The effectiveness and professionalism of hospice care services for children with cancer are of great significance for improving their quality of life and reducing the mental and economic burden on their families. Currently， a relatively complete quality evaluation system for hospice care for children with cancer has been established abroad， while research in this field in China is still in its infancy. By elaborating on the concept and connotation of quality assessment of hospice care for children with cancer in detail， systematically reviewing the research status of quality assessment of hospice care for children with cancer abroad， and addressing the problems and challenges faced by quality assessment of hospice care for children with cancer in China， corresponding inspirations and improvement strategies were proposed， aiming to provide a reference for improving the quality of hospice care for children with cancer in China.

OBJECTIVE To establish UHPLC-ELSD fingerprint and multi-component content determination methods, compare the differences in sheep bile from different regions, and conduct antioxidant activity research to provide a basis for the in-depth development and utilization of sheep bile. METHODS Used UHPLC-ELSD method to establish 21 batches of bile fingerprints of sheep from different origins and conduct similarity analysis. Measured the content of 6 components, DPPH and ABTS free radical scavenging ability, iron ion reduction ability, and conducted entropy weighted TOPSIS and grey correlation analysis. RESULTS A total of 11 common peaks were identified in the fingerprint spectra of 21 batches of sheep bile. Through comparison with the control sample, 6 components were identified, including taurocholic acid(TCA), glycocholic acid(GCA), taurochenodeoxycholic acid(TCDCA), tauroursodeoxycholic acid(TDCA), glycodeoxycholic acid(GDCA), and cholic acid(CA). Except for 4 batches of samples, the similarity of the fingerprint spectra was greater than 0.90. The total content range of 6 components in the freeze-dried powder of 21 batches of sheep bile was 55.34% to 86.08%. The highest content of taurocholic acid ranged from 34.74% to 60.86%, indicating significant differences in the content of the six components in samples from different regions. Sheep bile from different regions had antioxidant activity, and there were also certain differences. The results of entropy weighted TOPSIS analysis using six component contents as variables showed that the top ten scoring groups were S2, S18, S16, S9, S8, S21, S1, S10, S20, and S15, indicating good quality and slightly better bile quality from sheep in the northern region. The grey correlation analysis results between the content of 6 components and 3 antioxidant indicators showed that all 6 components were correlated with each antioxidant indicator, and TCA, TDCA, and TCDCA had the highest correlation, which might be important components for sheep bile to exert antioxidant effects. CONCLUSION The use of entropy weighted TOPSIS and grey correlation analysis methods can effectively analyze the quality differences and antioxidant active components of sheep bile from different regions, providing scientific basis for its quality evaluation.

