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 provide reference for the further implementation of national essential medicines. METHODS:The drugs consumption data of outpatients and inpatients in our hospital from Jan. 1 to Jun. 30,2014 were statistically analyzed. RE-SULTS:Variety numbers of national essential medicines in our hospital occupied 37.38%(228/610) in total drugs variety numbers of the whole hospital,consumption sum of national essential medicines occupied 9.80%(817.02 million yuan/8 338.12 million yu-an) in all drugs consumption sum. The first 20 national essential medicines listed in consumption sum were mainly anti-cancer drugs and water,electrolyte and acid-base balance regulation drugs. CONCLUSIONS:In the utilization of national essential medi-cines,variety proportion and consumption sum ratio in our hospital are relatively low. It is suggested to make clear the use require-ments of national essential medicines in cancer hospitals to make more reasonable and scientific selection of anti-tumor medicines in National Essential Medicines List and reasonably increase the assistant medicines related to the treatment of neoplastic diseases;hos-pitals should take effective measures to promote the usage rate of national essential medicines.

Objective To investigate the effect of solution-focused therapy on the care burden and negative emotions of the primary caregivers with elderly patients with hip fractures. Methods One hundred and sixty-eight elderly patients with hip fractures and caregivers were divided into intervention group and control group with 84 pairs by random digits table method, and the two groups were given continual nursing care. At the same time, the primary caregivers of intervention group accepted the solution-focused therapy. Caregiver Burden Inventory (CBI), Self-rating Anxiety Scale (SAS), and Self-rating Depression Scale (SDS) were used as the evaluation indexes. Results Before intervention, the score of CBI, SAS,SDS was (42.07 ± 4.24), (50.75 ± 11.21), (51.59 ± 13.18) points in control group and (42.10 ± 3.96), (50.48 ± 12.59), (52.96 ± 13.51) points in intervention group, and there was no significant differences between two groups (P>0.05). After intervention, the score of CBI, SAS, SDS was (40.49±3.17), (50.64±11.33), (50.14±10.25) points in control group and (28.95±2.87), (36.73±9.45), (41.60±8.23) points in intervention group, and there was significant differences between two groups (t=5.42, 8.73, 7.45, all P<0.05). Conclusions Solution-focused therapy can effectively reduce the care burden of the primary caregivers of elderly patients with hip fractures and alleviate their anxiety and depression.

BACKGROUND: After reviewing the literature, the author found that most of the epidemiological data related to cancer pain was reported by physicians from the point of view of treatment, or of patients' response to the treatment. Although the nurses in oncology department are most direct participants in the cancer pain management, there is less investigation about the nurses' knowledge, attitudes to and skills of cancer pain management.OBJECTIVE: The purpose of this investigation was to provide information so as to suggest the nursing managers and educators in specifically propagating and disseminating the knowledge of cancer pain management.DESIGN: A sampled investigation.SETTING: Integrated Medicine Ward, College of Clinical Oncology,Peking University.PARTICIPANTS: The participants of this investigation were 128 nurses who took part in the National Tumor Care Academic Exchanges and Seminar Conference held in June 1998.METHODS: This investigation was carried out through a survey questionnaire and the questionnaire was designed on the basis of the Cancer Analgesics Questionnaire (for nurses use only) established by the Oncology Profession Committee of Chinese Nursing Association in 1993, furthermore,suggestions from experts were adopted.MAIN OUTCOME MEASURES:①The perception about "three-step analgesic ladder";②currently most commonly used analgesics in clinical;③assessment methods for cancer pain④knowledge of being addicted to analgesics⑤attitude of nursing staff to cancer pain management.RESULTS: The number of those who could correctly designate the relationship of three steps and pain intensity was 82(64.0% ). Only one person could correctly write down the contents of three steps analgesic ladder (0.7%) . Physician's orders for analgesics for cancer pain in the responders' hospitals were classified into the following types: temporary order:54.0%; when necessary, 38.0%; long-term order, 24.0%. But none of the nurses could mark correctly the range of mild, moderate and severe grade on the scale. Only 49.2% (63/128) of the nurses considered that "The pain scale should be determined according to the cancer patients' self-perception to the pain intensity(chief complaint)" . Among the responders, only 12.5% (16/128) of them accepted that "the incidence of addiction occurred as a result of analgesics used for pain control is less than 1% ". Only 26. 5% (34/128) of the responders could distinguish the concepts of tolerance, physical dependence, and addiction.CONCLUSION: From the results of the investigation, we can see that, the nursing professionals do not have sufficient knowledge about "three-step analgesic ladder". The popularization of related knowledge among nurses has been delayed severely. Nurses will obtain the knowledge of cancer pain management by clinical experience instead of in regular ways. The attitude of nursing personnel to cancer pain treatment is one of the important factors that affect the pain management. The frontline nurses should master the pharmacological characteristics of opioids so as to explain it to the patients and their relations distinctly. Nurses should bring into play a more powerful action in reducing the "addiction-phobia" due to their professional characteristics. We suggest that the latest new progress in cancer pain treatment should be incorporated into the normal textbooks on the management of cancer pain. We also propose that the methods of cancer pain treatment,contents of the principle of drug prescription be included in the training of a medical care personnel of oncology professional before entering into clinic.

