苦参碱对上消化系肿瘤临床药理作用的研究进展

苦参碱能防治大鼠胃癌前病变以及乙基硝基亚硝基胍诱发大鼠原发性胃癌,也能防治人胃癌MKN-45细胞、SGC-7901细胞、BG823细胞、人胰腺癌BxPC-3细胞移植瘤在裸鼠或大鼠体内生长。经体外实验发现,苦参碱能浓度相关地抑制人胃癌SGC-7901细胞、MGC803细胞、BGC823细胞、MKN-45细胞、NCI-N87细胞、AGS细胞、人胰腺癌BxPC-3细胞、CFPAC-1细胞、人胆管癌QBC939细胞、人胆囊癌GSC-SD细胞、人食管癌Eca109细胞、Escl细胞的增殖并诱导其凋亡。经体内外实验结果发现,苦参碱能增强化疗药抗人胃癌SGC-7901细胞作用。综述苦参碱对消化系肿瘤临床药理作用的研究文献,并对其研究进展做了分析。     

Implementing remote triage in large health systems: A qualitative evidence synthesis

Remote triage (RT) allows interprofessional teams (e.g., nurses and physicians) to assess patients and make clinical decisions remotely. RT use has developed widespread interest due to the COVID‐19 pandemic, and has future potential to address the needs of a rapidly aging population, improve access to care, facilitate interprofessional team care, and ensure appropriate use of resources. However, despite rapid and increasing interest in implementation of RT, there is little research concerning practices for successful implementation. We conducted a systematic review and qualitative evidence synthesis of practices that impact the implementation of RT for adults seeking clinical care advice. We searched MEDLINE®, EMBASE, and CINAHL from inception through July 2018. We included 32 studies in this review. Our review identified four themes impacting the implementation of RT: characteristics of staff who use RT, influence of RT on staff, considerations in selecting RT tools, and environmental and contextual factors impacting RT. The findings of our systemic review underscore the need for a careful consideration of (a) organizational and stakeholder buy‐in before launch, (b) physical and psychological workplace environment, (c) staff training and ongoing support, and (d) optimal metrics to assess the effectiveness and efficiency of implementation. Our findings indicate that preimplementation planning, as well as evaluating RT by collecting data during and after implementation, is essential to ensuring successful implementation and continued adoption of RT in a health care system.     

Successful integration of the histology core laboratory in translational research

Abstract

In a diagnostic setting, the histology laboratory is a key resource for production of quality tissues so the pathologist can make an appropriate diagnosis. In a research setting, the histology laboratory is a valuable resource in providing an excellent quality product for publications and grants for the investigator. Optimal collaboration with research investigators requires that histotechnologists recognize the diverse challenges and opportunities in research. This paper emphasizes the importance of positive interaction with researchers, optimizing professional service for these clients and recognizing key services of histology laboratories in a research setting to maximize success.     

Étude qualitative de l’expérience de la formation en hypnose clinique pour les professionnels de santé

ObjectiveTraining in clinical hypnosis leads to important transformations in healthcare professionals, in their professional practices as well as in their personal lives. The objective of this study was to explore how health professionals experience the transformations that result from such a training.MethodSemi-structured interviews with health professionals from France and Europe were conducted. The qualitative method used was Interpretative Phenomenological Analysis. Purposive sampling required to include participants from different professions, experience and regions of origin. They had already completed training in clinical hypnosis at different teaching institutions.ResultsTen participants were included. The analysis showed four meta-themes of experience. First, it revealed participants’ motivations for training in clinical hypnosis as one's desire to improve one's practice, leading to extraordinary discoveries, at a particular timing in their life. Second, participants described that hypnosis sometimes set the ground for a relationship verging on the more “intimate”, therefore requiring greater caution so as not to disrupt the patient/healthcare professional relationship. Third, some participants experienced unforeseen personal fulfilment, better self-regulation of emotions and improved quality of life as well as greater comfort at the workplace. Finally, this study shed light on two limitations of training in clinical hypnosis as it can sometimes generate stress for the participants and/or result in bring about potential harmful effects: one of the risks being that the trainer might cross some ethical lines.DiscussionThe level of personal change experienced by the participants is similar to some changes induced by personal psychotherapy. For several participants, issues of power and vulnerability in the relationship using hypnosis were associated with a feeling of instability during the training. In hypnosis, the management of an asymmetrical relationship involves a two-way risk: vulnerability of the hypnotized person to the all-powerful relationship of their therapist as well as destabilization of therapists by the reduction of power asymmetry during hypnotic work with their patients.     

Reliability of a computer-based neurobehavioral assessment test battery for Bangladeshi adolescent children

In developing countries, there is a need for low-cost neurobehavioral (NB) test batteries for vulnerable populations, particularly for children exposed to environmental neurotoxicants. The objective of the current study was to assess the feasibility and test-retest reliability of the Behavioral Assessment and Research System (BARS) in children from a rural community in Bangladesh. Fifty healthy adolescents living in the Health Effects of Arsenic Longitudinal Study (HEALS) area in Araihazar, Bangladesh completed all six tests from the BARS in two test sessions scheduled two weeks apart. The BARS tests evaluated NB functions such as motor coordination, attention, memory, and information processing speed. The reliability assessment, evaluated by test-retest correlations demonstrated moderate to strong correlations (i.e., correlation coefficients ranged from 0.43 to 0.85), which were statistically significant (p < 0.05). Paired t-tests for comparing the test and retest outcomes indicated significant improvement in NB performance, highlighting learning and practice effects. NB performance improved with increasing age in most cases. Adolescent boys performed better than the girls in Finger Tapping, Digit Span, and Simple Reaction Time, whereas the girls performed better in Continuous Performance and Symbol Digit tests. The reliability scores (Pearson’s correlations 0.43−0.85) were consistent with other children studies in different cultural settings. The effects of age and sex on NB tests were also consistent with findings reported in other countries. Overall, the findings of the study support the feasibility of using this computer-based test system to assess vulnerability of brain health due to environmental exposures among rural Bangladeshi children.