Objective:To conduct the visual analysis of emergency palliative care based on the Web of Science database.Methods:The literature on emergency palliative care collected from 2012 to 2022 was systematically searched in the Web of Science core collection. CiteSpace software was used for visual analysis.Results:A total of 630 articles were included, and the number of publications was on the rise. The country with the highest number of publications was the United States, with 8 out of the top 10 institutions in terms of publication volume coming from the United States. The author with the highest number of publications was Grudzen. The top 10 journals in terms of citation frequency were mostly specialized journals on palliative care and first aid. The results of keyword analysis showed that a total of 15 clustering labels and 20 emergent words were output, reflecting the changes of key research objects, main research types and areas of concern.Conclusions:At present, nursing research in this field is in the development stage in China. We can draw on the practical experience of foreign countries to further explore the emergency palliative care model and service system based on China's national conditions.

Objective:To investigate the incidence and prothrombotic risk factors of postoperative venous thromboembolism(VTE) in Cushing′s disease and to further develop an assessment model to identify those at high risk of postoperative VTE events.Methods:A retrospective study was performed in 82 patients who were admitted to Huashan Hospital, Fudan University during January 2019 and January 2020 and diagnosed with Cushing′s disease. These patients underwent the evaluation about their clinical, hormonal, and coagulation parameters, as well as ultrasonography and pulmonary angio-CT when necessary. The least absolute shrinkage and selection operator(LASSO) regression analysis was used to screen independent risk factors, and a nomogram model for postsurgical VTE risk assessment in Cushing′s disease was initially established, and Bootstrap method was used for internal verification. Finally, the predictive model was evaluated for calibration and clinical applicability in the study cohort.Results:Nineteen patients(23.17%) developed VTE events, with 14 cases occurring after endoscopic transsphenoidal surgery. Compared to patients without VTE, those in the VTE group were older( P<0.001), had longer postoperative bed rest, higher rates of current infection, higher HbA 1C levels, and more severe glucose tolerance impairment(all P<0.05). Through LASSO regression analysis, two independent risk factors for postoperative VTE were identified: Age and current infection. Then a VTE risk assessment nomogram model was established to predict the patients at high risk of VTE. In the nomogram model for VTE risk assessment, the area under the receiver operating characteristic curve was 0.868(95% CI 0.787-0.949), with the calibration curve closely aligning with the ideal diagonal line and the clinical decision curve exceeding the two extreme curves. Conclusions:Advanced perioperative assessment needs to be taken to screen those with high VTE risks in patients diagnosed with Cushing′s disease. Additionally, during the perioperative period, patients with Cushing′s disease should undergo mandatory physical activity or prophylactic anticoagulant therapy.

Objective:To clarify the clinicopathological, especially molecular, features of early-onset gastric cancer with the aim of informing analysis of treatment strategies.Methods:In this retrospective case-control study, we examined data from a dedicated gastric cancer database in Zhongshan Hospital affiliated to Fudan University. The original cohort comprised 2506 patients with gastric cancer who had undergone gastrectomy in Zhongshan Hospital Fudan University from July 2020 to October 2021, including 198 with early-onset gastric cancer (aged ≤45 years) and 2,308 with non-early gastric cancer. We used a simple random sampling method to select 396 of the 2,308 patients aged >45 years (ratio of 1:2) as the control group and then compared molecular diagnostic data and clinicopathological features of the two groups.Results:The median age was 39 years in the early-onset gastric cancer group, while 66 years in the control group. The clinicopathological features of early-onset gastric cancer included female predominance (59.1% [117/198] vs. 27.8% [110/396], χ 2=54.816, P<0.001), less comorbidity (32.3% [64/198] vs. 57.1% [226/396], χ 2=32.355, P<0.001), poorer differentiation (93.9% [186/198] vs. 74.5% [295/396], χ 2=30.777, P<0.001) and higher proportion of diffuse type (40.4% [80/198] vs. 15.9% [63/396], χ 2=69.639, P<0.001), distant metastasis (7.1% [14/198] vs. 2.8% [11/396], χ 2=6.034, P=0.014). Regarding treatment, distal gastrectomy was more commonly performed than proximal gastrectomy (55.1% [109/198] vs. 47.0% [186/396], 1.5% [3/198] vs. 8.3% [33/396], χ 2=11.644, P=0.003). Family history of gastric cancer, TNM stage, tumor size, lymph node dissection, nerve invasion, nodes harboring metastases, range of lymph node dissection, digestive tract reconstruction procedure, implementation of laparoscopic surgery, combined resection, and preoperative treatment did not differ significantly between the two groups (all P>0.05). Molecular diagnosis showed there was a smaller percentage of mismatch repair deficiency in the early-onset gastric cancer than in the control group (1.0% [2/198] vs. 10.1% [40/396], χ 2=16.301, P<0.001), and a higher rate of positivity for Claudin 18.2 (77.8% [154/198] vs. 53.0% [210/396], χ 2=5.442, P<0.001). HER-2 and Epstein–Barr virus positivity rates did not differ significantly between the two groups. Conclusion:Early-onset gastric cancer is a distinct type of gastric cancer with a high degree of malignancy, and treatment targeting Claudin 18.2 may be effective.

