Factors influencing willingness to participate in ophthalmic clinical trials and strategies for effective recruitment

AIM:To explore the factors influencing individuals’willingness to participate in ophthalmic clinical trials.METHODS:A questionnaire survey was conducted from January to April 2021 among patients and their family members at Zhongshan Ophthalmic Center,Sun Yat-sen University,in Guangzhou,China.The survey gathered data on respondents’willingness,demographic and socioeconomic profiles,as well as their reasons and concerns regarding engagement in clinical trials.RESULTS:Of the 1078 residents surveyed(mean age 31.2±13.1y;65.8%females)in Guangzhou,749(69.5%)expressed a willingness to participate in future ophthalmic clinical trials.Specific characteristics associated with greater willingness included a younger age,lower annual income,higher education,prior participation experience,previous ophthalmic treatment,and a better understanding of clinical trials.With the exception of age,these characteristics were significantly linked to a higher willingness.The primary barrier to participation,expressed by 64.8%of those willing and 54.4%of those unwilling,was“Uncertain efficacy”.In terms of motivations,the willing group ranked“Better therapeutic benefits”(35.0%),“Professional monitoring”(34.3%),and“Trust in healthcare professionals”(33.1%)as their top three reasons,whereas the unwilling participants indicated“Full comprehension of the protocol”(46.2%)as the key facilitator.CONCLUSION:This study reveals a substantial willingness to participate in ophthalmic clinical trials and demonstrates the predictive role of demographic and socioeconomic factors.Variations in motivators and concerns between willing and unwilling participants highlight the significance of tailored recruitment strategies.Importantly,the need for and trust in healthcare professionals stand out as powerful motivations,underscoring the importance of enhancing physician-patient relationships,adopting patient-centered communication approaches,and addressing individualized needs to improve accrual rates.

Double-Blind, Parallel Group Study to Compare the Clinical Effectiveness of Calcium Dobesilate 500 mg BID vs. Calcium Dobesilate LP 1 g OD, in Patients with Chronic Venous Insufficiency of the Lower Limbs

Background: Chronic venous insufficiency (CVI) describes a condition that affects the venous system of the lower extremities due to venous hypertension (VH. The prevalence is between 5% - 30%. CVI is associated with older age, smoking, lower extremity trauma, presence of an arteriovenous shunt, and elevated estrogen levels. All patients should be initially treated with conservative management. Venoactive drugs like calcium dobesilate are useful. Objectives: The primary objective compared the clinical improvement in patients with CVI, grades 0 - 3 of the CEAP classification of chronic venous disease, produced by two formulations of calcium dobesilate: calcium dobesilate LP 1 g OD vs calcium dobesilate 500 mg BID, immediate release. The secondary objective assessed the side effects of both formulations. Method: All patients took one tablet and one capsule at 7 am, and one capsule at 7 pm, for 8 weeks. One group received dobesilate 1 g OD and the other group received dobesilate 500 md BID. They were evaluated after 15, 30 and 60 days of treatment, using the symptom evaluation scale. Results: In both groups, there was a significant decrease in the symptom score after 15 days. Four patients in the Dobesilate OD group: had adverse effects, which did not require suspension of treatment. In the BID dobesilate group, there was one therapeutic failure, and one case of gastric discomfort. Conclusions: Prolonged-release Calcium dobesilate 1 g OD is as effective as calcium dobesilate 500 mg BID for the treatment of patients with chronic venous insufficiency.

