喉癌DNA含量与临床生物学特性及预后的研究

用流式细胞术分析３６例喉鳞癌的ＤＮＡ指数（ＤＩ）和增殖活性，并与正常喉上皮细胞对照，结果表明，喉癌ＤＩ明显异常，非整倍体率高达９１．７％，且有多倍体出现，增殖指数（ＰＩ）是正常细胞的３．４倍，具侵袭指征及病理分级Ⅱ，Ⅲ级的喉癌，ＤＩ，ＰＩ及Ｓ期细胞比例（Ｓ％）呈增加趋势，死亡组ＤＩ，Ｓ％高于存活组（Ｐ〈０．０５）。提示ＤＮＡ定量研究能力预测喉癌生物学特性及判断预后提供依据。     

喉癌与肺结核

为探讨喉癌与肺结核的关系，本文分析了78例喉癌患者的临床资料，发现其中合并肺结核者14例，本组喉癌患者合并肺结核的发生率为17．95％，而同期非喉癌患者肺结核发生率为1．30％，x^2检验结果显示两组肺结核发病率有显著性差异（P〈0．01），14例喉癌合并肺结核患者，有11例行PPD皮内试验，结果均为阴性。表明：喉癌与肺结核并存于机体，细胞免疫功能紊乱是内在联系，肺结核为喉癌发病的危险因素。喉癌与肺结核之关系未见丈献报告。     

喉癌全喉切除术后的发声问题

喉癌的手术治疗已有一百余年历史,1860年即有报告全喉切除治疗喉梅毒,并在1873年开始用于治疗喉癌。全喉切除术治疗喉癌虽然效果良好,但术后不能经喉发声和用鼻呼吸,患者甚感痛苦,为此,有些患者拒绝手术治疗。近30年来,由于对喉的胚胎学、解剖学及喉癌扩散方式的深入研究,发现喉癌早期尚局限于喉的一个解剖区时,很少向其他解剖区扩展。随着喉癌防治知识普及临床确诊的早期病例增多,由于诊断技术与     

喉癌细胞核DNA含量变化的生物学意义

本文应用流式细胞光度分析（Ｆｌｏｗｃｙｔｏｍｅｔｒｙ，ＦＣＭ）仪对已存档多年的石腊包埋标本细胞核内ＤＮＡ含量进行了回顾性分析，其中喉鳞状细胞癌３５例，癌前病变４例，正常喉上皮组织６例。结果表明：随着肿瘤倍体的增高ＤＮＡ指数（ＤＮＡＩｎｄｅｘ，ＤＩ）也随之增高。３５例喉癌中，非整倍体癌占５７．２％，二倍体癌占４２．８％。正常组织、癌前病变、喉癌３组中随着病变的出现及加重，Ｓ＋Ｇ２Ｍ期细胞百分比逐渐增高，ＤＩ值也随之上升。Ｓ期百分比率越高，ＤＩ值越高，恶性度越高，预后差。     

喉癌患者外周血淋巴细胞姐妹染色单体互换频率的检测

对２５例喉鳞状细胞癌患者外周血淋巴细胞姐妹染色单体互换（ＳＣＥ）频率进行检测。结果表明，喉癌患者外周血淋巴细胞ＳＣＥ频率较对照组增高（Ｐ〈０．００１），ＳＣＥ频率不随肿瘤的分期而增加（Ｐ〉０．０５）。结果提示喉癌患者染色体ＤＮＡ受损及其修复能力降低，检测外周血淋巴细胞ＳＣＥ对喉癌的辅助诊断具有临床意义。     

吸烟者喉癌术后分泌物护理的探讨

吸烟与喉癌的发生及预后的相关性有许多报道,而吸烟者喉癌术后护理特点未见报道,作者在多年的临床护理工作中发现吸烟者喉癌术后分泌物明显增多,吸痰刺激反应重[1],鼻饲时因咳嗽使食物反流加重呛咳,终止鼻饲吸痰[2],而这些因素若得不到有效解决,会影响患者的康复或导致并发症的     

乙酰肝素酶表达及其与喉鳞状细胞癌生物学行为关系

目的探讨乙酰肝素酶（HPA）在喉鳞状细胞癌（喉癌）组织表达及其与喉癌临床分期、淋巴结转移和预后的关系。方法采用免疫组化技术检测45例喉癌和癌旁组织组织中HPA的表达。结果HPA在喉癌组织中表达阳性率为53.3%,癌旁组织为13.3%,二者比较差异有显著性（χ2=16.2,P〈0.05）;HPA表达阳性率与喉癌的临床分期、淋巴结转移及5年生存率明显相关（χ2=4.86~5.18,P〈0.05）,与喉癌的组织分化程度无关（χ2=2.13,P〉0.05）。结论HPA在喉癌的侵袭和转移中可能起到重要作用,可作为判断喉癌生物学行为和预后的有用指标。     

