目的 总结医护人员对COPD患者实施肺康复体验的阻碍因素及应对策略,为促进肺康复在COPD患者中的开展提供参考.方法 检索中国知网、维普资讯中文期刊服务平台、万方数据知识服务平台、中国生物医学文献数据库、PubMed、Embase、CINAHL、Webof Science及Cochrane Library从建库至 2022年5月的所有医护人员对COPD患者实施肺康复体验的质性研究,采用汇集性整合的方法对结果进行Meta整合.结果 共纳入 9 篇文献,提炼出 47 个研究结果,归纳形成6个类别,得出2个整合结果:实施肺康复面临多重阻碍(患者肺康复动力不足、肺康复服务资源有限、肺康复组织管理待优化);实施肺康复需要多方位支持(肺康复理念推广、有力的社会支持、多形式的资源支持).结论 识别医护人员实施肺康复的阻碍因素,采取针对性策略,以促进肺康复在COPD患者中的开展.

目的:探讨护理实习生职业自我效能在职业态度和职业决策间的中介效应.方法:选取2022年3月—2022年5月安徽省3所三级甲等医院的216名护理实习生为研究对象,采用一般资料问卷、中文版护理职业态度量表、护生职业自我效能问卷以及职业决策调查表进行问卷调查.结果:93.98％的护理实习生在职业决策时选择从事临床护理工作;护理实习生的职业态度得分为(120.46±11.57)分,职业自我效能得分为(100.94±17.10)分;职业态度与职业决策、职业自我效能均呈正相关(r值分别为0.280,0.728,P<0.001),职业自我效能与职业决策呈正相关(r=0.333,P<0.001),职业自我效能在职业态度与职业决策间的中介效应为0.094,占总效应的63.51％.结论:护理实习生职业自我效能在职业态度和职业决策间起中介作用,可为临床实践教学和职业规划教育提供参考依据.

目的 对实施氛围量表(ICS)进行翻译和调试,并检验该量表的信效度,为评估护士对于循证护理实施氛围的感知水平提供可靠工具.方法 获得Ehrhart教授的授权后,按Brislin翻译模式对ICS量表进行汉化.调查690名护士的实施氛围水平,并对中文版ICS量表信效度进行检验.结果 中文版ICS量表共18个条目,验证性因子分析拟合指数良好(卡方自由度比、适配度指数、调整后适配度指数、增值适配指数、比较适配指数、非规准适配指数、渐进残差均方和平方根分别为5.076、0.904、0.860、0.970、0.970、0.960、0.077);各个维度与量表总分的Person相关系数0.868～0.935;各维度的Cronbach'sα系数在0.908～0.959之间;各个维度平均组内一致性系数(Rwg)为0.801～0.869,组内相关系数ICC(1)值0.036～0.064,组内相关系数ICC(2)的值0.272～0.484.结论 中文版ICS量表与原量表的框架结构一致,具有良好的信效度,可以用于评价医疗机构循证护理实施氛围的水平.

Objective:To explore the application effect of three mode pre-rehabilitation strategy in gastric cancer patients after laparoscopic radical operation and its effect on the recovery of physical function and quality of life after operation.Methods:Totally 96 patients undergoing elective laparoscopic-assisted radical gastric cancer surgery admitted in the Second Affiliated Hospital of Anhui Medical University from January 2019 to September 2020 were divided into control group (48 cases) and observation group (48 cases) by the random number table. Finally two cases in control group were excluded. The control group received gastric cancer regular preoperative health guidance, the observation group received trimodal pre-habilitation strategy for 6-8 days on the basis of the control group. The perioperative indicators and complications were compared between the two groups. The 36-item Health Survey Summary (SF-36) scores were measured before and after intervention.Results:The first postoperative exhaust time, first out of bed time, first oral meal time, hospital stay in the observation group were (61.49 ± 6.71) hours, (19.54 ± 6.13) hours, (71.23 ± 6.79) days, (5.62 ± 1.03) days, which lower than (79.21 ± 8.15) hours, (22.95 ± 7.19) hours, (78.95 ± 7.21) days, (6.64 ± 1.17) days in the control group, and the differences were statistically significant between the two group ( t values were 2.48-11.53, all P<0.05). The incidence of complications was 6.25% (3/48) in the observation group and 21.74% (10/46) in the control group, and the difference was statistically significant between the two groups ( χ2=8.72, P<0.05). At 1 d before operation and 30 d after operation, the average scores of SF-36 were (68.74 ± 8.02), (65.85 ± 7.44) points in the observation group and (60.73 ± 7.43), (61.04 ± 6.85) points in the control group, and the differences were statistically significant ( t=5.02, 3.26, both P<0.05). Conclusions:Preoperative three mode pre-rehabilitation training for gastric cancer patients is beneficial to improving the state of exercise, nutrition and immune function, speeding up postoperative gastrointestinal function and overall rehabilitation, reducing the incidence of postoperative complications and improving the quality of life of patients.

