With the development of the human society, people have come to pay more and more attention not only to their life quality but also to the quality of their life before death. Hence the emergence of hospice. At present there are three types of hospice in China: the family type, the general hospital type, and the special institution type. Each of these types has its own shortcomings. Hence the need for social work to intervene in hospice. The paper discusses the viability and necessity of the intervention through the notion, channels and methods of intervention. The role of social workers in hospice is also discussed.

Objective To explore the effect of microRNA‐21(miR‐21) on the migration and invasion ability in human laryn‐geal squamous carcinoma cell Hep2 .Methods The MTT method was used to detect the viability of Hep2 cells at 48 h after miR‐21 inhibitor and miR‐21 NC transferring into Hep2 cells by LipofectamineTM 2000 .The cell migration ability was detected by using the scratch test .The cell invasion ability was detected by using the Transwell method .The activation of phosphatase and tensin homo‐logue deleted on chromosome 10 (PTEN)/phosphatidylinositol 3 kinase (PI3K) /protein kinase B(Akt) signal pathway and the expression of matrix metalloproteinase 2 (MMP2) ,MMP9 ,reversion inducing cysteine rich protein with kazal motif (RECK) was detected by using the Western blotting .Results Compared with miR‐21 NC ,miR‐21 inhibitor could significantly reduce the Hep2 cellviability[(0.688±0.043)vs.(0.375±0.012)],inhibitedthemigrationability[(6.57±0.02)μm vs.(20.49±2.18)μm]and invasion ability[(100 .7 ± 10 .2) vs .(46 .8 ± 4 .3)] ,and the differences were statistically significant (P<0 .01) ,meanwhile miR‐21 inhibitor could down‐regulate the expression of PI3K ,MMP2 and MMP9(P<0 .01) ,and reduced the phosphorylation level of Akt (P<0 .01) ,up‐regulated the expression of PTEN and RECK (P<0 .01) .Conclusion miR‐21 inhibitor can significantly suppress the migration and invasion ability of Hep2 ,which may be related with the PTEN/PI3K/Akt signal pathway .

Acute Coronary Syndrome ; therapy ; Drugs, Chinese Herbal ; therapeutic use ; Humans ; Medicine, Chinese Traditional ; Phytotherapy

Objective To figure out the preliminary clinical value of real-time three-dimensional echocardiography(RT-3DE) in evaluating the systolic dyssynchrony in patients with coronary artery heart disease(CAD).Methods Eighty patients who were suspected as CAD were included in this study.RT-3DE was performed first.After the analysis,we got the data:ejection fraction (EF),16 segments systolic dyssynchronic index (SDI 16).All subjects should take the coronary angiography.According to coronary angiography results,the patients with the vascular stenosis rate ≥50% were defined as the CAD group,and the patients with the vascular stenosis rate <50% were defined as the coronary atherosclerosis group,the patients with the completely normal angiographic results were included in the control group according to the results of angiography.The parametric differences among the groups were compared.Results There was no significant difference in LVEF among the three groups.SDI 16 had no significant difference between the control group and the coronary atherosclerosis group (t=-1.03,P>0.05).However,SDI 16 had significant difference between the control group[(3.72±2.68)%]and the CAD group[(7.14±3.10)%],the same between coronary atherosclerosis group[(5.12±3.46)%]and the CAD group[(7.14±3.10)%](t=-3.71,-2.34,all P<0.05).ROC curve analysis revealed that a cut-off value for SDI of 5.49%,yielded a sensitivity of 81.8%,with a specificity of 73.1% to predict coronary atherosclerosis to CAD(AUC=0.743).Conclusion SDI 16 >5.49% has a higher value in evaluating systolic dyssynchrony in patients with CAD with RT-3D of Siemens Acuson SC2000 ultrasonic diagnostic instrument.

