Purposes:To explore if pretreatment brain function/structure connectome could explain the response to a psychosocial intervention on resilience in breast cancer. Methods:Between February 2018 and October 2021, women newly diagnosed with breast cancer were retrospectively enrolled from the Be Resilient to Breast Cancer (BRBC) trial and received a supportive-expressive therapy intervention. Baseline Resting-state Functional Magnetic Resonance Imaging (rs-fMRI) combined with Diffusion Tensor Imaging (DTI) were administered and resilience was scored by 10-item Resilience Scale specific to Cancer (RS-SC-10) at baseline and after the intervention (6 months). Response to the supportive intervention on resilience was defined as > 0.5 standard deviation (SD) improvement at 6 months compared to baseline mean resilience score. Results:A total of 105 patients received intervention. At 6 months, the resilience score improved in 62.9 % (N = 66), defined as the Response group. Amygdala (53 %) and Hippocampus (15 %) in rs-fMRI and CorpusCallosum_ForcepsMinor (96 %) in DTI were recognized as the main significant brain regions associated with treatment response. Conclusion:These preliminary data suggest that neuro-markers of brain function/structure connectome from MR imaging might be useful in evaluating response to behavioral interventions on resilience.

目的 分析美军在延续现场救护(prolonged field care,PFC)中医疗文书记录的经验做法,为促进我军战伤救治理论体系发展提供借鉴.方法 通过查阅文献资料,梳理美军在PFC中常用的医疗文书记录类型、内容及作用.结果 美军PFC医疗文书记录主要包括:DD1380 TCCC卡、PFC流程图、交接报告、行动报告和远程医疗服务指南等,且美军在PFC临床实践指南中,给出了 PFC救护的基本策略(即应遵循"最低""更高""最佳"的原则),并提供了相应的PFC记录文书建议.结论 我军可参考美军医疗文书记录的内容,优化设计伤票和野战病历,提高战伤救治能力.

目的 了解我国军、地医院创伤院前救护能力现状及延时现场救护(prolonged field care,PFC)认知及能力准备情况,为相关培训提供参考.方法 2021年2月—6月,采用分层抽样和便利抽样相结合的方法,选取东北、西南、中部、东南以及珠三角地区242名军队及地方医护人员,采用自行设计的《中国创伤院前急救及延时现场救护(PFC)认知情况调查问卷》,借助于问卷星平台进行多中心横断面调查.结果(1)部队三甲医院年均院前救护任务显著多于地方二甲医院(P<0.05),道路交通伤在所有伤型中占比最高;(2)"途中持续监护和复苏预案"是制定最多的院前救护预案,"转运时间过长"是反映最多的问题;(3)PFC知晓率仅为35.1％;(4)"现场处理能力"和"复杂伤情评估"被分别认为是军、地医院创伤院前急救培训中最急需和最缺少的能力.结论 当前我国军、地医院救护人员对创伤院前急救措施的掌握情况不容乐观,对各类预案了解不足,PFC概念知晓度普遍较低,缺乏复杂伤情评估和决策能力,亟待完善培训策略,提升整体创伤院前救护能力.

目的 研究火针联合银离子治疗感染性压力性损伤的临床效果,为临床治疗提供理论依据.方法 选取广州中医药大学第一附属医院治疗的46例感染性压力性损伤患者为研究对象,分为对照组和观察组,每组23例.对照组采用外科清创+含银离子敷料负压治疗的方法,观察组在对照组治疗基础上联合火针治疗,每2天1次,记录治疗前和治疗后7、14、21 d两组伤口 pH值、伤口愈合情况、肉芽组织生长情况及不良反应发生情况.结果 与对照组比较,观察组7、14、21 d伤口 pH值更低,14、21 d压疮愈合计分量表(PUSH)评分、肉芽组织评分更低,差异有统计学意义(P＜0.05),两组均无不良反应发生.结论 火针联合含银离子敷料能加快感染性压力性损伤的愈合.

