In Situ Encapsulation of Nile Red or Doxorubicin during RAFT‐Mediated Emulsion Polymerization via Polymerization‐Induced Self‐Assembly for Biomedical Applications

Hydrophobic agents, a fluorescent dye (Nile red, NR) or an anticancer drug (doxorubicin, DOX), are encapsulated into poly((N‐[3‐(dimethylamino) propyl] methacrylamide)‐b‐poly (methyl methacrylate) (PDMAPMA‐b‐PMMA) nanoparticles (NPs) via one‐pot reversible addition‐fragmentation chain‐transfer (RAFT)‐mediated emulsion polymerization in water. The macroRAFT, PDMAPMA, is chain‐extended with the methyl methacrylate (MMA), with the hydrophobic agents soluble in MMA, resulting in loaded NPs, with either NR or DOX via polymerization‐induced self‐assembly (PISA). The NR‐loaded NPs are visualized by structured illumination microscopy (SIM), thus indicating the successful loading of the fluorescent dye into the PMMA core. The DOX‐loaded NPs exhibit a sustained release profile over 5 d, showing a small burst effect during the first 2 h, as compared with the free DOX. The DOX‐loaded NPs show higher cell toxicity than the free DOX in RAW 264.7 cell line. The results demonstrate the potential of using emulsion polymerization for synthesis of tailored and reproducible NPs encapsulating hydrophobic agents.     

From expert-derived user needs to user-perceived ease of use and usefulness: A two-phase mixed-methods evaluation framework

Underspecified user needs and frequent lack of a gold standard reference are typical barriers to technology evaluation. To address this problem, this paper presents a two-phase evaluation framework involving usability experts (phase 1) and end-users (phase 2). In phase 1, a cross-system functionality alignment between expert-derived user needs and system functions was performed to inform the choice of “the best available” comparison system to enable a cognitive walkthrough in phase 1 and a comparative effectiveness evaluation in phase 2. During phase 2, five quantitative and qualitative evaluation methods are mixed to assess usability: time-motion analysis, software log, questionnaires – System Usability Scale and the Unified Theory of Acceptance of Use of Technology, think-aloud protocols, and unstructured interviews. Each method contributes data for a unique measure (e.g., time motion analysis contributes task-completion-time; software log contributes action transition frequency). The measures are triangulated to yield complementary insights regarding user-perceived ease-of-use, functionality integration, anxiety during use, and workflow impact. To illustrate its use, we applied this framework in a formative evaluation of a software called Integrated Model for Patient Care and Clinical Trials (IMPACT). We conclude that this mixed-methods evaluation framework enables an integrated assessment of user needs satisfaction and user-perceived usefulness and usability of a novel design. This evaluation framework effectively bridges the gap between co-evolving user needs and technology designs during iterative prototyping and is particularly useful when it is difficult for users to articulate their needs for technology support due to the lack of a baseline.     

分析医护专病一体化管理模式在中青年高血压患者中的临床护理效果(护理管理）

目的 研究医护专病一体化管理模式在中青年高血压患者中的临床护理效果。方法 选择2017年6月~2018年6月本院收治的120例中青年高血压患者作为本次研究的对象,运用随机法将其分为治疗组和对照组,每组各60例患者。对对照组患者实施传统管理模式,对治疗组患者在传统管理模式的基础上,实施医护专病一体化管理模式。对比两组患者的自我管理疾病能力评分、健康行为评分、服药依从性以及护理满意度。结果 两组患者自我管理疾病能力评分,两组组内比较1年和1个月、3个月之间存在差异;组间评分对比1个月、3个月时,治疗组和对照组无显著差异,1年后治疗组评分显著高于对照组,差异有统计学意义（P<0.05）。两组患者健康行为评分,两组组内比较1年和1个月、3个月之间存在差异,组间评分对比1个月、3个月时,治疗组和对照组无显著差异,1年后治疗组评分显著高于对照组,差异有统计学意义（P<0.05）。治疗组服药依从率为88.33%显著高于对照组的56.67%,差异有统计学意义（P<0.05）。治疗组的护理满意度为98.33%,显著高于对照组的75.00%,差异有统计学意义（P<0.05）。结论 医护专病一体化管理模式应用于中青年高血压患者临床护理中的效果显著,能有效增强其自我管理疾病能力,改善其健康行为,提高其服药依从性和护理满意度,建立起和谐的护患关系。     

