With more details of end-of-life-care such as moral principle and standard management,the development condition of end-of-life-care in China is compendiously introduced, and "1,3,9——PSD"service mode of end-of-life-care is also put forward in this artical.

Neuronal intranuclear inclusion disease (NIID) is a slowly progressive neurodegenerative disease characterized by eosinophilic hyaline intranuclear inclusions in the central and peripheral nervous system, and also in the visceral organs. Although in recent years skin biopsy is useful for the antemortem diagnosis of this disease, it is often misdiagnosed due to its highly variable clinical manifestations. A case of NIID is reported here. The patient had a long course of disease, mainly presenting as dysfunction of autonomic nervous system. No significant cognitive impairment was found. Thus, a new idea is provided for the diagnosis of this disease.

Objective:To summarize the scope of relevant research on the psychological state of parents during perinatal loss of re-pregnancy, and summarize the research status, so as to provide reference for future research and intervention.Methods:From the establishment of the database to December 2020, the literatures of China biomedical literature database, China Knowledge Network, VIP, Wanfang database, Medline, CINAHL, Web of Science, psychINFO and Cochrane Library were searched, the studies related to the psychological state, feelings and experience of the population were screened, and the JBI scope Review Guide was used as the methodological framework for analysis.Select the research related to the psychological state, feelings and experience of the population, and use the JBI scope review guide as the methodological framework for analysis.Results:Finally, 25 literatures were included, including 11 qualitative studies and 14 quantitative studies. Perinatal loss leads to an increased risk of psychological diseases when parents were re-pregnants, facing a complex mixture of new hope and uncertainty, and fathers were even more troubled by dual identity, but some parents could still benefit from perinatal loss.Conclusions:At present, China is lack of attention to the parents of perinatal loss of re-pregnancy. Medical staff should respect the differences of parents′ emotional expression, formulate targeted intervention measures, reduce the negative impact of perinatal loss, and guide the generation of positive psychology of the parents of re pregnancy.

OBJECTIVETo examine the contribution of insulin related indices on the association between body fat and blood pressure among overweight adults.

METHODSFrom April to May 2014, based on convenience sampling, we recruited overweight and obese volunteer participants aged 20-55 years living in Beijing at least 1 year through a strict examination by doctors in a physical examination center. In this study, we excluded the participants who reported suffering from any severe heart, lung, liver or kidney organic diseases, and abnormal development, disabilities, and secondary obesity caused by other disease. Also participants with use of antihypertensive drugs, hypoglycemic drugs and lipid lowering drugs were excluded for this study. A total of 1 221 participants were investigated in this study. With a simple self-designed questionnaire, the birthdates, sex, drug use, and disease history were examined. Participants' blood pressure (BP), percentage of body fat (PBF), glucose and fasting insulin level were measured. Mediation analysis was used to analyze the total effect of PBF on BP (c), the association between PBF and insulin related indices (a), and the mediation effect of serum fasting insulin level/HOMA-IR/HOMA-%S on relation between PBF and systolic/diastolic blood pressure (SBP/DBP).

RESULTSPBF was positively associated with SBP (c=0.25 ± 0.05 and 0.19 ± 0.03 for male and female, respectively, P<0.001). In males, PBF was positively associated with fasting insulin level and HOMA-IR (a=0.28 ± 0.05 and 0.24 ± 0.05, P<0.001), and negatively associated with HOMA-%S (a=-0.29 ± 0.05, P<0.001); in females, PBF was positively associated with fasting insulin level, HOMA-IR (a=0.21 ± 0.04 and 0.20 ± 0.04, P<0.001), and negatively associated with HOMA-%S (a=-0.13 ± 0.04, P<0.001). In further mediation analysis for female participants, fasting insulin level/HOMA-IR/HOMA-%S played mediation roles in the relation between PBF and SBP, with ratio of mediation of 13.78%,18.3%, and 5.98%. Fasting insulin level/HOMA-IR also mediated the relation between PBF and DBP, with mediation ratio of 11.98% and 14.13%.

CONCLUSIONIn overweight/obese female participants, insulin related indices mediated the relation between PBF and BP.

