Objective To construct a decision support education program for the family members of patients with advanced cancer and to investigate its application effects,so as to improve understanding and acceptance of hospice care for family members of advanced cancer patients.Methods Using the Ottawa Decision Support Framework as a theoretical guide,the program was initially drafted based on a literature review,qualitative interview and expert consultation.From September 2023 to January 2024,a convenience sampling method was used to select patients' families in a tertiary-level hospital in Tianjin as the research subjects,and they were randomly divided into an experimental group and a control group.The experimental group received the decision support education program in addition to routine care,while the control group received routine care.Family members' knowledge about hospice,the scores on the Death Attitude Profile Scale,and their willingness to choose hospice care were compared before and after the interventions.Results The program finally included 4 first-level items,15 second-level items,and 59 third-level items.During the program implementation phase,4 cases withdrew from the study,resulting in 46 cases in the experimental group and 47 cases in the control group.After intervention,the experimental group had higher scores on hospice knowledge and positive attitude towards death than the control group,while scores on negative attitude towards death were lower(P＜0.05);their willingness to choose hospice care for themselves and for the patients was higher than that of the control group(P＜0.05).Conclusion The hospice care decision support education program is scientific,feasible and practical,which can improve the knowledge of hospice care of the family members,improve their attitude towards death,and ultimately improve their willingness to choose hospice care.

Objective To construct a decision support education program for the family members of patients with advanced cancer and to investigate its application effects,so as to improve understanding and acceptance of hospice care for family members of advanced cancer patients.Methods Using the Ottawa Decision Support Framework as a theoretical guide,the program was initially drafted based on a literature review,qualitative interview and expert consultation.From September 2023 to January 2024,a convenience sampling method was used to select patients' families in a tertiary-level hospital in Tianjin as the research subjects,and they were randomly divided into an experimental group and a control group.The experimental group received the decision support education program in addition to routine care,while the control group received routine care.Family members' knowledge about hospice,the scores on the Death Attitude Profile Scale,and their willingness to choose hospice care were compared before and after the interventions.Results The program finally included 4 first-level items,15 second-level items,and 59 third-level items.During the program implementation phase,4 cases withdrew from the study,resulting in 46 cases in the experimental group and 47 cases in the control group.After intervention,the experimental group had higher scores on hospice knowledge and positive attitude towards death than the control group,while scores on negative attitude towards death were lower(P＜0.05);their willingness to choose hospice care for themselves and for the patients was higher than that of the control group(P＜0.05).Conclusion The hospice care decision support education program is scientific,feasible and practical,which can improve the knowledge of hospice care of the family members,improve their attitude towards death,and ultimately improve their willingness to choose hospice care.

Objective:To develop a training system for head and neck oncology nurses to improve the emergency response competency to recognize and response to acute and critical medical conditions.Methods:Based on literature review and semi-structured interviews with 12 nurses, two rounds of consultation with 15 head and neck cancer care specialists from 6 Tertiary hospitals using Delphi method were conducted to establish the training system for head and neck oncology nurses.Results:The authority coefficients of experts were 0.87 and 0.89, respectively. The coefficient of variation of each item ranged from 0 to 0.167. The coefficients of concordance ranged from 0.243 to 0.403 ( P<0.01). There was statistical significance after Chi-square test ( χ2 values were 14.60-436.64, all P<0.01). In the final training system, training aims included 5 first-level indicators and 16 second-level indicators; training contents included 5 first-level indicators, 16 second-level indicators, and 60 third-level indicators. Conclusions:The authority coefficients and the coefficients of concordance of the experts for the training system were both high. The training system can be applied to improve the emergency response competency of head and neck oncology nurses.

Insomnia has become a common central nervous system disease. At present, the pathogenesis of insomnia is not clear. Animal models can help us understand the pathogenesis of the disease and can be used in transformational medicine. Therefore, it is very necessary to establish an appropriate model of insomnia. Clinical data show that insomnia patients with high levels of thyroxine and often accompanied by cardiovascular problems, a common mechanism underlying all of these physiological disruptions is the sympathetic nervous system. Combined with the characteristics of chronic onset of clinical insomnia, an insomnia model induced by long-term intraperitoneal injection of thyroid hormone has been created in our laboratory. In this paper, the insomnia-like state of the model was evaluated based on three validity criteria. Face validity has been demonstrated in metabolism, the Morris water maze, electrocardiogram (ECG) and electroencephalogram (EEG). Structure validity has been proved by the results of targeted metabolomics. After treatment with diazepam, a commonly used clinical anti-insomnia drug, the above physiological and pathological disorders were reversed. The results of comprehensive analysis show that the established thyrotoxicosis-associated insomnia model meets the validity requirement to establish an appropriate animal model of insomnia. The model presented in this article might help to study pathogenetic mechanisms of clinical insomnia, as well as to test promising methods of insomnia treatment.

