标准化病人在护理教学中的应用和研究

随着医学的发展，标准化病人（SP）已逐渐应用到护理教学中。因此，作者综述了SP的培训以及SP在教学过程中的应用和职能，并分析了SP对护生的影响。     

标准化病人的培训及在护理学基础教学中的应用

该文介绍了宁夏医科大学护理学院在标准化病人(standardized patient,SP)招募、培训、管理及在护理学基础教学中的应用情况,总结了经验并对应用SP教学模式所具备的优势及不足进行了分析。实践证明学生作为SP应用于教学能够提高护理实训的教学质量。     

标准化病人在国内外护理教学中应用研究进展

从标准化病人（SP）的概述、SP在护理教学中应用的重要性与必要性、SP在国内外护理教学中的应用进行综述,指出SP教学要在我国更好地发展与运用,一方面要引起国家部门的关注,另一方面要考虑我国的国情和教学实际情况。     

标准化病人在国内外护理教学中应用研究进展

从标准化病人(SP)的概述、SP在护理教学中应用的重要性与必要性、SP在国内外护理教学中的应用进行综述,指出SP教学要在我国更好地发展与运用,一方面要引起国家部门的关注,另一方面要考虑我国的国情和教学实际情况.     

标准化病人在护理教育中应用的思考

标准化病人(standardized patients,SP)能稳定、逼真地复制真实临床情景的正常人或病人,在医学教育和考核中具有重要的作用。SP在我国护理教育中已得到日益广泛的使用,在使用过程中积累了一定经验,也遇到了一些问题,如职业SP的缺乏、SP规范化培训不足等。该文从SP的应用范围、SP的种类和作用、SP对学生考核的评价和反馈、SP的规范化培训和资格认证、SP使用中的伦理5个方面,就目前SP在我国护理教学中的应用现状和不足进行了说明,为今后SP护理教学深入和广泛开展提供借鉴和参考。     

应用标准化病人培养高职护生健康教育和人文素养的效果分析

目的:探讨应用标准化病人(SP)培养高职护生健康教育和人文素养的效果。方法:选取10名青海SP社区成员进行内科常见疾病的脚本训练和人文素养评价培训,对2017级护理7班51名护生进行SP健康教育教学,应用问卷调查评价SP教学前后的效果,并通过面对面半结构式访谈15名护生。结果:SP教学前后,护生在用药知识的应用、个体化生活方式指导、应用知识解决实际问题能力、沟通自信度、独立思考能力、学习效果等方面比较差异有统计学意义(P0.05);访谈显示,SP教学记忆深刻,课堂难点得到解决,锻炼了突发情况的应对能力。结论:应用SP开展健康教育教学,对提升护生人文素养和健康教育能力有重要意义,有利于发挥护生潜能,培养其职业岗位核心能力。     

从10年文献回顾分析我国标准化病人教学的发展

目的 通过回顾相关文献,分析标准化病人(SP)在我国医学教育领域中的应用现状及存在的主要问题并提出相应的对策.方法 以"标准化病人"或"SP"为主题词,检索1998-2007年中国期刊全文数据库中收录的文献.结果 共检索出相关文献26766篇,不符合要求的26502篇,最后获有效统计264篇.结论 尽管SP教学在我国受到了教育者的关注,并取得了长足的发展,但是大部分文献都集中在理论阐述方面,用于实践教学的却很少,特别是在护理教育领域.医学教育者应提高对SP教学的认识,推广对SP的应用.     

标准化病人在高职健康教育实训中的应用研究

目的探讨标准化病人(standardized patient,SP)在高职内科护理学课程中的应用方法和效果。方法选取高职二年级的2个班,一个班为试验组,在内科护理学课程的健康教育实训中应用SP开展教学;另一个班为对照组,在此部分教学中由学生扮演病人。教学结束后,用问卷调查学生对教学的评价,并对每组15名学生进行访谈,收集学生对教学的反馈。结果问卷调查显示,试验组对教学的评价优于对照组(P<0.05)。访谈结果:试验组认为SP反馈真实、有针对性,有助于他们根据不同病人的具体情况应用知识,对疾病知识的记忆深刻。对照组认为护患沟通能力和对突发情况的应对能力没有得到锻炼。结论应用SP开展健康教育实训取得较好教学效果。     

