Clinical Practice of Multiple Disciplinary Team Care Model Following the Concept of Palliative Care for Advanced Head and Neck Cancer:Report of One Case / 中国医学科学院学报

We provided the palliative care of a multiple disciplinary team care mode to a patient diagnosed with advanced head and neck cancer and her caregivers.People-centered integrated health services were provided according to the specific needs and preferences of individuals.The team-based palliative care relieved the suffering and improved the quality of life of the patient and that of her family who were facing challenges associated with life-threatening illness.

Standard Process for Palliative Sedation in Peking Union Medical College Hospital / 中国医学科学院学报

End-stage patients experience unbearable pain because of refractory symptoms.Palliative sedation is a form of palliative care which relieves patients' agony by lowering their consciousness.Standard palliative sedation can help patients die with dignity.It is distinct from euthanasia and does not alter the survival of patients.Sufficient palliative care is the premise of palliative sedation.Repeated and detailed clinical evaluation,as well as multidisciplinary involvement,is necessary for the standardized implementation of palliative sedation.Here,we proposed the standard process and specifications of palliative sedation in Peking Union Medical College Hospital.Furthermore,we reported a case of palliative sedation for an advanced cancer patient with refractory delirium and living pain to demonstrate its application in clinical practice.

A butterfly shaped Eu4(OH)2 cluster-based luminescent metal-organic framework with Lewis basic triazole sites demonstrating turn off sensing in the presence of organic amines.

The effective detection of organic amines is particularly important for environmental protection and human health. Herein, according to hard and soft acid base theory, a novel three-dimensional (3D) butterfly shaped Eu4(OH)2 cluster-based metal-organic framework with Lewis basic triazole sites, {[Eu4(taip)4(ox)(OH)2(H2O)4]·3H2O}n (1) (H2taip = 5-(1,2,4-triazol-1-yl) isophthalic acid, H2ox = oxalic acid), was successfully synthesized under solvothermal conditions, and was characterized by single crystal X-ray diffraction, powder X-ray diffraction, elemental analysis, infrared spectroscopy and thermogravimetric analysis. Structural analysis reveals that compound 1 is a 3D net constructed from butterfly shaped Eu4(OH)2 clusters and contains isosceles triangular channels with dimensions of 8.84 × 8.84 × 8.63 Å3, which shows an unprecedented 8-connected topology with a Schläfli symbol {36·418·53·6}. Fluorescence experiments of compound 1 show sensitive luminescence quenching responses to organic amines such as diethylamine (DEA), trimethylamine (TMA), triethylamine (TEA), ethylenediamine (EDA) and aniline, and the quenching constants (KSV) decrease in the following order: EDA > DEA > TMA > TEA > aniline. The fluorescence quenching responses may be attributed to the energy gap between the LUMO energy values of H2taip and organic amines, which hinders the transfer of excited state energy to the emission state of Eu3+ and results in luminescence quenching. The fluorescence lifetimes of compound 1 in ethanol and organic anilines indicate that the fluorescence recognition process of organic amines was static.

Four new Cu6S6 cluster-based coordination compounds: synthesis, crystal structures and fluorescence properties.