Effects of L-carnitine on treatment outcomes of COVID-19 patients hospitalized in intensive care units:A double-blind randomized clinical trial

Objective:To assess the effects of L-carnitine on the outcomes of patients with moderate to severe coronavirus disease 2019(COVID-19)in intensive care unit(ICU).Methods:This double-blind clinical trial was carried out in 2022-2023.64 Patients with COVID-19 were selected from Amiralmomenin and Khansari hospitals in Arak,Iran.They were randomly assigned to the control and the L-carnitine treatment group via block randomization.Venous blood gases,disease severity,and levels of D-dimer,lactate dehydrogenase,ferritin,and C-reactive protein were daily assessed during the seven days of the intervention,and the length of ICU stay,the need for endotracheal intubation,and mortality rate were documented.Results:There were significant differences in length of ICU stay,the need for endotracheal intubation,and levels of D-dimer,lactate dehydrogenase,ferritin,APACHE栻score,and C-reactive protein between the two groups(P<0.05).However,the groups did not significantly differ in mortality rate and venous blood gas indexes(P>0.05).Conclusions:L-carnitine can improve outcomes of patients with COVID-19.Therefore,it can be used as an adjuvant therapy for these patients.

Comparison of the clinical effects of dual-modality endoscopy and traditional laparotomy for the treatment of intra-and extrahepatic bile duct stones

BACKGROUND Bile duct stones(BDSs)may cause patients to develop liver cirrhosis or even liver cancer.Currently,the success rate of surgical treatment for intrahepatic and extrahepatic BDSs is not satisfactory,and there is a risk of postoperative complic-ations.AIM To compare the clinical effects of dual-modality endoscopy(duodenoscopy and laparoscopy)with those of traditional laparotomy in the treatment of intra-and extrahepatic BDSs.METHODS Ninety-five patients with intra-and extrahepatic BDSs who sought medical services at Wuhan No.1 Hospital between August 2019 and May 2023 were selected;45 patients in the control group were treated by traditional laparotomy,and 50 patients in the research group were treated by dual-modality endoscopy.The following factors were collected for analysis:curative effects,safety(incision infection,biliary fistula,lung infection,hemobilia),surgical factors[surgery time,intraoperative blood loss(IBL)volume,gastrointestinal function recovery time,and length of hospital stay],serum inflammatory markers[tumor necrosis factor(TNF)-α,interleukin(IL)-6,and IL-8],and oxidative stress[glutathione peroxidase(GSH-Px),superoxide dismutase(SOD),malondialdehyde(MDA),and advanced protein oxidation products(AOPPs)].RESULTS The analysis revealed markedly better efficacy(an obviously higher total effective rate)in the research group than in the control group.In addition,an evidently lower postoperative complication rate,shorter surgical duration,gastrointestinal function recovery time and hospital stay,and lower IBL volume were observed in the research group.Furthermore,the posttreatment serum inflammatory marker(TNF-α,IL-6,and IL-8)levels were significantly lower in the research group than in the control group.Compared with those in the control group,the posttreatment GSH-Px,SOD,MDA and AOPPs in the research group were equivalent to the pretreatment levels;for example,the GSH-Px and SOD levels were significantly higher,while the MDA and AOPP levels were lower.CONCLUSION Dual-modality endoscopy therapy(duodenoscopy and laparoscopy)is more effective than traditional laparotomy in the treatment of intra-and extrahepatic BDSs and has a lower risk of postoperative complications;significantly shortened surgical time;shorter gastrointestinal function recovery time;shorter hospital stay;and lower intraop-erative bleeding volume,while having a significant inhibitory effect on excessive serum inflammation and causing little postoperative oxidative stress.

Alzheimer's disease with depressive symptoms: Clinical effect of intermittent theta burst stimulation repetitive transcranial magnetic stimulation

