数据挖掘法探讨周珉教授治疗原发性肝癌用药规律及经验总结

[目的]数据挖掘法分析周珉教授治疗原发性肝癌的中医用药规律,探讨相关病机并进行经验总结。[方法]收集2016年2月—2018年5月周珉教授门诊期间治疗原发性肝癌的方剂,运用"中医传承辅助系统(V2.50)"进行数据挖掘,并结合周珉教授临床经验,进行原发性肝癌病机探讨及用药规律分析。[结果]共收集治疗原发性肝癌方剂176首,涉及中药235种,列出方剂中的高频药物及组合规律。[结论]总结原发性肝癌以"湿热痰毒、气阴两伤"为基础病机,"清热化湿、健脾养阴"治则贯穿原发性肝癌治疗始末,同时,根据疾病不同发展阶段及治疗措施,权衡"扶正"与"祛邪"的主次分配,斟酌应用"攻毒散结""行气化瘀"等治法,以达到改善患者生活质量、延缓疾病进展的目的。     

情景模拟联合案例讨论在急诊护理临床带教中的应用体会

目的探究急诊护理临床带教中采用情景模拟、案例讨论联合教学法效果。方法在本院实习的若干名护生中,选取124名护生分按照教学方法分组,对照组62名实施传统急诊护理带教,观察组62名实施案例讨论、情景模拟联合教学法,对比临床带教效果。结果两组实践与理论成绩相比,观察组成绩更高(P<0.05)。思维、急救及应激能力自我评价相比,观察组的总提高率高于对照组(P<0.05)。实施案例分析结合情景模拟教学模式后,问卷调查中观察组无护生不赞同此模式,非常赞同此教学模式的护生占总人数的90%以上。结论实施案例讨论、情景模拟联合教学模式后,护生急诊护理实践与理论水平均提升,护生我评价较高。     

Brazilian versions of the Measure of Processes of Care-20 and Measure of Processes of Care-Service Providers: translation,cross-cultural adaptation and reliability

BackgroundThe Measure of Processes of Care (MPOC) questionnaires evaluate Family-Centered Practice (FCP) in services for children with developmental disorders. The MPOC-20 and MPOC-SP are completed by parents and by rehabilitation professionals, respectively, and are widely used in several countries.ObjectivesTo translate and cross-culturally adapt the MPOC-20 and MPOC-SP to Brazilian Portuguese and evaluate their reliability and internal consistency.Methodsthis study included translation, back-translation, cognitive interviews, testing of the pre-final versions, analysis of reliability and of internal consistency of the final versions. Respondents included parents and rehabilitation professionals from rehabilitation centers in four capital cities in Brazil.ResultsTranslation and cultural-adaptation procedures ensured the Brazilian versions were understandable and semantically equivalent to the original MPOC-20 and MPOC-SP. Pre-final and final versions were analyzed and vetted by the original authors. The MPOC-20 internal consistency Cronbach's alpha varied between 0.61 and 0.91 (n = 107), the test-retest reliability ICC varied between 0.44 and 0.83 and the standard error of measurement varied between 0.66 and 0.85 (n = 50). The MPOC-SP internal consistency Cronbach's alpha varied between 0.52 and 0.83 (n = 92), the test-retest reliability ICC between 0.83 and 0.90, and the standard error of measure between 0.34 and 0.46 (n = 62).ConclusionThe Brazilian versions of the MPOC-20 and the MPOC-SP are in general stable and sufficiently reliable. They are relevant to the evaluation of FCP and provide information that can improve health services and ensure better care.     

Sonodynamic Therapy: Advances and Challenges in Clinical Translation

Sonodynamic therapy (SDT) consists of the synergetic interaction between ultrasound and a chemical agent. In SDT, the cytotoxicity is triggered by ultrasonic stimuli, notably through cavitation. The unique features of SDT are relevant in the clinical context more than ever: the need for efficacy, accuracy, and safety while being noninvasive and preserving the patient's quality of life. However, despite the promising results of this technique, only a few clinical reports describe the use of SDT. The objective of this article is to provide an extensive overview of the clinical and preclinical research conducted in vivo on SDT, to identify the limitations, and to detail the developed strategies to overcome them.