Remote online exams (ROEs) have become more prevalent in higher education, however they have long raised issues in the field of online learning, with educators expressing concerns about assessment effectiveness and risks of academic integrity. The article primarily aims to review students’ perceptions of ROEs to offer insights for their future improvement. ROEs most commonly utilize multiple-choice and short-answer questions, and many employ invigilation. Among studies that included relevant explicit information, students predominantly had positive overall impressions of ROEs. Ease of use stood out as the most prominent form of advantage, and technology-related problems were the most frequently mentioned form of disadvantage. On some aspects, such as test anxiety and ease of cheating, different studies reported opposing perceptions. Many studies also proposed solutions concerning aspects such as exam support and exam format. The authors believe that educators should be aware of students’ differences in individual characteristics, such as working style and test anxiety, and try to accommodate the variety of preferences when designing exams if possible. Moreover, the need for improvement exists not only in the exams themselves but also in various aspects surrounding the exams.

Background/Objectives: Aztreonam/avibactam is a promising treatment option for serious infections caused by metallo-β-lactamase-producing carbapenem-resistant Enterobacterales (MBL-CRE). However, the labeled regimen is operationally demanding because it requires frequent, prolonged infusions, and the recommended loading dose does not match the commercially available vial strength. This population pharmacokinetic (PopPK)-based Monte Carlo simulation study aimed to optimize aztreonam/avibactam dosing across renal function strata while maintaining pharmacokinetic/pharmacodynamic (PK/PD) target attainment. Methods: Published PopPK models for aztreonam and avibactam were reconstructed and applied in Monte Carlo simulations. Virtual adult patients (body weight 70 kg) were stratified into five renal function groups according to creatinine clearance (CrCL): 101-120, 81-100, 51-80, 31-50, and 15-30 mL/min. Simulated scenarios varied infusion duration, dosing interval, maintenance dose, and loading strategy. Prespecified PK/PD targets were 60% fT > MIC (the percentage of dosing interval that free drug concentration remains above the minimum inhibitory concentration) for aztreonam (MIC 8 mg/L) and 50% fT > CT (the percentage of dosing interval that free drug concentration remains above the critical threshold concentration) for avibactam (CT 2.5 mg/L). A joint probability of target attainment (PTA) ≥ 90% was considered acceptable. Results: Regimen performance differed across renal function strata. For patients with CrCL > 80 mL/min, the labeled q6h regimen infused over 3 h remained the most robust option, whereas shortening the infusion to 1 h or 2 h reduced target attainment. In the CrCL 51-80 and 31-50 mL/min subgroups, both q6h/3 h and q6h/2 h regimens generally achieved acceptable PTA. However, in the CrCL 31-50 mL/min subgroup receiving q6h/2 h administration, omitting a loading dose was associated with reduced early avibactam exposure. In the CrCL 15-30 mL/min subgroup, a simplified half-vial regimen (0.75/0.25 g q8h/2 h) provided PTA comparable to that of the complex labeled reduced-dose regimen. Across loading dose scenarios, omission of the loading dose was best supported in the CrCL 51-80 mL/min subgroup, whereas retaining the labeled loading dose remained the more prudent approach in the CrCL 31-50 mL/min subgroup when a 2 h infusion was used. Conclusions: PopPK-guided, renal function-stratified simplification of aztreonam/avibactam dosing may improve clinical practicality without materially compromising PK/PD target attainment in selected patient subgroups. A 2 h infusion appears a reasonable alternative for patients with CrCL 31-80 mL/min, and a 0.75/0.25 g q8h/2 h half-vial regimen may be considered a plausible exploratory option for patients with CrCL 15-30 mL/min. These findings support more feasible administration strategies, but prospective clinical validation remains necessary.