64例声门上型喉癌的区域性颈淋巴结清扫术的研究

目的：探讨区域性颈淋巴结清扫术治疗声门上喉癌的作用。方法：64例声门上型喉癌N0病例，根据颈淋巴结引流的特点，进行选择性区域性颈淋巴结清扫术，随访分析5年的临床效果。结果：64例声门上型喉癌N0病例发现24例有颈淋巴结转移，转移率为37．5％，行区域性颈淋巴结清扫术治疗五年生存率为75．5％。结论：声门上型喉癌N0颈部的治疗可采用选择性区域性颈清扫术，治疗效果与传统性全颈清扫相似。同时具有创伤小，手术时间短的优点，具有一定的临床运用价值。     

喉癌手术治疗后复发的相关因素分析

目的:分析喉癌患者术后复发情况,探讨影响其术后复发的临床病理因素。方法:收集2003-2007年在广东省人民医院初诊并接受手术治疗的喉鳞状细胞癌患者的临床和随访资料,应用Kaplan-Meier法分析复发与生存率的关系,通过卡方检验分析影响患者术后复发的因素,并进行Logistic多元回归分析。结果:205例喉癌患者,总复发率为23.4%(48/205),经log-rank检验发现复发的患者生存率显著低于无复发者(χ2=85.95,P<0.001),术后复发时间自术后3～38个月不等,中位复发时间为11个月。单因素分析显示T分期、N分期、临床分期、分型、甲状软骨受侵、手术切缘组间术后复发差异具有统计学意义(P<0.05);Logistic回归多因素分析结果显示,仅外科切缘是喉癌复发的危险因素(P<0.05)。结论:外科手术切缘是影响喉癌患者术后复发的主要临床病理因素,喉癌术后复发时间多发生于术后3年内。因喉癌术后复发显著降低患者生存率,提示了尽可能获得喉癌外科手术切缘阴性以及术后3年密切随访以便尽早处理复发灶的重要性。     

黑色素瘤抗原在喉癌中的表达及临床评价

目的探讨肿瘤相关的黑色素瘤抗原(MAGE-A3)在喉癌中的表达情况,及与癌生物学行为的相关性。方法用间接免疫荧光技术,从蛋白水平观察和比较MAGE-A3在喉癌、癌旁组织中的表达,分析喉癌中MAGE-A3的表达与临床病理参数的关系。结果 (1)MAGE-A3荧光绿色染色表明其主要表达于癌细胞胞质,癌组织染色呈斑状、块状、线状、絮状等,有时其中弥散着强染色的颗粒。而癌旁黏膜内仅见极弱的可疑的荧光染色颗粒。(2)癌旁黏膜中MAGE-A3蛋白表达率为5.56%(2/36)。喉癌中MAGE-A3蛋白表达率为51.92%(27/52)。MAGE-A3在癌组织中的表达与癌旁黏膜相比,差异有统计学意义(P<0.05)。(3)在关于喉癌中MAGE-A3的表达与临床病理参数的关系中,随喉癌T分级、N分级、临床分期的进展,MAGE-A3表达率均增高(P<0.05)。结论 (1)喉癌中MAGE-A3蛋白有较高表达,参与喉癌的发生和发展。(2)喉癌中MAGE-A3的表达受一些临床病理参数的影响。(3)MAGE-A3蛋白表达的差异可以对喉癌的发生、发展、转移作一定的预测,并可为喉癌靶向免疫治疗奠定理论基础。     

Determination of creatine kinase isoenzyme MB activity in serum using immunological inhibition of creatine kinase M subunit activity. Activity kinetics and diagnostic significance in myocardial infarction.

This is a new method for the determination of creatine kinase isoenzyme MB activity in serum. The method uses direct activity measurement of creatine kinase B subunit activity after blocking of CK-M subunit activity by inhibiting antibodies. The test takes no longer than 15 min. The method yields an intra-serial C.V. of 2.0-12.9%, and a C.V. from day to day of 5.5%. The detection limit is 3.4 U/l creatine kinase MB. In the 95 cases with proven myocardial infarction several types of creatine kinase MB activity kinetics could be determined. The percentage of creatine kinase MB of peak CK-total is 6-25%, with a mean of 11.1%. The amount of creatine kinase MB with respect to total CK activity after reinfarction is higher than the amount after initial infarction.     

