Objective:under the protective medical system,health care professional incline not to disclose the medical information to vulnerable patients in order to protect them from any unpleasant stimuli which might worsen their illness condition.This study aims to understand how patients' perceived illness severity and prognostic awareness impact on their will to live and healthcare expectations.Participants & Methods:twenty newly admitted patients,6 men and 14 women,with confirmed diagnosis of metastasis cancer in a hospice ward in Shanghai participated in the study.Semi-structured interviews were used to illicit the patients' view and experience.The interview questions include the patients' understanding of their illness condition,concerns in different aspects of life and expectation on treatment and care.Audio-recorded interviews were verbatim transcribed and analyzed using vanKaam's method of controlled explication.Result:although the patients did not learn their illness directly from others,they were able to capture their illness severity by observing the reaction of doctors or family members.Among them,9 patients actively sought evidence to confirm their illness condition.Although all 20 patients considered themselves gravely ill,their will to live ranged form very strong to very weak,which can be categorized into three major kinds of responses: struggling for life,letting-it-to-happen and pleading for death.The patient's level of prognostic awareness did not have a strong association with their will to live,but the will to live was associated with their expressed quality of life concerns.The patients with more negative emotion,weaker family ties and more physical discomforts had weaker will to live.The patients who had unfinished business such as young children had the strongest will to live.The letting-it-go-happen patients were complacent that they had fulfilled their life responsibilities.Both patients who struggled for life and who pleaded for a hastened death had unrealistic healthcare expectations.The former hoped the medical staff could cure their illness whilst the latter preferred the medical staff to end their life.This is inconsistent to the concept of hospice care as dying should be treated as a natural process.Conclusion: This study shows that empathetic and open interactions with terminally cancer patients are possible.No untoward emotional reactions were noted after the interviews.The patients could receive better psychological support form the health care providers,and their needs were more realistically addressed.Furthermore,it can facilitate the family and healthcare providers to fulfill patients' last wishes and help them to pass their last days in peace,comfort and dignity.

Objectives:In the study, effect of Ala Gln on glutathione concentration and antioxidation were investigated in burned rats . Methods:Thirty male SD rats were randomly divided into three groups,A:control group,B:TPN group,C:Ala Gln PN group.The nutrient solution was administered through central venous catheter for 7 days.Glutathione concentration and levels of xanthine oxidase(XOD) and superoxide dismutase(SOD) in the serum were determined. Results:Compared with control group and TPN group,the levels of serum glutathione and SOD in group C were significantly increased( P

OBJECTIVE:To provide reference for rational use of parenteral nutrition. METHODS:Combining with the pa-tients'nutritional status,clinical diagnosis and lab examination,5770 parenteral nutrition medical orders were collected from our hospital during May 2015-Apr. 2016,and then analyzed in respects of the stability of drug use,rationality of drug selection and pharmacoeconomics. RESULTS:The qualified stability of nutrient solution in 5770 parenteral nutrition medical orders accounted for 89.46%. The rates of reasonable drug selection in patients with abnormal liver function,renal function,hyperemesis gravidarum,pan-creatitis,complete fasting,long term parenteral nutrition (>14 d) and triacylglycerol >4.5 mmol/L were 76.19%,63.16%, 75.00%,78.95%,65.95%,64.06%and 50.00%,respectively. Four kinds of drugs were with same effect and dose,price difference between 4-34 times,the rate of inappropriate drug selection ranged 7.58%-61.64%. CONCLUSIONS:Parenteral nutrition design need to not only consider about nutritional status,clinical diagnosis and lab examination,but also take into account high efficiency,safety, economy and the stability of whole nutrient solution.

Objective To investigate the fine management in the role of infection control management and the effect evaluation in pharmacy intravenous admixture services. Methods From July 2013 to June 2016, infection control management were reviewed retrospectively in pharmacy intravenous admixture services:routine management (from July 2013 to December 2014) and fine management (from January 2015 to June 2016). The settlement of air bacteria formation rate, hand hygiene compliance and accuracy of drug-care workers, and worker′s hand colonization monitoring data before and after the fine management were compared. Results After the implementation of fine management, the settlement of air bacteria formation rate was reduced from 10.42%(120.0/1152) to 4.45%(51.3/1152); there was significant differences (t=3.417, P<0.01).The hand hygiene compliance of drug-care workers increased from 81.50%(1172/1438) to 95.56%(1314/1375), the difference was statistically significant (χ2=1.353, P<0.01);the accuracy rate increased from 86.09%(1109/1172) to 95.13%(1250/1314), the difference was statistically significant (χ2=60.975, P<0.01); workers′ hands colonies number after fine management decreased than before, and there was significant differences (χ2=41.163, P<0.01). Conclusions The fine management has a higher application value in the infection control management of pharmacy intravenous admixture services, which can reduce the settlement of air bacteria formation rate, workers′ hands colonies number, improve hand hygiene compliance and accuracy of drug-care workers, further standardize the worker′s behavior, provide a more secure configuration environment, and guarantee the quality of drug configuration.

OBJECTIVE:To investigate the role of clinical pharmacists on parenteral nutrition support for liver cirrhosis patients with gastrointestinal bleeding.METHODS:Clinical pharmacists participated in parenteral nutrition support consultation for a liver cirrhosis patient with gastrointestinal bleeding.Based on etiology,liver function,complications and the effects of drugs on liver function,through two consultation,it was suggested to no longer add insulin into the patient's nutrient solution,adjust 20％ Fat emulsion injection(C14-24)250 mL to 20％ Medium-chain and long-chain fat emulsion injection (C8-24) 250 mL,adjust Compound amino acid injection(18AA-V)350 mL to 6 Amino acid injection(6AA)350 mL,adjust Calcium gluconate injection 1.0 g to 0.7g.Sodium glycerophosphate injection 10 mL and Alanyl glutamine for injection 10 g were added,decreasing dripping speed from 2 mL/min to 1.5 mL/min,increase Glucose injection (100 mL:50 g) from 300 mL to 350 mL.Blood glucose was also detected.RESULTS:Physicians adopted the suggestion of clinical pharmacists.The patient's condition and blood glucose control would keep stable till gastrointestinal bleeding was controlled,the diet returned to normal and none of above symptoms occurred again.CONCLUSIONS:The participation of clinical nutrition pharmacists in pharmaceutical care as parenteral nutrition support plays active role on the improvement of patients' nutritive condition and clinical prognosis improvement.

OBJECTIVE: To investigate the maxillary sinus development and provide data for sinus surgery on children. METHOD: Two thousand two hundred and thirty-eight children were randomly selected among those who underwent skull and nasal sinus CT scanning because of certain symptoms and signs. Patients were divided into eighteen age cohorts based on their age at the time of the scan. Anterior-posterior, transverse diameters and vertical height of the maxillary sinus were measured and statistically analyzed. RESULT: The maxillary sinus volume was enlarging even in adult, hut the growth of maxillary sinus was relatively stable in adolescent. The difference of transverse and anterior-posterior diameters of maxillary sinus had no statistical significance between female and male (P > 0.05), while there was statistically significant difference in the vertical height of maxillary sinus (P < 0.05). CONCLUSION The results will aid the physicians when correlating the clinical and radiographic findings of pediatric patients who are being evaluated for sinus disease and potential surgical intervention.
Adolescent ; Child ; Child, Preschool ; China ; Female ; Humans ; Infant ; Male ; Maxillary Sinus ; diagnostic imaging ; growth & development ; Sinusitis ; Tomography, X-Ray Computed ; Young Adult