Laparoscopic sleeve gastrectomy, as the significantly effective weight loss surgery currently recognized, is widely used at home and abroad, and the quality of life of postoperative patients also receives widespread attention. At present, domestic researchers often use universal scales to evaluate the quality of life of postoperative patients, but such scales cannot truly reflect the quality of life of postoperative patients. This paper reviews the universal and specific assessment tools for quality of life in patients after laparoscopic sleeve gastrectomy, elaborates on the advantages and disadvantages of each tool, compares and analyzes the specific assessment tools, and proposes the shortcomings of the specific assessment tools and future research directions. The aim is to provide a reference for selecting and developing suitable assessment tools for the quality of life of patients after laparoscopic sleeve gastrectomy in China.

With the application of accelerated rehabilitation surgery mode in metabolic bariatric surgery, the postoperative hospital stay of patients is gradually shortened, but it also leads to the lack of postoperative knowledge of patients after discharge. Adequate guidance on discharge readiness is beneficial for improving the self-management ability of patients and improving dietary, medication and exercise compliance. This paper reviews the status quo, assessment tools, influencing factors and intervention measures of discharge readiness of patients undergoing metabolic bariatric surgery, in order to provide references and ideas for developing discharge readiness evaluation tools and related studies for patients undergoing metabolic bariatric surgery in China.

Objective To systematically evaluate the intervention effect of social psychological intervention on the health status of patients with bariatric surgery(BS).Methods 8 databases,including PubMed,PsycInfo,and Embase and Clinic Trials,were retrieved to recruit randomized controlled trials with computer from database establishing time to Sep.2022.Independent quality evaluation was conducted by 2 researchers,and Meta-analysis was performed by the RevMan5.3 software.Results Totally 23 RCTs were included.The meta-analysis showed that psychosocial interventions in BS patients improve emotional eating and binge eating behavior[SMD=-0.44,95％CI(-0.78,-0.09),P=0.010;MD=-5.88,95％CI(-8.65,-3.11),P＜0.001],promote better quality of life[SMD=0.30,95％CI(0.02,0.59),P=0.040]and physical mobility,alleviates anxiety and depression[SMD=-0.37,95％CI(-0.67,-0.08),P=0.010;SMD=-0.59,95％CI(-0.84,-0.33),P＜0.001].However,the effect on improving eating disorders[MD=-0.01,95％CI(-0.19,0.18),P=0.950]is not significant,and subgroup analysis results of different intervention measures and follow-up times showed that there was no statistically significant difference in weight changes between the social psychological intervention group and the control group.Conclusion Psychosocial intervention can effectively improve the mental state and eating behavior of the bariatric surgery patients,improve the quality of life and increase physical activity of patients.However,the effect of intervention on eating disorder and weight change is still unclear.More high-quality clinical studies need to be carried out for further verification.

Objective:To retrieve, evaluate, and sum up the evidence on target temperature management in stroke patients, and summarize the best evidence.Methods:Based on the "6S" pyramid model, clinical practice guidelines, expert consensus, evidence summary, and systematic review on target temperature management in stroke patients were searched from top to bottom in British Medical Journal Best Practice, UpToDate, Joanna Briggs Institute Evidence-Based Health Care Center, Guidelines International Network, Agency for Healthcare Research and Quality, National Institute for Health and Clinical Excellence, Scottish Intercollegiate Guidelines Network, Registered Nurses' Association of Ontario, American Heart Association, American Stroke Association, European Stroke Organization, Medlive, Cochrane Library, PubMed, Embase, Web of Science, China National Knowledge Infrastructure, WanFang Data, VIP and China Biology Medicine Disc. The search period was from database establishment to October 7, 2022. Two researchers received evidence-based nursing training independently evaluated the quality of the article, extracted, integrated, and summarized the best evidence.Results:A total of 12 articles were included, including three clinical practice guidelines, four systematic reviews, and five expert consensuses. 24 best pieces of evidence were summarized from five aspects, involving target temperature population, target temperature implementation, complication monitoring, nutritional support, and prognosis evaluation.Conclusions:This study adopts an evidence-based approach to systematically summarize the best evidence for target temperature management in stroke patients, which can provide the best decision-making basis for clinical medical and nursing staff to manage temperature in stroke patients, further standardize temperature monitoring and management, and offer scientific basis for future research and practice.

