Objective To conduct a systematic review on the need and experience of patients in end of life and provide evidence-based guidance for delivery of end-of-life care in hospital and community settings. Methods Two Chinese (CBM and CNKI) and four English relevant databases (PsycINFO,MEDLINE,EMbase and CINAHL) were in-cluded to retrieve literatures on Chinese dying patients' needs and experience between inception and August 2016. The JBI Critical Appraisal Tool for qualitative studies in Australia was used to evaluate the quality of studies. The searching results were synthesized by employing Integrating Methods. Results Seventy-five findings were extracted from 9 qualified studies. The 75 findings were sequently integrated into 5 categories and finally 2 synthesized re-sults were summarized from the 5 categories. Integration result 1:under the sufferings from both physical and psy-chological aspects,dying patients require support from both family and society. Integration result 2:although death is acceptable for patients,they still hope for dignity and goals of life. Conclusion Needs of patients in end-of-life should be understood and respected. Reasonable and effective measures need to be taken to meet their needs and improve their quality of life.

Oligonucleotide microarray technology is a powerful data-mining platform and has been widely applied in biosciences. To improve the performance of assays on the oligonucleotide microarray, the factors that influence the hybridization effects such as surface chemistry, probe size, spacer length, hybridization conditions etc were intensely studied and optimized. However, it is a key problem with DNA microarrays how to generate higher fluorescent signals to improve the detection sensitivity. Two types of multiply labeled primers, termed multiply labeled linear primer and multiply labeled branched primer, were used to enhance the fluorescent signal obtained from two-dimensional DNA microarrays.The signal was intensified by increasing the number of fluorophores labeled on the target DNA segment. It was indicated that the detection limit (minimum template amoumt for detection) of the multiply labeled primers is about 1% of that of the singly labeled primer. Multiple labeling is an effective signal amplification method to increase the detection sensitivity of the probes in a miniaturized array format.

Objective To explore the mediating role of self-esteem in optimism and suicidal risks,and the moderate effect of life events in optimism,suicidal risk and self-esteem.Methods 1 750 college students were surveyed with the life orientation test-revised (LOT-R),the suicidal behaviors questionnaire-revised (SBQ-R),rosenberg self-esteem scale(SES) and adolescent self-rating life events check list (ASLEC).Results The total scores of SBQ-R,LOT-R,SES and ASLEC of college students were (4.78±2.10),(23.17±3.22),(29.58±4.43)and (36.54±21.73).Optimism scores were negatively correlated with suicidal risk scores(r=-0.23,P＜0.01),optimism scores were positively correlated with self-esteem (r=0.50,P＜0.01).Scores of self-esteem scales were negatively correlated with suicidal risk scores(r=-0.35,P＜0.01).A structure equation model consists of optimism,self-esteem,suicidal risk and it had a better degree of fitting (the path form optimism to suicidal risk were r =-0.05,P＜0.05,RMSEA =0.05,GFI =0.90,NFI =0.92,CFI =0.93).The relationship between optimism and suicide risk were mediated by self-esteem(P＜0.01),which accounted for 76％of the total effects.The life events' moderating effects between self-esteem and suicide risk were significant(P＜0.01).Conclusion Self-esteem has a significant correlation with optimism and suicidal behaviors,self-esteem plays an intermediary role between optimism and suicidal behaviors,and life events play an regulation role between self-esteem and suicidal behaviors.

Objective To observe Rongxin Pills in the treatment of viral myocarditis in children (deficiency of both qi and yin and heart meridian stasis syndrome) and the effectiveness and clinical application of safety.Methods Viral myocarditis patients (280 cases,deficiency of both qi and yin and heart meridian stasis syndrome),according to 3:1 ratio as the test group (n =21 0) and control group (n =70).The test group took orally Rongxin pills each time 4.5～9 g,3 times daily;the control group oral coenzyme Q10 capsule each time 10 ～ 20 mg,twice daily.The course of treatment was 28 d.The experiment was carried out with the random and double blind method.The symptoms of myocarditis,integrated and electrocardiogram,echocardiography,myocardial enzymes,as well as the efficacy of traditional Chinese medicine and improvement of the effect of the disease were observed.Results The results of FAS (PPS) analysis showed that 28 d after treatment,the symptom score and mean of experimental group and control group were 5.975 (6.000) and 4.721 (4.788).The syndromes of the total effective rates were 91.62％ (90.59％) and 70.59％ (71.21％),curative effect the total effective rates were 90.14％ (92.08％) and 72.06％ (72.73％).The total effective rate of experimental group was higher than that of the control group,the difference was statistically significant.In this experiment,three cases of clinical adverse events were reported,which were not related to the experimental drug.It also not belongs to adverse drug reactions.Conclusion Rongxin Pill in the treatment of viral myocarditis in children (deficiency of both qi and yin and heart meridian stasis syndrome) is more effective than coenzyme Q 10 capsule,and there was no indication of higher risk of clinical application.

