1.End-of-life resuscitation decision-making preferences and their influencing factors among terminally ill patients with malignant tumors
Tingting JIANG ; Rujun ZHENG ; Zheng JI ; Dan WEI ; Qian CHEN
The Journal of Practical Medicine 2025;41(23):3676-3683
Objective To explore the preferences and influencing factors of terminal malignant tumor patients,and to provide a basis for optimizing hospice care.Methods A convenience sampling method was employed to select 485 patients with terminal malignant tumors from the oncology departments of two tertiary,class-A hospitals in Sichuan Province between September 2023 and November 2024.Data on demographic characteristics,decision-making-related information,preferences regarding resuscitation,and cultural belief levels were collected using a structured questionnaire.Results In critical situations,39.4%of patients opted for active rescue,33.6%chose to forgo treatment,and 27.0%preferred to maintain current treatment.Acceptance rates for nine specific interventions ranged from 28.9%to 61.2%.Multivariate logistic regression analysis revealed that stronger cultural beliefs,younger age,having a spouse,being the primary caregiver,employee medical insurance coverage,and use of invasive tubes were significantly associated with a tendency toward active or continued treatment(P<0.05).Prioritizing quality of life or concerns about economic burden were significantly associated with the decision to forgo life-sustaining interventions(P<0.05).Conclusions Patients with terminal malignant tumors exhibit diverse preferences regarding end-of-life resuscitation,significantly shaped by cultural beliefs,demographic factors,and family support.Clinicians should integrate patients'values,cultural backgrounds,and individual needs to provide tiered decision-making support,thereby facilitating medically appropriate and value-concordant care choices.
2.End-of-life resuscitation decision-making preferences and their influencing factors among terminally ill patients with malignant tumors
Tingting JIANG ; Rujun ZHENG ; Zheng JI ; Dan WEI ; Qian CHEN
The Journal of Practical Medicine 2025;41(23):3676-3683
Objective To explore the preferences and influencing factors of terminal malignant tumor patients,and to provide a basis for optimizing hospice care.Methods A convenience sampling method was employed to select 485 patients with terminal malignant tumors from the oncology departments of two tertiary,class-A hospitals in Sichuan Province between September 2023 and November 2024.Data on demographic characteristics,decision-making-related information,preferences regarding resuscitation,and cultural belief levels were collected using a structured questionnaire.Results In critical situations,39.4%of patients opted for active rescue,33.6%chose to forgo treatment,and 27.0%preferred to maintain current treatment.Acceptance rates for nine specific interventions ranged from 28.9%to 61.2%.Multivariate logistic regression analysis revealed that stronger cultural beliefs,younger age,having a spouse,being the primary caregiver,employee medical insurance coverage,and use of invasive tubes were significantly associated with a tendency toward active or continued treatment(P<0.05).Prioritizing quality of life or concerns about economic burden were significantly associated with the decision to forgo life-sustaining interventions(P<0.05).Conclusions Patients with terminal malignant tumors exhibit diverse preferences regarding end-of-life resuscitation,significantly shaped by cultural beliefs,demographic factors,and family support.Clinicians should integrate patients'values,cultural backgrounds,and individual needs to provide tiered decision-making support,thereby facilitating medically appropriate and value-concordant care choices.
3.Analysis of the mechanism of curcumol in regulating iron death and autophagy based on systemic pharmacology
Jiahui Wang ; Wenxing He ; Rujun Huang ; Jiaxi He ; Xiaoqing Li ; Yang Zheng ; Lei Wang
Acta Universitatis Medicinalis Anhui 2022;57(4):621-625
Objective:
To explore the molecular biological mechanism of curcumol in regulating ferroptosis and autophagy.
Methods:
The Pharm Mapper database was used to screen out curcumol targets, various known related databases were used to establish a database of ferroptosis and autophagy related targets, and the String database was used to construct a protein-protein interaction network. The key targets were enriched and analyzed using DAVID database.
Results:
152 curcumol targets, 259 ferroptosis targets, and 796 autophagy targets were obtained; curcumol mainly regulated the ferroptosis process through PTGS2, ALB, MAPK1, MAPK8, and MAPK14 targets, and curcumol mainly through HSP90 AA1, MAPK1, MAPK8, ALB, NOS3 targets regulated the autophagy process, and curcumol mainly regulated the ferroptosis and autophagy process through ALB, MAPK1, MAPK8 targets.
Conclusion
Curcumol can exert pharmacological effects by regulating ferroptosis and autophagy.
