Objective:To explore the influence of family function and personal characteristics on death anxiety in patients with advanced cancer, providing reference for finding methods and approaches to alleviate death anxiety in advanced cancer patients.Methods:From March to June 2023, convenience sampling was used to select 182 advanced cancer patients admitted to the Cancer Center of the Fifth Affiliated Hospital of Sun Yat-sen University. The Chinese Version of Death and Dying Distress Scale and Family APGAR Index were used to investigate patients' death anxiety and family function. The Numerical Rating Scale and Kamofsky Performance Status were used to assess patients' pain and performance status. Single factor analysis and multiple linear regression were used to analyze the influencing factors of death anxiety in advanced cancer patients.Results:A total of 182 questionnaires were distributed, and 165 valid questionnaires were collected, with a valid response rate of 90.7%. The death anxiety score of advanced cancer patients was (22.52±15.27), and 10.3% (17/165) of patients had moderate or above death anxiety. The patients' total family function score was (8.62±1.97), and 86.7%(143/165) patients self-reported good family function. The death anxiety score was negatively correlated with the family function score ( P<0.05). Multiple linear regression analysis showed that Kamofsky Performance Status score, pre-illness employment, family function, place of residence, and pain score were the influencing factors of death anxiety in advanced cancer patients, and the differences were statistically significant ( R2=0.196, P<0.01) . Conclusions:The advanced cancer patients have low levels of death anxiety in our study. Advanced cancer patients with moderate family dysfunction, living in rural areas, working before illness, and high pain scores have high levels of death anxiety, while patients with good performance status have low levels of death anxiety. It is recommended that clinical workers strengthen the assessment of death anxiety and family function in patients with advanced cancer, take timely and effective measures based on influencing factors, and help alleviate death anxiety in patients with advanced cancer.

Objective:To explore the mediating effects of hope between disease self-management and quality of life.Methods:By convenient sampling, 347 Parkinson inpatient were analyzed by using Herth Hope Index (HHI) and Chronic Disease Self-Management Study Measures (CDSMSM) and 12-item Short Form health survey (SF-12) and the self-designed General Condition Questionnaire, and proposes a mediating model and tests the impacts of hope on disease self-management and quality of life.Results:The score of HHI was 28.11±4.59, and the score of CDSMSM was 5.52±1.59, and the score of physical component summary physical component summary(PCS) was 51.64±21.09, and the score of mental component summary(MCS) was 71.42±18.35. The scores of HHI significantly was positively correlated with the scores of CDSMSM ( r value was 0.358, P<0.01)and the scores of PCS ( r value was 0.437, P<0.01) and MCS ( r value was 0.514, P<0.01), and there was positive correlation between the scores of CDSMSM and the scores of PCS ( r value was 0.334, P<0.01) and MCS ( r value was 0.326, P<0.01). The mediating model had high degree of fitting, and level of path had statistical significance ( P<0.01). Hope was the mediator between disease self-management and quality of life. Disease self-management had direct effects ( β value was 0.221) on quality of life and indirect effects ( β value was 0.176) through hope. Conclusions:Disease self-management was a direct predictor of quality of life, and hope had mediating effects between disease self-management and quality of life. We should pay enough attention to the effects of disease self-management ability and mental health of patients with Parkinsonism in clinical nursing, and increased the care to the Parkinson's inpatient with emotion disorder, while promote and develop their coping ability, propaganda and psychological guidance, so that improves mental health of the Parkinson inpatient and help them positive coping, and maintain good mental health status, and improve the quality of life.

Objective: To investigate the effects of artesunate treatment on chronic graft-versus-host disease (cGVHD). Methods: Recipient BALB/c mice received 8 × 10⁶ bone marrow cells with 8×10⁶ spleen cells from B10D2 mice. Artesunate solubilized in acetone was injected intraperitoneally every day at the dose of 1 mg/kg at Day 28 after BMT. The clinical scores, survival and histopathological damage were analyzed. The frequency of Th17 and Tregs in PB and spleens from the mice were evaluated by flow cytometry. In addition, CD4⁺ T cells from the spleens of mice were cultured in vitro, then stimulated with artesunate, the frequency of Th17 and Tregs in these splenocytes were evaluated by flow cytometry. Results: Artesunate administration diminished clinical and histopathological damage, and improved the survival of cGVHD mice[(46.57±7.83)% vs (55.71±6.99)%, χ²=5.457, P=0.020]; Artesunate contributed to Tregs development [(4.45±0.04)% vs (8.40±0.23)%, t=15.679, P<0.001; (6.62±0.24)% vs (10.48±0.48)%, t=6.587, P=0.003] while decreased Th17 cells [(1.51±0.18)% vs (0.58±0.19)%, t=7.233, P<0.001; (1.48±0.38)% vs (0.71±0.18)%, t=3.653, P=0.011] expressions in both PB and spleens, and decreased the Th17/Treg ratio (0.34±0.05 vs 0.09±0.03, t=7.621, P=0.002; 0.19±0.03 vs 0.06±0.02, t=6.993, P=0.002). Moreover, artesunate suppressed the Th17 cells expressions [(0.82±0.37) % vs (3.39±1.22) %, t=4.044, P=0.007] and contributed to Tregs development [(34.63±1.29) % vs (14.28±1.69) %, t=19.119, P<0.001], and also decreased the Th17/Treg ratio (0.24±0.09 vs 0.02±0.01, t=4.780, P=0.003) in vitro. Conclusions Artesunate suppressed the Th17 cells expressions and contributed to Tregs development, which provided new sights into the development of a novel drug for cGVHD, e.g., artemisinin.