Molecular characterization of virulence and antimicrobial resistance profile of Shigella species isolated from children with moderate to severe diarrhea in northeastern Brazil

Molecular characterization of virulence and antimicrobial resistance profiles were determined for Shigella species isolated from children with diarrhea in Fortaleza, Brazil. Fecal specimens were collected along with socioeconomic and clinical data from children with moderate to severe diarrhea requiring emergency care. Shigella spp. were isolated by standard microbiological techniques, and we developed 4 multiplex polymerase chain reaction assays to detect 16 virulence-related genes (VRGs). Antimicrobial susceptibility tests were performed using disk diffusion assays. S. flexneri and S. sonnei were the predominant serogroups. S. flexneri was associated with low monthly incomes; more severe disease; higher number of VRGs; and presence of pic, set, and sepA genes. The SepA gene was associated with more intense abdominal pain. S. flexneri was correlated with resistance to ampicillin and chloramphenicol, whereas S. sonnei was associated with resistance to azithromycin. Strains harboring higher numbers of VRGs were associated with resistance to more antimicrobials. We highlight the correlation between presence of S. flexneri and sepA, and increased virulence and suggest a link to socioeconomic change in northeastern Brazil. Additionally, antimicrobial resistance was associated with serogroup specificity in Shigella spp. and increased bacterial VRGs.     

Biofilm-related disease

Introduction: Biofilm formation represents a protected mode of growth that renders bacterial cells less susceptible to antimicrobials and to killing by host immune effector mechanisms and so enables the pathogens to survive in hostile environments and also to disperse and colonize new niches. Biofilm disease includes device-related infections, chronic infections in the absence of a foreign body, and even malfunction of medical devices.

Areas covered: This review puts forward a new medical entity that represents a major public health issue, which we have named ‘biofilm-related disease’. We highlight the characteristics of biofilm disease including its pathogenesis, microbiological features, clinical presentation, and treatment challenges.

Expert commentary: The diversity of biofilm-associated infections is increasing over time and its impact may be underestimated. This peculiar form of development endows associated bacteria with a high tolerance to conventional antimicrobial agents. A small percentage of persister cells developing within the biofilm is known to be highly tolerant to antibiotics and has typically been involved in causing relapse of infections. Knowledge of the pivotal role played by biofilm-growing microorganisms in related infections will provide new treatment dynamics for this biofilm-related disease.     

Ostéochondrites disséquantes rares du genou chez l’enfant. À propos d’un cas tibial et d’ un cas rotulien et revue de la littérature

Osteochondritis dissecans is a rare condition and often involves the medial femoral condyle. We are here reporting two uncommon localizations in children involving the lateral portion of the tibial plateau in one and the patella in the other. They were two fourteen-year-old boys with respectively 4 and 3 months history of a right knee pain and locking. No previous trauma had been noted. X-ray studies and MR images provided definitive diagnosis. However, in the tibial localization, osteochondritis was associated to a damaged lateral discoid menisci and in the patellar localization, the osteochondral fragment was detached in the joint. Regularization of the lateral menisci and removal of a loose body were respectively performed under arthroscopy in the two knees. Literature is reviewed with an emphasis particularly on pathogenesis of these rare localizations.     

Development of new agents for peripheral T-cell lymphoma

Introduction: Peripheral T-cell lymphoma (PTCL) is a relatively rare, heterogeneous group of mature T-cell neoplasms generally associated with poor prognosis, partly because of refractoriness against conventional cytotoxic chemotherapies. To improve the outcome of patients with PTCL, the clinical development of several novel agents is currently under investigation.

Areas covered: Since the first approval of pralatrexate (dihydrofolate reductase inhibitor) by the US Food and Drug Administration, belinostat, romidepsin (histone deacetylase inhibitors), and brentuximab vedotin (anti-CD30 antibody-drug conjugate) have been approved in the US, and many other countries. In addition, mogamulizumab (anti-CC chemokine receptor 4 antibody), chidamide (histone deacetylase inhibitor), and forodesine (purine nucleoside phosphorylase inhibitor) have been approved in Asian countries, including China, and Japan. In this review, we have summarized the available data regarding these approved agents and new agents currently under development for PTCL.