目的 探讨表没食子儿茶素没食子酸酯(EGCG)对人子宫肌瘤细胞增殖的影响及其机制.方法 获取人子宫肌瘤组织后提取人子宫肌瘤细胞.将细胞分为对照组、50μmol/L EGCG组、100μmol/L EGCG组、200μmol/L EGCG组,各EGCG剂量组分别加入相应浓度的EGCG,对照组加入等体积的磷酸缓冲盐溶液.干预24 h、48 h、72 h后,检测细胞存活率;干预48 h后观察细胞形态,并检测Wnt5 b、β-连环蛋白(β-Catenin)、上皮生长因子受体(EGFR)蛋白的表达情况.结果 干预48 h、72 h后,对照组、50μmol/L EGCG组、100μmol/L EGCG组、200μmol/L EGCG组人子宫肌瘤细胞存活率依次降低;随着干预时间的延长,各干预组细胞存活率有下降趋势(均P<0.05);免疫组化检测结果显示,各浓度EGCG干预组Wnt5 b、β-Catenin蛋白表达水平均低于对照组;200μmol/L EGCG组Wnt5 b蛋白表达水平低于其他两个浓度干预组,50μmol/L EGCG组、100μmol/L EGCG组、200μmol/L EGCG组β-Catenin蛋白表达水平依次降低(均P<0.05).免疫印迹试验结果显示,各浓度EGCG干预组EGFR、β-Catenin蛋白表达水平均低于对照组,100、200μmol/L EGCG组Wnt5 b蛋白表达水平低于对照组;200μmol/L EGCG组的EGFR、Wnt5 b蛋白表达水平均低于其他两个干预组(均P<0.05).结论 EGCG可抑制人子宫肌瘤细胞增殖,其机制可能与抑制Wnt/β-Catenin信号通路和EGFR的表达有关.

阐述了灾害相关伤口的临床特点,包括伤情复杂、感染问题严重,其发生和演变与灾后时间密切相关;处置的基本步骤可分为现场初步评估和急救、二次评估和处置、持续评估和记录等环节.提出灾害相关伤口护理缺乏专门的组织设定,护理策略不清晰,对实施者的能力要求不够明确,且培训不足.应进一步确定救灾人员的伤口护理能力,加强与灾害有关的伤口护理能力的培训和研究,加快完善与灾害有关的伤口护理组织管理体系的建设.

目的 观察火针联合湿性愈合敷料在慢性难愈性伤口治疗后创面愈合的临床疗效.方法 将86例慢性难愈性伤口患者按随机数字表法随机分为对照组和实验组,每组43例.对照组采用湿性愈合治疗方法,实验组在湿性愈合治疗基础上联合火针治疗.治疗7 d、14 d、21 d后比较两组的创面愈合率、创面肉芽生长评分、视觉模拟量表(VAS)评分以及不良反应发生率,并比较两组临床疗效.结果 实验组在治疗7 d、14 d、21 d后创面愈合率优于对照组(P<0.05),实验组在治疗14d、21 d的肉芽生长评分优于对照组(P<0.05),治疗7d、21 d后实验组VAS评分明显低于对照组(P<0.05).两组临床疗效比较,差异有统计学意义(P<0.05).结论 火针联合湿型敷料能有效促进肉芽生长,促进创面愈合,减轻患者疼痛,无不良反应发生,提高临床疗效.

目的 了解新疆边防军入冬季睡眠质量状况及其影响因素.方法 采用一般人口学资料调查表、匹兹堡睡眠质量指数量表(PSQI)和焦虑自评量表(SAS),于2018年1月采用整群抽样法,抽取新疆边防某部500名军人进行问卷调查.结果 (1)调查对象PSQI平均总分为(6.08±3.05)分,睡眠质量存在问题者占33.9％.(2)PSQI评分较高的指标有日间功能障碍、主观睡眠质量和入睡时间.(3)不同文化程度的军人在PSQI总分、睡眠时间因子、睡眠障碍因子和日间功能障碍因子得分差异有统计学意义(P＜0.01),且均为大专及以上＞高中及以下.(4)有饮酒史军人的PSQI总分、入睡时间因子、睡眠障碍因子和催眠药物因子得分均高于不饮酒的军人(P＜0.05).(5)PSQI总分及各因子分与SAS总分呈正相关(P＜0.05).结论 新疆边防军入冬季睡眠质量存在问题者较多,文化程度高、饮酒史和焦虑情绪是睡眠质量的影响因素.

