Objective To observe the effect and mechanism of imiquimod on T helper (Th) cell subsets in the Parabronchial lymph node (PBLN) cell cultures from ovalbumin (OVA)-sensitized rats.Methods PBLN were isolated and cultured. PBLN cells were divided into A~F, according to different concentrations of intervention. Cultured for 0, 3, 6, 12, 24, 48 hours, the expressions of IL-4 and IFN-? in supernatants were determined by ELISA. The mRNA expressions of the cytokines in cells were detected by RT-PCR.Results In the group A, only low concentrations of IFN-? were detected. Based on the cultured time, the concentrations of IFN-? were increased significantly if imiquimod concentration was between 1 and 10 ?g/ml. Levels of IL-4 were increased slowly compared with those in the group B (P0.05).Conclusion Imiquimod show the best effect on antigen-specific Th cell subsets when cultured for 12h. The results suggest that imiquimod have benefit in atopic diseases such as the late inflammation reaction of asthma.

Objective:To construct an evaluation index system for the quality of hospice care services, so as to provide scientific basis for evaluating the clinical practice quality of hospice care in China.Methods:Based on theories related to medical quality, a primary item pool was constructed through literature analysis. From November to December 2023, the Delphi method was used to conduct two rounds of consultation with 18 hospice care experts from 10 provinces and municipalities directly under the central government, to establish the indicators at all levels of the evaluation index system. The weights and combination weights of indicators at all levels were calculated using the analytic hierarchy process. The expert's positive coefficient was expressed as the effective response rate of the questionnaire. The degree of expert authority was expressed as the expert authority coefficient. The degree of coordination of expert opinions was represented by Kendall's W and coefficient of variation. Results:In the two rounds of expert consultation, the effective response rates of the questionnaires were 88.89% (16/18) and 93.75% (15/16), the expert authority coefficients were 0.885 and 0.897, the kendall's W values of the overall indicators were 0.152 and 0.191 ( P<0.01), and the coefficients of variation of indicators at all levels were 0 to 0.31 and 0 to 0.21, respectively. The final constructed evaluation index system for the quality of hospice care services included seven first level indicators, 22 second level indicators, and 42 third level indicators. Conclusions:The evaluation index system for the quality of hospice care services constructed is scientific, comprehensive, and targeted, which can provide reference for the comprehensive evaluation of hospice care service quality in China.

With the rapid acceleration of aging in China, there is a huge need for elderly patients to have improved quality of life in the terminal stage.Palliative sedation is an integral part of palliative care and can alleviate painful refractory symptoms, and its use in patients in various terminal illnesses is being explored across the world.Attention is focused on its indications and implementation.In China, palliative sedation in clinical practice is in an early exploratory stage and relevant criteria and guidelines have yet to be established.A review of the current practice and research progress concerning palliative sedation for patients' end-of-life care in China and the rest of the world will offer insight and strategic considerations in the initial pursuit and accelerated acceptance in the future in China.

Pain is a prevalent symptom in both cancer and non-cancer end-stage diseases, often being the most feared by patients and significantly impacting their quality of life.Hospice care aims to address physical, psychological, spiritual, and other needs of patients and their families during this stage, with a focus on alleviating pain and discomfort.Effective pain management is a crucial component of hospice care, particularly given the increasing prevalence of cancer and chronic diseases in China and the growing elderly population.To provide analgesic management for hospice patients, a thorough assessment of pain is essential to identify its type and characteristics.Treatment approaches may include etiological interventions, pharmacotherapy, interventional therapy, physiotherapy, psychotherapy, and comfort care, all aimed at achieving comprehensive pain management.The use of opioid should be carefully guided by scientific principles to minimize adverse effects and optimize pain relief, ultimately enhancing patients' end-of-life quality of life.

Pain is one of the most common and unendurable symptoms in cancer patients and a major factor affecting their quality of life.Patient-controlled analgesia(PCA) is an important palliative measure in additional to conventional pharmacological control of pain.Nurses play the primary role in the management of PCA for cancer pain, and their knowledge, attitude and practice about PCA for cancer pain directly affect the effectiveness of cancer pain management.This article summarizes and analyzes the current status of nurses' knowledge, attitude and practice and associated influencing factors, aiming to improve nursing management of PCA, reinforce specialized nursing training, propose recommendations for an expert consensus on PCA for cancer pain and provide a reference for nursing practice in PCA for cancer pain.