4. Analysis on treatment of eight extremely severe burn patients in August 2nd Kunshan factory aluminum dust explosion accident
Jiake CHAI ; Qingyi ZHENG ; Ligen LI ; Shengjie YE ; Zhongguang WEN ; Jijun LI ; Shujun WANG ; Dongjie LI ; Wenzhong XIE ; Junlong WANG ; Henglin HAI ; Rujun CHEN ; Jianchuan SHAO ; Hao WANG ; Qiang LI ; Zhiming XU ; Liping XU ; Huijun XIAO ; Limei ZHOU ; Rui FENG
Chinese Journal of Burns 2018;34(6):332-338
Objective:
To summarize the measures and experience of treatment in mass extremely severe burn patients.
Methods:
The clinical data and treatment of 8 extremely severe burn patients in August 2 Kunshan factory aluminum dust explosion accident who were admitted in the 100th Hospital of PLA on August 2nd, 2014, were retrospectively analyzed. There were 4 males and 4 females, aging 22-45 (34±7) years, with total burn area of 55%-98% [(89±15)%] total body surface area (TBSA) and full-thickness burn area of 45%-97% [(80±21)%] TBSA. All the 8 patients were accompanied with severe shock, inhalation injury, and blast injury. According to the requirements of former PLA General Logistics Department and Nanjing Military Command, a treatment team was set up including a special medical unit and a special care unit, with Chai Jiake from the First Affiliated Hospital of PLA General Hospital as the team leader, Zheng Qingyi from the 175th Hospital of PLA (the Affiliated Dongnan Hospital of Xiamen University) as the deputy leader, the 100th Hospital of PLA as the treatment base, and burn care, respiratory, nephrology, nursing specialists from the First Affiliated Hospital of PLA General Hospital, and the burn care experts and nursing staff from the 180th Hospital of PLA, 118th Hospital of PLA, 98th Hospital of PLA, and 175th Hospital of PLA, and nurses from the 85th Hospital of PLA, 455th Hospital of PLA, 101th Hospital of PLA, 113th Hospital of PLA as team members. Treatment strategies were adopted as unified coordination by the superior, unified responsibility of team leader, division of labor and cooperation between team members, and multidisciplinary cooperation led by department of burns. With exception of one patient who received deep vein catheterization before admission, the other 7 patients were treated with deep vein catheterization 0.5 to 3.0 hours after admission to correct hypovolemic shock as soon as possible. Eight patients received tracheotomy, and 7 patients were treated with mechanical ventilation by ventilator in protective ventilation strategy with low tide volume and low volume pressure to assist breathing. Fiberoptic bronchoscopy was done one to three times for all the 8 patients to confirm airway injuries and healing status. Escharectomy and Meek dermatoplasty in the extremities of all the 8 patients were performed 3 to 6 days after injury for the first time. Escharectomy, microskin grafting, and covering of large pieces of allogeneic skin on the trunks of 4 patients were performed 11 to 16 days after injury for the second time. The broad-spectrum antibiotics were uniformly used at first time of anti-infective therapy, and then the antibiotics species were adjusted in time. The balance of internal environment was maintained and the visceral functions were protected. One special care unit was on responsibility of only one patient. Psychological intervention was performed on admission. The rehabilitative treatment was started at early stage and in company with the whole treatment.
Results:
Acute renal injury occurred in 5 patients within 36 hours after injury and their renal function was restored to normal 4 days after injury due to active adjustment of fluid resuscitation program. No pulmonary complications, such as severe pulmonary infection and ventilator-associated pneumonia, occurred in the survived patients. One of the 8 patients died, and the other 7 patients were cured successfully. The wounds were basically healed in 2 patients in 26 or 27 days by 2 or 3 times of operation, and in 5 patients by 4 or 5 times of operation. The basic wound healing time was 26-64 (48±15) days for all the 7 patients.
Conclusions
Treatment strategies of unified coordination by the superior, unified responsibility of team leader, division of labor and cooperation between team members, and multidisciplinary cooperation led by department of burns are the bases to successful treatment. Correcting shock as soon as possible is the prerequisite and closing wound as soon as possible is the key to successful treatment. Comprehensive treatment measures, such as maintaining and regulating the function of viscera, improving the body immunity, and preventing and treating the complications, are the important components to successful treatment. It is emphasized that in the treatment of mass extremely severe burn patients, specialist burn treatment should always be in the dominant position, and other related disciplines may play a part in auxiliary function.