目的 探讨人子宫肌瘤原代细胞体外培养的改良方法.方法 分别采用常规法和改良法获取人子宫肌瘤细胞,并进行原代培养和传代培养.应用光学显微镜、电子透射显微镜观察原代及传代培养细胞的形态学及生长特性;采用平滑肌肌动蛋白及细胞免疫组化法对细胞进行鉴定及纯度评估.比较两种方法获取的细胞数、细胞贴壁率、首次成功传代时间、传代次数以及复苏成功情况.结果 免疫组化鉴定结果显示两组细胞平滑肌肌动蛋白抗体呈阳性反应.改良组获得细胞数多于常规组,细胞贴壁率高于常规组,首次传代时间短于常规组(均P<0.05).两组传代次数及冻存后复苏成功情况差异均无统计学意义(均P>0.05).结论 改良后的细胞培养技术可以较快获得较多数量的人子宫肌瘤细胞原代.

[目的]观察社区健康管理对肥胖症病人肥胖指标及生活质量的影响。[方法]将140例肥胖症病人随机分为2组,各70例,两组均建立健康管理档案,干预组观察期间应用中医养生保健措施促进病人的健康管理,对照组予常规健康管理。两组干预前及干预后3个月、6个月比较体重、体质指数（BMI）变化,应用健康状况调查简表（SF-36）测评病人的生存质量。[结果]两组干预后3个月、6个月时体重、BMI均呈下降趋势;干预后6个月两组病人体重、BMI差异有统计学意义（P＜0.05）;干预后6个月两组病人SP-36量表中生理机能、生理职能、精神健康得分比较,差异具有统计学意义（P＜0.05）。[结论]社区健康管理可有效改善肥胖病人的肥胖指标,提高肥胖病人的生活质量。

Abstract Background: Septic shock is a serious disease with high morbidity, which will lead to organ dysfunction. Shen fu injection (SFI) has been widely used for septic shock as a treatment in China. Many clinical trials have been reported that it could assess the efficacy and safety of SFI to cure septic shock and accelerate resuscitation. Reassessing the efficacy and safety of SFI as a treatment of patients with septic shock is the objective of this updated systematic review. Methods: The following electronic databases major in English and Chinese will be conducted a systematic search until September 2018: PubMed, EMBASE, Cochrane Library, Chinese National Knowledge Infrastructure, Chinese Science and Technology Periodical Database, Chinese BioMedical Literature Database, and Wan-fang Database. Randomized controlled trials of SFI will be included. Review Manager 5.2 software will be used for assessment of risk of bias, data synthesis, and subgroup analysis. We will conduct the GRADE system to assess the quality of evidence, if possible. Results: This study will provide a rational synthesis of current evidences for SFI on septic shock. Conclusion: We hope our research results will provide an objective and reliable evidence to patients, clinicians and healthcare policymakers who are concerning the treatment options of SFI in septic shock. Registration: PROSPERO CRD42016049332.

Background: Septic shock is a serious disease with high morbidity, which will lead to organ dysfunction. Shen fu injection (SFI) has been widely used for septic shock as a treatment in China. Many clinical trials have been reported that it could assess the efficacy and safety of SFI to cure septic shock and accelerate resuscitation. Reassessing the efficacy and safety of SFI as a treatment of patients with septic shock is the objective of this updated systematic review. Methods: The following electronic databases major in English and Chinese will be conducted a systematic search until September 2018: PubMed, EMBASE, Cochrane Library, Chinese National Knowledge Infrastructure, Chinese Science and Technology Periodical Database, Chinese BioMedical Literature Database, and Wan-fang Database. Randomized controlled trials of SFI will be included. Review Manager 5.2 software will be used for assessment of risk of bias, data synthesis, and subgroup analysis. We will conduct the GRADE system to assess the quality of evidence, if possible. Results: This study will provide a rational synthesis of current evidences for SFI on septic shock. Conclusion: We hope our research results will provide an objective and reliable evidence to patients, clinicians and healthcare policymakers who are concerning the treatment options of SFI in septic shock.

皮肤完整性研究小组(Skin integrity research group)隶属于根特大学护理和助产士中心[1].该研究小组由Dimitri Beeckman[1]教授领导,旨在产生和实施基于证据的实践,在医疗保健中预防和治疗皮肤完整性问题.在2018年1月,该小组发布了一项为期两年的项目的成果:根特全球失禁性皮炎分类工具(GLOBIAD).来自30个国家的22名国际专家和823名临床医生参与了这个项目.本文旨在对GLOBIAD进行详细介绍,GLOBIAD通过对受累的皮肤区域进行肉眼检查,并以此为依据对失禁性皮炎(Incontinence-associated dermatitis,IAD)的严重程度进行分类.它的目的是建立一个国际公认的IAD严重程度的描述,并使临床实践和研究中这种病症的文献记载标准化.

