术前控制营养状态评分与肝细胞癌肝切除术后预后的研究进展

肝细胞癌(HCC)是最常见的恶性肿瘤之一。尽管在早期诊断和个体化治疗方面取得了进展,但经根治性切除等治疗后,HCC患者的临床预后仍不佳,复发率高。因此,在HCC患者中识别准确可靠的预后标志物是必要的。作为一种新的免疫营养生物标志物,控制营养状态(CONUT)评分已被报道用于预测癌症患者的预后。本文将对术前CONUT评分与HCC肝切除术后预后的研究进展进行综述。     

Photodynamic therapy during second surgery for recurrent gliomas improves survival

BackgroundGlioma accounts for most central nervous system tumors, and the degree of invasion and malignancy are higher in the recurrent glioma. Photodynamic therapy (PDT) is an effective strategy in glioma. This study aimed to explore the risk factors for re-recurrence after a second glioma surgery and the effects of PDT on re-recurrence.MethodsThis was a retrospective study in the Second Affiliated Hospital of Harbin Medical University in China, and 43 patients that received the secondary surgery for recurrent glioma were included. The Kaplan-Meier test and Cox proportional hazard method were used to analyze.ResultsThe total re-recurrence rate after the second surgery for recurrent glioma was 48.84%. When the age increased by 1, the risk of re-recurrence increased 1.065 times (95% CI 1.000–1.134, P = 0.049). High matrix metalloproteinase (MMP) 2 expression was associated with a significantly higher risk of re-recurrence than low MMP2 expression (HR = 25.550, 95% CI 3.190–204.650, P = 0.002). Pathological grades IV and III were associated with a significantly higher risk of re-recurrence than pathological grade II (HR = 17.121, 95% CI 2.345–124.986, P = 0.005; HR = 2863.470, 95% CI 100.697–81,427.197, P < 0.001). PDT decreased the risk of re-recurrence (HR = 25.550, 95% CI 3.190–204.650, P = 0.002) and increased survival time (HR = 3.611, 95% CI 1.012–12.888, P = 0.048).ConclusionThe age, MMP2 expression, and pathological grade are independent risk factors for re-recurrence after a second surgery for recurrent glioma. PDT during the second surgery decreased the risk of re-recurrence and increased survival time.     

多层次学员“一体化”临床思维培训与评价

随着“5+3”医学人才培养模式的推行，临床教学中更需注重对医学生临床思维的培养，然而现有的培训模式存在不足；如教学模式不完善，教师带教意识不够，学生难以适应角色转变，形成固有思维定势，依赖辅助检查等。通过梳理临床思维的内涵，并根据多层次学员不同的培训目标，从专业整体思维框架的建立、专题讲座、启发式查房、多点思路扩展实操训练、“传-帮-带”小组的自主互动学习、病例讨论等方面，探索并构建了多层次学员“一体化”临床思维培训及评价模式；且经过小范围应用后，得到了师生的广泛认可。     

组织·社会性课题学习法在临床护理管理现状中的应用

目的 探索和实践组织·社会性课题学习法在临床管理的现状,找出临床护理管理的缺陷,根据缺陷提出解决措施,从而提升优质护理服务.方法 2018年3月—2018年8月选取东北三省15家医院55名临床护理人员通过不同视角收集的图像资料,应用组织·社会性课题学习法分析临床护理管理中的缺陷并提出解决方案.结果 通过组织·社会性课题学习法的应用,多角度直观可视化分析了临床护理工作存在的缺陷并提出相应的解决方案.结论 组织·社会性课题学习法的应用可以促进护理管理创新,为管理者的工作方式提供全新的思路.     

Hotspot Analysis of Traditional Drugs in Diabetes Treatment Literature

Objective:To summarize current hotspots and predict the potential trends in traditional drugs of diabetes treatment for further research.Methods:Publications on the application of traditional drugs in diabetes treatment were searched from PubMed without language limits.Highly frequent MeSH terms were identified through Bibliographic Item Co-Occurrence Matrix Builder(BICOMB).Biclustering analysis results were visualized utilizing the gCLUTO software.Finally,a strategic diagram was generated.Results:Totally 2,386 relevant publications were obtained from PubMed on November 9th,2018,and 69 highly frequent MeSH terms were identified.Biclustering analysis revealed that these highly frequent MeSH terms were classified into 7 clusters.After calculating the density and centrality of each cluster,strategy diagram was presented.Cluster 0"Chinese medicine monomers such as antioxidant and hypoglycemic effects"was considered as the most potential research hotspot.Conclusions:In this study,we found 7 topics related to the application of traditional drugs in diabetes treatment.The molecular mechanisms of Chinese medicine monomers in diabetes could become a potential hotspot with high centricity and low density.