Pain management for cancer patients in hospice wards of community health centers / 中华全科医师杂志

Objective:To investigate the status quo of pain management for cancer patients in hospice care wards of community health service centers.Methods:The electronic medical records of 373 cancer patients admitted in hospice wards of Kangjian Community Health Center of Xuhui District and Jinshanwei Town Community Health Center of Jinshan District from January 2015 to July 2021 were collected. The characteristics of cancer pain, the use of analgesic drugs, the effects of analgesic drugs and its influencing factors were analyzed.Results:The incidence of cancer pain in 373 patients was 93.0% (347/373), and the proportion of moderate to severe cancer pain was 55.6% (193/347). Analgesics were used in 304 patients, among whom 233 (76.6%) patients used oral analgesics, 297 (97.7%) used on time, 97.6%(285/292) used sustained-release opioids, and 94 (30.9%) used combinedly. Breakout pain occurred in 100 cases (32.9%), all of which was controlled with immediate-release morphine. Cancer pain was not relieved in 132 cases (43.42%), and multivariate logistic regression analysis showed that the pain degree on admission (moderate: OR=3.69, 95 %CI:2.09-6.49; severe: OR=5.52, 95 %CI:2.43-12.53), the presence of burst pain ( OR=3.28, 95 %CI:1.77-6.06), the type of analgesics used (non-steroidal+weak opioids: OR=0.39, 95 %CI:0.20-0.76; nonsteroidal+strong opioids: OR=0.20, 95 %CI:0.08-0.51) and the adverse reactions ( OR=1.92, 95 %CI:1.03-3.60) were the influencing factors of pain relief in cancer pain patients (all P<0.05). Conclusion:The pain of cancer patients admitted to community palliative care wards cannot be ignored. Although most cancer pain patients use analgesic drugs in a standard way, there are still a high proportion of patients whose pain is not controlled. Various factors affect the effect of analgesic treatment.

Long non-coding RNA LINC00339 facilitates the tumorigenesis of non-small cell lung cancer by sponging miR-145 through targeting FOXM1.

Non-small cell lung cancer (NSCLC) is one of leading causes of cancer-related death worldwide. Long noncoding RNAs (lncRNAs) has been identified to modulate the tumorigenesis of NSCLC. However, the precise molecular mechanism of lncRNAs in the course is still unclear. Results showed that LINC00339 was significantly up-regulated in NSCLC tissue and cells, which indicated the poor prognosis of NSCLC patients. Loss-of-function experiments showed that LINC00339 silencing inhibited the proliferation and invasion, accelerated the apoptosis, and suppressed the tumor growth of NSCLC cells in vitro and in vivo. Luciferase reporter assay and RNA immunoprecipitation (RIP) revealed that LINC00339 promoted the NSCLC progression via FOXM1 via targeting miR-145. In conclusion, our results identify the important role of the LINC00339/miR-145/FOXM1 axis in the NSCLC tumorigenesis, providing neoteric mechanism for the NSCLC tumorigenesis.

Anesthetics inhibit extracellular signal-regulated Kinase1/2 phosphorylation via NMDA receptor, phospholipase C and protein kinase C in mouse hippocampal slices.

BACKGROUND: Extracellular signal-regulated kinase 1/2 (ERK1/2) has been implicated in learning and memory; however, whether intravenous anesthetics modulate ERK1/2 remains unknown. The aim of this study was to examine the effect of several intravenous anesthetics on the phosphorylation of ERK1/2 in the hippocampus of adult mice. METHODS: Western blotting was used to examine cellular levels of phosphorylated and unphosphorylated ERK1/2 in mouse hippocampus slices, which were incubated with or without anesthetics including propofol, etomidate, ketamine and midazolam, a protein kinase C (PKC) activator or inhibitor, or phospholipase C (PLC) activator or inhibitor. RESULTS: Propofol, etomidate, ketamine and midazolam reduced phosphorylation of ERK1/2 in a time-dependent manner. Washing out propofol after 5 min increased ERK1/2 phosphorylation. The anesthetic-induced depression of ERK1/2 phosphorylation was blocked by 0.1 µM phorbol-12-myristate 13-acetate (an activator of PKC), 50 µM U73122 (an inhibitor of PLC). The anesthetic-induced depression of ERK1 phosphorylation was blocked by 1 mMN-methyl-d-aspartate (NMDA). Whereas 100 µM chelerythrine (an inhibitor of PKC) and 100 µM carbachol (an activator of PLC) and 20 µM PD-98059 (an inhibitor of MEK) had additive effects on propofol-induced inhibition of ERK1/2 phosphorylation. In contrast, 10 µM MK801 (a NMDA receptor antagonist) did not block anesthetic-induced inhibition of ERK1/2 phosphorylation. CONCLUSION: Intravenous anesthetics markedly decreased phosphorylation of ERK1/2 in mouse hippocampal slices, most likely via the NMDA receptor, and PLC- and PKC-dependent pathways. Thus, ERK1/2 represents a target for anesthetics in the brain.

