By reviewing the latest published papers on palliative care, the article discussed the development and research progress of palliative care for people with advanced cancer, so as to provide reference for the development of palliative care specialty. According to the analysis, it suggested that by means of striving for more government support in both economic and education, raising funds through various channels, perfecting the social insurance system and volunteer′s regimen, promoting group working model, establishing standardized policies and regulations, increasing the publicity of palliative care, palliative care would move forward to a professional and normalized road, so that the people with incurable disease will receive better palliative care to improve the quality of life to the most.

Objective·To investigate the role and mechanism of CaMKKβ in RAW264.7 macrophage M2 polarization induced by interleukin-4 (IL-4).Methods·IL-4 induced RAW264.7 polarization was measured by RT-PCR and ELISA.Western blotting was used to analyze the total and phosphorylated protein levels of CaMKKβ,AMPK,JAK2 and STAT3 during polarization.A lentiviral vector carrying an shRNA targeting the CaMKKβ gene was successfully constructed.The expression of M1 and M2 markers and the expression of phosphorylated AMPK,JAK2,STAT3 were detected by RT-PCR and Western blotting respectively.The protein activity ofAMPK,JAK2 and STAT3 were selectively blocked,and then the effect of IL-4 on macrophage polarization was detected by RT-PCR.Results·IL-4 significantly polarized RAW264.7 cells towards M2 macrophages (P＜0.05),and the phosphorylated protein expression of CaMKKβ,AMPK,JAK2,STAT3 was significantly increased (all P＜0.05).The expression of M2 markers induced by IL-4 was decreased and the phosphorylation ofAMPK,JAK2 and STAT3 was also decreased after knockdown of CaMKKβ by shRNA (all P＜0.05).The polarization of macrophages to M2 was decreased after the activities of AMPK,JAK2 and STAT3 proteins were blocked respectively (all P＜0.05).Conclusion·CaMKKβ promotes IL-4 induced M2 macrophage polarization via activation of AMPK/JAK2/STAT3 pathway.

Aqueous extract of Dracocephalum tanguticum Maxim. (DtM ),when given ig or ip to experimental hypoxia mice,markedly increased their tolerance to normobaric and hypobaric hypoxia. Erythrocyte superoxide dismutasc (SOD ) activity of mice or rats determined at high altitude (animaquing mountain 4700 m above sea level ) showed an elevated dismutation activity of peroxide anions. At an experimentally simulatcd altitude of 6000 m above sea level,determunation of MDA, Hb and Hct showed an obvious reduction of all the abnormally elevated criteria. It is suggested that the antihypoxia activity of DTM may be partly due to its free radical scavenging activity

Objective:To screen the optimal formula and technology of demethoxycurcumin nano-structured lipid carriers. Meth-ods:The encapsulation efficiency as the main investigation index, the single factor exploration and orthogonal design were used to study the main factors affecting the quality of the nanoparticles. The optimal formula and technology were obtained. Results:The optimized parameters were as follows:the ratio of drug to lipid materials was 1 ∶40, the ratio of liquid lipid to total lipid materials was 10%, the amount of surfactants was 4% and the amount of lecithin was 2%. The prepared nanoparticles were spheric and regular. The size dis-tribution of the nanoparticles was narrow with the average particle size of 110nm and PDI of 0. 199. Conclusion:The optimized formula and technology of demethoxycurcumin nano-structured lipid carriers are stable and practicable,which provide reference for the further research of demethoxycurcumin.

Objective To investigate the interaction between uropathogenic Escherichia coli (UPEC) and host uroepithelial cells, define the role uroepithelial cells play in initiating and modulating the host response to infection with UPEC strain. Methods The human bladder transitional epithelial EJ cells were evaluated for their capacities to allow the adherence and invasion by UPEC132, a clinical strain isolated from Tianjin, China, and a cDNA microarray for 22 000 human genes was used to identify the gene expression differences between EJ cells infected with UPEC132 and uninfected EJ cells. Results Microscope observation showed that UPEC132 could adhere to EJ cells with the adherence rate of (73.20 ± 5.26)%. And visualization by confocal microscope revealed that this microorganism could be seen within the cells. EJ cells infected with UPEC132 changed mRNA expression of a total of 29 genes, including 28 genes up-regulated and 1 gene down-regulated. Of these, regulators of growth and proliferation, cytokines, and modulators of apoptotic responses were the most prominent. Conclusion The gene expression profiling of EJ cells is affected by the infection of UPEC strain. The differentially expressed genes may contribute to further investigate the interaction of UPEC and uroepithelial cells.

