This paper examines the integration of Confucian ethics into modern nursing practice and its implications,offering a review of the book Contemporary Medicine and Confucian Thought by Professor Fan Ruiping.The book addresses six key topics:medical decision-making,healthcare systems,medical technology,organ transplantation,mental health,and elderly care.It highlights the conflicts between individual autonomy emphasized in Western ethics and the family-centered approach of Confucianism,especially in clinical decision-making.Through case studies and ethical discussions,the book suggests integrating Confucian ethics with modern medical systems to balance personal and familial interests in patient care.From the perspective of nursing,this review emphasizes the relevance of Confucian principles such as family-centered care,the integration of moral emotions like benevolence and respect,and the importance of developing culturally appropriate ethical models for clinical decision-making.It calls for a paradigm shift in nursing education and practice toward a family-centered approach,promoting harmony between individual and collective needs.Additionally,it discusses the challenges and opportunities for integrating Confucian ethics into cross-cultural nursing in a globalized healthcare environment.The review concludes that Confucian ethics can provide valuable insights into the development of more humanistic and ethically sound nursing practices,particularly in the context of a rapidly evolving medical landscape.

Objective:To explore the inhibitory effect of fentanyl combined with hyperbaric oxygen (HBO) on the proliferation of tumor tissues of the gastric cancer tissues of nude mice.Methods:A total of 20 six-week-old male specific pathogen free (SPF) BALB/c nude mice were used to establish a model of transplanted tumors and then were divided into four groups according to the experimental requirements: control group, HBO group, FEN group, and HBO+ FEN group. The control group was raised normally after successful modeling; the HBO group inhaled oxygen for 60 min every day at 0.20 MPa; the FEN group was given 10 mg/kg fentanyl by intragastric administration; and the HBO+ FEN group inhaled oxygen for 60 min at first at 0.20 MPa and then was given 10 mg/kg fentanyl by intragastric administration. All groups were treated every other day for a total of 21 days. After treatment, the nude mice were executed to strip the tumor of which the volume and weight were measured. Terminal deoxynucleotidyl transferase-dUTP nick end labeling (TUNEL) assay was applied to detect the apoptosis of tumor cells and Western blotting was adopted to detect the expressions of apoptosis-related proteins and signaling pathway protein.Results:After 21 days of treatment, the tumor volume and weight of the mice in the HBO+ FEN group were significantly lower than those of the other three groups with statistically significant differences ( P<0.05). The number of apoptotic cells of transplanted tumors in the HBO+ FEN group was significantly higher than those of the other three groups with statistically significant differences ( P<0.05). Compared with the control group, the FEN group, and the HBO group, the expression levels of Bax, Caspase-3, and Cytochrome C in transplanted tumor tissues of nude mice in the HBO+ FEN group were significantly higher, while the expression of Bcl-2 protein was significantly lower, with statistically significant differences ( P<0.05). Compared with the control group, the HBO group, and the FEN group, the expression level of p65 protein in transplanted tumor cells in the HBO+ FEN group was significantly lower, while the expression level of p53 protein was significantly higher, with statistically significant differences ( P<0.05). Conclusion:The combination of HBO and fentanyl can promote tumor cell apoptosis by regulating NF-κB and p53 signaling pathways in nude mice with gastric cancer.

Objective:To explore the inhibitory effect of fentanyl combined with hyperbaric oxygen (HBO) on the proliferation of tumor tissues of the gastric cancer tissues of nude mice.Methods:A total of 20 six-week-old male specific pathogen free (SPF) BALB/c nude mice were used to establish a model of transplanted tumors and then were divided into four groups according to the experimental requirements: control group, HBO group, FEN group, and HBO+ FEN group. The control group was raised normally after successful modeling; the HBO group inhaled oxygen for 60 min every day at 0.20 MPa; the FEN group was given 10 mg/kg fentanyl by intragastric administration; and the HBO+ FEN group inhaled oxygen for 60 min at first at 0.20 MPa and then was given 10 mg/kg fentanyl by intragastric administration. All groups were treated every other day for a total of 21 days. After treatment, the nude mice were executed to strip the tumor of which the volume and weight were measured. Terminal deoxynucleotidyl transferase-dUTP nick end labeling (TUNEL) assay was applied to detect the apoptosis of tumor cells and Western blotting was adopted to detect the expressions of apoptosis-related proteins and signaling pathway protein.Results:After 21 days of treatment, the tumor volume and weight of the mice in the HBO+ FEN group were significantly lower than those of the other three groups with statistically significant differences ( P<0.05). The number of apoptotic cells of transplanted tumors in the HBO+ FEN group was significantly higher than those of the other three groups with statistically significant differences ( P<0.05). Compared with the control group, the FEN group, and the HBO group, the expression levels of Bax, Caspase-3, and Cytochrome C in transplanted tumor tissues of nude mice in the HBO+ FEN group were significantly higher, while the expression of Bcl-2 protein was significantly lower, with statistically significant differences ( P<0.05). Compared with the control group, the HBO group, and the FEN group, the expression level of p65 protein in transplanted tumor cells in the HBO+ FEN group was significantly lower, while the expression level of p53 protein was significantly higher, with statistically significant differences ( P<0.05). Conclusion:The combination of HBO and fentanyl can promote tumor cell apoptosis by regulating NF-κB and p53 signaling pathways in nude mice with gastric cancer.

