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BACKGROUND: Caring is the essence and core of nursing. Current studies on the effect of gender on nurses' perception of caring have been inconsistent. Most of these studies were quantitative and conducted before the COVID-19 pandemic. The study aimed to explore the gender similarities and differences in nurses' perception of caring during the COVID-19 pandemic. METHODS: In 2020, a cross-sectional mixed-method study was conducted in 11 cities in China using structured online questionnaire (n = 8030) and face-to-face individual interview (n = 42). Data collection tools included the Caring Dimensions Inventory and semi-structured interview. RESULTS: In stepwise multivariable linear regression analysis, female nurses scored 1.93 points higher on caring than male nurses, after completely controlling for the other factors. The interview results showed that both male and female nurses agreed that caring was to deal with three kinds of relationships, namely nurses and people, nurses and themselves, nurses and society. There were gender differences in the connotation of caring between nurses and themselves, but not in the connotations of caring between other relationships. The ranking of the importance of caring connotations among these relationships showed no gender difference except between nurses and themselves. CONCLUSION: The quantitative findings suggest that gender influences nurses' perception of caring. The qualitative findings demonstrate that nurses regard themselves as both recipients and implementers of caring. The qualitative results indicate nurses of different genders have similarities and differences in their perception of caring, and the biggest difference lies in the relationship between nurses and themselves.
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Oleanolic acid has previously been shown to possess PI3K inhibitory activity, thus, the purpose of this work was to generate a series of derivatives that improve the potency. Twenty rationally designed oleanolic acid derivatives were synthesized and tested the cytotoxicity and PI3K inhibitory activity. The results suggested that attachment of additional structural elements such as association of thiazole group to A ring and insertion of phenylurea group was important for increasing activities. The most active derivative was compound II2, which exhibited PI3K inhibitory activity (IC50 = 58.42 nmol/l) and improved interaction with activity site of PI3K according with docking studies.
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AIM: The aim of this work is to explore the influencing factors of nurses' caring behaviour during the COVID-19 pandemic based on the Capability, Opportunity, Motivation as determinants of Behaviour (COM-B) theoretical framework. BACKGROUND: Nurse caring behaviour is vital to reduce and speed up the healing process of COVID-19 patients. It is important to understand the factors that influence caring behaviour among nurses during the COVID-19 pandemic. Research suggests that when it comes to understanding behaviour, using a theoretical framework is likely to be most effective, and the COM-B framework is a recommended approach. METHODS: Semistructured interviews with 42 nurses working in 11 Chinese cities were conducted, and their verbatim statements were transcribed and analysed using thematic analysis. The results were mapped to COM-B framework. RESULTS: Ten key themes emerged: Capability (professional knowledge and skills, emotional intelligence, cross-cultural care competence); opportunity (resources, organizational culture, social culture); motivation (past experience, character, role, beliefs). CONCLUSIONS: Ten factors were found to influence nurses' caring behaviour. This study added two new influencing factors, social culture and past experiences, that further contributed to the understanding of nurses' care behaviours. IMPLICATIONS FOR NURSING MANAGEMENT: Nurses' caring behaviour is influenced not only by themselves but also by institutions and society, so interventions aiming to improve their caring behaviour should consider these elements. The negative impact of the pandemic on capability factors that influence nurses' caring behaviour should be counteracted as soon as possible.
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COVID-19 , Enfermeras y Enfermeros , Humanos , Pandemias , Motivación , COVID-19/epidemiología , Investigación Cualitativa , China/epidemiologíaRESUMEN
Mantle cell lymphoma (MCL) is a unique subtype of B-cell non-Hodgkin lymphoma with a generally aggressive and heterogeneous clinical course. Chemokines are one of the complex components in the tumor microenvironment (TME), and they play a vital role in tumor progression and metastasis. There is no information about the monokine induced by gamma interferon (MIG)/CXC chemokine receptor 3 (CXCR3) axis in patients with MCL. In the present study, we discovered that CXCR3 was highly expressed in MCL tissues and some cell lines including Maver, Z138, and Jeko-1, and significantly associated with clinical factors reflecting high tumor burden in MCL patients. Moreover, elevated serum MIG at diagnosis showed a close relationship with advanced disease and poor prognosis in MCL patients. Additionally, the role of CXCR3 in promoting the proliferation and inhibiting the apoptosis of primary MCL cells and Jeko-1 cells was validated by in vitro experiments. Further research indicated that the MIG/CXCR3 axis mediated MCL cell migration to the TME through the PI3K/AKT signaling pathway. Therefore, the MIG/CXCR3 axis might be a potential target with fewer off-target side effects than other targets in MCL.
