From the perspective of humanistic care,the article explores the dilemmas and misunderstandings in the treatment of patients with terminal cancer,and states great significance to develop palliative treatment and hospice service.The importance to establish the center for pain prevention and hospice care hospital for patients with terminal cancer is also clarified so as to improve the quality of their life.The development of palliative care and hospitalpice service also plays an active role in the establishment of a harmonious society in Hunan province.It is also called for to include the education of proper values on death as a part of public education.

Objective To investigate the relationship between serum adipocyte fatty acid binding protein (FABP4),insulin resistance and maternal complications in patients with gestational diabetes mellitus (GDM) with satisfactory glucose control.Methods 60 cases of pregnancy between 24 and 28 weeks of OGTT diagnosed GDM pregnant women were selected.30 cases with satisfactory blood sugar control were selected as satisfactory blood sugar control group,30 cases with unsatisfied blood sugar control were selected as unsatisfied blood glucose control group.Healthy control group was selected from 24 to 28 weeks of healthy pregnancy in 30 patients.Fasting serum FABP4,fasting blood glucose(FPG) and fasting insulin(FINS) were measured in three groups of pregnant women after 24 to 28 weeks and pregnant term.To calculate the insulin resistance index (HOMA-IR) of the steady state model,and record and observe the complications of the three groups.Results In the satisfactory blood glucose control group,the incidence rates of pregnant hypertensive disorders,excessive amniotic fluid,premature rupture of membranes,postpartum hemorrhage,cesarean section,macrosomia,neonatal asphyxia,neonatal hypoglycemia,hyperbilirubinemia of newborn were 10.0％,6.7％,13.3％,6.7％,23.3％,16.7％,10.0％,16.7％,10.0％,which were significantly lower than those in the unsatisfied blood glucose control group (23.3％,20.0％,23.3％,16.7％,33.3％,33.3％,20.0％,30.0％,36.7％),the two groups had significant differences(x2 =4.33,6.12,6.01,3.97,7.41,5.46,10.02,4.79,9.22,all P ＜ 0.05).The incidence rates of pregnant hypertensive disorders,excessive amniotic fluid,macrosomia between the satisfactory blood glucose control group (10.0％,6.7％,16.7％) and healthy control group(3.3％,0.0％,6.7％) had statistically significant differences (x2 =7.45,8.46,4.69,all P ＜ 0.05).The incidence rates of postpartum hemorrhage,premature rupture of membranes,cesarean section,neonatal asphyxia,neonatal hypoglycemia,neonatal hyperbilirubinemia between the satisfactory blood glucose control group (6.7％,13.3％,23.3％,10.0％,16.7％,10.0％) and healthy control group(10.0％,10.0％,20.0％,6.7％,13.3％,3.3％) had no statistically significant differences (all P ＞ 0.05).Pregnant 24 ～ 28 weeks,FABP4,FINS,FPG and HOMA-IR of the satisfactory blood glucose control group were (1.78 ± 0.33) ng/mL,(12.35 ± 0.48) mIU/L,(5.51 ± 0.96) rmmol/L,(3.88 ± 0.55),which of the unsatisfied blood glucose control group were (2.36 ± 0.08) ng/mL,(13.92 ± 1.17) mIU/L,(5.46 ±0.74)mmol/L,(3.95 ± 1.17),the differences between the two groups were not statistically significant (all P ＞ 0.05),and compared with the healthy control group,the differences were statistically significant(t =15.32,10.36,11.54,7.34,all P ＜ 0.05).After term pregnancy,the FINS,HOMA-IR of the satisfactory blood glucose control group were still higher than those in the healthy control group,the differences were statistically significant(all P ＜ 0.05).However,FABP4,FPG between the satisfactory blood glucose control group and healthy control group had no statistically significant differences (all P ＞ 0.05).Conclusion With the control of blood glucose levels,decreased in patients with GDM FABP4,fasting blood glucose,glycosylated hemoglobin level,but high insulin resistance still persists and glycemic control satisfaction does not completely reduced the occurrence of the complications in both mothers and neonates.

Objective To explore the invasion effect of CXCR3 overexpression on T lymphoblastic leukemia (Jurkat cells) with chemokine receptors. Methods Mouse CXCR3 was amplified by RT-PCR and overexpressing CXCR3 lentivirus carrying GFP&Puromycin (puro) was constructed. CXCR3 expression on infected Jurkat cells surface was detected by FCM. Constructed cells were seeded in Transwell invasion model to study whether CXCR3 overexpression would increase the invasion or not. Results GFP expression on Jurkat cells was less than 10% after 96 h lentivirus infection. CXCR3 expression was 90% higher than vector group , and GFP expression reached 90% after screening. Therefore, Jurkat cells with stable overexpression of CXCR3 were successfully constructed. Invasion rate of Jurkat CXCR3 cells was [(12.71 ± 1.03)%], which was significant higher than that of vector control group [(6.82 ± 0.49)%], (P < 0.0001). Conclusions CXCR3 expression on leukemia cells is closely associated with leukemia invasion. The increase of CXCR3 expression can enhance the invasion of leukemia cells, and may be one of the mechanisms of T lymphoblastic leukemia invasion.