Objective To observe the effects of homemade head and neck fixation pillow in patients with oral and maxillofacial free flap transplantation. Methods Totally 114 patients who needed head and neck fixation after oral and maxillofacial free flap transplantation were divided into the observation group (58 cases) and the control group (56 cases) based on the admitted consequence. Besides the routine treatment and nursing measures, the observation group received head and neck fixation with homemade head and neck fixation pillow, while the control group received traditional fixation with sandbags. The patients′ comfortable degree, compliance, occipital skin condition and the nurses′evaluation of clinical application were investigated. Results The degree of comfort were (2.93 ± 1.28) points in the observation group and (4.96±1.25) points in the control group, respectively. The comfortable degree was higher in the observation group than that in the control group, the difference was statistically significant (t=-8.569,P<0.05). There were 43 patients with complete compliance, 15 with partial compliance, and 0 with no compliance in the observation group respectively, while 18 with complete compliance, 35 with partial compliance, and 3 with no compliance in the control group respectively. The compliance was better in the observation group than that in the control group, the difference was statistically significant (P<0.05). None of the patients in the observation group had pressure ulcer, while 3 patients in the control group had stageⅠpressure ulcer. 96.9％of the nurses considered the homemade head and neck fixation pillow was easy to operate. 100.0％of the nurses considered the homemade headand neck fixation pillow could immobilize the patient′s head and neck effectively. Conclusion The homemade head and neck fixation pillow is easy to operate and can effectively immobilize the patient′s head and neck, protect the patient′s occipital skin, as well as improve patient′s comfort and compliance.

Objectives To investigate the imaging ability of magnetic sensitive weighted imaging (SWI) scans with 2.0 mm and 1.0 mm slice thickness on intracerebral veins and branches.Methods 47 healthy volunteers were recruited,including 20 males and 27 females,aged 21-45 (30.1 ± 12.93).Two SWI sequences with thickness of 2.0 mm and 1.0 mm were performed in all healthy volunteers.After reconstructed by minimal intensity projection (MIP),the display rate and diameter of intracerebral veins and branches were counted by two doctors.McNemar test and paired t-test were used for statistical analysis.Results (1) The display rates of bilateral internal cerebral veins,papular veins and left ventricular veins were 100％ in both scanning schemes,while the display rates of left and right septal veins,anterior caudate nucleus veins and right ventricular veins on SWI sequence images with 2.0 mm thickness were 90.0％ (left),91.0％ (right) and 87.2％ (right),91.5％,respectively.The display rates on SWI sequence images with 1.0 mm thickness were 97.9％ (left),94.0％ (right),97.9％ (left),95.7％ (right) and 95.7％ respectively.(2) There were significant differences in the diameter of bilateral septum pellucidum veins and bilateral anterior caudate nucleus veins between the two scanning schemes (P ＜ 0.05).While there was no significant difference in the diameter of bilateral internal cerebral veins,bilateral papular veins and bilateral intraventricular veins (P ＞0.05).(3) The displaying rate of veins with diameter ＞0.9 mm was 100％ for both scanning schemes,while the displaying rate of veins with diameter ranging from 0.6-0.9 mm (including 0.6 mm and 0.9 mm) in the two scanning schemes had significant difference (P ＜ 0.05).Conclusions SWI sequence can clearly show the anatomical shape of intracerebral veins and branches.In contrast to SWI of the scan slices thickness of 2.0 mm,the SWI of scan slices thickness of 1.0 mm showed more efficiency in display thinner brain venous.Therefore,using SWI sequence scanning scheme with 1.0 mm slice thickness will be more conducive to observe and study intracerebral veins and branches.

Objective To evaluate the effectiveness of discharge planning in patients after total laryngectomy. Methods One hundred and four patients were randomly divided into the intervention group and the control group, there were 52 cases in each group. The patients in the control group were received routine nursing, while the patients in the intervention group were received discharge planning based on routine nursing. The patients'days of hospitalization, scores of the Exercise of Self-care Agency Scale (ESCA) at discharge and 4 weeks after discharge, scores of University of Washington Quality of Life Questionnaire (UW-QOL) at 4 weeks after discharge and re-admission rate were compared between the two groups. Results The ESCA scores in the intervention group at discharge (108.62 ± 11.23) and 4 weeks after discharge (116.35 ± 12.08) were significantly higher than those of the control group at discharge (96.16±10.34) and 4 weeks after discharge (105.20±10.76) respectively (t=5.886, 4.970, P<0.05), and the UW-QOL score in the intervention group (810.56±98.25) was significantly higher than that of the control group (687.32±96.74) at 4 weeks after discharge (t=6.445, P<0.05). No significant difference in the days of hospitalization was found between the intervention group (15.27 ± 3.33) and the control group (16.60 ± 3.97) (P>0.05). The re-admission rate in the intervention group (2/52,3.85%) was significantly lower than that of the control group (8/52,15.38%) (χ2=3.983, P<0.05). Conclusions Discharge planning can improve the ability of self-care and quality of life in patients after total laryngectomy, and reduce the re-admission to hospital.

