"Qiong Yao incident" has triggered a discussion on the life-or-death choice in critically ill patients.Aimed at this problem,this paper analyzed the decision-making short cut of Confucian familism in Confucian life ethics,from the perspective of the implication of Confucian familism in medical ethics,the family consultation principle in medical decision making,the great significance of family-oriented medical decisions for patients and family members,and the family love in hospice care.In addition,it pointed out that hospice care in China is still in the preliminary exploration stage,so we should actively establish a road of hospice care which is suitable for China's national conditions.

OBJECTIVES: We conducted a qualitative study to explore the feasibility of mobile applications for self-monitoring of diet. METHODS: We conducted in-depth and focus group interviews with eight laymen who had used mobile dietary applications and eight experts. Interviews were audio-recorded and analyzed using an open coding method. RESULTS: The qualitative data of our study revealed two key themes: (1) perceptions, opinions and attitudes towards mobile applications of self-monitoring of diet and (2) future directions to improve mobile applications. CONCLUSIONS: Our qualitative study suggested the potential use of mobile applications as a food-tracking and dietary monitoring tool and the need for improved mobile applications for self-monitoring of diet. The results of our study may provide insights into how to technically improve mobile applications for self-monitoring of diet, how to utilize dietary data generated through mobile applications, and how to improve individual's health though mobile applications.
Clinical Coding ; Diet ; Focus Groups ; Methods ; Mobile Applications

OBJECTIVES: We conducted a qualitative study to explore the feasibility of mobile applications for self-monitoring of diet. METHODS: We conducted in-depth and focus group interviews with eight laymen who had used mobile dietary applications and eight experts. Interviews were audio-recorded and analyzed using an open coding method. RESULTS: The qualitative data of our study revealed two key themes: (1) perceptions, opinions and attitudes towards mobile applications of self-monitoring of diet and (2) future directions to improve mobile applications. CONCLUSIONS: Our qualitative study suggested the potential use of mobile applications as a food-tracking and dietary monitoring tool and the need for improved mobile applications for self-monitoring of diet. The results of our study may provide insights into how to technically improve mobile applications for self-monitoring of diet, how to utilize dietary data generated through mobile applications, and how to improve individual's health though mobile applications.
Clinical Coding ; Diet ; Focus Groups ; Methods ; Mobile Applications

Objective:To investigate the expression of mBmi-1 in papillary thyroid cancer (PTC) and to analyze its relationship with clinical features of PTC and its mechanism.Methons:A total of 60 tissue samples were collected from Jun. 2018 to Dec. 2018 in Department of Oncology Surgery of Affiliated Hangzhou First People’s Hospital, Zhejiang University School of Medicine. Real-time quantitative polymerase chain reaction (RT-PCR) was used to detect the expression level of B cell-specific MLV integration site-1 (mBmi-1) in PTC tissues and its relationship with pathological features was analyzed. Bmi-l microRNAs (miRNAs) were predicted by bioinformatics sites targetscan and microRNA.org and confirmed by luciferase reporter gene experiments. CCK-8 (Cell Counting Kit-8) kit and Transwell chamber were used to measure changes in PTC proliferative capacity and invasive ability.Results:In this study, we found that mBmi-1 expression was positively correlated with PTC lesion size and invasion ability. Bioinformatics prediction results suggested that Bmi-1 was a target gene of microRNA-203 (MicroRNA-203, miR-203) , and the 3’-UTR target sequence of miR-203 against Bmi-1 was GUAAAGU. After transfection of the miR-203 mimetic, the expression of Bmi-1 mRNA in the PTC cell line TPC-1 was significantly down-regulated. The dual luciferase reporter gene assay demonstrated that miR-203 can act on the 3’UTR region of the Bmi-1 gene to predict the target. In addition, the transfection of miR-203 mimetic effectively inhibited the proliferation and invasion of PTC cells, and the ability of proliferation and invasion of PTC cell TPC-1 was restored after overexpression of Bmi-1 in PTC cell TPC-1 transfected with miR-203 mimic.Conclusions:Bmi-1 is positively correlated with the proliferation and invasion ability of PTC. miR-203 can inhibit the proliferation and invasion of PTC cells by directly targeting Bmi-1 gene.

