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

Journal of Interventional Cardiac Electrophysiology -     

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。     

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...     

CIP2A在子宫内膜样腺癌中的表达及临床意义

目的:探究蛋白磷酸酶2A(CIP2A)在子宫内膜样腺癌中的表达情况及临床意义。方法:选取2011年1月至2014年3月行手术切除并经病理证实的50例子宫内膜样腺癌(EAC)及同期行门诊刮宫术获取的40例正常增生期子宫内膜(NE)组织标本。应用RT-PCR、Western blot法检测EAC和NE组织中CIP2A mRNA及蛋白水平，免疫组化法检测CIP2A阳性表达情况。分析CIP2A在EAC和NE组织中的表达差异及与子宫内膜样腺癌临床病理特征的关系。采用Kaplan-Meier法分析CIP2A不同表达水平对患者预后生存的影响，通过COX分析预后独立危险因素。结果:免疫组化染色显示:CIP2A在子宫内膜样腺癌中呈高表达，阳性着色定位于细胞浆和细胞核中，EAC组织中CIP2A阳性表达率显著高于NE组织(P＜0.01)。RT-PCR和Western blot检测显示EAC组织中CIP2A mRNA及蛋白表达水平高于NE组织(P＜0.01)。CIP2A表达与EAC的组织学分级、FIGO分期、宫颈管受累情况、p53表达及Ki-67增殖指数有关（P＜0.05）。Kaplan-Meier法生存分析显示EAC患者5年无病生存率为92.0%、总生存率为88.0%；CIP2A表达、组织学分级、FIGO分期、肌层浸润深度、附件转移、脉管内癌栓及Ki-67增殖指数与患者预后不良相关（P＜0.05）。多因素分析显示，组织学分级、FIGO分期及脉管内癌栓是影响子宫内膜样腺癌患者预后生存的独立危险因素（P＜0.05）。结论:CIP2A在子宫内膜样腺癌中呈高表达，与患者总生存率下降相关，并非影响患者预后的独立危险因素。