Objective To investigate the effects of berberine on cholesterol efflux in THP-1 macrophage derived foam cells, and explore the possible mechanism. Methods HP-1 cells were induced into macrophages by phorbol myristate acetate (PMA), and were treated with acetylated low-density lipoprotein (Ac-LDL) to establish the THP-1 macrophage derived foam cell models. Foam cells were divided into blank control group and berberine (5 to 20 μmol/L) treatment groups according to the way of treatment and berberine concentrations. After treatment for 24 h, flow cytometry was employed to detect AcLDL aggregation, enzymic method was adopted to detect contents of cholesterol and triglyceride, scintillation counting technique was used to detect cholesterol efflux, and effects of peroxisome proliferator-activated receptor-γ (PPARγ) antagonist GW9662 pretreatment on cholesterol efflux (pioglitazone as positive control) were analysed. Besides, RT-PCR was applied to detect expression of liver X receptor α (LXRα) and ATP binding cassette transporter A1 (ABCA1) mRNA. ResultsCompared with blank control group, AcLDL aggregation and contents of cholesterol and triglyceride of foam cells in various berberine treatment groups decreased significantly (P＜0.01), while cholesterol efflux increased (P＜0.01) in a dose-dependent manner. After GW9662 pretreatment, there was no significant difference in cholesterol efflux between various berberine treatment groups and control group (P>0.05). Furthermore, expression of LXRα and ABCA1 mRNA of foam cells in various berberine treatment groups was higher than that in blank control group. Conclusion Berberine may increase cholesterol efflux in THP-1 macrophage derived foam cells, the mechanism of which may be associated with activation of PPARγ pathway and increase of expression of LXRα and ABCA1 mRNA.

Objective To study the relationship between breast symptom, characteristic of ultrasound image and sex hormone level in women with different menstruation status.Methods 50 women with normal men-strual cycle, 129 women in menopause transition and 318 menopausal women were recruited.Breast ultrasound were performed.Breast section thickness, ductal width, breast structure and blood flow were measured.Serum estradiol( E2 ) and progesterone( P) level were measured by enzyme immunoassay on the day when ultrasound was performed.Onset and persistent days of breast pain were recorded.Results ①32(60.4%)women with normal menstrual cycle and 74(57.4%)women in menopause transition women experienced cyclic mastalgia.The aver-age serum E2 level and serum progesterone level were higher in women with cyclic breast pain than in women with-out breast pain.12.5%of menopausal women had breast pain.There was no significant difference of average ser-um E2 level between women with cyclic breast pain and women without breast pain②Breast section thickness was (14.4 ±4.3)mm,(13.0 ±3.7)mm and(10.6 ±3.2)mm, and ductal width was(0.62 ±0.18)mm,(0.88 ± 0.39)mm and(0.90 ±0.47)mm in normal menstrual group, menopause transition group and menopausal group, respectively.The difference had statistical significance.③26 women ( 49.1%) in normal menstrual group had breast structure changes, while 42 cases ( 32.6%) and 60 cases ( 18.9%) in menopause transition group and menopausal group had breast structure changes.Conclusions Most women in normal menstruation and meno-pause transition group experience mastalgia.About 1/3 breast structure change in women of normal menstruation are inversible.About 1/2 breast structure change in menopause transition and menopausal group are similar to those with normal menstruation.

Objective To design a kind of bed board that is suitable for various medical image diagnostic equipments. It is used to make the body position of the person who is examined to be fixed and can be moved with whom. Methods The bed board is made of low density plastics; its structure is similar to "winnowing fan" in shape. In which, the pipes filled with "multifunction developer" are arranged in order. The negative pressure vacuum bag and belts for the body positioning are installed on the bed board. Volumetric reconstruction has been done with single mode images, then multi- mode images volumetric fusion depend on registration with coronal and arrowy mark of image pipeline in volumetric reconstruction. Results The bed board can not be showed in CT, MRI, PET and SPECT with the soft tissue window, but the pipes be used as the marker for image fusion is displayed clearly. The body position is all the same with each medical image examination. National patent of the product was declared. Conclusion With the designed bed board, the multimode image fusion is rapid, simple and accurate, is easily expansion and popularize.

