Objective To explore the pain experience,illness uncertainty and hope level of pancreatic cancer patients and examine the relationships between them.Methods Participants completed a self-designed demographic questionnaire,Brief Pain Inventory,Mishel Uncertainty in Illness Scale Adult and Herth Hope Index.Results Most of the patients reported moderate to severe pain intensity and the incidence of pain was as high as 61.72％.The total pain interferences on patients' enjoying life,sleep,daily life were apparent.The illness uncertainty and hope level in pancreatic cancer patients in pain were in middle level.The percent of pain relief was negatively correlated with illness uncertainty,and positively correlated with hope level,the total pain intensity level and the total pain interference were positively correlated with illness uncertainty and negatively correlated with hope level.Condnsions The patients with pancreatic cancer experience moderate to severe pain that affects their illness uncertainty and hope level.The pain is correlated with illness uncertainty and hope level.It is advised that clinical nurses should take effective measures to relieve pain and to illness uncertainty and improve hope level of pancreatic cancer patients.

Objective To understand the psychological experience of primary caregivers of patients with cancer-related pain,care to focus on caregivers psychological health, improve life quality and ability to cope with pain. Methods A qualitative, descriptive, semi-structured research were used in this study. Nineteen primary caregivers of cancer patients with cancer-related pain were in-depth interviewed. Colaizzi′s analytical method was adopted to analyze the data, which were then organized into themes and subthemes. Results The primary caregivers confronting cancer-related pain experienced a series of negative psychological changes, worry, fear, anxiety, vexation, sadness, helplessness and powerlessness, their physical and mental health, life were also affected .The primary caregivers were lack of pain related knowledge and pain management skills generally. Conclusion Medical staff should pay high attention to the psychology status of primary caregivers, to provide support, health education and skill training of pain coping strategies, which then might help relieve cancer patients′pain and in turn improve their quality of life.

OBJECTIVE: To explore the factors,general pattern and characteristics of adverse drug reactions(ADR) in children.METHODS: A total of 188 pediatric ADR reports collected in our city from Jan.2002 to Sept.2007 were statistically analyzed in respect of children's age and sex,route of administration,ADR severity,category of drugs involved,organs or systems involved and clinical manifestations etc.RESULTS: Of the 188 pediatric ADR cases,95(50.5%) were induced by intravenous route.A total of 112 kinds of drugs were involved in the ADR,with anti-infective agents showing the highest proportion.Digestive system,neural system,urinary system and skin etc were involved in the ADR.CONCLUSION: Clinic should attach great importance to the monitoring and reporting of pediatric ADR to reduce or avoid the occurrence of ADR.

Objective To elucidate the experience and attitude of bad news delivery from nurses to advanced cancer patients, in order to offer better nursing care to the dying cancer patients as well as to provide evidence for end-of-life cancer care. Methods A phenomenological research method of qualitative study was employed in this study. Fifteen nurses caring for dying cancer patients were in-depth interviewed with semi-structured interview guide. Colaizzi analytical method was adopted to collect and analyze the data, which was then organized into themes and subthemes. Results Three themes wereconflict between will and behavior barriers of bad news delivery delivery with comprehensive assessment of dying cancer patients. Conclusions Though the oncology nurses thought the dying cancer patients should be told they were dying, few nurses did that. Communication and hope maintenance related to end-of-life cancer care training should be offered to oncology nurses, as well bad news delivery to ensure cancer patients′safety.

ObjectiveTo study the effect of high altitude (HA) of 4300 m on the hepatic gluconeogenesis in rats and its underlying mechanism. MethodsThirty-six healthy adult male Sprague-Dawley (SD) rats were randomly assigned to group H1 (HA exposure for 1 day, n=6), group H3 (HA exposure for 3 days, n=6), group H7 (HA exposure for 7 days, n=6), group H15 (HA exposure for 15 days, n=6), group H30 (HA exposure for 30 days, n=6), and group C (no HA exposure, n=6). After the treatment, the mRNA and protein levels of glucose-6-phosphatase (G6Pase), and forkhead box transcription factor O1 (FoxO1) in the hepatic tissues were determined by RT-PCR and Western blot, respectively. The content of hepatic glycogen was determined by spectrophotometry, and the blood glucose level was measured using an automatic biochemical analyzer. The one-way analysis of variance (ANOVA) was used to analyze the differences between groups, and the Tukey test was further used to compare the differences between two groups. ResultsCompared with those in group C, the levels of G6Pase and glycogen in the hepatic tissues of rats increased significantly in groups H1, H3, and H7 (P＜0.05), and the expression level of FoxO1 decreased significantly in groups H3, H7, H15, and H30 (P＜0.01). No significant differences in the concentration of blood glucose were observed between the HA-treated groups. ConclusionIncreased hepatic gluconeogenesis and glycogen synthesis in the early phase of HA exposure may be one of the important mechanisms of HA acclimatization. FoxO1 and AMPK are involved in the regulation of hepatic gluconeogenesis. The increased content of hepatic glycogen is associated with the decreased activity of AMPK.