Objective:To clarify the clinicopathological, especially molecular, features of early-onset gastric cancer with the aim of informing analysis of treatment strategies.Methods:In this retrospective case-control study, we examined data from a dedicated gastric cancer database in Zhongshan Hospital affiliated to Fudan University. The original cohort comprised 2506 patients with gastric cancer who had undergone gastrectomy in Zhongshan Hospital Fudan University from July 2020 to October 2021, including 198 with early-onset gastric cancer (aged ≤45 years) and 2,308 with non-early gastric cancer. We used a simple random sampling method to select 396 of the 2,308 patients aged >45 years (ratio of 1:2) as the control group and then compared molecular diagnostic data and clinicopathological features of the two groups.Results:The median age was 39 years in the early-onset gastric cancer group, while 66 years in the control group. The clinicopathological features of early-onset gastric cancer included female predominance (59.1% [117/198] vs. 27.8% [110/396], χ 2=54.816, P<0.001), less comorbidity (32.3% [64/198] vs. 57.1% [226/396], χ 2=32.355, P<0.001), poorer differentiation (93.9% [186/198] vs. 74.5% [295/396], χ 2=30.777, P<0.001) and higher proportion of diffuse type (40.4% [80/198] vs. 15.9% [63/396], χ 2=69.639, P<0.001), distant metastasis (7.1% [14/198] vs. 2.8% [11/396], χ 2=6.034, P=0.014). Regarding treatment, distal gastrectomy was more commonly performed than proximal gastrectomy (55.1% [109/198] vs. 47.0% [186/396], 1.5% [3/198] vs. 8.3% [33/396], χ 2=11.644, P=0.003). Family history of gastric cancer, TNM stage, tumor size, lymph node dissection, nerve invasion, nodes harboring metastases, range of lymph node dissection, digestive tract reconstruction procedure, implementation of laparoscopic surgery, combined resection, and preoperative treatment did not differ significantly between the two groups (all P>0.05). Molecular diagnosis showed there was a smaller percentage of mismatch repair deficiency in the early-onset gastric cancer than in the control group (1.0% [2/198] vs. 10.1% [40/396], χ 2=16.301, P<0.001), and a higher rate of positivity for Claudin 18.2 (77.8% [154/198] vs. 53.0% [210/396], χ 2=5.442, P<0.001). HER-2 and Epstein–Barr virus positivity rates did not differ significantly between the two groups. Conclusion:Early-onset gastric cancer is a distinct type of gastric cancer with a high degree of malignancy, and treatment targeting Claudin 18.2 may be effective.

