“临床早期接触”对医学生关怀能力养成的效果分析——以汕头大学医学院“医者之心（HEART）”课程为例

目的探讨医者之心（HEART）课程中“临床早期接触社会实践环节”对关怀能力养成的效果，对该课程纳入“临床早期接触”的教学设计做小结。方法编纂临床早期接触中的“隐性课程”体验问卷，对参加医者之心（HEART）课程的临床早期接触社会实践环节的学生进行事后访问及问卷调查，以此评估“隐形课程”对医学生关怀能力养成的初步情况。 结果医学实习生对各种具有隐性课程内涵举措的各个维度对其关怀能力培育的帮助，均呈偏正向的态度。“带教教师教学示范”“关怀展现”“专业胜任能力对学生关怀能力影响”这3个构面的强弱程度，会因“学生临床早期接触时长”“带教教师年资”“临床早期接触过程满意程度”的不同而呈现显著差异。结论“临床早期接触各类组织形式”对第一次进入临床体验的医学生关怀能力认知有重要影响，典范学习及同伴影响对医学生关怀能力认知有正向影响。     

Congenital dysplasia involving both medial and inferior recti: clinical features and surgical outcomes

AIM: To investigate the clinical features and surgical outcomes of congenital dysplasia involving both inferior recti (IR) and medial recti (MR) muscles. METHODS: A retrospective review was conducted including cases of simultaneous congenital dysplasia of IR and MR that were diagnosed and surgically treated at the Zhongshan Ophthalmic Center, Sun Yat-sen University, China, from July 2009 to November 2019. Ocular motility, ocular alignment at distance (6 m) and near (33 cm) by prism alternating cover test and stereoacuity were assessed in all patients before and after surgery. RESULTS: A total of five patients (four males and one female; three with right eye and two with left eye congenital dysplasia) were included in this review. The patients ranged in age from 10 to 42y (21±13.4y). The main clinical findings were hypertropia and exotropia of the affected eye, along with motility limitations in adduction and depression. Lateral rectus (LR) recession/transposition combined with IR resection was performed in one case. Two scheduled surgeries were performed in four cases, with one involving superior rectus recession and IR resection and the others LR recession and MR resection. Mean±SD pre-surgical exotropia of 51.0±31.11 prism diopter (PD) and hypertropia of 29.20±7.12 PD in the primary position were decreased to 3.6±12.90 and 3.2±10.09 PD, respectively, at two years after surgery, with a success rate of 60% and an under-correction rate of 40%. CONCLUSION: The main clinical features associated with simultaneous MR/IR congenital dysplasia are hypertropia and exotropia of the affected eye along with motility limitations in adduction and depression. Scheduled two-stage surgeries achieved a success rate of 60%.     

Coping Strategies for HIV-Related Stigma in Liuzhou,China

This study explores the feelings, experiences, and coping strategies of people living with HIV (PLHIV) in Liuzhou, China. In a southwestern Chinese city with high HIV prevalence, we conducted semi-structured in-depth interviews with 47 PLHIV selected to represent individuals who had acquired HIV via different acquisition routes. Many participants felt severely stigmatized; they commonly reported having very low self-esteem and feelings of despair. Based on style of coping and whether it occurred at the interpersonal or intrapersonal level, four types of coping that participants used to deal with HIV-associated stigma were identified: (1) Compassion (Passive/Avoidant—Interpersonal); (2) Hiding HIV status (Passive/Avoidant—Intrapersonal); (3) Social support (Active/Problem-focused—Interpersonal; and (4) Self-care (Active/Problem-focused—Intrapersonal). Educational and stigma-reduction interventions targeting potential social support networks for PLHIV (e.g., family, close friends, and peers) could strengthen active interpersonal PLHIV coping strategies. Interventions teaching self-care to PLHIV would encourage active intrapersonal coping, both of which may enhance PLHIV quality of life in Liuzhou, China.     

大学生人格的年级变异性

目的探讨大学生人格变化与所处年级的关系。方法采用卡特尔人格问卷(16PF)对浙江农林大学健康管理专业大一至大三104名学生进行为期一学年前后测评。结果①具有统计学显著性变异的人格因子一年级有:C(t=2.079,P<0.05)、E(t=-3.606,P<0.01)、G(t=-2.456,P<0.05)、L(t=-4.86,P<0.01)、Q3(t=2.447,P<0.05)、Q4(t=-2.893,P<0.01);二年级有:E(t=-3.438,P<0.01)、I(t=3.369,P<0.01)、X3(t=-3.747,P<0.01)、Y2(t=-2.5277,P<0.05);三年级有:E((t=-2.832,P<0.01)、M(t=-3.092,P<0.01)、Q1(t=-2.361,P<0.05)、X4(t=-4.629,P<0.01)、Y2(t=-2.603,P<0.05);②不同年级相比,变异程度大的人格因子主要有C(t=-2.103,P<0.05)、I(t=2.321,P<0.05)、X1(t=2.25,P<0.05)、X3(t=-2.052,P<0.05);Q4(t=2.081,P<0.05)、X4(t=-2.322～-2.143,P<0.05)。结论大学生人格变异具有年级特点,一年级人格因子值提高的有C、Q3;降低的有E、G、L、Q4;二年级提高的有I,降低的有E、X3、Y2;三年级人格因子值降低的有E、M、Q1、X4、Y2。并且,情绪性因子变异程度较大。     

Giardia intestinalis: effects of Pulsatilla chinensis extracts on trophozoites

Pulsatilla chinensis is a medicinal root plant that has been used to treat a wide range of disease conditions. Our study determined the antiprotozoal activity of various P. chinensis extracts and fractions against Giardia intestinalis including their effects on parasite growth, cell viability, adherence, and morphology. Ethyl acetate extracts (IC50?=?257.081?μg/ml) were the most active to inhibit the growth of G. intestinalis followed by aqueous extract (PWE), saponins, and n-butanol extract. The PWE and ethyl acetate extract inhibited G. intestinalis trophozoites adherence after 3?h of incubation and killed almost 50?% of the parasite population in a time-dependent manner. Changes in morphology, presence of precipitates in the cytoplasm, dissolved cytoplasm with large vacuole, break of flagella and ventral disk, membrane blebs, and intracellular and nuclear clearance of the treated trophozoites were observed by scanning and transmission electron microscopy. We demonstrated that P. chinensis induced these changes in G. intestinalis morphology and consequently has potential therapeutic use against giardiasis.     

Therapie der rezidivierten und fernmetastasierten Plattenepithelkarzinome des Kopf-Hals-Bereichs

This year, the treatment of patients with recurrent or metastatic head and neck squamous cell carcinoma (R/M-HNSCC) was mainly dominated by immunotherapy. The corresponding studies are presented in another article. Beside this, results of phase II studies in particular were presented at the ASCO Annual Meeting, in which—as in recent years—new drugs (monoclonal antibodies, small molecules) played a major role. Furthermore, a clinical scoring system for prognosis evaluation in R/M-HNSCC patients was presented and the influence of HPV status on survival in this patient cohort was investigated. The studies presented herein reflect the different drug-based treatment concepts in R/M-HNSCC and represent the variety of therapeutic approaches in the recurrent and metastatic setting.