Objective:To understand the current situation of self-evaluation of clinical competence of new nurses in hospital, so as to provide a basis for standardized training of new nurses in clinical practice.Methods:The multistage sampling method was used to select the new graduate nurses from 9 hospitals in Anhui Province (3 provincial, municipal and county-level hospitals respectively) as the survey objects, and the six-dimension scale of nurse behavior was used to conduct a questionnaire survey.Results:The clinical competence score of new graduate nurses in Anhui province was (164.56±30.12) points, and the scores of new nurses in provincial, municipal and county hospitals were (159.92±30.01) points, (171.04±29.18) points and (162.60±30.25) points, respectively. The total score of clinical competence and the scores of 6 dimensions of new nurses in different levels of hospitals were compared, and the results of variance analysis showed that the differences were statistically significant ( P<0.05). Conclusions:The self-evaluation of clinical nursing ability of new nurses in Anhui Province is at a good level, and municipal hospitals are better than county hospitals, while county hospitals are better than provincial hospitals. It is necessary to improve the organization and implementation of the standardized training system and program for new graduate nurses as soon as possible, strengthen the communication and exchange between hospitals at all levels, and improve the quality of standardized training for new graduate nurses.

目的:调查新入职护士共情能力、正念水平与工作投入的现状,并分析三者之间的相关性.方法:采用一般资料问卷、正念注意觉知量表、共情能力量表以及Utrecht工作投入量表对某三甲医院153名新入职护士进行调查.结果:新入职护士工作投入得分为(77.08±18.28)分,处于中等水平.共情能力得分(28.58±5.34)分;正念水平得分为(65.54±12.88)分.共情能力与正念水平呈显著正相关(r=0.204,P<0.05),且与工作投入呈显著正相关(r=0.411,P<0.01).正念水平与工作投入呈显著正相关(r=0.616,P<0.01).共情能力在正念水平和工作投入之间起部分中介作用,占总效应的9.861％.结论:提高新入职护士的共情能力和正念水平可以改善新入职护士的工作投入.

Objective: Sorafenib resistance has been a major factor limiting its clinical use as a targeted drug in liver cancer. The present study aimed to investigate whether cryptotanshinone can enhance the sensitivity of liver cancer and reduce the resistance to sorafenib.Methods: Sorafenib-resistant cells were established based on HepG2 and Huh7 cell lines. And the anti-tumor effect of sorafenib combined with cryptotanshinone on the sorafenib-resistant cells was verified by MTT, colony formation, transwell assays and tumor growth xenograft model. Moreover, the effects of the combined treatment on the expression of phosphorylated (p)-STAT3, as well as epithelial mesenchymal transition (EMT) and apoptosis related proteins of cells were evaluated by western blot analysis. Results: It was identified that cryptotanshinone inhibited the viability of both HepG2 and Huh7 cells in a dose- and time-dependent manner, and decreased p-STAT3 expression rather than total STAT3 expression at a concentration of 40 μmol/L. In the sorafenib-resistant cells, sorafenib in combination with cryptotanshinone markedly inhibited cell viability, invasion and migration compared with sorafenib alone. In contrast, increased p-STAT3 level by colivelin led to the inhibition of the synergistic effect of cryptotanshinone and sorafenib not only on cell viability, but also on EMT and apoptosis, suggesting that cryptotanshinone and sorafenib may act by downregulating STAT3 signaling. Further, the inhibition of carcinogenicity effect was also verified in xenografted tumor models. Conclusion: The present results indicated that cryptotanshinone could synergize with sorafenib to inhibit the proliferative, invasive, and migratory abilities of sorafenib-resistant cells by downregulating STAT3 signaling.

