Objective To survey and compare the awareness and attitude of hospice care among medical staff from hospitals ranked 1, 2, and 3. And to examine the association of hospital grading with awareness and attitude of hospice care. So that this study would promote orientation for hospice care theoretically. Methods A cross-sectional questionnaire survey was performed among medical staff in Suzhou to investigate the awareness and attitude of hospice care from hospitals ranked 1, 2, and 3. Generalized linear regression model was applied to examine the association of hospital levels with awareness and attitude of hospice care. Results A total of 990 individuals were surveyed. Among them, 580 were from hospitals ranked 3, 252 were from hospitals ranked 2, and 158 were from hospitals ranked 1. The attitude to someone self′s death scored 7.2 ±2.1, 7.6 ±2.4, 7.2 ±2.1, the attitude to patients′death scored 11.0 ±2.6, 11.6 ±2.3, 11.5±2.3, there was a significant difference among the 3 levels (F=3.34, 3.69, all P<0.05). After controlling for age, education level, years of work, religion status, family type, and disease condition in family, as compared with hospitals ranked 3, the average score of the awareness of hospice care decreased 0.431 (P=0.049) and the average score of attitude to hospice care decreased 2.944 (P=0.022) in medical staff from hospitals ranked 1. As for the 7 aspects of hospice care attitude, the average score of attitude to patients′death decreased 0.634 (P=0.003), the average score of attitude to implementation of hospice care for patients and their families decreased 0.926 (P=0.046), and the average score of supporting hospice care decreased 0.664 (P=0.011) in medical staff form hospitals ranked 1 as compared with hospitals ranked 3. We failed to find a significant difference in awareness and attitude of hospice care between hospitals ranked 2 and 3 (all P>0.05). Conclusions The awareness and attitude of hospice care is poorer in medical staff from hospitals ranked 1 as compared with those from hospitals ranked 2 or 3. Our finding suggests that medical staff from hospitals ranked 1 is a target population on whom hospice care training would be performed.

Objective To explore the association between the infection rate of Helicobacter pylori (Hp) and intake frequency of capsicum in dietary pattern. Methods A total of 914 health check-up participants were recruited from Tianjin Medical University General Hospital (male: 510,female:404). All participants were asked about the intake frequency of capsicum. Diagnostic criteria of the Hp infection included positive C13 breath test. Results The intake frequency of capsicum was ≥2 times/week, 1 time/week and <1 time/week. The infection rate of Hp was 56.08%, 49.04% and 48.29%. After adjusting for covariates, compared with the≥2 times/week, the odds ratios(95%confidence interval)of intake frequency of capsicum 1 time/week and <1 time/week: the frequency of capsicum intake ≥2 times/week was 1.00 (reference), the frequency of capsicum intake 1 time/week was 0.57(0.33-0.97) and the frequency of capsicum intake<1 time/week was 0.69(0.42-1.14) in men;the frequency of capsicum intake≥2 times/week was 1.00 (reference), the frequency of capsicum intake 1 time/week was 1.01(0.54-1.88), and the frequency of capsicum intake<1 time/week was 0.71(0.41-1.23) in women. Conclusions This study found that food intake frequency of capsicum≥2 times/week was associated with the infection rate of Hp in men. But similar relationship was not observed in women.

Objective:To evaluate the effect of Nutlin-3,a MDM2 antagonist,on the pyroptosis in SMMC-7721 cells.Methods: The expression of actived caspase-1(p20) and IL-1β was detected using Western blot analysis.Pyroptosis was investigated by a standard lactate dehydrogenase release assay(LDH).IL-1β content in the cell culture supernatant was quantified by ELISA.Results: Nutlin-3 up-regulated the expression level of actived caspase-1 and IL-1β in SMMC-7721 cells.Meanwhile,Nutlin-3 increased significantly the content of LDH and IL-1β in the cell culture supernatant(P<0.05).Conclusion: Nutlin-3 activated pro-caspase-1,promoted pyroptosis and IL-1β release in SMMC-7721 cells.

Carcinoma, Squamous Cell ; genetics ; metabolism ; pathology ; Esophageal Neoplasms ; genetics ; metabolism ; pathology ; Gene Frequency ; Humans ; Lymphatic Metastasis ; Neoplasm Invasiveness ; Neoplasm Staging ; Polymorphism, Genetic ; Prognosis ; Proportional Hazards Models ; Risk Factors ; Survival Rate ; Tumor Necrosis Factor-alpha ; genetics ; metabolism

