attention is needed for treatment of delayed CINV, in terms of both overall use and the components of a typical treatment regimen.
基金supported by grants from the Shanghai Municipal Health Bureau Programs (No.2010L058A)the National Natural Science Foundation of China (No.81403248, No.81273955)
文摘Background: Chemotherapy?induced nausea and vomiting adversely affects the quality of life of patients who receive chemotherapy via intravenous infusion or transcatheter arterial chemoembolization(TACE). This study aimed to investigate the clinical effects of transcutaneous electrical acupoint stimulation(TEAS) on nausea and vomiting after TACE.Methods: A total of 142 patients who received TACE with cisplatin for primary or metastatic liver cancer were assigned to the active?acupuncture(n = 72) or placebo?acupuncture(n Hegu(LI4), Neiguan(P6), an= 70) groups using a covariate?adaptive randomization at a ratio of 1:1. The acupointsd Zusanli(ST36) were stimulated twice daily for 6 days. The effects of TEAS on nausea and vomiting were assessed by using occurrence rate and severity of these symptoms. Anorexia scale and M. D. Anderson Symptom Inventory(MDASI) scores were secondary endpoints and were used to assess the effect of TEAS on patient appetite and quality of life. The safety of the treatments was also monitored.Results: Between the two groups, the differences in occurrence rates and severities of nausea and vomiting after TACE were not significant(all P > 0.05). From the second day after TACE, anorexia scores were significantly lower in the active?acupuncture group than in the placebo?acupuncture group and continued to decrease over time with treat?ment(all P values less than 0.01). On days 0, 1, and 2, the mean MDASI scores for the active?acupuncture group were slightly lower than those for the placebo?acupuncture group, but the differences were not statistically significant(all P > 0.05). No significant differences were found between the two groups in the occurrence rate of any adverse event(P > 0.05).Conclusion: TEAS appears to be a safe and effective therapy to relieve patients' gastrointestinal discomfort after chemotherapy.
文摘AIM： To evaluate the clinical presentation, response to prophylactic therapy and outcome of children with cyclic vomiting syndrome （CVS） in Shiraz, Iran. METHODS： During a period of 11 years （March 1994 to March 2005）, 181 consecutive children with a final diagnosis of CVS were evaluated, treated and followed in our center. Patients were randomized to receive either amitriptyline or propranolol as prophylactic treatments. RESULTS： There were 88 boys and 93 girls with mean age of onset of symptoms of 4.9 ± 3.3 years （range, neonatal period to 14 years）, the mean age at final diagnosis was 6.9 years （range, 1.5 to 14）, and the mean duration between the onset of the first attack and the final diagnosis of CVS was 2 ± 1.81 years （range, 1/6 to 8）. The mean duration of each attack was 4.26 days （range, from few hours to 10 d） and the mean interval between the attacks was 1.8 mo （range, 1 wk to 12 too）. The time of onset of the attacks was midnight to early morning in about 70% of cases. Amitriptyline was effective in 46 out of 81 （56%） patients （P 〈 0.001）. Propranolol appeared to have a superior action and was effective in 74 out of 83 （92%） patients （P 〈 0.0001）. CONCLUSION： There is a significant lag time between the onset of clinical symptoms and the final diagnosis of CVS in our area. In patients with typical clinical presentations of CVS, who are examined by an experienced physician, invasive workup is not necessary. Propranolol appears more effective than arnitriptyline for prophylactic use in children with CVS.
