Case and Analysis of Narrative Palliative Care Consultation: the Third Written Talks Outcome of the "10 Years of Palliative Care" / 中国医学伦理学

The research team focused on the deep integration of palliative care and narrative medicine. This paper defined the concept of "pain point", that is medical personnel encounter psychological confusion, vague goals and helpless in the biomedical practice. Based on the definition concept, the paper discussed the clinical practice of narrative medicine by relieving the "pain point" as the "code" of clinical operation, and combining with the case of palliative care consultation. The case in the paper were presented in the form of doctor’s oral text together with explanation and analysis, and then put forward the clinical practice steps of narrative medicine, such as identifying the suffering, establishing relationship and relieving "pain point" with narrative competence, so as to take palliative care field as an example to provide reference for the practice of narrative medicine in other medical fields.

The Compatibility of Narrative Medicine and Palliative Care: the Second Written Talks Outcome of the "10 Years of Palliative Care" / 中国医学伦理学

Narrative Medicine to achieve high-quality development on the basis of systematic education effectiveness, it also needs to promote the implementation of clinical diagnosis and treatment practice. Based on the review and analysis of the clinical practice of narrative medicine, the research team will continue to deepen the integration of narrative medicine and palliative care practice, and then demonstrate the compatibility of the two disciplines, to provide thoughts for the clinical diagnosis and treatment practice research of narrative medicine; pay attention to excavate and sort out the existing local clinical practice experience of narrative medicine, and feed back to medical education and practice. This paper demonstrated the compatibility of narrative medicine and palliative care, including the unique value of narrative medicine in the realization of palliative care, the theoretical basis and logic of narrative medicine education, the tools and paths of implementing narrative palliative care, the compatibility of the two subjects in the applicable fields, and the compatibility of the value levels of the two disciplines.

The Compatibility Intersection of Narrative Medicine and Palliative Care: the First Written Talks Outcome of the "10 Years of Palliative Care" / 中国医学伦理学

Based on the teaching and clinical practice in the field of palliative care in Peking Union Medical College Hospital, combined with the educational practice in Narrative Medicine, this paper presented the preliminary findings of continuous and in-depth interdisciplinary dialogue between palliative care, anthropology and narrative medicine. Specifically, medical education was placed at the core in the context of the development of the palliative medicine field; teaching was closely integrated with clinical practice and it was expected to realize the transformation of clinical practice; the application of narrative medical records indicated the unique value of narrative in palliative care practice, and the possible path of mutual interpretation between narrative medicine and palliative care.

Mainland China Should Vigorously Develop Hospice and Palliative Care: Experience of Peking Union Medical College Hospital / 中国医学伦理学

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.

The current situation for acceptance of palliative care in mainland China / 中华老年医学杂志

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.

Roles of MAPK/ERK signaling pathway in the growth inhibition of an established A431 xenograft tumor in nude mice by resveratrol / 中华皮肤科杂志

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.

Changes of exercise and the clinical effects among eldly non-small cell lung cancer survivors / 中国肺癌杂志

<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>

Multivariate analysis for the factors affecting recurrence of aggressive fibromatosis / 基础医学与临床

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.