Objectives:This study aimed to compare the effectiveness of the semi-virtual simulation and traditional simulation teaching models based on the Standards of Best Practice (SOBP) according to the International Nursing Association for Clinical Simulation and Learning (INACSL) in the Adult Nursing course. Methods:This study used a quasi-experimental design. A total of 94 third-year nursing students from a university in Beijing between November and December 2022 were recruited as participants. An innovative semi-virtual simulation teaching model was designed based on the SOBP established by the INACSL. In the Adult Nursing course, both the semi-virtual and traditional simulation teaching models were implemented. At the end of the simulation sessions, participants completed the Chinese version of the Simulation Effectiveness Tool-Modified (SET-M) to assess the effectiveness of the two teaching models. Results:All nursing students completed the simulation sessions. There was no difference (t = -0.93, P = 0.353) in the total scores between the semi-virtual simulation teaching model (50.87 ± 5.30) and the traditional simulation teaching model (50.37 ± 5.16). However, there was a statistically significant difference (t = -2.65, P = 0.010) in the prebriefing section (semi-virtual simulation: 5.60 ± 0.71; traditional simulation: 5.33 ± 0.78). In contrast, no statistically significant differences were found for the scenario and debriefing sections (P > 0.05). At the individual item level, statistical differences (P < 0.05) between the two models were identified for items 1 and 9, but not for the remaining items (P > 0.05). By analyzing the open-ended question, it was found that both simulation models were effective, and students' comments were similar. Conclusions:The study demonstrated equivalent effectiveness between the semi-virtual and traditional simulation teaching models. Semi-virtual simulation teaching model could offer a more flexible and feasible approach to simulation teaching.

Objectives: To establish a population pharmacokinetics (PopPK) model of nirmatrelvir in Chinese COVID19 patients and provide reference for refining the dosing strategy of nirmatrelvir in patients confirmed to be infected with SARS-CoV-2. Methods: A total of 80 blood samples were obtained from 35 mild to moderate COVID-19 patients who were orally administered nirmatrelvir/ritonavir tablets. The PopPK model of nirmatrelvir was developed using a nonlinear mixed effects modelling approach. The stability and prediction of the final model were assessed through a combination of goodness-of-fit and bootstrap method. The exposure of nirmatrelvir across various clinical scenarios was simulated using Monte Carlo simulations. Results: The pharmacokinetics of nirmatrelvir was well characterised by a one-compartment model with first-order absorption, and with creatinine clearance (Ccr) as the significant covariate. Typical population parameter estimates of apparent clearance and distribution volume for a patient with a Ccr of 95.5 mL min -1 were 3.45 L h -1 and 48.71 L, respectively. The bootstrap and visual predictive check procedures demonstrated satisfactory predictive performance and robustness of the final model. Conclusion: The final model was capable of offering an early prediction of drug concentration ranges for different nirmatrelvir dosing regimens and optimise the dose regimen of nirmatrelvir in individuals with confirmed SARS-CoV-2 infection. (c) 2024 Elsevier Ltd and International Society of Antimicrobial Chemotherapy. All rights are reserved, including those for text and data mining, AI training, and similar technologies.

Sepsis is a life-threatening organ dysfunction caused by an excessive host response to infection, manifested by elevated levels of inflammatory cytokines. At present, the use of hemoperfusion to remove inflammatory cytokines from the bloodstream has been expanding. Meanwhile, the pharmacokinetics and pharmacodynamics characteristics of antibiotics in critically ill patients may be impacted by hemoperfusion. The patient was a 69-year-old male with poorly controlled type 2 diabetes. When admitted to the ICU, Multiple Organ Dysfunction Syndrome (MODS) appeared within 48 h, and he was suspected of septic shock due to acute granulocytopenia and significantly increased procalcitonin. Broad-spectrum antibiotics imipenem was administered according to Sepsis 3.0 bundle and hemoperfusion lasting 4 h with a neutron-macroporous resin device (HA-380, Jafron, China) five times was conducted to lower the extremely high value of serum inflammatory factors. Blood samples were collected to measure imipenem plasma concentration to investigate the effect of hemoperfusion quantitatively. This study showed that 4 h of hemoperfusion had a good adsorption ability on inflammatory factors and could remove about 75.2

Aims: Cetirizine is frequently administered at an increased dosage in clinical practice and recommended by several guidelines. Nonetheless, the pharmacokinetic (PK) profile and real-world safety data remain insufficient in the Chinese pediatric population. The objective of the current study is to develop a population pharmacokinetic (PPK) model for cetirizine in Chinese pediatric patients and to investigate the rationale behind its off-label usage.Methods: A prospective cohort study was conducted, enrolling children who had been diagnosed with allergic diseases and prescribed cetirizine. The outcomes were safety and pharmacokinetic (PK) parameters. Cetirizine concentrations were measured using a pre-established analytical method. Subsequently, a PK model was developed, followed by model evaluation and simulation. The developed PK model was employed to investigate the drug exposure differences across various age groups and to simulate scenarios of potential overdose.Results: Sixty-three children were enrolled, and 24 of them received a cetirizine dose exceeding the recommended dosage. A PPK model, based on published literature, served as the basis of our analysis, with adjustment made to estimate certain parameters. The final model evaluation and validation indicated accurate predictive performance and robust parameter estimation. Simulations conducted for the label-dose among age 1–12 indicated median maximum concentration at steady state (Cmax,ss) of 7 year old children could be the highest. The model was also used to predict the off-label dose scenarios and overdose patient to support the clinical decision. There were no adverse drug reactions in either group.Conclusion: This study provides evidence-based and model-based exploration for optimizing cetirizine usage in Chinese pediatric patients. The cetirizine PPK model showed accurate predictive performance and could be utilized to simulate individual patient exposure in real-world clinical scenarios.

