Is ignorance bliss,or is knowledge power? When cancer healthcare professionals become cancer patients

Cancer healthcare professionals who are diagnosed with cancer enter the patient journey with considerable illness‐specific and healthcare expertise, which may influence the nature of their experience. Insights gained from having personal cancer experience may also lead to changes in professionals' subsequent clinical practice. This study explored cancer professional‐patients' experiences of their own cancer diagnosis, changes in practice, and recommendations for cancer care improvements. Participants were current or former cancer healthcare professionals who had ever received a cancer diagnosis. Semi‐structured interviews were conducted with 26 participants. Thematic analysis with an inductive approach was used for data analysis. Cancer professional‐patients faced unique needs, benefits and disadvantages due to their professional background, which both aided and marred their personal cancer experience. Individuals reported subjective practical and emotional‐related improvements in their clinical practice, although adverse emotional consequences upon returning to work were also prevalent. Care recommendations highlighted the importance of communication skills training for professionals, integrating psychological support, and providing patient‐centred care. In order to provide optimal care for cancer professional‐patients, providers must acknowledge their distinct challenges. Findings may help to foster improvements in cancer care practices through developing guidelines for treating cancer professional‐patients, and as part of narrative‐based medicine.     

营养及化疗对肿瘤患者血清微量元素和免疫功能的影响

目的 探讨肿瘤患者化疗后血清微量元素及免疫功能的变化，以及肠内营养支持对上述测定指标的影响。方法 　 选择 2018 年 3 月至 5 月进入武汉市中心医院化疗的肿瘤患者 19 例，年龄为 18~70 岁；KPS 评分≥ 60。随机分为两组： 9 例患者化疗期间行肠内营养干预，10 例患者未进行营养干预。在化疗前后分别测定血清微量元素和外周血淋巴细胞亚 群，并进行统计学分析。结果 未经营养干预的患者化疗后血清锰含量比化疗前显著减低（P=0.004），化疗后血清铅呈 现临界水平降低（P=0.057）；行营养干预的患者血清锌含量显著降低（P=0.013），外周血中NK 细胞比例在化疗后呈 临界水平降低（P=0.059），而 CD4+/CD8+ 之比在化疗后呈临界水平升高（P=0.057）。结论 化疗及营养干预对血清微 量元素浓度有一定的作用；营养干预对外周血T 细胞的分布有一定的影响，表现为NK 细胞比例在化疗后有降低趋势， CD4+/CD8+ 比值有升高趋势。由于病例数较少以及营养干预时间较短，因此有必要增加病例数以及延长营养干预时间并 做进一步深入研究。     

食管癌放化疗患者自我效能感与领悟社会支持相关性研究

目的 探讨食管癌患者放化疗期间自我效能感与领悟社会支持状况及其相关性。方法 选择2017 年 1~5 月首都 医科大学附属北京康复医院口腔科收治的 216 名食管癌住院患者，应用一般自我效能感量表、领悟社会支持量表和一般资 料调查表进行调查。结果 食管癌患者在放化疗期间自我效能感总体得分为（25.94±5.28）分；其中年龄＞35 岁、月收入 在 5000 元以上、有医保、诊断年限在6~10 年、有治疗史的患者自我效能感水平较高（P ＜ 0.05）。领悟社会支持总分为 （61.67±10.86）分，家庭内支持得分为（23.46±3.91）分，家庭外支持得分为（38.09±8.90）分；其中年龄越大、民族为少 数民族、文化程度越高、居住在城市、职业为医务人员、月收入在 5000 元以上、有医保、确诊年限在 6 年以下的患者领悟 社会支持水平较高（P＜0.05）。患者自我效能感得分与领悟社会支持总分及各维度均呈显著正相关（P＜0.01）。另外， 本研究还发现，完全缓解、部分缓解者的自我效能感、领悟社会支持得分、家庭内支持及家庭外支持得分均显著高于部分稳定、 疾病进展者，差异之间存在统计学意义（P＜0.05）。结论 食管癌患者在放化疗期间自我效能感和领悟社会支持水平较高， 患者感知到的社会支持越高，自我效能感越高。同时，自我效能感和领悟社会支持水平对判断该人群的预后具有重要的临 床意义。     

Endoscopic diagnosis of sessile serrated polyp: A systematic review

The aim of the present review was to clarify how we should detect and diagnose sessile serrated polyps (SSP) endoscopically. A systematic search was conducted of MEDLINE from January 2004 through March 2018. Nine findings: (i) proximal location; (ii) size >10 mm; (iii) irregular shape; (iv) indistinctive border; (v) cloud‐like surface; (vi) mucus cap; (vii) rim of debris in white‐light endoscopy; (viii) dilated vessels; and (ix) dilated crypts (pits) in image‐enhanced endoscopy were considered to be candidate discriminators of SSP from hyperplastic polyps. Prospective studies in a general setting are warranted to validate the above‐mentioned endoscopic features of SSP during real‐time colonoscopy and to determine whether these features are useful for the differential diagnosis of SSP.     

Rodent models of diet-induced type 2 diabetes mellitus: A literature review and selection guide

Several research teams have focused on finding the “ideal” animal model that reflects the pathophysiological changes and closely simulates the metabolic characteristics of patients with type 2 diabetes. However, the multitude of studies on this topic has resulted in large variations, making the models difficult to compare, as the measured parameters vary significantly. Additionally, selecting the appropriate animal model for a new study has become more difficult due to the increasing number of background variables. This article gives a detailed overview of the literature, covering the entire range of animal models and model characteristics, and most importantly, provides guidance for selecting the most suitable model for specific research goals in the future.