A hexagonal prismatic Cu6S6 cluster exhibits excellent near-infrared fluorescence properties due to its short Cu-Cu bonds, however, the construction of Cu6S6 cluster-based compounds with extended structures is still a challenge. Here, four new Cu6S6 cluster-based coordination compounds, formulated as Cu3(pymt)3 (1), {(CuCN)2[Cu3(mpymt)3]}n (2), {(CuSCN)[Cu3(mpymt)3]}n (3) and {(CuCN)2[Cu3(dmpymt)3]·CH3CN}n (4) (Hpymt = pyrimidine-2-thiolate, Hmpymt = 4-methyl-pyrimidine-2-thione and Hdmpymt = 4,6-dimethylpyrimidine-2-thione), have been synthesized through the reactions of mercaptopyrimidine derivatives and CuCN or CuSCN under solvo-thermal conditions and characterized by single-crystal X-ray diffraction, powder X-ray diffraction, IR spectroscopy, elemental analysis, and thermal gravimetric analysis. Single-crystal X-ray diffraction analysis reveals that compound 1 is a zero-dimensional Cu6(pymt)6 molecule containing a distorted pseudo-hexagonal prismatic Cu6S6 core. Compounds 2 and 4 with isomorphic frameworks but different organic linkers show a rare three-dimensional framework with nor topology constructed from Cu6(mpymt)6 units and one-dimensional chiral [Cu(CN)]n chains; compared with compound 2, a more hydrophobic one-dimensional channel in compound 4 is observed due to the increase of the methyl groups on the pyrimidine ligand, in which acetonitrile molecules are filled in the channels of compound 4. Compound 3 shows a rare two-dimensional layer constructed from Cu6(mpymt)6 units and one-dimensional puckered (CuSCN)n chains. For the first time, Cu6S6 clusters are connected to one-dimensional inorganic CuCN (or CuSCN) chains through mercaptopyrimidine derivatives to obtain extended arrays in compounds 2-4. The crystals of compounds 1-4 in the solid state all show apparent red light emission. Compound 4 shows sensitive luminescence quenching response to nitrobenzene (NB), and the corresponding quenching constant (Ksv) and detection limit are 2.06 × 103 M-1 and 9.27 ppm, respectively. This study provides a new strategy to construct Cu6S6 cluster-based coordination polymers that have great potential in various applications such as luminescence sensing.

Investigation on inpatient service quality of general hospital based on SERVQUAL model / 中华医院管理杂志

Objective:To investigate the gap between the expectation and actual feeling of inpatients in general hospital, so as to provide reference for improving inpatient service quality.Methods:From October to November 2019, a questionnaire survey was conducted on the inpatient service quality with the revised SERVQUAL scale. The questionnaire included 20 items in 6 dimensions of reliability, assurance, responsiveness, economy, caring and tangibility. According to the gap between the expected service quality and the actual experience, improvement strategies were formulated.Results:Among the 211 inpatients investigated, the expected service quality was consistent with the actual experience in all dimensions. The quality value was ranked from the highest to the lowest as assurance, caring, reliability, responsiveness, tangible and economy. The gap between the expected value and actual value of economy was the largest and the gap between assurance was the smallest. The actual value was lower than the expected value of 20 items, among which the gap in the rationality of hospital diet, drugs and examination fees was the largest.Conclusions:There is a big gap between the expected service quality and the actual feeling of patients in tertiary general hospitals, and corresponding improvement measures should be taken, including moving forward the management port and improving the service quality.

Exploration and Practice of the Whole-course Care Mode from Hospital to Home for an Advanced Malignant Tumor Patient / 中国医学科学院学报

This paper depicted the whole-course care for an advanced cancer patient from hospital to home.In this case,telemedicine was employed to provide guidance on the symptom control,comfort care,psychotherapy,and bereavement counseling.The patient got the holistic care from the whole family and team.The holistic care finally gave a good death of the patient and aided in the recovery of the family members from grief.

TNNT1, a prognostic indicator in colon adenocarcinoma, regulates cell behaviors and mediates EMT process.

Slow skeletal muscle troponin T (TNNT1) has been reported to be correlated with several cancers, but there are no evidences proving that TNNT1 is required in colon adenocarcinoma (COAD). TNNT1 expression in COAD tissues and its prognostic significance were acquired from TCGA database. The proliferative, migratory, and invasive abilities of COAD cells were detected by CCK-8 and transwell assays, respectively. Correlations between TNNT1 and epithelial-mesenchymal transition (EMT)-related markers were determined using western blotting and Pearson's analysis. Our results stated that TNNT1 expression was high-regulated in COAD tissues, which was related with unfavorable prognosis of COAD patients. Functional analyses suggested that TNNT1 promoted the cellular behaviors. Moreover, aberrant expression of TNNT1 affected the expression level of EMT-related proteins. And TNNT1 was negatively linked with E-cadherin. In conclusion, our findings indicated that TNNT1 may promote the progression of COAD, mediating EMT process, and thus shed a novel light on COAD therapeutic treatments.