Objective:To develop an assessment instrument for evaluating Filial Piety Value Scale among Children Whose Parents were Advanced Cancer Patients and to test the reliability and validity of the tool.Methods:Through literature review, semi-structured interview and expert letter consultation, the first version of the Filial Piety Value Scale (FVS) was developed. A convenience sampling method was adopted to recruit 352 children of patients with advanced cancer as respondents. Item analysis, reliability and validity were adopted to evaluate the items, and finally the formal version of FVS was developed.Results:The Internal Consistency of FVS was 0.86, and the content validity index of each item was 0.93-1.00.Two factors were extracted from exploratory factor analysis, and the cumulative contribution rate of variance was 60.25%. The two factors were named as Care (10 items) and Respect (5 items).The correlation coefficient between the total score of FVS and the total score of Filial Piety Values Index (FVI) was 0.496, and the correlation coefficient between the FVS total score and FVI Care and Respect score was 0.50 and 0.46, and the results were statistically significant ( P<0.01). Conclusion:The Filial Piety Value Scale of children whose parents were advanced cancer patients has good reliability and validity, which can be used to evaluate the filial piety value of children whose parents are advanced cancer.

Objective To study the effect of clinical pharmacist interventions on the rational use of antibiot-ics.Methods 1 000 hospitalized patients before the implementation of intervention in April 2012 to April 2013 (control group)and the other 1 000 cases of hospitalized patients in May 2013 to May 2014 after the implementation of the intervention (study group)were selected,the antibiotics use rate,hospitalization time and cost,cost of using antibacterial drugs were compared between the two groups.Results The antibiotics use rate of the study group was 56.0%(560/1 000),significantly lower than 78%(780/1 000)of the control group,with significant differences between the two groups(χ2 =11.089,P=0.032),the hospitalization time,cost of using antibacterial drugs of the study group were (12.6 ±0.8)days,(912.2 ±13.2)yuan,significantly better than (16.9 ±0.7)days,(1 528.1 ± 32.5)yuan of the control group,with significant differences between the two groups (t=9.892,10.142,P=0.028, 0.014);The two groups of hospitalization expenses showed no statistical significance (t =4.984,P =0.072 ). Conclusion Clinical pharmacist intervention has a positive effect on the application of antibacterial drugs,which can significantly reduce the use of antimicrobial drugs and reduce the hospitalization days.

Objective:To investigate the filial piety value level and the influencing factors of filial piety among children whose parents were diagnosed as advanced cancer.Methods:A convenient sampling method was used to recruit 383 participants in Tumor Hospital, Tianjin Medical University.Results:The total score of Filial Piety Value Scale among children whose parents were advanced cancer patients was (66.50±4.10) . The age of the patient, the number of hospitalization and the degree of awareness of the condition, the age of the children, whether the child was the-only-child, whether the child was living with the patient, and the average daily care time influenced the filial piety values of children whose parents were advanced cancer patients ( Z=16.64-62.94, U=2.04-4.27, P<0.05). Conclusion:Children whose parents were with advanced cancer have a better understanding of filial piety. Nurses understand the values of filial piety of children in the context of traditional filial piety and family care mode in China, which can enhance the experience of filial piety and filial piety of both children and parents, also improve the mental health problems of patients, and finally improve the quality of life of patients with advanced cancer.

Objective: To explore these adults′ perspective with filial piety and as well to elucidate adults′experience and filial caring behaviour whose parents were diagnosed as advanced cancer. Methods: This is a qualitative study. A semi-structured and individual in-depth interview guide was designed and utilised to explore perspectives of 15 adults whose parents were diagnosed as advanced cancer. Thematic analysis method was adopted to analyse the data, which were synthesised into themes and subthemes. Results: Three main themes were explicated: emotional experience, filial caring behaviours for parents and dilemmas and pressures. These adults adopted obedience, accompany, improving quality of life, completing parents’ wish to fulfil their commitment and filial piety during taking care of their cancer parents. However, they encountered ethical dilemmas regarding disclosure or non-disclosure cancer diagnosis to their parents. Conclusions Due to the profound influence of Chinese traditional culture, the adults whose parents were diagnosed as advanced cancer committed their filial caring behaviour to their parents very wholeheartedly and encountered difficulties and dilemmas. Therefore, oncology nurses are advised to share their love to cancer patients, to work with compassion and sympathy and support them by assisting with taking care of their patients, which in turn may facilitate their filial caring behaviours, decrease their pressure and negative emotions.

Objective To understand the growth experiences of senior nurses in coping with the death of patients so as to provide reference for clinical nursing management and teaching.Methods A phenomenological research method of qualitative study was employed in this study.Twenty-five senior nurses were in-depth interviewed with semi-structured interview guide.Thematic analysis method was adopted to collect and analyze the data,which were then organized into themes and subthemes.Results Three themes were "changes in growth" "ways to grow" and "unmet needs".Senior nurses could cope with patients' death well through accumulation and sharing of clinical experience,as they reorganized of death more definitely,their emotional response transferred reasonable,their coping strategy became matured,whereas the senior nurses still need help in the areas of psychological adaption,social support and professional theory education.Conclusions It is suggested that nursing managers should value the experience sharing and teaching function of senior oncology nurses,pay attention to the physical-mental health of senior nurses and provide professional psychosocial support to them.Otherwise,it is important to provide all oncology nurses with systematic knowledge training concerning hospice/death education to promote their career development ultimately.