Objective:To investigatethe empathy ability among surgical oncology doctors in Three-A hospitals in Shenyang,and analyze the effects of demographic factors on their empathy ability.Methods:Cluster random sampling method was used to conduct a questionnaire survey in order to investigate the empathy ability of surgical oncology doctors in six Three-A hospitals in Shenyang.Results:The average empathy score of surgical oncology doctors was(42.12 ± 11.19),and each item scored(1.91 ±0.51).The empathy ability of surgical oncology doctors was significantly different in gender,educational background,professional title,and employment type (P ＜0.05),while no difference was observed in age,marital status,working experience,department and whether one child or not (P ＞0.05).Conclusions:The empathy ability of surgical oncology doctors was at a relative low level,which was influenced by gender,educational background,professional title and employment type.Hospital managers should attach great importance to enhance the doctors' empathy ability.In order to improve the doctors' humanistic competency,targeted training for them is necessary.Through the cultivation of empathy ability,the surgical oncology doctors can provide warmer treatment for the patients,and eventually improve patients' quality of life.

Alzheimer's disease (AD) is a complex neurodegenerative disorder which seriously causes the dementia in elderly people and afflicts millions of people worldwide. Drug discovery for Alzheimer's disease therapy has been a hot research area and a big challenge, in which development of acetylcholinesterase (AChE) inhibitors design was the most active and some AChE inhibitors are commercially available for AD medication already. However, practical using of commercial AChE inhibitors showed their limited usefulness and related adverse effects. Thus, it is extremely urgent to find novel AChE inhibitors with higher potency and less adverse effects. Based on the accurate crystallographic studies about AChE, strategies for multi-binding site AChE inhibitors have been formed, followed by design of the multi-target directed ligands. In this review, the structures and binding modes of commercial AChE inhibitors were briefly discussed, together with the development of AChE inhibitor design for AD therapy: from multi-binding site inhibitors to multi-target directed ligands.

Objective:To investigate the clinical value of the free fibula flap transplantation in repair of the defect of tibia and soft tissue with the help of augmented reality (AR) technology.Methods:From May, 2017 to May, 2019, 9 patients with tibial and soft tissue defects were treated. Before operation, CTA scan was performed on both shanks to obtain DICOM data of tibial bone defect. Images of the designed fibular flap and its blood supply model were imported into Sina software through computer virtual surgery assistant technology. With the AR technology, information of virtual fibula flap were projected onto the body surface at the donor site, and the operation was carried out under the precise positioning. In this group, the free fibular flap was harvested with an area of 6.0 cm×4.0 cm-12.0 cm×6.0 cm and the length of fibula was 6.0-13.5 cm. The free fibula flap were used to repair the tibial defect with 5.0-12.0 cm in length and soft tissue defect area at 5.0 cm×3.0 cm-10.0 cm×4.5 cm. Patients were followed-up to observe the survival of fibular flap and the functional recovery of the repaired lower limb, and evaluate the clinical effect.Results:All the fibular flaps survived without vascular crisis and without serious complications occurred at both of donor and recipient sites. After 8-12 months of follow-up, the flap was soft in texture and good in blood supply. The appearance of the repair site was not bloated. Callus began to form at the junction of fibula and tibia at 3-5 months and healed well in 8-12 months. No bone resorption, nonunion, loosening or falling off of screws were found. There was no pain in the shank of the recipient area. Patients could stand and walk freely, and the weight-bearing function was close to normal. According to Enneking system, the average score was 27 points; 7 cases were excellent and 2 cases were good.Conclusion:Application of AR technology in the repair of tibial bone defect with fibular flap transplantation has good clinical effect and has certain practical value.

Objective To verify the influence of oncology nurses'empathy on the psychological dis-tress and benefit finding in breast cancer patients. Methods 30 oncology nurses were selected by random sampling and their empathy scores were measured with the interpersonal reactivity index (IRI-C).And they were divided into three groups based on empathy scores. 12 breast cancer patients from each primary nurse were selected by random sampling.Their psychological distress and benefit finding were measured by distress thermometer (DT) and benefit finding scale (BFS).Variance analysis was used to compare psychological distress and benefit finding among patients in different groups. The effect of nurse empathy on patients psy-chological distress and benefit finding was measured by Spearman correlation analysis and logistic regression. Results The empathy score of nurses was (44.87±17.23).The difference of empathy score in the three groups of nurses was statistically significant (F=55.941,P<0.01).There was no significant difference in psy-chological distress (low-score group:5.0(4.0,6.0),middle-score group:5.0(4.0,6.0),high-score group:5.0 (4.0,6.0)) and benefit finding (low-score group:47.5(42.0,52.8),middle-score group:48.0(43.0,54.0), high-score group:46.0(42.0,52.0)) in the three groups of patients at admission(P>0.05),while at dis-charge,the psychological distress of the patients in the high-score nurse group was lower than that of the low-score nurse group (P<0.01),and the benefit was higher than that of the low-score group (P<0.01).There was a negative correlation between the nurses'empathy abilities and patients'psychological distress ( r=-0.470, P<0.01) ,and a positive correlation between the nurses'empathy abilities with the patients'benefit finding ( r=0.521,P<0.01).When controlling for other variables,patients in nurse group with higher empathy scores would result in lower psychological distress(95％CI=0.042-0.397) and higher benefit finding (95％CI=0. 095-0.554) than patients in nurse group with lower empathy scores.Conclusion Oncology nurses'empathy effect breast cancer patients'psychological distress and benefit finding.Nurses should enhance their empathy further.

