Palliative care not only embodies modern life perspectives, but also encompasses significant traditional Chinese cultural elements.The primary objective of palliative care is to alleviate patient suffering, preserve their dignity, and facilitate a peaceful passing.Traditional Chinese medicine, known for its simplicity, accessibility, affordability, and efficacy in disease prevention and treatment, adopts a holistic approach to address systemic pain through personalized treatment based on symptom differentiation.This approach aims to enhance the quality of life for terminally ill patients.To equip palliative care providers with essential clinical skills in traditional Chinese medicine, the National Center of Gerontology and Beijing Palliative Care Guidance Center collaborated with experts and scholars to develop guidelines focusing on common end-of-life symptoms.Through extensive deliberation, expert evaluation, and revisions, this guidance document was crafted as a valuable resource for palliative care practitioners, traditional Chinese medicine clinicians, and researchers in the field.

Objective:To evaluate the characteristics and risk factors for blood transfusion in very low birth weight infants(VLBWI).Methods:Clinical data of one hundred VLBWI, hospitalized from July, 2016 to June, 2019, were studied retrospectively.The infants were divided into two groups according to whether they received blood transfusion.The general information, incidence of diseases and treatment measures were compared between two groups.The risk factors influencing the blood transfusion were analyzed.Results:Of the one hundred VLBWI, sixty-nine cases needed blood transfusion.The first time of blood transfusion ranged from one to four weeks after birth, and average number of transfusions was 6 times.Maternal anemia during pregnancy, birth weight, gestational age, hemoglobin and hematocrit at birth, volume of blood taking within two weeks after birth, duration of hospitalization, duration of paraenteral nutrition, delivery method, need for intubation and neonatal respiratory distress syndrome, apnea, bronchopulmonary dysplasia, patent ductus arteriosus showed significant differences between the two groups( P<0.05). Logistic regression analysis revealed that lower gestation( OR=0.386, 95% CI 0.212-0.704, P=0.002), longer duration of hospital stay( OR=2.177, 95% CI 1.170-4.049, P=0.014), prolonged parenteral nutrition( OR=1.195, 95% CI 1.083-1.319, P<0.001), greater volume of blood taking within two weeks after birth ( OR=1.269, 95% CI 1.083-1.487, P=0.003)and cesarean delivery( OR=5.513, 95% CI 1.056-28.770, P=0.043) were associated with increasing risk of blood transfusion in VLBWI. Conclusion:The gestational age, length of hospital stay, blood intake within two weeks after birth, duration of paraenteral nutrition and delivery method all affected the risk of blood transfusion to varying degrees.

Objective: To investigate the clinical relevant factors associated with transfusion associated necrotizing enterocolitis (TANEC) in order to reduce the incidence of neonatal necrotizing enterocolitis (NEC). Methods: The clinical data of neonates admitted to the First Hospital of Lanzhou University and received blood transfusion therapy from January 2017 to June 2018 were collected, including perinatal factors, basic conditions of children, and comorbidities.According to the occurrence or absence of NEC within 48 hours after transfusion, the patients were divided into TANEC group and no-TANEC group.The clinical data of the two groups were compared. Results: Univariate analysis showed that there were statistical differences (P<0.05) in the mode of delivery, gestational age, birth weight, neonatal sepsis, patent ductus arteriosus(PDA), neonatal respiratory distress syndrome (NRDS), and anemia.The logistic multivariate analysis revealed that gestational age(P<0.05, OR=0.772, 95%CI: 0.684-0.871), the birth weight(P<0.05, OR=0.236, 95%CI: 0.079-0.711)were protect fators of TANEC, the degree of anemia(mode 1: P<0.05, OR=3.129, 95%CI: 1.003-9.756; mode 2: P<0.05, OR=3.449, 95%CI: 1.024-11.609)and sepsis (mode 1: P<0.05, OR=6.327, 95%CI: 1.732-23.720; mode 2: P<0.05, OR=8.154, 95%CI: 2.122-31.336)were significant risk fators for TANEC. Conclusion The factors leading to the occurrence of TANEC are various.When transfused, the greater the gestational age, the higher the birth weight, the lower the risk of developing NEC.The more severe the combination of neonatal sepsis and anemia, the higher the risk of developing TANEC.Clinically, comprehensive measures should be taken to prevent neonatal anemia.According to the specific conditions of the children and the degree of anemia, a reasonable clinical strategy should be formulated to avoid blood transfusion to reduce the incidence of TANEC and improve the prognosis of the children.

