ObjectiveTo understand the level of medical narrative competence among hospice care practitioners in Shanxi Province， explore its influencing factors， and provide references for carrying out targeted training and improving the medical narrative competence of the medical and nursing staff. MethodsUsing convenience sampling， a total of 102 medical and nursing staff from hospitals providing hospice care in Shanxi Province were recruited as the research subjects. Questionnaire surveys were conducted with the Self-Designed General Information Questionnaire and the Self-Rating Scale for Medical Narrative Competence as the research tools. Univariate analysis and multiple linear regression analysis were adopted to explore the level of medical narrative competence and its influencing factors among hospice care practitioners in Shanxi Province. ResultsThe total score of medical narrative competence among hospice care practitioners in Shanxi Province was （158.19±19.69）. The mean scores of all dimensions were ranked from the lowest to the highest as attention and listening， understanding and response， and reflection and representation. Univariate analysis demonstrated that working years in hospice care， daily communication frequency with patients， weekly communication duration， degree of colleague care， professional recognition， job satisfaction， and familiarity with narrative medicine constituted the influencing factors for the level of medical narrative competence among hospice care practitioners （all P<0.05）. Multiple linear regression analysis showed that working years in hospice care， degree of colleague care， and familiarity with narrative medicine had statistically significant effects on the medical narrative competence of hospice care practitioners （all P<0.05）. ConclusionAdministrators of hospice care should prioritize medical and nursing staff who lack familiarity with narrative medicine， have low degrees of colleague care， experience short working years， and possess low professional recognition and job satisfaction with hospice care work. Targeted training should be strengthened for these individuals to improve their medical narrative competence level， thereby enhancing the quality of hospice care services.

Tenascin-C (TNC), an extracellular matrix glycoprotein, is lowly expressed in normal adult tissues while significantly upregulated under pathological conditions such as injury, inflammation, or tumors. Recent studies have shown that TNC plays an important role in Alzheimer's disease (AD) development: it is not only closely related to the formation of β-amyloid (Aβ) plaque, but also involved in neuroinflammation regulation and Aβ clearance process. This article reviews the effect of TNC on AD pathology in aspects of neuroinflammation, synaptic function, autophagy and Aβ load, aiming to provide theoretical basis for TNC-targeted AD treatment and drug development.

Ovarian sclerosing stromal tumor(OSST)is a benign tumor originating from the ovarian sex cord-stroma,accounting for only 2%-6%of ovarian stromal tumors.It predominantly occurs in young women,and cases of OSST concurrently presenting with Meigs syndrome are extremely rare.This study reports a case of OSST,summarizes its clinical manifestations,and reviews relevant literature.The patient,a 22-year-old female,was admitted due to abdominal distension for 2 months,worsening over the past week.The physical examination results revealed abdominal distension,shifting dullness,mild tenderness,and no muscle tension or rebound tenderness.A mass measuring approximately 16.0 cm×14.0 cm×8.0 cm was palpated in the pelvic and abdominal cavity,with a firm texture,moderate mobility,and no tenderness.The gynecological ultrasound results showed a mixed cystic-solid echo of about 15.3 cm×14.0 cm×8.4 cm above the left side of the uterus,with clear boundaries,and fluid-filled dark areas in the pelvic and abdominal cavity,with a maximum anteroposterior diameter of about 11.9 cm.The-CT results revealed a cystic-solid mixed-density mass in the lower abdomen and right adnexal area,suggestive of a neoplastic lesion,with increased glucose metabolism in the solid portion,leaning toward malignancy.Carbohydrate antigen 125(CA125)was>800 U·mL-1,and pelvic puncture cytology indicated no cancer cells.The findings suggested a benign or borderline ovarian tumor,requiring differentiation from ovarian malignant tumors.Based on intraoperative observations and rapid pathological results,a left ovarian tumor enucleation was performed.Postoperative pathology confirmed ovarian sclerosing stromal tumor.Follow-up over 2 years showed no abnormalities.As a benign ovarian tumor,the clinical manifestations of OSST often mimic those of malignant tumors,leading to frequent misdiagnosis.Early diagnostic accuracy should be improved to develop the optimal treatment plan for patients.

Differentiated liposarcoma is a rare connective tissue malignancy in adults that mostly occurs in the extremities and retroperitoneum, with a tendency to aggressiveness and recurrence, and the ten-year survival rate of about 10%. Clinically, dedifferentiated liposarcoma of the pharynx has been reported to be rare abroad and only one case has been reported in China. Clinical symptoms are mainly foreign body sensation in the pharynx, which can be easily misdiagnosed as benign tumors. Pathological diagnosis is the main examination tool for this kind of disease, and immunohistochemistry and FISH test can help to differentiate it from other tumors. This article presents a case of a male patient with dedifferentiated liposarcoma of the hypopharynx, who had a foreign body sensation in the pharynx for more than 1 month, and underwent supported laryngoscopic pharyngeal lesion resection after completing the preoperative relevant examinations and postoperative radiation therapy, with postoperative pathology returned as dedifferentiated liposarcoma. The present postoperative follow-up was 12 months without recurrence. Therefore, accurate diagnosis and timely treatment are extremely important for the prognosis of this disease.
Humans ; Male ; Liposarcoma/diagnosis* ; Hypopharyngeal Neoplasms/diagnosis* ; Middle Aged ; Hypopharynx ; Adult

Tenascin-C (TNC), an extracellular matrix glycoprotein, is lowly expressed in normal adult tissues while significantly upregulated under pathological conditions such as injury, inflammation, or tumors. Recent studies have shown that TNC plays an important role in Alzheimer's disease (AD) development: it is not only closely related to the formation of β-amyloid (Aβ) plaque, but also involved in neuroinflammation regulation and Aβ clearance process. This article reviews the effect of TNC on AD pathology in aspects of neuroinflammation, synaptic function, autophagy and Aβ load, aiming to provide theoretical basis for TNC-targeted AD treatment and drug development.