基金Supported by the Health Department of Shandong Province,No,1999CA1CBA3
文摘AIM： To establish a new, reliable vomit model of minks METHODS： Adult male minks were randomly divided into 8 groups （n=6）： cisplatin （7.5 mg/kg） intraperitoneal injection （ip） group, copper sulfate （40 mg/kg） intragastric injection （ig） group, apomorphine （1.6 mg/kg） subcutaneous injection （sc） group, and 18 Gy whole-body X-irradiation group, ondansetron injection group （2 mg/kg ip） 30 min later followed by cisplatin （7.5 mg/kg） ip, normal saline （NS） ip injection control group, metoclopramide injection group （4 mg/kg ip） 30 rain later followed by apomorphine （1.6 mg/kg） sc, NS ig control group. The frequency of retching and vomiting was calculated. After behavioral experiment, distribution of 5-HT in the ileum was detected by immunohistologic method. RESULTS： Cisplatin, apomorphine, copper sulfate and X-irradiation administered to minks evoked a profound emetic response in the animals. However, retching and vomiting were significantly inhibited by pretreatment with ondansetron and metoclopramide in cisplatin and copper sulfate groups （P=0.018）. Immunohistologic result showed that 5-HT released from enterochromaffin cells （EC cells） was involved in vomiting mechanism. CONCLUSION： Mink vomit model has a great value in studying the vomiting mechanism and screening new antiemetic drugs.
文摘BACKGROUND Ganglioneuroma (GN) is a rare neurogenic tumor that accounts for about 0.1%- 0.5% of all tumors of the nervous system.It originates from neural crest cells.GN has no specific clinical symptoms or laboratory findings,which leaves it easily overlooked and misdiagnosed as other tumors.Retroperitoneal GN with very large volume and vascular penetration is extremely rare.CASE SUMMARY We present the imaging and pathological findings of a giant retroperitoneal GN in a child.A 4-year-old boy had suffered from postprandial vomiting for more than 6 mo with no precipitating factors.Abdominal computerized tomographic examination showed a giant cystic mass in the retroperitoneal area.After injection of contrast agent,the mass showed heterogeneous enhancement.Surgery with local excision of the mass was performed to address the embedded abdominal blood vessels,and the histopathological and immunohistochemical diagnosis of the mass was GN.Postprandial vomiting was relieved,and no complications occurred after the operation.CONCLUSION In the diagnosis of giant retroperitoneal hypodense masses in children,GN should be considered if the mass presents delayed enhancement,punctate calcification,and vascular embedding but no invasion.Pathology is the golden standard for the diagnosis of GN,and surgical excision is the optimal treatment for GN.
基金Supported by Shanghai Three-Year Action Plan for Advanced Accelerated Development of the Course of Traditional Chinese Medicine:ZY(2018-2020)-CCCX-2001-05。
文摘Objective:To analyze the acupoint selection rules in acupuncture treatment for chemotherapy-induced nausea and vomiting(CINV)in China through data mining technology.Methods:The relevant literature on acupuncture treatment for CINV were searched from SinoMed,China National Knowledge Infrastructure(CNKI),Wanfang,VIP and Pubmed databases from the establishment to January 3,2021 and the worksheet was set up for the information extraction of acupuncture-moxibustion prescriptions.Using IBM SPSS Statistics 25.0 and SPSS Modeler 18.0 software,cluster analysis and association rule analysis were conducted to explore the rules of acupoint selection.Results:A total of 179 articles were eligible,including 206 acupuncture prescriptions and 64 acupoints.The total use frequency of acupoints was 784 times.The acupoints with the highest use frequency were Zúsānlǐ(足三里ST36),Zhōngwǎn(中脘CV12)and Nèiguān(内关PC6).The commonly used meridians included stomach meridian of foot-yangming,conception vessel,pericardium meridian of hand-jueyin and bladder meridian of foot-taiyang.The acupoints located on the chest,the abdomen and the lower limbs were mostly selected.Five-shu points and crossing points were highly involved in terms of the specific points.The most common combination was ST36,CV12 and PC6.Conclusion:In treatment of acupuncture for CINV,the acupoints were generally selected from stomach meridian of foot-yangming,conception vessel,pericardium meridian of hand-jueyin.Front-mu points on the chest and the abdomen,the he-sea points and lower he-sea points in the lower limbs are commonly used.The core acupoint prescription of acupuncture for CINV included ST36,CV12 and PC6.
