A Perioperative Care Display for Understanding High Acuity Patients

Background  The data visualization literature asserts that the details of the optimal data display must be tailored to the specific task, the background of the user, and the characteristics of the data. The general organizing principle of a concept-oriented display is known to be useful for many tasks and data types. Objectives  In this project, we used general principles of data visualization and a co-design process to produce a clinical display tailored to a specific cognitive task, chosen from the anesthesia domain, but with clear generalizability to other clinical tasks. To support the work of the anesthesia-in-charge (AIC) our task was, for a given day, to depict the acuity level and complexity of each patient in the collection of those that will be operated on the following day. The AIC uses this information to optimally allocate anesthesia staff and providers across operating rooms. Methods  We used a co-design process to collaborate with participants who work in the AIC role. We conducted two in-depth interviews with AICs and engaged them in subsequent input on iterative design solutions. Results  Through a co-design process, we found (1) the need to carefully match the level of detail in the display to the level required by the clinical task, (2) the impedance caused by irrelevant information on the screen such as icons relevant only to other tasks, and (3) the desire for a specific but optional trajectory of increasingly detailed textual summaries. Conclusion  This study reports a real-world clinical informatics development project that engaged users as co-designers. Our process led to the user-preferred design of a single binary flag to identify the subset of patients needing further investigation, and then a trajectory of increasingly detailed, text-based abstractions for each patient that can be displayed when more information is needed.     

新冠肺炎临床评价核心指标集比较分析＊

目的 对已公开发表的新冠肺炎核心指标集及其研究方法进行比较分析，为临床试验和证据转化研究提供参考信息。方法 计算机检索COMET数据库，并补充检索CNKI、WanFang、PubMed、Web of Science、The Cochrane Library等数据库，收集发表的新型冠状病毒肺炎（Coronavirus Disease 2019，COVID-19）核心指标集（Core Outcome Set，COS）研究，检索时间截至为2021年3月31日。按照纳入排除标准筛选文献，并提取研究基本信息、研究方法及指标数据，对其进行描述性分析。结果 共纳入5项COVID-19核心指标集相关研究（4项为COVID-19-COS研究，1项为COVID-19核心指标测量工具研究）。相同的结局指标包括死亡率、病毒核酸检测、临床进展、恢复期、临床症状评分及临床分型等。指标来源主要来自临床试验注册平台和问卷调查；达成共识的方法主要采用共识会议；利益相关群体中临床专家、方法学专家和医疗管理人员涉及较多。结论 不同的新冠肺炎核心指标集研究有一定的共性，但由于应用场景不同，也存在一定差异。随着对疾病认识的深化，相关COVID-19核心指标需要加强测量方法和疗程推荐。     

染料木黄酮对前列腺癌细胞增殖、迁移和侵袭的影响及机制

本研究拟探讨染料木黄酮对前列腺癌细胞LNCaP和CWR22RV1的增殖、迁移和侵袭能力的影响。一、材料与方法1.材料:前列腺癌细胞株LNCaP和CWR22RV1(中国科学院上海生命科学研究院);Genistein(天津科瑞泰科技有限公司);RPMI 1640、胎牛血清(FBS)、胰蛋白酶(美国Gibco公司);E-钙黏蛋白(E-cadherin)、N-钙黏蛋白(N-cadherin)、波形蛋白(Vimentin,Abcam公司);聚氰基丙烯酸正丁酯(BCA)试剂盒、十二烷基硫酸钠-聚丙烯酰胺凝胶电泳(SDS-PAGE)上样缓冲液(×5)及蛋白质印迹法(Western blot)试剂盒(上海市碧云天生物公司);2.实验方法:采用噻唑蓝(MTT)实验、划痕实验和Transwell实验检测Genistein对细胞增殖、迁移及侵袭能力的影响。采用Western blot检测E-cadherin、N-cadherin、Vimentin、CD44和Oct-4的表达水平。     

Comparison of the protective effects of curcumin and caffeic acid phenethyl ester against doxorubicin-induced testicular toxicity