S­allyl­cysteine sulfoxide (alliin) alleviates myocardial infarction by modulating cardiomyocyte necroptosis and autophagy.

S­allyl­cysteine sulfoxide (alliin) is the main organosulfur component of garlic and its preparations. The present study aimed to examine the protective effect of alliin on cardiac function and the underlying mechanism in a mouse model of myocardial infarction (MI). Notably, alliin treatment preserved heart function, attenuated the area of infarction in the myocardium of mice and reduced lesions in the myocardium, including cardiomyocyte fibrosis and death. Further mechanistic experiments revealed that alliin inhibited necroptosis but promoted autophagy in vitro and in vivo. Cell viability assays showed that alliin dose­dependently reduced the necroptotic index and inhibited the expression of necroptosis­related receptor­interacting protein 1, receptor­interacting protein 3 and tumor necrosis factor receptor­associated factor 2, whereas the levels of Beclin 1 and microtubule­associated protein 1 light chain 3, which are associated with autophagy, exhibited an opposite trend upon treatment with alliin. In addition, the level of peroxisome proliferator­activated receptor γ was increased by alliin. Collectively, these findings demonstrate that alliin has the potential to protect cardiomyocytes from necroptosis following MI and that this protective effect occurs via the enhancement of autophagy.

Three novel Cu6S6 cluster-based coordination compounds: synthesis, framework modulation and the sensing of small molecules and Fe(3+) ions.

Three novel Cu6S6 cluster-based coordination compounds formulated as [Cu(mpymt)3]2 (1), {(CuBr4)[Cu(mpymt)6]}n (2), and {(CuI6)[Cu(mpymt)6]}n (3) (Hmpymt = 4-methylpyrimidine-2-thione), have been synthesized under solvothermal conditions and characterized by elemental analysis, infrared (IR) spectroscopy, thermal gravimetric analysis, powder X-ray diffraction and single-crystal X-ray diffraction. Structural analysis reveals that compound 1 shows a distorted octahedral core of six copper atoms (Cu6S6) constructed from four α and two ß type N[double bond, length as m-dash]C-SH parts from six mpymt(-) anions. Compound 2 displays an interesting 3D framework constructed from Cu6S6 and Cu4Br4 Cu(i) clusters simultaneously, interestingly, six mpymt(-) with α type N[double bond, length as m-dash]C-SH parts are involved in the formation of Cu6S6. Compound 3 displays an infinite 1D framework constructed from Cu6S6 and Cu6I6 Cu(i) clusters, notably, four α and two ß type N[double bond, length as m-dash]C-SH parts are involved in the formation of the Cu6S6 cluster, however, only mpymt(-) ligands containing α type N[double bond, length as m-dash]C-SH parts form the bridged Cu6I6 cluster. The experimental results reveal that halogen ions finely modulate the structural features of compounds 1-3. The fluorescent properties of compounds 1-3 in the solid state and in various solvent emulsions were investigated in detail, the results of which indicate that compounds 1-3 are all highly sensitive naked eye colorimetric sensors for NB, 2-NT and Fe(3+) (NB = nitrobenzene and 2-NT = 2-nitrotoluene).

A novel 3D Cu(I) coordination polymer based on Cu6Br2 and Cu2(CN)2 SBUs: in situ ligand formation and use as a naked-eye colorimetric sensor for NB and 2-NT.

