Decision-making for end-of-life care is an important problem faced by end-stage patients in the process of treatment and care. The decision-making is complex and there are many influencing factors. Prospect theory is one of the important decision-making theories, which believes that individuals will have different risk attitudes based on different reference point locations, so as to make different end-of-life treatment choices. The selection of reference points varies from person to person, and is affected by individual characteristics, cognition, experience, psychological characteristics, social environment and so on. Based on the prospect theory, this paper summarizes the end-of-life decision-making preferences and its influencing factors in end-stage patients from three aspects of personal, psychology and social environment, in order to provide reference for improving the quality of care of end-stage patients.

The advance care planning is conducive to reducing the over treatment of terminally ill patients and improving the quality of life of patients. Video decision aid can effectively transmit terminal decision-making information, which has become an important means to implement advance care planning in countries and regions with better palliative care development. This paper summarizes the application types and effects and puts forward suggestions for constructing and using relevant tools in China, so as to provide references for research and practice of video decision aids in advance care planning in China.

Humans ; Infant, Newborn ; Intensive Care Units, Neonatal ; Logistic Models ; Phenotype ; Risk Factors

Objective:To analyze the salary characteristics of medical institutions and the influencing factors of personnel expenditure as found in the salary system reform of public hospitals in Sichuan province, for reference in furthering such reform in public hospitals.Methods:The data of personnel expenditure, business operation and medical services came from 96 medical institutions in 21 cities(prefectures)of Sichuan province from 2017 to 2020 by means of institutional survey. The average salary level and salary structure of medical staff were used to describe the salary characteristics, and the total salary was presented by the level of personnel expenditure. The measurement data was represented by M(IQR), the counting data was described by frequency and constituent ratio, and the influencing factors of personnel expenditure were analyzed by generalized linear mixed model. Results:From 2017 to 2020, the personnel expenditure of medical institutions increased by 13.04% annually. In 2020, the per capita salary level of medical staff was 151 900 yuan, while the basic salary and performance salary accounted for 16.20% and 54.60% of personnel expenditure respectively. The analysis results of the generalized linear mixed model showed that the average cost of patients per visit( β=0.596), the level of drugs and sanitary materials consumed per 100 yuan medical income( β=0.286), the number of medical visits( β=0.328), and the years [(2018, 2019, 2020) β=0.025, 0.052, 0.066] were positively correlated to personnel expenditure, while the average length of stay( β=-0.693), the proportion of medical service income( β=-0.392), and the balance rate of income and expenditure( β=-0.062)were negatively correlated to personnel expenditure( P<0.05). The proportion of fiscal subsidy revenue, regional GDP and asset-liability ratio were not the influencing factors of personnel expenditure( P> 0.05). Conclusions:In the reform of the salary system of the province, its salary level of medical institutions has surpassed the current wage ceiling of these institutions. As the salary distribution was mainly made based on the workload, the " baton" role of the salary system reform has begun to pay off. However, the basic guarantee role of compensation has not yet been fully leveraged.Further reform is needed in upgrading refined management, and timely dynamic adjustment of personnel expenditure in combination with the hospital's financial performance and cost analysis, and reasonably optimizing the level of medical staff compensation.

Ovarian cancer is the most malignant gynecologic malignancy. In recent years, histone modifying enzymes (HMEs) have been widely studied as an important part of epigenetic modifi-cations in ovarian cancer. Histone modifying enzymes, including histone methyltransferases and demethylases, histone acetyltransferases and deacetylases, play an important role in the prolif-eration and migration of ovarian cancer cells by modifying histone and non-histone proteins, and can regulate the development of chemoresistance. Inhibitors of various histone modifying enzymes play good anti-tumor effects in ovarian cancer by promoting cell growth arrest and apoptosis, inhibi¬ting tumor cell invasion, and increasing chemo¬therapy sensitivity, and are expected to be a new strategy for precision treatment of ovarian cancer. Therefore, this paper will review the mechanism of action and therapeutic potential of histone modifying enzymes involved in methylation and acetylation processes in ovarian cancer.

Quality of life reflects the effect of clinical treatment and care in end-stage elderly patients with chronic diseases. End-stage elderly patients with chronic diseases have poor quality of life and high care needs, but they are not sufficiently addressed in clinical practice and research. This article summarizes the concept of quality of life and the content, reliability, validity, advantages and disadvantages of quality of life assessment tools for end-stage elderly patients with chronic diseases, so as to provide a reference for clinical and nursing medical staff to select appropriate tools and make clinical decisions and improve patients' quality of life.

OBJECTIVETo explore the acupoint electrosensitivity and regularity for assisting the clinical diagnosis and treatment so as to improve the clinical therapeutic effects.

METHODSBy means of the computer retrieval (CBMdisc, CNKI, VIP, WanFang, PubMed and EMBASE) and manual retrieval, the relevant literature on acupoint electrosensitivity was reviewed and the modern literature database of acupoint electrosensitivity was established. Using bibliometric, the relations were analyzed among the detected indexes, acupoints, meridians and disorders in the conditions of acupoint electrosensitivity, and the potential regularity was explored.

