Objective:To systematically evaluate the transitional care experience of family caregivers in palliative care from hospital to home.Methods:A computer-based search was conducted in PubMed, Web of Science, Cochrane Library, Embase, CINAHL, PsycINFO, SinoMed, China National Knowledge Infrastructure, VIP, and Wanfang Data for qualitative studies on the transitional care experience of family caregivers in palliative care, from database inception to November 25, 2024. The quality of the included studies was assessed using the Joanna Briggs Institute Critical Appraisal Checklist for Qualitative Research (2016 edition). Data were synthesized and integrated using meta-aggregation.Results:A total of 10 studies were included, from which 33 primary findings were extracted. These findings were classified into nine new categories and further synthesized into four overarching themes: development and exacerbation of physical and psychological distress during the transition, multiple challenges and dilemmas during the transition, multidimensional support needs during the transition, and positive coping and personal growth.Conclusions:Family caregivers in palliative care experience complex physical and psychological changes, multiple challenges, and diverse care needs during the hospital-to-home transition. Healthcare professionals should pay close attention to the lived experiences and actual needs of family caregivers during this period, so as to facilitate a successful transition from hospital to home.

Objective:To systematically evaluate the transitional care experience of family caregivers in palliative care from hospital to home.Methods:A computer-based search was conducted in PubMed, Web of Science, Cochrane Library, Embase, CINAHL, PsycINFO, SinoMed, China National Knowledge Infrastructure, VIP, and Wanfang Data for qualitative studies on the transitional care experience of family caregivers in palliative care, from database inception to November 25, 2024. The quality of the included studies was assessed using the Joanna Briggs Institute Critical Appraisal Checklist for Qualitative Research (2016 edition). Data were synthesized and integrated using meta-aggregation.Results:A total of 10 studies were included, from which 33 primary findings were extracted. These findings were classified into nine new categories and further synthesized into four overarching themes: development and exacerbation of physical and psychological distress during the transition, multiple challenges and dilemmas during the transition, multidimensional support needs during the transition, and positive coping and personal growth.Conclusions:Family caregivers in palliative care experience complex physical and psychological changes, multiple challenges, and diverse care needs during the hospital-to-home transition. Healthcare professionals should pay close attention to the lived experiences and actual needs of family caregivers during this period, so as to facilitate a successful transition from hospital to home.

Objective:To systematically review qualitative research on the experiences of palliative care patients and caregivers in home medication management, so as to improve their drug management capabilities and optimize grassroots palliative care services as a reference.Methods:This review was conducted using databases including the Cochrane Library, PubMed, Embase, Web of Science, CINAHL, China National Knowledge Infrastructure, Wanfang Data, VIP Database, and China Biology Medicine disc, searching for qualitative research on the medication management experiences of palliative care patients and caregivers up to April 30, 2024. The quality of the literature was assessed using the Australian Joanna Briggs Institute Evidence-Based Health Care Center standards for qualitative research quality assessment. A convergent integrated approach was employed to synthesize and integrate the findings.Results:Eleven articles were included, all of which were from abroad, synthesizing 51 findings into 7 new categories, which were then integrated into 3 composite outcomes: complex feelings of patients and caregivers in home medication management, including responsibility and self-efficacy, anxiety and fatigue; challenges in home medication management, including polypharmacy and experiences using pain medication, disagreements over medication management at home, and perceived inadequacies in primary healthcare resources;the need for multifaceted support, including desires for more medication guidance and communication with palliative care professionals in the community.Conclusions:Due to the complexity of medication needs and insufficient regulatory support, home medication management in palliative care presents challenges. It is recommended to enhance the self-efficacy and medication management skills of patients and caregivers, improve risk response capabilities, optimize medication administration processes, and strengthen training for healthcare professionals. Government agencies should also support policies to ensure a safe and comfortable home medication environment for palliative care patients in China.