Advance care planning(ACP)is designed to ensure that patients lacking autonomous decision-making capacity receive medical services in accordance with their expectations and preferences.Individuals with advanced cancer are a crucial target for ACP implementation.However,the current practice of ACP in this group in China is suboptimal,demanding high-quality implementation evidence to strengthen ACP in the clinical practice of patients with advanced cancer.The existing literature can be summarized into 27 pieces of evidence across 7 dimensions,including initiation time,intervention content,intervention providers,intervention modalities,communication skills,outcome indicators,and environmental support.The aforementioned evidence could provide crucial support for improving ACP implementation for patients with advanced cancer.Subsequent research efforts should integrate patient preferences and explore the most suitable implementation strategies for ACP in the Chinese population with advanced cancer,considering diverse aspects such as traditional culture,ACP education and training,legislative support,and healthcare system refinement.

AIM:To investigate the effect of curcumin on the viability and apoptosis of human papillomavirus(HPV)-positive cervical cancer cells via down-regulating the expression of adenovirus E1A-associated 300 kD protein(P300).METHODS:HeLa cells in logarithmic phase were divided into four experimental groups(20,40,60 and 80 μmol/L Cur treatment groups),and the untreated group was used as control.Cell apoptosis was detected by flow cytome-try,and the expression of E6 gene was detected by RT-qPCR and Western blot.Silencing plasmid(shE6)and negative control shRNA(shNC)were constructed and transfected into HeLa cells,the cells were randomly divided into four groups including shNC,shNC+Cur(40 μmol/L),shE6 and shE6+Cur(40 μmol/L).The cell viability,apoptosis and expression of apoptosis-related proteins were detected by CCK-8,flow cytometry and Western blot,respectively.Then silencing plas-mid(siP300)and negative control siRNA(siNC)were constructed and transfected into HeLa cells.The mRNA and pro-tein expression of P300 was detected by RT-qPCR and Western blot.The protein expression of E6 and P300 and histone was detected by Western blot after treated with 20 and 40 μmol/L curcumin.RESULTS:Compared with the untreated group,the HeLa cells treated with different concentrations of curcumin could significantly inhibit the viability and increase the early apoptosis rate(P<0.05).The results showed that the mRNA and protein expression of E6 were down-regulated in HeLa cells after treated with different concentration curcumin,while the early apoptosis and the expression of pro-apop-tosis-related proteins in the shE6 group were lower than those in the non-knockdown group after treated with 40 μmol/L cur-cumin(P<0.05).And the expression of E6 protein was decreased after knockdown of P300,while the expression of P300 and histone was down-regulated after treatment with 20 and 40 μmol/L curcumin.CONCLUSION:Curcumin can inhibit the viability and promote the apoptosis of HPV18 positive cervical cancer cells,and the mechanism may be that it can in-hibit E6 acetylation by down-regulating P300 expression.