OBJECTIVE:To compare the therapeutic effect between thunder-fire moxibustion combined with external applicaion of Shuangbai powder and thunder-fire moxibustion alone for mild and moderate knee osteoarthritis.METHODS:A total of 70 patients with mild and moderate knee osteoarthritis were randomly divided into an observation group and a control group, 35 cases in each group. In the observation group, thunder-fire moxibustion combined with external applicaion of Shuangbai powder were applied, Thunder-fire moxibustion was applied at Xuehai (SP 10), Liangqiu (ST 34), Neixiyan (EX-LE 4), Yanglingquan (GB 34) and ashi point, external applicaion of Shuangbai powder was given to the affected knee after the treatment of thunder-fire moxibustion. Simple thunder-fire moxibustion was given in the control group. All patients in the two groups were treated once a day, 7 days as one course and the consecutive 4 courses were required, with an interval of 1 day between courses. Before and after treatment, the visual analogue scale (VAS) score and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score were used to assessed knee pain, stiffness and physical function in the two groups. In addition, the efficacy was evaluated.RESULTS:Compared before treatment, the VAS scores, total scores of WOMAC, pain scores, stiffness scores and physical function scores were reduced after treatment in the two groups (P<0.01), and the scores in the observation group were significantly lower than those in the control group (P<0.01, P<0.05). The total effective rate was 97.0% (32/33) in the observation group, which was superior to 91.2% (31/34) in the control group (P<0.05).CONCLUSION:Thunder-fire moxibustion combined with external applicaion of Shuangbai powder are superior to simple thunder-fire moxibustion in improving the symptoms and delaying the development of the disease for mild and moderate knee osteoarthritis.

[目的]评价延续性护理对泌尿造口病人的影响.[方法]通过计算机检索PubMed、Web of science、Cochrane Library、MED-LINE数据库、中国知网(CNKI)、万方数据知识服务平台、维普中文期刊数据库(VIP)、中国生物医学文献数据库中关于延续性护理干预泌尿造口病人的随机对照试验和半随机对照试验,对符合质量标准的文献进行Meta分析.[结果]与常规护理相比,延续性护理在提高泌尿造口病人生活质量(P＜0.000 01)、降低并发症发生率(P＜0.000 01)、缓解焦虑情绪(P＜0.000 01)方面有优势.[结论]延续性护理可提高泌尿造口病人的生活质量、减少并发症、缓解病人焦虑情绪.

[目的]探讨下肢静脉溃疡治疗过程中创面红期(肉芽组织生长期)时采用消肿生肌膏联合藻酸钙钠盐敷料处理对疗效的影响.[方法]将64例下肢静脉溃疡患者随机分为试验组和对照组,每组各32例.试验组在创面清洗消毒后,给予涂抹一层消肿生肌膏,并覆盖藻酸钙钠盐敷料+弹力绷带加压包扎处理,对照组在创面清洗消毒后,给予藻酸钙钠盐敷料覆盖+弹力绷带加压包扎处理.分别于治疗3、7、14、21 d后计算2组患者的创面缩小率及换药时疼痛评分,并于干预治疗21 d后计算2组患者的治愈率及创面愈合时间.[结果](1)干预治疗3d和7d后,试验组的伤口创面缩小率明显大于对照组,换药时疼痛评分明显小于对照组(P<0.05或P<0.01);随着干预治疗时间的延长,在14 d和21 d换药时,2组患者的伤口创面缩小率及换药时疼痛评分比较,差异均无统计学意义(P>0.05).(2)干预治疗21 d后,2组患者的治愈率比较,差异无统计学意义(P>0.05);而试验组的治愈时间较对照组明显缩短,差异有统计学意义(P<0.01).[结论]消肿生肌膏在下肢静脉溃疡创面红期时介入可有效促进新生肉芽及上皮组织的生长,减轻患者的疼痛,加速创面的愈合.