Expert opinion: Novel agents will be a promising therapeutic option in selected patients with relapsed/refractory PTCL and will change the daily clinical practice in the treatment of PTCL. However, these are not a curative option when used as a single agent. Further clinical developments are expected, comprising 1) combination therapies of new agents with cytotoxic chemotherapies; 2) ‘novel-novel’ combinations; 3) immune therapies, including chimeric antigen receptor T-cell therapy; and 4) predictive marker analysis.     

Partizipative Entscheidungsfindung als neuer Qualit?tsindikator in der Nephrologie

Zusammenfassung Hintergrund und Ziel:   Partizipative Entscheidungsfindung (Shared Decision-Making) gewinnt als Modell der Arzt-Patienten-Beziehung auch im deutschen Gesundheitssystem zunehmend an Bedeutung. Insbesondere im Bereich chronischer Erkrankungen erwartet man sich von diesem Konzept mittel- bis langfristige Verbesserungen der Behandlungsergebnisse. Bislang liegen der deutschen Versorgungsforschung jedoch kaum empirische Daten zum Stand und zu den Entwicklungstendenzen der partizipativen Entscheidungsfindung vor. Diese Studie liefert aktuelle Ergebnisse zu dieser Fragestellung aus einer deutschlandweiten Befragung von terminal niereninsuffizienten Patienten. Methodik:   Im Rahmen des Programms Qualität in der Nephrologie (QiN) wurden in einer schriftlichen, deutschlandweiten Erhebung 6 614 Patienten mit terminaler Niereninsuffizienz befragt. Der Fragebogen enthielt ein zuvor übersetztes und validiertes Instrument zur Erfassung der wahrgenommenen Einbeziehung in die Therapie (PICS). Ergebnisse:   82% der Befragten fühlen sich durch ihre Ärzte für eine Beteiligung an Entscheidungen motiviert. 81% der Patienten informieren sich aktiv bei ihren Ärzten über ihre Erkrankung und Behandlungsmöglichkeiten. 69% geben an, dass eine gemeinsame Entscheidungsfindung von Arzt und Patient stattgefunden hat. Das Lebensalter, die Dialysejahre und das Geschlecht stehen im Zusammenhang mit der wahrgenommenen Einbeziehung. Schlussfolgerung:   Dieser Aufsatz bietet eine valide Grundlage für die prospektive Erforschung der partizipativen Entscheidungsfindung in der Behandlung der terminalen Niereninsuffizienz. Die Ergebnisse der vorliegenden Studie deuten auf eine hohe Bereitschaft von Dialysepatienten hin, sich aktiv am Prozess der Entscheidungsfindung zu beteiligen. Spezifische Patientencharakteristika und die Präferenzen der Patienten sollten nicht nur bei der alltäglichen klinischen Interaktion mit den Patienten Berücksichtigung finden. Sie könnten darüber hinaus im Rahmen der Qualitätssicherung systematisch erfasst und als Verbesserungspotential genutzt werden.und ärztliche Leiter der teilnehmenden KfH-Nierenzentrenkooperierende Nierenzentren (4. Quartal 2003): Prof. Dr. W. Pommer (Berlin Nordgraben), Prof. Dr. H.-H. Neumayer, Dr. R. Krause (Berlin Turmstraße), Prof. Dr. E. Scheuermann, Prof. Dr. H. Geiger, V. Belwe (Frankfurt Schleusenweg), Dr. H. Militzer (Hof ), Priv.