Closed loop stimulation helps with weaning from chronotropic incompetence-related ventilator dependence

Journal of Interventional Cardiac Electrophysiology -     

限时进食对恶性肿瘤的潜在防治作用

间歇性禁食是一种新的饮食干预策略,其可能改善恶性肿瘤治疗的疗效并减少并发症。 限时进食是间歇性禁食的 一种特殊形式,通常仅限制每天的进食时间窗而不限制热量,除了和其他间歇性禁食手段一样能够控制体重并改善代谢紊乱 以外,限时进食还能调节昼夜节律并影响自噬水平,具有潜在的抗衰作用,相关研究已经表明了它预防肿瘤发生以及减缓肿 瘤发展的潜力。 同时,由于实施方案便利、不良反应轻微,限时进食有着不错的依从性及安全性,有可能成为一种适合肿瘤患 者长期实施的辅助治疗方案乃至健康生活方式。 本文从改善肥胖和代谢紊乱、调节昼夜节律和自噬水平以及目前与肿瘤相 关的研究进展这三个方面阐述了限时进食对恶性肿瘤的潜在作用,旨在为将来的相关研究提供理论依据和探索方向,探讨限 时进食作为一种营养干预手段对恶性肿瘤发生的潜在预防作用以及对恶性肿瘤的治疗或辅助治疗作用,以期可以完善对肿 瘤患者的营养干预策略,改善患者的生活质量及预后。     

我国护士对多点执业认知与实践体验的Meta整合

目的 系统评价我国护士参与多点执业体验的质性研究，为推行护士多点执业提供切实可行的参考方案。方法 计算机检索中英文数据库中关于护士参与多点执业的质性研究，检索时间截至2022年6月。采用JBI质性研究质量评价标准对所纳入的文献进行文献质量评价，使用汇集性整合方法对结果进行整合。结果 共纳入13篇研究，提炼50个结果，归纳形成12个类别，最终整合成4个结果，包括护士对多点执业的态度；护士进行多点执业的促成因素；护士进行多点执业的阻碍因素；护士对多点执业的期望。结论 目前护士多点执业有诸多阻碍因素,医院管理者应重视护士多点执业真实体验，结合相关部门完善政策制定，完善多点执业管理制度，规范多点执业服务流程。     

幽门螺杆菌感染相关因素的研究进展

幽门螺杆菌（HP）是革兰阴性微需氧的螺旋样杆菌，主要通过口-口途径在人-人之间感染传播。HP的发现加深了人类对慢性感染、炎症和癌症之间关系的认识。其特定的螺旋形体型、鞭毛及动力、尿素酶和黏附素活性，以及细胞毒素基因A（cagA）、空泡细胞毒素基因A（vacA）等是影响HP感染研究较多的相关致病因素。HP感染在胃癌的发生、发展中可能具有重要作用，但尚未确切证实HP感染是导致胃癌的主因。文章概述了HP感染相关致病因素的研究进展。     

临床护理教师胜任力现状及与护生的评价比较

目的 调查临床护理教师胜任力水平及影响因素，为提高临床护理教学质量提供参考。方法 采用临床护理教师胜任力问卷、学习动机量表对重庆市11所三级医院的749名临床护理教师及458名实习护生进行调查。结果 临床护理教师胜任力自评均分为4.38±0.49,护生评价均分为4.12±0.65,护生评价总分及6个维度得分显著低于教师自评(均P<0.01);护龄、职务和学习动机是临床护理教师胜任力的影响因素(均P<0.01)。结论 临床护理教师胜任力处于较好水平，但护生评价低于教师自评；护理管理者可通过激发教师的学习动机进一步培养和提升临床护理教师的胜任力。     

The Empathy Tank as a revised model for fostering empathy in medical education

Empathy has been difficult to sustain and foster in medical training. Based on empirical evidence and intuitive human experience, this paper proposes that empathy can be re-conceptualized as a dynamic reservoir, referred to as an “empathy tank.” Physicians and learners who have personally experienced or received much empathy will naturally have a stronger tendency and greater capacity for empathy than others who have experienced little. These instances of empathy that fill the “empathy tank” can take the form of personal experiences, re-experiencing memories, and vicarious experiences. As this reservoir is filled, the empathy therein can more readily be poured out to others. Thus, all trainees should be educated to recognize first and foremost their personal need for empathy that they share with patients and subsequently seek encounters that highlight these empathic experiences. Three practical implications for educational interventions are discussed: (1) Learners and preceptors should recognize instances in training of perceived inadequacy as opportunities to provide empathy, (2) Interventions should target foundational rather than secondary issues in empathy, and (3) Interventions should enable empathy in learners to be self-sustaining.     

The PROFILE of assessment program for internal medicine internship of Sun Yat-Sen University

Objective: To reflectively look at the present methods by which the clinical competence of 5th-year medical students (i.e. interns) in Sun Yat-Sen University (SYSU) are assessed upon finishing internship rotation in internal medicine (IM).

Methods: Current procedures for the competence assessment of end-of-rotation IM interns in the First Affiliated Hospital of SYSU were reviewed, along with a point-by-point appraisal based on the PROFILE approach to structured assessment, and, whenever possible, suggestions for future improvement.

Results and discussions: On a scale of 1–10, with 10 being the best or the most ideal, our marks for current methods to assess end-of-rotation IM interns in terms of being Programmatic, Real-World, Outcome-based, Formative, Impactful, Learner-engaged, and Evaluation-guaranteed were 7, 9, 3, 4, 6, 8, and 1, respectively. The strengths, weaknesses as well as potential solutions in each of the seven aspects are also discussed separately.

Conclusions: Current assessment program for IM internship is strong in being programmatic, real-world, educationally impactful and learner engaged, and has room for further improvement in its time-based arrangements, relative shortage of feedback provision, as well as a systematic lack of quality control measures.     

SNPs in the COX-2/PGES/EP signaling pathway are associated with risk of severe capecitabine-induced hand-foot syndrome

Cancer Chemotherapy and Pharmacology - Capecitabine is a widely used 5-fluorouracil oral prodrug. Hand-foot syndrome (HFS), one of the most common adverse events of capecitabine, impacts...