0bjective To know the influential factors towards the truth.telling strategy for the family members of patients with cancer.providing theoretical basis for scientific disclosure of cancer diagnosis. Methods 305 family members were investigated by a self-designed questionnaire.Results The result of Logistic analysis showed that gender,residence,occupation,history of caring critical patient,the time after being informed,experience of attending funeral and bereavement.religious belief and attitude about discuss death wel-e predictors of the family members'aRitudes toward the cancer.informing strategy.Conclusions In order to build up the harmonious relationship and get out of the dilemma of truth.telling.it's the best ways for the medical staffs to respect to the families'choice,consult about their strategy and conduct their opinion, obtaining the largest balance between"truth-telling"and"avioding injury".

Objective to learn the non-cancer patients' attitude towards terminal cancer treatment and death,and influential factor.Provide scientific basis for the choice of terminal cancer treatment and death education.Methods 307 non-cancer patients in common clicnic were investigated by a self-designed questionnaire.Results 73.6% of'the patients didn' t mind talking about death,the score they gave to such items as "hospice care',"making a will of treatment" and "euthanasia" was more than 3.8.The Logistic Regression analysis suggested that city residents tend to approve of " hospice care"," making a will of treatment" and "euthanasia";the elder people tend to approve of "euthanasia","more love for life after thinking of death-related issues" and "talking about death with family members openly".The discrepancies were statistically significant.Conclusions The bioethieal concepts such as "hospice care"," euthanasia" are being gradually accepted by the public.To achieve the transition from a "cure" to "care",we still should make an effort to build a more open atmosphere for death,reduce the differences between urban and rural areas and carry out death education earlier.

en the cancer patients and the other groups.

OBJECTIVETo investigate the role of Caspase-8 and Bcl-2 in the formation of loose bodies in Kashin-Beck disease (KBD).

METHODSSpecimens of cartilage loose bodies were collected from 50 adult patients with KBD, and the samples of articular cartilage were collected from 10 healthy adults to serve as control. Avidin-biotin alkaline phosphatase immunohistochemistry was employed to examine Bcl-2 and Caspase-8 positivities in the chondrocytes in the loose bodies.

RESULTSIn KBD loose bodies, the percentage of chondrocytes positive for Bcl-2 and Caspase-8 [(18.40∓8.78)% and (67.54∓12.29)%, respectively] were significantly higher than those of the control group [(12.25∓1.58)% and (24.70∓4.35)%, respectively]. Caspase-8 was found to promote chondrocyte apoptosis in the loose bodies, and this effect overrode the apoptosis-suppressing effect of Bcl-2. Bcl-2 and Caspase-8 positivities were found mainly in the deep hypertrophic chondrocytes in the cartilage or in cells adjacent to the bone tissues.

CONCLUSIONKBD loose bodies contain an increased percentage of apoptotic chondrocytes positive for Bcl-2 and Caspase-8. The apoptosis-inducing effect of Caspase-8 was a dominant feature in the cartilage pathology of KBD compared to the apoptosis-suppressing effect of Bcl-2.

Adult ; Apoptosis ; Cartilage ; pathology ; Case-Control Studies ; Caspase 8 ; metabolism ; Female ; Humans ; Joint Loose Bodies ; metabolism ; Kashin-Beck Disease ; metabolism ; pathology ; Male ; Middle Aged ; Proto-Oncogene Proteins c-bcl-2 ; metabolism

Objective To study the medical staff' s attitude towards the treatment of advanced cancer and the death, providing the theoretical basis for the development of hespiee care. Methods 634 medical staffs were investigated with the self-designed questionnaires. Results Part of the medical staffs showed ambivalent feelings about the treatment in the final stage and showed an attitude of evasion and rejection towards death. Conclusions For getting rid of obfuscation for the treatment of advanced cancer, the medical staff should consult the patients' last wish of treatment and increase the sense of responsibility to make whole stage of life better. For implementing better care for the last stage cancer patients, the medical staff should accept death and strengthen the death education.

Objective To get information about the attitude of the family members towards the disclosure of cancer diagnosis and the influencing factors.Methods 305 family members were investigated bv using a self-designed questionnaire.Results Moat family members believed that the medical staffs should inform cancer patients about their diseases after getting consent from their family members.The Logisfic Regression analysis suggested that the time after being informed,education ackground,experiences of taking care of critical patients and bereavement influenced the attitudes of family members towards the disclosure.Conclusions In order to take the feelings of both the patients and their family members into consideration,the medical staffs should provide guidance to the family members,and fully respect their attitude.especially those with above-mentioned experience and hisher educational background.It is the best to inform cancer patients about their diseases after enough time for their family member to get used to the change in their family.

Objective To understand the expectation of good death in ordinary patients with a view to provide a research basis for the hospice.Methods 190 outpatients were surveyed with good death scale.Results On the core items,the patients gave the highest score to “good relationship with family(4.18 ±0.69)”,followed by “physical and cognitive control(4.15 ±0.72)”,“preparation for death(4.13 ±0.70)”placed the third,“dying in a favorite place(3.98 ±0.85)”,“physical and psychological comfort(3.84 ± 1.00)” placed the fourth and fifth in sequence,however “life completion(3.77 ± 0.91)” scored the lowest.Conclusions A good hospice care needs to help patients access to family support,meet the person who want to meet,maintain independence and self-care,and respect for their value.