BACKGROUND Alzheimer's disease(AD),characterized by the ongoing deterioration of neural function,often presents alongside depressive features and greatly affects the quality of life of individuals living with the condition.Although several treatment methods exist,their efficacy is limited.In recent years,repetitive transcranial magnetic stimulation(rTMS)utilizing the theta burst stimulation(TBS)mode,specifically the intermittent TBS(iTBS),has demonstrated promising therapeutic potential in the management of neuropsychiatric disorders.AIM To examine the therapeutic efficacy of iTBS mode of rTMS for treating depressive symptoms in patients with AD.METHODS This retrospective study enrolled 105 individuals diagnosed with AD with depressive symptoms at Huzhou Third Municipal Hospital,affiliated with Huzhou University,between January 2020 and December 2023.Participants received standard pharmacological interventions and were categorized into control(n=53)and observation(n=52)groups based on treatment protocols.The observation group received iTBS mode of rTMS,while the control group received pseudo-stimulation.A comparative analysis evaluated psychological well-being,adverse events,and therapeutic at initiation of hospitalization(T0)and 15 days post-treatment(T1).RESULTS At T1,both groups exhibited a marked reduction in self-rating depression scale and Hamilton depression scale scores compared to T0.Furthermore,the observa-tion group showed a more pronounced decrease than the control group.By T1,the Mini-mental state examination scores for both groups had increased markedly from their initial T0 assessments.Importantly,the increase was particularly more substantial in the observation group than in the control group.Fourteen patients in the control group had ineffective treatment effects,while five patients in the observation group experienced the same.Additionally,the observation group experienced a substantially reduced incidence of ineffective treatment as compared to the control group(both P<0.05);there were no recorded serious adverse events in either group.CONCLUSION The iTBS model of rTMS effectively treated AD with depression,improving depressive symptoms and cognitive function in patients without serious adverse reactions,warranting clinical consideration.

Does progress in microfracture techniques necessarily translate into clinical effectiveness?

BACKGROUND Multitudinous advancements have been made to the traditional microfracture(MFx)technique,which have involved delivery of various acellular 2nd generation MFx and cellular MFx-III components to the area of cartilage defect.The relative benefits and pitfalls of these diverse modifications of MFx technique are still not widely understood.AIM To comparatively analyze the functional,radiological,and histological outcomes,and complications of various generations of MFx available for the treatment of cartilage defects.METHODS A systematic review was performed using PubMed,EMBASE,Web of Science,Cochrane,and Scopus.Patients of any age and sex with cartilage defects undergoing any form of MFx were considered for analysis.We included only randomized controlled trials(RCTs)reporting functional,radiological,histological outcomes or complications of various generations of MFx for the management of cartilage defects.Network meta-analysis(NMA)was conducted in Stata and Cochrane’s Confidence in NMA approach was utilized for appraisal of evidence.RESULTS Forty-four RCTs were included in the analysis with patients of mean age of 39.40(±9.46)years.Upon comparing the results of the other generations with MFX-I as a constant comparator,we noted a trend towards better pain control and functional outcome(KOOS,IKDC,and Cincinnati scores)at the end of 1-,2-,and 5-year time points with MFx-III,although the differences were not statistically significant(P>0.05).We also noted statistically significant Magnetic resonance observation of cartilage repair tissue score in the higher generations of microfracture(weighted mean difference:17.44,95%confidence interval:0.72,34.16,P=0.025;without significant heterogeneity)at 1 year.However,the difference was not maintained at 2 years.There was a trend towards better defect filling on MRI with the second and third generation MFx,although the difference was not statistically significant(P>0.05).CONCLUSION The higher generations of traditional MFx technique utilizing acellular and cellular components to augment its potential in the management of cartilage defects has shown only marginal improvement in the clinical and radiological outcomes.

Evaluation of the Effect of Endoscopic High- Frequency Electrocoagulation Electrodesiccation of Intestinal Polyps in the Clinical Nursing Pathway

Objective: To evaluate the effect of endoscopic high-frequency electrocoagulation electrodesiccation (HFEE) of intestinal polyps in the clinical nursing pathway. Method: A total of 120 patients who underwent HFEE of intestinal polyps were randomly divided into two groups of 60 cases. The control group received conventional nursing care while the observation group received the clinical nursing pathway of HFEE. Results: The average length of hospitalization, hospitalization costs, and mastery of the three health education of the observation group was lower than that of the control group (P < 0.01). The satisfaction of care in the observation group was significantly better than the control group (P <0.01). Conclusion: The clinical care path was suitable for HFEE of intestinal polyps, which shortened the patient’s length of hospitalization, improved their awareness of health education, improved their satisfaction with care, reduced medical disputes, and promoted the good development of nurse-patient relationships .