BACKGROUND/OBJECTIVES: The aim of this study was to examine the validity and reproducibility of a food frequency questionnaire (FFQ) developed in Korea for breast cancer survivors. SUBJECTS/METHODS: Ninety-nine breast cancer survivors who completed an FFQ twice and three 3-day dietary records (DRs) between 2016–2017 were included. Energy and 14 nutrient intakes were calculated from FFQs and DRs. To determine the validity of the FFQ, energyadjusted de-attenuated Pearson correlations between two FFQ assessments and the average of the three 3-day DRs were calculated, and to determine reproducibility, energy-adjusted Pearson correlations and degrees of agreement were calculated between the first and second FFQ assessments. RESULTS: Correlation coefficients of validity ranged from 0.29 (protein) to 0.47 (fat) (median value = 0.36) for the FFQ assessment and from 0.20 (riboflavin) to 0.53 (calcium) (median value = 0.37) for the second. Correlation coefficients of reproducibility ranged from 0.22 (sodium) to 0.62 (carbohydrate) (median value = 0.36). Regarding FFQ reproducibilities, percentage classifications of exact agreements for energy-adjusted nutrients ranged from 27.3% (sodium) and 45.5% (fat). A median 76.8% of participants were classified into the same or adjacent quartiles, while a median of 5.6% of participants were classified in extreme quartiles. Bland–Atman plots for the majority of data points of three macronutrients, calcium and vitamins A and C fell within limits of agreement. CONCLUSIONS These results indicated that the newly developed FFQ for Korean breast cancer survivors has acceptable validity and reproducibility as compared with three 3-day DRs collected over a one-year period.

Objective:To explore the key targets and mechanism of Bielong Ruangan decoction in the treatment of liver cancer based on network pharmacology and molecular docking.Methods:Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform (TCMSP) database, PubChem database and PharmMapper database were used to search and screen the chemical components and related targets of Bielong Ruangan decoction and the targets of liver cancer diseases. The network diagram of " Bielong Ruangan decoction-traditional Chinese medicine-active ingredient-predicted target-disease" was constructed; Protein-protein interaction (PPI) network were analyzed through String database; gene ontology (GO) enrichment analysis was performed through WebGestalt database; Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis was carried out through KEGG Orthology Based Annotation System (KOBAS) database; Molecular docking of the active components and core target proteins of Bielong Ruangan decoction was carried out by using PyMOL, Auto DockVina and other software.Results:Bielong Ruangan decoction had 67 active components, 154 liver cancer targets and 244 pathways. According to the analysis of network pharmacology, Bielong Ruangan decoction may play an anti-cancer role through key targets such as epidermal growth factor receptor (EGFR), mitogen activated protein kinase 1 (MAPK1), estrogen receptor 1 (ESR1), MAPK8, serine threonine protein kinase 1 (AKT1), MAPK14, cysteine protease 3 (CASP3), cyclin-dependent kinase 2 (CDK2), bone morphogenetic protein 2 (BMP2), aldose reductase (AKR1B1) and other key targets. KEGG enrichment analysis showed that the treatment of liver cancer by Bielong Ruangan decoction involved the regulation of vascular endothelial growth factor (VEGF) signaling pathway, tumor necrosis factor (TNF) signaling pathway, thyroid hormone signaling pathway, T cell receptor signaling pathway and other pathways. The results of molecular docking showed that the binding energy of all compounds to protein was less than -5.6 kcal/mol, indicating that each compound and each protein could bind well.Conclusions:Bielong Ruangan decoction participates in the treatment of liver cancer through " multi-component, multi-target and multi-channel" ways, and plays an anti-cancer role mainly by regulating the proliferation and invasion of tumor cells and tumor inflammatory microenvironment.