标准化病人在养老护理员岗前培训中的应用

[目的]探讨标准化病人(SP)的培训及在养老护理员岗前培训中的应用效果。[方法]选用老年人担任SP,对老年志愿者进行培训,然后将SP引入到养老护理员培训中。将60名养老护理员学员随机分为观察组和对照组各30名。在教学中,分别采用SP教学法和传统教学法进行教学。课程结束后运用相同的闭卷理论考试和操作考试的成绩来评价教学效果。[结果]两组学员训练前基本情况一致;训练后技能考核成绩比较,SP教学组学员应用知识解决问题的得分和操作考试得分高于传统教学组(P<0.05)。[结论]在老年护理基本技能的训练中,SP充分发挥了模拟病人、评估者和指导者三重作用,增加模拟的真实性;有效提高了养老护理员的基本技能和护患沟通能力。将SP引入养老护理员教学过程中,有助于改善教学环境,更好地促进学员理论知识的学习并能提高基本技能。     

标准化病人在《康复医学》教学中的应用

目的:评价标准化病人(SP)在《康复医学》课程教学中的应用效果。方法:选取大学本科二、三年级学生作为研究对象,分为SP教学组(n=42)和传统教学组(n=41),分别采取SP教学、传统教学法,采用课堂测验成绩及问卷调查检验教学效果。结果:实验组学生的课程成绩明显优于对照组(P0.01),并且实验组学生获得更高的满意度。结论:SP教学效果明显,提高了学生的学习成绩和综合素质,值得进一步推广应用于康复专业的其它课程的教学中。     

An unusual cause of spontaneous pneumothorax: Post-COVID-19 pulmonary fibrosis

Spontaneous pneumothorax (SP) is characterized by the escape of broncho-alveolar air into presence of air in the pleural space without preceding blunt or penetrating trauma. SP requires prompt diagnosis and treatment. SP is divided into two groups as primary and secondary. Primary SP is usually seen in tall and thin patients with no clinically evident underlying lung disease (especially in tall and thin subjects), whereas secondary SP cases have an underlying lung disease, such as cystic lung disease, cavitary lung lesions, severe asthma, emphysema or pneumonia. Patients with Coronavirus-2019 (COVID-19) may experience the SP during the diagnosis and treatment processes, and it is a significant cause of morbidity. However, late-onset SP after recovering from COVID-19 is unusual. Herein we present a case with post-COVID-19 pulmonary fibrosis-like changes and subsequent late onset spontaneous pneumothorax (SP). We also present the patient's radiological findings.     

K562细胞株侧群细胞分离及耐药蛋白和细胞周期的表达

背景：血液肿瘤细胞中的侧群细胞能够逃避细胞周期化疗药物的作用,可能与白血病复发有关。目的：鉴定人慢性粒细胞白血病细胞株K562中是否存在侧群细胞,并观察侧群细胞亚群与非侧群细胞亚群耐药蛋白、细胞周期表达的差异。方法：采用流式细胞术检测K562细胞株中是否存在侧群细胞;并分析K562侧群细胞和非侧群细胞两亚群间耐药蛋白P-gp、ABCG2以及细胞周期的表达情况。结果与结论：K562细胞株中均存在侧群细胞,这群细胞比例均少。侧群细胞亚群耐药蛋白ABCG2表达高于非侧群细胞亚群（P〈0.05）,两亚群耐药蛋白P-gp中表达差异无显著性意义;侧群细胞亚群中G0/G1期细胞占80%,非侧群细胞亚群中G0/G1期细胞占43.7%。证实K562细胞株中确实存在较少比例的侧群细胞,其和主群细胞在耐药蛋白表达上有异质性,大部分处于静止期,可能富含和肿瘤耐药有关的白血病干细胞。     

Slow Potential-Guided Radiofrequency Catheter Ablation in Atrioventricular Nodal Reentrant Tachycardia: Characteristics of the Potential Associated with Successful Ablation