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Biomarcadores de Tumor/metabolismo , Quimiocina CXCL9/metabolismo , Regulación Neoplásica de la Expresión Génica , Linfoma de Células del Manto/patología , Receptores CXCR3/metabolismo , Apoptosis , Estudios de Casos y Controles , Proliferación Celular , Femenino , Humanos , Linfoma de Células del Manto/metabolismo , Masculino , Persona de Mediana Edad , Pronóstico , Tasa de Supervivencia , Células Tumorales CultivadasRESUMEN
BACKGROUND: Aberrant expression of B7 homologue 3 (B7H3) has been observed in various malignancies. Our previous study demonstrated that knocking down of B7H3 inhibited cell proliferation, invasion and enhanced the therapeutic efficacy of chemotherapy in mantle cell lymphoma (MCL). However, the mechanism regulating of B7H3 expression remains unknown. Here, we present a new regulatory microRNA of B7H3, miR-506, that directly targets B7H3 and may play an inhibitory role in MCL progression. METHODS: The expression of miR-506 and B7H3 was investigated by real-time quantitative PCR (RT-qPCR). B7H3 was confirmed to be a novel direct target gene of miR-506 by a dual-luciferase assay and western blot analysis. MiR-506 overexpression in the Maver and Z138 MCL cell lines was established using lentiviral transduction. Cell counting kit-8, flow cytometry and Transwell assays were used to detect changes in cell proliferation, cycle distribution, migration and invasion, respectively. RESULTS: The RT-qPCR results showed that miR-506 was expressed at a low level, while B7H3 was overexpressed in MCL patients and cell lines. By using a bioinformatics analysis combined with a dual-luciferase assay, we determined that miR-506 could target the 3'-untranslated region (3'-UTR) of B7H3 mRNA. Moreover, miR-506 had a negative regulatory effect on B7H3 expression according to the western blotting and RT-qPCR results. In terms of function, increased expression of miR-506 led to reduced MCL cell proliferation, invasion and migration, caused cell cycle arrested at G0/G1 phase, similar to the effects of B7H3 knockdown. Furthermore, we measured the expression of invasion-related proteins by western blotting and found that miR-506 could reduce MMP-2 and MMP-9 expression in MCL cells. Rescue experiments suggested that the restoration of B7H3 expression in MCL cells reversed the inhibition of proliferation and invasion induced by miRNA-506 overexpression. CONCLUSIONS: Our findings suggest that miR-506 functions as a tumor suppressor miRNA and plays a significant role in inhibiting human MCL cell proliferation and metastasis by suppressing B7H3 expression.
