Adenovirus-mediated wild-type p53 gene transfer in combination with bronchial arterial infusion for treatment of advanced non-small-cell lung cancer, one year follow-up

Objective: In the present study, we have examined the safety and efficacy of recombinant adenovirus encoding human p53 tumor suppressor gene (rAd-p53) injection in patients with advanced non-small-cell lung cancer (NSCLC) in the combination with the therapy of bronchial arterial infusion (BAI). Methods: A total of 58 patients with advanced NSCLC were enrolled in a non-randomized, two-armed clinical trial. Of which, 19 received a combination treatment of BAI and rAd-p53 (the combo group), while the remaining 39 were treated with only BAI (the control group). Patients were followed up for 12 months, with safety and local response evaluated by the National Cancer Institute's Common Toxicity Criteria and response evaluation criteria in solid tumor (RECIST), respectively. Time to progression (TTP) and survival rates were also analyzed by Kaplan-Meier method. Results: In the combo group,19 patients received a total of 49 injections of rAd-p53 and 46 times of BAI, respectively, while 39 patients in the control group received a total of 113 times of BAI. The combination treatment was found to have less adverse events such as anorexia, nausea and emesis, pain, and leucopenia (P<0.05) but more arthralgia. fever, influenza-like symptom, and myalgia (P<0.05), compared with the control group. The overall response rates (complete response (CR)+partial response (PR)) were 47.3% and 38.4% for the combo group and the control group, respectively (P>0.05). Patients in the combo group had a longer TTP than those in the control group (a median 7.75 vs 5.5 months, P=0.018). However, the combination treatment did not lead to better survival, with survival rates at 3, 6, and 12 months in the combo group being 94.74%, 89.47%, and 52.63%, respectively, com-pared with 92.31%, 69.23%, and 38.83% in the control group (P=0.224). Conclusion: Our results show that the combination of rAd-p53 and BAI was well tolerated in patients with NSCLC and may have improved the quality of life and delayed the disease progression. A further study to better determine the efficacy of this combination therapy is warranted.     

The fog of innovation: Innovativeness and deviance in developing new clinical testing equipment

Even when innovators know they are working with a potential breakthrough innovation, they face formidable difficulties in assessing the exact ways it will be innovative as well as deviant in regard to extant systems, business and practices. This finding emerges from our case study that spans the 40-year history of an ongoing and by now potentially radical innovation in automated and miniaturized liquid processing. We analyze the changes in the system-to-be and its relationship to its future contexts throughout this period and show how the developers were able to reliably predict technical compatibility, the outcome, the interface points and effects towards the intended environment only some distance ahead. This ‘fog of innovation’ presents a management challenge not duly met by instruments available in innovation literature.     

Acceptability of the Predicting Abusive Head Trauma (PredAHT) clinical prediction tool: A qualitative study with child protection professionals

The validated Predicting Abusive Head Trauma (PredAHT) tool estimates the probability of abusive head trauma (AHT) based on combinations of six clinical features: head/neck bruising; apnea; seizures; rib/long-bone fractures; retinal hemorrhages. We aimed to determine the acceptability of PredAHT to child protection professionals. We conducted qualitative semi-structured interviews with 56 participants: clinicians (25), child protection social workers (10), legal practitioners (9, including 4 judges), police officers (8), and pathologists (4), purposively sampled across southwest United Kingdom. Interviews were recorded, transcribed and imported into NVivo for thematic analysis (38% double-coded). We explored participants’ evaluations of PredAHT, their opinions about the optimal way to present the calculated probabilities, and their interpretation of probabilities in the context of suspected AHT. Clinicians, child protection social workers and police thought PredAHT would be beneficial as an objective adjunct to their professional judgment, to give them greater confidence in their decisions. Lawyers and pathologists appreciated its value for prompting multidisciplinary investigations, but were uncertain of its usefulness in court. Perceived disadvantages included: possible over-reliance and false reassurance from a low score. Interpretations regarding which percentages equate to ‘low’, ‘medium’ or ‘high’ likelihood of AHT varied; participants preferred a precise % probability over these general terms. Participants would use PredAHT with provisos: if they received multi-agency training to define accepted risk thresholds for consistent interpretation; with knowledge of its development; if it was accepted by colleagues. PredAHT may therefore increase professionals’ confidence in their decision-making when investigating suspected AHT, but may be of less value in court.     