The Effect of the Direct Anti-Human Globulin Test on the Clinical Outcome of Patients Receiving Blood Transfusion

Objective:To study the effect of the direct anti-human globulin test on the clinical efficacy of blood transfusion patients.Methods:52 transfused patients were selected for this study,of which 26 cases with positive direct anti-human globulin tests were included in the positive group,and another 26 cases with negative direct anti-human globulin tests were included in the negative group.The apparent efficacy of the patients in the two groups after blood transfusion was compared.Results:After blood transfusion,the apparent efficacy of the negative group was significantly higher,P<0.05;in the positive group,the proportion of the predominantly multi-antibody group was the highest;after blood transfusion,the post-transfusion apparent efficacy of the simple IgG group was higher than that of the multi-antibody group,P<0.05;comparing the intensity of the different antibodies resulted in the 1+group,and the 3+to 4+groups were significantly lower after blood transfusion,P<0.05.Conclusion:The use of the direct antiglobulin test in transfused patients showed that patients with positive results would have better clinical efficacy.Direct anti-human globulin tests will have an impact on the clinical efficacy of blood transfusion in patients with positive results,so it is very important to carry out a direct anti-human globulin test on blood transfusion patients.

Teaching Research and Effect Observation on the Integration of Clinical Medicine Integrated Course and Ideological and Political Elements from the Perspective of“Sanquan Education”

Purpose:To analyze the application path of the integration of clinical medicine integrated courses with the elements of ideology and politics under the theory of“Sanquan Education,”and to provide references for the promotion of educational reform in medical schools.Methods:60 clinical medicine undergraduates at Jiamusi University in 2018 and 2019 were randomly selected as research subjects.On the basis of the analysis of students’characteristics and pre-study content,the students were divided into the integration group and the traditional group,each with 30 students.Students in the integration group carried out clinical medicine integrated class with the integration of ideological and political elements.Students in the traditional group carried out the traditional clinical medicine integrated class.Classroom evaluation scales,anonymous questionnaires,and interviews were used to conduct research,collect data,and compare and observe the application effects.Results:After carrying out different modes of clinical medicine integrated courses,the undergraduates of the Excellent Physician Class in the integration group were higher than those in the traditional group in terms of teaching satisfaction,comprehensive quality,basic knowledge test,and case analysis scores through questionnaire analysis(P<0.05).In the evaluation of the effect of ideological education,the undergraduates of the Excellent Physician Class of the integration group were higher than the traditional group in terms of the acceptance of doctor-patient communication,the correct rate of mastering the history of the discipline,and the correct rate of mastering the frontiers and policies(P<0.05).Conclusion:Through the integration of clinical medicine integrated course and ideological and political elements,we can help students establish correct values while teaching them professional knowledge,improve the implementation of moral education in medical schools,cultivate excellent medical workers with high morality and firm beliefs for the society,and realize the fundamental educational task of establishing morality and educating people in medical schools in the context of“Sanquan Education.”

Effectiveness and safety of traditional Chinese medicine for diabetic retinopathy:A systematic review and network meta-analysis of randomized clinical trials