Objective:To meet the demand of medical system for talents, the training of medical students' competency has become a new direction of medical education. This study aims to evaluate the effectiveness of training quality in medical graduates through the competency scale.Methods:Taking "attitude", "skill" and "knowledge" as the evaluation dimensions, the competency development was divided into four levels of "state", "explain", "apply" and "transfer", and we proposed the competence concept of "A.S.K.-SEAT" and formulated an evaluation scale. Questionnaires and behavior event interviews (BEI) were conducted in medical graduates of Shantou University in 2018. Reliability and validity of the questionnaire were evaluated and current situation of different competency items were analyzed.Results:A total of 155 questionnaires were collected with good reliability and validity, and 15 graduates participated in BEI. A total of 21 A.S.K. competency items (including five basic competency items and two discriminating competency items) and SEAT textual descriptions were finally established.Conclusion:A.S.K.-SEAT scale can provide valid references for the competency evaluation of medical graduates.

Objective:To investigate the incidence and risk factors of human cytomegalovirus (HCMV) reactivation in immunocompetent severe pneumonia patients with mechanical ventilation and their effects on clinical outcomes.Methods:A prospective observational study was conducted. Forty-eight immunocompetent patients requiring invasive mechanical ventilation due to severe pneumonia in the department of critical care medicine of the First Affiliated Hospital of Guangzhou Medical University from June 30th, 2017 to July 1st, 2018 were enrolled. Meanwhile, all cases were followed up until 90 days after inclusion and were required to quantitatively detect HCMV DNA in serum at regular weekly intervals until 28 days after transferring to intensive care unit (ICU). Patients were divided into HCMV reactivation group (≥5×10 5 copies/L) and non-reactivation group (<5×10 5 copies/L) based on HCMV DNA at any time point within 28 days. Demographic data, basic indicators, respiratory indicators, disease severity scores, laboratory indicators, complication and clinical outcomes of the two groups were collected and analyzed. Multivariate Logistic regression analysis was performed to screen independent risk factors for HCMV reactivation. Results:All 48 subjects were tested positive for HCMV immunoglobulin G (IgG), so HCMV seropositive rate was 100%. HCMV reactivation occurred in 10 patients within 28 days after admission to ICU, and the reactivation incidence of HCMV was 20.83%. There was no significant difference in gender, age, body mass index (BMI), underling disease reasons for ICU transfer (except sepsis), basic vital signs, disease severity scores, or laboratory findings including infection, immune, blood routine, liver, kidney and circulatory indicators except neutrophils count (NEU), hypersensitivity C-reactive protein(hs-CRP), hemoglobin (Hb), blood urea nitrogen (BUN), N-terminal pro-brain natriuretic peptide (NT-proBNP) between the two groups. The height (cm: 160±6 vs. 166±8), body weight (kg: 49.4±11.2 vs. 57.6±10.5), Hb (g/L: 87±18 vs. 104±24) in HCMV reactivation group were significantly lower than non-reactivation group, as well as NEU [×10 9/L:12.7 (9.9, 22.5) vs. 8.9 (6.2, 13.8)], hs-CRP [mg/L: 115.5 (85.2, 136.6) vs. 39.9 (17.5, 130.2)], BUN [mmol/L:13.7 (8.9, 21.5) vs. 7.1 (4.9, 10.5)] and NT-proBNP [ng/L: 6 751 (2 222, 25 449) vs. 1 469 (419, 4 571)] within 24 hours of admission to ICU. The prevalence of sepsis [60.0% (6/10) vs. 15.8% (6/38)], blood transfusion [100.0% (10/10) vs. 60.5% (23/38)], hospitalization expense [ten thousand yuan: 35.7 (25.3, 67.1) vs. 15.2 (10.4, 22.0)], 90-day all-cause mortality [70.0% (7/10) vs. 21.1% (8/38)], length of ICU stay [days: 26 (16, 66) vs. 14 (9, 19)], the duration of mechanical ventilation [days: 26 (19, 66) vs. 13 (8, 18)] in HCMV reactivation group were significantly higher than non-reactivation group, and there were significant statistical differences between the two groups (all P < 0.05). Logistic regression analysis showed that sepsis was an independent risk factor for HCMV reactivation in immunocompetent mechanical ventilation severe pneumonia patients with mechanical ventilation [odds ratio ( OR) = 9.35, 95% confidence interval (95% CI) was 1.72-50.86, P = 0.010]. Conclusions:HCMV infection is very common in immunocompetent severe pneumonia patients on mechanical ventilation and incidence of HCMV reactivation is high. Moreover, HCMV reactivation could adversely affect clinical prognoses, and sepsis may be a risk factor for HCMV reactivation.