RESULTSThe general detection indexes of acupoint electrosensitivity were resistance, inertia area, volt-ampere area, electric conduction quantity, electric potential, electric current and capacitance. The electrosensitive points included meridian points, auricular points and extraordinary points. Among those points, the electrosensitivity easily occurred at the special points.

CONCLUSIONThe acupoint electrosensitivity is mainly reflected on the electrical impedance and volt-ampere characteristics. The relative specificity exists between acupoint electrosensitivity and disorders. In clinical practice, detecting acupoint electrosensitivity may assist the diagnosis and instruct acupoint selection to improve the clinical therapeutic effects.

Objective:Imatinib is extensively used as a first-line therapeutic agent for patients with chronic myeloid leukemia (CML) at the chronic phase (CP). Although CML patients undergoing imatinib treatment are enrolled mainly in the Glivec International Patient Assistance Program (GIPAP) in China since 2003, limited data have been reported on the long-term outcome of these patients. This study aims to compare the treatment response and prognosis of CML-CP patients who received different treatments from January 2003 to December 2013 in the First Affiliated Hospital of Nanchang University. Methods:A total of 295 patients were enrolled, includ-ing 185, 30, 50, and 30 patients for imatinib, interferon-alpha (IFN-α) plus Ara-C, hydroxycarbamide (HU), or allogeneic hematopoietic stem cell transplantation (Allo-HSCT) treatments, respectively. Results:Patients in imatinib and Allo-HSCT groups achieved excellent complete hematologic remission (CHR) (i.e., 96.7%vs. 96.7%), complete cytogenetic response (CCyR) (i.e., 89.7%vs. 93.3%), and com-plete molecular remission (CMoR) (i.e., 49.7%vs. 83.3%, P=0.001). However, significantly low rates of CHR, CCyR, McyR, and CMoR were observed in IFN-αand HU groups. Moreover, patients from imatinib group showed longer overall survival (OS) time than patients from other groups (P<0.001), even patients in Allo-HSCT group (10-year OS, 89.0%vs. 67.0%, P<0.001) because of high risk of Allo-HSCT-related complication. Multivariate analysis showed that receiving imatinib treatment (HR=5.267, 95%CI:1.054-1.940, P=0.022) and achieving CCyR (HR=9.541, 95%CI:1.692-10.513, P=0.002) were independent predictors for OS. Conclusion:Imatinib treatment may be an optimal first-line choice for Chinese patients with CML-CP who have not received any previous treatments.

SUMMARY Thehumanembryonicstemcells(hESCs)serveasaself-renewable,genetically-healthy, pluripotent and single source of all body cells,tissues and organs.Therefore,it is considered as the good standard for all human stem cells by US,Europe and international authorities.In this study,the standard and healthy human mesenchymal progenitors,ligament tissues,cardiomyocytes,keratinocytes,primary neurons,fibroblasts,and salivary serous cells were differentiated from hESCs.The human cellular health-safety of NaF,retinoic acid,5-fluorouracil,dexamethasone,penicillin G,adriamycin,lead ace-tate PbAc,bisphenol A-biglycidyl methacrylate (Bis-GMA)were evaluated selectively on the standar-dized platforms of hESCs,hESCs-derived cardiomyocytes,keratinocytes,primary neurons,and fibro-blasts.The evaluations were compared with those on the currently most adopted cellular platforms.Parti-cularly,the sensitivity difference of PM2.5 toxicity on standardized and healthy hESCs derived fibroblasts, currently adopted immortalized human bronchial epithelial cells Beas-2B and human umbilical vein endo-thelial cells (HUVECs)were evaluated.The results showed that the standardized hESCs cellular plat-forms provided more sensitivity and accuracy for human cellular health-safety evaluation.

Objective To establish a level three class A hospital diabetes specialist nurse training modes and methods, in order to create specialist nurse training new model positioning in the different of national ( provincial) diabetes specialist nurses and diabetes care team contact nurses, and provide a new method and thought for college talent team construction. Methods Union Hospital Tongji Medical College Huazhong University of Science and Technology started diabetes specialist nurse training program in 2013, and 36 nurses was registered for these first program, then after the assessment, 21 people was participated in training. They carried out a 8 full-time comprehensive theory and clinical practice training, the training plan and assessment scheme formulated by the diabetes specialist nursing team. Results In the process of training, attendance rate was 98. 5%, and the theory and specialized operation achievement qualified rate was 90. 48% and 100. 00%. The non endocrine specialist carried out individualized diabetes education for more than 1100 times in 2014 after the training, organized medical lectures 23 times, compiled a diabetes specialist nursing guideline, organized 12 times special quality control of the ward, and carried out more than 60 lectures in diabetes patients; the process of diabetes care consultation between departments was improved and nursing consultation more than 70 person-time. It published 5 diabetes related papers in 2014, successful applied for 2 research subjects, organized 4 teaching activities for diabetes, applied and carried out report and extension services 11 projects. Conclusions This training cultivates many specialized nurses overall understanding of diabetes related knowledge, can implement nursing and health education for high blood glucose patients in the hospital, and improve the specialized nursing and scientific research ability.