AIM:To investigate the clinical fea-tures of acute exacerbation chronic obstructive pul-monary disease(AECOPD)of complicated with type 2 diabetes mellitus(T2DM),and analyze the relat-ed clinical features and risk factors.METHODS:This was a single-center cross-sectional study.From March 2020 to January 2023,479 hospitalized pa-tients with AECOPD in the department of respirato-ry and critical care medicine,Suining Central Hospi-tal were included.There were 215 patients in AE-COPD group and 60 patients in AECOPD with T2DM group.The collected variables included demograph-ic data,complications,blood routine,infection in-dex,random blood glucose,blood gas analysis and lung function.The adoption rate and constituent ra-tio of the basic description classification data were expressed as mean standard deviation for the nor-mal distribution measurement data and median in-terquartile range for the skew distribution measure-ment data.T-test was used for normal distribution and non-parameter test was used for non-normal distribution.The categorical variables were tested by chi-square test.Rank sum test was used for rank variable data.Binary logistic regression model was used to investigate the independent factors associ-ated with T2DM in patients with AECOPD.Finally,the results of logistic regression were verified and visualized by nomogram,validation curve,ROC curve and DCA curve.P＜0.05 was a significant sta-tistical difference.RESULTS:Univariate analysis showed that there were significant differences in body mass index(BMI),essential hypertension,cor-onary heart disease,atrial fibrillation(AF),pulmo-nary function(GOLD stage),blood neutrophil(NS),blood lymphocyte(LYM),arterial blood gas PaCO2,Alanine transaminase(ALT)and random blood glu-cose(RBG)between the two groups(P＜0.05).The binary logistic regression model(C-index=0.847)was constructed with the above 10 variables,the results showed that BMI(OR=1.309),Af(OR=8.188),LYM counts(OR=0.474),PaCO2(OR=1.082)and RBG(OR=1.434)were independently associat-ed with type 2 diabetes in patients with AECOPD(all P＞0.05).The results of logistic regression were verified and visualized by Nomogram and its-associ-ated ccurves.The MAE and AUC curves were 0.021 and 0.847 respectively,indicating that the model had good prediction consistency and accuracy.The DCA curve showed that Nomogram's risk threshold ranged from 0.01 to 0.99,suggesting that nomo-gram's model had better clinical predictive value.CONCLUSION:Our results showed that increased BMI,PaCO2 and random glucose,decreased blood lymphocyte,and atrial fibrillation is an indepen-dent clinical feature of AECOPD with T2DM.These results suggest that the immune function of pa-tients with AECOPD and T2DM are more severely impaired and more likely to be accompanied by atrial fibrillation,which is a potential cause of poor prognosis in these patients.Meanwhile,this conclu-sion needs to be further verified in multicenter study with large sample size.

Objective:To systematically evaluate the qualitative research on the decision-making participation experience of parents of terminally ill neonates in neonatal intensive care unit (NICU).Methods:Qualitative research on the decision-making participation experience of parents of terminally ill neonates in NICU were searched from PubMed,Web of Science,Embase,CINAHL,Cochrane Library,Sinomed,China National Knowledge Infrastructure (CNKI),Wanfang,and VIP databases,with the search period from the establishment of the database to August 2023.The quality of the literature was evaluated using the qualitative research quality evaluation standard of the Joanna Briggs Institute (JBI) in Australia,and the literature was summarized using a synthesizing meta-synthesis method.Results:A total of 13 articles of literature were included,as well as 33 results were extracted and classified into 12 new categories and synthesized into 4 integrative outcomes,including participation tendency,role experience,obstacles,and needs on parental decision-making of terminally ill neonates.Conclusion:Parents of terminally ill neonates in NICU face difficult decision-making choices.Medical staff need to work together with parents to determine their ideal role in decision-making and develop personalized communication content.Society,hospitals,and families need to create a supportive social and psychological environment to provide parents with information and emotional support,as well as improve the coping ability of parents of terminally ill neonates in decision-making.

AIM: To investigate the clinical features of acute exacerbation chronic obstructive pulmonary disease (AECOPD) of complicated with type 2 diabetes mellitus (T2DM), and analyze the related clinical features and risk factors. METHODS: This was a single-center cross-sectional study. From March 2020 to January 2023, 479 hospitalized patients with AECOPD in the department of respiratory and critical care medicine, Suining Central Hospital were included. There were 215 patients in AECOPD group and 60 patients in AECOPD with T2DM group. The collected variables included demographic data, complications, blood routine, infection index, random blood glucose, blood gas analysis and lung function. The adoption rate and constituent ratio of the basic description classification data were expressed as mean standard deviation for the normal distribution measurement data and median interquartile range for the skew distribution measurement data. T-test was used for normal distribution and non - parameter test was used for non-normal distribution. The categorical variables were tested by chi-square test. Rank sum test was used for rank variable data. Binary logistic regression model was used to investigate the independent factors associated with T2DM in patients with AECOPD. Finally, the results of logistic regression were verified and visualized by nomogram, validation curve, ROC curve and DCA curve. P<0.05 was a significant statistical difference. RESULTS: Univariate analysis showed that there were significant differences in body mass index (BMI), essential hypertension, coronary heart disease, atrial fibrillation (AF), pulmonary function (GOLD stage), blood neutrophil (NS), blood lymphocyte (LYM), arterial blood gas PaCO2, Alanine transaminase (ALT) and random blood glucose (RBG) between the two groups (P<0.05). The binary logistic regression model (C-index=0.847) was constructed with the above 10 variables, the results showed that BMI (OR=1.309), Af (OR= 8.188), LYM counts (OR=0.474), PaCO2 (OR=1.082) and RBG (OR=1.434) were independently associated with type 2 diabetes in patients with AECOPD (all P>0.05). The results of logistic regression were verified and visualized by Nomogram and its-associated ccurves. The MAE and AUC curves were 0.021 and 0.847 respectively, indicating that the model had good prediction consistency and accuracy. The DCA curve showed that Nomogram's risk threshold ranged from 0.01 to 0.99, suggesting that nomogram's model had better clinical predictive value. CONCLUSION: Our results showed that increased BMI, PaCO2 and random glucose, decreased blood lymphocyte, and atrial fibrillation is an independent clinical feature of AECOPD with T2DM. These results suggest that the immune function of patients with AECOPD and T2DM are more severely impaired and more likely to be accompanied by atrial fibrillation, which is a potential cause of poor prognosis in these patients. Meanwhile, this conclusion needs to be further verified in multicenter study with large sample size.