Objective:To understand the seroepidemiological characteristics of pertussis in healthy population in Ningbo, and estimate the overall incidence of pertussis.Methods:A cross-sectional survey method was used in this study. A total of 1 206 healthy residents in 9 age groups were stratified randomly selected from 3 counties of Ningbo. Serum samples were collected from the subjects, and the pertussis toxin immunoglobulin G antibody (PT-IgG) levels were measured quantitatively by enzyme-linked immunosorbent assay (ELISA).Results:The mean PT-IgG seropositive rate in the subjects was 0.91% (95% CI:0.45%-1.63%) with a geometric mean titer (GMT) of 3.10 (95% CI:2.86-3.36) IU/ml. The seropositive rates ranged from 0.00% to 1.68%, and the GMTs ranged from 2.08 IU/ml to 5.28 IU/ml in 9 age groups. The incidence rate of pertussis was estimated to be 4 572.81 per 100 000 in age group ≥5 years (95% CI:1 807.30 per 100 000-9 348.12 per 100 000), and the peak of estimated incidence rates were found in age group 5- years (9 301.62 per 100 000, 95% CI:1 121.77 per 100 000-33 154.68 per 100 000) and age group ≥50 years old (8 967.02 per 100 000, 95% CI: 1 059.45 per 100 000-31 845.94 per 100 000). Conclusions:The actual incidence of pertussis was high in Ningbo in 2019. As a result of waning immunity after vaccination, pertussis can occur in adolescents and adults. The pertussis surveillance should be strengthened and the pertussis vaccination strategy should be improved.

Objective To investigate the role of nicorandil pretreatment on protecting myocardium after coronary microembolization (CME) and on the PDCD4/NF-κB/TNF-α signaling pathway in miniature pigs. Methods Fifteen Bama miniature pigs were randomly(random number) divided into the sham operation group (sham group), microembolization group (CME group) and CME plus nicorandil group, with 5 pigs in each group. The CME model was constructed by injecting polyethylene microspheres via microcatheter into the left anterior descending artery, and pigs in the sham group were injected with the same amount of saline. Pigs in the CME plus nicorandil group were injected intravenously with nicorandil (150 μg/kg) via ear vein 30 min before CME. Cardiac function indexes were measured using cardiac ultrasonography. The expression of PDCD4 and TNF-α mRNA in myocardium were detected by fluorescence quantitative PCR, and the protein expression of PDCD4 and TNF-α in myocardium were detected by Western blotting. NF-κB activation was evaluated by electrophoretic mobility shift assay. Results (1) Cardiac function was significantly lower and the level of serum cTnI was significantly higher in the CME group compared with the sham group. CME reduced myocardial systolic dysfunction and left ventricular dilatation. The CME plus nicorandil group showed improved CME-induced cardiac function and reduced serum cTnI level when compared with the CME Group (P < 0.05). (2) Compared with the CME group, the CME plus nicorandil group showed lower PDCD4 and TNF-α expression and NF-κB activity as well as improved cardiac function (P < 0.05). Conclusions The pretreatment of nicorandil effectively reduced the myocardial damage caused by CME, mainly through inhibiting the PDCD4/NF-κB/TNF-α pathway in cardiomyocytes.

Objective To systematically review the efficacy and safety of tandospirone in the treatment of generalized anx-iety disorder(GAD) and to provide evidence-based references for clinic. Methods Databases include PubMed,Embase,The Co-chrane Library,CBM,CNKI,VIP and Wanfang Data were electronically searched from the inception to November 2016,to collect randomized controlled trials(RCTs)about the tandospirone citrate in the treatment of generalized anxiety disorder.Meta-analysis was performed by RevMan5.3 software after data extraction and quality evaluation. Results A total of 5 RCTs involving 500 patients were included.The results of Meta-analysis showed no significant differences in the Hamilton Anxiety Scale(HAMA) score between experimental group and control group[MD=0.47,95%CI(-0.51,1.45),P=0.34];and there was no significant differences of total effective rate between experimental group and control group[OR=1.03,95%CI(0.64,1.67),P=0.90].The incidence of adverse reactions in experimental group was significantly lower than that of control group,the difference was statistically significant[OR=0. 65,95%CI(0.44,0.95),P=0.03]. Conclusion Tandospirone citrate,as a new type of non-BZDs of antianxiety drug,shows exact clinical curative effect in the treatment of generalized anxiety disorder with mild adverse reaction and good safety.

