• Journals

除臭方案對腸造口病人消除氣味、生活品質和社會調適之成效：系統性文獻回顧

本系統性文獻回顧目的是在彙整目前最佳證據，以佐證除臭方案對腸造口病人消除氣味的成效，提供最佳照護依據。搜尋台灣博碩士論文網、華藝線上圖書館、PubMed、Cochrane Library、EMBASE、EBSCO和ProQuest Nursing Allied Health，年限設為2023年8月前。以PICO模式建立中英關鍵字，P為結腸造口、迴腸造口、腸造口；I為除臭劑、活性炭、精油；C為常規照護或其他措施；O為消除氣味、生活品質和社會調適，篩選實驗性研究，品質評估以JBI實證品質工具評估。三篇證據等級評等為Level 1.c-2.d，共74人腸造口病人，結果顯示使用薰衣草精油、10%大千層精油或帶沖洗閥門的造口袋，能消除氣味，提升生活品質和社會調適，證據力顯薄弱，但考量其無顯著不良事件，以及台灣未進口10%大千層精油和帶沖洗閥門的造口袋，因此建議在病人更換造口袋時，滴入10滴薰衣草精油入袋中，未來仍需更多研究探討除臭措施有效性。

• Journals

醫學與多元文化的對話－臺灣醫學人文教育之文化能力2.0的孕育

面對社會變遷中多元文化的趨勢與發展，當代醫療服務已無法迴避病人各種多樣的文化背景。同樣地，醫學教育者必須肩負培育醫療照護者之責任，才能妥善並適時回應病人的醫療照護需求，本文目的是藉由醫學與多元文化的對話孕育出的多元文化醫學教育。介紹與時俱進的醫學人文教育，闡明多元文化醫學教育批判與反思的思維，所要培育醫學生的文化能力2.0課程。同時比較傳統醫學教育的文化能力與文化能力2.0的異同與補足關係。最後展望臺灣多元文化醫學教育之啓航與前㬌，思索文化能力2.0可使醫學生，活躍在醫學與人文之間之可能。

• Journals

運動激素對健康的影響

運動能改善新陳代謝，對健康有益，並能促進許多器官釋放胜肽、代謝物和RNA物種進入血流，這類分子物質被稱為運動激素。其中以脂肪激素和肌激素常具有抗發炎功效，能減少許多慢性疾病，如第II型糖尿病、血管粥狀硬化、癌症、肌少症、骨質疏鬆症等。運動激素可能經運動後產生，因其可能作為器官間和全身性功能協調重要的媒介物，故有助於健康。

• Journals

A Correlational Study of Self-Perceived Competence and Objective Assessment of Evidence-Based Medicine Skills among Post-Baccalaureate Medical Students

Objective: To investigate the correlation between self-perceived competence of evidence-based medicine (EBM) and an objectively measured competence using the Assessing Competence in Evidence-Based Medicine (ACE) tool in post-baccalaureate medical students. Methods: A cross-sectional study involving 61 post-baccalaureate third-year medical students was conducted. A questionnaire with 10 questions consisting of 22 discrete items was used to assess students' self-perceived EBM competence, and their EBM skills were objectively assessed using the ACE tool. The correlation between self-perceived competence, scores of ACE tool, and final EBM academic score was analyzed. We also examined the effect of EBM teaching experience and clinical exposure on EBM competence and attitude. Results: Forty students (65.6%) responded to the self-perceived competence questionnaire, and all of the 61 students completed ACE tool assessment. Three-quarters of the students reported that they had received formal training in literature search and critical appraisal of research article. A substantial number of students reported little observation of EBM in clinical settings. There was no correlation between the students' self-rating competence and their true performance. A moderate correlation was observed between the overall ACE score and final EBM academic score. There was no statistical difference in overall EBM competence between students who reported to have opportunity in participating EBM process in clinical setting versus who did not. Conclusion: This study showed that our students perceived themselves as moderately competent in EBM skills, which was not correlated well with their competence measured objectively using ACE tool.

• Journals

薑黃素－朝鮮薊－褐藻糖膠複方製劑對H_2O_2誘發Hep-G2人類肝癌細胞氧化傷害之保護作用

目的：肝臟為是人體內一個重要的器官，日常的保養是不可或缺的。本研究將薑黃素、朝鮮薊、褐藻糖膠依特定比例合成一種複方製劑（CSF）並探討其對H_2O_2誘發Hep-G2人類肝癌細胞氧化傷害之保護作用。方法：探討CSF對H_2O_2所造成Hep-G2細胞氧化傷害的保護效果，並進行細胞存活率、細胞週期、Annexin V/PI、DAPI、ROS活性及細胞內抗氧化酵素活性之研究。結果：細胞存活率的結果顯示，25ppm的CSF對Hep-G2的存活率約為98.5%±1.3%，經過300μM H_2O_2處理後，Hep-G2的存活率為51.7%±1.4%，而在25ppm CSF的保護下，細胞存活率可回復至84.4%±0.2%。細胞週期的結果顯示，在H_2O_2處理下會增加Sub-G1細胞的比例，在CSF的保護下則有下降的趨勢。Annexin V/PI的結果顯示，經過H_2O_2處理後，活細胞下降至58.1%±1.6%，而在CSF的保護下活細胞則可增加至68.8%±0.5%。藉由DAPI染色、ROS的產生量、抗氧化酵素（SOD1、GPx1和GST）的產生量等結果亦可發現CSF對H2O2誘發Hep-G2氧化傷害具有良好的保護效果。結論：CSF可以在低劑量（約25ppm）下降低H_2O_2對Hep-G2細胞造成的氧化壓力，後續可將CSF開發成為具有護肝功效的保健食品素材。

• Journals

探討COVID-19期間曾接受過畢業後護理培訓計畫人員的自我效能及其情緒特質的關聯性

目的：本研究旨在了解在COVID-19爆發期間護理人員畢業後培訓計畫（NPGY）的自我效能及影響因素。方法：採橫斷式研究設計；以簡單隨機抽樣法，選取南部某區域教學醫院護理人員為對象。使用自我效能量表及情緒特質量表等對受過NPGY訓練的護理人員進行調查。結果：共收集有效問卷188份；以逐步迴歸分析重要影響因子。結果顯示，正向情緒與負向情緒為影響NPGY同仁自我效能的主要影響因子，可有效預測自我效能（F=38.62, p<.001），解釋變異量為28.7%；正向情緒越好者，自我效能愈好，負向情緒分數越高者，自我效能愈差。結論：因應COVID-19大流行或新興傳染病爆發時，情緒特徵及照護經驗可能對NPGY的個人自我效能產生積極影響。

• Journals

Belimumab Treatment in Systemic Lupus Erythematosus Patients with Lupus Nephritis That Requires Hemodialysis: A Case Report

Systemic lupus erythematosus (SLE) often leads to lupus nephritis (LN), with up to 10% of LN cases progressing to advanced chronic kidney disease that requires renal replacement therapy RRT. Patients under RRT experience non-renal SLE activity that can increase mortality if left untreated. Treatment options for SLE with severe active LN lack evidence-based guidance, due to drug toxicity from common medications. Belimumab, an FDA-approved antibody targeting B-cell activating factor (BAFF), shows promise in SLE treatment by inhibiting B-cell survival. While recommended for LN patients with eGFR > 30ml/min, research on belimumab's efficacy and safety in severe renal disease requiring RRT is limited, with no reported cases from Taiwan. We present a case of a 45-year-old female with long-standing SLE and LN progressing rapidly to severe renal disease necessitating hemodialysis, to whom belimumab was initiated post-hemodialysis onset.