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In mainland China, the concept of curative treatment is dominant, and the quality of death needs to be improved. It is urgent to promote and practice the concept of palliative care. This concept can not only improve the quality of death, but also achieve the goal of win-win for doctors, patients, government and society. This paper shared some experience based on the analysis of the understanding, practice and promotion of palliative care concept in Peking Union Medical College Hospital. Regarding the connotation of death, quality of death and good death, the medical and nursing team had the obligation to introduce them actively. Faced the topic of death, it is necessary to learn the corresponding communication methods. Meanwhile, it is necessary to have the concept of "total pain", with the perspective of " holistic care", thus we can take care of the dying patients from physical, social, psychological and spiritual aspect.
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Objective To summarize studies about palliative care (PC) in mainland China and to provide a guidance for propagandizing the concept of palliative care and to carry out related investigations.Methods Key words of Shu Huan Yi Xue,Gu Xi Zhi Liao,An Ning Liao Hu,Ling Zhong Guan Huai,Shu Huan Yi Liao,together with conception,acceptance were used in CBM.And palliative care AND China AND(acceptance OR acknowledgement OR concept OR conception) were used in PubMed.Above searches were for articles,without any other limitations such as publishing date,author,journal,type or language.Eligible articles investigating acceptance of palliative care in mainland China were screened out with artificial work.Descriptive analysis was adopted as a statistic method.Results A total of 35 articles related with palliative care were picked out.Most of the investigation methods were questionnaire.The palliative care-accepting degrees were 25.3 ％ to 86.6％ in overall,25.3％ ～70.8％ in the elderly,30.8％ ～ 56.2％ in advanced stage of cancers,61.7％ ～ 68.4％ in families of patients,and 56.6％～95.8％ in health care workers.In the subgroup analysis,the acceptance showed no difference between genders.But age,followed by careers,degrees of medical education and religions and nationalities were all effective factors for the acceptance of palliative care,which was mostly agreed in all the articles.Conclusions People in mainland China are insufficient very much in the perception of palliative care idea.More publicity and education are needed to popularize the palliative care idea.More studies with better design and more rigorous protocol are needed to have a better understanding of the acceptance of palliative care.
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Objective To evaluate the effect of resveratrol on the growth of an established A431 xenogratt tumor in nude mice.Methods The model of human skin squamous cell carcinoma was established by inoculating A431 cells in log-phase growth into the left axillary fossa of Balb/c (nu/nu) nude mice.After 7-8 days,60 mice bearing human A431 skin squamous cell carcinoma xenografts were randomly and equally divided into 6 groups:blank control group receiving no treatment,negative control group treated with intraperitoneal sodium chloride physiological solution,positive control group treated with intraperitoneal cyclophosphamide,high-,medium-and low-dose resveratrol groups treated with intraperitoneal resveratrol of 40,20 and 10 μg per gram body weight per day,respectively.Tumor size was measured at a 4-day interval during the treatment course.After 14-day treatment,the mice were sacrificed.Xenograft tumors were removed from these mice and subjected to weight measurement,pathological examination by hematoxylin and eosin (HE) staining and apoptosis detection by terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling (TUNEL).Western blot was conducted to quantify the protein expression of apoptosis-related factors,including phosphorylated extracellular signal-regulated protein kinase (p-ERK),p53 and caspase 3.Data were processed by SPSS 13.0 software,and statistical analysis was carried out by analysis of variance and Pearson correlation analysis.Results By the end of treatment,the xenograft tumor volume was (1153.56 ± 255.41) mm3,(1001.69 ± 115.08) mm3,(1206.80 ± 175.88) mm3,(1342.28 ± 211.12) mm3,(1642.34 ± 225.85) mm3 and (1564.32 ± 156.49) mm3,and the weight was (1.84 ±0.30) g,(1.72 ± 0.39) g,(1.96 ± 0.40) g,(2.67 ± 0.73) g,(3.16 ± 0.52) g,and (3.33 ± 0.59) g,respectively in the positive control group,high-,medium-and low-dose resveratrol group,negative control group and blank control group.Significant differences were observed in the xenograft tumor volume (F =16.00,P ＜ 0.05) and weight (F =19.15,P ＜ 0.05) among the 6 groups.According to the tumor weight,the growth of tumor was inhibited by 45.57％,37.97％ and 15.51％ respectively in the high-,medium-and low-dose resveratrol groups.Increased apoptotic index was observed in the positive control group,high-,medium-and low-dose resveratrol groups compared with the negative control group and blank control group (36.79 ± 8.86,33.15 ± 6.00,18.09 ±3.92 and 10.53 ± 4.20 vs.3.87 ± 1.63 and 2.73 ± 1.61,F =93.26,P ＜ 0.05).Analysis of variance showed that the protein expressions of p-ERK,p53 and caspase 3 were all higher in the three resveratrol groups than in the negative control group and blank control group (F =6.65,6.78,11.56,respectively,all P ＜ 0.05).The protein expression of p53 was statistically correlated with p-ERK (r =0.68,P ＜ 0.05) and caspase 3 (r =0.56,P ＜0.05).Conclusions Resveratrol shows an inhibitory effect on the growth of human A431 skin squamous cell carcinoma xenografts in nude mice,likely by increasing p53 expression and inducing tumor cell apoptosis via the activation of MAPK/ERK pathway.