Objective:To study the efficacy of different surgical methods in treatment of hilar cholangiocarcinoma (HCCA), and to analyze the factors affecting long-term prognosis of HCCA patients after surgical treatment.Methods:The clinical data of 105 patients who underwent surgical treatment for HCCA at the First Affiliated Hospital of Soochow University from April 2010 to October 2021 were retrospectively analysed. There were 58 males and 47 females, with age (64.2±10.6) years old. Data analysed included surgical treatments, postoperative pathological data, perioperative complications and survival on follow-up. The Kaplan Meier survival curve was plotted, and the log-rank test and Cox proportional hazard model were performed to analyze the key factors affecting long-term prognosis.Results:Of 105 patients, 4 (3.8%) patients died during the perioperative period, and 58 patients (55.2%) developed complications with included 32 (30.5%) patients with pleural effusion and 12 (11.4%) patients with biliary leakage. The follow-up data was available in 85 patients with the overall median survival time of 19 months, and the 1-, 3-, 5-year cumulative survival rates of 58.1%, 27.0% and 24.8% respectively. The 1-, 3-, and 5-year cumulative survival rates for the R 0 resection patients ( n=59) were 69.4%, 36.2%, 27.4%, respectively, which were significantly better than 49.4%, 12.3%, 0% for the R 1/2 resection patients ( n=20), and 0% for the palliative drainage patients ( n=6) (all P<0.05). Univariate analysis and Cox multivariate analysis showed that age ≥70 years ( HR=2.158, 95% CI: 1.175-3.965), preoperative CA19-9 level ≥1 015 U/ml ( HR=1.981, 95% CI: 1.009-3.894), resection margin ( HR=2.587, 95% CI: 1.371-4.881), and lymph node metastasis ( HR=2.308, 95% CI: 1.167-4.567) were independent risk factors for long-term prognosis of HCCA patients (all P<0.05). Conclusions:R 0 resection was an effective way to prolong survival of patients with HCCA. Age, preoperative CA19-9 level, resection margin and lymph node metastasis were related to long-term survival of HCCA patients.

Objective:To investigate the value of CT radiomic model based on analysis of primary gastric cancer and the adipose tissue outside the gastric wall beside cancer in differentiating stage T1-2 from stage T3-4 gastric cancer.Methods:This study was a case-control study. Totally 465 patients with gastric cancer treated in Affiliated People′s Hospital of Jiangsu University from December 2011 to December 2019 were retrospectively collected. According to postoperative pathology, they were divided into 2 groups, one with 150 cases of T1-2 tumors and another with 315 cases of T3-4 tumors. The cases were divided into a training set (326 cases) and a test set (139 cases) by stratified sampling method at 7∶3. There were 104 cases of T1-2 stage and 222 cases of T3-4 stage in the training set, 46 cases of T1-2 stage and 93 cases of T3-4 stage in the test set. The axial CT images in the venous phase during one week before surgery were selected to delineate the region of interest (ROI) at the primary lesion and the extramural gastric adipose tissue adjacent to the cancer areas. The radiomic features of the ROIs were extracted by Pyradiomics software. The least absolute shrinkage and selection operator was used to screen features related to T stage to establish the radiomic models of primary gastric cancer and the adipose tissue outside the gastric wall beside cancer. Independent sample t test or χ2 test were used to compare the differences in clinical features between T1-2 and T3-4 patients in the training set, and the features with statistical significance were combined to establish a clinical model. Two radiomic signatures and clinical features were combined to construct a clinical-radiomics model and generate a nomogram. The area under the receiver operating characteristic curve (AUC) was used to evaluate the efficacy of each model in differentiating stage T1-2 from stage T3-4 gastric cancer. The calibration curve was used to evaluate the consistency between the T stage predicted by the nomogram and the actual T stage of gastric cancer. And the decision curve analysis was used to evaluate the clinical net benefit of treatment guided by the nomogram and by the clinical model. Results:There were significant differences in CT-T stage and CT-N stage between T1-2 and T3-4 patients in the training set ( χ2=10.59, 15.92, P=0.014, 0.001) and the clinical model was established. After screening and dimensionality reduction, the 5 features from primary gastric cancer and the 6 features from the adipose tissue outside the gastric wall beside cancer established the radiomic models respectively. In the training set and the test set, the AUC values of the primary gastric cancer radiomic model were 0.864 (95% CI 0.820-0.908) and 0.836 (95% CI 0.762-0.910), and the adipose tissue outside the gastric wall beside cancer radiomic model were 0.782 (95% CI 0.731-0.833) and 0.784 (95% CI 0.702-0.866). The AUC values of the clinical model were 0.761 (95% CI 0.705-0.817) and 0.758 (95% CI 0.671-0.845), and the nomogram were 0.876 (95% CI 0.835-0.917) and 0.851 (95% CI 0.781-0.921). The calibration curve reflected that there was a high consistency between the T stage predicted by the nomogram and the actual T stage in the training set ( χ2=1.70, P=0.989). And the decision curve showed that at the risk threshold 0.01-0.74, a higher clinical net benefit could be obtained by using a nomogram to guide treatment. Conclusions:The CT radiomics features of primary gastric cancer lesions and the adipose tissue outside the gastric wall beside cancer can effectively distinguish T1-2 from T3-4 gastric cancer, and the combination of CT radiomic features and clinical features can further improve the prediction accuracy.