A novel coordination polymer with the chemical formula [Cu4Br(CN)(mtz)2]n (mtz = 5-methyl tetrazole) (), has been synthesized under solvothermal conditions and characterized by elemental analysis, infrared (IR) spectroscopy, thermal gravimetric analysis, powder X-ray diffraction and single-crystal X-ray diffraction. Interestingly, the Cu(i), CN(-) and mtz(-) in compound are all generated from an in situ translation of the original precursors: Cu(2+), acetonitrile and 1-methyl-5-mercapto-1,2,3,4-tetrazole (Hmnt). The in situ ring-to-ring conversion of Hmnt into mtz(-) was found for the first time. Structural analysis reveals that compound is a novel 3D tetrazole-based Cu(i) coordination polymer, containing both metal halide cluster Cu6Br2 and metal pseudohalide cluster Cu2(CN)2 secondary building units (SBUs), which shows an unprecedented (3,6,10)-connected topology. Notably, a pseudo-porphyrin structure with 16-membered rings constructed by four mtz(-) anions and four copper(i) ions was observed in compound . The fluorescence properties of compound were investigated in the solid state and in various solvent emulsions, the results show that compound is a highly sensitive naked-eye colorimetric sensor for NB and 2-NT (NB = nitrobenzene and 2-NT = 2-nitrotoluene).

Effects of ropivacaine infiltration combined with dezocine intravenous on stress response during recovery from general anesthesia in patients undergoing esophageal cancer surgery / 临床麻醉学杂志

Objective To investigate the effects of ropivacaine infiltration combined with dezo-cine intravenous on stress response during recovery from general anesthesia in patients undergoing e-sophageal cancer surgery.Methods One hundred and forty-four patients of esophageal cancer under-going elective surgery were randomly divided into dezocine group (group D,n = 48 ),ropivacaine group (group R,n =47)and ropivacaine combined with dezocine group (group RD,n =49 ).Before slicing 10 min,patients in group D were taken 20 ml saline infiltration anesthesia (1∶200 000 epi-nephrine),while in group R and group RD were taken 20 ml 0.5% ropivacaine infiltration anesthesia. Patients in the group R were injected intravenously 2 ml saline,while in group D and group RD were injected intravenously 10 mg dezocine 30 min before the end of surgery.Peri-operative bleeding,oper-ation time,recovery time of anesthesia,extubation time and the dosage of propofol and sufentanil of three groups were recorded respectively.At the time points of before induction of anesthesia (T0 ), the end of the surgery (T1 ),removal trachea immediate (T2 ),10 min (T3 )and 30 min (T4 ),the blood pressures and heart rates were recorded,and the serum levels of malondialdehyde (MDA),epi-nephrine (E)and norepinephrine (NE)were detected.Results Recovery time of anesthesia and extu-bation time in group R and group RD were shorter than that in group D significantly (P <0.05).The dosage of propofol and sufentanil in group R and group RD were less than that in group D significantly (P <0.05).Compared with T0 ,SBP in three groups were elevated significantly at T1-T4 (P <0.05), DBP and HR in group D and group R increased significantly at T3 (P <0.05).DBP and HR in group RD at T3 were lower than that in group D and group R significantly (P <0.05).Compared with T0 , the levels of blood sugar,Cor,MDA,E and NE in three groups were elevated significantly at T1-T4 (P <0.05).The levels of blood sugar,Cor,MDA,E and NE in group RD at T1-T4 were lower than that in group D and group R significantly(P < 0.05 ).The incidences of agitation and elevation of blood pressure in group RD were lower than that in group D and group R significantly (P <0.05 ). Conclusion Ropivacaine infiltration combined with dezocine intravenous applied in the esophageal cancer surgery could effectively reduce the stress response during recovery from anesthesia,and de-crease the incidence of agitation.

Dual-index evaluation of character changes in Panax ginseng C. A. Mey stored in different conditions.

Panax ginseng C. A. Mey has been used as a traditional medicine and functional food in Asia for thousands of years for its improvement of human immunity and metabolism and its antitumor and antifatigue activities. This study reports the impact of storage conditions and storage period on the quality of P. ginseng. The contents of four major ginsenosides in P. ginseng and phosphorylation activities of Akt of ginseng extracts were affected by both storage conditions and storage period. In contrast, the ATP generation capacity of ginseng extracts was affected by storage conditions, but not by storage period. The results showed that the quality of P. ginseng could be well maintained at a relative humidity between 70% and 90%, and dry conditions might decrease the quality of P. ginseng. Through dual-index evaluation, the present study extended our knowledge on the changes of ginsenosides and bioactivities in P. ginseng with respect to different storage conditions and storage periods.