以临床为导向的吞咽障碍资源库的开发和建设

将多种新型教学模式应用于专业课程资源库的建设是目前高等院校康复治疗学专业教学改革一个重要的方向。本课题通过以临床为导向进行资源库内容和框架的开发和建设,使康复治疗师能够快速融入临床教学环节。     

Establishing the need for health communication research: best practices model for building transdisciplinary collaborations

The benefits of transdisciplinary collaboration for addressing complex health problems are widely accepted; however, acknowledging the bumps and twists along the road that are inherent in those collaborations is often considered taboo. Academic norms that prevent open discussion of these challenges can have counter-productive results. This essay describes the major education efforts, milestones, and footfalls in the development of an effective partnership between communication-trained researchers in a College of Journalism and Communications and medical researchers in a College of Medicine. We hope it can serve as “best practice” for understanding the value of team science and interdisciplinary research collaborations.     

高职临床专业“德技并修、校院循环、三级模块”人才培养模式改革与实践

为深入地探究高职临床专业“德技并修、校院循环、三级模块”人才培养模式,文章从高职临床专业人才培养模式存在的主要问题入手,对其进行了全方位、深层次地剖析,并在此基础上全面而深入地探析了高职临床专业“德技并修、校院循环、三级模块”人才培养模式的特点和优势,最后探究了高职临床专业“德技并修、校院循环、三级模块”人才培养模式改革与实践策略,给出了作者具有代表性的个人建议。     

Post-traumatic stress disorders in women who experienced childhood incest

Symptoms exhibited in a clinical population of 17 women who had experienced childhood or adolescent incest appear to fit the features of a chronic and/or delayed post-traumatic stress disorder. These women, entering individual therapy an average of 17 years after the abuse had ended, ranged in age from 24 to 44. All regarded their incest experience as the most damaging event of their lives, and had manifested, in adulthood, such symptoms as intrusive imagery of the incest, feelings of detachment or constricted affect, sleep disturbance, guilt, and intensification of symptoms when exposed to events resembling the incest trauma. Treatment included establishment of trust, expression of feelings, guilt reduction through an understanding of family dynamics and acquisition of new, adaptive behaviors.     

翻转课堂在临床医学本科生《神经病学》的应用探讨

在传统教学模式为主的《神经病学》教学实践过程中,存在学生学习的主动性及积极性不高,学生对《神经病学》中的难点、重点理解和把握不够,对神经系统与其他系统的联系阐明不到位及教师无法将所有相关知识传授给学生等问题。翻转课堂则可有效改变学生以往固有的学习模式,把“被动学习”变为“主动学习”,把“灌输式”教学法变为“启发式”教学法,真正将“教、学、做”融为一体,逐步提高教师的教学水平和学生的自主学习能力。并且也可锻炼学生的团队合作精神,加强同学间相互沟通的能力以及解决临床问题的能力。还可培养学生的创新能力,提升学生的学习效率并促进学生的个性化发展。因此,应用翻转课堂教学不仅可让学生学到新知识,其综合素质也得到极大的提高。     

掌浅弓的临床解剖学研究

目的：为手掌血管损伤的修复重建时寻找浅静脉移植修复掌浅弓提供解剖学基础．方法：对54侧成人掌浅弓的类型、形状、对称性和分支进行观察．结果：掌浅弓分5型即尺动脉型、桡尺动脉型、正中尺动脉型、桡正中尺动脉型、尺动脉掌深弓分支型；以尺动脉型和桡尺动脉型为主，正中尺动脉型、桡正中尺动脉型、尺动脉掌分支型少见；有5种形状，弧线形、单弓形多见，不完全形、鞍形、双弓形少见；左右两侧对称性多见，占55．6％．掌浅弓的分支有3—6条，44例发出小指尺掌侧固有动脉，占81．5％．9例小指尺掌侧固有动脉与第3指掌侧总动脉共干，占16．7％．26例发出3条指掌侧总动脉，占48．1％．26例发出4条指掌侧总动脉，占48．1％．结论：手损伤修复重建掌浅弓时应充分注意掌浅弓的分型、形状、对称性和分支．     

基于DS18B20的数字体温计

介绍了一种新型数字体温计,其核心采用了新型数字式温度传感器DS18820和微控制芯片AT89C2051,系统具有实用性强、可靠性高,测量精度准确,测量速度快等优点。另外还增加了定时功能,只要测量时间一到,即便有优美的音乐进行提示,为医生和病人带来极大的方便。