5.Effect of the pattern of nurse-patient double-check and signature in security management of intravenous administration
Chunhua YU ; Junying LI ; Yan FU ; Rujun ZHENG
Chinese Journal of Modern Nursing 2017;23(22):2924-2927
Objective To explore the effect of the pattern of nurse-patient double-check and signature in security management of intravenous administration and to understand the degree of satisfaction of patients with safe medication management.Methods The experience on security management of intravenous administration in inpatients from Oncology Department in the West China Hospital of Sichuan University were summarized from December 2015 to January 2017. Inpatients with intravenous administration between December 2015 and June 2016 acted as control group. Inpatients with intravenous administration between July 2016 and January 2017 acted as improved group along with the management method of the pattern of nurse-patient double-check and signature. The situation on security management of intravenous administration and the degree of satisfaction of patients with safe medication was compared between two groups.Results After implementing the pattern of nurse-patient double-check and signature along with intravenous administration, there was no medication administering errors (MAE). The degree of satisfaction of patients with safe medication raised from 94.20 % to 100.00% with a significant difference (P< 0.01).Conclusions The pattern of nurse-patient double-check and signature realizes the goal of patients' involvement in medical safety, ensures the infusion safety. It is worth to be used widely in clinical application.
6.Short-term group cognitive behavioral intervention in cancer patients
Rujun ZHENG ; Yan FU ; Lin CHEN ; Qianqian MOU ; Shanshan LIU ; Junying LI ; Chunhua YU
Chinese Journal of Practical Nursing 2015;31(34):2599-2602
Objective To explore the effect of cognitive behavioral intervention on quality of life and distress of cancer patients. Methods The research was a random control study, and computer randomized grouping, the experimental group and control group contained 64 cases, 66 cases, respectively. The control group only accepted health education, while experimental group accepted cognitive behavioral intervention twice a week. Before and after the research, the patients were investigated with quality of life and distress scale. Results After the study of cognitive behavioral intervention, quality of life of experimental group scored (71.7±17.5) points which showed greater improvement than the control group scored (63.9±18.3) points (t=2.2,P<0.05), the distress score of experimental group was (2.6±0.6) points which was significant lower than the control group scored (3.9 ±0.7) points (t=11.8, P<0.05), and the proportions of distress problems contained anxiety [42.2% (27/64)], pain [29.7% (19/64)], depression [35.9% (23/64)] and sleep [23.4% (15/64)] in the experimental group were all significant lower than the control group [60.6% (40/66), 47.0% (31/66), 53.0% (35/66), 39.4% (26/66)]( X2=4.4, 4.1, 3.9, 4.5, P<0.05). Conclusions Short-term group cognitive behavioral intervention can alleviate the distress and pain, improve their negative emotions and sleep, eventually improve the quality of life of cancer patients.
7.The design and application of the machine for making animal model for pressure ulcer
Deyu JIANG ; Zhixia JIANG ; Aiting ZHOU ; Rujun HU ; Xilan ZHENG
Chinese Journal of Practical Nursing 2015;31(24):1814-1816
Objective To develop a kind of new machine for making animal model for pressure ulcer,and inspect its effect through experiments,in order to lay the foundation for the research of pressure ulcer experiments on animals.Methods This study developed the machine after reviewing the domestic and foreign literature,making full use of the existing experimental platform of our university.Then 55 Sprague Dawley(SD) rats were selected,after anesthesia and the skin preparation,the researchers imposed certain pressure with 70 mmHg/cm2 (1 mmHg=0.133 kPa) on the skin and muscle tissue on the inner left thigh of SD rats by using self-designed machine,pressing for 2 h,then reperfusion for 30 min,3 times a day,a total of 7 days.Results The authors developed a kind of new machine for making animal model for pressure ulcer,and successfully prepared Ⅲ phase pressure ulcers model in SD rats with success rate of 98.2%(54/55).Conclusion This machine can prepare Ⅲ phase pressure ulcers model on animals,it's easy to use and efficient,it can be used for researches in the field of prevention and cure of pressure ulcers.