BACKGROUND Diabetic retinopathy(DR)is currently recognized as one of the most serious diabetic microangiopathies and a major cause of adult blindness.Commonly used clinical approaches include etiological control,microvascular improvement,and surgical intervention,but they are ineffective and have many side effects.Oral Chinese medicine(OCM)has been used for thousands of years to treat DR and is still widely used today,but it is unclear which OCM is more effective for DR.AIM To estimate relative effectiveness and safety profiles for different classes of OCMs for DR,and provide rankings of the available OCMs.METHODS The search time frame was from the creation of the database to January 2023.RevMan 5.3 and Stata 14.0 software were used to perform the systematic review and Network meta-analyses(NMA).RESULTS A total of 107 studies and 9710 patients were included,including 4767 cases in the test group and 4973 cases in the control group.Based on previous studies and clinical reports,and combined with the recommendations of Chinese guidelines for the prevention and treatment of DR,9 OCMs were finally included in this study,namely Compound Xueshuantong Capsules,Qiming Granules,Compound Danshen Dripping Pills,Hexue Mingmu Tablets(HXMM),Qiju Dihuang Pills(QJDH),Shuangdan Mingmu Capsules(SDMM),Danggui Buxue Decoction(DGBX),Xuefu Zhuyu Decoction and Buyang Huanwu Decoction.When these nine OCMs were analyzed in combination with conventional western medicine treatment(CT)compared with CT alone,the NMA results showed that HXMM+CT has better intervention effect on the overall efficacy of DR patients,HXMM+CT has better effect on improving patients'visual acuity,SDMM+CT has better effect on inhibiting vascular endothelial growth factor,DGBX+CT has better effect on reducing fundus hemorrhage area,HXMM+CT has better effect on reducing fasting blood glucose,and QJDH+CT has better effect on reducing glycated hemoglobin.When there are not enough clinical indicators for reference,SDMM+CT or HXMM+CT treatments can be chosen because they are effective for more indicators and demonstrate multidimensional efficacy.CONCLUSION This study provides evidence that combining OCMs with CT leads to better outcomes in all aspects of DR compared to using CT alone.Based on the findings,we highly recommend the use of SDMM or HXMM for the treatment of DR.These two OCMs have demonstrated outstanding efficacy across multiple indicators.

Real-world clinical effectiveness of sorafenib among patients with unresectable hepatocellular carcinoma at two centers in the United States

BACKGROUND In the United States,sorafenib monotherapy was approved in 2007 for first-line(1L)treatment of patients with unresectable hepatocellular carcinoma(uHCC).As other therapies have been approved in recent years for hepatocellular carcinoma treatment in later lines,it is essential to assess clinical effectiveness of older therapies in actual clinical practice to inform healthcare practitioners’decisions for better patient care.AIM To assess patient characteristics/clinical effectiveness of 1L sorafenib in uHCC patients treated in United States academic and community practice settings.METHODS A retrospective observational study was conducted among adult patients(≥18 years)in the United States initiating sorafenib monotherapy as 1L systemic therapy for uHCC with Eastern Cooperative Oncology Group status of 0 or 1 between January 2016 and December 2019 at City of Hope and Advent Health.Data were extracted by trained abstractionists from individual patients’electronic health records and captured in electronic case report forms.Institutional Review Board approvals were obtained prior to study initiation.Data were captured from the time of sorafenib initiation until death or the end of follow-up.All data were de-identified prior to analyses.Clinical outcomes assessed included provider-reported best response,progression-free survival(PFS),and overall survival(OS).PFS and OS were estimated using Kaplan-Meier methods.RESULTS Among 134 uHCC patients treated with 1L sorafenib,majority were male(75%),and most were Caucasian(62%)or Asian(19%).Median patient age was 64 years.The most common etiologies of liver disease were hepatitis C(54%),alcohol-related liver disease(16%),and hepatitis B(11%).Most patients were reported to have Barcelona Clinic Liver Cancer stage B(19%)or stage C(70%)disease.Of 134 patients,110(82%)were reported to have discontinued treatment or died during follow-up.Primary reasons for sorafenib discontinuation were reported as progression(35%)and toxicity(30%).Best overall response was reported for 124 patients,of which 7.3%reported complete or partial response.Median time to treatment discontinuation was 2.3 mo.Overall,103 patients(77%)had disease progression or died during sorafenib therapy.Median PFS was estimated to be 2.9 mo.At the end of follow-up,82 patients(61%)were deceased.Median OS was 8.5 mo.CONCLUSION Newer therapeutic options that have reported higher PFS and OS in real-world clinical practice should be considered to enhance patient outcomes.

