Dignity is the idea that a being has the innate right to be valued, respected, and treated ethically. It reflects the value of life.Dignity therapymainly discusses thedignity during the period of death and dying.It involves symptom control, body integrity, au-tonomy, privacy boundaries, respect, and proper handling of personal affairs and death in peace. Dignity therapy is a unique, individu-alized, and brief psychotherapy that was developed for the purpose of relieving distress, enhancing end-of-life experience, reducing psychological and mental burden, and improving the quality of life for dying patients.

Liver fibrosis is the excessive accumulation of extracellular matrix (ECM) proteins that occurs in most types of chronic liver diseases. Hepatic stellate cells (HSCs) are major sources of the excess ECM deposited in fibrotic liver. Transforming growth factor ? (TGF-?) is considered to play a generic role in the development of tissue fibrosis, as it stimulates the synthesis and deposition of ECM components. Smad pathways are central mediators of signals from the receptors for transfor- ming TGF-? to the nucleus. However, growing biochemical and developmental evidence supports the notion that non-Smad pathways also participate in TGF-? signalling. TGF-? signalling pathways play an important role in regulating tissue homeostasis and have been implicated implicated in diverse pathological conditions. It is oow our challenge to design ways of blocking the fibrosis-specific actions of TGF-? through downstream signalling pathways and mediators without compromising the other activities of this multifunctional cytokine, which is essential for health.

Objective To assess the clinical siginificance of the cardiopulmonary resuscitator in respiratory and cardiac arrest patients by comparing the curative effect of cardiopulmonary resuscitator and bare-handed cardiopulmonary resuscitation. Methods 102 patients on the verge of the death were randomiy divided into two groups and begin to CPR in four seconds after confirmation of respiratory and cardiac arrest. Patients in group 1 were given bare-handed CPR. Patients in group 2 were given cardiopulmonary resuscitation by cardiopulmonary resuscitator. Patients in both group 1 and group 2 received lasting CPR according to the 2010 GUIDE of CPR, then we observed their self-heart-beating, self-breathing, caroid puise, expression, puplillas, ECG. Results In the group 1,the effective case was 1,the non-effcctive cases were 63,the effective rate was 1.56%. In the group 2, the effective cases were 6, the non-effective cases were 31, the effective rate was 16.21%, there was a statistically significant difference between two groups ( <0.01) . Conclusion Cardiopulmonary resuscitator has good effect in cardiopulmomary resuscitation for respiratory and cardiac arrest patients, and the effective rate is significantly higher than bare-handed CPR,so it deserves clinical promotion.

Objective To study the effect of recombinant human endostatin hormone combined with transcatheter arterial chemoembolization (TACE) for the treatment of primary hepatocellular carcinoma (HCC).Methods Fifty-two primary HCC patients were divided into combined group (26 patients) and control group (26 patients) by random digits table method.The patients in combined group received TACE and recombinant human endostatin hormone added in embolism emulsion.The recent curative effect,level of serum vascular endothelial growth factor (VEGF),adverse reactions,recurrence rate and survival rate were compared between two groups.Results The response rate(RR) and clinical benefit rate(DCR) in combined group were 57.69％(15/26),84.62％(22/26),in control group were 34.62％(9/26),73.08％(19/26),there were significant differences (x2 =5.237,P ＜ 0.05 ; x2 =4.284,P ＜ 0.05).The 7th,14th,28th day after TACE,the level of VEGF in two groups was first increased and then a downward trend,the difference were statistically significant (P ＜ 0.05).The level of VEGF in combined group was significantly lower than that in control group (P＜ 0.05).The follow up rate was 94.23％(49/52),the 1-year and 2-year recurrence rate in combined group was significantly lower than that in control group (P＜ 0.05).The 2-year and 3-year survival rate in combined group was significantly higher than that in control group (P ＜ 0.05).Conclusion With TACE plus recombinant human endostatin hormone can effectively inhibit the increase of serum VEGF level,improve curative effect and disease control rate,reduce tumor recurrence and improve survival rate.