Following the publication of this paper, it was drawn to the Editors' attention by a concerned reader that certain of the flow cytometric data shown in Figs. 2C, 4C and 5C, and the cell invasion assay data shown in Figs. 2D and E, 4D and E and 5D and E were strikingly similar to data appearing in different form in other articles by different authors. In addition, the authors independently contacted the Editorial Office to request that this paper be retracted owing to the fact that they had not obtained approval from the Ethics Committee of The Second Affiliated Hospital of Harbin Medical University to use the tissue samples, even though they had written that this study was approved by the Ethics Committee, and written informed consent had been provided by all patients enrolled in the research. Owing to the fact that the contentious data in the above article had already been published elsewhere, or were already under consideration for publication, prior to its submission to Oncology Reports, and the authors' own admission of serious problems concerning the ethical nature of the study, the Editor has decided that this paper should be retracted from the Journal. The authors have agreed to the decision to retract the paper. The Editor apologizes to the readership for any inconvenience caused. [Oncology Reports 40: 3890‑3898, 2018; DOI: 10.3892/or.2018.6763].

目的:探讨台式汞柱血压计、上臂式电子血压计和机械袖带血压计在测量住院病人血压上的差异.方法:选取2019年10月—2019年11月安徽省3所三级甲等医院107例心内科住院病人,在相同时间、相同条件下分别使用台式汞柱血压计、机械袖带血压计和上臂式电子血压计测量病人肱动脉血压.结果:3种血压计测量结果比较,差异无统计学意义(P>0.05).结论:在相同条件且规范测量血压的前提下,3种血压计均可适用于临床病人的血压测量工作.

The infiltration degree of immune and stromal cells has been shown clinically significant in tumor microenvironment (TME). However, the utility of stromal and immune components in Gastric cancer (GC) has not been investigated in detail. In the present study, ESTIMATE and CIBERSORT algorithms were applied to calculate the immune/stromal scores and the proportion of tumor-infiltrating immune cell (TIC) in GC cohort, including 415 cases from The Cancer Genome Atlas (TCGA) database. The differentially expressed genes (DEGs) were screened by Cox proportional hazard regression analysis and protein-protein interaction (PPI) network construction. Then ADAMTS12 was regarded as one of the most predictive factors. Further analysis showed that ADAMTS12 expression was significantly higher in tumor samples and correlated with poor prognosis. Gene Set Enrichment Analysis (GSEA) indicated that in high ADAMTS12 expression group gene sets were mainly enriched in cancer and immune-related activities. In the low ADAMTS12 expression group, the genes were enriched in the oxidative phosphorylation pathway. CIBERSORT analysis for the proportion of TICs revealed that ADAMTS12 expression was positively correlated with Macrophages M0/M1/M2 and negatively correlated with T cells follicular helper. Therefore, ADAMTS12 might be a tumor promoter and responsible for TME status and tumor energy metabolic conversion.

目的 总结术后复发性肝癌外科治疗的现状及进展.方法 查阅近年来有关术后复发性肝癌外科治疗的相关文献并进行综述.结果 外科手术是治疗复发性肝癌的有效手段,其手术方式分为再次肝切除和挽救性肝移植.再次肝切除的手术适应证尚无统一标准,但基本原则一致,而挽救性肝移植的适应证目前主要依据Milan标准.对于符合手术适应证的复发性肝癌患者,外科手术可提高患者远期生存率,使患者获益.结论 采用外科手术治疗复发性肝癌,应结合患者的手术适应证、初次肝切除时的肿瘤情况、术后复发时间等因素选择合适的患者及合理的手术方式积极进行治疗,可延长患者生存时间、提高患者远期生存率.

目的 探讨模块化护理在ICU脓毒症患者中的应用价值.方法 选取2015年10月-2019年10月在我院住院治疗的ICU脓毒症患者60例为研究对象,采用随机数字表法分为2组,各30例.所有患者均给予液体复苏、机械通气、抗感染、抗休克、营养支持等对症治疗,并积极对原发疾病进行治疗.对照组给予ICU常规护理,观察组在常规护理的基础上给予模块化护理.比较2组的护理效果、循环功能、氧合功能及肾功能相关指标.结果 观察组机械通气时间、住ICU时间及APACHEⅡ评分均显著低于对照组(P<0.05),恢复良好率显著高于对照组(P<0.05);干预后2组CVP、MAP、PaO2、PaO2/FiO2水平均显著升高,且观察组显著高于对照组(P<0.05);干预后2组尿量均明显升高,BUN、Scr水平水平明显降低,且观察组显著优于对照组(P<0.05).结论 模块化护理可显著缩短ICU脓毒症患者的机械通气时间、住ICU时间,降低APACHEⅡ评分,还能够有效改善患者的循环功能、氧合功能及肾功能相关指标,值得临床借鉴.

目前肝细胞肝癌的细胞增殖及侵袭转移机制尚未完全阐明,治疗方面也缺乏令人满意的有效方法.近年来,随着模拟基质硬度的细胞培养平台的建立和逐步改进,基质硬度等生物力学因素及其影响的研究逐渐受到重视.细胞外基质硬度的改变,可通过一系列分子机制调控细胞行为,促进肝癌细胞增殖和增强其侵袭转移能力,本文对其相关机制的研究现状进行综述,希望为肝癌治疗新靶点和新策略的开发提供线索.