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Antígenos B7/metabolismo , Linfoma de Células del Manto/genética , Linfoma de Células del Manto/patología , MicroARNs/metabolismo , Regiones no Traducidas 3'/genética , Antígenos B7/genética , Secuencia de Bases , Puntos de Control del Ciclo Celular/genética , Línea Celular Tumoral , Movimiento Celular/genética , Proliferación Celular/genética , Regulación hacia Abajo/genética , Femenino , Fase G1/genética , Regulación Neoplásica de la Expresión Génica , Humanos , Masculino , MicroARNs/genética , Persona de Mediana Edad , Invasividad Neoplásica , ARN Mensajero/genética , ARN Mensajero/metabolismo , Fase de Descanso del Ciclo Celular/genéticaRESUMEN
Thymopentin is a group of biologically active peptide secreted mainly by the epithelial cells of thymic cortex and medulla. Whether it promotes T cells production from human embryonic stem cells(hESCs) in vitro remains an elusive issue. In the present study, we develop a novel strategy that enhances T-cell lineage differentiation of hESCs in collagen matrix culture by sequential cytokine cocktails treatment combined with thymopentin stimulation. We observed that approximately 30.75% cells expressed CD34 on day 14 of the cultures and expressed the surface markers of erythroid, lymphoid and myeloid lineages. The results of colony assays and gene expressions by RT-PCR analysis also demonstrated that hematopoietic progenitor cells (HPCs) derived from hESCs were capable of multi-lineage differentiation. Further study revealed that culturing with thymopentin treatment, the CD34(+)CD45RA(+)CD7(+) cells sorted from HPCs expressed T-cell-related genes, IKAROS, DNTT, TCRγ and TCRß, and T-cell surface markers, CD3, cytoplasmic CD3, CD5, CD27, TCRγδ, CD4 and CD8. The differentiated cells produced the cytokines including IFN-γ, IL-2 and TNF-α in response to stimulation, providing the evidence for T-cell function of these cells. In conclusion, thymopentin enhances T-cell lineage differentiation from hESCs in vitro by mimicking thymus peptide environment in vivo.
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Células Madre Embrionarias/citología , Linfopoyesis/efectos de los fármacos , Linfocitos T/citología , Timopentina/farmacología , Antígenos CD34/biosíntesis , Antígenos CD34/metabolismo , Antígenos CD7/metabolismo , Antígenos de Superficie/biosíntesis , Linaje de la Célula , Células Cultivadas , Células Madre Hematopoyéticas/citología , Humanos , Interferón gamma/biosíntesis , Interleucina-2/biosíntesis , Antígenos Comunes de Leucocito/metabolismo , Células Madre Pluripotentes/citología , Factor de Necrosis Tumoral alfa/biosíntesisRESUMEN
Human embryonic stem (hES) cells can differentiate into cells of the three germ layers in vitro and serve as a powerful resource to study mechanisms involved in cell fate decisions. However, it is difficult to promote the directed and efficient differentiation of hES cells toward a specific lineage. Here we establish a stepwise strategy for generating hemato-endothelial and cardiac precursors from hES cells in single culture conditions. The efficiency of committing hES cells to three cell lineages was significantly higher with our approach than with exposure to single or multiple cytokines. Efficiency was determined using quantitative analysis by gene expression, flow cytometry, and colony assays. Several cytokines were sufficient to drive the efficient differentiation of hES cells into specific lineages. Each of these factors appeared to regulate specific steps of differentiation: BMP4 promoted the efficient formation of mesoderm; bFGF induced the differentiation of these mesodermal precursors to the hemangioblast fate; VEGF and TPO were required for the production of committed hematopoietic progenitors. This stepwise control of differentiation in vitro leads to a high frequency of hemato-endothelial and cardiac precursors derived from hES cells and offers a unique model for studying the molecular and cellular events that regulate hematopoiesis and cardiogenesis.
