ABSTRACT
Objective:To explore the meaning of life in patients with advanced lung cancer.Methods:A total of 21 patients with advanced lung cancer who were hospitalized in the Pulmonary Hospital Affiliated to Shanghai Tongji University from April 2018 to July 2018 were selected for in-depth interviews using qualitative research method, and the collected data were analyzed with the Colaizzi 7-step Colaizzi method.Results:Three dimensions, seven themes were extracted. The core of the meaning of life was "self-iteration", which included the two themes of self-recognition and cherishing life; the existence form of the meaning of life was "you-wei", which included the two themes of self-reliance and altruismin; the meaning of life was embodied in three levels: life -reviewing, including gratitude, stigma and avoidance; cherishing the present, including using the support system, active response, independence and integrity; confronting the future, including accompanying relatives, preparing for death, living with high quality of life.Conclusions:Medical care providers and family members can provide targeted professional guidance and psychological support according to the characteristics of patients to help them discover the meaning of life, thereby enhancing their sense of meaning of life, improving the quality of life, and achieving a good end.
ABSTRACT
Objective To investigate the relationship between serum adipocyte fatty acid binding protein (FABP4),insulin resistance and maternal complications in patients with gestational diabetes mellitus (GDM) with satisfactory glucose control.Methods 60 cases of pregnancy between 24 and 28 weeks of OGTT diagnosed GDM pregnant women were selected.30 cases with satisfactory blood sugar control were selected as satisfactory blood sugar control group,30 cases with unsatisfied blood sugar control were selected as unsatisfied blood glucose control group.Healthy control group was selected from 24 to 28 weeks of healthy pregnancy in 30 patients.Fasting serum FABP4,fasting blood glucose(FPG) and fasting insulin(FINS) were measured in three groups of pregnant women after 24 to 28 weeks and pregnant term.To calculate the insulin resistance index (HOMA-IR) of the steady state model,and record and observe the complications of the three groups.Results In the satisfactory blood glucose control group,the incidence rates of pregnant hypertensive disorders,excessive amniotic fluid,premature rupture of membranes,postpartum hemorrhage,cesarean section,macrosomia,neonatal asphyxia,neonatal hypoglycemia,hyperbilirubinemia of newborn were 10.0％,6.7％,13.3％,6.7％,23.3％,16.7％,10.0％,16.7％,10.0％,which were significantly lower than those in the unsatisfied blood glucose control group (23.3％,20.0％,23.3％,16.7％,33.3％,33.3％,20.0％,30.0％,36.7％),the two groups had significant differences(x2 =4.33,6.12,6.01,3.97,7.41,5.46,10.02,4.79,9.22,all P ＜ 0.05).The incidence rates of pregnant hypertensive disorders,excessive amniotic fluid,macrosomia between the satisfactory blood glucose control group (10.0％,6.7％,16.7％) and healthy control group(3.3％,0.0％,6.7％) had statistically significant differences (x2 =7.45,8.46,4.69,all P ＜ 0.05).The incidence rates of postpartum hemorrhage,premature rupture of membranes,cesarean section,neonatal asphyxia,neonatal hypoglycemia,neonatal hyperbilirubinemia between the satisfactory blood glucose control group (6.7％,13.3％,23.3％,10.0％,16.7％,10.0％) and healthy control group(10.0％,10.0％,20.0％,6.7％,13.3％,3.3％) had no statistically significant differences (all P ＞ 0.05).Pregnant 24 ～ 28 weeks,FABP4,FINS,FPG and HOMA-IR of the satisfactory blood glucose control group were (1.78 ± 0.33) ng/mL,(12.35 ± 0.48) mIU/L,(5.51 ± 0.96) rmmol/L,(3.88 ± 0.55),which of the unsatisfied blood glucose control group were (2.36 ± 0.08) ng/mL,(13.92 ± 1.17) mIU/L,(5.46 ±0.74)mmol/L,(3.95 ± 1.17),the differences between the two groups were not statistically significant (all P ＞ 0.05),and compared with the healthy control group,the differences were statistically significant(t =15.32,10.36,11.54,7.34,all P ＜ 0.05).After term pregnancy,the FINS,HOMA-IR of the satisfactory blood glucose control group were still higher than those in the healthy control group,the differences were statistically significant(all P ＜ 0.05).However,FABP4,FPG between the satisfactory blood glucose control group and healthy control group had no statistically significant differences (all P ＞ 0.05).Conclusion With the control of blood glucose levels,decreased in patients with GDM FABP4,fasting blood glucose,glycosylated hemoglobin level,but high insulin resistance still persists and glycemic control satisfaction does not completely reduced the occurrence of the complications in both mothers and neonates.