Effect of sitagliptin combined with Yiqi yangyin huoxue decoction on clinical efficacy and hemorheology in early diabetic nephropathy

BACKGROUND Early diabetic nephropathy(DN)is a complication of diabetes mellitus.It mainly affects kidney microvessels and glomerular function,and its timely and effective treatment is critical for early DN.However,the effects of treatments comprising simple Western medicine are not optimal.With the promotion and implementation of integrated Chinese and western medicine treatments,remarkable results have been achieved for many diseases.To this end,we explored the clinical efficacy of integrated traditional Chinese and western medicines for the treatment of early DN.AIM To investigate the effect of sitagliptin tablets combined with Yiqi yangyin huoxue decoction on clinical efficacy and hemorheology in patients with early DN.METHODS Through a retrospective analysis,123 patients with early DN were admitted to the endocrinology clinic of the Changzhou NO.7 People’s Hospital from January 2021 to October 2022 and were selected as study subjects.After rigorous screening,100 patients with early DN were enrolled.The control group(CG,n=50)and the observation group(OG,n=50)were divided according to the treatment method.The CG were treated with sitagliptin,and the OG were treated with sitagliptin plus the Yiqi yangyin huoxue decoction.Both groups were treated for 3 mo.For both groups,the baseline data and clinical efficacy were compared,and changes in blood glucose levels,lipid levels,renal function,and hematological indicators before(T0)and after(T1)treatment were assessed.RESULTS The total effective rate for the OG was 94.00%and that of the CG was 80.00%(P<0.05).After treatment(T1),the levels of fasting blood glucose,2 h postprandial glucose,total cholesterol,triacylglycerol,and low-density lipoprotein cholesterol in OG patients were obviously lower than those in the CG(P<0.05),and cystatin C,homocysteine,urinary microalbumin,and blood creatinine values in OG patients were also obviously lower than those in the CG(P<0.05);erythrocyte deposition,plasma viscosity,whole blood high shear viscosity,and whole blood low shear viscosity were markedly lower in OG patients than in the CG(P<0.05).CONCLUSION Sitagliptin combined with Yiqi yangyin huoxue decoction has a remarkable effect when used to treat patients with early DN.Further,it is helpful in improving hemorheological indices and controlling disease progression.

Research progress of modern pharmacological effects of Pueraria lobata and its compound clinical application

As a traditional Chinese medicine, Pueraria lobata has been widely recorded in Chinese herbal works of the past dynasties. Modern studies have found that its main chemical components are isoflavones, triterpenoids, saponins, etc., which have antipyretic, anti⁃inflammatory, anti⁃infection, blood pressure, blood sugar, blood lipid, and pharmacological effects such as improving reproductive function. Clinically, it is used in the treatment of diabetic diseases, gastrointestinal diseases, cardiovascular diseases, etc. in the form of traditional Chinese medicine compound prescriptions. This reseach aims to summarize related articles of Pueraria lobata in the past 5 years, focusing on its pharmacological effects and clinical application of the compound, and provide references for its further development and utilization.

Evaluation of the Application Effect of Short Video Combined with BOPPPS Teaching Mode in Clinical Anesthesia Teaching

Objective:To study the application effect of short video combined with BOPPPS teaching mode in clinical anesthesia practice.Method:48 students assigned to clinical anesthesia in digestive endoscopy of Shanxi Bethune Hospital from July 1,2022 to April 1,2023 were selected as research objects.They were randomly divided into the control group(PowerPoint presentation teaching group)and the observation group(short video combined with BOPPPS teaching group),with 24 students in each group.After the internship,the students’theoretical and technical scores were tested,the effects of the two teaching modes were compared,and the students’satisfaction was investigated.Results:The test scores of students in the observation group were significantly better than those in the control group(P<0.05).The short video combined with BOPPPS teaching mode can significantly improve students’learning interest,operation skills,and memory(P<0.05).The students’satisfaction in the observation group was higher than that in the control group(P<0.05).Conclusion:In clinical practice,the application of short video combined with BOPPPS teaching mode has achieved great effect,which is worth further promotion and research.