Objective To observe the effect of five-tone music therapy on relieving anxiety and depression and on improving the quality of life of patients receiving chemotherapy after gastric cancer radical surgery.Methods Ninety anxiety and depression in-patients treated with chemotherapy after gastric cancer radical surgery were randomly divided into observation group and control group,45 cases in each group.Patients of the two groups were treated with the same chemotherapy regimen and nursing,and additionally,the observation group was given fivetone musie therapy and the control group was given conventional music therapy.The intervention effects were evaluated by scoring with Self-rating Anxiety Scale (SAS),Self-rating Depression Scale (SDS) and questionnaire for the quality of life of gastric cancer patients (QLQ-STO22) at admission time and when discharging from hospital.Results The SAS and SDS standard scores and the scores of each dimension of QLQ-STO22 in the observation group were markedly decreased after intervention,the differences being statistically significant (P ＜ 0.01 compared with those before intervention).And the SAS and SDS standard scores of the observation group after intervention were lower than those of the control group (P ＜ 0.01).In the aspects of quality of life,the scores of all dimension of QLQ-STO22 except taste,appearance and hair loss in the observation group were lower than those in the control group (P ＜ O.05).Conclusion Five-tone music therapy is effective on relieving anxiety and depression and on improving the quality of life of patients receiving chemotherapy after gastric cancer radical surgery.

Objective To investigate the relation among clinical nurses′resilience, emotional, the pressure load and self-efficacy with the 10-item Connor-Davidson Resilience Scale. Methods A total of 449 nurse in Guangzhou were recruited to investigate by 10-item Connor-Davidson Resilience Scale (CD-RISC-10), Kessler 10 Scale (K10), General Self-Efficacy Scale (GSES), Chinese Stress Overload Scale (SOS). Results The average score was 23.6±6.7 for CD-RISC-10 , 24.4±8.2 for K10,24.7±5.7 for GSES , 63.3 ±16.6 for SOS ,and the individual vulnerability scoring was (31.2±10.0) points, events load was (32.0±7.5) points. High mental toughness of nurses in general self-efficacy scores higher than that of low mental toughness group (t=-8.53, P<0.01), in the K10 dated, S0S scores were lower than low mental toughness group (t=11.23, 7.70, P<0.01). Nurse relevant regression analysis results showed that gender, general self-efficacy, K10 dated, SOS as the main factors influencing nurses mental toughness, could explain 40%of variances. Conclusions The CD-RISC-10 can better reflect the level of clinical nurses′resilience, and the gender, self-efficacy were the main effects, as well as effectively predict the nurses′emotional distress and stress level. However how to improve the toughness of the clinical nurses need more research.

Objective To investigate the influence of continuous nursing care on the quality of life for patients with gastric cancer after radical operation .Methods A total of 90 patients with gastric cancer after radical operation were randomly divided into experimental group and control group ,with 45 cases in each group .The control group received the usual discharged instruction and telephone follow -up, while the experimental group was given continuous nursing care .The score of quality of life in the total and each field after 14-day,1-,2-, 3-and 6-month discharge ,and the degree of satisfaction for nursing care ,the incidence rate of postoperative complication ,the cases having further consultation in 14 and 30 days after discharge were compared between the two groups .Results The overall score of quality of life , and the role function ,cognitive function ,emotion function and society function scores in the experimental group were higher than those in the control group,and the scores of fatigue,insomnia,poor appetite and astriction in the experimental group were lower than those in the control group(all P<0.05).The degree of satisfaction for nursing care in the experimental group was higher than that in the control group (P<0.05).The cases having further consultation in 14 days after discharge in the experimental group were less than those in the control group(P<0.05).Conclusion Continuous nursing care can improve the level of quality of life and the degree of satisfaction for nursing care in patients with gastric cancer after radical operation ,and reduce the number of patients having further consultation in the short term after discharge .

目的 探讨医护药合作培训在提高护士胃癌根治术后延续护理知识水平中的应用效果.方法 应用小组培训方法,对外科、肿瘤科护士进行胃癌根治术后延续护理知识培训,对比护士培训前后胃癌根治术后延续护理的理论考核成绩、技能考核成绩、综合能力考核成绩及考评总成绩.结果 经过医护药合作培训,护士胃癌根治术后延续护理的理论考核成绩、技能考核成绩、综合能力考评成绩及考评总成绩均比培训前提高,差异均有统计学意义(P<0.01).结论 医护药合作培训能较好地提高护士胃癌根治术后延续护理知识水平.