Objective To evaluate the safety and effectiveness of partial cystectomy combined with chemotherapy in treating localized muscle invasive bladder cancer.Methods The patients admitted to localized muscle invasive bladder cancer from October 2011 to December 2015 were screened according to the strict inclusion criteria,and the final 53 patients were enrolled in the study,37 males and 16 females,aged 36 to 85 (63.72 ± 13.31)years.Tumor diameter 1.5-4.0 (2.52 ±0.56)cm,the number of≤ 3 and the edge of the tumor from the ureteral opening ＞ 2 cm.All pathological types are urothelial carcinoma.All patients were examined by MRI clinical stage T2a-T2b period.A total of 53 patients with muscle invasive bladder cancer who refuse or older,merge the heavier medical disease,difficult to tolerate radical cystectomy.Using partial cystectomy,intraoperative electrosurgical excision to deep muscle,parallel to the tumor bed frozen to confirm negative margins,postoperatively systemic chemotherapy of gemcitabine combined cisplatin and bladder perfusion chemotherapy of hydroxycamptothecin.Results Patients were successfully opcrated,and no margin positive or incision planting cases.The operating time is 55-110 min and average (79.11 ± 17.25)min.There was no serious complication in operation and postoperative,pathological diagnosis was invasive epithelial cell carcinoma of the urinary tract,pathology classification:low level 41 cases,and high level 12 cases.Follow up of 12 to 62 months,an average of (27.11 ± 12.22)months,21 cases of recurrence,12 patients had superficial recurrence in the bladder who was treated successfully by transurethral resection of bladder tumor,5 cases of multiple myometrial invasion who was treated by radical cystectomy (3 cases died of bladder cancer after the surgery in 8,12,and 18 months later),4 cases of myometrial invasion with recurrence of pelvic lymph node metastasis or even distant metastasis to give up treatment (all died within six months of bladder cancer).The first tumor recurrence time 3-18 months,11 months and the median time.Conclusions Our data indicate that partial cystectomy combined with chemotherapy is a safe and effective in treating localized muscle invasive bladder cancer,with less trauma,shorter operative time and higher safety,so as to provide an alternative treatment for patients with advanced age,high risk or who can not be implemented transurethral resection of bladder tumor or who refused to undergo radical cystectomy.

BACKGROUND: The occurrence and severity of acute high-altitude disease(AHAD) are determined by the speed entering the highland, the altitude of highland and seasons. The association between obesity and AHAD has not been fully investigated.OBJECTIVE: To investigate the association between obesity and acute high-altitude in people exposed rapidly to the highland.DESIGN: Comparative observation.SETTING: Department of Cardiology, General Hospital of Chinese PLA and Department of Cardiology, Tibetan General Hospital of Chinese PLA.PARTICIPANTS: The experiment was conducted at the Department of Cardiology, General Hospital of Tibetan Military Area Command of Chinese PLA in August 2006. Totally 82 Henan subjects aged 28-45 years were selected from the male workers constructing the Qinghai-Tibet Railway and their managers with acute high-altitude exposure. They had never been to the highland before, and all agreed to the detection.METHODS: ①Every subject completed the AHAD self-report questionnaire at sea level and 12 hours and 24 hours after ascending high-altitude. The items in the questionnaire included symptoms of headache, gastrointestinal symptoms,fatigue or weakness, dizziness, and insomnia. Each symptom was graded from 0-3 with 0 as no symptoms, 1 as mild symptoms, 2 as moderate symptoms, and 3 as severe symptoms and a total score of 15. A score of 4 or more could by identified as AHAD. ②The height and body mass were measured to calculate the body mass (BMI). Those with BMI≥28 kg/m2 served as the obesity group [n =39, mean age (35±8) years], and those with BMI of 18.5-23.9 kg/m2 as the normal body mass group [n =43, mean age (35±8) years]. ③Arterial blood was taken to evaluate arterial oxygen saturation (SO2), arterial oxygen pressure (PaO2) and arterial carbon dioxide pressure (PaCO2) at baseline and 24 hours after ascending high-altitude. ④The measurement data was compared by t test.MAIN OUTCOME MEASURES: BMI, vital capacity of lungs, SO2, PaO2 and PaCO2 levels of obese and normal people.RESULTS: Totally 39 obese people and 43 normal people were involved in the result analysis. ①AHAD score: No symptom was reported at sea level in all participants (scored 0), but the AHAD scores in the obesity group were significantly higher than those in normal group 12-hour and 24-hour after ascending high-altitude. ②Blood gas analysis:At sea level, there were no statistical differences in the levels of SO2, PaO2, and PaCO2 between two groups (P ＞ 0.05).But 24 hours after ascending high-altitude, SO2 and PaO2 of the obesity group were much lower than in the normal group (P＜ 0.01), and PaCO2 was significantly higher than in the normal group (P＜ 0.01).CONCLUSION: Obese men are more vulnerable to high-altitude hypoxia than people with normal body mass. Obesity is an important risk factor for the development of acute high-altitude disease.