Exploring the Application Effect of Flipped Classroom Combined with Problem-Based Learning Teaching Method in Clinical Skills Teaching of Standardized Training for Resident Doctors of Traditional Chinese Medicine

Objective: To explore the application effect of flipped classroom combined with problem-based learning teaching method in clinical skills teaching of standardized training for resident doctors of traditional Chinese Medicine. Methods: The study used the experimental control method. The study lasted from September to November 2022. The subjects of this study were 49 students of standardized training for resident doctors of traditional Chinese Medicine from grades 2020, 2021 and 2022 of Dazhou integrated TCM & Western Medicine Hospital. They were randomly divided into experiment group (25) and control group (24). The experiment group adopted flipped classroom combined with problem-based learning teaching method, and the control group adopted traditional teaching method. The teaching content was 4 basic clinical skill projects, including four diagnoses of traditional Chinese Medicine, cardiopulmonary resuscitation, dressing change procedure, acupuncture and massage. The evaluation method was carried out by comparing the students’ performance and a self-designed questionnaire was used to investigate the students’ evaluation of the teaching method. Results: The test scores of total scores in the experimental group (90.12 ± 5.89) were all higher than those in the control group (81.47 ± 7.96) (t = 4.53, P P Conclusions: The teaching process of the flipped classroom combined with problem-based learning teaching method is conducive to improving the efficiency of classroom teaching, cultivating students’ self-learning ability, and enhancing students’ willingness to learn.

Effect of “Four Passes” Training and Assessment of Nurse Specialty Knowledge on the Cultivation of Core Competence of Clinical Nurses

Background: With the development of high quality nursing service, hospitals put forward higher requirements for nurses’ service level. In recent years, the number and quality of specialized nurses remain to be improved despite the remarkable achievements in the construction of specialized nurses. Objective: This study intended to explore a standardized training mode for nurses oriented by training and assessment of nursespecialty knowledge and to summarize the practical experience of this mode. Methods: The training and assessment program was formulated by starting from the objectives of training clinical front-line nursing staff in our hospital, and the standard training and assessment were carried out from four aspects: the specialized disease knowledge, the condition observation and reporting ability, emergency and severe disease nursing, and perioperative accelerated rehabilitation guidance. These four items are hereinafter referred to as “Four Passes” training and assessment, and it was practiced in the assessment and training of nurses in our hospital from 2020 to 2022. Results: A total of 915 front-line caregivers were surveyed in our study, including 772 nurses and 143 doctors. After two years of implementation, the self-evaluation of nurses increased from (2.96 ± 0.79) points to (3.64 ± 0.78) points, and the evaluation score by doctors increased from (3.94 ± 0.74) points to (4.26 ± 0.72) points. The core competence of specialty increased from (69.22 ± 16.53) points to (85.42 ± 14.44) points. The scores of all dimensions after training were higher than those before training, with statistical significances. Conclusion: The “Four Passes” training and assessment of nurse specialty knowledge can fully mobilize the enthusiasm of managers and nurses in all departments, ensure solid specialty knowledge, improve nurses’ core competence, improve nursing quality, and create a harmonious relationship between nurses and patients as well as between doctors and patients.

Research on the Effect of Comprehensive Intervention in the Clinical Treatment of Patients with Type 2 Diabetes Mellitus

Objective:This study aims to explore the value of comprehensive intervention in the clinical treatment of patients with type 2 diabetes mellitus complicated with hypertension.Methods:90 patients with type 2 diabetes and hypertension were selected and divided into a control group and an intervention group according to the random number table method,with 45 cases in each group.The control group received conventional treatment,and the intervention group received comprehensive intervention on the basis of the control group,including a diet plan,an exercise program,scientific treatment,regular monitoring,and psychological counseling.The blood sugar,blood pressure,and other indicators of the two groups were compared.Results:After 5 months of intervention,the fasting blood glucose,postprandial 2 h blood glucose,glycosylated blood glucose protein,diastolic blood pressure,systolic blood pressure,mean arterial pressure,and other indicators of the intervention group were significantly lower than the control group(P<0.05),and the rate of decrease was significantly greater than that of the control group(P<0.05).Conclusion:Comprehensive intervention for patients with type 2 diabetes mellitus and hypertension helps in controlling blood sugar and lowering blood pressure,with clinical significance.