Subarachnoid hemorrhage (SAH) is the third common type of stroke in the world,and its mortality and disability rates have declined over the past few decades due to the advances in neuroimaging technology and endovascular interventional therapy and promotion of healthy physical examination,but long-term neurological deficits and cognitive impairment of the patients have not significantly improved,which may be related to the white matter injury (WMI) after SAH.Little attention has been paid to WMI after SAH in the past,which may be an important reason for the poor prognosis of the patients with SAH.The neuroin-flammation response is an important pathophysiological process after SAH,and the neuroinflammation after SAH can aggravate WMI.This article reviews the relationship between neuroinflammation and WMI after SAH in order to deepen the understanding of its effects on cognitive function after SAH.

Objective:To explore the role of tripartite motif-containing protein 21(TRIM21)in chronic apical periodontitis(CAP)and its potential mechanism.Methods:Human CAP tissue and normal periodontal tissue were collected.The expression of inflamma-tory factors(IL-1 β,IL-6,TNF-a,TGF-β1),osteoclast related genes(TRAP,RANKL,CTSK),macrophage polarization related genes(CD86,iNOS,CD206,Arg1)and TRIM21 were detected by RT-qPCR.TRIM21 protein was detected by immunohistochemical staining,and the osteoclasts was detected by tartrate resistant acid phosphatase(TRAP)staining.The inflammation cell model was es-tablished by stimulating Raw264.7 cells with lipoteichoic acid(LTA)or lipopolysaccharide(LPS),and the expression of the above factors was detected.The bone marrow-derived macrophages(BMDMs)extracted from wild-type and TRIM21-/-mice stimulated by LPS were used to verify the expression of the above factors by RT-qPCR,the osteoclasts were detected by TRAP staining,and the po-larization of macrophages was detected by immunofluorescence staining.Results:In CAP tissue the expression of inflammatory factors,osteoclast related genes,CD86,iNOS and TRIM21 increased,while CD206 and Arg1 decreased,and osteoclasts were more than that in normal tissue.The stimulation of LTA/LPS promoted the proliferation of Raw264.7 cells,and the expression of these factors in cells was consistent with that in tissues.After LPS stimulation,BMDMs of TRIM21-/-mice had lighter inflammation,lower expression of os-teoclast specific genes,fewer osteoclasts and lower M1 polarization than those of wild type mice.Conclusion:TRIM21 might promote the progress of CAP by promoting M1 polarization of macrophages.