Objective To investigate the clinical therapeutic effect of Chaishi fever particles on patients with epidemic encephalitis B and to study the machanism of anti-inflammatory.Methods One hundred and twenty one patients with epidemic encephalitis B admitted to the Second Clinical Medical College of Henan University of Chinese Medicine from January 2014 to May 2017 were enrolled, and they were divided into a routine treatment group (60 cases) and a traditional Chinese medicine (TCM) treatment group (61 cases) by random number table. The patients in routine treatment group were given symptomatic support and comprehensive treatment for 15 days, while those in the TCM treatment group were given as that of routine group with the addition of Chaishi fever particles 8 g, 4 times every day, orally taken for consecutive 15 days. The levels of tumor necrosis factor-α (TNF-α), interleukin (IL-1β, IL-10) in the serum of two groups were determined by enzyme-linked immunosorbent assay (ELISA), and the clinical therapeutic effect, complications and sequelae in two groups after treatment were observed.Results Compared with the routine treatment group, after treatment the time of body temperature recovering normal (days: 5.8±1.2 vs. 7.5±1.7), the coma time (days: 5.5±1.3 vs. 6.8±1.6), the remission time of convulsion (days: 5.2±1.4 vs. 6.5±1.5), and the length of stay in hospital (days: 22.6±1.9 vs. 25.2±1.8 ) were significantly shorter in TCM treatment group (P < 0.05). After treatment, the levels of serum tumor TNF-α and IL-1β were decreased, IL-10 was increased in both groups, moreover, compared with the routine treatment group, the changes were more obvious in TCM treatment group [TNF-α (μg/L): 11.4±3.6 vs. 14.6±3.5, IL-1β (μg/L): 22.3±6.2 vs. 26.2±5.6, IL-10 (μg/L): 225.2±19.2 vs. 186.2±21.5, allP < 0.05]. In addition, compared with the routine treatment group, the total effective rate was higher [98.3% (60/61) vs. 90.0% (54/60),P < 0.05], and the incidence of sequelae was lower [1.64% (1/61) vs. 13.3% (8/60),P < 0.05] in TCM treatment group.Conclusion The Chaishi fever particles can effectively treat the patients with epidemic encephalitis B and the action is related to the inhibition of inflammatory reaction.

Objective To verify the relationship between personality traits and clinical nurse competence in five third-A level hospitals in Shenyang. Methods A total of 1559 clinical nurses from five tertiary-level hospitals in Shenyang were recruited into this study. Two self-report questionnaires, the Nurse Competence Scale (NCS) and the Tridimensional Personality Questionnaire (TPQ), were used to collect data. Results The average score of NCS was 71.97 ± 13.25.Nursing competence increased with the increase of working years (β=0.272, P<0.01) and RD (β=0.134, P<0.01). Practicing nurses with the lower HA appear to have a higher level of competence (β=-0.117, P<0.01). Conclusions The overall level of nurses' competencies good in third-A level hospitals in Shenyang. The predicting factors of nursing competence are work experience, HA and RD. More psychological courses should be provided in fundamental nursing education and continuing nursing education for helping nurses shape their good personality traits.

OBJECTIVE:To explore the ideas for the prescription comment of TCM injections,and provide reference for clini-cal rational use. METHODS:Totally 9 457 prescriptions in PIVAS and 400 hospitalized medical records in our hospital in 2015 were collected. The prescriptions and hospitalized medical records which contained TCM injections were retrospectively commented in aspects of indications,usage and dosage,drug combination,solvent selection and repeat medication,and analysis of typical case. RESULTS:In 2015,there were 2 544 prescriptions(26.90%)in PIVAS and 195 medical records(48.75%)that used TCM injections;the irrational use was mainly inappropriate solvent selection(50.70%),inappropriate usage and dosage(27.00%),inap-propriate indications (10.33%),inappropriate combination therapy (7.51%) and repeat medication (4.46%). CONCLUSIONS:Prescription of TCM injections should be commented with the medical records and individual analyzed;in terms of unreasonable prescriptions and medical records TCM clinical pharmacists should actively intervene unreasonable prescriptions by the bed.