With the effective implementation of universal salt iodization measures to prevent iodine deficiency disorders, severe iodine deficiency in pregnant women has been rare. However, due to the difficulty in changing the state of iodine deficiency in natural environment and insufficient iodine intake in diet to meet the iodine nutritional needs during pregnancy, mild or moderate iodine deficiency in pregnancy still occurs frequently, and may have adverse effects on the development of nervous system of their offspring. At the same time, the effect of excessive iodine intake of pregnant women on the development of nervous system of their offspring can not be ignored. In addition, if the ability of thyroid regulation in pregnant women is out of balance that leads to thyroid dysfunction and even hormone secretion disorder, which can not meet the needs of fetal growth and development, it may also affect the nervous system function of their offspring. This paper summarizes the human population studies in recent years: the effects of maternal mild to moderate iodine deficiency, iodine excess, abnormal thyroid function and thyroid hormone treatment on neuro development of offspring, and the mechanism of corresponding animal iodine related exposure experiments, in order to provide scientific basis for "precise prevention and treatment" of iodine deficiency disorders in the future.

Liver fibrosis is the common result of various chronic liver injuries and can progress to liver cirrhosis and even liver cancer, and at present, there is still no effective means to reverse liver fibrosis. The transformation of activated hepatic stellate cells (HSC) in perisinusoidal space into myofibroblasts and the secretion of collagen are a central event in the process of liver fibrosis. NLRP3 inflammasome can be activated by various injury stimuli and mediate inflammatory response and pyroptosis. Recent studies have found that the activation of NLRP3 inflammasome is closely associated with HSC activation. This article introduces the activation of NLRP3 inflammasome in different pathways in HSC under various pathological factors and role of NLRP3 inflammasome in the formation of extracellular inflammatory microenvironment, thereby mediating HSC activation and playing an important role in promoting liver fibrosis.

Objective:To evaluate the intelligence, movement and physical development of 2-month-old infants, and to explore the influencing factors of early infant development.Methods:A total of 203 infants aged 42 days who underwent physical examination in the Department of Neonatology of the Fourth Affiliated Hospital of Harbin Medical University from May to December 2021 were selected as subjects. At the age of 2 months, 184 infants were followed up for their intelligence, movement and physical development. The intelligence and movement development of infants were evaluated with the intelligence development scale. Their body length, weight, and head circumference were measured, and physical development was assessed by Z-score method. Logistic regression was used to analyze the influencing factors of intelligence, movement and physical development of 2-month-old infants.Results:The median mental developmental index (MDI) of 184 2-month-old infants was 101; the median psychomotor developmental index (PDI) was 89; the body length was (59.3 ± 2.0) cm, the body weight was (5.8 ± 0.6) kg, and the head circumference was (38.9 ± 1.1) cm. Multiple logistic regression analysis showed that the influencing factors of MDI were maternal delivery age and infant gestational age [odds ratio ( OR) = 0.849, 0.463, P < 0.05]; the influencing factors of PDI were maternal prenatal education and average sleep time per night during pregnancy ( OR = 0.512, 0.666, P < 0.05); the influencing factor of body mass index (BMI) was maternal iodine supplements during pregnancy ( OR = 2.858, P = 0.018); the influencing factor of length-for-age Z-score (LAZ) was maternal prenatal education during pregnancy ( OR = 0.265, P = 0.026); the influencing factors of weight-for-age Z-score (WAZ) included maternal average sleep time per night, the frequency of sleeping time exceeding 12 am and the average weekly exercise duration during pregnancy ( OR = 0.277, 1.106, 0.990, P < 0.05). Conclusion:Maternal delivery age, prenatal education, sleep duration, intake of iodine supplements, exercise duration during pregnancy, and infant gestational age are factors affecting the intelligence, movement and physical development of 2-month-old infants, which should be paid attention to and measures should be taken to improve the population quality.