Objective To explore hospice home care method of dying children.Methods In 58 cases of dying children at home were given personalized hospice care plan,then the questionnaire were adopted to investigate the related indexes and the results were analyzed.Results In home hospice care,parents had a high recognition and satisfaction to children's pain management and symptom care.The parents with different education background had significant difference in recognition extent of psychological support,games support and death education.The parents anxiety and depression mood got effective mitigation through hospice home care of dying children.Conclusions Implementation of personalized home hospice care can increase life quality of dying children and improve adverse mood of their parents.

Objective:To compare the clinical effects of restrictive blood transfusion combined with hyperbaric oxygen preconditioning (HBOPC) and restrictive blood transfusion in the treatment of hip,knee arthroplasty (THA,THA).Methods:40 patients in the period of epidural anesthesia,femoral nerve hysteresis hip and knee arthroplasty were selected and randomly divided into two groups:restrictive transfusion group (maintain 80 g/L≤ Hb ＜100 g/L,n=20) and restrictive blood transfusion combined with HBOPC (HBOPC+maintain 80 g/L =Hb ＜100 g/L,n=20).The red blood cell transfusion,red blood cell transfusion rate,perioperative Hb,blood oxygen saturation (SO2),the incidence of hypotension during operation,hospitalization time and postoperative cerebral infarction,acute pulmonary embolism,pneumonia,myocardial infarction,wound infection rate and 90 days mortality rate were compared between two groups.Results:Compared with the restrictive transfusion group,the postoperative Hb,blood oxygen saturation (SO2) of restrictive blood transfusion combined with HBOPC group were significantly increased(P ＜ 0.05);the red blood cell transfusion,red blood cell transfusion rate,incidence of pneumonia,wound infection rate were significantly decreased (P＜0.05).Conclusion:Restrictive blood transfusion combined with hyperbaric oxygen preconditioning could improve the anoxic state of the hip,knee arthroplasty patients,which could effectively reduce red blood cell transfusion,reduce postoperative complications,has good clinical curative effect.

Objective To investigate the relationship between serum-VEGF(sVEGF)and clinical features in children and adolescent patients with non-Hodgkin lymphoma(NHL) and acute lymphoblagtic leukemia(ALL).Methods The sVEGF in 101 of pretreated NHL and ALL patients were detected by enzymelinked inununosorbent assay(ELISA).The sVEGF prior and post-treatment were compared in 61 patients who achieved complete remission(CR).Results The median sVEGF was 567.70 ng/L in 81 prior-treated NHL patients.It was significantly higher than that in normal controls(P＜0.001).The median sVEGF wag 253.90 ng/L in 49 patients with CR,which was significantly different compared to pretherapeutic level(P＜0.001),whereag no statistical difference was observed compared to the normal controls. No relationships were found between sVEGF and clinical indexes such as clinical stage,Bsymptoms,gender,performance status(PS)score,bulk and serum lactate dehydrogenage (LDH)et al in untreated NHL patients.The median sVEGF was 198.60 ng/L in 20 untreated ALL patients.which wag no statistically different in comparison with that of normal controls.And the median sVEGF wag 181.73 ng/L in 12 of the CR ALL patients.which wag not statistically different in comparison with that in prior-treatment group or normal controls.Conclusion This study showed that the sVEGF in untreated children and adoleseent patients with NHL were higher than that of normal controls.The high sVEGF dmpped after achieving CR.There was no relationship between the level of sVEGF and clinical characteristics in the NHL patients.The sVEGF level in untreated ALL patients wag not difierent compared to that of the normal controls.and there was no change for sVEGF after chemotherapy in ALL patients.