Objective To evaluate the therapeutic effect of intramyocardial controlled releasing base fibroblast growth factor (b-FGF) stent combined with transplanting bone marrow-derived mesenchymal stem cells (BM-MSCs) in porcine acute myocardial infarction (AMI) models. Methods Eighteen porcines were divided into three groups (each n=6):transmyocardial revascularization (TMR)+naked stent (control group), TMR+b-FGF stent (b-FGF group) and TMR+b-FGF stent+BM-MSCs (b-FGF+BM-MSCs group). Acute myocardial infarction models were induced by ligating the left anterior descending artery in 18 porcine. In the control and b-FGF group, naked stents, b-FGF stents and b-FGF stent+BM-MSCs were implanted into TMR channels in the infarct and border zone. ~(99m)Tc-methoxyisobutylisonitrile (MIBI) myocardial perfusion imaging were performed to evaluate changes in myocardial blood flow, and echocardiography and immunohistochemical studies were also performed. Results After 6 weeks, the quality of myocardial infarction, fractional shortening, neovascular density in b-FGF and b-FGF stent+BM-MSCs group were higher than those of control gruop (P<0.05), and in b-FGF stent+BM-MSCs group was higher than those in b-FGF group (P<0.05). Conclusion BM-MSCs combined with controlled releasing intramyocardial b-FGF stent can improve the flow of myocardial infarction area, promote angiogenesis and heart function, and the therapeutic effect which can be evaluated with myocardial SPECT imaging.

Objective To explore the diagnostic value of N‐terminal Pro‐Brain Natriuretic Peptide (NT‐proBNP) in Kawasaki disease (KD) in children .Methods Ninety one children with KD were collected and 80 patients with acute upper respiratory infec‐tion were used as controls .Plasma NT‐pro BNP concentrations and other laboratory date were collected in the acute of KD .The re‐lationships between NT‐pro BNP values and different clinical and laboratory data in the acute phase were sought .Results The mean plasma NT‐pro BNP concentration in patients with KD in the acute phase was (1 042 .38 ± 528 .7)pg/mL ,significantly higher than those of control group(458 .6 ± 412 .3)pg/mL (P<0 .05) .The results of linear correlation analysis indicated that plasma NT‐pro BNP was positively correlated with CRP (r= 0 .442 ,P< 0 .05) ,and negatively correlated with Hematocrit ,Albumin and Na (r= -0 .216 ,r= -0 .204 ,r= -0 .315 ,respectively ;P<0 .05) .According to ROC analysis ,the AUC of NT‐pro BNP for detection of KD were 0 .881 ,sensitivity and specificity was 70 .1% and 84 .0% respectively for the cut‐off value of 530 pg/mL .Conclusion Our findings showed that NT‐proBNP would elevate in the acute stage of KD and was a reliable marker for the diagnosis of KD .A high level of NT‐pro BNP is associated with systemic inflammatory responses and increased vascular permeability .

Objective Neutrophil/lymphocyte ratio (NLR) is an easy-to-analyze inflammation biomarker but few studies have assessed the relationship between NLR and type 2 diabetes. In order to evaluate how NLR is related to type 2 diabetes, we designed a large scale cross?sectional study in an adult population. Method A cross?sectional study (including 49 861 men and 40 376 women) was conducted on participants recruited from the Health Management Center of Tianjin Medical University General Hospital in Tianjin, China. Measurements of neutrophil and lymphocyte counts, fasting blood glucose and other potential confounding factors were performed. Type 2 diabetes was defined according to the criteria of American Diabetes Association. Adjusted logistic regression models were used to assess relationships between NLR quintiles and type 2 diabetes. Result In the final multivariate models, the odds ratios (95% confidence interval) for T2D across NLR quintiles were 1.00 (Reference), 1.19 (1.05, 1.35), 1.33 (1.17, 1.50), 1.28 (1.13, 1.44) and 1.34 (1.19, 1.51) (P for trend<0.000 1), in men. Similar relationships were also observed in women. Conclusion This study demonstrated that NLR was related to the prevalence of type 2 diabetes in men and women, and suggesting that NLR may be an efficient and accurate prognostic biomarker for type 2 diabetes.

Objective To evaluate whether the serum uric acid (SUA) levels are related to development of prediabetes. Methods This was a 6-year cohort study, subjects were recruited from Tianjin Medical University General Hospital Health Management Center. A prospective assessment (n=30 910) was performed. Subjects without a history of prediabetes were followed up for 6 years (with a median follow-up of 2.7 person-years). All relevant variables including SUA concentrations, and fasting plasma glucose were assessed at baseline and yearly during the follow-up. Prediabetes was defined in accordance with the American Diabetes Association criteria of 2014. Multivariate-adjusted Cox proportional hazards regression models were fitted to assess relationships between the quintiles of baseline SUA and the incidence of prediabetes. Results The incidence of prediabetes was 55 per 1 000 person-years. In comparison with subjects in the lowest quintile, the odds ratios and hazard ratio (95%confidence interval) of higher quintile of SUA were 1.04 (0.93, 1.15), 1.07 (0.95, 1.19), 1.13 (1.01, 1.28) and 1.15 (1.02, 1.30) (P for trend=0.01), respectively, after adjusting for potential confounders. Conclusion SUA levels predicted an increased risk of prediabetes in adults.