BACKGROUND:Trimethylamine N-oxide (TMAO), a gut microbiota-derived metabolite, has emerged as a new potentially important cause of increased atherosclerosis and cardiovascular risk in chronic kidney disease (CKD) patients. However, the possible causes whereby TMAO potentiates atherosclerosis development remain poorly defined. The strong association between gut microbiota and obesity suggested that the TMAO pathway may be linked to the pathogenesis of obesity.MATERIALS AND METHODS:A total of 184 hemodialysis (HD) patients and 38 healthy controls were enrolled in the study from March 2019 to May 2019. We evaluated visceral fat area (VFA) by anthropometric measurement and measured serum TMAO concentrations using liquid chromatography/differential ion mobility spectrometry tandem mass spectrometry. We also examined the relationship between TMAO levels and visceral fat accumulation.RESULTS:TMAO level was markedly higher in HD patients than in control subjects (5.80 (3.96, 9.46) vs. 0.18 (0.11, 0.32) µg/mL, p < 0.01), and its level in diabetic HD patients was significantly higher than in nondiabetic patients (6.93 (4.67, 11.40) vs. 5.25 (3.78, 8.02) µg/mL, p < 0.01). A significant positive correlation was found between serum TMAO level and VFA in these patients (r = 0.282, p = 0.005). Multiple regression analysis showed that Ln(TMAO) was independently associated with Ln(VFA) in HD patients (p = 0.008).CONCLUSION:Our results showed that there was a significant positive correlation between serum TMAO levels and visceral fat in HD patients, which suggested that TMAO may predict cardiovascular risk through increased visceral fat.

Background: Accumulating evidence showed a bidirectional association between post-traumatic stress disorder and inflammation. However, whether the association is causal remains unclear. We aimed to evaluate the causal relationships between inflammatory cytokines and post-traumatic stress disorder using two-sample bi-directional Mendelian randomization analysis. Methods: Single nucleotide polymorphism from genome-wide association studies of inflammatory cytokines, C-reactive protein, and post-traumatic stress disorder (23,212 patients and 151,447 controls) was selected as instrumental variables. The causal associations were estimated by inverse variance weighting with sensitivity analyses using weighted median, MR-Egger, and MR-PRESSO methods.Results: We observed suggestive associations of genetically predicted interleukin-17 (IL-17) and RANTES with post-traumatic stress disorder. One standard deviation (SD) increase in genetically predicted level of IL-17 lowered the risk of post-traumatic stress disorder with an odds ratio (OR) of 0.902 (95 % CI = 0.828, 0.984, P = 0.02). One SD higher genetically predicted RANTES (CCL5) concentration increased post-traumatic stress disorder risk (OR = 1.067, 95 % CI = 1.005, 1.133, P = 0.032). However, we found no evidence of causal as-sociations of post-traumatic stress disorder with the selected inflammatory cytokines and biomarkers. We observed no evidence supporting the presence of pleiotropy. The results of sensitivity analyses demonstrated the same directions and similar effect sizes as the primary findings.Limitations: Potential pleiotropy, possible weak instruments, and low statistical power limited our findings.Conclusion: Inflammation was suggestively causally associated with the risk of post-traumatic stress disorder, and inflammatory cytokines had no downstream effect on post-traumatic stress disorder. Further studies are needed to explain the mechanisms of systemic inflammation and neuroinflammation in post-traumatic stress disorder.

