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Impact of a simulation-based induction programme in gastroscopy on trainee outcomes and learning curves

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World Journal of Gastrointestinal Endoscopy 2020年第3期12卷 98-110页

作者： Keith Siau James Hodson Peter Neville Jeff Turner Amanda Beale Susi Green Aravinth Murugananthan Paul Dunckley Neil D Hawkes Joint Advisory Group on Gastrointestinal Endoscopy Royal College of PhysiciansLondon NW14LEUnited Kingdom Medical and Dental Sciences University of BirminghamBirmingham B152TTUnited Kingdom Institute of Translational medicine University Hospitals BirminghamBirmingham B152THUnited Kingdom Department of Gastroenterology Cwm Taf Morgannwg Health BoardLlantrisant CF454SNUnited Kingdom Department of Gastroenterology Cardiff and Vale University Health BoardCardiff CF144XWUnited Kingdom Department of Gastroenterology University Hospitals Bristol NHSFTBristol BS13NUUnited Kingdom Department of Gastroenterology Royal Sussex County HospitalBrighton BN25BEUnited Kingdom Department of Gastroenterology Royal Wolverhampton NHS TrustWolverhampton W100QPUnited Kingdom Department of Gastroenterology Gloucestershire Hospitals NHSFTGloucester GL13NNUnited Kingdom

BACKGROUND Pre-clinical simulation-based training(SBT)in endoscopy has been shown to augment trainee performance in the short-term,but longer-term data are *** To assess the impact of a two-day gastroscopy induction course combining theory and SBT(Structured PRogramme of INduction and Training–SPRINT)on trainee outcomes over a 16-mo *** This prospective case-control study compared outcomes between novice SPRINT attendees and controls matched from a United Kingdom training *** outcomes comprised:(1)Unassisted D2 intubation rates;(2)Procedural discomfort scores;(3)Sedation practice;(4)Time to 200 procedures;and(5)Time to *** Total 15 cases and 24 controls were included,with mean procedure counts of 10 and 3(P=0.739)***-SPRINT,no significant differences between the groups were detected in long-term D2 intubation rates(P=0.332)or discomfort scores(P=0.090).However,the cases had a significantly higher rate of unsedated procedures than controls post-SPRINT(58%vs 44%,P=0.018),which was maintained over the subsequent 200 *** tended to perform procedures at a greater frequency than controls in the post-SPRINT period(median:16.2 vs 13.8 per mo,P=0.051),resulting in a significantly greater proportion of cases achieving gastroscopy certification by the end of follow up(75% vs 36%,P=0.017).CONCLUSION In this pilot study,attendees of the SPRINT cohort tended to perform more procedures and achieved gastroscopy certification earlier than *** data support the role for wider evaluation of pre-clinical induction involving SBT.

关键词： Gastroscopy Esophagogastroduodenoscopy Endoscopy training Induction Competency development Simulation

Targeted molecular therapy (modified RIST regimen) in relapsed high risk stage Ⅳ neuroblastoma: two cases report

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theory and Clinical Practice in Pediatrics 2018年第1期2卷 2-4页

作者： Paolo Indolfi Selim Corbacioglu Silverio Perrotta Francesca Rossi Antonio Marte Elvira Pota Martina Di Martino Daniela Di Pinto Cristiana Indolfi Fiorina Casale Unit of Pediatric Oncology Pediatric DepartmentSecond University of Naplesvia Luigi De Crecchio 280138 NaplesItaly Department of Pediatrics and Adolescent medicine University of RegensburgRegensburgGermany Unit of Pediatric Oncology Department of Women-Children and General and Specialistic SurgeryUniversity of Campania “Luigi Vanvitelli”NaplesItaly Department of Pediatric Surgery University of Campania “Luigi Vanvitelli”NaplesItaly

The prognosis for children with recurrent or refractory neuroblastoma remains a significant clinical challenge,and currently there are no known curative salvage *** this paper we investigated the effect of imatinib with rapamycin and the chemotherapeutic agents temozolomide and *** treated two children with recurrent neuroblastoma with this so called RIST *** patients,off therapy for 15 and 31 months,respectively are well,and developing normally,without any *** findings suggest that a combination regimen of RIST may provide a therapeutic benefit with a favorable toxicity profile to a unfortunate subset of patients with neuroblastoma.

关键词： RIST therapy Neuroblastoma Pediatric cancer

静息状态功能MRI持续时间对脑神经网络连接图论度量稳定性的影响

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国际医学放射学杂志 2011年第4期 378-378页

作者： C.T.Whitlow R.Casanova J.A.Maldjian 余华君 Advanced Neuro Science Imaging Research Laboratory Division of Radiologic SciencesDepartment of Radiologyand Division of Public Health SciencesDepartment of Biostatistical SciencesWake Forest University School of MedicineMedical Center Blvd

目的研究静息状态(resting-state,RS)功能MRI血氧水平依赖(blood oxygen level-dependent,BOLD)信号采集持续时间对脑神经网络连接计算机图论度量稳定性的影响。材料与方法学术伦理委员会授权该项研究,病人签署

关键词： MRI 静息状态网络连接脑神经颅神经周围神经图论拓扑

Pharmaceutical care of a patient with antibiotic-associated encephalopathy

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TMR Modern Herbal medicine 2021年第3期4卷 29-36页