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Linaje de la Célula/fisiología , Citocinas/fisiología , Cuerpos Embrioides/citología , Células Madre Embrionarias/citología , Células Endoteliales/citología , Células Endoteliales/fisiología , Corazón/embriología , Células Madre Hematopoyéticas/citología , Diferenciación Celular/fisiología , Células Cultivadas , Cuerpos Embrioides/fisiología , Células Madre Embrionarias/fisiología , Células Madre Hematopoyéticas/fisiología , Humanos , Mesodermo/citología , Mesodermo/embriología , Miocardio/citologíaRESUMEN
OBJECTIVE: To investigate whether chlorophyllin could protect human umbilical vein endothelial cell (HUVEC) against oxidative damage by inducing the expression of heme oxygenase-1 (HO-1) and to explore the underlying mechanism. METHODS: The cellular protection of chlorophyllin against oxidative damage was detected by cell-survival assay with flow cytometry. The level of free radicals was detected directly by electron spin resonance spectra. The induced expression of HO-1 was shown by RT-PCR, Western blot, immunofluorescence confocal laser microscopy and enzymatic activity test. Whether the activation of PI3K/Akt pathway was involved was detected by Western blot. RESULTS: Chlorophyllin could protect HUVEC against oxidative damage caused by H2O2 via scavenging the excessive free radicals. Chlorophyllin treatment could induce expression of HO-1 in a dose- and time-dependent manner. The activation of PI3K/Akt pathway was required in the induction of HO-1. LY294002, the specific inhibitor of PI3K, could suppress the activation of PI3K/Akt and the induced expression of HO-1 in a dose-dependent manner. CONCLUSIONS: Chlorophyllin shows cellular protection against oxidative damage by counteracting the excessive free radicals. Up-regulation of HO-1 expression plays a pivotal role in the protection of chlorophyllin, while the activation of PI3K/Akt signaling pathway is required in the induction of HO-1.
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Clorofilidas/farmacología , Depuradores de Radicales Libres/farmacología , Estrés Oxidativo/efectos de los fármacos , Especies Reactivas de Oxígeno/metabolismo , Células Cultivadas , Cromonas/farmacología , Hemo-Oxigenasa 1 , Células Endoteliales de la Vena Umbilical Humana/efectos de los fármacos , Humanos , Morfolinas/farmacología , Inhibidores de las Quinasa Fosfoinosítidos-3 , Proteínas Proto-Oncogénicas c-akt/metabolismo , Transducción de SeñalRESUMEN
Objective: To examine the impact of caring for COVID-19 patients on the professional identity of nurses. Methods: An online survey was conducted between 19 May and 7 August 2020 in 11 Chinese cities, including Dongguan, Foshan, Guangzhou, Hong Kong, Huizhou, Jiangmen, Macao, Shenzhen, Zhaoqing, Zhongshan, and Zhuhai. Propensity score matching was used to adjust for confounding variables between nurses with and without experience caring for COVID-19 patients. To analyze the impact of caring for COVID-19 patients on nurses' professional identity, a nominal logistic regression model was used rather than an ordinal regression model because the parallel regression assumption was violated. Results: After propensity score matching, the final sample contained 1,268 participants, including 634 nurses who cared for COVID-19 patients. During the COVID-19 outbreak, 88.6% of nurses had high levels of professional identity. Nurses who cared for COVID-19 patients had the lowest percentage of high score level on the professional identity subscale for "sense of organizational influence," as did nurses who did not care for COVID-19 patients. The findings indicated that nurses who cared for COVID-19 patients were 17.95 times more likely to have a high professional identity than a low professional identity (95% CI 2.38-135.39, p = 0.005), after completely controlling for the other factors. There were significant differences between nurses who cared for COVID-19 patients and those who did not in scores on the subscales of professional identity, except for the subscales "sense of self-decision-making" (χ2 = 4.85, p = 0.089) and "sense of organizational influence" (χ2 = 4.71, p = 0.095). Conclusion: Nurses' professional identity is positively impacted by their experience caring for COVID-19 patients. Caring for COVID-19 patients should be highlighted as an opportunity to enhance nurses' professional identity. To further enhance the professional identity of nurses, we call for visible nursing leadership during the COVID-19 pandemic and improve their working environment.