RationaleThe consistency evaluation of generic drugs is important for the overall reformation of drug registration in China. In this study, we used meropenem as a model drug to explore the key techniques for clinical consistency evaluation by studying the plasma protein binding (PPB) ratio of different preparations. Because the free portion of drug is the effective part in vivo, it is essential to measure the free drug concentration in the circulatory system. Therefore, in this study, a fast and accurate high‐performance liquid chromatography tandem mass spectrometry (HPLC–MS/MS) method was developed to determine the total and free concentrations of meropenem in human plasma.MethodsSimple protein precipitation procedures were used for the sample processing assay, and ultrafiltration was implemented for the separation of free drugs. Liquid chromatography separation was performed using a hydrophilic interaction liquid chromatography (HILIC) silica column (2.1 × 50 mm, 3 μm). The mobile phase and sample preparation procedures were optimized. Factors affecting the measurement of free drug concentration were also determined. Nonspecific binding of the ultrafiltration membrane was negligible because the recovery rate for post‐ultrafiltration was greater than 96%.ResultsUnder optimal conditions, the drug concentrations were linear from 0.5 to 50 μg/ml for both total and free drug concentrations. The PPB ratio was calculated based on the free and total drug concentrations. The PPB of meropenem varied from 1.4% to 24.2% in different subjects. The validated method was applied to evaluate PPB of four preparations, and the results varied from 6.57 ± 3.19% to 10.40 ± 8.31%. One‐way analysis of variance (ANOVA) showed no significant differences between the four preparations.ConclusionsWe established a rapid, robust, and reliable method for the determination of total and free meropenem concentrations using LC–MS/MS with ultrafiltration techniques. The method provided a new perspective for the clinical consistency evaluation of generic drugs.

BACKGROUND:Acute kidney injury (AKI) is a serious clinical emergency with an acute onset, rapid progression and poor prognosis, which has high morbidity and mortality in hospitalized patients. DNA methylation plays an important role in the occurrence and progression of kidney disease, and aberrant methylation and certain altered methylation-related metabolites have been reported in AKI patients. However, the specific alterations of methylation-related metabolites in the AKI patients were not investigated clearly. METHOD:In this study, 61 AKI and 61 matched non-AKI inpatients were recruited after propensity score matching the age and hypertension. And 11 methylation-related metabolites in the plasma and urine of the two groups were quantified by using UHPLC-MS/MS method. RESULTS:Certain methylation-relate intermediates were up-regulated in the plasma (choline, trimethylamine N-oxide (TMAO), trimethyl lysine (TML), S-adenosylmethionine (SAM) and S-adenosylhomocysteine (SAH)) and down-regulated in the urine of AKI inpatients (choline, betaine, TMAO, dimethylglycine (DMG), SAM and taurine). The correlation analysis revealed a relatively strong correlation between plasma SAH, SAM/SAH ratio and renal function index (serum creatinine (SCr) and estimated glomerular filtration rate (eGFR), r = 0.523-0.616), and the correlation of urinary intermediates with renal function index was weaker than that in the plasma. Furthermore, receiver operating characteristic (ROC) analysis showed that plasma SAH and urinary SAM/SAH ratio represented the best distinguishing efficiency with AUC 0.844 and 0.794, respectively. Moreover, the findings of binary regression analysis demonstrated plasma choline, TMAO, TML, SAM and SAH were the risk markers of AKI (up-regulation in plasma, OR > 1), urinary choline, betaine, TMAO, DMG and SAM were protective markers of AKI (down-regulation in urine, OR < 1), and SAM/SAH ratio was a protective marker in plasma and urine (down-regulation in both two biofluids, OR = 0.510, 0.383-0.678 in plasma, OR = 0.904, 0.854-0.968 in urine), indicating the increased risk of AKI when combined with the alteration of plasma and urinary levels. CONCLUSION:The comprehensive analysis of plasma and urine samples from AKI inpatients offers a more extensive assessment of methylated metabolic alterations, suggesting a close relationship between AKI stress and altered methylation ability. The plasma level of SAH and SAM/SAH ratio and urinary SAM/SAH ratio both showed a strong correlation with renal function (SCr and eGFR) and good accuracy for distinguishing AKI in the two biomatrices, which exhibited promising prospects in predicting renal function decline and providing further information for the pathogenesis of AKI.

