摘要：Objective: The aim of this study was to reduce or eliminate the stressors to enhance nursing students' clinical learning experience through implementation of an iterative approach that developed a personalised response to student ***: A prospective cohort research design was applied to collect data from a sample of undergraduate nursing students across the four study *** iterative approach was employed to improve students' learning experience and the Stressors in Nursing Students Scale-Chinese Version (SINS-CN) was used to measure student *** problems encountered by students were identified,refined and the responding solutions were worked out and implemented among this group of students through their first year to fourth ***: The overall SINS-CN mean score (2.17-2.82) of students was declined to a moderate ***: Having implemented iterative approach to address factors that led to stressful environments encountered by the nursing students,the overall stress score and each sub-dimension score decreased ***,it is recommended that this approach could be adopted by other colleagues in the nursing arena around the world.

摘要：目的与常规服务相比,评估健康教练使用动机谈话(MI)的干预对改善2型糖尿病(T2DM)患者的血糖控制,以及临床、心理社会和自我保健结果的影响。设计实用性群组随机对照试验。研究地点中国北京市丰台区社区卫生服务站(CHSs)。参与者在41家随机选取的CHSs(21家干预组和20家对照组),有21家干预组CHSs(372名患者)和18家对照组(296名患者)在开始时参与试验。干预干预组患者接受电话和面对面MI健康教练服务,并同时在CHSs接受常规的服务。对照组只接受常规的服务。2组的医疗费用均得到减免。结局指标在基线、6个月和12个月进行结果评估。主要指标是糖化血红蛋白(HbAlc)。次要指标包括一组人体测量学指标、血压、空腹血糖、社会心理和自我保健。结果在12个月时,没有发现HbA1c的治疗效果差别,[调整后差别为0.02,95%可信区间(CI)-0.40~0.44,P=0.929],干预组和对照组都显示出明显的改善。不过,2个次要指标:心理忧郁(调整后差别为-2.38,95%CI-4.64~-0.12,P=0.039)和收缩压(调整后差别为-3.57,95%CI-6.08~-1.05,P=0.005)显示为明显改善的结果,与明显的治疗效果差别相一致,并得到敏感性分析的支持。有意义的是,在HbA1c之外,两组均显示出甘油三酯、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇上的明显改善。结论在当今中国初级卫生保健改革的形势下,本研究是在中国第一个在CHSs实际现场开展的、特别针对T2DM的大规模群组随机对照研究。虽然没有在HbA1c上发现治疗效果差别,但在2组的很多结果(包括HbAlc)上呈现改善,该结果支持在中国对T2DM患者进行常规和免费的临床健康检查。

摘要：A series of new 6-substituted 3 H-quinazolin-4-ones（3 a-3 d） were designed, synthesized and evaluated as the type I positive allosteric modulators（PAMs） of human α7 n ACh R expressed in Xenopus ooctyes by two-electrode voltage clamp. However, no compound showed a better efficacious PAM than lead compound 2 in the presence of acetylcholine（100 μM）. The structure-activity relationship（SAR） analysis suggested that thiazolo[4,5-d]pyrimidin-7（6 H）-one was the key biological skeleton.

摘要：Understanding cell behavior inside three-dimensional (3D) microenvironments with controlled spatial patterning of physical and biochemical factors could provide insight into the basic biology of tissue engraftment, vascular anastomosis, and revascularization. A simple layer by layer projection microstereolithography (PμSL) method was utilized to investigate the effects of a nonporous and porous bioinert barrier on myocutaneous flap engraftment and revascularization. A cranial-based, peninsular-shaped myocutaneous flap was surgically created on the dorsum of C57Bl6 mice. Porous (SP) and nonporous (S) silicone implants were tailored to precise flap dimensions and inserted between the flap and recipient bed prior to sutured wound closure. Porous implant myocutaneous flaps became engrafted to the recipient site with complete viability. In contrast, distal cutaneous necrosis and resultant flap dehiscence was evident by day 10 in nonporous implant flap mice. Laser speckle contrast imaging demonstrated flap revascularization in (SP) mice, and markedly reduced distal flap reperfusion in (S) mice. Histologic analysis of day 10 (SP) flaps revealed granulation tissue rich in blood vessels and macrophages growing through the implant pores and robust neovascularization of the distal flap. In contrast, the nonporous implant prevented tissue communication between recipient bed and flap with lack of bridging inflammatory cells and neovasculature and resultant distal tissue necrosis. We have fabricated porous and nonporous silicone implants via a simple and inexpensive technique of PμSL. Using a graded-ischemia wound healing model, we have shown that porous implants allowed contact between flap and recipient bed resulting in proximal flap arteriogenesis and neovascularization of the distal flap. Future research will utilize variations in implant pore size, spacing, and location to gain a better understanding of the cellular and molecular mechanisms responsible for myocutaneous flap

摘要：目的研究足踝步态模拟机动力学特性,仿真着地相中的足底垂直、前后、水平3个足底反力,并在实验台中验证。方法运用设计的5自由度步态模拟机,建立Adams虚拟样机和足踝模型(包含足部主要韧带和跖腱膜、足底软组织及跟腱力),对其进行动力学仿真,并把仿真中的控制规律运用到实验台验证;将仿真和实验中测力板测得的足底反力与仿真和真实数据比较。结果着地相进程中3个方向的足底反力与实际步态中吻合度较高,足部的韧带和跖腱膜、跟腱和软组织等对正确的步态有重要的影响,步态实验台能够很好重复仿真特性。结论模拟机具备仿真人体步态着地相的能力,为活体无法进行测量的实验提供临床研究平台。

