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With the process of China’s aging population intensifying, palliative care, as an important guarantee for improving the quality of life of terminally ill patients, is receiving more and more social attention, and the demand is constantly increasing. Palliative care needs versatile professionals, and general education can enhance people’s awareness and understanding of it, enabling more people to understand, accept, and participate in palliative care. With the advancement of knowledge and technology in palliative care, the traditional cramming education models are no longer able to meet the actual needs. Therefore, there is an urgent need to innovate palliative care education strategies. By analyzing the current problems in the general education of palliative care in China, this paper proposed thoughts and suggestions for general and innovative education of palliative care in several aspects, such as establishing general and innovative education systems and evaluation systems of palliative care, diversifying educational contents and methods, strengthening medical staffs training, promoting diversified student groups, and strengthening the popularization of palliative care knowledge among the public.
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ObjectiveTo explore the effect of paliperidone palmitate treatment on schizophrenic patients in the community. Methods446 schizophrenic patients who used paliperidone palmitate injection were selected in Shanghai. Before and after the treatment, the disease family burden scale, the concise evaluation scale of drug treatment compliance, the VAS100 score of treatment satisfaction, the short form of quality of life measurement scale, and the screening scale of social function defects were used to evaluate the effects of paliperidone palmitate injection. The data were statistically analyzed using SPSS 26.0 software. ResultsAfter using paliperidone palmitate injection, the total score of family burden (13.94±12.17), the score of daily family activities (3.26±2.74), the score of family entertainment activities (2.21±2.30), and the score of family relationship (2.79±2.76) were significantly higher than those before the treatment (14.98±12.64, 3.51±2.88, 2.48±2.38, 3.11±2.87, respectively, all with P<0.05). The scores of the World Health Organization on quality of life brief scale (62.89±11.94) and the medication compliance scale (28.11±5.64) were better than those before treatment (60.67±12.62 and 27.37±6.96, all with P<0.05). Compared with the prior treatment without paliperidone palmitate injection, the number of readmissions after treatment was significantly reduced (P<0.01). ConclusionThe treatment of paliperidone palmitate injection has significant effect, which can effectively reduce the disease family burden of Schizophrenic patients, improve their quality of life, enhance their drug compliance, reduce the readmission rate of patients, ensure long-term treatment effect and promote disease recovery.
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Objective:To explore the application value of humidifying high-flow nasal cannula oxygen therapy (HHFNC) in children with pediatric intensive care unit (PICU) after weaning.Methods:From January 2018 to October 2021, 42 children with endotracheal intubation admitted to PICU of Tai′an city Central Hospital were prospectively selected and randomly divided into HHFNC group and nasal continuous positive airway pressure (NCPAP) group, with 21 patients in each group. The blood gas analysis [arterial partial pressure of oxygen (PaO 2), partial pressure of carbon dioxide in artery (PaCO 2), PaO 2/oxygen concentration (FiO 2)], blood oxygen saturation (SaO 2), comfort, non-invasive ventilation time, and total hospital stay of the two groups of children 1 hour after using HHFNC and NCPAP were compared, and the rate of reintubation of trachea within 48 hours, gastroesophageal reflux, nasal injury, facial skin indentation, abdominal distension, and pulmonary air leakage were recorded. Results:There was no significant difference between the two groups in terms of blood gas analysis (PaO 2, PaCO 2, PaO 2/FiO 2), SaO 2, pulmonary air leakage, non-invasive ventilation time, hospital stay, and reintubation rate within 48 h after weaning (all P>0.05). Compared with NCPAP group, HHFNC group had higher comfort, lower incidence of facial skin indentation, gastroesophageal reflux, nasal injury and abdominal distension, and the difference was statistically significant (all P<0.05). Conclusions:HHFNC and NCPAP can both be used as the transitional respiratory support mode after weaning, and the clinical treatment effect are similar. The HHFNC group has higher comfort, which is more conducive to improving the tolerance of children, reducing adverse reactions, and has higher safety.
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Objective To evaluate the effect of aerobic exercise combined with resistance exercise on blood sugar and constitution in patients with type 2 diabetes mellitus.Methods Fifty eligible subjects in community type 2 diabetes database were randomly selected and a model intervention group of"1+2+1" was established.The regular exercise intervention was conducted for six months by combining aerobic exercise with resistance exercise.The fasting blood sugar,blood pressure,heart rate,body mass and fat mass before and after intervention were compared by paired t test.Changes in related physical indicators.Results After 6 month of exercise therapy,fasting blood glucose of subjects reduced from (8.58±4.40) mmol/L to (6.29 ±1.72) mmol/L(P=0.032).Body weight also reduced from (62.44±7.35) Kg to (60.70±7.54) Kg(P=0.008). In physical quality related indexes, fat mass decreased significantly, while protein content increased significantly.There were no changes in muscle mass and fat free body weight.In addition, grip strength and flexion range of subjects significantly increased after exercise therapy.Comprehensive score of physical quality of subjects increased from (73.25± 5.65) to (75.48± 5.04) ( P=0.010).Conclusion Exercise therapy of aerobic exercise combined with resistant exercise can effectively reduce blood glucose, body weight and fat mass,increase muscle strength,flexibility and physical quality.This also reflects that the community?led "health and physical integration" mode of work is an effective means to manage chronic diseases and enhance the physical fitness of residents.
