Objective:To investigate the ethical challenges inhospice for community terminal cancer patients. Method:8 members of terminal Cancer Patients in palliative care wards were observed and interviewed. Datas were collected by narrative, communication,field note,work diary. Results:Get to know the ethical challenges in-hospice for community terminal cancer patients,and find the measures. Conclusions:The development of commu-nity hospice career need caring, life and death education,ethicaleducation,ethical environment improving,a harmo-nious ethical relationship and society,and life quality improving.

High-fat diet-induced insulin resistance rat model was assessed by euglycemic-hyperinsulinemic clamp technique.Compared with the control group,the vaspin mRNA expression in adipose tissue was significantly decreased in insulin resistant rats induced by high-fat diet( P＜0.05 ),which was increased by metformin( P＜0.05 ).These data indicate that metformin may ameliorate insulin resistance in rats via upregulating vaspin mRNA expression.

Objective:To establish a headspace capillary gas chromatography method for the determination of residual solvents in erlotinib hydrochloride .Methods:A DB-624 capillary column (30 m ×0.53 mm, 3.0 μm) was used and the carrier gas was nitro-gen.The flow rate was 2.0 ml· min-1 and the inlet temperature was 190℃.The FID detector temperature was 230 ℃.The column temperature program was with the initial temperature of 35℃( maitaining 8 min) , risen to 170℃with the rate of 28℃· min-1 ( main-taining 8 min) , and then risen to 200℃with the rate of 32℃· min-1 ( maintaining 7 min) .The headspace vial temperature was 100℃and the time was 30 min.Results:Ethanol, isopropanol, methylene chloride and n-butanol had a good linear relationship within the range of 0.68-409.14 μg· ml-1 (r=0.999 8),0.67-404.88 μg· ml-1 (r=0.999 8),1.71-51.31μg· ml-1 (r=0.999 7) and 0.72-431.12 μg· ml-1(r=0.999 8), respectively.The average recovery was 99.0% (RSD=0.41%, n=9), 100.2%(RSD=0.52%, n=9),97.1%(RSD=1.75%, n =9) and 102.5% (RSD=1.08%, n=9), respectively.Conclusion: The method is simple and accurate , which can be used for the determination of four residual organic solvents in erlotinib hydrochloride .

Objective:To establish a method for the content determination of magnesium in esomeprazole magnesium. Methods:The content of magnesium in esomeprazole magnesium was determined by inductive coupled plasma atomic emission spectrometry. Re-sults:The linear range was 10.0-80.0 μg·ml-1(r=0.999 8). The average recovery was 99.55% with RSD of 1.35% (n=9). The detection limit was 0. 000 75 μg·ml-1 and the quantitative limit was 0. 002 5 μg·ml-1 . Conclusion:The method is accurate, sensitive and reproducible, which can be used for the content determination of magnesium in esomeprazole magnesium.

OBJECTIVE:To establish a method for the simultaneous determination of 6 kinds of residual organic solvents in Omeprazole magnesium,such as methanol,isopropanol,acetonitrile,dichloromethane,ethyl acetate and toluenein. METHODS:Headspace GC was adopted. The determination was performed on the column of DB-624 column by temperature programming. The inlet temperature was 200 ℃,and hydrogen flame ionization detector was adopted with the temperature of 250 ℃;nitrogen gas was used as carrier gas with flow rate of 2.0 mL/min;the splitting-radio was 5 : 1,and sample size was 1 mL;the headspace tem-perature was 80 ℃ and the equilibrium time was 20 min. RESULTS:The linear range were 12.56-628.00 μg/mL for methanol(r=0.9997),20.22-1011.20 μg/mL for isopropanol(r=0.9999),1.96-97.76 μg/mL for acetonitrile(r=0.9997),3.10-154.88 μg/mL for dichloromethane(r=0.9998),20.69-1034.56 μg/mL for ethyl acetate(r=0.9998),and 3.53-176.72 μg/mL for toluene(r=0.9998);the limits of quantitation were 1.00,0.91,0.47,0.93,0.41 and 0.35 μg/mL respectively;the limits of detection were 0.31,0.30,0.14,0.31,0.12 and 0.11 μg/mL respectively;RSDs of precision,stability and reproducibility tests were lower than 3%;the recoveries were 94.53%-101.29%(RSD=2.15%,n=9),97.78%-103.42%(RSD=1.77%,n=9),96.99%-105.76%(RSD=2.59%,n=9),96.83%-102.05%(RSD=1.86%,n=9),97.98%-101.13%(RSD=0.88%,n=9)and 97.80%-102.40%(RSD=1.41%,n=9). CONCLUSIONS:The method is sensitive and accurate,can be used for the simultaneous determination of 6 kinds of residual organic solvents in Omeprazole magnesium,such as methanol,isopropanol,acetonitrile,dichloromethane,eth-yl acetate and toluenein.

After 4 weeks old male Sprague-Dawley rats were fed with normal diet and high-fat diet for 10 weeks,the rats were treated with metformin (200 mg/kg) for 6 weeks. Insulin sensitivity was determined by hyperinsulinemic-euglycemic clamp technique.Realtime PCR and western blot were used to measure mRNA and protein levels of chemerin in perirenal adipose tissue of rats.The results showed that the expressions of chemerin mRNA and protein were higher in high-fat diet-induced insulin resistant rats compared with rats fed with normal diet ( both P＜0.05 ),and these incremental findings were diminished by metformin treatment ( both P＜0.01 ).The levels of chemerin mRNA and protein were correlated well with the epididymis fat mass index.