8.Meta-analysis of effect on needlestick injury intervention in medical staffs
Huiping WANG ; Zhixia JIANG ; Zheng XIAO ; Xiaoli YUAN ; Rujun HU ; Xing SHAO
Chinese Journal of Practical Nursing 2014;30(28):10-14
Objective To systematically analyze and evaluate the intervention effect of foreign and domestic research about needlestick injuries in medical staffs and provide the basis for reducing the rate of occupational exposure of medical staffs.Methods The intervention study of needlestick injuries in medical staffs between 1981 and 2013 were collected in CNKI,VIP,Wanfang and PubMed databases,Metaanalysis was conducted for the included studies by RevMan5.2 software.According to I2 and P value heterogeneity was determined,choose a fixed or random effect model to analyze and merge the data to measure the effect of the intervention by OR and 95% confidence intervals (C I).Results The total of included studies was 19,the number of the intervention group and the control group was 20 592 and 19 855,the OR and 95% CI of intervention effect as shown below:comprehensive intervention OR=0.40,CI 95% (0.27~0.59),education and training OR=0.24,CI 95% (0.11~0.55),safety management OR=0.09,CI 95% (0.06~0.13),engineering intervention OR=0.30,CI 95% (0.16~0.55),safe operation OR=0.15,CI 95% (0.09~0.26).The intervention group and the control group were statistically significant on reducing the incidence of needlestick injuries.Conclusions Education and training,safety management,engineering intervention,and safe operation can reduce the incidence of needlestick injuries,improve the quality of life of medical staffs.
9.Meta analysis on effect of heat moisture exchangers on airway humidification in mechanically ventilated patients
Rujun HU ; Zhixia JIANG ; Xilan ZHENG ; Jing ZHOU ; Ting LOU ; Yu LI
Chongqing Medicine 2014;(11):1308-1311,1314
Objective To assess the effectiveness and safety of heat moisture exchangers (HMEs) on the artificial airway humid-ification in the mechanically ventilated patients .Methods The related literature in the Cochrane Library ,PubMed ,Embase ,CNKI , VIP ,WanFang database and CBM from the establishment to March 2012 were retrieved ,then included the randomized controlled trial(RCT) and quasi-RCT on the effect of HMEs for the artificial airway humidification in the mechanically ventilated patients were performed the meta analysis by using RevMan 5 .1 .2 software .Results 19 RCT were included(involving 2 960 patients) , which were the random parallel controlled trials .The meta analysis results showed that HMEs could not reduce the incidence rate of ventilator-associated pneumonia(VAP)(RR=0 .78 ,95% CI 0 .61-1 .01 ,P=0 .06) ,also could not decrease the hospitalization mor-tality(RR=0 .94 ,95% CI 0 .83-1 .08 ,P=0 .40) ,the length of ICU stay(MD= -0 .32 ,95% CI -3 .13 -2 .50 ,P=0 .82) and the occurrence rate of catheter occlusion (RR=0 .65 ,95% CI 0 .22 -1 .93 ,P= 0 .44) ,the differences between the two groups had no statistical significance .But 5 RCT reported that using HMEs could reduce the patient′s costs .Conclusion HMEs can not reduce the incidence rate of VAP ,mortality ,length of ICU stay ,occurrence rate of airway occlusion ,but can cut down the patient′s cost . Due to the risk of bias existing in all included RCT and the low quality of the obtained evidences ,more strictly designed and imple-mented RCTs are needed to further verify thse evidences .
10.The anxiety level of the patients who will have ultrasound-guided puncture biopsy: a survey study.
Shuzhen ZHAO ; Yulan PENG ; Rujun ZHENG ; Xiaoli HE ; Ii LIANG ; Hong HUANG
Journal of Biomedical Engineering 2012;29(3):453-459
In order to fully understand the anxiety level of the patients who will have ultrasound-guided puncture biopsy, and the survey results will guide the future clinical care to reduce the anxiety score of the patients, and to im-prove the satisfaction of them, which reflects the quality of care, we used Zung Self-rating Anxiety Scale (SAS) to investigate outpatients who will have ultrasound-guided puncture biopsy in a upper first-class hospital by convenience sampling way. The results showed that the SAS standard score of the patients was higher than the Chinese normal population's, and there is significant difference between the patients and the normal population's score (t = 47.12, P < 0.001). So for reducing the patients' anxiety level we should give health education and care intervention to the patients before the operation. This reflects the Patient-centered Culture and Excellent-quality Care in China.
Adolescent
;
Adult
;
Aged
;
Anxiety
;
etiology
;
prevention & control
;
Biopsy, Needle
;
methods
;
psychology
;
Breast Neoplasms
;
diagnostic imaging
;
pathology
;
Female
;
Humans
;
Male
;
Middle Aged
;
Patient Education as Topic
;
Patient Satisfaction
;
Surveys and Questionnaires
;
Thyroid Neoplasms
;
diagnostic imaging
;
pathology
;
Ultrasonography
;
Young Adult


Result Analysis
Print
Save
E-mail