Objective: This study aimed to investigate the relationship between the genetic variation of CD55 promoter and the risk of esophageal cancer. Methods: A total of 700 esophageal cancer patients recruited between April 2008 and December 2012 at Tangshan Grongren Hospital and Tangshan Renmin Hospital, and 700 frequency matched controls were randomly selected from a pool of cancer free subjects recruited from a nutritional survey. Genotypes of CD55 rs2564978 polymorphism among all subjects were conducted by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). The OR and 95%CI were calculated by non-conditional Logistic regression to evaluate the association of CD55 rs2564978T/C polymorphism with the risk of esophageal cancer. Results: The average age of cases and control was (60.04±9.19) and (59.21±9.98) years old. Compared with CD55 rs2564978 TT carriers, the individuals with CC genotype had a significantly higher risk of esophageal cancer (OR=1.94, 95%CI:1.42-2.66) . When stratified by sex, this genetic variation affected the risk of esophageal cancer among both males (OR=1.92, 95%CI:1.37-2.70) and females (OR=2.34, 95%CI:1.04-5.27). When stratified by age, the CD55 rs2564978 CC was associated with the susceptibility of developing esophageal cancer among younger individuals (OR=1.79, 95%CI:1.19-2.68) and older people (OR=2.32, 95%CI:1.41-3.83).When stratified by drinking status, CC genotype carriers increase the risk of esophageal cancer when drinking (OR=1.93, 95%CI:1.03-3.63) or not drinking (OR=1.95, 95%CI:1.36-2.80). When stratified by smoking status, CC genotype was associated with the risk of esophageal cancer among non-smokers (OR=1.79, 95%CI: 1.13-2.83), light smokers (less than 30 packs/year, OR=1.86, 95%CI:1.31-2.64) and heavy smokers (more than 30 packs/year, OR=2.67, 95%CI:1.28-5.57). Gene-environmental interaction analysis showed that CD55 rs2564978T/C polymorphism interacted with smoking status to increase the risk of esophageal cancer. Conclusion CD55 rs2564978 polymorphism effects on the risk of esophageal cancer.

Objective To investigate the natural changes of high-risk HPV (HR-HPV) in women with negative for intraepithelial lesion or malignancy (NILM) for regulating HR-HPV screening.Methods Four hundred and thirty-three newly-diagnosed women were enrolled from January 1st,2015 to December 31,2015 in Beijing Obstetrics and Gynecology Hospital.The ages of these patients were between 22 and 74 years,the average age was (45±21) years old.Two hundred and sixty-three cases were less than 50 years old,170 cases were more and equal to 50 years old.One hundred and fifty-six cases were HR-HPV positive,277 cases were HR-HPV negative.Follow up tests were conducted for all 433 patients,who were screened by ThinPrep cytologic test (TCT) combined with HR-HPV and were diagnosed with NILM,for a period of 1 year (at the 3,6,9 and 12 months intervals respectively),if the TCT results are abnormal and the HR-HPV test results are positive,will follow up colposcopy directed cervical biopsy.Results (1) HR-HPV natural changes:of 156 NILM cases with HR-HPV infection,42 cases (26.9％,42/156) turned negative within 3 months,88 cases (56.4％,88/156) turned negative within 6 months,99 cases (63.5％,99/156) turned negative within 9 months,and 100 cases (64.1％,100/156) turned negative within 12 months.The negative conversion ratio at 3,6,9 and 12 months for women at childbearing age (＜50 years) were significantly higher than those at non-childbearing age (≥50 years old;all P＜0.05).Of 277 NILM cases without HR-HPV infection,35 cases (12.6％,35/277) had new HR-HPV positive infections within 3 months,70 cases (25.3％,70/277) had new infections within 6 months,80 cases (28.9％,80/277) had new infections within 9 months,and 83 cases (30.0％,83/277) had new infections within 12 months.The new infections rate at 3,6,9 and 12 months for women at childbearing age (＜50 years old) were slightly higher than those at non-childbearing age (≥50 years old;all P＞0.05).(2) The progress of cervical leision:of 156 NILM cases with HR-HPV positive,no case progressed during 12 months follow-up.Of 277 NILM cases with HR-HPV negative,4 cases progressed to cervical intraepithelial neoplaisa (CIN) with HR-HPV infection and TCT abnormal during 12 months follow-up,including 2 cases pathology diagnosed with CIN Ⅰ,1 case with CIN Ⅱ,and 1 case with CIN Ⅲ.The progression rate was 1.4％ (4/277),which accounts for 4.8％ (4/83) of new HR-HPV infections cases in women.Conclusions The results of cytology combined with HR-HPV screenings suggest every 6 months for simple HR-HPV positive women,colposcopy directed cervical biopsy is recommended to assess cervical lesions if necessary.Cytology combined with HR-HPV screenings suggest every 12 months for simple HR-HPV negative women to early detection of cervical leision.

