Developing normal number of small segments-activity clouds of the electromyography interference pattern

Guillain-Barré syndrome (GBS) is an inflammatory polyradiculoneuropathy associated with numerous viral infections. Recently, there have been many case reports describing the association between coronavirus disease-2019 (COVID-19) and GBS, but much remains unknown about the strength of the association and the features of GBS in this setting. We reviewed 37 published cases of GBS associated with COVID-19 to summarize this information for clinicians and to determine whether a specific clinical or electrodiagnostic (EDx) pattern is emerging. The mean age (59 years), gender (65% male), and COVID-19 features appeared to reflect those of hospitalized COVID-19 patients early in the pandemic. The mean time from COVID-19 symptoms to GBS symptoms was 11 days. The clinical presentation and severity of these GBS cases was similar to those with non–COVID-19 GBS. The EDx pattern was considered demyelinating in approximately half of the cases. Cerebrospinal fluid, when assessed, demonstrated albuminocytologic dissociation in 76% of patients and was negative for severe acute respiratory distress syndrome–coronavirus-2 (SARS-CoV-2) in all cases. Serum antiganglioside antibodies were absent in 15 of 17 patients tested. Most patients were treated with a single course of intravenous immunoglobulin, and improvement was noted within 8 weeks in most cases. GBS-associated COVID-19 appears to be an uncommon condition with similar clinical and EDx patterns to GBS before the pandemic. Future studies should compare patients with COVID-19–associated GBS to those with contemporaneous non–COVID-19 GBS and determine whether the incidence of GBS is elevated in those with COVID-19.     

Professional values development during a baccalaureate nursing degree completion program

Faculty recognized a need to further study professional values development in registered nurses during a baccalaureate degree completion program. Study participants were surveyed at the beginning and conclusion of their program using the Nurses Professional Values Scale – Revised (NPVS-R) with several additional open-ended questions. The results supported that associate degree–prepared nurses returning to school possess a level of professional values similar to nurses with a baccalaureate degree.     

An Environmental Scan of the National and Provincial Diagnostic Reference Levels in Canada for Common Adult Computed Tomography Scans

Several regulatory bodies have agreed that low-dose radiation used in medical imaging is a weak carcinogen that follows a linear, non-threshold model of cancer risk. While avoiding radiation is the best course of action to mitigate risk, computed tomography (CT) scans are often critical for diagnosis. In addition to the as low as reasonably achievable principle, a more concrete method of dose reduction for common CT imaging exams is the use of a diagnostic reference level (DRL). This paper examines Canada's national DRL values from the recent CT survey and compares it to published provincial DRLs as well as the DRLs in the United Kingdom and the United States of America for the 3 most common CT exams: head, chest, and abdomen/pelvis. Canada compares well on the international scale, but it should consider using more electronic dose monitoring solutions to create a culture of dose optimization.     

Design,synthesis and pharmacological evaluation of 4-(3-chloro-4-(3-cyclopropylthioureido)-2-fluorophenoxy)-7-methoxyquinoline-6-carboxamide (WXFL-152): a novel triple angiokinase inhibitor for cancer therapy

Angiokinases, such as vascular endothelial-, fibroblast- and platelet-derived growth factor receptors (VEGFRs, FGFRs and PDGFRs) play crucial roles in tumor angiogenesis. Anti-angiogenesis therapy using multi-angiokinase inhibitor has achieved great success in recent years. In this study, we presented the design, synthesis, target identification, molecular mechanism, pharmacodynamics (PD) and pharmacokinetics (PK) research of a novel triple-angiokinase inhibitor WXFL-152. WXFL-152, identified from a series of 4-oxyquinoline derivatives based on a structure–activity relationship study, inhibited the proliferation of vascular endothelial cells (ECs) and pericytes by blocking the angiokinase signals VEGF/VEGFR2, FGF/FGFRs and PDGF/PDGFRβ simultaneously in vitro. Significant anticancer effects of WXFL-152 were confirmed in multiple preclinical tumor xenograft models, including a patient-derived tumor xenograft (PDX) model. Pharmacokinetic studies of WXFL-152 demonstrated high favourable bioavailability with single-dose and continuous multi-dose by oral administration in rats and beagles. In conclusion, WXFL-152, which is currently in phase Ib clinical trials, is a novel and effective triple-angiokinase inhibitor with clear PD and PK in tumor therapy.     

Association between Disability,Cognition, Fatigue,EQ-5D-3L Domains,and Utilities Estimated with Different Western European Value Sets in Patients with Multiple Sclerosis

Objectives

To assess the association between fatigue, cognition, domains of the EuroQol five-dimensional questionnaire (EQ-5D-3L), disability, and utilities estimated with several Western European value sets in patients with multiple sclerosis (MS).

DOPS在外科实习医师技能操作考核中的应用探讨

目的探讨临床操作技能直接观察评估考核(DOPS)在外科实习医师"换药"操作考核中的应用价值。方法以徐州医科大学2017届和2018届在我院实习的临床医学专业46名本科实习医师为研究对象,将其随机分为研究组和对照组。研究组在第1周末、第2周末、第3周末、第4周末进行DOPS评估操作考核;对照组在第1周末、第2周末、第3周末进行传统操作考核,第4周末进行DOPS操作考核。比较研究组和对照组第4周末DOPS考核的平均分数及教师、实习医师对考核的满意度。结果研究组第4周末DOPS考核平均分高于对照组(85.25±2.57)分vs.(76.64±4.96)分;研究组教师满意度为高于对照组教师满意度(7.42±0.41)分vs.(5.76±1.12)分;研究组实习医师满意度为高于对照组实习医师满意度为(7.43±0.85)分vs.(6.17±1.26)分;差异均有统计学意义(P<0.05)。结论DOPS评价系统应用于外科实习医师的操作考核中,可有效提高实习医师的操作水平,增加教师与实习医师的满意度。