The cultivation of medical students' scientific research and innovation ability is the need of our country to accelerate the construction of an innovative country. This paper starts from the significance of strengthening the cultivation of medical students' scientific research and innovation ability, emphasizes participation in teacher's scientific research in colleges and universities to strengthen the feasibility of the medical students' scientific research and innovation ability cultivation, and summarizes the practical experience of cultivating medical students' scientific research ability based on scientific research projects of teachers in colleges and universities, which can provide reference for peers.

目的 探究居家腹膜透析患者自我管理能力的影响因素及提升能力水平的措施.方法 选取2016年1月至2020年6月安徽省某三甲医院进行腹膜透析置管术并参与门诊随访的居家腹膜透析患者110例,调查患者的自我管理能力,并分析影响因素.结果 居家腹膜透析患者的自我管理能力为中等,透析年龄、社会支持、文化及自我效能为影响因素.结论 居家腹膜透析患者的自我管理能力不高,透析年龄、社会支持、文化及自我效能为影响因素,医护人员需根据实际情况采用相关措施,不断提升自我管理能力.

目的 探讨共享决策干预在慢性阻塞性肺疾病(COPD)患者中的应用效果.方法 选取2018年6月-2019年6月我科收治的62例COPD患者作为研究对象,采用随机数字表法分为对照组和试验组,各31例.对照组给予常规护理.试验组在常规护理的基础上给予共享决策干预.比较两组治疗满意度、生活质量、治疗依从率及血气分析指标.结果 两组干预前治疗满意度、生活质量评分、治疗依从率及血气分析指标比较差异无统计学意义(P>0.05),试验组干预后治疗满意度、生活质量评分、治疗依从率均优于对照组(P<0.05).结论 共享决策干预有助于提升COPD患者治疗满意度、生活质量及治疗依从率,可应用于临床护理.

基于食管癌手术患者并发症多、生活质量差等特征,健康教育在改善患者围手术期早期活动、肺部康复、饮食管理、自我照护行为等方面发挥重要作用.本研究从食管癌手术患者健康教育内容、方式及质量评价指标等方面对国内外相关文献进行综合分析与归纳.旨在改善食管癌手术患者围手术期的知信行现状,降低围手术期并发症的相关风险、促进患者快速康复方面提供借鉴思路.

With the dawn of organ donation after a citizen's death in China, the use of split-liver transplantation (SLT) can effectively increase the source of donor liver, reduce the waiting time for organ transplantation in patients, and particularly solve the problem of organ shortage in children. In recent years, many transplantation centers have been performing SLT to varying degrees and efficacy. At the current stage, the experiences of countries with advanced transplantation techniques should be used to establish an SLT consensus that is suitable for China to further increase the ratio and efficacy of SLT. In this paper, we combined expert experiences to generate an SLT expert consensus that included donor and donor liver evaluation, recipient selection criteria, donor and recipient matching, selection of splitting form and tools, blood vessels and bile ducts dissection and allocation, perioperative management of SLT, and organ allocation.& COPY; 2020 The Third Affiliated Hospital of Sun Yat-sen University. Publishing Services by Elsevier B. V. on behalf of KeAi Communications Co., Ltd. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

Objectives The present study aimed to develop a gene signature based on the ESTIMATE algorithm in hepatocellular carcinoma (HCC) and explore possible cancer promoters. Methods The ESTIMATE and CIBERSORT algorithms were applied to calculate the immune/stromal scores and the proportion of tumor-infiltrating immune cells (TICs) in a cohort of HCC patients. The differentially expressed genes (DEGs) were screened by Cox proportional hazards regression analysis and protein–protein interaction (PPI) network construction. Cyclin B1 (CCNB1) function was verified using experiments. Results The stromal and immune scores were associated with clinicopathological factors and recurrence-free survival (RFS) in HCC patients. In total, 546 DEGs were up-regulated in low score groups, 127 of which were associated with RFS. CCNB1 was regarded as the most predictive factor closely related to prognosis of HCC and could be a cancer promoter. Gene Set Enrichment Analysis (GSEA) and CIBERSORT analyses indicated that CCNB1 levels influenced HCC tumor microenvironment (TME) immune activity. Conclusions The ESTIMATE signature can be used as a prognosis tool in HCC. CCNB1 is a tumor promoter and contributes to TME status conversion.