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Objective To investigate the changes of the levels of sonic hedgehog (SHH) and vascular endothelial growth factor (VEGF) in serum and its relationship with collateral circulation in patients with symptomatic middle cerebral artery stenosis. Methods From January 2015 to January 2018, a total of 268 patients with acute ischemic stroke confirmed as unilateral middle cerebral artery M1 segment (MCA-M1) severe stenosis or occlusion by digital subtract angiography (DSA) were enrolled. The baseline clinical data were collected. According to the establishment of collateral circulation shown by DSA, they were divided into good collateral circulation group (152 patients) and poor collateral circulation group (116 patients). The levels of SHH and VEGF in serum were detected by enzyme linked immunosorbent assay (ELISA), the expression characteristics of SHH and VEGF in serum and the relative factors influencing the establishment of collateral circulation were analyzed. Results The levels of serum SHH and VEGF in good collateral circulation group were significantly higher than those in poor collateral circulation group (P < 0.01). Pearson correlation analysis showed that there was a positive correlation between SHH and VEGF (r=0.758, P < 0.01). Multivariate Logistic regression analysis showed that the levels of serum SHH ( OR=0.310, 95% CI 0.117-0.819, P=0.018) and VEGF ( OR=0.361, 95% CI 0.147-0.887, P=0.026) were independent protective factors for the establishment of collateral circulation. Diabetes ( OR=3.094, 95% CI 1.321-7.245, P=0.009) was independent risk factor for the establishment of collateral circulation. Conclusions The levels of serum SHH and VEGF are closely related to the formation of collateral circulation and they are independent protective factors. SHH may be involved in the establishment of cerebral collateral circulation by regulating the expression of VEGF and diabetes is not conducive to the formation of collateral circulation.
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In eukaryotic cells ,NF-κB transcription factor family regulates many processes like cell sur-vival,growth,and apoptosis.It participates in the development of a variety of diseases ,including inflammatory,im-mune disease ,and cancer .As an inflammatory factor , NF-κB mediates the transformation of chronic colitis to cancer during the course of colorectal cancer .Furthermore,it could inhibit cell apoptosis through regulating cell cycles,which promotes the development of colorectal cancer and mediates the multidrug resistance of the tumor cells.Therefore,targeting NF-κB,a large number of preparations involved both Chinese and western medicine has been researched .The further research and the use of them may be an effective method to cure the colorectal cancer in clinical work .
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Objective To establish a clinical cytokine test method based on flow multiple microarray technology,and discuss its clinical significance by observing the change of cytokines level in the early stage of influenza.Methods 54 cases of influenza A virus positive and 20 cases of influenza A virus negative influenza like patients were selected as influenza group.Among them,influenza A virus positive patients were divided into mild group and severe group,influenza A virus negative influenza like patients were as neg-ative group.In addition,35 healthy people were selected as the control group,and the cytokine of all the whole blood samples was detected and statistically analyzed.Results Interleukin-6(IL-6),interleukin-21(IL-21),interleukin-12p70(IL-12p70),interleukin-1 β(IL-1 β)and interleukin-10(IL-10),chemokine-10(IP-10),interleukin-2(IL-2),monocyte chemoattractant protein-1(MCP-1)lev-els were significantly higher in the patients with early onset of influenza,and the difference was statistically significant(P<0.05). The difference of interferon-γ(IFN-γ)between the influenza group and the control group was not statistically significant(P> 0. 05).The levels of IL-6 and IP-10 in the severe group were higher than that of the mild group and the negative group,and the differ-ence was statistically significant(P<0.05).Conclusion IL-6,IL-21,IL-12p70,IL-1 beta,IL-10,IP-10,IL-2 and MCP-1 levels can be used as clinical biological evaluation indicators of patients with fever,of which IL-6 and IP-10 can be used as important indicators for disease progression assessment.
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Objective To discuss the relationship between hepatitis B virus (HBV) genotype and HBV DNA ,liver fibrosis ,liver function and HBeAg .Methods HBV genotypes ,HBV DNA ,liver fibrosis indicators and alanine aminotransferase(ALT ) ,aspartate aminotransferase(AST ) ,total bilirubin(TBIL) ,albumin(ALB) and HBV e antigen(HBeAg) were detected in patients with serum hepatitis .All data were statistically analyzed .Results There was no significant difference of HBV DNA ,ALT ,AST ,TBIL ,ALB , procollagen- Ⅲ -peptide ,type Ⅳ collagen ,hyaluronic acid and laminin between patients with B and C genotype infection (P> 0 .05) . However ,HBeAg level in patients with C genotype infection was higher than that in patients with B genotype infection (P< 0 .05) . Conclusion There might be no significant difference of HBV DNA ,liver function and liver fibrosis between patients with B and C genotype infection ,but HBeAg level in patients with C genotype infection could be higher than patients with B genotype infection .
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Objective Studying the status quo and constraints for rural healthcare service in grassroot rural healthcare units,for policy recommendations.Methods Using data from the fourth healthcare service investigation,by means of quantitative interview and qualitative interview,for an investigative interview of 348 township hospitals and 251 village clinics in 31 provinces in China.Results Deployment percentage of primary heahhcare services at township hospitals level is 49.1% (28.0/57),and that for village clinics is 60.6%(5.4/9).Conclusions The key to upgrading rural healthcare service system at grassroots level is to deploy better diagnostic equipments,upgrade the diagnostic competence of grassroots healthcare personnel and build a continuous service system for primary healthcare service.