ObjectiveTo investigated the effect of post-operative primary site radiotherapy on stage Ⅳ neuroblastoma.Methods From Jan 2003 to Dem 2010,47 newly diagnosed stage Ⅳ neuroblastoma treated in Sun Yet-sen university cancer center.The treatment protocol for these patients were induction chemotherapy 4- 12 cycles,followed by surgery if possible,then 4-6 cycles consolidation chemotherapy and/or primary site radiotherapy and maintenance immunotherapy.The median age was 4 years old,the median induction chemotherapy cycles was 5.37 patients received resection of the primary tumor (total resection and nearly gross resection).24 out of 37 received primary site radiotherapy.ResultsThe followup rate was 89％.34 cases were followed up more than 36 months.For patients with or without postoperative primary site radiotherapy,the local recurrence rate were 13％ ( 3/24 ) and 54％ ( 7/13 ),respectively ( P =0.016),the 3-year local control rate were 84％ and 47％,respectively ( χ2 =7.95,P =0.005 ).The 3-year overall survival rate were 56％ and 28％,respectively ( χ2 =5.44,P =0.020 ). There was no severe radiation side effect. Conclusions This study indicated that postoperative primary site after induction chemotherapy and surgery could reduce the local recurrence rate and possibly improve the overall survival rate of stage Ⅳ neuroblastoma.

Objective:To investigate the clinical efficacy of transnasal low-flow oxygen therapy after noninvasive mechanical ventilation in the treatment of acute exacerbation of chronic obstructive pulmonary disease (AECOPD) complicated by type II respiratory failure.Methods:This study is a retrospective study. A total of 200 patients with AECOPD complicated by type II respiratory failure who received treatment in The First People's Hospital of Huzhou from January 2021 to March 2023 were selected as the research subjects through the health management platform of The First People's Hospital of Huzhou. These patients were divided into a control group and an observation group ( n = 100 per group) according to the treatment methods. The control group received noninvasive mechanical ventilation but without transnasal low-flow oxygen therapy. The observation group received noninvasive mechanical ventilation and transnasal low-flow oxygen therapy. The anti-inflammatory factors (interleukin 10 and transforming growth factor-beta) and pro-inflammatory factors (tumor necrosis factor-alpha and interleukin 6) were measured by enzyme-linked immunosorbent assay in both groups. Oxygen pressure and carbon dioxide pressure were compared between the two groups before and after treatment. The relief and disappearance time of symptoms such as fever, difficulty in breathing, palpitations, and difficulty in coughing were compared between the two groups. Statistical analysis was performed using IBM SPSS 26.0 software. Results:After treatment, the interleukin-10 level in the control group was (21.45 ± 7.02) ng/L, which was significantly lower than (26.77 ± 9.40) ng/L in the observation group ( t = 4.54, P < 0.001). The interleukin-6 level in the control group was (25.56 ± 8.58) ng/L, which was significantly higher than (18.98 ± 5.78) ng/L in the observation group ( t = 6.37, P < 0.001). Oxygen pressure in the control group was (71.41 ± 5.91) mmHg (1 mmHg = 0.133 kPa), which was significantly lower than (93.69 ± 4.45) mmHg in the observation group ( t = 30.09, P = 0.004). Carbon dioxide pressure in the control group was (43.85 ± 2.99) mmHg, which was significantly higher than (37.87 ± 4.48) mmHg in the observation group ( t = 11.10, P < 0.001). The time to fever relief in the control group was (6.59 ± 1.51) days, which was significantly longer than (6.13 ± 1.19) days in the observation group ( t = 2.39, P = 0.008). The time to dyspnea relief in the control group was (5.61 ± 2.17) days, which was significantly longer than (4.47 ± 1.73) days in the observation group ( t = 4.10, P = 0.021). Conclusion:Noninvasive mechanical ventilation combined with transnasal low-flow oxygen therapy exhibits good therapeutic effects on inflammation control, symptom relief, and pulmonary function recovery in patients with AECOPD combined with type II respiratory failure.

Objective To observe the manifestations of adult adrenal glands in intraoperative ultrasound(IOUS).Methods A total of 71 patients who underwent surgery for liver,biliary or pancreatic lesions were enrolled.Adrenal glands manifestations in IOUS were observed,and the displaying rate and the measured thickness of adrenal glands of IOUS were compared with those of CT/MRI.Results Adult adrenal gland manifested as bilateral weak echogenic structures with clear boundary and irregularly shape in IOUS.CT/MRI displaying rate of adrenal gland was 97.18％(138/142),of IOUS was 95.07％(135/142).IOUS displaying rate of the left side adrenal gland was 97.18％(69/71),of the right side adrenal gland was 92.96％(66/71),including 4 adrenal glands not shown on CT/MRI.The thickness of adrenal gland measured with IOUS was greater than those with CT/MRI(all P＜0.05).Conclusion IOUS of Adult adrenal glands present as bilateral weak echogenic structures with clear boundary and irregularly shape.IOUS displaying rate of adult adrenal gland was higher of the left side than the right side.