作者： Shaoqing Shen Qiongshi Wu Xingjun Cai Hua Wu Yamei Zheng Min Wang Hainan General Hospital(Hainan Affiliated Hospital of Hainan Medical University) Department of PharmacyHainan Province570311China Hainan General Hospital(Hainan Affiliated Hospital of Hainan Medical University) Department of respiratory and critical care medicineHainan Province570311China Hainan General Hospital(Hainan Affiliated Hospital of Hainan Medical University) Clinical Laboratory HaikouHainan Province570311China Department of Pharmacy Hainan Hospital of PLA General HospitalSanyaHainan Province572013China

Objective:To provide reference of pharmaceutical care for the clinical treatment of a severe patient with antibiotic-associated ***:Clinical pharmacists participated in the clinical treatment of the patient with antibiotic-associated encephalopathy,provided pharmaceutical care for clinicians,including the evaluation of adverse drug events and the prevention of adverse drug interaction and development of anti-infection programs by using Pharmacokinetics/pharmacodynamics theory and therapeutic drug monitoring ***:Through active clinical treatment and pharmaceutical care,the symptoms of patients with encephalopathy were relieved,and the infection was effectively ***:Clinical pharmacists play a positive role in the treatment for the case with antibiotic associated encephalopathy.

关键词： Antibiotic-associated encephalopathy Epilepsy Cefoperazone tazobactam Pharmaceutical care

Massive health industry urgently needs to be guided by project management theory

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History & Philosophy of medicine 2021年第2期3卷 1-2页

作者： Yi Mou Yi-Bo Wu Ge Pu Tao Wang Shanghai Jiao Tong University School of Media and CommunicationShanghai 200240China Key Research Base of Philosophy and Social Sciences in Shaanxi Province Health Culture Research Center of ShaanxiXi’an 712046China Peking University Health Science Center Beijing 100191China University of Macao Institute of Chinese Medical Sciences&State Key Laboratory of Quality Research in Chinese MedicineMacao 999078China College of Art and Media Tongji UniversityShanghai 200092China “Dayixiaohu”Medical Communication Think Tank Shanghai 200092China.

The global COVID-19 epidemic has given a powerful boost to the massive health industry that has been growing *** the COVID-19 epidemic,people have developed a deep awareness of health and attached great importance to public epidemic *** immunity and social management ability have been regarded as effective means of disease prevention and control[1].At the same time,population aging in China is becoming more and more serious and the health problems of the aging population are getting more *** guidelines issued by China,including National Nutrition Program 2017–2030,Healthy China 2030 Guidelines and Healthy China Initiative 2019–2030,have embodied the characteristics of grand hygiene,massive health,great sports,great nutrition and great integration in the new era and reflected the thoughts of General Secretary Xi Jinping,“no public health,no overall well-off”.

关键词： prevention attached becoming

慢性肾脏病肠道菌群失调的病理机制、治疗策略及中药的干预作用

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中国中药杂志 2017年第13期42卷 2425-2432页

作者：韩文贝刘莹露万毅刚孙伟涂玥杨晶晶吴薇何伟明姚建南京中医药大学中西医结合鼓楼临床医学院中医科江苏南京210008 南京大学医学院附属鼓楼医院中医科江苏南京210008 南京中医药大学附属医院肾内科江苏南京210029 南京中医药大学第二临床医学院中医养生学教研室江苏南京210023 Division of Molecular Signaling Department of Advanced Biomedical ResearchInterdisciplinary Graduate School of Medicine and EngineeringUniversity of Yamanashi

肠道菌群失调是中、晚期慢性肾脏病(chronic kidney disease,CKD)进展至尿毒症的高危因素之一,其特征就是益生菌减少、能产生尿毒素的条件致病菌(产尿素酶菌群、产内毒素菌群以及产代谢毒素菌群)增多。"肠-肾轴(gut-kidney axis)"学说和... 详细信息

肠道菌群失调是中、晚期慢性肾脏病(chronic kidney disease,CKD)进展至尿毒症的高危因素之一,其特征就是益生菌减少、能产生尿毒素的条件致病菌(产尿素酶菌群、产内毒素菌群以及产代谢毒素菌群)增多。"肠-肾轴(gut-kidney axis)"学说和"慢性肾脏病-结肠轴(chronic kidney disease-colonic axis)"概念的核心观点认为,失调的肠道菌群通过加剧尿毒素蓄积和诱导全身性微炎症反应等途径加重肾脏的损伤。初步的临床试验和动物实验的结果显示,以乳酸菌和双歧杆菌制剂为代表的益生菌和以菊粉、低聚半乳糖为代表的益生元,还有鲁比前列酮、活性炭吸附剂等都可以针对CKD患者体内失调的肠道菌群,通过减轻尿毒素蓄积和抑制全身性微炎症反应等途径而改善肾功能。不仅如此,一些经口服或肠道给药的单味中药、中药复方还有中药提取物(大黄素等)在一定程度上也能调节肠道细菌,保护肠道上皮屏障,减轻尿毒素蓄积,延缓CKD进展。其中,大黄类经方——大黄甘草汤(浓缩颗粒TJ-84)改善肾衰竭动物模型体内尿毒素蓄积的靶点不是肾脏,而可能是"肠道菌群所启动的肠-肾轴"。基于此,针对中、晚期CKD患者肠组织中肠道菌群相关的病理因素(紧密连接蛋白、辅助性和调节性T细胞等)的干预性研究可能是今后的重点发展方向之一。

关键词：肠道菌群中药慢性肾脏病肠-肾轴病理机制