Objective:To investigate the value of programmed death-1（PD-1） expression on the T lymphocytes for the prognosis of septic patients.Methods:From September 2017 to May 2019, septic patients were included in Department of Intensive Care Unit at 6 hospitals. The PD-1 expression on T cells were measured by flow cytometry. Logistic regression was conducted to analyze independent risk factors related to death within 28 days，and receiver operating characteristic curve(ROC) was conducted to evaluate the prognostic value of PD-1 expression on T cells in septic patients.Results:A total of 64 septic patients were enrolled to this study，including 32 survivors and 32 deaths. The PD-1 expression on T cells in the death group was significantly higher than that in the surviving group ( P<0.05). Correlation analysis showed that the percentages of PD-1 +/CD3 +T cells and PD-1 +/CD8 +T cells were positively correlated with procalciton in ( r=0.313, P =0.015； r=0.375, P=0.003), logistic regression analysis showed that the percentages of PD-1 +/CD3 +，PD-1 +/CD4 +，PD-1 +/CD8 +T cells were independent risk factors for the death of sepsis patients. The percentage of PD-1 +/CD3 +T cell was 3.63%, with AUC 0.842, sensitivity to predict the mortality 96.43% and specificity 59.38%, ( P<0.000 1). The percentage of PD-1 +/CD4 +T cell was 4.65%, with AUC 0.847, sensitivity 96.43%, specificity 62.50%，( P<0.000 1). The percentage of PD-1 +/CD8 +T cell was 3.91%, with AUC 0.771, sensitivity 64.29%, specificity 81.25%，( P=0.000 3). Conclusions:The T cell PD-1 expression is an independent risk factor to predict the 28-day mortality in septic patients. Combining the proportions of PD-1 +/CD3 +, PD-1 +/CD4 +and PD-1 +/CD8 +T cells may further enhance the predictive value for death.

Objective To investigate the possible effect of citrate on electrolyte metabolism in healthy people with different genders and races and provide a reference for the possible clinical interventions.Methods A cross over,placebo-controlled study was conducted in 22 age-matched Chinese(11 males and 11 females)and 10 male Caucasian volunteers after informed consents were obtained.Volunteers received of saline solution,separated by a wash-out period of two to three weeks.Serial blood and urine samples were collected during the observation period and analyzed for the selective biochemical parameters.Results Comparable basal levels of serum albumin[male(43.05±1.81)g/L vs female(42.26±2.67)g/L]and serum ionized calcium[male(1.27±0.04)mmol/L vs female(1.26±0.04)mmol/L]were observed between different genders of Chinese volunteers.However,citrate intervention led to more pronounced decrease of ionized calcium level in Chinese females compared to Chinese males[-28.68%(-20.00%--35.2%)vs-23.84%(-16.53%--29.32%),t=3.19,P ＜ 0.01].There was no differences of the levels of serum inorganic phosphate[-18.81%(-3.16%--25.09%)vs-19.23%(-1.22%--32.16%),t=0.36,P＞0.05]and albumin[-0.32%(3.27%--7.60%)vs 1.88%(6.03%--9.31%),t=0.47,P＞0.05].Independent of gender,citrate intervention resulted in an increased excretion of urine calcium in Chinese volunteers[before 0.34(0.09-0.87)vs after 0.96(0.18-1.47),t=6.66,P ＜0.01].Compared to Caucasian males,Chinese males has a higher basal level of serum ionized calcium [(1.27±0.04)mmol/L vs(1.22±0.02)mmol/L,t=3.7,P ＜0.01]and larger amplitude basal rhythm in serum albumin level[-11.72%(-5.70%--14.21%)vs-1.74%(2.43%--7.68%),t=7.43,P ＜ 0.01].Application of citrate resulted in comparable changes of serum ionized calcium [-23.84%(-16.53%--29.32%)vs-21.95%(-18.31%--30.92%)],phosphate[-19.23%(4.65%--32.16%)vs-12.68%(0.68%--42.19%)],albumin[-0.32%(1.05%--7.60%)vs-1.39%(1.87%--7.26%)]and urine calcium excretion[237.70%(11.8%-935%)vs 234.37%(5.45%-504.00%)]between Chinese and Caucasian males(t=0.32,0.03,0.25 and 0.04 respectively,P＞0.05).Serum levels of magnesium were not influenced in all volunteers during two interventions.Conclusions Independent of race and gender,the invention of citrate results in comparable changes of serum magnesium,inorganic phosphate and albumin.The effect of citrate on ionized calcium levels between genders implicates a higher risk for hypocalcemic reactions in females compared to males undergoing automatic apheresis procedures.