To examine the characteristics of Haïssaguerre's slow potential (SP) specific to effective catheter ablation of the slow pathway in AV nodal reentrant tachycardia, the properties of SP and its recording site ware analyzed in 52 patients who underwent successful SP-guided ablation. The properties of SP included the ratio of the amplitude of SP to that of atrial potential (A)(SP/A), the SP duration, the interval between His-bundle potential (HP) and SP (HP-SP), the interval between A and SP (A-SP), the interval between SP and ventricular potential (V) (SP-V), and the ratio of A-SP to the interval between A and the V (A-SP/A-V). The SP recording site was determined by the ratio of the amplitude of A to that of V (A/V) and by the relative position of the ablation catheter on X ray (right anterior oblique projection), expressed as the ratio of the distance between the coronary sinus ostium and SP site to that between the coronary sinus ostium and HP recording site (relative SP position). Twenty-eight slow pathways were ablated with a single energy application, while the other 24 required applications ≥ 2. In all successful applications, SP/A, SP duration, HP-SP, A-SP. SP-V, A-SP/A-V, A/V, and relative SP position were 51 %± 25%, 28 ± 5 ms, -11 ± 9 ms, 57 ± 25 ms, 68 ± 13 ms, 46%± 9%, 15%± 13%, and 51%± 13%, respectively. A significant correlation was observed between the relative SP position and A-SP, and between the relative SP position and A-SP/A-V (r = 0.60 and 0.37, respectively), while it was not between the relative SP position and HP-SP, nor between the relative SP position and SP-V. When the characteristics of SP were comparatively analyzed between the effective and ineffective applications in 24 patients in whom applications ≥ 2 were required, there was no difference observed in HP-SP, A-SP, SP-V, A-SP/A-V, and A/V. However, SP/A, SP duration, and the relative SP position in the effective applications were all greater than those in the ineffective ones (56%± 20% vs 35%± 18%, P < 0.001; 29 ± 4 vs 26 ± 5 ms, P < 0.01; and 52%± 15% vs 33%± 11%, P < 0.001, respectively). These results indicate that SP with an amplitude over a half of A amplitude and recorded at the mid-septum of the tricuspid annulus can be a marker for successful slow pathway ablation. Although the local atrial electrogram appears late as the SP recording site shifts to the lower position, the timing of SP relative to HP and V remained unchanged, suggesting that SP is independent of the local atrial activation.     

标准化病人在临床护理评估培训及考核中的应用

目的:探讨标准化病人(SP)在临床护理评估培训及考核中的应用效果。方法:分层随机选取护士116人,按入选顺序分单、双抽签号进入对照组与实验组,各58人。实验组护士除采用传统方法培训外,增加SP形式的培训并采用SP形式考核(培训后);考核后对实验组护士进行问卷调查。结果:两组护士护理评估质量比较,P<0.05,具有统计学差异,实验组护理评估质量高于对照组;实验组93%的护士对SP的考核形式非常满意或满意,90%的护士认同SP的考核形式能客观公正反映护士护理评估的质量。结论:采用SP形式的培训方法提高了护理评估质量;护士对SP的考核形式认同度较高,该方法值得在临床推广应用。     

血液肿瘤细胞株中侧群细胞的检测和分选

背景:侧群细胞广泛分布在多种成体组织,胚胎和某些肿瘤细胞系中,在不同的成体组织中含量不尽相同.血液肿瘤是危害人类的主要疾病之一,在血液肿瘤进行侧群细胞分布和方法研究对认识侧群细胞有重要的意义.目的:鉴定血液肿瘤的4个细胞株中是否存在侧群细胞,并掌握稳定的检测和分选侧群细胞的方法.方法:利用干细胞高效能将Hoechst33342荧光染料泵出细胞的特性,采用流式细胞仪检测在NB4、Raji、K562/ADM和K562细胞株中是否存在侧群细胞;对分选后K562两亚群细胞进行侧群细胞检测,以检测分选细胞的纯度.结果与结论:经Hoechet33342染色,流式细胞仪分析结果显示在4个血液肿瘤细胞株NB4、Raji、K562/ADM和K562细胞株中均存在侧群细胞,这群细胞比例均少,分别为0.8%、2.7%、1.3%和2.7%,能被Verapamil完全抑制.分选K562细胞侧群和非侧群细胞再次检测发现分选细胞纯度高.     