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COVID-19 , Humanos , Estudios Transversales , Pandemias , Puntaje de Propensión , Encuestas y CuestionariosRESUMEN
hESCs (human embryonic stem cells) can differentiate into tissue derivatives of all three germ layers in vitro and mimic the development of the embryo in vivo. In this study, we have investigated the potential of an hESC-based assay for the detection of toxicity to cardiac differentiation in embryonic development. First of all, we developed the protocol of cardiac induction from hESCs according to our previous work and distinguished cardiac precursor cells and late mature cardiomyocytes from differentiated cells, demonstrated by the Q-PCR (quantitative real-time PCR), immunocytochemistry and flow cytometry analysis. In order to test whether CPA (cyclophosphamide) induces developmental and cellular toxicity in the human embryo, we exposed the differentiating cells from hESCs to CPA (a well-known proteratogen) at different stages. We have found that a high concentration of CPA could inhibit cardiac differentiation of hESCs. Two separate exposure intervals were used to determine the effects of CPA on cardiac precursor cells and late mature cardiomyocytes respectively. The cardiac precursor cells were sensitive to CPA in non-cytotoxic concentrations for the expression of the cardiac-specific mRNA markers Nkx2.5 (NK2 transcription factor related, locus 5), GATA-4 (GATA binding protein 4 transcription factor) and TNNT2 (troponin T type 2). Non-cytotoxic CPA concentrations did not affect the mRNA markers' expression in late mature cardiomyocytes, indicating that cardiac precursors were more sensitive to CPA than late cardiomyocytes in cardiogenesis. We set up the in vitro developmental toxicity test model so as to reduce the number of test animals and expenses without compromising the safety of consumers and patients. Furthermore, such in vitro methods may be possibly suited to test a large number of chemicals than the classical employed in vivo tests.
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Antineoplásicos Alquilantes/toxicidad , Diferenciación Celular/efectos de los fármacos , Ciclofosfamida/toxicidad , Células Madre Embrionarias/efectos de los fármacos , Miocitos Cardíacos/efectos de los fármacos , Biomarcadores/metabolismo , Células Madre Embrionarias/citología , Células Madre Embrionarias/metabolismo , Humanos , Miocitos Cardíacos/citología , Miocitos Cardíacos/metabolismo , ARN Mensajero/metabolismo , Reacción en Cadena en Tiempo Real de la Polimerasa , Pruebas de ToxicidadRESUMEN
AIM: Ghrelin is involved in regulating the differentiation of mesoderm-derived precursor cells. The aim of this study was to investigate whether ghrelin modulated the differentiation of human embryonic stem (hES) cells into cardiomyocytes and, if so, whether the effect was mediated by growth hormone secretagogue receptor 1α (GHS-R1α). METHODS: Cardiomyocyte differentiation from hES cells was performed according to an embryoid body (EB)-based protocol. The cumulative percentage of beating EBs was calculated. The expression of cardiac-specific markers including cardiac troponin I (cTnI) and α-myosin heavy chain (α-MHC) was detected using RT-PCR, real-time PCR and Western blot. The dispersed beating EBs were examined using immunofluorescent staining. RESULTS: The percentage of beating EBs and the expression of cTnI were significantly increased after ghrelin (0.1 and 1 nmol/L) added into the differentiation medium. From 6 to 18 d of differentiation, the increased expression of cTnI and α-MHC by ghrelin (1 nmol/L) was time-dependent, and in line with the alteration of the percentages of beating EBs. Furthermore, the dispersed beating EBs were double-positively immunostained with antibodies against cTnI and α-actinin. However, blockage of GHS-R1α with its specific antagonist D-[lys(3)]-GHRP-6 (1 µmol/L) did not alter the effects of ghrelin on cardiomyocyte differentiation. CONCLUSION: Our data show that ghrelin enhances the generation of cardiomyocytes from hES cells, which is not mediated via GHS-R1α.
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Células Madre Embrionarias/citología , Ghrelina/metabolismo , Miocitos Cardíacos/citología , Receptores de Ghrelina/metabolismo , Diferenciación Celular , Línea Celular , Células Madre Embrionarias/metabolismo , Humanos , Miocitos Cardíacos/metabolismoRESUMEN
Heme oxygenase-1 (HO-1), an inducible enzyme, degrades heme to carbon monoxide (CO), iron, and bilirubin. We have investigated the relationship among HO-1 protein expression, HO activity, and CO concentrations in the hippocampus of CO-exposed rats. Western blotting and immunohistochemistry revealed that the enzyme is predominantly localized in hippocampal CA1 and CA3 pyramidal cells and in granule cells of the dentate gyrus. HO enzyme activity was reduced immediately following CO exposure, while expression of HO-1 protein was consistently upregulated in a time-dependent manner. Local CO concentrations in hippocampus rose immediately following exposure, but the elevation was maintained for ~20 h despite the decline in blood carboxyhemoglobin levels toward baseline. We suggest that CO initially inhibits HO enzyme activity, whereas at later time points the inhibition is released and local CO generation is maintained by the activity of the endogenous HO enzyme. And the noninducible form of heme oxygenase, HO-2, was not altered following CO administration. Together these results indicate that the HO/CO pathway in the rat hippocampus is induced by acute CO exposure; local CO production may play a regulatory role in brain injury following CO poisoning.