Objective To compare the accuracy of Marsh model and Schnider model for propofol target?controlled infusion ( TCI) system. Methods Eighty patients, aged 20-60 yr, of American Society of Anesthesiologists physical status ⅠorⅡ, with body mass index of 17?5-28?0 kg∕m2 , scheduled for e?lective gynecological operation under general anesthesia, were equally and randomly divided into either Marsh model group ( group M) or Schnider model group ( group S) using a random number table. The target plasma concentration was set at 3 μg∕ml in both groups. During TCI and at different time points after the end of TCI, the blood samples were collected for determination of blood propofol concentrations by high per?formance liquid chromatography with fluorescence detector. The difference between measured and predicted concentrations (△C) at each time point was calculated. The median performance error ( MDPE) , median absolute performance error ( MDAPE) , and wobble of propofol TCI system were calculated in each group. Results In M and S groups, the MDPE was 9. 90% and 14?00%, respectively; the MDAPE was 11?43% and 14?49%, respectively;the wobble was 7?77% and 7?79%, respectively. There was no sig?nificant difference in △C at each time point during TCI between group M and group S (P>0?05). After TCI was stopped, △C at each time point was significantly lower in group M than in group S ( P<0?05) . Conclusion Marsh model provides higher accuracy than Schnider model for propofol TCI system in the pa?tients undergoing gynecological operation.

Objective To detect whether and where brain functional connectivity exists in the resting state of patients with early-onset schizophrenia by using functional magnetic resonance imaging (fMRI). Methods Nineteen early-onset schizophrenic patients were diagnosed with Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) of American Psychiatric Association. The 19 early-onset schizophrenic patients and another 19 healthy volunteers underwent fMRI in resting state. Cingulate gyrus was selected as region of interest and the difference was analyzed in the cingulate gyrus functional connectivity pattern between the 19 patients with early-onset schizophrenia (EOS) and 19 matched controls using resting-state fMRI. A two-sample t test was performed on the individual in a voxel by voxel manner. Results Statistical map was set a combined threshold of P＜0.005 and the number of voxel>20. Functional connectivity in the resting state was abnormal in the patients,including decreased functional connectivity and increased functional connectivity. The abnormal area was distributed all over the brain. The brain area with decreased functional connectivity included bilateral posterior cerebellar lobes, superior frontal gyrus, middle frontal gyrus, gyrus rectus,hippocampus, cuneus gyrus,fusiform gyrus,middle occipital gyrus,inferior occipital gyrus, right inferior temporal gyrus,right middle temporal gyrus, and right angular gyrus. The brain area with increased functional connectivity included left middle temporal and left inferior temporal gyrus. Conclusion Abnormal cingulate gyrus functional connectivity of schizophrenia might exist in the resting state. Resting state fMRI is important for the research of schizophrenia.

OBJECTIVE: To explore the regional homogeneity of resting state brain activity in early onset schizophrenia using functional magnetic resonance imaging. METHODS: Schizophrenia or schizophreniform disorder was diagnosed according to DSM-IV-TR (diagnostic and statistical manual of mental disorders, fourth edition, text revision). A total of 18 adolescents with early-onset schizophrenia (EOS; onset of psychotic symptoms by age 18) and 18 age- and gender-matched healthy volunteers were tested in a resting-state fMRI scan. Regional homogeneity approach was used to analyze the functional imaging data,and statistical parametric mapping 5 (SPM5)was used to perform t-test in ReHo maps between the patients and controls. RESULTS: In comparison with the controls, the early-onset patients showed significantly decreased regional homogeneity in bilateral medial prefrontal cortex(P<0.001,uncorrected; voxel>20), but no brain regions showed significantly increased regional homogeneity in the patients. CONCLUSION Regional homogeneity of resting state brain activities in EOS was decreased in bilateral medial prefrontal cortex. These abnormal changes may be involved in the psychopathology of schizophrenia.
Adolescent ; Brain ; physiopathology ; Case-Control Studies ; Child ; Female ; Humans ; Magnetic Resonance Imaging ; methods ; Male ; Prefrontal Cortex ; physiopathology ; Schizophrenia ; physiopathology ; Time Factors ; Young Adult