Objective:To develop and test the reliability and validity of the scale of nurses′ medication competence. To provide scientific basis for the safe medication management of clinical nurses.Methods:Based on the qualitative interview results, combined with role theory and core competence theory, the initial item pool of the scale was formed through literature analysis and discussion in the research group. The first draft of the scale was formed through expert correspondence and pre-investigation. Using the cross-sectional survey methed, from October to November 2022, a questionnaire survey was conducted among 825 clinical nurses from 6 tertiary hospitals in Dalian by convenience sampling method to test the reliability and validity of the scale.Results:Totally 20 experts were consulted, aged 35-49 years old. The nurses′ medication competence evaluation scale contained 11 dimensions, including pharmacological knowledge, medication management ability, medication evaluation ability, medication order checking and execution ability, clinical practice ability, modern technology application ability, educational consulting ability, communication and coordination ability, scientific research and learning ability, ethical and legal practice ability, quality management and risk management ability, with a total of 50 items. Exploratory factor analysis identified 11 common factors, which accounted for 86.525% of the variance. The Cronbach α coefficient of the scale was 0.975, the Cronbach α coefficient of all dimensions were 0.880-0.977, and the retest reliabilities were 0.721-0.875. The content validity index of the scale was 0.99, and the content validity index of all items were 0.83-1.00. The correlation coefficients between the scale and the Competency Inventory for Registered Nurse were 0.636-0.938. Conclusions:The nurses′ medication competence evaluation scale had good reliability and validity, and could be used as an effective tool to evaluate the medication ability of nurses.

Due to the lack of precise microstructure and functions of the two-dimensional culture model, the in vitro culture models of lung organoids and lung-on-chips, as two main research tools to mimic lung development, homeostasis, injury, and regeneration, allow further exploration of pulmonary fibrosis, lung cancer, and other diseases. Lung organoid refers to isolated lung epithelial stem cells growing in a three-dimensional environment in vitro to form mini-clusters of cells that self-renew, self-reorganize, and differentiate into functional cell types. Based on the microfluidic chip technology, lung-on-chips use porous flexible membrane made of poly to provide tissue-layered structures for cells and simulate microenvironment and mechanical forces. We reviewed the classification, research and development history, establishment methods, practical applications, advantages and disadvantages of two main in vitro culture models derived from lung adult stem cells, hoping to provide a reference for organ transplantation and regeneration and drug screening.
Adult ; Adult Stem Cells ; Humans ; Lung ; Lung Neoplasms ; Organoids ; Stem Cells ; Tumor Microenvironment

Objective:To establish a good model of incomplete ablation of ectopic implanted tumor of liver, and explore the changes in the molecular landscape of residual cancer, cancer in nude mice.Methods:Eight immunodeficient BALB/c nude mice were used to establish an ectopic tumor model with the MHCC97-H hepatoma cell line, and they were randomly divided into experimental group and control group, with 4 mice in each group. The experimental group underwent simulated clinical incomplete ablation, and the control group only underwent false ablation. The differences between the models were evaluated by ultrasonic diagnostic equipment, thermal imaging cameras, HE staining and high-throughput whole transcriptome sequencing.Results:Liver cancer ectopic implantations in nude mices were all successful. The experimental group showed that the temperature of the tumor around the tip of the needle monitored by the thermal imaging camera was at 50-73.9 ℃. Compared with the control group, the HE staining of the experimental group mostly showed the coexistence of necrotic area-degeneration area-tumor cell area. The necrosis area was (23.75±13.77)%, and the degeneration area was 50%(30%). High-throughput whole transcriptome sequencing revealed that there were hundreds of overlapping stable molecular landscapes in the incomplete ablation simulation model both in vivo and in vitro.Conclusions:By establishing an ectopic implantion model of nude mice with incomplete ablation of residual liver cancer, it can provide a basis for studying the biological characteristics of incomplete ablation of residual cancer at the molecular level.

Objective:To analyze the causes of postoperative stricture of biliary-enteric anastomotic for congenital choledochal cysts.Methods:These 28 patients underwent salvage operation on an average 15 years (0.2-25 years) after initial surgeries at the Department of Hepatobiliary Surgery, Hunan Provincial People's Hospital from Jan 2014 to Jun 2018.Results:In 26 patients the biliary-enteric anastomotic stenosis was benign, and in 2 the stricture was caused by cancerration. In 26 cases the Roux-en-Y hepaticojejunostomy was redone,among them 8 cases underwent concurrent hepatectomy for a better exposure of the intrahepatic bile duct. In 2 cases the anastomotic stenosis was found to be caused by canceration with extensive intraabdominal metastasis ,an external drainage was adopted. There were no inhospital deaths, and no serious complications. The postoperative follow-up time was 6-67 months. Two cancerated patients died within half a year, and the remaining patients had no long-term complications.Conclusions:Biliary-enteric anastomotic stenosis is one of the serious complications in postoperative patients for congenital choledochal cysts. Hence a wide, tension free biliary-enteric anastomosis performed by a experienced hand is necessary.

As an emerging branch of biology, Synthetic Biology has seen rapid development with great potential in theoretical research and application. With a lot of brand-new concepts and research methods, it brings challenges to university teachers, and little experience is available in China on the teaching of Synthetic Biology. In this study, we discussed the general education-based development and application of the course on Synthetic Biology (a discipline in "liberal arts" in Zhejiang University) from the background, design, implementation, outcome, and problems of the course, hoping to provide a reference for the optimization of the course and the design of similar courses in other universities in China.
China ; Humans ; Synthetic Biology ; Universities