文摘BACKGROUND Chemotherapy is the primary treatment for patients with advanced gastrointestinal cancer,but it has many adverse reactions,particularly nausea and vomiting.Music therapy can reduce anxiety symptoms,avoid the response to the human body under various stress conditions through psychological adjustment,and improve the adverse reactions of chemotherapy.AIM To investigate the impact of music therapy on relieving gastrointestinal adverse reactions in chemotherapy for patients with digestive tract cancer by metaanalysis.METHODS EMBASE,PubMed,OVID,WoS,CNKI,CBM,and VIP database were all used for searching relevant literature,and the efficacy after treatment was combined for analysis and evaluation.RESULTS This study included seven articles.The results of meta-analysis indicated that music therapy could reduce the nausea symptom score of patients after chemotherapy[mean difference(MD)=-3.15,95%confidence interval(CI):-4.62 to-1.68,Z=-4.20,P<0.0001].Music therapy could reduce the vomiting symptom score of patients after chemotherapy(MD=-2.28,95%CI:-2.46 to-2.11,Z=-25.15,P<0.0001).Furthermore,music therapy could minimize the incidence of grade I and above nausea or vomiting in patients after chemotherapy(odds ratio=0.38,95%CI:0.26-0.56,Z=-4.88,P<0.0001).Meta-regression analysis found that publication year was not a specific factor affecting the combined results.There was no significant publication bias(P>0.05).CONCLUSION Music therapy can significantly improve the scores of nausea and vomiting symptoms in patients with digestive system cancer during chemotherapy and reduce the incidence of grade I and above nausea and vomiting after chemotherapy,making it an effective psychological intervention method worthy of clinical promotion.
基金Excellent Financial Talents Project of Hebei Province:2018133214。
文摘Objective:To observe the influence of wrist-ankle acupuncture(WAA)on postoperative nausea and vomiting(PONV)undergoing radiofrequency ablation(RFA)in thyroid nodule and its analgesic effect.Methods:A total of 66 patients with thyroid nodule and undergoing RFA were randomized into a WAA group and a sham-acupuncture(SA)group,33 cases in each one.Acupuncture was exerted after the patients entering operation room.In the WAA group,WAA was applied on the bilateral Upper 1,2 and 3 areas.In the SA group,the sham-acupuncture was given on the same areas.In 30 min after needle insertion,the routine RFA started in the patients of the two groups.All the needles were removed when the operation was finished.The proportion of intraoperative sufentanil supplementation,the incidence of24 h PONV and the proportion of intraoperative intravenous injection of urapidil were recorded in the patients of the two groups.Results:In the WAA group,sufentanil was supplemented by 12.90%,obviously less than 36.36%in the SA group.The incidence of 24 h PONV was 9.68%in the WAA group,remarkably lower than 27.27%in the SA group,indicating statistical significances(both P<0.05).The intravenous injection of urapidil was not applied during operation in the two groups,without statistical difference between the groups(P>0.05).Conclusion:Wrist-ankle acupuncture reduces the intraoperative demand of sufentanil in radiofrequency ablation of thyroid nodule and this therapy is preventive for PONV.
文摘Objective: To describe the prescribing trends of antiemetics in chemotherapy-induced nausea and vomiting (CINV), assess adherence to American Society of Clinical Oncology (ASCO) guidelines, and evaluate the effectiveness of prescribed antiemetics. Additionally, we also sought to explore barriers that hinder clinical practice guideline (CPG) implementation. Methods: One hundred fifty-five patients between the ages of 18 and 60 who were admitted to the haematology/oncology department/clinic to receive intravenous chemotherapy, either as in-patients or outpatients, were enrolled in a prospective observational study. Relevant patient demographic data, chemotherapy protocols and antiemetics were collected. Chemotherapies were classified according to their emetogenic potential. This information was used to assess whether the antiemetic prescribed matched the emetogenic risk of treatment. The analysis of outcomes was performed using the MASCC antiemetic assessment tool. Key Findings: The results showed that 95% of antiemetic prescription pre-chemotherapy regimens did not adhere to the guidelines. The findings were use of twice the recommended dose of granisetron (87.7%), overuse granisetron (16%) and metoclopramide (62.6%), and underuse dexamethasone (27%) and corticosteroid duplication (7.7%). With respect to post-chemotherapy antiemetic prescriptions, 91% of prescriptions were not adherent to guidelines, with overuse of granisetron (81.9%) and metoclpramide (34.2%) and underuse of dexamethasone (66.5%) being the most frequently reported trends. Conclusion: This study shows a lack of conformity to antiemetic guidelines, resulting mainly in overtreatment. Although vomiting was well-managed, nausea remains under controlled and requires additional medical attention. The lack of knowledge and motivation are considered barriers to CPG implementation.