Study of the Effect of Bacterial Resistance Monitoring in Clinical Microbiology Testing

Objective:To observe and analyze the effect of bacterial resistance monitoring in clinical microbiology testing.Methods:600 microbial specimens collected in our hospital in the past year(April 2021 to April 2022)were used as the test subjects of this study.The specimens were divided into Group A(control group)and Group B(research group),with 300 cases in each group.Group A consisted of blood culture specimens,while Group B consisted of sputum specimens.After the tests were completed,the rates of unfavorable and favorable results,bacterial species distribution,and bacterial drug resistance of the specimens in both groups were compared.Results:Among group A specimens,29 cases were positive(9.67%)and 271 cases were negative(90.33%);among group B specimens,99 cases were positive(33.00%)and 201 cases were negative(66.00%);the difference between the two groups of data was statistically significant(P<0.05).As for the distribution of the types of bacteria,there were 472 cases of Gram-negative bacteria and 128 cases of Gram-positive bacteria.Conclusion:Bacterial resistance monitoring is helpful in clinical microbiology testing.Through proper monitoring,bacterial resistance can be well understood.In this way,patients get to receive appropriate treatment measures and suitable antibacterial prescriptions,thereby improving the patient outcome.

Assessing the Clinical Efficacy and Effectiveness of Sentinel Lymph Node Biopsy Combined with Breast-Conserving Surgery for Early-Stage Breast Cancer

Objective:To analyze the impact of sentinel lymph node biopsy(SLNB)combined with breast-conserving surgery in the clinical treatment of early-stage breast cancer.Methods:80 patients with early-stage breast cancer admitted to the Second Department of Breast Surgery at Dezhou Second People’s Hospital from September 2020 to September 2022 were selected and randomly divided into a control group and an observation group using the random number table method,with 40 cases in each group.The control group underwent a modified radical mastectomy,while the observation group underwent SLNB combined with breast-conserving surgery.The surgical efficacy and prognosis between the two groups were compared.Results:The observation group exhibited shorter operation,hospitalization,and extubation times,as well as less intraoperative blood loss and drainage volume,all of which were significantly better than those in the control group(P<0.05).Additionally,the observation group demonstrated a higher rate of excellent breast cosmetology and quality of life,with lower complication incidence,significantly outperforming the control group(P<0.05).There was no statistical difference in the metastasis rate and recurrence rate between the two groups(P>0.05).Conclusion:The combination of SLNB and breast-conserving surgery proves highly effective for patients with early-stage breast cancer,presenting fewer complications and enhancing both breast cosmetic outcomes and quality of life.

Radiation Induced Bystander Effect: From in Vitro Studies to Clinical Application

In the past 20 years, the classic paradigm in radiobiology recognizing DNA as the main target for the action of radiation has changed. The new paradigm assumes that both targeted and non-targeted effects of radiation determine the final outcome of irradiation. Radiotherapy is one of the main modality treatments of neoplastic diseases with intent to cure, or sometimes to palliate only, thus radiation-induced non-targeted effect, commonly referred to as the radiation-induced bystander effect (RIBE) may have a share in cancer treatment. RIBE is mediated by molecular signaling from radiation targeted cells to their non-irradiated neighbors, and comprises such phenomena as bystander effect, genomic instability, adaptive response and abscopal effect. Whereas first three phenomena may appear both in vitro and in vivo, an abscopal effect is closely related to partial body irradiation and is a systemic effect mediated by immunologic system which synergizes with radiotherapy. From the clinical point of view abscopal effect is particularly interesting due to both its possible valuable contribution to the treatment of metastases, and the potential harmful effects as induction of genetic instability and carcinogenesis. This review summarized the main results of investigations of non-targeted effects coming from in vitro monolayer cultures, 3-dimentional models of tissues, preclinical studies on rodents and clinically observed beneficial abscopal effects with particular emphasis on participation of immunotherapy in the creation of abscopal effects.