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<p><b>BACKGROUND AND OBJECTIVE</b>Exercise can improve circulation, muscular strength and happiness of cancer survivors. But more data were needed to demonstrate both the exercise ability of cancer suivivors after pulmonary lobectomy and the influences of exercise on their survivals. The aim of this study was to examine changes of exercise and its clinical effects among eldly non-small cell lung cancer survivors.</p><p><b>METHODS</b>Elderly non-small cell lung cancer survivors who had progression-free disease after surgery, chemotherapy, radiation therapy or tyrosine kinase inhibitors were included. Their exercises and participation rates per week before cancer diagnosis, after 3 months anticancer therapy and 1 year after diagnosis as well as their exercise motivations and prevalences were investigated retrospectively.</p><p><b>RESULTS</b>Forty-eight elderly non-small cell lung cancer survivors were selected. Moderate-vigorous intensity exercise had by the elderly progressin-free non-small cell lung cancer survivors after diagnosis decreased, but the participation rate of light intensity exercise was higher in 1 year after diagnosis than before diagnosis. 75.9% (14/58) patients had exercise up to the standard and the cancer recurrence rate was 20.0% (7/35). The recurrence rate of the other group was 35.7% (5/14), and the risk ratio of recurrence was 2.14 (95% CI: 0.81-5.68, P = 0.26). The most common motivations of exercise were improving health, increasing physical activity, maintaining healthy life style and improving immunity. And the main disturbances were fatigue, discomfort and lack of motivation.</p><p><b>CONCLUSION</b>The exercise participation rate during anticancer treatment among the elderly non-small cell lung cancer survivors decreased and did not return to prediagnosis levels after treatments were completed. The relationship between exercise and recurrence of cancer was not clear and needed further work.</p>
Subject(s)
Aged , Aged, 80 and over , Female , Humans , Male , Carcinoma, Non-Small-Cell Lung , Pathology , Motor Activity , Physiology , Retrospective Studies , SurvivorsABSTRACT
Objective To study the factors influencing the recurrence of aggressive fibromatosis(AF) patients.Methods Analyze clinical features and find out factors affecting AF recurrence with univariate and multivariate analysis. Results One hundred and three AF patients were analyzed. Diameter of all the masses was (7.84?5.62)cm. 98.2% of all patients received surgery and radical resection rate is 79.4%. First recurrent time after surgery of male and female is (1563?377) and (2117?3704) days for male and female cases respectively,it's (2723?461),(657?262),(2090?499),(812?220) and (721?234) days for that of abdomen wall、head and neck(H & N),deep mass,joints and chest wall. Recurrent time is (2232?271) and (1347?267) days for those with or without surgery history patients. Univariate analysis showed that gender,tumor site and surgery history of tumor site are prognostic factors of tumor recurrence. Multivariate analysis suggest that only surgery history of tumor site is an independant prognostic factors of AF recurrence after surgery. Conclusion Gender,tumor location and surgery history of tumor site can be valuable to predict postsurgery recurrence of AF.