文摘Thyrotoxicosis may present in many ways;severe vomiting as a prominent symptom of thyrotoxicosis is uncommon.In this paper,we report a 24-year-old Chinese male with hyperthyroidism who presented with recurrent severe vomiting.The patient had had intermittent vomiting for seven years and had lost approximately 15 kg of weight.Gastroscopic examinations revealed chronic gastritis and one occasion peptic ulcer.He was treated with antacid and proton pump inhibitors,but his symptoms had no relief.His presenting symptoms suggested hyperthyroidism and were confirmed by laboratory data.After a month of propylthiouracil therapy,his symptoms were relieved.It should be noted that hyperthyroidism patients can have unexplained vomiting,and that hyperthyroidism may coexist with peptic ulcer in rare cases.Awareness of such atypical presentations of hyperthyroidism may help to make a correct diagnosis.
文摘OBJECTIVE: To observe the effect of transcutaneous electroacupuncture(TEA) at Neiguan(PC 6) on refractory vomiting in critically ill patients in intensive care(ICU) setting.METHODS: Ten patients admitted in ICU and presenting vomiting refractory to one or more antiemetic drugs were prospectively included in the study. TEA was applied at acupoint of Neiguan(PC6) during 30 min with a neuromuscular transmission monitor(single-twitch stimulation with 1 Hz at a constant current of 10 m A). Nausea and Vomiting were evaluated at the following intervals: immediately after 30 min of TEA at Neiguan(PC 6),30 min-6h and 6-24 h. The presence of nausea and/or vomiting throughout the observational period was defined as the primary end point.RESULTS: The presence of nausea or vomiting throughout the observational period was 10% at the end of TEA, 40% between 30 min and 6 h, and50% between 30 min and 24 h(P < 0.001, P = 0.01 and P = 0.03 vs pre-TEA, respectively). There were no complications or side effects related to TEA.CONCLUSION: TEA at Neiguan(PC 6) seems effective in reducing refractory vomiting in the patients in ICU setting, even if larger trials are needed to define optimal modalities.
基金This study was supported by the Major projects of Sichuan Science and Technology Department of China (No.18ZDYF0347)Mianyang Science and Technology Bureau of China (No. 17YFHM008).
文摘Background:Postoperative nausea and vomiting(PONV)refers to a problem commonly occurring after surgery.Acupuncture is considered a critical complementary alternative therapy for PONV.The acupoints selection critically determines the efficacy of acupuncture,whereas the selection rules remain unclear.The objective of the present study was to delve into the principles of acupoints selection for PONV using data mining technology.Methods:The clinical trials assessing the acupuncture effect for PONV were searched with the use of computer in PubMed,China National Knowledge Infrastructure,and Chinese Biomedical Database;the time span was confined as 2009–2019.The database of acupuncture prescriptions for PONV was built using Excel 2016;the description and association were analyzed by IBM SPSS modeler 18.Result:Eighty-three relevant literatures were screened out.The number of specific acupoints took up 72.5%of all acupoints;specific acupoints exhibited the frequency taking up 91.30%of the total frequency.As revealed from the result,Neiguan(PC 6),Zusanli(ST 36),Hegu(LI 4),and Zhongwan(CV 12)were most frequently applied,suggesting the tightest associations.Most acupoints were taken from the stomach meridian and pericardium meridian.The common acupoints were concentrated in the lower limbs,chest,as well as abdomen.Conclusion:Data mining acts as a feasible method to identify acupoints selection and compatibility characteristics.As suggested from our study,the acupoints selection for PONV prioritizes specific acupoints and related meridians.The selection and combination of acupoints comply with the theory of traditional Chinese medicine.