Explore the clinical value of adrenomedullin on children with acute heart failure treatment and prognosis / 国际检验医学杂志

Objective To e xplore the clinical value of adrenomedullin on children with acute heart failure treatment and progno-sis.Methods Selected 58 cases of AHF children,40 patients with pneumonia,40 cases of children with congenital heart disease and 50 healthy children as the object,radioimmunoassay was taken to detected plasma adrenomedullin and endothelin level,and analysed correlation between AMD,ET-1 and cardiac function.Results Pneumonia complicated with heart failure group,congenital heart disease complicated with heart failure group plasma AMD,ET-1 levels were significantly higher than those in the control group, congenital heart disease group and pneumonia group (P<0.05),congenital heart disease group and pneumonia group of plasma AMD,ET-1 levels were significantly higher than those in the control group (P<0.05).Heart failure stage plasma AMD,ET-1 lev-els were significantly higher than those of early stage and recovery period (P<0.05),heart failure early stage plasma AMD,ET-1 levels were significantly higher than those of early heart failure recovery period (P<0.05).There was a significantly negative cor-relation between with AMD,EF-1 levels and CI,LVEF in AHF children (r= -0.614,-0.793,-0.618,-0.547,P<0.05);AMD mutation rate was significantly higher than that of EF-1 (P<0.05).Conclusion Plasma levels of ADM are closely relate with heart function in AHF children,through the determination of plasma ADM level can assessment treatment and the prognosis of children with AHF,and worthy of clinical application.

Observation and evaluation of the disinfection effect of ventilator circuits by two different methods / 中国实用护理杂志

ObjectiveTo investigate the disinfection effects of two different methods on the ventilator circuits. MethodsThe ventilator circuits which had been used by patients were disinfected by the artificial brushing method and the strict program of the full automatic cleaning-disinfecting machine,respectively.Samples from circuits were cultured after disinfection,and the numbers of bacterium colony forming unit (CFU) were counted. ResultsThe qualified rate of disinfection of the ventilator circuits by the strict program of the full automatic cleaning-disinfecting machine was 100％,which was significantly higher than that by artificial brushing method.50 samples disinfected by artificial brushing method were selected,among which 14 samples had pathogenic bacteria.100 samples disinfected by the strict program of the full automatic cleaning-disinfecting machine were selected and total bacterial count≤5 cfu/cm2. ConclusionsThe sterilization of the ventilator circuits with the full automatic cleaning-disinfecting machine is effective and safe,which can make the disinfection work more standardized.

Early clinical features of severe cases with hand-foot-mouth disease / 中华全科医师杂志

The clinical features of 120 severe cases with hand-foot-mouth disease (HFMD) were retrospectively analyzed compared with those of the regular cases. Clinical data showed that the age of mostsevere cases ranged from 1-3 years. Sustained high fever ( 55% ) , hypertension ( 40% ) , fewer rash (73.3%) were important clinical features. Lethargy, somnolence or restlessness (70. 8% ), vomiting (30. 8% ) were early signs of central nervous system ( CNS) ; and the CNS involvement in severe cases was characterized by body trembling or muscle spasm (80% ). High white cell count(75. 8% ) and high blood glucose levels(32. 5% ) were important makers to diagnose the severe HFMD at early stage. There were significant differences in presentation of above features between severe cases and regular cases of HFMD ( P < 0. 01 or P < 0. 05 ) . Early treatment with mannitol, gamma globulin and glucocorticoids were effective, no death was reported and no side effects were found in this case series.

Clinical analysis with 72 cases of respiratory failure rescued by nasotracheal intubation / 中国基层医药

Objective To investigate the clinical application and significance of nasotracheal intubation (NTI)on patients with respiratory failure.Methods 72 cases of post-operative and non-operative patients with respiratory failure were performed with urgent NTI or blind nasotracheal intubation(BNTI)and then mechanical venfilation.Results In all of the cases NTI were successful.32 cases received direct vision NTI;26 cases were BNTI:9 case8 were NTI through fibrobronchoscope and 5 cases were NTI under awake surface anesthesia.Operation were performed within 20 second to 11 minutes[(5.1±3.1)min].The remaining time of tracheal catheter were 2～21d [(9.3±5.9)d].Conclusion NTI was an important measure in rescuing the patients with respiratory failures.It is an essential rescue technique under the condition without fibrobronchoseope.