Objective To determine the triterpenoid content in Loquat leaf by using HPLC method and to explore the feasibility of ursolic acid and oleanolic acid as the quantitative markers for determination of Loquat leaf and its preparations.Methods Two desugaring methods of Loquat leaf extracts were compared.The contents of ursolic acid and oleanolic acid in Loquat leaf as well as preparations were measured based on a system of HPLC,with a Dumas Diamonsil C18 column (250 mm×4.6 mm,5 μm) was used as analytical column.The mobile phase was consisted of acetonitrile-0.1% phosphoric acid (95∶5) with the flow rate of 0.5 mL·min-1.The column temperature was 30 ℃,the injection volume was 10 μL, the detective wavelength was 210 nm.Results Ursolic acid and oleanolic acid were measured in both Loquat leaf and its preparations,and their contents were fairy stable and comparable.Conclusion Ursolic acid and oleanolic acid can be served as quantitative markers for the determination of Loquat leaf and its preparations.

Objective To evaluate the application value of 256 slice spiral CT angiography (CTA)in the bridge vessels lesions af-ter grafts operation in lower extremity arteriosclerosis obliterans patients.Methods Taken DSA as the gold standard,using 256 slices spiral CTA to analysis the post-processing image of 76 article Bridge vascular which can be assessed in 65 cases patients with lower extremity arteriosclerosis obliterans,and to evaluated the diagnosis accuracy,sensitivity,specificity,positive predictive rate and negative predictive rate of postoperative bridge intravascular lesions.Results Using 256 slices spiral CTA,the bridge vascular of grafts operation patients can be clearly displayed,stenosis or unobstructed,and the anastomosis of the bridge vascular.5 graft occlu-sion,22bridge intravascular plaque were diagnosed correctly,3 vascular lesions were undiscovered.The accuracy,sensitivity,speci-ficity,positive predictive rate and negative predictive rate were 98.15%,96.15%,97.90%,92.59% and 97.96% respectively. Conclusion Using 256 slices spiral CTA can clearly show the endovascular lesions of lower extremity arteriosclerosis obliterans after grafts operation,and has high accuracy and specificity.It can be safely used as one of noninvasive follow-up means after grafts oper-ation.

Objective To evaluation the anatomy relationship between thoracic artery and coronary artery by using 256 layer spiral CT angiography. Methods The angiographic images of thoracic aortic and coronary artery angiography were re?vealed in 200 patients with chest pain. Values of the major branch length, diameter, length of the aorta-coronary artery by?pass on both sides of the thoracic artery and coronary artery were measured. Results The diameter of thoracic artery was (2.52±0.38) mm, and the length of thoracic artery from the starting point to terminal was (190.12 ±1.90) mm. There were no significant differences in the thoracic artery lumen diameter and length between both sides. The inner diameters of left anteri?or descending coronary artery, left circumflex, diagonal branch, right coronary artery and the posterior interventricular branch were (2.82 ±0.25), (2.60±0.12), (2.22±0.25), (3.02±0.27) and (2.35±0.35) mm respectively. There were no significant differences in thoracic artery diameters except for the right coronary artery diameter, which was higher than that of the thorac?ic artery. About free transplantation the length from 2cm above in the ascending aorta starting to the halfway point of anterior descending coronary artery, to the atrioventricular node along the left circumflex way, to the atrioventricular node along the right coronary artery and from the atrioventricular node to halfway point of posterior interventricular branch was shorter than that of thoracic artery (P<0.05). About situ transplantation in addition to the length from the thoracic artery start department to the point of anterior descending compared with the thoracic artery length, there were no statistical significance ( P>0.05). The length from the thoracic artery start department to the left-hand atrioventricular node, to the right coronary artery atrio?ventricular node was higher than that of the thoracic artery length (P<0.05). Conclusion The branches of internal thoracic artery and coronary artery are similar. About situ transplantation is suitable for the wall blood vessels before the heart. With free thoracic artery transplantation, its length can meet any bridging from the ascending aorta to the coronary arteries.