Objective To construct a lentiviral vector carrying rat sirt1 gene and observe the expression of sirt1 in retinal ganglion cell (RGC) of rat.Methods Rat sirt1 cDNA was inserted into pLV5 vector.After identification by sequencing analysis and PCR,the recombinant sirt1expressinglentivirus vector was packaged by cotransfecting 293T cells with packaged plasmid.Then pLV5-sirt1 was used to infect the cultured Sprague-Dawley rat RGC cell in vitro.The expressions of sirt1 protein and mRNA in infected rat RGC were detected by quantitative real-time PCR and Western blot.Results The sirt1 expression vector pLV5 was successful constructed and sequence was proved to be correct.The expression of sirt1 protein and mRNA in RGC was significantly increased than that in cells infected with control lentiviruses (P ＜ 0.05).Conclusion We have successful constructed a sirt1 expression lentivirus vector pLV5-sirt1 and it can increase the expression of sirt1 protein and mRNA in the rat retinal ganglion cells.

OBJECTIVE:To provide reference for strengthening the management of drug off-label dosage in hospital. METH-ODS:PDCA cycle management was conducted to investigate the current situation of off-label dosage of Alprostadil injection (Li-po-PGE1)in endocrinology department of our hospital before Jul. 2012 in the Plan stage,identify problems,find reasons and devel-op intervention objectives and measures;after intervention in Do stage,medical advices were checked periodically in Check stage, and the data in the same stage of 2013 were spot-checked in Astage stage,intervention effect was analyzed and interventional pro-cess was standardized. RESULTS:Totally 943 medical advices,including 126 cases/times were analyzed before PDCA intervention and according to the data of cases,medical advices and drug usage amount,the incidences of off-label dosage were 39.68%, 31.50% and 47.90%,respectively;after a cycle of PDCA intervention,totally 414 medical advices,including 73 cases were ana-lyzed and the incidences of off-label dosage were 0. The prescribed daily dose(PDD)was decreased from 13.15 μg to the predeter-mined range(10.00 μg)with decrease rate of 23.95%;the drug use density(DUD)was decreased from 59.82 to 20.07 with de-crease rate of 66.45%. There were significant differences in among the incidence of off-label dosage,PDD and DUD of Lipo-PGE1 (P<0.05). It reached the expected targets. CONCLUSIONS:Because of its well-organized ideas on work and continuous improve-ment methods of circulation,PDCA cycle management provides a workable avenue to manage drug off-label dosage uses in hospital.

OBJECTIVETo explore the role of mitochondrial DNA 5178 C/A (Mt5178) polymorphism of NADH-dehydrogenase subunit 2 (ND2) gene in type-2 diabetes mellitus (T2DM) among ethnic Han Chinese through a case-control study.

METHODSThe Mt5178C/A polymorphism was determined by sequencing 1103 T2DM patients and 791 healthy controls. Logistic regression analysis was conducted to estimate odds ratios (OR) and 95% confidence intervals (CI). To confirm the results, a meta-analysis was conducted based on published literature on the association of Mt5178 variant with T2DM.

