The “hospital-community” hospice care model involves multiple stakeholders，including demander，executor，leader，and fundraiser of medical and health services.The degree of benefit correlation，policy influence，and implementation willingness of various stakeholders were analyzed to provide reference for terminal cancer patients to obtain continuous，convenient，and high-quality hospice care.Health department and medical insurance department are the main driving forces for cross-institutional hospice care，but there are differences in their driving paths.The financial department is an important guarantor of policy implementation，and needs to ensure that its core interests are not lost.Community medical institutions are an important driving factor for policy implementation，but they require policy support and hospital drive. Medical staff in hospitals and communities，have weak willingness to implement policies，which can easily become obstacles to policy implementation in the absence of incentive and compensation mechanisms.Patients and their caregivers are important beneficiaries，but lack of publicity，education，and interactive communication can also lead to rejection and contradiction.Therefore，it is necessary to leverage the collaboration and coordination between policy enforcement departments，innovate the development model of hospitals，lead community medical institutions，and promote interactive communication and decision-making sharing of “doctor-doctor” and “doctor-patient”.

Nicotine addiction is a concern worldwide. Most mechanistic investigations are on nicotine substance dependence properties based on its pharmacological effects. However, no effective therapeutic treatment has been established. Nicotine addiction is reinforced by environments or habits. We demonstrate the neurobiological basis of the behavioural aspect of nicotine addiction. We utilized the conditioned place preference to establish nicotine-associated behavioural preferences (NABP) in rats. Brain-wide neuroimaging analysis revealed that the medial prefrontal cortex (mPFC) was activated and contributed to NABP. Chemogenetic manipulation of µ-opioid receptor positive (MOR⁺) neurons in the mPFC or the excitatory outflow to the nucleus accumbens shell (NAcShell) modulated the NABP. Electrophysiological recording confirmed that the MOR⁺ neurons directly regulate the mPFC-NAcShell circuit via GABA_A receptors. Thus, the MOR⁺ neurons in the mPFC modulate the formation of behavioural aspects of nicotine addiction via direct excitatory innervation to the NAcShell, which may provide new insight for the development of effective therapeutic strategies.
Animals ; Nucleus Accumbens/drug effects* ; Prefrontal Cortex/drug effects* ; Nicotine/pharmacology* ; Receptors, Opioid, mu/metabolism* ; Male ; Rats ; Rats, Sprague-Dawley ; Tobacco Use Disorder/metabolism* ; Neurons/drug effects* ; Neural Pathways/drug effects*

PurposeTo analyze the far infrared thermography characteristics before and after surgery in patients with acoustic neuroma.Materials and Methods Thirty-two patients with acoustic neuroma were included as observation group and 40 normal healthy individuals as control group. Un-cooled thermal imaging system (ATIR-M301B) was used with working temperature of 20-25℃. Craniofacial infrared images were collected to analyze temperature differences among different detection zones.Results Far infrared thermography revealed that there were no obvious temperature differences between both sides of supraorbital region, endocanthion region, frontal region and buccal region in the control group (P>0.05). The temperature differences in bilaterally symmetrical parts of supraorbital region, endocanthion region, frontal region, buccal region were significantly higher in observation group (t=1.557, 1.714, 1.483 and 1.569,P<0.05). The craniofacial temperatures of 32 patients changed after operation, and the differences reduced in supraorbital region, endocanthion region, frontal region, and buccal region (t=2.655, 2.462, 2.897 and 4.465,P<0.05).Conclusion Far-infrared thermography inspection can detect abnormal temperature changes.

Objective To evaluate the value of MR angiography in thrombolytic therapy of acute ischemic stroke. Methods According to inclusion criteria, 65 patients who also having large vessel occlusion were selected, and they were performed rt-PA treatment (38 patients) and routine treatment (27 patients) within 3-6 hours of onset of symptoms, respectively. Mann-Whitney U test and chi square test were performed to compare the clinical and MR imaging baseline index and the clinical outcome between the two groups respectively. Clinical outcome was assessed after 3 months using a dichotomized modified Rankin scale score.Data were also compared with the combined analysis of the ATLANTIS, ECASS, NINDS rt-PA trials. Resets The difference of clinical outcome in 3 months between the two groups was significant (P < 0. 05) and the median of the two group was 1 and 3, respectively. The ratio of favorable outcome (mRS 0-1) in the two groups was 52. 6% (20/38) and 33.3% (9/27), respectively. Conclusion MR angiography plays an important role in thrombolytic therapy of acute ischemic stroke and it should be used to consummate the conventional inclusion criteria, the patients with large vessel occlusion should be treated by rt-PA.

Objective To observe the effect of APA-BCC(alginate-polylysine-alginate microencapsulated bovine adrenal medullary chromaffin cells)microcapsules transplantation into the subarachnoid space of cancer pain patients on endogenous opioid peptides and catecholamine concentration in cerebrospinal fluid(CSF).Methods The different doses of APA-BCC microcapsules were transplanted into the spinal subarachnoid space of cancer patients with moderate or serious pain.The concentrations of Leu-enkephalin(L-EK),β-endorphin(β-EP),dynorphin A(DynA),noradrenaline(NA)and adrenaline(AD)in CSF were tested.Results L-EK concentration in CSF increased remarkably after transplantation,and the increase was most remarkable when transplantation doses were 1.0×107and 1.25×107;there were no remarkable changes of β-EP,DynA,NA and AD after transplantation.Conclusion The analgetic effects of APA-BCC microcapsules tranplantation may correlate with the increase of L-EK in CSF of cancer pain patients;the dose of 1.0×107 and 1.25×107cells may be the most effective dose.

ObjectiveTo explore the methods of low temperature preservation for alginate-polylysine-alginate (APA) microcapsules.MethodsAPA microcapsules were prepared with static electricity, and underwent hypothermal treatment respectively through methods of program control, gradient by icebox and put in liquid nitrogen directly, finally preserved in liquid nitrogen. The form and permeability of APA microcapsules were checked after rewarming.ResultsThe rates of integrity, crenation and damage were (91.2±1.57)%, (3.1±0.81)% and (5.7± 2.62 )% in the program control group; (85.3±1.42)%, (5.2±0.74)% and (9.5± 3.81 )% in the gradient by icebox group; (14.5±1.57)%, (84.1±3.47)% and (1.4±2.62)% in the directly put in liquid nitrogen group. The membrane permeability of full APA microcapsules after frozen and reworming was not changed obviously.ConclusionThe program control method can preferably preserve APA microcapsules at low temperature and keep them having normal form and permeability.