Objective:To investigate the effect of Qideng Mingmu capsule on the formation and remodeling of retinal neovascularization in mice with oxygen-induced retinopathy (OIR).Methods:Thirty-six postnatal day 7 (P7)SPF grade C57BL/6J pups were divided into normal group, OIR group, Qideng Mingmu capsule group and apatinib group by random number table method, with 9 mice in each group.The mice in the normal group were raised in normal environment.The mice in the other three groups were fed in hyperoxic environment of (75±2)% oxygen concentration for 5 days from P7 to P12 and then were fed in normal environment for 5 days from P12 to P17 to establish the OIR model.From P12, mice in Qideng Mingmu capsule group and apatinib group were given intragastric administration of Qideng Mingmu capsule (900 mg/kg) and vascular endothelial growth factor receptor 2 inhibitor apatinib (70 mg/kg) respectively, once a day for 5 consecutive days.On P17, paraffin sections of mouse eyeballs were made and stained with hematoxylin-eosin to count the number of vascular endothelial cells that broke through the internal limiting membrane.The retinal slices were prepared and stained with FITC-dextran to quantify the retinal non-perfusion area, neovascularization density and total vascular density.The distribution and fluorescence intensity of retinal vascular endothelial cell marker CD31 and pericyte marker α-smooth muscle actin (α-SMA) were observed by double immunofluorescence staining.Immunohistochemical staining was used to detect the expression and distribution of retinal hypoxia inducible factor-1α (HIF-1α) and vascular endothelial cadherin (VE-cadherin).The use and care of animals were in accordance with the Regulations on the Management of Laboratory Animals issued by the Ministry of Science and Technology.This study was approved by the Animal Ethics Committee of Chengdu University of Traditional Chinese Medicine (No.2019-30).Results:The number of vascular endothelial cells breaking through the internal limiting membrane in normal group, OIR group, Qideng Mingmu capsule group and apatinib group were (2.83±4.40), (37.33±5.43), (23.83±6.79) and (14.00±9.34), respectively, with a statistically significant overall difference ( F=28.313, P<0.001).There were more vascular endothelial cells breaking through internal limiting membrane in OIR group than in normal group, Qideng Mingmu capsule group and apatinib group, showing statistically significant differences (all at P<0.05).In the observation of mouse retinal slices, there were large non-perfusion areas, neovascularization buds and disordered distribution of blood vessels in OIR group.The distribution of blood vessels was more uniform and the areas of non-perfusion and neovascularization were smaller in Qideng Mingmu capsule group and apatinib group than in OIR group.The relative area of central retinal non-perfusion area and neovascularization density were significantly lower in normal group, Qideng Mingmu capsule group and apatinib group than in OIR group (all at P<0.05).The immunofluorescence intensity of CD31 and the absorbance value of HIF-1α were significantly lower, and the immunofluorescence intensity of α-SMA and the absorbance value of VE-cadherin were significantly higher in normal group, Qideng Mingmu capsule group and apatinib group than in OIR group (all at P<0.05). Conclusions:Qideng Mingmu capsule can inhibit retinal neovascularization formation, increase vascular pericyte coverage, relieve retinal hypoxia and increase vascular integrity in OIR mice.It can protect the retinal vessels of OIR mice.

Based on the theory of"deficient Qi leads to stagnation",this paper discusses the pathogenesis evolution and treatment of obese type 2 diabetes.The occurrence and development of obese type 2 diabetes mellitus has obvious stages,which often begins with spleen deficiency obesity,changes in qi full spleen dan,becomes dry retention diabetes,and appears toxic stagnation syndrome.According to the stage development characteristics of the pathogenesis,it can be summarized as"deficiency","Qi","retention"and"stagnation",which is in line with the overall theoretical connotation of"deficient Qi leads to stagnation".On this basis,according to the different periods of the disease,the treatment methods of"warm medicine treatment","orchid grass treatment","Yiyin treatment"and"Gongbu treatment"were summarized,which provided reference for guiding the accurate syndrome differentiation and treatment of obese type 2 diabetes in clinical practice.