Medicine, Chinese Traditional ; Translations

Arterial ischemic stroke (AIS) is an important cause of acquired brain injury in children,with a high morbidity and mortality.AIS in children differs from adult ischemic stroke in etiologies and risk factors.Recognition of AIS in children is challenging,and significant delays in diagnosis often occur.This article reviews the risk factors,diagnostic evaluation and treatment of AIS in children.

Based on the hospital information system, the hospital value-added service platform is constructed.The paper intro-duces the design scheme of the platform, its functional modules, the design of the database, the implementation of the platform and its application prospect, points out that the platform can not only serve as the channel for the information exchange between doctors and pa-tients but also offer such value-added services as health consultation and illness tracking other than regular services.

Objective To evaluate the CT features of solitary inflammatory nodules of the lung. Methods CT features in twenty-three cases of solitary inflammatory nodules of the lung confirmed by operation or clinical were analyzed retrospectively. Spiral CT including plainscans and contrast enhanced scans was done in all patients. Thin-slice target scan and multiple plane reconstruction were used on the area of nodule. Different width and level of window were used to show the characteristic sign of the nodule.Results No calcification,satellite lesion,concentrated vessels and enlarged lymph nodes were found in or around all of the nodules. The size of these nodules were 10 mm?15 mm～30 mm?40 mm with round or irregular margin. Superficial lobular or spiculated margin was seen in only three nodules. Hyperemia and clouding appearance were found in 19 nodules and reflecting thickening pleura in 18 nodules. Unsteady edge enhancement were found in 18 nodules and no enhancement in 5 nodules. Effused change around the nodules could be seen perfectly when the level was about -400. MPR was the most accurate technique to show the relationship of nodule and pleura. Conclusion Solitary inflammatory nodules of the lung have obvious CT characterizes. By analyzing various CT manifestations comprehensively most nodules can be diagnosed correctly. Suitable width and level of window as well as MPR are helpful in showing the characterizes of the nodules.

OBJECTIVE:To establish an LC-MS method for the determination of nimesulide in human plasma. METHODS:The separation was performed on Agilent Zorbox SB-Cl8 column,using acetonitrile-0.1% formic acid (65 ∶ 35) as the mobile phase at a flow rate of 1.0 mL?min-1. The column temperature was set at 35 ℃ and valsartan was served as internal standard. Positive electrospray ionization detection was applied to monitor m/z 309(nimesulide,[M+H]+)and m/z 436(valsartan,[M+H]+). RESULTS:The linear range of nimesulide was 5～50 ng?mL-1(r=0.998 9). The method recovery of nimesulide ranged from 87.1% to 92.9%. The intra-day and inter-day RSD were 3.1%～5.8%,6.4%～9.2%,respectively.CONCLUSION:The method is sensitive,simple,convenient,accurate and reproducible,and it is suitable for clinical plasma concentration monitoring and pharmacokinetics research of nimesulide.

Objective: To explore risk factors of percutaneous coronary intervention (PCI)-induced vagal reflex and its emergency treatment strategies.Methods: Clinical data of 214 patients undergoing successful PCI in our hospital were retrospectively analyzed.According to presence of vagal reflex or not, they were divided into vagal reflex group (n=56) and no vagal reflex group (n=158).Clinical features were compared between two groups.Logistic analysis was used to analyze related risk factors for PCI-induced vagal reflex, meanwhile, those patients with vagal reflex received emergency treatment and observation;and prevention and treatment plans were analyzed.Results: Single factor Logistic regression analysis indicated that age, diabetes mellitus, repeated puncture, indwelling sheath, previous PCI and hemostasis time by compression were risk factors for induced vagal reflex (OR=1.155~3.005, P<0.05 or <0.01).Multifactor Logistic analysis found that diabetes mellitus, indwelling sheath time and hemostasis time by compression were independent risk factors for induced vagal reflex (OR=1.846~2.998, P<0.05 all).Symptoms of those patients with vagal reflex were effectively controlled via rapid intravenous rehydration, blood volume expansion, intravenous injection of dopamine and atropine etc.Conclusion: Diabetes mellitus, indwelling sheath time and hemostasis time by compression are related factors for PCI-induced vagal reflex;high risk patients should be closely monitored, given standardized treatment rapidly.