Circulating free androgens are important indicators for a variety of diseases, so accurate determination of these hormones in serum is of great clinical significance. However, there are still many challenges for the accurate quantification of free androgens using mass methods because of their very low levels and complex interferences in serum, as well as the high serum protein binding rate and high nonspecific binding (NSB) rate. Here, an HPLC-MS/MS method coupled with magnetic solid phase extraction (MSPE) and in-situ derivatization was developed to quantify two free androgens-free testosterone (FT) and free androstenedione (FA4)-in human serum simultaneously and accurately. Ultrafiltration was used to obtain free androgens in serum. To minimize the NSB rate and obtain accurate results, the ultrafiltration membrane was doubly modified with surfactant followed by a silane-coupling agent. Multiple pre-saturation with the tested samples was also used. With these strategies, the ultrafiltration recoveries were up to 95.4% for FT and 94.0% for FA4, so the NSB was negligible. After that, the extremely low levels of free androgens in ultrafiltrates were extracted and enriched using MSPE with core-shell structured ferroferric oxide coated with graphene oxide. Hydroxylamine hydrochloride was used to derivatize the analytes and the reaction took place on the surface of the adsorbent. All the extraction and derivatization conditions were optimized. Under such conditions, the assays were linear for FT within the range of 2-100 pg mL-1 and for FA4 within the range of 5-500 pg mL-1. The intra- and inter-run CV was less than 12.3% and 10.9% for FT and less than 7.2% and 8.3% for FA4, respectively. For the intra- and inter-run accuracies, the relative error of the mean was 9.9% and 8.4% for FT, and 11.5% and 7.3% for FA4, respectively. The total extraction recoveries with MSPE in-situ derivatization were 93.2% for FT, 93.8% for FA4 and 95.7% for the internal standard. The method was validated and was used to quantify the trace level of these two free androgens in serum samples from female patients suspected of having polycystic ovary syndrome (PCOS) accurately. It is expected to improve the diagnosis accuracy of PCOS when combined with other clinical indicators.

BACKGROUND AND AIMS:As numerous studies have reported the concentration-exposure relationships of epidermal growth factor receptor-tyrosine kinase inhibitors (EGFR-TKIs), therapeutic drug monitoring is a promising approach in lung cancer treatment, aiming to avoid treatment failure or toxicity. A new method for the simultaneous analysis of five EGFR-TKIs (afatinib, erlotinib, gefitinib, icotinib and osimertinib) and their metabolites in human plasma samples was developed and validated using liquid chromatography-tandem mass spectrometry (LC-MS/MS).MATERIALS AND METHODS:Afatinib-d6, erlotinib-d6, OSI-420-d4, gefitinib-d6 and osimertinib-C13,d3 were used as internal standards (ISs). The samples were prepared by liquid-liquid extraction using tert-butyl methyl ether. Chromatographic separation was undertaken on an XBridge C18 column using a linear gradient elution. LC-MS/MS was conducted in positive ionization mode with multiple reaction monitoring.RESULTS:The proposed method showed satisfactory results in terms of linearity, sensitivity, specificity, precision (intra- and inter-day coefficients of variation ranged from 1.1 to 13.9%), and accuracy (from 93.3 to 111.1%). The IS-normalized matrix factors were below 15%. The sensitivity and linearity were highly appropriate for the expected concentrations according to the analysis of samples from non-small cell lung caner (NSCLC) patients who received EGFR-TKIs.CONCLUSIONS:The proposed method showed an acceptable reproducibility, high sensitivity and selectivity, and low matrix effects. This method could be significant for monitoring plasma concentrations of the mentioned EGFR-TKIs in NSCLC patients, aiming to improve the efficacy and safety of targeted therapies.

Abstract. Background:. Weight gain during chemotherapy in patients with breast cancer contributes to their poor prognosis. However, a growing number of studies have found that metabolic disorders seem to play a more important role in breast cancer prognosis than weight gain. This study aimed to explore the prognostic effects of body mass index (BMI), weight gain, and metabolic disorders on the overall survival (OS) and prognosis of patients with breast cancer who underwent chemotherapy. Methods:. Data from the inpatient medical records of patients with breast cancer who underwent chemotherapy at the Beijing Cancer Hospital Breast Cancer Center from January to December 2010 were retrospectively collected, and the patients were followed up until August 2020. Results:. A total of 438 patients with stages I to III breast cancer met the inclusion and exclusion criteria. Forty-nine (11.19%) patients died, while 82 (18.72%) patients had tumor recurrence and metastasis at the last follow-up (August 2020). From the time of diagnosis until after chemotherapy, no significant differences were observed in the body weight (t = 4.694, P < 0.001), BMI categories (χ2 = 19.215, P = 0.001), and incidence of metabolic disorders (χ2 = 24.841, P < 0.001); the BMI categories and weight change had no effect on the OS. Both univariate (χ2 = 6.771, P = 0.009) and multivariate survival analyses (hazard ratio = 2.775, 95% confidence interval [CI]: 1.326–5.807, P = 0.007) showed that low high-density lipoprotein cholesterol (HDL-C) levels at diagnosis had a negative impact on the OS. The multivariate logistic regression analysis showed that the HDL-C level at diagnosis (odds ratio [OR] = 2.200, 95% CI: 0.996–4.859, P = 0.051) and metabolic disorders after chemotherapy (OR = 1.514, 95% CI: 1.047–2.189, P = 0.028) are risk factors for poor prognosis in patients with breast cancer. Conclusions:. Chemotherapy led to weight gain and aggravated the metabolic disorders in patients with breast cancer. Low HDL-C levels at diagnosis and metabolic disorders after chemotherapy may have negative effects on the OS and prognosis of patients with breast cancer.

