Objective:To explore the needs and feelings of emergency palliative care from the perspective of medical and nursing staff.Methods:Purposeful sampling was used to recruit 23 emergency medical and nursing staff with experience in end-of-life care from two Class Ⅲ Grade A hospitals in Wenzhou City between September and October 2024. Semi-structured interviews were conducted with the respondents. Results were analyzed using NVivo 12 software.Results:Emergency patients at the end of life and their families had immediate needs, including acute symptom control, pain management, and respiratory distress treatment needs, urgent decision support needs, cultural conflict needs, immediate emotional comfort needs and alexithymia. Medical and nursing staff faced numerous obstacles when providing palliative care in emergency settings, such as role conflicts and skill gaps among emergency medical and nursing staff, lack of dedicated palliative care areas and noisy environments that hindered communication due to physical space limitations in the Emergency Department, short decision-making time and difficulties in referral due to limited emergency room time window, the multidisciplinary collaboration in the emergency department lags behind and the response of the specialized team was delayed, and lack of information sharing between emergency departments and wards.Conclusions:Emergency palliative care is characterized by both urgent needs and implementation barriers. It is necessary to optimize the physical space of the Emergency Department, establish a rapid decision mechanism for medical and nursing staff, strengthen multidisciplinary collaboration, and conduct professional training to build a palliative care model suitable for emergency situations.

Objective:To explore the needs and feelings of emergency palliative care from the perspective of medical and nursing staff.Methods:Purposeful sampling was used to recruit 23 emergency medical and nursing staff with experience in end-of-life care from two Class Ⅲ Grade A hospitals in Wenzhou City between September and October 2024. Semi-structured interviews were conducted with the respondents. Results were analyzed using NVivo 12 software.Results:Emergency patients at the end of life and their families had immediate needs, including acute symptom control, pain management, and respiratory distress treatment needs, urgent decision support needs, cultural conflict needs, immediate emotional comfort needs and alexithymia. Medical and nursing staff faced numerous obstacles when providing palliative care in emergency settings, such as role conflicts and skill gaps among emergency medical and nursing staff, lack of dedicated palliative care areas and noisy environments that hindered communication due to physical space limitations in the Emergency Department, short decision-making time and difficulties in referral due to limited emergency room time window, the multidisciplinary collaboration in the emergency department lags behind and the response of the specialized team was delayed, and lack of information sharing between emergency departments and wards.Conclusions:Emergency palliative care is characterized by both urgent needs and implementation barriers. It is necessary to optimize the physical space of the Emergency Department, establish a rapid decision mechanism for medical and nursing staff, strengthen multidisciplinary collaboration, and conduct professional training to build a palliative care model suitable for emergency situations.

Objective To investigate the relationship between interleukin-17 (IL-17) and vitiligo.Methods Totally,32 vitiligo patients and 30 healthy human controls were enrolled in this study.Blood samples were collected from all the subjects,and enzyme-linked immunosorbent assay (ELISA) was performed to determine the plasma levels of IL-17.The relationship of plasma IL-17 levels with disease stage,clinical course and lesion area was assessed.Results The plasma levels of IL-17 were significantly higher in the patients with progressive and stable vitiligo than in the healthy controls (both P ＜ 0.05),and higher in the patients with progressive vitiligo than in those with stable vitiligo (P ＜ 0.05).Moreover,the plasma levels of IL-17 were positively correlated with the area of vitiligo lesions (r =0.456,P ＜ 0.05),but unrelated to the clinical course of vitiligo (r =0.239,P ＞ 0.05).Conclusion IL-17 may play a certain role in the occurrence and development of vitiligo.

Objective To investigate the effects of ulinastatin ( UTI) on renal function after cardiopulmonary bypass (CPB) .Methods Twenty-four NYHA functional capacity class Ⅱ - Ⅲ patients (15 male, 9 female) aged 24-52 yr, weighing 41-75 kg undergoing valve replacement with CPB were randomly divided into two groups :group ulinastatin (group U, n = 12) and group control (group C, n = 12) . Anesthesia was induced with midazolam 0.1 mg ? kg-1 , fentanyl 10 55% ? kg-1 and vecuronium 0.15 mg ? kg-1 and maintained with intermittent iv boluses of fentanyl, midazolam and vecuronium supplemented with isoflurane inhalation. In group U UTI 300 000 U was added to the priming solution and 300 000U/d was infused iv on the first three days after operation. In group C normal saline was given iv instead of UTI. Blood samples were taken and urine was collected before operation (T0), on the 1st (T,), 3rd (T3), 5th (T5) and 7th day (T7) after operation for determination of serum urea nitrogen (BUN), creatinine (Cr), ? 2-microglobulin (? 2-MG) and urinary ?2-MG, RBP and NAG. Results (1) There were no significant differences between the two groups with respect to age, sex, body weight, CPB time and aortic cross-clamping time. (2) BUN, Cr and serum ? 2-MG levels increased significantly after operation at T1 and/or T3 as compared with the baseline values (T0) in group C and were significantly higher than those in group U at the corresponding time points ( P