Targeting the common fact that colleges and universities of traditional Chinese medicine neglect management post practice,are lack of cutting-edge,cross-disciplinary and methodological courses,fail to reflect the traditional Chinese medicine's singularity and update courses slowly during the process of cultivating their graduate students,Heilongjiang University of Chinese Medicine innovates its culture system of graduate student in related major.It is also devoted to developing problem-based learning,introducing bitutor system,reforming course system,which may hopefully improve their graduate students' innovative thoughts and abilities,strengthen their innovative knowledge theory system to finally discover an appropriate reform model for the culture system which can be perfectly replicable.

Objective To investigate the effects of high-flux hemodialysis (HFD) on fibroblast growth factor-23 (FGF-23) levels in maintenance hemodialysis (MHD) patients and its clinical significance.Methods Sixty uremia patients were divided into HFD group and hemodialysis (HD)group and observed for 12 months.Flow mediated dilation (FMD),cardiac ultrasonography,levels of FGF-23,serum phosphorus,serum calcium,25-(OH)D3,parathyroid hormone (PTH),homocysteine (Hcy) and interleukin-6 (IL-6) were tested in all patients before and after treatment.The correlation of above indexes were analyzed.Results No statistical difference were found in primary disease,age and duration of dialysis in two groups.The levels of FGF-23 [(56.07±26.63) vs (85.53±40.54) ng/L,P ＜0.01],IL-6 [(3.37±2.48) vs (5.59±2.53) ng/L,P ＜ 0.05] and Hcy [(21.13±6.95) vs (29.40±11.66) μmol/L,P ＜ 0.05] decreased and FMD,25-(OH)D3 [(27.3± 10.26) vs (23.15± 10.73) μg/L,P ＜ 0.05] increased significantly after the treatment of HFD.There were no significant changes in the HD group.The baseline FMD was negatively correlated with FGF-23 (r =-0.413,P ＜ 0.05) and Hcy (r =-0.301,P ＜0.05).The baseline LVMI was correlated with FGF-23 (r =0.464 P ＜ 0.05).After one year's trearmeat of HFD,the changes of FMD(/△ FMD) was negatively correlated with the changes of FGF-23 (/△ FGF-23)(r =-0.347,P ＜ 0.05).Conclusions HFD can improve FMD and decrease FGF-23 levels.The improvement of FMD may be related to the decreased level of FGF-23.The effect of FGF-23 on FMD should be independent of serum phosphate.

ABSTRACT:Objective To investigate the regulation of adenovirus type 36 infection on precursor protein particles progranulin expression in Uygur obese patients.Methods Based on the diagnostic criteria of obesity,the samples were divided into obese group and non-obese group.Serum neutralization test was used to detect the antibody of Ad36.The progranulin mRNA expressions in abdominal omental and subcutaneous adipose tissues were detected by real-time quantitative PCR.ELISA method was used to determine serum progranulin protein levels. CD68 protein expression of macrophage was detected by immunohistochemistry. Results ① In the Uygur population of our study,compared with that in the non-obese group (38/1 1 7,32.5%),the number of obese patients (54/1 1 5,47.0%)infected with Ad36 was significantly higher than that in non-obese group (P <0.05 ).② Serum progranulin was significantly increased in the Ad36-infected obese group (408.45±1 56.92)than in non-obese group (326.1 1±1 58.60)(P <0.05).The mRNA expression of progranulin did not differ between the two groups.③ The macrophage infiltration was significantly higher in the Ad36-infected obese group (14 730.1 6 ± 2 227.39 )than in non-obese group (10 786.50 ± 2 772.80 )(P < 0.05 ).Conclusion Ad36 infection may be associated with the occurrence of obesity in Uygur population,and adenovirus type 36 infection may regulate the expression of serum progranulin at the protein level.