Although there is a lot of movement for euthanasia legalization after the middle of the 20~(th)century,only Holland and Belgium pass the bill.The reasons include not only that general ethics consensus on euthanasia hasn't been achieved,but also the difficulties of legal definition and systemic arrangement as well as the unhealthy social consequence.To solve the problem,developing the health care system and hospice care is more practical than legalization.

Objective:To explore the angiogenic ability of vascular endothelial cells in solid tumors.Methods:Immunocytochemistry,reverse transcription polymerase chain reaction (PT-PCR),and two-well co-culture system were used to detect the expressions of matrix metalloproteinase 9(MMP-9),transforming growth factor-?1(TGF-?1),tenascin(TN)and bcl-2,telomerase activity,and their ability of both migration and tube formation of ECV304-SKOV3 cells respectively,which ,as the cell model,had been established in our laboratory before.Then their abilities of protein synthesis and adhesion were analysed.Results:The ability to synthesize proteins and telomerase activity was enhanced(P

Objective:To explore the synergism of vascular endothelial cells and fibroblasts derived from tumors in the tumor angiogenesis after the establishment of the cell models.Methods:Reverse transcription polymerase chain reaction,two-well co-culture system were used to detect the tolomerase activity,and their abilities of migration and angiogenesis of ECV304-SKOV3 cells and the potential of L_(929)-H_(22) to promote angiogenesis and invasion of MDA-MB-231 cells,respectively,which were established as the cell models for vascular endothelial cells and fibroblasts derived from tumors in our laboratory before.Results:Tolomerase activity level of ECV304-SKOV3 cells was higher than that of ECV304 cells (0.778?0.011 vs 0.692?0.014,P

ObjectiveTo investigate the efficacy of intravenous parecoxib combined with femoral nerve block on postoperative analgesia and knee functional rehabilitation in elderly patients following total knee replacement.MethodsForty elderly patients with osteoarthritis schedu[ed for total knee arthroplasty under general anesthesia,aged 65-74 years,weighing 45-90 kg,ASA [Ⅱ,were randomly divided into two groups( n ＝ 20 each).FNB group received femoral nerve blockade for postoperative analgesia ( local injection of 0.25 ％ ropivacaine 25 ml at the end of surgery,repeated every 8 h up to 72 h after surgery).FNB-Pa group received the femoral nerve blockade plus the parecoxib (administered Ⅳ bolus of 40 mg 30 min before the end of surgery,12,24,and 48 h after surgery respectively).Pain was scored at rest or during continuous passive motion using Visual Analog Scale (VAS).The Hospital for Special Surgery (HSS) knee score was determinated before surgery,at 24,48 and 72 h after surgery respectively.Side effects were also recorded in both groups.Results VAS score was significantly lower at rest and during continuous passive motion in FNB-Pa group than in FNB group ( P < 0.05).Compared with baseline value,HSS score increased significantly during postoperative analgesia in both groups( P < 0.05 or 0.01 ).HSS score were significantly higher at 48 h and 72 h after surgery in FNB-Pa group than in FNB group ( P < 0.05).No severe related side effects occured in both groups.ConclusionFemoral nerve block in combination with intravenous parecoxib can safely and effectively relieve the static and dynamic pain after total knee replacement and is helpful for rehabilitation of the prosthesis knee joint function after surgery.

Objective To observe effect of home nursing on prevention and control of asthma. Methods Emergency patients(85 cases) were divided into the treatment group(42 cases) and the control group (43 cases).The control group received routine medical treatment after emergency management.The treatment group was given family intervention based upon routine medical treatment,the family intervention included regular visits or telephone followup,short message or internet multimedia, etc.These interventions supplied correct medication method,self-monitoring of asthma, self first-aid at acute attack,how to seek medical emergency treatment and psychological support,ete.The followup continued for 1 year. The asthma control test (ACT) was adopted to compare the clinical effect of the two groups. Results The control rate of the treatment group was greatly improved compared with that of the control group (P < 0.05). Conclu-sion Family intervention played a pivotal role in the improvement of control rate of asthma.

Objective To explore the effect of palliative care led by oncology professional nurses in the elderly patients with late tumor. Methods Ninety patients who were diagnosed with late tumor were randomly divided into control group and intervention group. Routine nursing care was conducted in the control group and in the intervention group, palliative care lead by professional nurses was conducted besides the routine nursing care for 8 weeks. The two groups were compared in view of life, symptom distress, and self-efficacy intervention effect. Result The quality of life and self-efficacy were significantly higher than those of the control group (P<0.05) and the symptom distress was significantly lower than that of the control group eight weeks after the intervention (P<0.05). Conclusion The multi-disciplinary intervention led by the oncology professional nurses can improve the quality of life and self-efficacy of the patient and improve the symptoms of the patient.

OBJECTIVETo investigate the clinical value of pleural biopsy in the etiological diagnosis of pleurisy in children.

METHODTotally 213 cases with pleurisy, who underwent pleural biopsy and hospitalized in Children's Hospital of Chongqing Medical University from January 2007 to April 2014 were enrolled into this study. Clinical symptoms, imaging manifestations, pleural fluid characteristics, the results of pleural biopsy and postoperative complications were retrospectively analyzed to evaluate the clinical value and security of pleural biopsy in making the etiological diagnosis of pleurisy.