Immunomodulatory effects of crude phenylethanoid glycosides from Ligustrum purpurascens.

ETHNOPHARMACOLOGICAL RELEVANCE: Ligustrum purpurascens, named as "Ku ding cha", has been used as a kind of functional tea in southern China for about two thousand years, which has the effects on diuresis, anti-hypertension, weight-loss and anti-inflammation. THE AIM OF THE STUDY: This study was aimed to investigate the immune enhancement effects of the crude phenylethanoid glycosides (CPGs) from Ligustrum. Purpurascens on mice and analyze the chemical profiles of phenylethanoid glycosides in the CPGs. MATERIALS AND METHODS: The immune functions enhancing potential of CPGs was determined using serum hemolysin antibody, phagocytosis, splenocyte antibody production, and NK cells activity assays. The contents of five major constituents in the crude glycosides of Ligustrum purpurascens were determined by using liquid chromatography, other five glycosides were deduced according to their UV and MS spectra compared with the literature as well. RESULTS: In the immunizing experiment, mice treated with different doses of CPGs showed an increase (p<0.01) in the haemagglutination titre compared with the control group. The increases (p<0.05) were found to be significant at doses of 440 mg/kg and 1.32 g/kg in the experiments of antibody production of spleen cells, MΦ phagocytosis of chicken RBCs and NK cell activity. Further chemical characterization yielded 10 constituents from CPGs, five glycosides were quantified by HPLC and the structures of other five compounds were speculated according to their UV and MS spectra. CONCLUSION: The results suggested that phenylethanoid glycosides from Ligustrum purpurascens have immunomodulatory effects on mice.

(µ-5-Carb-oxy-1H-imidazole-4-carboxyl-ato-κN,O:N,O)bis-[amminesilver(I)].

In the title compound, [Ag(2)(C(5)H(2)N(2)O(4))(NH(3))(2)], each of the two Ag(I) atoms is coordinated by two N atoms from an ammonia mol-ecule and a 5-carb-oxy-1H-imidazole-4-carboxyl-ate ligand in an almost linear geometry, and by one carboxyl-ate O atom with a weak inter-action. The Ag atoms are assembled into a linear tetra-mer through Ag⋯Ag inter-actions. Each Ag tetra-mer is linked by four 5-carb-oxy-1H-imidazole-4-carboxyl-ate ligands, forming a puckered chain. The complex involves a strong intra-molecular O-H⋯O hydrogen bond.

4-Hydr-oxy-6-[(4-hydr-oxy-1-oxo-1,2-dihydro-phthalazin-6-yl)carbon-yl]phthalazin-1(2H)-one.

In the crystal structure of the title compound, C(17)H(10)N(4)O(5), the mol-ecules lie on twofold axes (through the ketone bridge C and O atoms). The dihedral angle between the two phthalazine rings is 52.25 (1)°. In the crystal, inter-molecular N-H⋯O and O-H⋯O inter-actions link the mol-ecules.

5,5'-Di-4-pyridyl-2,2'-(p-phenyl-ene)di-1,3,4-oxadiazole.

In the crystal structure of the title compound, C(20)H(12)N(6)O(2), the mol-ecules are located on centres of inversion. The complete mol-ecule is almost planar, with a maximum deviation from the mean plane of 0.0657 (1) Šfor the O atom. In the crystal, mol-ecules are stacked into columns elongated in the a axis direction. The centroid-centroid distances between the aromatic rings of the mol-ecules within the columns are 3.6406 (1) and 3.6287 (2) Å. Mol-ecules are additionally connected via weak inter-molecular C-H⋯N hydrogen bonding.