整合式教学策略在医学本科生心电图实验课中的教学效果分析

目的探讨整合式教学策略在医学本科生心电图实验课中的教学效果。 方法选择2019年于中山大学附属第三医院学习诊断学心电图实验课的2016级临床医学五年制学生63人,采用随机数字表法分为传统教学组(n＝30)和教学改革组(n＝33),比较两组的心电图考核成绩及学生对教学的反馈评价情况。 结果教学改革组学生的心电图阅读成绩以及总成绩分别为[(82.93±4.71)分]和[(82.74±4.40)分],均较传统教学组成绩[(78.24±6.28)分,(80.23±4.72)分]高,均差异有统计学意义(t＝4.71,2.52;均P<0.05)。教学改革组在激发学习兴趣(90.91%,30/33)、提高心电图分析能力(87.88%,29/33)、提高临床操作能力(84.85%,28/33)、提高自主学习能力(84.85%,28/33)、对教学内容满意度(87.88%,29/33)、对教学形式满意度(87.88%,29/33)的反馈评价均明显高于传统教学组[66.67%(20/30),60.00%(18/30),56.67%(17/30),60.00%(18/30),60.00%(18/30),56.67%(17/30)],均差异有统计学意义(χ²＝5.64,6.45,6.12,4.93,6.45,6.90;均P<0.05)。 结论整合式教学策略可显著提高学生的心电图考试成绩,提升学生的心电图阅读分析能力,激发学习兴趣,达到较好的教学效果,值得推广。     

高脂高糖、饮酒建立家兔脂肪肝模型及超声量化诊断

目的:模拟人类不良饮食结构建立家兔不同程度脂肪肝模型,进行肝脏背向散射积分 (integrated backscatter,IBS)和图像灰阶平均强度(gray scale,GS)测定,并结合临床研究,探讨具有病理基础的脂肪肝无创性超声量化诊断标准．方法:选用纯种新西兰家兔40只,采用高脂高糖饲料及乙醇饮料建立不同程度脂肪肝模型三组(每组n=10),设立对照组(n=10):临床病例同步进行肝组织病理学及超声检测．病理组织学检测采用苏丹Ⅳ,HE和Masson三色染色:应用HP Sonos 5500超声诊断仪实时检测肝脏IBS,包括图像平均强度(average image intensity,AII)、峰-峰强度及图像强度标准差; 采用Photo shop 7．0直方图分析超声图像GS．所得数据采用SAS8．2进行统计学分析．结果:肝脏AII随脂肪变加重呈递增趋势,正常肝<轻度脂肪肝<中度脂肪肝<重度脂肪肝,尤以近区各组间差异显著(P<0．0001);同等程度肝脂肪变AII随炎症的发生而增大．临床研究显示,IBS对脂肪肝诊断率及与病理组织学符合率(85．7％)较常规超声检测(57．1％) 明显增高,重度脂肪肝AII显著高于轻度脂肪肝(P<0．0001,0．001或0．05)．肝脏GS与AII相关,于肝左、右叶近区二者随病变加重呈一致性增高趋势(r1=0．442 21,P1=0．0012:r2= 0．335 73,P2=0．0160)．中重度脂肪肝伴炎症 GS显著高于正常肝及轻度脂肪肝(P<0．05)．结论:高营养及乙醇联合喂养家兔可快速建立不同程度脂肪性肝病模型;肝脏超声IBS及 GS强度可反映肝脂肪变、炎症和纤维化的病变程度,为脂肪肝无创性量化诊断提供可靠依据．     

中西医结合护理对四肢远端骨折术后恢复的影响

目的:观察中西医结合护理对四肢远端骨折术后恢复的影响。方法:选取88例四肢远端骨折术后患者,按随机数字表法分为对照组与观察组各44例。对照组行常规护理,观察组行中西医结合护理,比较2组术后疼痛程度、肢体功能恢复情况及并发症发生率。结果:术后1 d,2组VAS评分比较,差异无统计学意义(P>0.05)。术后3 d、7 d,2组VAS评分均较术后1 d降低(P<0.05),观察组VAS评分均低于同期对照组(P<0.05)。观察组肢体功能恢复优良率86.36%,高于对照组的68.18%,差异有统计学意义(P<0.05)。观察组术后并发症发生率11.36%,低于对照组的29.55%,差异有统计学意义(P<0.05)。结论:中西医结合护理可有效缓解四肢远端骨折患者术后疼痛度,提升肢体功能恢复效果,减少并发症发生。     