Adipose Tissue ; physiology ; Adult ; Beijing ; Blood Glucose ; analysis ; Blood Pressure ; Body Mass Index ; Female ; Humans ; Insulin ; physiology ; Insulin Resistance ; Male ; Middle Aged ; Obesity ; physiopathology ; Overweight ; physiopathology ; Risk Factors ; Young Adult

OBJECTIVETo develop a method for determination of 2, 4-dichlorophenoxyacetic acid (2, 4-D) in the air of workplace by high-performance liquid chromatography.

METHODS2, 4-D was collected by ultrafine glass filters, desorbed by methanol, separated by a C18 column, and detected by a UV detector. Identification and quantification of 2, 4-D were performed by retention time and peak areas, respectively.

RESULTSThe linear range of the test was 2∼200 µg/ml; the elution efficiency was 94.6%- 95.9%; the limit of detection (S/N = 3) was 0.034 µg/ml (injection volume of 20 µl eluant); the lower limit of quantification (S/N = 10) was 0.11 µg/ml; the minimum detectable concentration was 0.011 mg/m(3); the minimum quantifiable concentration was 0.037 mg/m(3) (with sampled air volume of 45 L).

CONCLUSIONThis method is convenient and simple in sample collection and preparation, and satisfies all methodological requirements. Therefore, this method is useful for the determination of 2, 4-D in the air of workplace.

2,4-Dichlorophenoxyacetic Acid ; analysis ; Air ; analysis ; Air Pollutants, Occupational ; analysis ; Chromatography, High Pressure Liquid ; methods ; Workplace

Objective:To study the prevalence and gene variation characteristics of human coronavirus (HCoV) in Beijing and provide molecular epidemiological basis for the prevention and control of HCoV infection.Methods:This study collected 287 samples and epidemiological data of HCoV positive cases collected by respiratory multi-pathogen surveillance in Beijing from 2016 to 2017, and analyzed the HCoV detection rate, population and seasonal characteristics. HCoV pol gene fragments were amplified by RT-PCR for HCoV typing and evolutionary analysis.Results:In this study, the detection rate of HCoV was 1.89%. The co-infection rate of respiratory virus in HCoV positive samples was 20.56% (59/287). 69 strains were identified as type OC43 with nucleotide homology of 97.2%~100% and amino acid homology of 92.2%~100%. Thirty-nine strains were identified as type 229E with nucleotide homology of 99.2%~100% and amino acid homology of 99.2%~100%. Ten strains were identified as type HKU1 and 2 strains were identified as type NL63.Conclusions:OC43 and 229E are still the main types of HCoV in Beijing from 2016 to 2017, and both present certain seasonal difference. The endemic strains of the same type have high homology of nucleotide and amino acid.