Objective To prepare a gelatin hydrogel crosslinked by genipin and loaded with silver sulfadiazine(AgSD) nanoparticles,and test its in vitro anti-bacterial activities and in vivo wound healing enhancing properties. Methods The suspension of AgSD nanoparticles and coarse powder,hydrogels loaded with AgSD nanoparticles and coarse powder were prepared,respectively, and blank gels were used as control. The diameters of inhibition zone of sensitive bacteria were measured;The biocompatibility to L929 cells was studied by MTT method and relative growth rates of the cells were determined. The minimum inhibitory concentration (MIC)and minimum bactericidal concentration(MBC)of 3 sensitive bacteria were tested;DeepⅡdegree scald co-aureus infection mice model was established and the healing index of treatment by drug-loaded hydrogel dressing was calculated within 3 weeks. The collagen deposition was studied after sirius red staining and pathological manifestations were observed after HE staining. Results Compared with AgSD coarse powder,the antibacterial property of AgSD nanoparticles obviously improved in inhibition zone and MIC, MBC experiments. Better biocompatibility and antibacterial property were revealed for AgSD nanoparticles gel group compared with AgSD cream group in MTT assay and inhibition zone studies;Healing index increased significantly since the second week in AgSD nanoparticles gel group compared with staph group,AgSD cream group and AgSD coarse powder gel group in wound-healing experi-ment(P<0.05). Compared with those control groups,nanocrystal gel group had more content of typeⅠcollagen and total collagen, and higher pathology scores(P<0.05). Conclusion AgSD nanocrystal loaded gelatin hydrogel has good antibacterial activity in vitro and high quality healing enhancing property in vivo.

Objective To prepare a silver sulfadiazine(AgSD)-nanocrystal loaded hydrogel with gelatin as the main raw mate-rial,genipin as crosslinker,and test its physicochemical property and drug release characteristics. Methods AgSD-nanocrystal was prepared by ball milling,the particle size and polydispersity index were determined,the solubility was studied by an ultra perfor-mance liquid chromatography(UPLC)method and the microstructure was observed with transmission electron microscope(TEM);drug loaded gelatin hydrogel in different crosslinking degrees were prepared,the dissolution rate was studied in the same way as AgSD-nanocrystal and the possible dissolution mechanism was analyzed by fitting curves;the microstructure was observed by scanning elec-tron microscope(SEM). After 6 weeks,with the same method,all the above mentioned properties of drug loaded hydrogel and AgSD-nanocrystal suspension were determined repeatedly,and at the same time their stability was tested. Results After nanocrystalliza-tion,the polydispersity index of AgSD was 0.211,the mean particle size was about 267.8 nm,the dissolution rate greatly increased within 6 hours compared with that of AgSD bulk powder. There was a negative correlation between dissolution rate and crosslinking de-gree,and the nanoparticle gel's curve was higher than that of the bulk. In terms of stability,AgSD-nanocrystal in hydrogel was almost in the original state in SEM,while those in suspention had an increasing particle size and decreasing dissolution rate. Conclusion The stability and dissolution of the new drug loaded hydrogel are good,and its data can be used as reference for relevant study.

Objective To describe the status of breast reconstruction patients′decision regret, self-efficacy and satisfaction with information in the preoperative period, and discuss the correlation among them. Methods Four instruments were used to investigate 100 breast reconstruction patients in one tertiary hospital in Guangzhou, including participants′ personal profile, Decision Regret Scale, Modified Stanford Self-Efficacy Scale and the subscale of Information Satisfaction of Breast Reconstruction-Questionnaire. Results The mean score of Decision Regret Scale was (10.8 ± 2.5)points in breast reconstruction patients, and the minority of patients experienced decision regret (30%, 30/100). The mean score of self-efficacy and satisfaction with information in the preoperative period were (6.6±1.9) and (2.9± 0.6) points. The study also found that decision regret was negatively correlated with self-efficacy and satisfaction with information in the preoperative period (P < 0.01). Conclusions Totally 30 percent of patients experienced decision regret to undergo breast reconstruction. However, patients who had lower levels of self-efficacy and satisfaction with information in the preoperative period were at greater risk to experience decision regret to undergo breast reconstruction. The results may assist health care professionals to provide appropriate psychological support, care and information.