OBJECTIVE:To study the effect and mechanism of tandospirone citrate (TC) on blood pressure in spontaneously hypertensive rats (SHR). METHODS:SHR were divided into model group,positive control group (Levamlodipine besylate tab-lets,2.5 mg/kg),TC high-dose,medium-dose,low-dose groups(TC capsules,40,20,10 mg/kg),8 in each group. Other 8 nor-mal rats were chosen as normal control group. The rats were intragastrically administrated medicines,once a day,for 28 d. Systolic blood pressure(SBP)before first administration and after 0.5,1,1.5,2,3,4 h of administration in each group were measured, and SBP after 1 h of administration were measured once every 7 d. After last administration,nitric oxide(NO)content in serum, endothelin,renin,angiotensin Ⅱ(Ang Ⅱ) and norepinephrine (NE) contents in plasma were detected. RESULTS:In single ad-ministration,compared with model group,SBP in 0.5,1 h in positive control group and TC groups after first administration were obviously decreased (P<0.05 or P<0.01),then SBP were obviously decreased only in positive control group and TC high-dose group (P<0.05 or P<0.01). In multiple administration,compared with model group,SBP in 7th,14th,28th day of administra-tion in positive control group and TC high-dose,medium-dose groups were obviously decreased(P<0.05 or P<0.01). Compared with model group,NO content in serum in positive control group,TC high-dose group were obviously increased;endothelin,re-nin,Ang Ⅱ and NE contents in plasma were obviously decreased (P<0.05 or P<0.01). Compared with positive control group, NO content in serum in TC groups was obviously decreased;endothelin,renin,Ang Ⅱ and NE contents in plasma were obviously increased in TC medium-dose group (P<0.05). CONCLUSIONS:TC can obviously decrease the blood pressure of SHR. The mechanism may be associated with adjusting the balance of NO and endothelin,and decreasing renin,AngⅡand NE contents.

Natural polysaccharides are a kind of hydrophilic polymers.By grafting hydrophobic moieties to the polysaccharide backbone,could form self-assembled micelle with core-shell structure in aqueous by undergoing intramolecular or intermolecular association between hydrophobic moieties.The self-assembly micelles of amphiphilic polysaccharides provides a positive outlook for drug delivery systems with biodegradability,low antigenicity,good biocompatibility and so on.This review focus on biological activity of amphiphilic polysaccharide as self-assembly carriers,the principle of self-assembly of polymeric micelles,and the recent progress in hydrophobic modification of natural polysaccharides.

Objective To investigate the effect of treatment with endostatin combined with siRNA targeting VEGF on rats with collagen-induced arthritis (CIA).Methods Two mg/ml bovinetype Ⅱ collagen was injected into the rat footpad to build up the animal model of CIA.The experimental animal models were treated with endostatin combined with siRNA targeting VEGF 18 days later after immunization and the treatment ended 32 day later.The efficacy was evaluated by the weight,foot and ankle volume of rats.The levels of VEGF in plasma were detected by enzyme-linked immunosorbent assay (ELISA).The VEGF distribution within synovial tissue was detected and examined by immunohistochemical technique.The pathological changes of CIA were evaluated by the pathological changes of the biopsied ankle joints.Student's t test was used to evaluate the experimental data.Results The ELISA test showed that comparing with the model group (17.5±0.3),the endostatin group (15.7±0.3) ng/L and the endostatin combined siRNA targeting VEGF group (14.7±0.5) ng/L showed a significant efficacy in the treatment of CIA in rats (P＜0.05).The endostatin group (135±27) and the endostatin combined siRNA targeting VEGF group (126±71) were different in the number of VEGF in plasma and the VEGF distribution within synovial tissue (P＜0.05),the symptoms of arthritis in these rats were reduced than the model group.Conclusion Endostatin combined siRNA targeting VEGF has good therapeutic effect on rats with CIA.