Objective To systematically integrate the experience of medical staff participating in remote home palliative care,and to provide a reference for further promoting the development of remote home palliative care and improving the service quality in China.Methods PubMed,Web of Science,CINAHL,Cochrane Library,Embase,CNKI,Wanfang Database,VIP Database,and Chinese Biomedical Literature Database were searched to collect qualitative studies on the experience of medical staff participating in remote home palliative care,and the search time was from inception to November 2023.The quality of the included literature was evaluated according to the 2016 edition of the Qualitative Research Quality Evaluation Criteria of the Joanna Briggs Institute for Evidence-Based Health Care in Australia,and the results were summarized by meta-synthesis method.Results A total of 11 studies were included,and 40 research results were extracted,and 11 categories were formed,which were summarized into 3 integrated results.① Medical staff perceived the benefits of participating in remote home palliative care:improving the efficiency of medical services,breaking through the limitations of time and space,enhancing job satisfaction,and improving the continuity of palliative care.②Medical staff recognized the challenges of participating in remote home palliative care:poor stability of remote working environment,complex equipment operation,insufficient theoretical knowledge and professional skills,inability to meet the special care needs of patients,and difficulty in defining service time.③Medical staff believe that remote home palliative care services need to be improved:pay attention to the importance of family participation,use remote palliative care as an auxiliary method,and pay attention to establishing a doctor-patient trust relationship.Conclusion There are many benefits and challenges for medical staff to participate in remote home palliative care,and hospital managers should provide multi-faceted support for medical staff,strengthen the construction of remote home palliative care team,establish an online and offline linkage mechanism,and continuously improve the quality of remote home palliative care in China.

Objective:To construct a service index system suitable for palliative care institutions at all levels, and provide reference for medical institutions to carry out programmed palliative care services.Methods:From April 2020 to June 2021, using expert focus group method, combined with domestic and foreign literature review and pilot work experience, the flow chart of hospice care service was preliminarily drawn, and the service indicators were formulated. Delphi expert letter consultation method was used to conduct two rounds of consultation among 16 experts, and finally the palliative care service index system was formed.Results:The positive coefficient of experts in the two rounds of Delphi expert letter consultation were 16/20 and 16/16, the authority coefficient was 0.828, 0.831, and the Kendall harmony coefficient was 0.236, 0.389, respectively. Finally, the palliative care service index system consisted of 8 indicators for primary level, 18 indicators for secondary level and 40 indicators for tertiary level.Conclusions:The established palliative care service index system is scientific and reliable, which can provide reference for all levels of hospice care institutions to carry out programmed services.

Objective:To evaluate efficacy of combined therapy with ozonated water and oil on patients with tinea pedis.Methods:A total of 60 patients with tinea pedis were divided into 2 groups in a randomized and blinded test.Patients in a control group were treated with naftinfine hydrochloride and ketoconazole cream once a day.Patients in an ozone group were treated with ozonated water bath and then ozonated oil topical application once a day.Patients in the 2 groups were treated for 4 weeks.Clinical and laboratory data were collected for both groups at the end of the 1st week,the 2nd week,and the 4th week.The Pearson chi-square was performed to compare scores of the clinical signs and symptoms (CSS) and the mycological result between the 2 groups.Independent samples T-test was performed to compare the curative effect between the 2 groups.Results:After 4 weeks' treatment,6 patients were positive in the control group determined by mycological examination while 1 patient was positive in the ozone group,with no significant difference between the 2 groups (P＞0.05).Changes in CSS at the end of the 1st week,2nd week,and 4th week were obtained and showed no significant difference between the 2 groups at the 3 different time points (P＞0.05).No side effects were observed.Conclusion:Combination of ozonated water with oil is effective on treatment oftinea pedis and it shows no side effects.

Objective To explore the establishment and operating mode of hospice care beds in the cancer center of a tertiary general hospital and to evaluate its operating effects preliminarily. Methods Totally 3 hospice care beds were set up in the Cancer Center of Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School in October 2016. The operating mode of hospice care beds in the Class Ⅲgeneral hospital was explored by building a hospice care team, performing professional training, formulating admission and transfer standards, standardizing working processes, refining service contents and quality standards and establishing a community referral system. Totally 49 patients admitted in the hospice care beds from October 2016 to August 2018 were selected. The satisfaction with symptom control and medical services and the degree of psychological pain were compared before and after hospitalization in the hospice care beds. The patients' referral was statically analyzed. Results The satisfaction with symptom control in the 49 patients after hospice care was higher than that before hospice care except for hematemesis and hematochezia, edema and delirium could not be statistically analyzed because the sample size was too small (P＜0.05). The overall satisfaction with medical services rose from (2.88±0.99) to (4.96±0.19);psychological pain decreased from (4.37±1.32) to (1.37±0.73);and the sum of daily hospitalization costs dropped from (899.21±128.46) yuan to (355.16±50.73) yuan (t=10.84, 23.60, 11.34;P＜ 0.01). Conclusions The establishment of hospice care beds in the cancer center of the tertiary general hospital provides a place of hospice care for cancer patients, connects the patients with community resources, and improve the patients' satisfaction with medical services.