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Intoxicación por Monóxido de Carbono/sangre , Monóxido de Carbono/metabolismo , Hemo-Oxigenasa 1/metabolismo , Hipocampo/enzimología , Ratas Sprague-Dawley/metabolismo , Animales , Western Blotting , Carboxihemoglobina/análisis , Hemo Oxigenasa (Desciclizante)/genética , Hemo Oxigenasa (Desciclizante)/metabolismo , Hemo-Oxigenasa 1/genética , Hipocampo/metabolismo , Inmunohistoquímica , Modelos Animales , Ratas , Ratas Sprague-Dawley/sangre , Regulación hacia Arriba/efectos de los fármacosRESUMEN
The daily practice of filial piety (FP) is well prescribed under the traditional filial norms in the Chinese community. However, exploration of FP practices at the end of parents' lives is limited. The current study explored the FP representation and good death preferences of Macao Chinese. A cross-sectional web-based survey was conducted and discriminant analysis was used to identify possible predictors of FP representation in the context of parents' end of life. Results showed that Macao Chinese were inclined to perform most of the filial duties in the last journey of their parents. Among 705 participants, 150 (21.3%) tended to practice authoritarian FP, and 555 (78.7%) tended to practice reciprocal FP. Age, education, religion, and good death preferences were identified as predictors of different FP representation groups. The findings could help clinicians to obtain a preliminary perception of FP representation of Chinese patients and to determine the appropriate approach for end-of-life care from a family perspective.
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Hijos Adultos , Relaciones Padres-Hijo , Adulto , Humanos , China , Estudios Transversales , Análisis Discriminante , MacaoRESUMEN
Caring is central to nursing practice. Chinese nurses take care for the health of about 20% of the world's population and their perception of caring is critical. However, until recently, instrument specifically designed to measure the caring of nurses in China was not found. Caring dimensions inventory (CDI) is one of the most frequently used instrument when measuring caring and is applicable to nurses from different cultures. The aim of this study is to test the validity and reliability of the Chinese version of the 25-item CDI. The English version of CDI was translated into Chinese according to the guidelines of the World Health Organization. Content validity was conducted among seven senior nurses from different institutions in different cities in China. A convenience sample of nurses from 11 cities in China was employed. Exploratory factor analysis and confirmatory factor analysis of the CDI was carried out using a sample of 880 nurses. The overall content validity index was 0.98. Three factors (Nurturance, Collaboration, Skill) were identified in exploratory factor analysis and were confirmed by confirmatory factor analysis. The three-factor solution explains 70.15% of the total variance. The Cronbach alpha for overall the CDI was 0.97. This study demonstrated that the Chinese version of the CDI showed satisfactory reliability and validity, indicating that it could be a useful measurement to assess nurses' perception of caring in China.
