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Objective:To construct a palliative care quality evaluation index system in ICU, and to provide guidance for implementing high-quality palliative care in ICU.Methods:The questionnaire was designed by literature review, qualitative interview and questionnaire survey, and 20 experts were inquired in two rounds by Delphi method from September to November 2020.Results:After two rounds of letter consultation, experts′ response rates were 80% and 100% respectively, experts′ authority coefficient was 0.873, and coordination coefficient of experts′ opinion were 0.198 and 0.176 respectively. The quality evaluation index system for palliative care in ICU included 6 first-level indicators, 22 second-level indicators and 95 third-level indicators.Conclution:The constructed evaluation system for palliative care is scientific and reliable,which can provide guidance for the implementation and development of ICU high-quality palliative care in China.
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The organ system-based teaching model integrates the morphology and function of various organ and system of human body, breaks the boundaries of disciplines, and avoids the duplication and disjunction between disciplines. With this model general practitioners can effectively and efficiently learn basic knowledge and clinical skills in the training. This article introduces the organ system-based teaching model and its application in general practice job-transfer training in China.
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Objective To investigate the effects of tumor necrosis factor-related ligand-1A(TL1A)on activation of T helper 9(Th9)cells of colonic tissues in chronic experimental colitis mice.Methods The chronic experimental colitis mice model was established with drinking dextran sulfate sodium salt(DSS).A total of 32 lymphocytes TL1A highly expressed mice and wild type(WT)mice were divided into WT control group, transgene control group,WT modeling group and transgene modeling group.The mice of control groups were administrated with distilled water. The mice of modeling groups received 3% DSS in drinking water discontinuously.The mice were sacrificed on 29 days after modeling.Body mass was measured,length of colon was recorded,scores of gross colon and the disease activity index(DAI)were calculated.The colonic morphological changes were observed by hematoxylin-eosin(H-E)staining.The lamina propria mononuclear cells(LPMC)were isolated and the number of Th9 cells was tested by flow cytometry.The levels of interleukin-9(IL-9)in serum and LPMC were detected by enzyme-linked immunosorbent assay(ELISA).The expressions of IL-9 protein and mRNA of the colonic tissues were measured by Western blotting and real-time polymerase chain reaction(PCR),respectively.T test and single factor analysis of variance were performed for statistical analysis.Results The percentage of body mass loss of WT modeling group was lower than that of transgene modeling group(16.2% ± 1.0% vs 18.9% ± 1.2%),and the difference was statistically significant(t=4.90, P<0.05).The scores of gross colon,DAI and pathology of transgene modeling group were all higher than those of WT modeling group(2.80 ± 0.64 vs 1.60 ± 0.31,2.55 ± 0.20 vs 1.58 ± 0.17,and 11.85 ± 0.86 vs 9.50 ± 0.79),and the differences were statistically significant(t=4.77,10.45 and 5.69,all P<0.05).The number of LPMC in transgene modeling group was higher than that of WT modeling group(3.70×106± 0.28×106vs 2.65×106± 0.32 × 106)and the difference was statistically significant(t= 6.98,P< 0.05).The percentage of Th9 in total CD4+T cells of LPMC in colonic tissues of transgene modeling group was higher than that of WT modeling group(0.54% ± 0.04% vs 0.23% ± 0.03%),and the difference was statistically significant(t= 17.54,P< 0.05).The serum IL-9 level of transgene modeling group was higher than that of WT modeling group((170.23 ± 5.69)pg/mL vs(150.62 ± 6.45)pg/mL),and the difference was statistically significant(t= 6.50,P< 0.05).The level of IL-9 secreted by LMPC of transgene modeling group was higher than that of WT modeling group((265.21 ± 8.76)pg/mL vs (237.58 ± 10.24)pg/mL),and the difference was statistically significant(t= 5.80,P< 0.05).The expressions of IL-9 protein and mRNA of transgene modeling group were higher than those of WT modeling group(1.31 ± 0.09 vs 1.18 ± 0.03,and 8.26 ± 1.13 vs 2.25 ± 0.29,respectively),and the differences were statistically significant(t=3.88 and 14.57,both P< 0.05).Conclusion TL1A high expression in lymphocytes can promote Th9 cells differentiation and IL-9 secretion which involved in the genesis of chronic experimental colitis.
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120 teeth with wedge-shaped defects at subgingival depth of 0 ~2 mm were selected and divided into 3 groups(n =40).Gingival retraction code and EXPASYL gingival retraction paste were used for gingival retraction in the 2 retraction groups,and none retraction was used in the control group.After restoration of the defects,all cases were followed up for 1 year and 2 years.The results were evaluated by modified USPHS criteria.No significant difference was detected for 1 year and 2 year successful rates between the extraction groups(P >0.05).The successful rate in extraction groups was higher than that in the control group(P ＜0.05).
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In this article,stereologic method was applied in analyzing 17 morphological parametera of cell, nucleus and nucleolus in 20 cases of mid stage and late stage of the simple carcinoma of breast (the stylebooks of EM photos were 320). We analyzed the difference of each sort of cell with T test and Q test. Compared with the normal cells, the cancer cells of mid stage were found obviously not only decreased in their nucleus surface density Svn and nucleus contrast surface density Sn but also increased in their nucleus average section An and nucleus average perimeter Bn. Compared with the cancer cells of the mid stage the cancer cell of the late stage were found obviously increased in their nucleus average volume Vn and Bn. Compared with the normal cells, the cancer cells of the late stage were found obviously not only decreased in their Svn and Sn but also increased in their Vn, An, Bn and nucleolus average perimeter Bu.
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Cell morphometry method was applied in courting a nd analyzing 12 ultrastruc-ture morphological parameters of the rough endoplasmic reticulum and ribosome from 10 female patients of the simple breast carcinoma in the late stage by pathological diagnosis． The best equation was set up with stepwise regression analysis was as follows: y=0.22+0.503N6-013N7． Due to above equation, selecting the best parameters were the surface density of free ribosome N6 and specific surface of rough endoplasmic reticulum N7． They could be used to distinguish the normal cell-apparatus from carcinoma cell-apparatus． These results show that N6 and N7 in varying degrees could provide fixed quantity basis for the prognosis of breast carcinoma．