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.

BACKGROUND:The biomechanical effect of the implant-bone interface is one of the most important factors for bone resorption. The new structure of the periodontal-ligament-like implants may improve the distribution of the interfacial stress. OBJECTIVE:To discuss the effect of the internal structure changes of traditional implants on the cortical bone stress distribution and peak at the implant-bone interface under different occlusal load conditions, so as to provide a theoretical basis for the optimization design and clinical application of new structure implants. METHODS:Two kinds of digital models, new structure implant (model A) and non-threaded cylindrical implant (model B), were established by Pro/ENGINEER software. Variations of the stress peak and stress distribution of implant-bone interface cortical bone area under the same bone and force environment were analyzed using Ansys software. RESULTS AND CONCLUSION: Under a vertical loading, the stress peak under different forces was reduced by 17.54% in model A compared with model B; under a 45° loading, the stress peak of model A was reduced by 2.59% compared with model B, and it showed an evident tendency of high stress area focusing to the buccal side of model B. Under the chew-simulation loading, the stress peak of model A was lower than that of model B. The biggest difference (0.353 2 MPa) appeared atβ=12°(β is the angle of force direction and the implant axis), and it gradualy reduced atβ > 12°. At the same time, model A had a wider range of application degree compared with model B in two quantitative indicators, including optimal peak stress of promoting bone tissue growth and stress peak of maintaining healthy bone tissue. These results suggest that the optimized structure of implants contributes to improve the cortical bone stress distribution at the implant-bone interface, decrease the peak stress, and reduce the risk of cortical bone absorption in a wider range.

BACKGROUND:Transplantation of mesenchymal stem cells (MSCs) to multiple sclerosis (MS) is a new developed treatment to be given more and more attention.However,whether the MSCs function by cell replacement after going cross the blood-brain barricr or immune suppression needs further confirmation.OBJECTIVE:To establish a steady and effective method of Y chromosome in situ hybridization (ISH) and to detect the distribution of MSCs in a mouse model with MS.DESIGN,TIME AND SETTING:The observational study was performed at the Laboratory of Molecular Immunology,Institute of Healthy Science from September 2007 to February 2009.MATERIALS:A total of 30 C57BL/6 mice,aged 6-8 weeks and weighing 15-20 g,were selected.Female mice were used to establish experimental autoimmune encephalomyelitis (EAE).METHODS:Y chromosme specific DNA probe labled with digoxine (DIG) was designed and ISH was performed to confirm that the designed probe was Y chromosome specific and biologically sensitive.We transplanted the MSCs from male mice into the female EAE mice,and tracked the MSCs by Y chromosome ISH.MAIN OUTCOME MEASRUES:Distribution of MSCs in mice with EAE was observed under the optical and fluorescence microscope.RESULTS:The probe was confirmed to be Y chromosome specific and biologically sensitive.What's more,a steady and effective method of ISH was established.Some MSCs were detected in the periphery organs-spleen and lymph node of mice with EAE;seldom in spinal cord which indicated that MSCs might play its roles by immune suppression.CONCLUSION:Some MSCs were detected in the periphery organs-spleen and lymph node of mice with EAE,but seldom in spinal cord in the central nervous system.

Objective:To explore the clinical diagnosis and treatment methods for nasal septum malignancies. Methods:A retrospective study of seven cases of primary nasal septum malignancy was conducted. These cases were treated at the Tianjin First Central Hospital between February 1993 and October 2009. Results:Among the seven cases, one was reported malignant lymphoma, which underwent chemotherapy and radiation therapy;the other six malignant tumors included three cases of adenoid cystic carcinoma, one malignant melanoma, one chondrosarcoma, and one papilloma. Patients were treated by nasal endoscopy, external approach, lip midline incision, overturned facial surgery, chemotherapy, and radiation. During follow-up, which lasted for 2 years to 16 years from time of surgery, two fatalities resulting from recurrence or metastasis were recorded. One of these fatalities occurred after 2 years, and the other was recorded at 3 years and 4 months after surgery. Four patients survived without recurrence. Conclusion:The key treatment for nasal septum malignancies was one-time radical resection. Combined postoperative treatment and follow-up should be conducted.