Objective To study the relationship between breast symptom, characteristic of ultrasound image and sex hormone level in women with different menstruation status.Methods 50 women with normal men-strual cycle, 129 women in menopause transition and 318 menopausal women were recruited.Breast ultrasound were performed.Breast section thickness, ductal width, breast structure and blood flow were measured.Serum estradiol( E2 ) and progesterone( P) level were measured by enzyme immunoassay on the day when ultrasound was performed.Onset and persistent days of breast pain were recorded.Results ①32(60.4%)women with normal menstrual cycle and 74(57.4%)women in menopause transition women experienced cyclic mastalgia.The aver-age serum E2 level and serum progesterone level were higher in women with cyclic breast pain than in women with-out breast pain.12.5%of menopausal women had breast pain.There was no significant difference of average ser-um E2 level between women with cyclic breast pain and women without breast pain②Breast section thickness was (14.4 ±4.3)mm,(13.0 ±3.7)mm and(10.6 ±3.2)mm, and ductal width was(0.62 ±0.18)mm,(0.88 ± 0.39)mm and(0.90 ±0.47)mm in normal menstrual group, menopause transition group and menopausal group, respectively.The difference had statistical significance.③26 women ( 49.1%) in normal menstrual group had breast structure changes, while 42 cases ( 32.6%) and 60 cases ( 18.9%) in menopause transition group and menopausal group had breast structure changes.Conclusions Most women in normal menstruation and meno-pause transition group experience mastalgia.About 1/3 breast structure change in women of normal menstruation are inversible.About 1/2 breast structure change in menopause transition and menopausal group are similar to those with normal menstruation.

Objective To clone and express the new gene R049 of uropathogenic Escherichia coli 132.and to investigate the immunopmtective effects of the R049 recombinant protein on mice.Methods The pmkaryotic expression system of gene R049 was constructed by directed cloning.Thereafter,the R049 recombinant protein Was expressed and purified by Ni affinity chromatography.Polyclonal antibody was pre-pared by immunizing BALB/c mice with R049 recombinant protein.The R049 recombinant protein and whole bacterial proteins of UPEC132 were analyzed by SDS-PAGE and Western blot.BALB/c mice were im-munized with R049 recombinant protein before challenged by UPECl32 through urinary tract.Then the differences of urine and renal colony counts between immunization group and control group were compared.Results The recombinant strain E coli BL21(DE3)/pET32a-R049 ORF was constructed successfully,and the relative molecular mass of the R049 recombinant protein was 66.9×103 and its purity was up to 95% af-ter purification.The titer of polyclonal antibody wag≥1:102 400 analyzed by indirect ELISA.Both of the R049 recombinant protein and whole bacterial proteins of UPECl 32 were confirmed to show specffic reactions on the antiserunl throughh Western blot.The animal experiments showed the urine and renal colony counts of immunization group were significantly lower than that of the control group(P<0.01,P<0.05).Conclu-sion The new gene R049 of uropathogenic E.coli 132 had immunopmtective effects on mice and the defini-tive mechanism would be needed to further study.

Through the study of the pathology of sleep apnea-hypopnea syndrome, evaluation indexes, diagnosis requirements and so on, a portable sleep monitoring system was designed, which had the characteristics of convenience, wireless transmission and no disturbance. The system can be assessed by respiration monitoring and pulse oximetry, which is based on the pressure variation in miniature air-bag and spectral absorption method. It provides the value of the apnea-hypopnea index (AHI), which is used to evaluate OSAHS severity. The experiment of the system's stability and accuracy is done, which exhibits good performance, it can diagnose OSAHS effectively and provide convenience for home monitoring.
Humans ; Oximetry ; Polysomnography ; instrumentation ; Sleep Apnea, Obstructive ; diagnosis