下呼吸道感染在我国所致的社会和经济负担巨大，针对下呼吸道感染的病原体进行早期快速检测，是提高患者救治成功率的重要途径。经典的微生物分离和培养等传统的病原学检测方法存在如操作复杂、耗时长、阳性率低等诸多局限，因此，临床实践中迫切需求呼吸道病原体的新型快速精准检测方法。近年来，纳米孔基因测序技术飞速发展，其具备长读长、设备便携、可进行实时测序和直接分析等技术优势，使其在呼吸系统感染中的病原学诊断方面展示出了巨大的潜力。本文将从纳米孔测序技术的进展及其在呼吸系统感染性疾病中的应用做一综述，以期为临床病原学快检提供新思路，更好的为临床服务。

Introduction Vascular calcification (VC) is high prevalent and predicts cardiovascular mortality in dialysis patients. The mechanisms are not known clearly. Trimethylamine-N-oxide (TMAO), a gut-microbiota derivate metabolite, is also associated with cardiovascular outcomes in hemodialysis (HD) patients. This study aims to evaluate serum TMAO levels and establish their relation to VC in HD patients.Methods Serum TMAO concentrations were measured by high-performance liquid chromatography–mass spectrometry. Vascular calcification was evaluated by abdominal aortic calcification (AAC) scores. Taking the AAC score value 5.5 as the cutoff value, the participants were divided into the high AAC score group and the low AAC score group.Results A total of 184 HD patients and 39 healthy controls were enrolled in this cross-sectional study. Serum Ln(TMAO) (the natural logarithm of TMAO) concentrations were significantly higher in HD patients than that of control subjects (1.82 ± 0.62 vs. −1.60 ± 0.77, p < 0.001). Compared with the group with low AAC scores, the HD patients with high AAC scores showed significantly higher serum Ln(TMAO) levels (2.09 ± 0.55 vs. 1.67 ± 0.54, p < 0.001). In the multivariate regression analysis, serum Ln(TMAO), HD vintage, with diabetic mellitus, age and plasma intact parathyroid hormone (iPTH) were independent determinant factors for VC in HD patients.Conclusions Higher serum TMAO levels, older age, longer HD vintage, higher plasma iPTH and with diabetes mellitus were independent risk factors for VC in HD patients. The underlying mechanism deserves further investigations and the finding hints at a new target for the treatment of VC.

目的 了解高等院校护理教师对开展情景模拟教学的知信行情况,并分析其影响因素.方法 2020年3月,通过方便取样,采用自行编制的高等院校护理教师对情景模拟教学的知信行调查问卷对国内38所高等院校的201名护理教师进行电子问卷调查.结果 201名护理教师的情景模拟教学知识和态度总分分别为(60.85±12.78)分和(74.61±10.82)分,146名(72.6％)教师已经开展情景模拟教学,其情景模拟教学行为总分为(65.36±17.56)分.学历是护理教师情景模拟教学知识总分的影响因素,学校类型是护理教师情景模拟教学态度及行为总分的影响因素.结论 护理教师对开展情景模拟教学的知识水平较低,态度较积极,但行为存在不足.建议加强对护理教师情景模拟教学知识的规范化培训,同时不能忽略信念的培养,从而提高情景模拟教学的质量.

放射性黏膜炎及其相关疼痛、口干、唾液黏稠和吞咽困难等口咽部症状是头颈部癌症患者放射治疗期间常出现的症状,它们相互联系,常同时发生.本文通过回顾国内外相关文献,总结了口咽部症状对患者的影响及其评估方法、影响因素、管理方法,旨在为口咽部症状管理的研究和临床实践提供借鉴.