Objective To analyze the significance of postoperative radiotherapy for lymph node positive patients after radical resection of esophageal carcinoma.Methods Two hundred and sixty patients with esophageal squamous cell cancer,aged ≤70,with the performance status score of0 -1,who had undergone radical resection were divided into 2 equal groups:surgery alone group (Group A ) and surgery plus radiotherapy group (Group B).Group A was classified into 3 sub-groups:Group A1 (n =42)without lymph node involvement,Group A2 (n =43 ) with 1 to 3 involved lymph nodes,and Group A3(n =45) with ≥4 involved lymph nodes.Group B was classified into 3 sub-groups:Group B1 (n =43 )without lymph node involvement,Group B2 (n =44) with 1 to 3 involved lymph nodes,and Group B3(n =43 ) with ≥4 involved lymph nodes.The patients were followed up till death.Results The 1-,3-,and 5-year overall survival rates of Group A were 71.5％,35.4％ and 20％,respectively,all significantly lower than those in Group B (76.2％,48.5％ and 36.2％,respectively,x2 =7.822,P ＜0.05).The 1-,3-,and 5-year survival rates of Groups A1 were 83.3％,52.3％,and 38.1％,respectively,all not significantly different from those of Group B1 (81.3％,58.1％,and 46.5％,respectively,x2 =0.283,P ＞ 0.05 ).The 1-,3-,and 5-year survival rates of Groups A2 were 69.8％,34.9％,and 18.6％,respectively,all significantly lower than those of Group B2 (77.3％,47.7％,and 40.9％,respectively,x2 =4.188,P ＜ 0.05).The 1-,3-,and 5-year survival rates of Groups A3 were 62.2％,20％,and 4.4％,respectively,all significantly lower than those of Group B3 ( 69.8％,39.5％,and 20.9％,respectively,x2 =6.168,P ＜ 0.05).The 5-year metastatic lymph node rates of Groups A1 to A3 were 30.9％,53.4％,and 66.7％,respectively,all significantly higher than those of Groups B1 to B3 ( 11.6％,22.7％,and 30.2％,respectively,x2 =4.753,8.741,and 11.682,respectively,all P ＜0.05).The 5-year distant metastasis rates of Groups A1 to A3 were 11.9％,20.9％,and 31.1％,respectively,all not significantly different from those of Groups B1 to B3 (13.9％,20.4％,and 25.6％,respectively,x2 =0.079,0.003,and 0.203,respectively,all P ＞ 0.05 ).Conclusions Postoperative radiotherapy increases the survival rate of lymph node positive patients,but shows little efficacy on the lymph node negative patients.It reduces the occurrence of lymph node metastasis,even in the lymph node negative patients,and does not increase the morbidity of complications,especially that of anastomotic stenosis.The number of metastatic lymph node is one of the important factors affecting the survival of esophageal carcinoma.Distant metastasis increases along with the number of metastatic lymph nodes.

Objective To investigate the expressions of ABCG2 and V-ATPase in NSCLC and their expression rates in pathological classification, TNM stages and pathological grades and the expression correlation between ABCG2 and V-ATPase. Methods Expressions of ABCG2 and V-ATPase were accessed with EnVinsion immunohistochemistry in tumor samples from 92 NSCLC patients. The corresponding data was analyzed statistically. Results Expressions of ABCG2 and V -ATPase were found both in the lung adenocarcinoma and lung squamous cell cancer, and the difference between these two kinds of tumors was significant (P =0.003,0.000). ABCG2 expression was significantly different among TNM stages of lung adenocarcinoma (P=0.004) as well as among pathological grades of lung adenocarcinoma (P =0.028) and squamous cell carcinoma (P =0.000), while no significant difference was found among TNM stages of squamous cell lung carcinoma. The level of V-ATPase expression was associated with TNM stages of lung adenocarcinoma (P =0.026) and pathological grades of lung squamous cell carcinoma (P =0.002), however, among TNM stages of lung squamous cell carcinoma and pathological grades of lung adenocarcinoma, the difference was not significant. Additionally, the significant correlation was found between expression of ABCG2 and V-ATPase in all samples, adenocarcinoma and squamous cell carcinoma (P<0.001). Conclusion The significant correlation is found between expression of ABCG2 and V-ATPase, which indicate that they may co-work to participate in the mechanism of anticancer drug resistance.