Whether testicular toxicity is mediated by matrix metalloproteinases (MMPs) is an important question that has not been examined. This study investigated the suppressive effect of curcumin and caffeic acid phenethyl ester (CAPE) on oxidative stress, apoptosis, and whether MMPs mediate doxorubicin (DOX)-induced testicular injury. Male rats were randomly divided into eight groups (n = 8 per group). The groups were as follows: sham, dimethyl sulphoxide (100 µL), DOX (3 mg/kg), CAPE (2.68 mg/kg), curcumin (30 mg/kg), DOX+CAPE (3 mg/kg DOX and 2.68 mg/kg CAPE), DOX+curcumin (3 mg/kg DOX and 30 mg/kg curcumin) and DOX+CAPE+curcumin (3 mg/kg DOX, 2.68 mg/kg CAPE and 30 mg/kg curcumin). Injections were administered daily for 21 days. The oxidative stress, MMPs, proinflammatory cytokines and apoptotic markers in the DOX group were higher than the sham group (p < .05); these measures were lower in the groups treated with CAPE and curcumin together with DOX compared with the DOX group (p < .05). The results showed that MMPs mediated DOX-induced testicular injury, but CAPE and especially curcumin suppressed testis injury and cell apoptosis by suppressing DOX-induced increases in MMPs, oxidative stress and proinflammatory cytokines. However, curcumin exhibited more pronounced effects than CAPE in terms of all studied parameters.     

病房护士发生职业性肌肉骨骼疾患工作场所的MAPO指数评估及影响因素分析

目的评估病房手工搬运患者护士发生职业性肌肉骨骼疾患(WMSDs)工作场所的MAPO指数,并了解工作场所中WMSDs发生的影响因素。方法采用便利抽样法,于2019年3—5月选取某三甲医院26个病区的317名护士为研究对象。以一般资料调查表、MAPO评估方法、米尺为研究工具,采用现场调查和测量法,对病房手工搬运患者护士发生WMSDs工作场所的情况进行综合评估。依据MAPO指数将病区分为红灯、黄灯、绿灯3个风险等级,亮黄灯代表有必要执行中期和长期干预计划,亮红灯意味着必须执行短期干预计划。对病房手工搬运患者护士发生WMSDs的影响因素采用多因素Logistic回归分析。结果本研究共发放问卷317份,回收有效问卷265份,有效回收率为83.6%。265名病房护士中,76.2%(202/265)的护士发生WMSDs。有13个(50.0%,13/26)病区亮红灯,包含158名(59.6%,158/265)护士;6个(23.1%,6/26)病区亮黄灯,包含92名(34.7%,92/265)护士;7个(26.9%,7/26)病区亮绿灯,包含15名(5.7%,15/265)护士。多因素Logistic回归分析显示,MAPO指数和病房分值是病房护士发生WMSDs的影响因素(OR值分别为1.056、1.571;P<0.05)。结论病房护士工作场所发生WMSDs的风险较高,建议从病床类型、床间距、辅助设备、护理人力资源配置和职业防护培训方面入手来减少护士WMSDs的发生。     

Advancement of chimeric antigen receptor-natural killer cells targeting hepatocellular carcinoma

With the advance of genome engineering technology, chimeric antigen receptors (CARs)-based immunotherapy has become an emerging therapeutic strategy for tumors. Although initially designed for T cells in tumor immunotherapy, CARs have been exploited to modify the function of natural killer (NK) cells against a variety of tumors, including hepatocellular carcinoma (HCC). CAR-NK cells have the potential to sufficiently kill tumor antigen-expressing HCC cells, independent of major histocompatibility complex matching or prior priming. In this review, we summarize the recent advances in genetic engineering of CAR-NK cells against HCC and discuss the current challenges and prospects of CAR-NK cells as a revolutionary cellular immunotherapy against HCC.     

Responsabilidad social corporativa en los centros de la red hospitalaria de utilización pública de Cataluña

The adoption of a management approach that integrates corporate social responsibility in organizations is an increasing trend that responds to the demands of society related to sustainability, ethics and transparency. Health organizations are adopting corporate social responsibility asymmetrically, which raises the analysis of the implementation models and the developed initiatives. Through qualitative research, with four in-depth case studies of the Catalan health sector, this article analyzes the need to address this new approach and to identify good practices and the challenges for its implementation.     

患者报告结局在人类免疫缺陷病毒感染临床研究与实践中的应用进展

得益于高效抗反转录病毒治疗的发展,人类免疫缺陷病毒(human immunodeficiency virus,HIV)感染已成为可控的慢性疾病,患者对生命质量的要求日益增高,临床也逐渐向"以患者为中心"的诊疗新模式发展,以优化HIV感染者的长期管理。其中,以患者主观感受为导向的患者报告结局作为一类新的评价指标,有助于临床工作者将HIV感染者的治疗需求、对健康的偏好和价值取向纳入临床决策,进而提升患者的满意度。然而在我国HIV领域中,患者报告结局尚未得到广泛应用。本研究对患者报告结局的基本概念和内容进行阐述,并结合文献资料综述其在国内外HIV感染临床研究及实践中的进展,以期为患者报告结局在我国HIV领域中的普及和发展提供参考。