Objective:To explore the quality of inventory samples of a biobank stored in a deep freezer from 0 to over 10 years in Shanghai Ruijin Hospital. Methods:We extracted 24 pairs of stocked gastric cancer samples between 2003 and 2014. We used 1%aga-rose gel electrophoresis to analyze DNA and RNA purity and integrity while adding the RNA integrity number (RIN) for precise analysis. Bicinchonininc acid (BCA) assay was used for protein concentration evaluation. Coomassie brilliant blue method was used for protein integrity assay. Results: The samples were divided into four groups according to cryopreservation period (<2 years, 3-5 years, 6-8 years, and>9 years). No significant difference in DNA integrity was found between the groups (P>0.05);however, DNA degradation in normal gastric mucosa was faster than that in gastric cancer tissue (P=0.023). The RIN significantly declined when the storage period was 6 years or longer (P=0.018). No significant difference in protein concentration was observed between different groups. Using Coo-massie brilliant blue method, we found significant differences in preserved proteins with different molecular weights. Proteins with varying molecular weights were detected in the groups with the following cryopreservation periods:>9 years, a small number of low-molecular-weight (average 36.5 KD) proteins;6-8 years, medium-molecular-weight (average 65.63KD) proteins;3-5 years, high-molecu-lar-weight (average 127.5 KD) proteins;<2 years, high-molecular-weight (average 160 KD) proteins. Conclusion:Cryopreservation does not exert an obvious effect on DNA. If the cryopreservation period is more than 5 years, serious degradation of RNA should occur;like-wise, degradation of proteins with higher molecular weight should occur.

Objective To investigate the role of loss of heterozygosity (LOH) of SMAD2 and its relationship with clinicopathological parameters of primary gastric carcinoma. Methods Fifty cases of primary gastric carcinoma were monitored by polymerase chain reaction -single strand conformation polymorphism (PCR- SSCP) and silver staining to detect SMAD2 LOH. Results The incidence of LOH was 40.0%(22/45) at D18S450 and 33.3%(16/48)at D18S460 . LOH occurred in SMAD2 was 55.1%(27/49).The rate of SMAD2 LOH was 72.0% (18/25) in primary gastric carcinoma with lymph node metastasis , which was significantly higher than that in without lymph node metastasis (P

Objective To analyze the imaging characteristics of hepatic involvement in Langerhans cell histiocytosis(LCH) in children on MRCP, MRI and CT. Methods Twenty-nine children from three children hospitals in China, who were diagnosed as hepatic involvement by disseminated LCH during Aug 2008 and Jan 2015 were included in this study. Their MRCP (n=16), MRI (n=22), contrast?enhanced CT (n=15) data were retrospectively analyzed. The stenoses and dilatation of the intrahepatic bile ducts, the common hepatic bile duct and its first order branches and the common bile duct were evaluated on the MRCP image. The size and shape of the liver, the imaging characteristics of the periportal lesions in the Glisson sheath and hepatic parenchymal lesions were also evaluated on the cross?sectional images. Results MRCP indicated alternative stenoses/dilatation of the bile duct tree (n=16), stenoses of the common hepatic duct and its first?order branches (n=15), partialindistinctness of the common bile duct (n=2) and multiple cystic lesions along the biliary tree (n=5). On the cross?sectional images, the periportal lesions in the Glisson sheath were observed in 28 children. On MRI, the periportal lesions were shown in all the 22 children with MRI, presented as hypo-signal intensity on T1WI, hyper?signal intensity on T2WI (n=11) or mixed?signal intensity on T1WI and T2WI (n=11); On CT, the periportal lesions were found in 14 of the 15 children with CT, presenting as low density (n=13) and mixed density (n=1). Multiple nodular or cyst?like parenchymal lesions were observed in 21 patients including 18 patients on MRI and 5 patients on enhanced CT. Sixteen patients presented as hypo?intensity on T1WI, hyper?intensity on T2WI and low density on plain CT, and 5 patients with iso? or hypo?intensity on T1WI, hypo?intensity on T2WI,and milder enhancement relative to the adjacent parenchyma on contrast?enhanced CT. Conclusions The imaging characteristics of hepatic involvement by LCH include alternative stenoses and dilatation of the intrahepatic ducts, stenoses of the common hepatic bile duct and its first?order branches on MRCP, the periportal lesions in the Glisson sheath and hepatic parenchymal nodular or cyst?like lesions on cross?sectional images.

Objective To investigate the effect of chronotherapy (chemotherapy plus timely medication) on neutrophils in breast cancer patients with neoadjuvant chemotherapy.Methods Fifty breast cancer patients with neoadjuvant chemotherapy were selected from 2011 to 2014 and divided into chronotherapy group and conventional treatment group (conventional group) by random number table method with 25 cases each.Conventional group received conventional neoadjuvant chemotherapy and conventional drug treatment.Chronotherapy group received neoadjuvant chemotherapy combined with chronochemotherapy and timely medication treatment,and applied clinical nursing care pathway.Both groups were conducted three cycles of chemotherapy,three weeks after the first and the second chemotherapy,the results of routine blood and liver function were compared in patients between two groups.The number of readmission and fever because of agranulocytosis were calculated.Results The two groups of patients were successfully completed three cycles of chemotherapy,after the first cycle of chemotherapy,the neutrophil was (4.40 ± 2.20)x109/L in chronotherapy group,and (3.18 ± 1.35) × 109/L in conventional group;after the second cycle of chemotherapy,the neutrophil was (3.95 ± 1.58) × 109/L,and (2.83 ± 1.49) x 109/L in conventional group,the two groups were statistically significant,t=2.375,2.563,P ＜0.05.Two cases needed readmission in chronotherapy group during chemotherapy,accounting for 8％(2/25),much lower than conventional group of 8 cases accounting for 32％(8/25).Conclusions The use of chronotherapy in breast cancer chemotherapy has less neutropenia,mild side effects of bone marrow suppression.It is an effective and safe viable option.