After in-depth needs analysis, we combined our previously written textbook with digitalized platform by information technology, and proposed construction principles guided by English for academic purposes (EAP) theories. Through scientific design and ongoing modification, we finally developed an open online digital course with academic and practical properties. The course received positive feedback after release online. It may become an effective way to improve research paper writing skills for medical postgraduates and provide references for medical colleges to develop other EAP digital courses.

Objective:To investigate the incidence and risk factors of active human cytomegalovirus (HCMV) infection in patients with severe community-acquired pneumonia.Methods:Patients who required respiratory support and were diagnosed with severe community-acquired pneumonia in the respiratory intensive care unit (RICU) of the First Affiliated Hospital of Guangzhou Medical University from March 1, 2019 to June 1, 2020 were consecutively screened and divided into active HCMV infection group (20 cases) and non-active HCMV infection group (95 cases) based on whether a patient has active HCMV infection or not. Differences in demographic data, laboratory findings, and clinical outcomes were compared between the two groups. Moreover, logistic regression was applied to analyze risk factors for active HCMV infection.Results:The 20 of 115 patients with severe community-acquired pneumonia requiring respiratory support were confirmed to have active infection with HCMV, with a prevalence of active HCMV infection of 17.4%. The pneumonia severity index (PSI) and suppressor T lymphocytes (Ts) in active HCMV infection group were higher than that of the control group, and all the differences were statistically significant ( Z=2.432, P=0.015; Z=2.036, P=0.042); whereas lymphocytes, monocytes, blood lactate, and platelet levels were lower than those of the control group, and all the differences were statistically significant ( P < 0.05). Patients with active HCMV infection had a higher transfusion rate than the control group, and the differences were statistically significant (χ 2=3.941; P=0.047). Increasing levels of PSI and Ts percentage were independent risk factors for active HCMV infection ( OR=1.03, 95% CI: 1.01~1.05; OR=1.06, 95% CI: 1.00~1.11; P < 0.05). RICU length of stay, complication rates, and 90-day all-cause mortality were higher in the active HCMV infection group than the control group, and all the differences were statistically significant ( P < 0.05). Conclusions:Active HCMV infection is highly prevalent in patients with severe community-acquired pneumonia and associated with several adverse clinical outcomes, with PSI and Ts cell levels being independent risk factors.

English biomedical research paper writing is a key skill for biomedical postgraduates as it directly determines the publicity of their research findings and their international academic influence. It belongs to the field of ESP (English for Specific Purposes), and has the characteristics of diversified students, specialized and complicated teaching content, and a curriculum with time and space constraints. Based on the characteristics, needs analysis of this course as well as years of discipline construction and teaching research, the flipped classroom for English biomedical research paper writing based on collaborative teaching is put forward, which has combined the advantages of both collaborative teaching and flipped classroom: it integrates the knowledge expertise of biomedical teachers and English teachers to meet the requirements for ESP teachers; in the meantime, it has broken the time and space constraints of traditional classroom through "after-class knowledge input and in-class knowledge extension and deepening", blazing new trails for course delivery.

BACKGROUND:Induced pluripotent stem cel s have great prospects in tissue repair, due to the characteristic of self-renewal, multi-directional differentiation, no immunological rejection and ethics controversy.
OBJECTIVE:To summarize the differentiation of induced pluripotent stem cel s towards cardiomyocytes and endothelial cel s, and their applications in the cardiovascular diseases.
METHODS:The first author performed a data retrieval of PubMed and CNKI databases from 2000 to 2015 to search articles addressing the differentiation of induced pluripotent stem cel s towards cardiomyocytes and endothelial cel s, and reviewed the literatures systematical y. Final y, 78 articles were chosen for further analysis.
RESULTS AND CONCLUSION:Induced pluripotent stem cel s can differentiate into cardiovascular cel s through a variety of methods. Factors such as cyclosporin A and ascorbic acid C may improve myocardial differentiation of induced pluripotent stem cel s, while vascular endothelial growth factor and basic fibroblast growth factor may improve the endothelial differentiation of induced pluripotent stem cel s. Cardiovascular cel s derived from induced pluripotent stem cel s can be applied to build disease models in vitro, transplantation in vivo and drug screening.