A combination of poloxamers increases gene expression of plasmid DNA in skeletal muscle

Intramuscular administration of plasmid DNA is a promising strategy to express therapeutic genes, however, it is limited by a relatively low level of gene expression. We report here that a non-ionic carrier, SP1017, composed of two amphiphilic block copolymers, pluronics L61 and F127, also known as poloxamers, significantly increases intramuscular expression of plasmid DNA. Two reporter genes, luciferase and beta-galactosidase, and one therapeutic gene, erythropoietin, were injected intramuscularly with and without SP1017 into C57Bl/6 and Balb/C mice and Sprague-Dawley rats. SP1017 increased gene expression by about 10-fold and maintained higher gene expression compared with naked DNA. Comparison of SP1017 with polyvinyl pyrrolidone (PVP) showed that SP1017 exhibited a significantly higher efficacy and its optimal dose was 500-fold lower. Experiments with beta-galactosidase using X-gal staining suggested that SP1017 considerably increased plasmid DNA diffusion through the tissue. SP1017 also improved expression of the erythropoietin gene leading to an increase in its systemic level and hematocrits. Previous toxicity studies have suggested that SP1017 has over a 1000-fold safety margin. Poloxamers used in SP1017 are listed in the US Pharmacopeia as inactive excipients and are widely used in a variety of clinical applications. We believe that the described system constitutes a simple and efficient gene transfer method to achieve local or systemic production of therapeutic proteins.     

人淋巴瘤Raji细胞系中的边缘细胞：淋巴瘤干细胞存在之可能

背景：已有研究提示急性白血病、多发性骨髓瘤中肿瘤干细胞富集于SP细胞中,且免疫表型及生物学特性相比于主群细胞存在明显的异质性。而关于淋巴瘤淋巴瘤干细胞的研究报道甚少。目的：检测人淋巴瘤Raji细胞系中是否存在SP细胞,分选该群细胞后观察其与非SP细胞在分化抗原和P-糖蛋白表达以及细胞周期方面的差异,探讨淋巴瘤干细胞存在的可能性。方法：Hoechst-33342染色细胞后运用带紫外激发光的流式细胞仪进行Raji细胞系SP细胞的检测及分选。观察不同质量浓度维拉帕米对SP细胞抑制的程度,选择最佳抑制浓度。分选后分别检测SP和非SP细胞P-糖蛋白、分化抗原CD34,CD19,CD20,CD5表达以及细胞周期,并进行对比。结果与结论：Raji细胞系中存在SP细胞,比例在2%左右,当维拉帕米质量浓度为50mg/L时能被完全抑制。SP和非SP细胞CD20阳性表达率分别为18.2%和93.6%,CD5阳性表达率分别为78.0%和22.2%;P-糖蛋白表达差异无显著性意义,但SP中阳性细胞的平均荧光强度强于非SP细胞。提示Raji细胞系中SP与非SP细胞在分化程度、多药耐药性方面具有明显的差异,SP细胞是具有明显＂异质性＂的细胞亚群。据此可初步推测,Raji细胞系的构成也类似肿瘤干细胞分级组成模式,而淋巴瘤干细胞则有可能富集于SP亚群中。     

Why do US source plasma donors stop donating?

Background

In the United States, source plasma (SP) donors can donate up to 104 times per year. Considering the global need for SP and plasma-derived medicinal products, it is critical to maintain the health of frequent donors. This study explores SP donors' self-reported reasons for a lapse in donating.

Study Design and Methods

There were 5608 SP donors from 14 SP centers who enrolled in a longitudinal cohort study to assess self-reported functional health and well-being. Donors were assigned to one of four groups, according to the frequency of SP donation in the 12 months before enrollment. One thousand four hundred forty-eight SP donors who lapsed in donating during 6 months or greater during the study follow-up were asked to complete a survey.

Results

There were 545 lapsed SP donors who returned surveys (37.6%); 63% were female. Most responses given for stopping SP donation were categorized as convenience reasons (69.1%). Self-reported health concerns, including being deferred multiple times, which were categorized as possibly related or unable to determine a relationship to plasmapheresis, represented 45.5% of the responses.

Discussion

Primary reasons US SP donors report for a lapse in donation were categorized as convenience (e.g., schedule conflicts/lack of time). Donor responses categorized as health concerns which have a possible or uncertain relationship to plasmapheresis were less frequent but present in all frequency groups. This study adds to the body of evidence that SP donors cease donating for a variety of self-reported reasons with the majority not directly related to a perceived negative impact on their health.