Aim To study the effect of diazoxide on the apoptosis of PC12 cells induced by oxygen-glucose deprivation(OGD)and expression of Bcl-2 protein.Methods Cultured PC12 cells,treated with OGD,diazoxide and 5-HD,were divided into A(control group),B(OGD group),C(OGD+diazoxide group)and D(OGD+diazoxide+5-HD group).Neuronal apoptosis was detected by Annexin V-FITC/PI double-dyed flow cytometry,and the expression of Bcl-2 protein was detected by immunofluorescence and Western blot.Results The number of apoptotic PC12 cells increased after OGD in B,C,D group.C group and B,D groups were significantly different(P

Objective To explore the differential liver plasma membrane (PM) proteins that may be related to the occurrence,development and reversal process of hepatitis and to understand the pathogenesis of hepatitis and the new drug targets by performing a comparative proteomics research of liver PM between hepatitis B surface antigen (HBsAg) transgenic mice and wild-type C57 mice.Methods A 6-month-old HBsAg transgenic mouse model was established.The pathological examination was performed to observe the pathological changes of transgenic mice and wild-type C57 mice.The PM from liver tissue of 6-month-old transgenic mouse and the control mouse were purified through twice sucrose density grade centrifugation combined with second antibody magnetic bead enrichment.The purity of extracted PM was verified by Western blot.Differential proteome expression analysis was performed by using two-dimensional electrophoresis (2-DE) and ImageMaster software analysis.The differentially expressed proteins were lysed by trypsin and identified by liquid chromatography combined with tandem mass spectrometry (LC-MS/MS) analysis.Results The pathological examination results showed that hepatitis was observed in the transgenic mouse group,while no abnormity was found in the controls.The PM was successfully enriched and the mitochondria contamination was reduced by sucrose density grade centrifugation combined with second antibody magnetic bead purification treatment.Thirty differential mice liver PM protein spots were visualized,in which 11 non-redundant proteins were successfully identified by LC-MS/MS in transgenic mouse group,including 9 up regulated protein spots and 2 down-regulated protein spots.These differentially expressed proteins included keratin,cardiac Ca2+ release channel,cytochrome B5,ATP synthase subunit alpha,etc.Conclusions A batch of HBsAg gene expression related differential proteins are identified in mouse liver plasma.These proteins might be new drug targets for anti-HBV treatment.This study will guide further investigation on the mechanism of HBV infection induced hepatitis.

AIM:To study the expression level of S100 calcium-binding protein A4 (S100A4) in synovial tissue of the knee joint in rheumatoid arthritis (RA) patients and normal persons, and the effect of S100A4 on the angiogenesis induced by rheumatoid arthritis fibroblast-like synoviocytes (RAFLSs).METHODS:The synovial tissue was taken from the knee joint of the RA patients (RA group) and the normal persons (control group).The protein expression of S100A4 and vascular endothelial growth factor (VEGF) in the synovial tissue of the 2 groups was observed by immunohistochemistry.RAFLSs were isolated from synovial tissue of patients with active RA.ELISA was used to detect the effect of S100A4 on the secretion of VEGF by RAFLSs.The effect of S100A4 on the angiogenesis of HUVECs cultured with conditioned medium from RAFLSs was also detected.RESULTS:The protein of S100A4 and VEGF was highly expressed in the synovial tissues of RA group (P<0.05).rhS100A4 significantly stimulated the secretion of VEGF in RAFLSs in a time-and dose-dependent manner (P<0.05).Cultured with conditioned medium from RAFLSs, rhS100A4 significantly promoted HUVECs to form tube-like structures in vitro.CONCLUSION:S100A4 protein is highly expressed in synovial tissue of the knee joint in RA patients, and S100A4 stimulates synovial angiogenesis by promoting RAFLSs to generate VEGF, indicating that S100A4 may be used as a potential target for the treatment of RA.

Objective To develop a portable pressure detector to facilitate the battlefield self and buddy aids training for dressing,hemostasis and fixation.Methods The changes of pressure were converted into the ones of electric current with the pneumatic cuff,catheter and membrane pressure sensor,and then transmitted to the panel display by Bluetooth.The efficacy for the training was determined based on the acquired data.Results The detector implemented quantifying of the pressures during dressing,hemostasis and fixation,and non-medical staff obtained the results of battlefield treatment training easily to execute rapid assessment of battlefield self and buddy aids training.Conclusion The device gains advantages in visualized data,portability,easy operation and accurate measurement,and contributes to battlefield self and buddy aids training.