RESULTSNo significant association was found between the Mt5178C/A variant and T2DM either by our study or the meta-analysis which included eight published studies. Nevertheless, it was found that the T2DM patients with 5178C genotype were at a higher risk for nephropathy complication (OR=1.49, 95%CI: 1.005-2.197, P<0.05) and at significantly lower risk for hypertension complication (OR=0.744, 95%CI: 0.556-0.996, P<0.05) compared with those carrying a 5178A genotype.

CONCLUSIONNo association was found between the Mt5178C/A polymorphism of mitochondrial ND2 gene with the increased risk of T2DM. However, the polymorphism may affect the development of nephropathy and hypertension complications among T2DM patients.

Adult ; Aged ; Blood Glucose ; metabolism ; Cholesterol ; blood ; Cholesterol, HDL ; blood ; DNA, Mitochondrial ; chemistry ; genetics ; Diabetes Complications ; blood ; genetics ; Diabetes Mellitus, Type 2 ; blood ; complications ; genetics ; Diabetic Nephropathies ; blood ; genetics ; Fasting ; blood ; Female ; Humans ; Hypertension ; blood ; complications ; genetics ; Male ; Meta-Analysis as Topic ; Middle Aged ; Odds Ratio ; Polymorphism, Single Nucleotide ; Sequence Analysis, DNA ; Triglycerides ; blood

OBJECTIVETo establish a canine cell line with p53 gene knockdown by lentivirus- mediated RNA interference (RNAi).

METHODSFour pairs of oligonucleotide sequences of p53 gene were synthesized and cloned into the pGMLV-SC5 RNAi vector. Following confirmation by PCR and DNA sequencing, the recombinant pGMLV-p53 plasmids and packaging mix vectors were packaged into mature lentivirus to infect 293T cells. The supernatant of the infected cells was harvested to infect WRD cells, in which p53 expression was detected using Western blotting and real-time PCR. The lentivirus with the strongest p53⁻ silencing effect was packaged for infecting WRD cells at the optimal multiplicity of infection (MOI) to establish a stably infected cell line (WRD/p53⁻) screened using puromycin.

RESULTSThe lentivirus carrying p53 shRNA was constructed successfully and a virus titer of 1 × 10⁹ TU/ml. The 4 pGMLV-p53 plasmids all produced strong p53 interference affects, and pGMLV- p53A1 with the strongest effect. The stably infected cells line WRD/p53⁻ was established successfully using pGMLV-p53A1 plasmid.

CONCLUSIONThe canine cell line WRD/p53⁻ with stable lentivirus-mediated p53 silencing has been established successfully.

Animals ; Cell Line ; Dogs ; Gene Knockdown Techniques ; Genes, p53 ; Genetic Vectors ; Lentivirus ; Plasmids ; RNA Interference ; RNA, Small Interfering ; Real-Time Polymerase Chain Reaction

Objective To establish a canine cell line with p53 gene knockdown by lentivirus-mediated RNA interference (RNAi). Methods Four pairs of oligonucleotide sequences of p53 gene were synthesized and cloned into the pGMLV-SC5 RNAi vector. Following confirmation by PCR and DNA sequencing, the recombinant pGMLV-p53 plasmids and packaging mix vectors were packaged into mature lentivirus to infect 293T cells. The supernatant of the infected cells was harvested to infect WRD cells, in which p53 expression was detected using Western blotting and real-time PCR. The lentivirus with the strongest p53-silencing effect was packaged for infecting WRD cells at the optimal multiplicity of infection (MOI) to establish a stably infected cell line (WRD/p53-) screened using puromycin. Results The lentivirus carrying p53 shRNA was constructed successfully and a virus titer of 1 × 109 TU/ml. The 4 pGMLV-p53 plasmids all produced strong p53 interference affects, and pGMLV- p53A1 with the strongest effect. The stably infected cells line WRD/p53- was established successfully using pGMLV- p53A1 plasmid. Conclusion The canine cell line WRD/p53-with stable lentivirus-mediated p53 silencing has been established successfully.