加拿大麦吉尔大学护理硕士教学及其启示

介绍加拿大麦吉尔大学护理硕士课程设置及教学方法,详细描述课程教授负责下的临床护理专家一对一指导教学和概念图在临床课程中的应用。麦吉尔护理硕士课程既尊重学生的兴趣,又能因人而异地进行针对性教学,保证了高水平的教学质量。我国护理硕士教学可借鉴其教学经验,以提高我国护理硕士教学质量

Control Techniques of Bonnet Polishing for Free-form Optical Lenses with Precession

针对自由曲面光学元件的加工特点,研究气囊抛光自由曲面光学元件进动运动控制技术,用于求出气囊工具进动过程中两虚拟轴的转角,实现对气囊自转轴空间位置的控制。以气囊自转轴为研究对象,由于自由曲面光学元件上每个点的法线三维坐标都不相同且气囊进动抛光过程中气囊自转轴与工件加工点局部法线夹角不变,提出建立基坐标系和抛光点对应三维空间坐标系的方法,得到抛光过程中气囊自转轴的空间位置变化情况,而后利用旋转坐标变换得到气囊抛光进动运动控制模型;在所建立的自由曲面光学元件气囊抛光进动运动控制模型中加入控制算法,求出抛光自由曲面光学元件各点时气囊工具两个虚拟旋转轴的转角。利用MATlAb对自由曲面光学元件不同方向截面进行仿真抛光试验,得到自由曲面各方向上气囊抛光进动运动曲线以及仿真进动角曲线,结果证明了自由曲面光学元件气囊抛光进动运动控制模型及控制算法的正确性。Control techniques of bonnet polishing free-form optical lenses with 'precession' is studied,according to the processing characters of free-form optical lenses,to figure out the rotating angles of two virtual axes of bonnet tool,which lead to the controllability of spin axis of bonnet tool.The spin axis of bonnet tool is taken as the object,due to the difference of the local normal of each polishing point and the angle between the spin axis of bonnet tool and local normal is keeping constant in polishing process,a method about how to set up basic coordinate and corresponding coordinate of polishing point is proposed,aiming to get the positions of spin axis of bonnet tool in polishing process,by which a movement model can be obtained by combining with rotating coordinate transformation;Then control algorithm is added to the movement model,and rotating angles of two virtual axes of bonnet tool when polishing each point on free-form optical lenses are calculated.At the end,simulations in polishing different directions of free-form optical lens in Matlab are carried out,to get the curves of precession control and the simulated precession angles,the results reveal that the movement model and control algorithm presented are both correct.国家自然科学基金(51075343); 厦门市科技计划(3502Z20113007)资助项

养正消积胶囊辅助GP方案治疗晚期非小细胞肺癌临床研究

目的观察养正消积胶囊辅助GP方案治疗晚期非小细胞肺癌(NSCLC)的临床疗效。方法采用随机数字表法将89例晚期NSCLC患者分为对照组44例及观察组45例。2组均采用GP方案;观察组并予养正消积胶囊,每次4粒,每日3次,口服。2组均21d为1个周期,连续治疗2个周期,随访1年。观察2组治疗前后Ki67、Bax、Bcl-2蛋白表达及肿瘤标志物[血管内皮生长因子(VEGF)、骨桥蛋白(OPN)、癌胚抗原(CEA)、糖类抗原199(CA199)]、中医症状评分、生活质量评分,比较2组客观缓解率(ORR)、疾病控制率(DCR)、无进展生存时间(PFS),监测不良反应。结果观察组ORR、DCR明显优于对照组(P<0.05)。与本组治疗前比较,观察组治疗后、随访1年VEGF、OPN、CEA、CA199水平明显降低(P<0.05);对照组治疗后上述指标明显降低(P<0.05),随访1年CEA水平明显降低(P<0.05)。与本组治疗前比较,2组治疗后Ki67、Bcl-2蛋白表达明显降低,Bax蛋白表达明显升高(P<0.05);2组治疗后比较,观察组Ki67、Bcl-2蛋白表达低于对照组(P<0.05),Bax蛋白表达高于对照组(P<0.05)。与本组治疗前比较,2组治疗后中医症状评分(神疲乏力、胃纳少馨、腰膝无力、夜尿频多、头晕目眩)、生活质量评分(躯体功能、认知功能、社会功能、情绪功能)明显改善(P<0.05);2组治疗后比较,观察组上述评分改善明显优于对照组(P<0.05)。观察组PFS明显长于对照组(P<0.05),不良反应明显低于对照组(P<0.05)。结论养正消积胶囊辅助GP方案治疗晚期NSCLC可有效降低患者肿瘤标志物水平,改善生存质量,减少吉西他滨和顺铂的不良反应,提高疗效。福建省卫生厅中医药科研专项课题(wst201210