Objective To study the knowledge,attitude and practice on the evidence-based nursing (EBN) and its influencing factors.Methods A total of 180 nursing students with the high education were recruited and investigated with a self-designed questionnaire,which included fundamentals of knowledge (8 items),evidence-based attitude and belief( 14 items),evidence-based practice ( 8 items),and adopted 3 rating scale,every natural endowments 1-3 points.The Cronbach's α of the questionnaire was 0.910,and its Cronbach's α of items respectively was 0.850,0.897,0.893.Results The mean score of knowledge,attitude and belief,and behavior was ( 10.85 ± 2.83 ),( 34.34 ± 4.94 ),( 10.84 ± 3.24 ),respectively.The study mode,evidence-based nursing training,evidence - based nursing practice were the main influencing factors of the overall level(P ＜0.05).Conclusions The clinical nursing students show a positive attitude toward EBN,but they lack of basic EBN knowledge and practice.So the evidence-based nursing training should be strengthened and the sooner the better.

Objective To explore the applicable nursing intervention mode of family treatment and nursing for children with hemophilia which was appropriate for local hemophilia treatment center (HTC).Methods The nursing intervention group,which consisting of nurses,hemophilia patients aged 2 ～ 18 and their parents,discussed and summarized the problems in family treatment and nursing for children with hemophilia,through literature review and expert consultation,developed comprehensive nursing intervention measures,which including individualized coagulation factors injection training,hemophilia classes,children hemophilia families sodality and follow-up visiting of the family treatment and nursing behaviors.The effect of nursing intervention was judged through measuring and comparing the family treatment and nursing behaviors.Results After intervention,among 22 items of family treatment and nursing behaviors,19 items were significantly improved than that of no intervention ( x2=59.88,36.47,96.30,13.57,34.67,55.06,55.06,21.85,22.69,45.69,39.33,68.25,11.99,35.39,35.39,17.24,81.51,85.75,13.57,respectively; P＜0.01 ).Before intervention,the incidence of "correctly record every bleeding and treatment" among the patients was 2 cases(3.85％ ),while after intervention,that was 48 cases ( 92.31％ ),and the incidence of "monthly report the bleeding and therapy nursing information to nurses" was raised from 5 cases (20％) to 52 cases ( 100％ ) after intervention,and the difference was statistically significant (x2=81.51,85.75,respectively;P＜0.01).Conclusions Comprehensive nursing intervention measures can improve the families' treatment and nursing behaviors of children with hemophilia and achieve the effective management of patients' information at the sam time,which is applicable for local hemophilia treatment center.

Objective: To investigate the clinical characteristics and diagnosis and treatment strategies of patients with severe traumatic aortic injury (TAI). Methods: A total of 25 patients with TAI, who hospitalized in our hospital between August 2005 to March 2021 and underwent thoracic aortic endovascular repair (TEVAR), were included in this retrospective study. According to the time from admission to TEVAR, the patients were divided into emergency TEVAR group (14 cases, TEVAR within 24 h of admission) and elective TEVAR group (11 cases, patients underwent surgery or fracture reduction and fixation first for serious injuries and then underwent TEVAR more than 24 h after admission). The general clinical data of patients, injury severity score (ISS), time from admission to intervention, total hospital stay, the proportion of closed chest drainage and the proportion of abdominal organ repair were obtained and compared. Clinical follow-up and 1-year postoperative aortic computed tomography angiography (CTA) were performed on the patients. Death, the occurrence of aortic adverse events and injury recovery were followed up and recorded. Results: The mean age of these 25 TAI patients was (41.4±14.4) years, 20 patients were males (80.0%). 21 patients (84.0%) had persistent chest and back pain, 17 (68.0%) had pleural effusion and 5 (20.0%) had mediastinal hematoma. The injury severity score (ISS) was significantly higher in the elective TEVAR group than in the emergency TEVAR group (24.9±14.4 vs. 35.5±9.3, P=0.044). The time from admission to intervention ((1.0±0.0) d vs. (3.4±0.9) d, P<0.001], the time from admission to TEVAR ((1.0±0.0) d vs. (11.5±13.8) d, P=0.030) and total hospital stay ((6.1±2.3) d vs. (26.8±7.7) d, P<0.001) were significantly longer in elective TEVAR group than in emergency TEVAR group. The proportion of thoracic closed drainage was significantly lower in the elective TEVAR group than in the emergency TEVAR group (9 (64.3%) vs. 2 (18.2%), P=0.042). The proportion of abdominal organ repair was significantly higher than in the emergency TEVAR group (0 vs. 4 (36.4%), P=0.026). All of 25 patients were discharged alive and followed up for (84.0±30.5) months. All patients survived and completed 1-year postoperation CTA. There were no aortic adverse events occurred, and no complications after surgery, and the fractures and organ injuries healed well. Conclusions: The clinical characteristics of severe TAI are acute multi-injuries combined with persistent chest and/or back pain, pleural effusion, and mediastinal hematoma. Timely diagnosis and treatment are important factors for the outcome. The treatment strategy for multi-injuries should give priority to dealing with life-threatening injuries. TEVAR is the primary treatment strategy for severe TAI and is related to satisfactory outcomes.
Adult ; Aorta, Thoracic/surgery* ; Aortic Diseases ; Blood Vessel Prosthesis Implantation/adverse effects* ; Endovascular Procedures/methods* ; Female ; Hematoma/surgery* ; Humans ; Male ; Middle Aged ; Pleural Effusion/surgery* ; Retrospective Studies ; Risk Factors ; Treatment Outcome