Objective To explore the safety and feasibility of time of postoperative strict bed rest shorten to one hour among patients with CT-guided percutaneous lung biopsy.Methods From July 2016 to June 2017,we selected 140 patients with CT-guided percutaneous lung biopsy of cancer center at Nanjing Drum Tower Hospital,the Affiliated Hospital of Nanjing University Medical School,by convenience sampling.All of the patients were randomly divided into observation group and control group,70 cases in each group.Patients of observation group kept strict bed rest for one hour and those of control group for six hours by the routine.We compared the incidence of complication and patients' comfort between two groups after surgery using t test and χ2test.Results The total of 140 patients were treated with biopsy successfully without chest infection and asphyxia after surgery.There was no statistical difference in the incidences of pneumothorax and bleeding of patients between two groups (χ2=0.341,0.119;P＞0.05);the comfort of observation group was superior to that of control group six hours after biopsy with a significant difference (t=9.683,P＜0.01).Conclusions The time of postoperative strict bed rest shorten to one hour among patients with CT-guided percutaneous lung biopsy does not increase the incidence of complications after surgery and makes patients feel more comfortable.

Objective To investigate the safety, efficacy and key points of technology of endovascular embolization for ruptured wide-necked aneurysms of anterior communicating arteries. Methods The clinical, DSA imaging, interventional treatment and follow-up data of 35 patients with ruptured wide-neck aneurysms of anterior communicating arteries were analyzed retrospectively. Results Immediate postoperative angiography of the 35 patients found 100% occlusion were achieved in 29 (82.9%), 90% occlusion were achieved in 5 (14.3%), and 80%occlusion was achieved in 1 (2.8%). One patient had occlusion in ipsilateral anterior cerebral artery , whose blood vessel was patent after thrombosis. One patient had intraoperative aneurysm rupture. One patient had cerebral infaraction of anterior cerebral artery after the operation. Clinical follow-up was made from 6 to 60 months , and no aneurysms ruptured was found. 21 patients were followed up for 6 to 60 months with DSA. Two of them experienced recurrence, and they were not treated with supplementary packing. Conclusion Endovascular embolization for ruptured wide-necked aneurysms of anterior communicating arteries is more difficult , but it is safe and effective. Flexible choosing of various kinds of embolism technique and designing the most optimal embolism treatment plan are the keys to the improvement of embolization effect.

Objective To investigate the clinical and pathological characteristics of bacterial infectious diarrhea.Methods The clinical and pathological characteristics of 2380 cases of bacterial infectious diarrhea in Jinshan Hospital,Fudan University from 1998 to 2007 were analyzed retrospectively.Enumeration data were analyzed by X~2 test.Results Among the 20 169 patients who went to hospital because of diarrhea in 10 years,2380 cases fecal bacterial culture were positive,including Vibrio parahaemolyticus(2247 cases,94.4%),Shigella(99 cases,4.2%),Salmonella (29 cases,1.2%),Vibrio alginolyticus(3 cases),pathogenic Escherichia coli(2 cases).Patients with diarrhea were common from June to 0ctober in each year.The main manifestations of Vibrio parahaemolyticus infection were abdominal pain,diarrhea,nausea,vomit or dehydration.The main manifestations of Shigella infection were fever,abdominal pain and diarrhea.Conclusions The bacterial culture positive rate of stool samples from patients with bacterial infectious diarrhea is not high in Jinshan district.Shanghai.The major pathogens are Wbrio parahaemolyticus and Shigella.