Objective:To explore the effect of nerve physicians ' empathy on depressive mood of hospitalized stroke patients .Methods:Choosing hospitalized stroke patients in a hospital in Guangdong province from January 2017 to May 2017 ,we used the Hospital Anxiety and Depression Scale ( HADS) to measure their depressive mood;the Jefferson Scale of Empathy -Health Professionals ( JSE-HP) to measure their charge doctors ' empathy ability and analyzed the effect of doctors ' empathy on patients ' depressive mood .Results:The score of patients ' depres-sive mood was (7.48 ±4.75).Doctors' empathy ability and patients' family relationship were the influencing fac-tors of depressive mood of hospitalized stroke patients .After equilibrating other factors , when a one -point in-creased on the doctor ' s empathy score , the patient ' s depressive mood score decreased by 0 .135 points ( P <0 .001 ) .Conclusion:Hospitalized stroke patients managed by neurological physicians with high empathy ability are less likely to be depressive .Narrative medicine and empathy should be applied and deepened in the clinical prac -tice.

Objective:To investigate the feasibility and clinical effects of the application of augmented reality (AR) navigation on assisted design of the chimeric twin-paddled anterolateral thigh perforator flap (ALTPF) in reconstruction of soft tissue defects in extremities.Methods:From June 2017 to June 2023, 8 patients with soft tissue defects in extremities received reconstruction of chimeric twin-paddled ALTPF designed with the assistance of AR navigation in Department of Hand & Foot Microsurgery Orthopaedics, Guigang City People’s Hospital. All of them were traffic accidents or machine injuries, with 3 cases of calf, 2 cases of ankle, 1 case of foot, and 2 cases of hand defects. All the wounds were wide or irregular (defect sized 14 cm×14 cm-25 cm×13 cm). The images of bilateral thighs were acquired by CT angiography preoperatively. The dominant side and dominant perforators were selected. Three dimensional reconstruction was performed by Mimics software. AR technology was applied to guide the design and harvest of the chimeric twin-paddled ALTPF. Flap area was 15 cm × 16 cm to 26 cm × 14 cm. The donor site was sutured directly. Follow-up with outpatient visits or WeChat images and videos at 1, 3, 6 and 12 months postoperatively to record the appearance, colour, texture, recurrence of infection, and knee extension function of the flap donor site.Results:According to the preoperative design, the perforator flaps were harvested and transferred in all the 8 patients. All flaps survived and the recipient and donor sites healed in one stage. All patients entered postoperative follow-up for 3 to 12 (mean, 8.6)months. The colour and texture of the flaps were excellent, and the appearance of donor and recipient sites was satisfactory. Two patients with hand injuries were evaluated using the brief Michigan Hand Outcomes Questionnaire (MHQ), with scores of 43.74 and 81.25, respectively. Six patients with lower limb injuries were evaluated using the Maryland foot score, with scores of 2 excellent, 3 good and 1 fair.Conclusion:The application of AR navigation can effectively assist the design of a chimeric twin-paddled ALTPF. It also provides an effective basis for clinical personalised flap design.

Objective:To investigate the clinical value of augmented reality (AR) technology combined with Doppler ultrasound in repairing soft tissue defects around ankle with posterior tibial artery perforator flap.Methods:From June, 2017 to June, 2020, 13 patients with soft tissue defects around ankle were repaired with the posterior tibial artery perforator flap sized 3.0 cm×7.0 cm-5.0 cm×10.0 cm. Preoperative CTA scan was performed to obtain the 3-dimensional image of the blood supply of the donor site. The origin and direction of blood supply, length of pedicle, diameter and the location of perforator were determined. An image fusion software based on Android mobile phone was used from the body surface to realize the navigation by AR, and to mark the locations of the points where blood vessels ran and passed by. At the same time, Doppler ultrasound was employed to confirm the navigation. The optimal puncture fulcrum was used as the flap rotation point in design of the flap. After the flap had been designed, the flap was harvested and the defect was repaired. Outpatient clinic follow-up was performed to evaluate the survival of flap and the function of ankle.Results:All 13 flaps survied without vascular issues. After 6-16 (average 10) months follow-up, all flaps survived. The flaps appeared soft with good blood supply. The colour of the repaired sites were basically the same as normal skin. According to American Orthopedic Foot and Ankle Society (AOFAS) , the ankle function was excellent in 9 patients and good in 4 patients. There was no obvious scar formation on the donor sites.Conclusion:The application of AR technology combined with Doppler ultrasound in the surgical planning of posterior tibial artery perforator flap has advantages in easy to operate in clinical practice. It can reduce the risk of surgery, and has significance in clinical practice.