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Reproducibilidad de los Resultados , China , Análisis Factorial , Humanos , Psicometría , Encuestas y CuestionariosRESUMEN
When facing an infectious disease disaster, nurses' willingness to work is critical. Nurses' lack of willingness to work during a pandemic may worsen the shortage of health care personnel. The purpose of this study is to assess the willingness of nurses to participate in the fight against COVID-19 in China and to identify factors associated therewith. This cross-sectional study examines nurses working in 11 Chinese cities including Macau, Hong Kong, Shenzhen, Dongguan, Huizhou, Guangzhou, Zhaoqing, Foshan, Jiangmen, Zhongshan, and Zhuhai. Questionnaires were collected from 19 May to 7 August 2020. A total of 8065 questionnaires were received, of which 8030 valid questionnaires were included for analysis. A total of 53.4% of participants reported that they had signed up to support the COVID-19 pandemic response. Multivariate logistic regression analysis revealed that being single (OR = 0.72, 95% CI: 0.60-0.87), having no children (OR = 0.81, 95% CI: 0.68-0.97), possessing higher professional qualifications (OR = 1.25, 95% CI: 1.14-1.37), having a more prestigious professional title (OR = 1.68, 95%CI: 1.50-1.90), being an administrative supervisor (OR = 0.53, 95% CI: 0.45-0.63), having a higher caring dimensions inventory score (OR = 1.01, 95% CI: 1.01-1.01), working in a hospital (OR = 0.53, 95% CI: 0.39-0.72), and receiving employer-provided care training (OR = 0.77, 95% CI: 0.68-0.87) were predictive of nurses' willingness to participate in the fight against COVID-19. We suggest that unmarried nurses should be given priority when recruiting to fight an epidemic and, for married nurses with children who are recruited to fight an epidemic, supporting measures should be provided for childcare. We suggest strengthening workplace training of caring for nurses in order to better retain and recruit qualified support for an epidemic outbreak of infectious diseases.
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COVID-19 , Enfermeras y Enfermeros , Niño , China , Estudios Transversales , Hong Kong , Humanos , Macao , Pandemias , SARS-CoV-2 , Encuestas y CuestionariosRESUMEN
While advance directives (ADs) are considered to be part of government's healthcare agenda, there has not been any public consultation for legislation, nor investigation regarding the public's views about ADs in the Chinese culture of Macao. The current study explored the Macao Chinese people's willingness to make ADs. Data were collected from 724 residents aged 18 years and above. Results showed that 533 respondents (73.6%) claimed that they were willing to complete an AD if the document was recognized legally. The experience of caring for relatives or friends with terminal illnesses, palliative care as the preferred end-of-life treatment option, and scoring higher in the Hospice Care Attitude Scale were the predictors of willingness to make ADs. Results of the study suggested that there was a relatively high number of people who would consider setting up ADs. Our study recommends that healthcare professionals should equip themselves to raise ADs-related discussions with patients. Moreover, the Macao Government is responsible for facilitating the introduction and implementation of ADs in order to improve overall end-of-life care quality in Macao.
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Directivas Anticipadas , Cuidados Paliativos , China , Humanos , Macao , PrevalenciaRESUMEN
OBJECTIVE: To explore the relationship between Treg cells level in peripheral blood and prognosis of patients with diffuse large B-cell lymphoma (DLBCL). METHODS: The percentage and absolute value of Treg cells in peripheral blood of DLBCL patients were detected by flow lytometry, and their correlation to prognosis was analyzed by survival analysis. The absolute count of Treg cells was detected by using maximally selected Log-rank statistic, and it was used as cutoff point to distinguish difference survival. The new group of Treg based on cutoff point was combined with age, sex, pathological subtype, risk stratification, treatment plan, and other indicators to include in the single factor survival analysis of Kaplan-Meier. Finally, the COX proportional risk model was used to verify the effect of the above indicators on progression-free survival. RESULTS: The absolute count of Treg cells in DLBCL patients was significantly lower in the disease progressed group than those in the remission group. The cutoff point of absolute value of the Treg cell was 19 cells /µl. The absolute count of Treg cells was an independent prognostic factor of the risk stratification. CONCLUSION: At the beginning of diagnosis, the reduction of the absolute count of Treg cells in peripheral blood of DLBCL patients show a poor prognosis.