Objective To evaluate the antioxidant function of Chrysanthemum morifolium from different origins and to identify their antioxidant material basis.Methods The HPLC fingerprints of the water extracts of C.morifolium from different origins were established.The antioxidant activities of C.morifolium were assayed by measuring the 2.2-diphenyl-l-picrylhydrazyl(DPPH),hydroxyl radical,ABTS,superoxide anion radical scavenging capacity and ferric ion reducing capacity FRAP.Entropy-weighted TOPSIS was used to calculate the weighting coefficients of the single indexes.Grey relational analysis(GRA)and partial least squares were used for spectrum-effect analysis to identify the antioxidant material basis of C.morifolium.Results A total of 16 common peaks were discovered in the fingerprint of the water extracts of 10 batches of C.morifolium,among which 13 common components were identified.All the C.morifolium samples had good antioxidant capacity,and the results of entropy-weighted TOPSIS analysis showed that the ranking of total antioxidant potency of 10 batches of C.morifolium was follows:S1＞S8＞S3＞S5＞S4＞S10＞S7＞S2＞S9＞S6.The peaks of 1-5,9,10,12,14 were positively correlated with the antioxidant activity and the variable influence on projection(VIP)values were greater than 1.The correlation coefficients of these nine peaks in GRA were all greater than 0.7.Conclusion The entropy-weighted TOPSIS method combined with the spectrum-effect analysis could be used to screen out the antioxidant material basis of C.morifolium and the results provide a basis for establishing quality assessment system for C.morifolium based on Quality-markers thus improving the quality control level.

Aim To study the effect of maternal high-fat diet during pregnancy on endothelial to mesenchymal transition of aortic vessels in adult offspring.Methods The pregnant mice were randomly divided into normal diet group and high-fat diet group,and the offspring mice were fed normally for 16 weeks after the mother gave birth.Western blot and RT-qPCR were used to detect the expression and transcription of related proteins,and immunofluorescence and im-munohistochemical staining were used for pathological analysis.Results Compared with the offspring of maternal nor-mal diet during pregnancy,the expressions of vascular inflammatory factors,macrophage infiltration,monocyte-endothelium adhesion were significantly increased in the offspring of maternal high-fat diet(OHF)during pregnancy(P＜0.05).Vas-cular endothelial nitric oxide synthase(eNOS)activity,nitric oxide(NO)level were dramatically reduced(P＜0.05).Immunofluorescence results showed reduced endothelial cell marker CD31 and increased mesenchymal marker α-smooth muscle actin(α-SMA)in OHF.Western blot analysis further confirmed the results,which showed that maternal high fat diet reduced vascular endothelial-cadherin(VE-cadherin)and CD31 and increased α-SMA and Vimentin in the offspring(P＜0.05).The maternal high fat diet increased the extracellular matrix protein disposition and transforming growth factor beta(TGF-β)/Smad signaling in endothelium(P＜0.05).Moreover,the maternal high fat diet reduced Kruppel-like factor 2(KLF2)expression by 76％in mRNA level and 59％in protein level(P＜0.05).Conclusion Maternal high-fat diet during pregnancy lead to a transition of endothelial to mesenchyme in the offspring aorta.The results provide a clue for prevention of vascular disease in early stage.

Mutations in the SAMD9 and SAMD9L genes are associated with MIRAGE syndrome and ATXPC syndrome, respectively. This study reports the clinical characteristics and genetic analysis of one case with SAMD9 mutation (c.3809T > A, p.F1270Y) and two cases with SAMD9L mutations (c.2675T > G, p.M892R; c.1096T > G, p.F366V and c.4517T > C, p.L1506p), none of which have been previously reported. All patients presented with recurrent infections, growth retardation, and myelodys-plasia, with varying degrees of involvement of multiple systems, including respiratory, gastrointestinal, immune, endocrine, neurological, and reproductive systems. In terms of treatment, two patients underwent regular intravenous immunoglobulin and their clinical symptoms improved, while one patient had a favorable recovery following hematopoietic stem cell transplantation at the age of 1 year and 5 months of age. SAMD9/SAMD9L gene mutations, therefore, chould be considered in children with recurrent infections, myelodysplasia, pancytopenia, and growth retardation. Early genetic testing is crucial for timely diagnosis and treatment, which may improve patient outcomes.