BACKGROUND:Currently, hematopoietic stem celltransplantation mainly depends on unrelated donors. Mental state of the unrelated donors is very important to ensure the successful celltransplantation. OBJECTIVE:To compare mental and physical health status of relative and unrelated donors during the hematopoietic stem cellcol ection. METHODS:We compared the mental (Symptom Checklist-90) and physical (temperature, breath, pulse, and blood pressure) health status of relative and unrelated donors at admission, 1 day before cellcol ection, and 1-2 days after cellcol ection.RESULTS AND CONCLUSION:At admission, there was no difference in the mental health status of relative and unrelated donors (P>0.05), while the scores on Symptom Checklist-90 were significantly higher in the unrelated donors than the relative donors, including total score, forced, depression, anxiety, hostility, and fear (P<0.05). The physical signs were steady in the unrelated and relative donors, but the difference in breath and systolic blood pressure was of great significance before and after cellcol ection in the two groups. These findings indicate that during cellcol ection, the unrelated donors exhibit heavier mental load than the relative donors, and psychological counseling and health guidance are necessary.

In order to meet the social demand for ultrasound talents, a layered training system of ultrasound medical talents suitable for China's national conditions has been explored. The department of ultrasound of West China Hospital of Sichuan University has formulated and implemented a "three-layers" ultrasound education and training system in combination with its own reality. The first layer mainly refers mastering the basic ultrasound examination ability mainly through relevant ultrasound theoretical knowledge and basic operation skills training. The second layer is based on the first level to further master the ability of ultrasound diagnosis and differential diagnosis of common and frequently occurring diseases in various systems, and to be capable of engaging in basic ultrasound teaching and scientific research. The third layer means mastering the ability of ultrasound diagnosis, evaluation and interventional diagnosis and treatment of difficult and specialized diseases, grasping the latest development direction of the sub-specialty, and having the ability to engage in ultrasound teaching and clinical research. The results show that the "three-layers" ultrasound education and training system conforms to China's national conditions and is worthy of reference and promotion.

Objective To retrospectively evaluate the clinical efficacy and safety of brentuximab vedotin(BV) combined with chemotherapy in the treatment of malignant lymphoma. Methods We collected the data of 32 lymphoma patients with CD30-positive status, including 14 cases of Hodgkin's lymphomas, 2 cases of diffuse large B-cell lymphomas, and 16 cases of mature T/NK cell lymphomas. Chemotherapy combined with BV was administered to all patients for a minimum of two cycles. The efficacy of the treatment was evaluated according to Lugano criteria every two cycles. Results Complete response rate and overall response rate after four cycles of treatment were 22% and 50%, respectively. Sixteen cases (50.0%) had grades 1 and 2 toxicity, and 16 cases (50.0%) had grade 3 toxicity or higher. The most common adverse events were neutropenia (50.0%), pneumonia (46.9%), and anemia (43.8%). The most common grade 3 or higher adverse events were pneumonia (18.8%) and febrile neutropenia (12.5%). Four patients discontinued brentuximab vedotin because of severe adverse events. Conclusion BV is effective in treating relapsed and refractory CD30- positive Hodgkin's lymphoma and peripheral T-cell lymphoma, and its overall safety is acceptable.

Curcumin is a polyphenol pigment product from the rhizome of curcumin longa.It is associated with numerous therapeutic benefits,including antioxidant,anti-inflammatory and anticancer activities.Research shows that EF24 is a curcumin analog that can induce tumor cell apoptosis,arrest cell cycle,inhibit cell invasion and metastasis and has synergistic effect of combined antitumor agents.EF24 has improved anticancer activity and bioavailability against various cancer cell lines over curcumin without increased toxicity.EF24 would have great potential to be used as a useful therapeutic agent for the treatment of various types of cancer.