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Linfoma de Células B Grandes Difuso , Linfocitos T Reguladores , Humanos , Monocitos , Pronóstico , Modelos de Riesgos Proporcionales , Estudios RetrospectivosRESUMEN
Criminal responsibility is divided into three types: full criminal responsibility, diminished criminal responsibility and criminal irresponsibility in China. In forensic psychiatric expertise, doctors often have different opinions about the responsibility in a given case because of lacking objective criteria. The evaluation of criminal responsibility is always unresolved problem in forensic psychiatric expertise. Application of these evaluation tools in forensic psychiatric expertise were reviewed in this article. The value of the tools were still controversial in the reliability and validity, but it is clear that these tools have the positive roles in ensuring the standardization and the uniformity of the forensic investigation.
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Crimen/psicología , Psiquiatría Forense , Competencia Mental , Trastornos Mentales/psicología , Escalas de Valoración Psiquiátrica , Crimen/legislación & jurisprudencia , Testimonio de Experto/legislación & jurisprudencia , Humanos , Responsabilidad Legal , Responsabilidad SocialRESUMEN
OBJECTIVE: To compare and evaluate the sensitivity, specificity, and prognostic value of various assays for bone marrow involvement in patients with non-Hodgkin's lymphoma (NHL). METHODS: A total of 351 patients with NHL who underwent concurrent bone marrow biopsy in Third Hospital of Peking University from January 2013 to November 2017 were selected. Bone marrow biopsy (BMB), flow cytometry (FCM), gene rearrangement detection, and bone marrow morphology examination were performed for evaluation of bone marrow involvement. Bone marrow biopsy was used as the gold standard, the sensitivity and specificity of FCM, gene rearrangement and bone marrow morphology of bone marrow aspirate were analyzed, and their ROC curves were drawn. In the survival analysis of 77 patients with NHL, the overall survival (OS) time, progression-free survival (PFS) time, and complete remission rate (CRR) were counted. The survival of patients in the FCM positive group, the gene rearrangement positive group, the positive control group (BMB positive group) and the negative control group were compared. RESULTS: The detection rate of flow cytometry and gene rearrangement of bone marrow aspirate both were higher than that of bone marrow biopsy and bone marrow morphological examination, showing better diagnostic efficacy. The sensitivity of the combined method of flow cytometry and gene rearrangement was 82.5%, while the specificity was 90% and the AUC was 0.863. The gene rearrangement detection of bone marrow aspirate possessed the role suggesting the poor prognosis for NHL patients. The 3-year survival rate of patients in the gene rearrangement-positive group (RG group) was lower than that of patients in the no-bone involvement group (All negative group) (Pï¼0.05). Although the survival curve of patient in RG group was not significantly different from that of patients in All negative group (Pï¼0.1), it still showed a poor prognosis for NHL patients. And the significance of predicting death risk was reflected in Cox regression model (Pï¼0.05). There was no statistical difference in the prognosis of patients in the FCM-positive group (FCM group). CONCLUSION: In the bone marrow aspirate tests, flow cytometry and gene rearrangement detection have good diagnostic efficiency, and gene rearrangement can suggest the prognosis of patients. The combined detection efficacy of two methods is better.
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Médula Ósea , Linfoma no Hodgkin , Examen de la Médula Ósea , Citometría de Flujo , Humanos , PronósticoRESUMEN
This study aims to analyze the influence of comprehensive nursing intervention on the postoperative pain, complications, and psychological pressure of otolaryngology patients.A total of 300 otolaryngology patients in our hospital from February 2016 to October 2017 were selected and randomly divided into 2 groups using the random number table: control group (nâ=â150), patients were given routine nursing; experimental group (nâ=â150), patients were given comprehensive nursing intervention. Postoperative pain, complications, and psychological pressure between the 2 groups were analyzed.Residual pain in the experimental group at 3 months after the operation was lower than that in the control group (Pâ<â.05). The postoperative complications in the experimental group was lower than that in the control group (Pâ<â.05). The acute psychological pressure score and the psychological pressure self-test score in the experimental group were both lower than that in the control group (Pâ<â.05).Comprehensive nursing intervention for otolaryngology patients was associated to relieving pain after the operation and psychological pressure of patients in the short and long term. Besides, comprehensive nursing intervention for otolaryngology patients was associated with a lower risk of complications.