Objective To discuss the clinical application and significance of non-enhanced computed tomography axis rotating movie imaging technique in PCNL for complex renal calculi. Methods Thirty-one cases unilateral and 2 cases bilateral multiple and staghorn renal calculi with mild or mediurn hydronephrosis patients were performed bilateral kidneys non-enhanced CT scanning,three dimensional reconstruction and the axis rotating movie composition were carried on by computer software,PCNL accesses were designed and the residual stone were predicted referred to the access-calyces angle measured in axis rotating movie image,PCNL were performed after while.Comparing between preoperation accesses design and residual stone prediction with in-operation practice were carried out.Results The first PCNL access was constructed via posterior middle upper minor calyces in 22 renal units and via posterior middle lower minor calyces in 13 renal units,which was consistent with pre-operation design according to CT axis rotating movie image.The second PCNL accesses were constructed via lower calyx posterior upper minor calyces in 9 renal units and via lower calyx posterior lower minor calyces in 5 renal units,nephrolithotomy were performed in the same operation,clinical stone clearance rate was 80%(28/35),other 7 cases with residual stone were consistent with pre-operation prediction,No blood transfusion was necessary and no severe complication happened in all 33 cases.Conclusions Non-enhanced CT axis rotating movie imaging provided the detail three dimensional shape and spatial structure of complex renal calculi intuitively) that was benefit for designing appropriate PCNL accesses for complex renal calculi patients, guiding for searching stone fragments in operation, predicting residual stone, and ensuring operation safety.

STIM1 is recognized as an ER Ca2+ sensor of calcium release-activated calcium (CRAC) channel that is constructed by membrane protein Orai1, However, this regulatory system may also be regulated by other proteins. Reticulocalbin 2 (RCN2) was purified and identified from STIM1-Orai1 complex. Confocal microscopy revealed that RCN2 co-localized with STIM1 in ER before and after Ca2+ store depletion. Single cell [Ca2+]I measurements of RCN2 EF hands mutant showed slight influence on SOC electrophysiological characters. Furthermore, a novel collar form aggregation of RCN2 surrounding STIM1 clusters suggested that RCN2 potentially plays a role of structure maintenance in STIM1 clustering.

Based on thorough analysis of the present healthcare big data,and present problems found in precision medicine,the paper proposed the implementation approach of precision medicine driven by healthcare big data.Citing the practice of the hospital as an example,the authors centered on clinical data to build a precision medicine knowledge system,and leveraged in-depth data mining to develop integrated analysis technology for precision medicine.These efforts aim at application development of precision medicine series upon a panoramic medicine knowledge display,so as to enhance medical quality and diagnosis efficiency and translated use of healthcare big data in precision medicine.

Objective To analyze the succumbed reasons of emergent pereutaneous coronary intervention(EPCI)in treatment of acute myocardial infarction(AMI)during operation and in-hospital period.Method During March 1999 to June 2005,623 AMI patients received EPCI,and 27 patients died.The succumbed reasons and clinical characteristics of the succumbed patients were analyzed.Result Among the 27 succumbed patients,with age 51 to 91(69?18)years old, 16 had three-vessel lesions.10 had two-vessel lesions and l had single vessel lesion.Ten patients were accompanied with old myocardial infarction,9 with diabetes meUitus,19 with hypertensions,4 with impaired renal functions,and 6 with old cerebral infarction.Nine patients died of eardingenic shocks,6 died of no-reflows,2 died of heart ruptures,2 thrombosis, 2 acute left heart failure,2 acute renal failure,2 intracranial hemorrhage,l shock due to hemorrhage of puncture position, and l acute perieardiae tamponade.Conclusion The succumbed reasons of EPCI in treatment of acute myocardial infarction were various.Cardiac shock and no-reflow were primary reasons.Old age,multi-vessel lesion,diabetes mellitus, and old myocardial infarction may serve as predicting factors.