消风散合凉血五根汤联合西药治疗成人过敏性紫癜性肾炎临床疗效及对患者血表皮生长因子、血小板活化因子乙酰水解酶的影响

目的观察消风散合凉血五根汤联合西药治疗成人过敏性紫癜性肾炎(HSPN)的临床疗效及对患者血表皮生长因子(EGF)、血小板活化因子乙酰水解酶(PAF-AH)的影响。方法将90例成人HSPN患者按照随机数字表法分为2组。对照组45例予常规西医治疗;治疗组45例在对照组基础上加服消风散合凉血五根汤治疗。2组均治疗8周。比较2组治疗前后中医证候评分、血肌酐(Cr)、尿素氮(BUN)、24 h尿蛋白定量、尿红细胞计数(U-RBC)、尿微量白蛋白尿肌酐比值(UACR)、估算肾小球滤过率(e GFR)、血EGF、PAF-AH水平,并统计2组临床疗效及不良反应情况。结果治疗组总有效率88.89%,对照组总有效率68.89%,治疗组疗效优于对照组(P<0.05)。治疗后2组各项中医证候评分及总分均降低(P<0.05),治疗组治疗后各项中医证候评分及总分均低于对照组(P<0.05)。治疗后2组Cr、BUN、24 h尿蛋白定量、U-RBC、UACR均降低(P<0.05),e GFR升高(P<0.05);治疗组治疗后Cr、BUN、24 h尿蛋白定量、U-RBC、UACR均低于对照组(P<0.05),e GFR高于对照组(P<0.05)。治疗后2组血EGF、PAF-AH水平均降低(P<0.05),治疗组治疗后血EGF、PAF-AH水平均低于对照组(P<0.05)。治疗组不良反应率(11.11%)低于对照组(26.67%,P<0.05)。结论成人HSPN在西医治疗基础上,加用消风散合凉血五根汤可提高临床疗效,不仅可改善临床症状,还能改善肾功能,降低糖皮质激素不良反应,其机制之一可能与其下调血EGF、PAF-AH水平有关。     

滋肾续骨汤联合鲑鱼降钙素对老年椎体压缩性骨折术后血清骨形态发生蛋白9及血管内皮生长因子水平的影响

目的观察滋肾续骨汤联合鲑鱼降钙素对老年椎体压缩性骨折术后血清骨形态发生蛋白9(BMP9)及血管内皮生长因子(VEGF)水平的影响。方法将80例老年椎体压缩性骨折术后患者按照随机数字表法分为2组。对照组39例予鲑鱼降钙素治疗;治疗组41例在对照组治疗基础上加用滋肾续骨汤治疗。2组均治疗24周后统计临床疗效,并观察2组治疗前后血清BMP9、VEGF水平及疼痛视觉模拟评分(VAS)、胸腰椎损伤分类及损伤程度评分系统(TLICS)、Oswestry功能障碍指数(ODI)评分、日本骨科协会(JOA)腰痛评分,以及椎体前缘丢失高度、伤椎Cobb角、伤椎骨密度水平及并发症发生情况。结果治疗组总有效率95.12%(39/41),对照组总有效率76.92%(30/39),治疗组临床疗效优于对照组(P<0.05)。2组治疗后血清BMP9、VEGF水平均升高(P<0.05),且治疗组高于对照组(P<0.05)。2组治疗后疼痛VAS、TLICS评分均降低(P<0.05),且治疗组低于对照组(P<0.05)。治疗后2组ODI评分均降低(P<0.05),且治疗组低于对照组(P<0.05);治疗后2组JOA腰痛评分均升高(P<0.05),且治疗组高于对照组(P<0.05)。治疗后2组椎体前缘丢失高度、伤椎Cobb角均降低(P<0.05),伤椎骨密度均升高(P<0.05),且治疗组改善均优于对照组(P<0.05)。治疗组并发症总发生率4.88%(2/41),对照组并发症总发生率20.51%(8/39),治疗组并发症总发生率低于对照组(P<0.05)。结论滋肾续骨汤治疗老年椎体压缩性骨折术后患者疗效显著,可有效改善临床症状及血清BMP9、VEGF水平。     

Professor YANG Yu-fei’s Experience on the Integrated Chinese and Western Medicine Treatment Strategy for Advanced Colorectal Cancer

Colorectal cancer is one of the common malignant tumors in China.It poses a serious threat to the national health of China.For advanced colorectal cancer, the main goal of treatment is to prolong survival and improve quality of life.It complements other advantages, showing good therapeutic results.However, how to grasp the timing of integrated Chinese and Western Medicine for the treatment of advanced colorectal cancer and use the integrated Chinese and Western Medicine treatment methods flexibly contains profound therapeutic art.Prof.YANG Yu-fei is an authoritative expert in the field of integrated Chinese and Western medicine for colorectal cancer.She is good at accurately grasping the timing of treatment of integrated Chinese and Western Medicine, and flexibly adjusts the treatment strategy according to the specific conditions.In this paper, we shared Professor YANG Yu-fei's strategy for treating advanced colorectal cancer with emphasis on integrated Chinese and Western Medicine and attached a typical case, with a view to provide reference for the treatment of advanced colorectal cancer with integrated Chinese and Western Medicine.     

中西医结合治疗原发性痛风性关节炎30例总结

目的:观察中西医结合治疗原发性痛风性关节炎的临床疗效。方法:对照组采用西医常规治疗,治疗组采用中西医结合治疗,主要观察两组治疗前后血尿酸、血肌酐水平以及血清K 、Na 、Cl-、Ca2 水平、体重等指标变化情况。结果:治疗组血尿酸指标的下降程度明显优于对照组(P<0.05);但两组血清K 、Na 、Cl-、Ca2 水平及体重等指标比较无明显改变(均P>0.05);治疗组痛风发作次数也明显少于对照组(P<0.05)。结论:中西医结合治疗本病疗效满意。