Objective:To investigate the computed tomography (CT) features of adenocarcinoma of esophagogastric junction (AEG) after neoadjuvant chemotherapy.Methods:The retrospective and descriptive study was conducted. The clinicopathological data of 59 patients with AEG who underwent neoadjuvant chemotherapy in Peking University Cancer Hospital from February 2010 to November 2014 were collected. There were 51 males and 8 females, aged from 46 to 82 years, with a median age of 63 years. All the 59 patients underwent enhanced CT examination before and after neoadjuvant chemotherapy. Observation indicators: (1) pathological examination and neoadjuvant chemotherapy of patients with AEG; (2) results of CT examination in patients with AEG, including ① qualitative indicators of CT and ② quantitative indicators of CT. Measurement data with skewed distribution were represented as M( P25, P75) or M (range), and comparison between groups was analyzed using the Mann-Whitney U test. Count data were described as absolute numbers, and comparison between groups was analyzed by the chi-square test. Results:(1) Pathological examination and neoadjuvant chemotherapy of patients with AEG: of the 59 patients with AEG, high-differentiated adenocarcinoma was observed in 1 patient, moderate-differentiated adenocarcinoma in 40 patients, and low-differentiated adenocarcinoma in 18 patients. Effective response to neoadjuvant chemotherapy was observed in 13 patients, including 6 patients of pathological tumor regression grading (pTRG) 0 and 7 of pTRG 1; poor response was observed in 46 patients, including 12 patients of pTRG 2 and 34 patients of pTRG 3. (2) Results of CT examination in patients with AEG. ① Qualitative indicators of CT: for the 13 patients with effective response to neoadjuvant chemotherapy, 13 had the presence of ulcers, 5 had layered enhancement, 10 had infiltration of adventitia surface, and 2 had positive extramural venous invasion (EMVI) before neoadjuvant chemotherapy; after neoadjuvant chemotherapy, 13 had shallowed or disappeared ulcers, 7 patients had changed enhancement pattern, 3 had infiltration of adventitia surface, and 1 had positive EMVI. For the 46 patients with poor response to neoadjuvant chemotherapy, 28 had the presence of ulcers, 18 had layered enhancement, 37 had infiltration of adventitia surface, and 22 had positive EMVI before neoadjuvant chemotherapy; after neoadjuvant chemotherapy, 23 had shallowed or disappeared ulcers, 7 patients had changed layered enhancement pattern, 33 had infiltration of adventitia surface and 21 had positive EMVI, respectively. There was no significant difference in the layered enhancement or infiltration of adventitia surface before neoadjuvant chemotherapy between patients with different treatment response ( χ2=0.002, 0.000, P>0.05). There were significant differences in the presence of ulcers and positive EMVI before neoadjuvant chemotherapy between patients with different treatment response ( χ2=5.591, 4.421, P<0.05). After neoadjuvant chemotherapy, there were significant differences in the changes of layered enhancement pattern, infiltration of adventitia surface and positive EMVI between patients with different treatment response ( χ2=6.359, 10.090, 4.728, P<0.05); while there was no significant difference in the shallowed or disappeared ulcers between patients with different treatment response ( χ2=1.239, P>0.05). ② Quantitative indicators of CT: for the 13 patients with good response to neoadjuvant chemotherapy, the maximum tumor height, the maximum tumor area, enhanced CT value of the lesion before neoadjuvant chemotherapy were 1.37 cm(0.94 cm, 1.88 cm), 8.9 cm 2 (4.7 cm 2, 9.9 cm 2), 53 HU(47 HU, 63 HU), respectively. After neoadjuvant chemotherapy, the above indicators were 1.17 cm(0.79 cm, 1.29 cm), 4.4 cm 2(2.5 cm 2, 6.1 cm 2), 30 HU(25 HU, 53 HU), respectively. The change rates of the maximum tumor height, the maximum tumor area, and enhanced CT value of the lesion were -23%(-42%, 9%), -51%(-60 %, -21%), -44%(-51%, 19%), respectively. For the 46 patients with poor response to neoadjuvant chemotherapy, the maximum tumor height, the maximum tumor area, enhanced CT value of the lesion were 1.57 cm(1.21 cm, 1.96 cm), 9.4 cm 2(6.6 cm 2, 13.1 cm 2), 60 HU(53 HU, 66 HU) before neoadjuvant chemotherapy, respectively. After neoadjuvant chemotherapy, the above indicators were 1.16 cm(0.94 cm, 1.37 cm), 6.2 cm 2(4.8 cm 2, 8.1 cm 2), 55 HU(47 HU, 65 HU), respectively. The change rates of the maximum tumor height, the maximum tumor area, and enhanced CT value of the lesion were -27%(-38%, -9%), -33%(-47%, -12%), -9%(-22%, 9%), respectively. There was no significant difference in the maximum tumor height, the maximum tumor area, enhanced CT value of the lesion before neoadjuvant chemotherapy between patients with different treatment response ( Z=-1.372, -1.372, -1.331, P>0.05). There was no significant difference in the maximum tumor height after neoadjuvant chemotherapy between patients with different treatment response ( Z=-0.503, P>0.05), while there were significant differences in the maximum tumor area and CT value of the lesion ( Z=-2.743, -3.049, P<0.05). There was no significant difference in the change rate of the maximum tumor height or the maximum tumor area between patients with different treatment response ( Z=0.000, -1.481, P>0.05), while there was a significant difference in the change rate of CT value of the lesion ( Z=-3.231, P<0.05). Conclusion:Effective response of AEG to neoadjuvant chemotherapy was characterized by the changes in tumor layered enhancement pattern, reduction in the maximum tumor area, reduced CT value of the lesion, negative infiltration of adventitia surface, and negative EMVI.