Objective To investigate the risk factors of reversible posterior leukoencephalopathy syndrome (RPLS) in pre-eclampsia or eclampsia gravida. Methods This study was conducted in the Third Affiliated Hospital of Guangzhou Medical University between January 2013 and March 2016. A total of 100 patients who had no severe neurological diseases and were diagnosed pre-eclampsia or eclampsia, and underwent brain MRI were collected retrospectively. They were divided into 2 groups according to the MRI results, the RPLS group (n=49) and the non-RPLS group (n=51). The medical history, clinical symptoms and the results of laboratory examination were analyzed by the logistic regression, in order to explore the risk factors.Results In single factor analysis, HELLP syndrome, pregnancy associated with other diseases, poor prenatal care, grade 3 hypertension, elevated systolic blood pressure or diastolic blood pressure, elevated WBC, aspartate transaminase (AST), alanine aminotransferase (ALT), uric acid (UA) and lactate dehydrogenase (LDH), decreased platelet (PLT), headache, visual changes, seizures and conscious disturbance were more frequent in the RPLS group than those in the non-RPLS group (all P<0.05). According to the multivariate logistic regression analysis, the elevated WBC (OR=1.291, 95%CI:1.058-1.575, P=0.012), UA (OR=1.008,95%CI:1.001-1.016,P=0.032) and headache (OR=18.260, 95%CI:3.562- 93.607, P=0.000) were the independent risk factors.Conclusions Maternal history, clinical symptoms and some laboratory examinations might help in the early diagnosis of RPLS in pre-eclampsia or eclampsia gravida. Headache, the elevation of WBC and UA were the most significant factors.

AIM: To explore the effect of TNF-related apoptosis inducing ligand (TRAIL), a new apoptotic inducing molecule on the biological activity of hepatocarcinoma cell line. METHODS: The expression of membrane binding TRAIL on HepG2 cells was detected by immuno-cytochemistry. Quantity of secretory TRAIL was assayed by ELISA method. The cytotoxicity and apoptosis induced by TRAIL was detected by MTT and TUNEL method, respectively. The telomerase activity of HepG2 cells was detected by TRAP-PCR assay kit. The expression of hTERT, the catalytic subunit of telomerase, was detected by FCM. RESULTS: TRAIL was constitutively expressed on the membrane of HepG2 cell line. Soluble TRAIL was also expressed to a certain degree. Cytotoxicity assay showed that TRAIL significantly inhibited the growth of hepatocarcinoma cells. TUNEL assay indicated that TRAIL induced apoptosis in hepatocarcinoma cells. Detection of telomerase activity showed that TRAIL inhibited telomerase activity and the expression of telomerase catalytic subunit. CONCLUSION: TRAIL is an effective molecule to inhibit the growth of hepatocarcinoma through multiple pathways, such as inducing apoptosis and inhibiting the activity of telomerase.

Objective: To explore the peri-operative application of GLP-1 analogue and insulin on myocardial perfusion and clinical prognosis in patients of acute ST segment elevation myocardial infarction (STEMI) with stress-induced hyperglycemia. Methods: Our research was a prospective single center randomized control study. A total of 114 consecutive STEMI patients received percutaneous coronary intervention (PCI) within 12h of onset were enrolled, the patients had no diabetes while blood glucose ≥11.1mmol/L at immediate admission. Based on random number table, the patients were divided into 2 groups: Observation group, the patients received GLP-1 analogue, n=59 and Control group, the patients received insulin, n=55. The post-operative myocardial perfusion, indicators of myocardial damage and cardiac function, myocardial infarct area (MIA) and myocardial salvage index (MSI) were compared between 2 groups. The patients were followed-up for 6 months to record the incidence of major adverse cardiovascular events (MACE). Results: At peri-operative period, compared with Control group, Observation group had decreased peak values of creatine kinase isoenzyme (CK-MB) and troponin T (cTnT), P<0.05. At 6 months post-operation, compared with Control group, Observation group showed increased myocardial perfusion and left ventricular ejection fraction (LVEF), P<0.05, reduced MIA (15±12) g vs (20±14) g, P<0.05 and 12% elevated MSI as (0.64±0.13) vs (0.56±0.12), P<0.001. The MACE incidence was similar between 2 groups, P=0.217. Conclusion: In STEMI patients with stress-induced hyperglycemia, peri-operative application of GLP-1 analogue may safely regulate blood glucose, improve cardiac perfusion and function, reduce MIA; while it had no influence on myocardial perfusion at peri-operative period and no impact on MACE occurrence at 6 months post-operation.