Self-Coordinating System: A Four-Layer Model of Human Internal Dynamics

This project presents the first formal introduction of the Four-Layer Self-Coordinating System, a novel model proposed on November 11, 2025 (Beijing Time). The model integrates four components — Body, Inner Mind, Self-Awareness, and Brain — into a closed-loop dynamic system influenced by time, energy flow, and local entropy changes. The framework aims to explain the paradox of free will by showing how human actions, reflections, awareness, and neural processes form a coordinated system with predictive delays (300ms ± 50ms), supported by existing neuroscientific findings. This project includes theoretical foundations, system diagrams, entropy-based interpretations, and the potential for future empirical validation. All content is shared for open discussion and open peer review. Researchers are welcome to replicate, critique, or expand the model.** Project Name: Four-Layer Model Joint Statement: Participants: Zhang Jinhui &amp; ChatGPT We jointly declare that this project aims to explore and validate the theory and application of the Four-Layer Model, and is committed to advancing related practices. Both parties clearly acknowledge that the content of this project is a joint creation and research result, with all core outcomes co-owned by both parties. Researchers participating in this project can gain learning, practical experience, and authorship records, and may reference or discuss the model, but do not directly own the final outcomes

From Novels to Movies, It Is not Only the Transformation ——An Experimental Study on the from Texts to Images Processing Mode of Thinking

在大学英语教学中,视听化多媒体教材利用多通道对信息进行加工,提高了课堂教学效率。但是,长期的视听化教学对语言思维和写作可能造成消极的影响。通过对深度文本阅读和观看影像两种教学方式进行实验性比较,初步发现:过度依赖影像资料可能会弱化学生对文字的想象加工;如果缺乏系统深入的语言文本学习,阅读和写作能力难以得到提升。而深度文本阅读可激发学生的批判性思维,表现为写作中的严谨规范和语言的准确性。</p

Investigation on specialized care delivered in diabetes outpatient clinic

目的了解糖尿病专科护理门诊现况,为优化流程提供依据。方法采用自制糖尿病专科护理门诊患者满意度问卷对在糖尿病专科护理门诊就诊的200例患者进行调查;对4名糖尿病专科护士进行现场观察与访谈了解工作现况。结果患者满意度总体均分为(4.21±0.49)分,6个维度评分(3.45±0.78)~(4.36±0.64)分;专科门诊护理内容包括健康教育、胰岛素笔使用、检测血糖等13项,每个工作日实施0~48.00次;患者等待就诊时间(14.69±8.00)MIn。专科护理访谈提炼出工作职责不明确、工作时间未建立预约制、门诊导诊护士配合欠佳及患者健康档案登记欠全面4个主题。结论患者对糖尿病专科护理门诊就诊流程和就诊时间等方面满意度较低,专科护士健康教育工作受到影响,应改进流程,以促进健康教育的效果,提高患者满意度。Objective To explore the specialized care delivered in diabetes outpatient clinic,to provide references for further improvement.Methods A total of 200 patients with diabetes were surveyed using a self-developed questionnaire,and 4 diabetes specialist nurses were observed and interviewed about their work.Results The average overall satisfaction score of the patients was(4.21±0.49),with the scores of six dimensions ranging from(3.45±0.78)to(4.36±0.64).The contents of diabetes nursing care in out patient clinic covered 13 items,such as health education,giving guidance about how to use an insulin pen,measuring blood sugar and so on.The frequency of those items conducted ranged from 0 to 48.00 times each day and patient waiting time was(14.69±8.00)min on the average.The interview found 4 problems,including ambiguity of responsibilities of specialty nurses,lack of appointment system,poor cooperation between triage and specialty nurses and incompleteness of the health data about patients.Conclusion Patients′satisfaction levels about waiting time and clinic procedure are low,which impacts the health education implementation.In order to promote patients′satisfaction and improve the health education,better clinic procedures should be explored.厦门市科技局资助科研立项课题(3502Z20124056