RESULT(1) Of the 213 cases, 144 were boys and 69 were girls, their mean age was (6. 5 ± 4. 1) years. (2) Two hundred and thirteen patients had a surgical pleural biopsy under general anesthesia, the cause of 97 cases (45. 5%) were made clear by histopathological examination, including 35 purulent pleurisy, 55 tuberculous pleurisy and 7 paragonimus infection. For the remaining 83 (41. 3%) cases a final diagnosis was made based on the full analysis of clinical data, including 63 cases of purulent pleurisy, 3 cases of tuberculous pleurisy and 17 cases of paragonimiasis pleurisy but for 33 patients no exact cause was found at the end. (3) The mean operating time of the biopsy was (1. 4 ± 0. 6) hours. Seventy one (33. 3%) patients required blood transfusion during or after the operation. Thirty one (14. 6%) cases used the ventilator after surgery, and the ventilator supporting time was (6. 6 ± 5. 8) hours on average. The wound healing reached grade A in 200 cases (93. 9%), grade B in 13 cases (14. 6%). Postoperative complications included pneumothorax in 92 cases (43. 2%), subcutaneous emphysema in 18 cases (8. 5%), bronchopleural fistula in 3 cases(1. 4%). The average days of hospitalization was (17. 7 ± 7. 1) d.

CONCLUSIONPleural biopsy is of great diagnostic value in the etiological diagnosis and differential diagnosis of pleurisy in children, and it is considered reasonable to be used in the clinical practice when appropriate.

Biopsy ; Child ; Diagnosis, Differential ; Female ; Humans ; Infection ; diagnosis ; Male ; Pleura ; Pleurisy ; diagnosis ; etiology ; Retrospective Studies ; Tuberculosis, Pleural ; complications ; diagnosis

Objective To observe the clinical efficacy of umbilicus application withDa Huang (Rheum Officinale) during 5-7 a.m. in treating senile constipation after hip fracture.Method Fifty-nine elderly patients with constipation after hip fracture were randomized into a treatment group of 30 cases and a control group of 29 cases. The treatment group was intervened by umbilicus application withDa Huang (Rheum Officinale) during 5-7 a.m, while the control group was by umbilicus application withDa Huang (Rheum Officinale) at any time but avoiding 5-7 a.m. period. After a treatment course, the therapeutic efficacy was evaluated based on bowel movement frequency and shape of stool, and the two groups were compared with each other.Result The total effective rate and markedly-effective rate were respectively 93.3% and 70.0% in the treatment group versus 82.8% and 37.9% in the control group. The between-group difference in the total effective rate was statistically insignificant (P>0.05); there was a significant difference in comparing the markedly-effective rate between the two groups (P<0.01).Conclusion Umbilicus application withDa Huang (Rheum Officinale) during 5-7 a.m. is an effective method in treating senile constipation after hip fracture.

Objective: To examine the characteristics of the pulse manifestation in the hepatocarcinoma patients, and to study the value of pulse manifestation in typing according to diagnosis of Traditional Chinese Medicine. Methods: The patients' pulse manifestation was examined by the pulse instrument, and was typed according to the symptom, sign, and tongue appearance. The pulse indices and photography were analyzed among syndromes of Traditional Chinese Medicine. Results: Ninety percent of patients had string like pulse, slippery pulse, and string like and slippery pulse in 147 hepatocarcinoma cases. H 1 was significantly higher in stagnation of liver qi and deficiency of spleen patients type than that in dampness and heat in liver and gallbladder patients type and in Yin deficiency of liver and the kidney patients type. H 3/H 1 significantly decreased in of stagnation of liver qi and deficiency of spleen patients type than that in dampness and heat in liver and gallbladder patients type. H 4/H 1 was significantly lower in dampness and heat in liver and gallbladder patients type than that in other 3 types of patients. Conclusion: Pulse indices and photography detected by the pulse instrument are associated with types according to diagnosis of Traditional Chinese Medicine. It is valuable to pulse detection by the pulse instrument. [

Objective To observe the clinical effects of short-term intermittent ganeiclovir treatment on infants with cytomegalovirus (CMV) hepatitis. Methods The clinical data of infants with CMV hepatitis were analyzed retrospectively. The liver functions including total bilirubin (TBil), direct bilirubin (DBil), alanine aminotransferase (ALT), aspartate aminotransferase (AST) and γ-glutamyltransferase (γ-GT) of the patients in treatment group (85 cases) and control group (37 cases) were collected before and after treatment. Meanwhile, the side effects of ganciclovir during treatment were observed. The measurement data were compared by analysis of variance and numeration data were compared by chi-square test. Results After short-term intermittent ganciclovir treatment in treatment group, TBil level was decreased from (109.1±677.8)μmol/L to (62.9±68.1)μmol/L (F=15.34,P<0.01); ALT level was decreased from (160.2±395.3) U/L to (68.1±56.0) U/L (F=4.73, P<0.05). In control group, TBil level was decreased from (94.9±647.4)μmol/L to (49.2±631.5) μmol/L (F=14.80, P<0.01) ; while ALT level was decreased from (131.6±206.2) U/L to (55.3±631.2) U/L (F=3.50, P=0.067). The readmission rate in control group was significantly higher than that in treatment group (21.6% vs 10.6%). Only one case (0.8%) received three times of intermittent ganciclovir treatment. The longest hospitalization time was six weeks. Conclusions Short-term intermittent ganciclovir treatment may be more suitable for infants with CMV hepatitis. There is no obvious side effect observed during the treatment and the hospitalization time can be shortened.