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 explore the long-term health effects of overexpose to radiation.Methods The 32 -41-year medical followed-up observations were performed for 25 persons exposed to ionizing radiation in the dose range of 0.10 -0.33 Gy. Observations were made of clinical symptom,eye lens,cytogenetics,immune function and endocrine function for these persons. Results The incidence of neurasthenic symptom was higher in exposed group than that in control group.2 cases suffered from liver cancer and esophageal cancer,respectively. Posterior capsule punctate phacoscotasmus of the lens wereobserved in 7 cases.There was I case of cataract in the exposed group. The frequencies of chromosomeaberration and micronucleis in peripheral blood lymphocyte in the exposed group were significantly higherthan those in control group (x2 =8.88,8.71,40.60,45.63,P ＜ 0.05 ).The average value of serum IgG was higher(t =2.16,P ＜0.05 ),while that of IgM was obviously lower in the exposed group (t =2.03,P ＜0.05).The average values of serum triiodothyronine (T3),thyroxine (T4 ) and thyroid-stimulating hormone (TSH) in the exposed group were obviously lower than those in the control group (t =2.40,3.54,2.13,P ＜0.05 ).Conclusions Overexposure has effect on lens,immune function,cytogenetics to some degree.It is important to observe the long-term health effect on overexposed persons.

Objective To study the value of 256-slice spiral CT (MSCT) in internal thoracic artery. Methods The angiographic images of 107 patients who were suspected thoracic and abdominal aortic diseases were retrospectively ana-lyzed. The running rule and branches of internal thoracic artery on both sides were observed. Each side of the internal thorac-ic artery was divided into 3 sections according to the running rule. The lumen diameter, vessel length and its branches were measured in three segmental vascular of the internal thoracic artery. The lumen diameter of the diaphragmatic artery diame-ter,and the distance between internal thoracic artery and each border of the sternum were also measured. Results Both sides of the internal thoracic and diaphragmatic arteries were shown in 107 patients (100%). There were significant differenc-es in vascular lumen diameter of intrathoracic artery of both sides (P＜0.05). There were no significant differences between both sides of the corresponding segments (P>0.05). The left internal thoracic artery was significantly longer in the left side than that of right side (P＜0.05). There were no significant differences between the diameter of diaphragmatic arteries and the distance between the internal thoracic artery and the sternal edge of two sides (P>0.05). Conclusion The application of 256-slice spiral CT angiography can clearly show the running rule and anatomical features of internal thoracic artery ,and provide a relatively important clinical information.

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.

Objective To evaluate the value of retrospective ECG-gated 256 slices spiral CT technique in the scanning of inferior phrenic artery (IPA).Methods 80 patients with underdone abdominal CTA were divided randomly into two groups (40 patients each)as regular abdominal CTA scanning group and retrospective ECG-gated technique group.And further analysis was done to evaluate the display of IPA branches and the image quality.Results 80 patients were all scanned successfully.40 cases LIPA and 40 cases RIPA were showed in the regular group.80 cases showed 1st level branches of IPA,73 cases with 2nd level,59 cases with 3rd and 43 ca-ses showing 4th level.40 cases LIPA and 40 cases RIPA were showed in ECG-gated group.And the numbers of IPA branches levels were 80,79,71,65,respectively.There is no significant difference in the ability of showing the1st level IPA or their image quality between those two groups (P >0.05);and there is a statistical significance in the ability of showing other levels of IPA and their im-age quality.Conclusion It is feasible that we use retrospective ECG-gated 256 slices spiral CT scanning technique to show the IPA. And it could improve the ability of showing the IPA branches as well as the image quality.

Objective To understand the feeling of mothers of children with osteogenesis imperfecta during the accompany of children's diagnosis and treatment.Methods A total of 20 mothers of children with osteogenesis imperfecta participated the semi-structured interview.The data were analyzed by Colaizzi's method of phenomenology.Results Three themes were acquired including heavy psychological burden,facing multiple pressure and mother's support through analysis,reorganization and extraction of the subjects.Conclusions Mothers of children with osteogenesis imperfecta needed humanistic concern and emotional support.Nursers should adopted personalized care measures to improve their quality of life.

Objective To observe late effect of 60Co radiation accident on eye lens in the victims.Methods Medical observations of eye lens were performed on ten victims accidentally exposed to 60Co sources in four radiation accidents that have occurred from 1986 to 2000 in Henan Province.Pathological changes of the eye lenses were examined by using slit lamp microscopy after mydriasis with compound tropicamide.Results Of these ten victims, Liang in a radiation accident in Kaifeng (in 1986), Mei in Xinxiang (in 1999) and Xu in Xuchang (in 2000) all had typical radiation-induced cataract 2, 3 and 6 years after irradiation, respectively.Follow-up observation of the lens showed the punctate and/or granular opacities present in the eye posterior subcapsular of Yan in Kaifeng accident, Jie in Zhengzhou (1987), and Tian, Yong and Yi in Xinxiang accident, featuring the early changes of radiation-induced cataract, but the posterior subcapsular opacities were not observed in Wang and Min in Xinxiang accident.Conclusions Focus should be on the eye lens as the target organ of radiation exposure in long-term follow-up of victims accidentally exposed to radiation source.Severity of the lens opacity induced by ionizing radiation is closely associated with radiation doses.