Objective To observe the value of tissue motion mitral annular displacement(TMAD)technique to assess left ventricular function in patients with cardiac amyloidosis.Methods A total of 34 adult patients with cardiac amyloidosis diagnosed by pathology were retrospectively included as the observation group,and 32 healthy adults were collected as the control group for the same period.Basic data of the subjects were collected,and data of routine ultrasonic parameters of left ventricular function and TMAD parameters were obtained,and then compared between groups.The correlation of TMAD parameters with left ventricular ejection fraction(LVEF)or mitral annular plane systolic excursion(MAPSE)were assessed.Results Compared with the control group,the observation group had higher levels of body surface area(BSA),systolic blood pressure,N-terminal pro-B-type natriuretic peptide(NT-proBNP),creatinine and urea(all P＜0.05).The observation group had increased values of ascending aorta(AO),left atrium(LA),interventricular septum(IVS),left ventricular posterior wall thickness in diastole(LVPWD),pulmonary artery(PA),and early diastolic peark velocity of mitral inflow(peak E),while smaller values of left ventricular end-diastolic dimension(LVEDD),LVEF,fractional shortening(FS),early diastolic tissue Doppler velocity E'septal(IVS E')and lateral(LW E')and MAPSE(all P＜0.05),and the LVEF in observation group was(58.18±7.09)％.For TMAD patameters,the observation group had smaller values of the following parameters on apical four chamber(A4C)view as medial displacement of mitral valve annulus(A4C MV1),displacement of lateral mitral valve annulus(A4C MV2),displacement of the midpoint of the mitral valve annulus(A4C Midpt)and the corresponding percentage(A4C Midpt％),as well as smaller values of the following paramets on apical two chamber(A2C)view as A2C MV1,A2C MV2,A2C Midpt and A2C Midpt％(all P＜0.05).In the observation group,A4C Midpt％showed a moderate positive correlation with LVEF(r=0.488,P＜0.05),and A2C Midpt showed a high positive correlation with M APSE(r=0.712,P＜0.05),and A4C MV2,A4C Midpt,A4C Midpt％,A2C MV1,A2C MV2,A2C Midpt％all showed a moderate positive correlation with MAPSE(r=0.420 to 0.691,all P＜0.05).Conclusion Compared with LVEF,the TMAD parameters might reflect the changes in left ventricular systolic function more sensitively in patients with cardiac amyloidosis.

Malignant tumor has become an urgent threat to global public healthcare. Because of the heterogeneity of tumor, single therapy presents great limitations while synergistic therapy is arousing much attention, which shows desperate need of intelligent carrier for co-delivery. A core‒shell dual metal-organic frameworks (MOFs) system was delicately designed in this study, which not only possessed the unique properties of both materials, but also provided two individual specific functional zones for co-drug delivery. Photosensitizer indocyanine green (ICG) and chemotherapeutic agent doxorubicin (DOX) were stepwisely encapsulated into the nanopores of MIL-88 core and ZIF-8 shell to construct a synergistic photothermal/photodynamic/chemotherapy nanoplatform. Except for efficient drug delivery, the MIL-88 could be functioned as a nanomotor to convert the excessive hydrogen peroxide at tumor microenvironment into adequate oxygen for photodynamic therapy. The DOX release from MIL-88-ICG@ZIF-8-DOX nanoparticles was triggered at tumor acidic microenvironment and further accelerated by near-infrared (NIR) light irradiation. The

Pulmonary drug delivery has attracted increasing attention in biomedicine, and porous particles can effectively enhance the aerosolization performance and bioavailability of drugs. However, the existing methods for preparing porous particles using porogens have several drawbacks, such as the inhomogeneous and uncontrollable pores, drug leakage, and high risk of fragmentation. In this study, a series of cyclodextrin-based metal-organic framework (CD-MOF) particles containing homogenous nanopores were delicately engineered without porogens. Compared with commercial inhalation carrier, CD-MOF showed excellent aerosolization performance because of the homogenous nanoporous structure. The great biocompatibility of CD-MOF in pulmonary delivery was also confirmed by a series of experiments, including cytotoxicity assay, hemolysis ratio test, lung function evaluation,