Objective To discuss the prevention and management method for chylous fistula after neck lymph node dissec‐tion .Methods Totally 1 793 cases of neck lymph node dissection in this department from January 2005 to September 2014 were retrospectively analyzed .The clinical data in the cases of chylous fistula occurred after operation were summarized .Results Twenty one cases of chylous fistula occurred ,accounting for 1 .17% ,in which 13 cases were cured by the local compressed bandaging and continuous negative pressure drainage;5 cases adopted the conventional method for 2-3 d ,but under the ineffective condition ,then they were treated by combining with somatostatin pumping (somatostatin 6 mg+0 .9% normal saline 48 mL ,2 mL/h ,lasting for 24 h ,for successive 2-3 d) and finally cured;3 cases were cured after reoperation .Conclusion Prevention is the best treatment for chylous fistulas ,local compression bandage plus continuous negative pressure drainage is the main method for treatment of chylous fistulas after neck dissection .The combined therapy with somatostatin can increase the close rate of chylous fistulas;for the patients with long persistent time ,large drainage volume and invalid conservative therapy should adopt the remedial measure of operation .

Objective To investigate the primary repair methods and efficacy of island pedicled pectoralis major muscle flap in soft tissue defect after the operation of head and neck malignant tumors .Methods From April 2011 to September 2012 ,27 patients from this hospital who underwent primary repair using island pedicled pectoralis major muscle flap after a head and neck extensive soft tissue defect were investigated ,including 11 cases of tongue cancer defect ,2 cases of parotid gland defect ,3 cases of gum cancer defect ,2 cases of oropharyngeal cancer defect ,9 cases of floor of the mouth cancer defect .Results 27 patients were safety in periop-erative ,27 cases of island pectoralis major muscle flap survived ,patients were satisfied with both the appearance and function .There was postoperative neck hematoma in 1 patient ,it was eliminated through timely remove the hematoma and hemostasis completely ;There was 1 case of removing the epidermal necrolysis skin as flap necrosis ,while it was acceptable efficacy as the muscle flap sur-vival and surface granulation repaired .Conclusion Island pectoralis major muscle flap obtains unique advantages in repairing a large area of soft tissue defect in head and neck cancer patients after operation ,such as abundant of tissue ,a constant arterial anatomy of thoracoacromial ,easy to operate ,rich blood supply ,strong resistance to infection ,high survival rate and so on .A fine surgery opera-tion is the key of island pectoralis major muscle flap survival .

Objective To explore the value of a novel non-peptide renin inhibitor aliskiren on hypertension patients,and analyze the change of bradykinin (BK) and high sensitive C-reactive protein (hs-CRP).MethodsEighty patients with mild to moderate hypertension were selected.Patients were randomized divided into ramipril group,aliskiren 75 mg/d group,aliskiren 150 mg/d group,aliskiren 300 mg/d group with 20 cases each by random digits table method and received the following types of intervention:ramipril 5 mg/d,aliskiren 75 mg/d,aliskiren 150 mg/d and aliskiren 300 mg/d.Enzyme-linked immunosorbent assay method was used for detecting hs-CRP.Radioimmunoassay method was used for detecting BK.Results After treatment,the levels of BK and hs-CRP in aliskiren 75 mg/d group,aliskiren 150 mg/d group and aliskiren 300 mg/d group [(5.06 ± 1.61),(5.05 ± 1.87),(5.27 ± 1.39) μg/L and (0.38 ± 0.11 ),(0.25 ± 0.05),(0.33 ± 0.11 ) mg/L] were significantly lower than those in ramipril group [ (7.12 ± 1.12) μ g/L,(0.49 ± 0.19) mg/L ] (P＜0.05 ).After treatment,the levels of SBP and DBP had no significant difference among the four groups (P＞0.05).Conclusion Aliskiren has a very good effect in decreasing blood pressure and does not cause the levels of BK and hs-CRP increasing.

Objective To observe the effect of inhalation budesonide(pulmicort) in the treatment of cough variant asthma and(CVA) its influence on serum cytokine.Methods 112 children with CVA were randomly divided into the atomization group and control group,each group 56 cases.The atomization group was given pulmicort inhalation therapy,and the control group was given oral long-acting β2 agonist treatment.After 3 months of treatment,the efficacy and serum cytokine levels were compared between the two groups.Results 3 months after the treatment,the effective rate of the atomization group was 91.07％,and significantly higher than that of the control group(75.00％ )( x2 ＝ 5.13,P ＜ 0.05 ) ; The serum interleukin-4,γ-interferon,IgE,eosinophil counts of the atomized group were significantly lower than those of control group ( t =2.10,2.34,27.63,3.13,all P ＜ 0.05 ).Conclusion The effect of inhalation pulmicort in the treatment of cough variant asthma is good,and has good safety.