摘要：The quest for low‐cost yet efficient non‐Pt electrocatalysts for the oxygen reduction reaction(ORR)has become one of the main focuses of research in the field of catalysis,which has implications for the development of the next generation of greener fuel ***,we comprehensively describe the'big picture'of recent advances made in the rational design of ORR electrocatalysts,including molecule‐based,metal‐oxide‐based,metal‐nanomaterial‐based and two‐dimensional *** metals can fabricate molecular electrocatalysts with N4‐macrocycles such as porphyrin‐class compounds and the so‐formed M-N-C active centre plays a crucial role in determining the catalytic performances towards the ***‐IV and‐V Transition metal oxides represent another class of promising alternative of Pt‐based catalysts for the ORR which catalytic activity largely depends on the surface structure and the introduction of surface *** advances in synthesis of metallic nanoparticles(NPs)allow for precise control over particle sizes and shapes and the crystalline facets exposed to enhance the ORR performance of ***‐dimensional materials such as functionalized grapheme or MoS2are emerging as novel electrocatalysts for the *** review covers various aspects towards the design of future ORR electrocatalysts,including the catalytic performance,stability,durability and *** novel electrocatalysts even surpass commercial Pt/C systems,demonstrating their potential to be alternatives in industrial *** the encouraging progress,challenges,which are also described,remain to be overcome before the real‐world application of novel ORR electrocatalysts.

摘要：目的:探索个体针刺疗法作为常规治疗的辅助手段在精神分裂症患者中的效果;采用探索性病例研究的方法,使用定量和定性评价工具,以便能够对针刺治疗此类患者的确切疗效作出科学评价,并对未来采用针刺治疗此类患者的试验设计提供方法学建议。方法:共纳入11例精神分裂症患者,在予以10周的针刺治疗前,治疗过程中及治疗后分别采用多种有效的定量和定性评价工具对患者进行多方面的评价。这些评价手段包括对针刺治疗、全科医生及精神科医生病历的整理回顾。分析定性资料以评价受试者向研究者及其临床医生和护理人员报告的内容的可靠性。结果:11名受试者中共有8名完成了1个疗程的针刺治疗,全部11名受试者都报告了针刺治疗的积极作用,包括精神分裂症症状的改善,缓解药物的副作用,对精力、内在动机、睡眠、成瘾症状及其他身体机能的促进作用。但是,受试者向研究者和针刺医生报告的信息在不同治疗阶段有一定差别,且往往不一致;在研究结束后,受试者向研究者报告了更多的信息。结论:本研究表明,在常规疗法之外辅以针刺治疗能够给精神分裂症病人带来一定益处。对数据的三角测量表明了受试者报告内容的某些不一致性,而这些可以通过多种研究方法的混合使用得以克服。通过对数据的比较,推荐在将来的研究设计中使用阳性与阴性症状量表、针刺临床试验干预措施报告标准以及在问卷中增加对药物副作用、运动、睡眠以及日常作息的调查。在将来的研究中还应充分考虑到,恢复期患者容易复发,应该让他们可以方便地获得帮助。

摘要：Reimbursement policy for outpatient chronic diseases is an important part of the basic medical insurance scheme in China. The reimbursement policy for outpatient chronic diseases in basic medical insurance for urban residents of provincial capitals in China were analyzed from the perspectives of disease types, benefits package, qualification and health service access. Proposals to improve policy design, establish standardized disease inclusion criteria and set reasonable benefits package, strengthen management and complete supporting policy, strengthen policy coordination were put forward according the existing problems such as fragmented policy, great difference in disease types and benefit package, supervision difficulty, incomplete policy framework and lack of policy coordination.

摘要：With rapid spread of HIV(human immunodeficiency virus) on a global scale and increasingly severe drug-resistance of it,it is urgently necessary to develop novel effective anti-HIV ***-nucleoside reverse transcriptase inhibitor(NNRTIs)is one of the most significant antiretroviral drugs for fighting against HIV infection due to their various structures,unique mode of action,good efficacy and low *** derivatives,a type of NNRTIs,have been reported to achieve remarkable development in the past few *** this review,we summarized current drug design and medicinal chemistry efforts toward the development of next-generation pyridinones as HIV-1 NNRTIs.

摘要：实施科学是一门研究方法的学科,旨在实践和政策中促进循证干预措施的系统实施,进而改善健康。尽管实施研究需要高质量的证据,但实施策略的随机试验往往存在较为严重的局限性。这些局限性包括存在偏倚风险、缺乏理论运用、缺乏描述实施策略标准术语、局限于实施结局以及不充分报告。本文旨在对实施策略随机试验的设计、实施和报告提供指导,以提升循证实施科学。由研究人员、卫生政策制订者和实践者组成的国际小组整合了构建随机试验方法的重要文献和实施科学的最新进展。本文为实施策略随机试验的主要内容提供指导,包括试验目的阐明、试验中人员招募和保留策略、随机设计的选择、实施科学理论和框架的使用、测量(结局指标)、样本量计算、伦理审查和试验报告。本文也关注了实施试验中需要特别重视或调整的主题。为了推进实施策略随机试验的严格开展和报告,我们建议将本指南作为研究人员、卫生保健和公共卫生政策制订者或实践者、研究资助者和期刊编辑的参考资料。