Objective To evaluate the application value of 256 slice spiral CT angiography (CTA)in the bridge vessels lesions af-ter grafts operation in lower extremity arteriosclerosis obliterans patients.Methods Taken DSA as the gold standard,using 256 slices spiral CTA to analysis the post-processing image of 76 article Bridge vascular which can be assessed in 65 cases patients with lower extremity arteriosclerosis obliterans,and to evaluated the diagnosis accuracy,sensitivity,specificity,positive predictive rate and negative predictive rate of postoperative bridge intravascular lesions.Results Using 256 slices spiral CTA,the bridge vascular of grafts operation patients can be clearly displayed,stenosis or unobstructed,and the anastomosis of the bridge vascular.5 graft occlu-sion,22bridge intravascular plaque were diagnosed correctly,3 vascular lesions were undiscovered.The accuracy,sensitivity,speci-ficity,positive predictive rate and negative predictive rate were 98.15%,96.15%,97.90%,92.59% and 97.96% respectively. Conclusion Using 256 slices spiral CTA can clearly show the endovascular lesions of lower extremity arteriosclerosis obliterans after grafts operation,and has high accuracy and specificity.It can be safely used as one of noninvasive follow-up means after grafts oper-ation.

Objective To investigate the relationship between androgen level and body adipose tissue content and distribution via a cross sectional survey in healthy women aged 40 to 60 years. Methods A total of 222 women were divided into 4 groups according menstruation status, i.e. reproductive stage, early perimenopausal stage, late perimenopausal stage and postmenopausal stage. Serum level of dehydroepiandrosterone (DHEA), total testosterone (TT) and sex hormone binding globulin (SHBG) were measured. Free androgen index (FAI) was calculated. Body adipose tissue content and distribution were measured by dual-energy X-ray absorptiometry. Results In women aged 40 to 60 years, DHEA, TT and FAI level of reproductive stage women was (12.3±4.1) nmol/L, (0.56±0.22) nmol/L and 1.15 (quartile:0.71 to 1.85), respectively. DHEA, TT and FAI level of early perimenopausal stage women was (12.0±3.4) nmol/L, (0.56 ± 0.24) nmol/L and 1.37 (quartile: 0.89 to 1.61), respectively. DHEA, TT and FAI level of late perimenopausal stage women was (14.2 ± 4.7) nmol/L, (0.62 ± 0.18) nmol/L and 1.38 (quartile:1.12 to 1.63). DHEA, TT and FAI level of postmenopausal stage women was (11.6±3.5) nmol/L, (0.45±0.22) nmol/L and 0.94 (quartile:0.47 to 1.49). DHEA, TT and FAI level of perimenopausal stage women was comparable with those of reproductive stage women (P>0.05), however, TT and FAI level of postmenopausal women was significantly lower than those of reproductive stage women (P=0.001, 0.014). The total adipose percentage of reproductive stage women, early perimenopausal stage women, late perimenopausal stage women and postmenopausal stage women were (35 ± 6)%, (35 ± 5)%, (37 ± 4)%and (37 ± 5)%. The adipose percentage in“android”area of reproductive stage women, early perimenopausal stage women, late perimenopausal stage women and postmenopausal stage women were (43±5)%, (43±4)%, (47±5)%and (46±5)%. The total adipose percentage was similar in 4 groups (P=0.312). Compared with reproductive stage women, adipose percentage of“android”area increased in late perimenopausal and postmenopausal women (P=0.026). Women with higher FAI level presented higher adipose tissue content and higher percentage of centrally distributed adipose tissue (r=0.28, P=0.003). Conclusions Body adipose tissue tends to distribute centrally from perimenopausal stage. Androgen level is related to body adipose tissue content and distribution, but may not be the main reason of changes of fat distribution in middle life women.