-Doz. Dr. T. Marsen (Köln Gleueler Straße), Dr. T. Eich, Dr. N. Bröker (Köln Urbacher Weg), Dr. G. Junker, Dr. W. Hoffmann, Dr. A. Fritz (Linnich), Prof. Dr. R. Goerig, Dr. M. Leidig (Nürnberg Kreuzburger Straße), Prof. Dr. J. Braun (Nürnberg Virnsberger Straße), Dr. P. Jatzwauk, Dr. K. Burkhardt (Weißenburg), Dr. G. Janning, Dr. D. Bröckner (Dortmund), Dr. E. Braasch (Eberswalde), Dr. J. Nikolay (Fürth), Dr. D. Dorn (Kassel Mittelstraße), Dr. W. Gerding, Dr. W. Klimkait (Köln Graseggerstraße), M. Fey, Dr. J. Bargfrede (Köln Böckingstraße), Dr. M. Nebel (Köln Ostmerheimer Straße), Dr. M. Holzner-Achenbach, Dr. W. Böttcher (Köln Venloer Straße), Dr. B. Gmelin, Dr. P. Spiegel (Nürnberg Grossweidenmühlstraße), Prof. Dr. J. Zehner, Dr. H. Leitl (Passau), Dr. M. Eichhorn (Regensburg Plato-Wild-Straße), Dr. M. Gottsmann (Traunstein), Dr. A. Weber-Knorr (Trostberg), Dr. K. Lukowski, Dr. G. Meider (Bergisch-Gladbach), Priv.-Doz. Dr. D. Bokemeyer, V. Klüsener, Dr. O. Laue (Bochum Castroper Straße), Dr. C. Striebing (Dessau), Dr. R. Krämer, Dr. D. Bundschuh (Ehingen), Dr. G. Prager, Dr. G. Strack (Erbach), Priv.-Doz. Dr. A. Samizadeh, Dr. G. Weber (Essen Alfried-Krupp-Straße), Dr. T. Siegert (Görlitz), Dr. T. Lazarus, Dr. C. Mrowka (Ingolstadt), Dr. C. Blaser, Dr. U. Grunewald (Lohr), Dr. M. Heydenreich, Dr. G. Hillebrand (Neuried), Dr. C. Kuhlmann-Eilers, S. Abshagen (Oldenburg), Dr. L. Musselmann, Dr. A. Thiele (Rosenheim), Dr. P. Thon (Rotenburg), Dr. D. Bundschuh, Dr. R. Krämer (Ulm Eberhard-Finck-Straße), Dr. R. Krämer, Dr. D. Bundschuh (Ulm Magirusstraße), Prof. Dr. W. Schulz, Famira (Bamberg), Dr. C. Naoum (Berlin Große Hamburger-Straße), Dr. M. Buhl, Dr. L. Preuschhof (Berlin Teltowkanalstraße), Dr. B. Oser, Dr. S. Herrnberger (Bernkastel-Kues), J. Rieger (Bielefeld), Dr. N. Meyer, Dr. K. Anding-Rost (Bischofswerda), Dr. J. Geyer, Prof. Dr. W. Riegel (Darmstadt), Dr. M. Goller (Deggendorf ), Dr. W. Bihlmaier (Donauwörth), Dr. W. Bagnewski (Dülmen), Dr. Ch. Ambrecht, Dr. A. Heinig (Düsseldorf Kronenstrasse), Dr. K. Lange (Ebersberg), Dr. C.C. Haufe (Erfurt), Dr. H. Urzowski, Dr. G. Moser (Finsterwalde), Dr. R. Krallinger (Fürstenzell), Dr. T. Wichelhaus (Gummersbach), Dr. U. Hildebrand, Dr. C. Clemens (Hann.-Münden), Dr. P. Schulz (Haßfurt), Prof. Dr. D. Bach, Dr. E. Frank, Dr. F. Witsch (Krefeld), Priv.-Doz. Dr. H. Achenbach, Dr. L. Windgassen (Leipzig Philipp-Rosenthal-Straße), Dr. D. Soreth-Rieke (Miesbach), Dr. P. Roemisch, Dr. A. Hallwachs (München Isenschmidstraße), Dr. T. Leingärtner, Dr. R. Liebl (Regensburg Günzstraße), Dr. C. Dasch, Dr. M. Ballmann (Saarburg), Dr. B. Schober, A. Schober (Sulzbach-Rosenberg), Dr. V. Schulz (Annweiler), Dr. A.K. Mehlhorn (Aue), Dr. G. Prager, Dr. G. Strack (Bad König), Dr. D. Bleyl, Dr. T. Bleyl (Bautzen), Dr. H. Fischer (Berlin Bismarckstraße), Dr. T. Leimbach (Berlin Erwin-Bock-Straße), Dr.F. Himelsbach(Bingen), Priv.-Doz. Dr. M. Hollenbeck (Bottrop), Prof. Dr. H. Hennemann (Coburg), Dr. U. Bechtel, Dr. H. Lotz (Dillingen), Prof. Dr. P. Gross (Dresden), Dr. H. Spiegelberg (Düsseldorf Zeppenheimer Weg), Dr. R. Hasselbacher, H. Rau (Eisenach), Dr. U. Bunnemann (Erlangen), Priv.-Doz. Dr. R. Schäfers, Priv.-Doz. Dr. A. Kribben (Essen Eleonorastraße), Dr. A. Baus (Frankfurt/Oder), Dr. O. Wildgruber (Freising), Prof. Dr. W. Fassbinder, Dr. S. Graf (Fulda), Dr. F. Diekämper (Greven), Dr. H. Anschütz (Groß-Gerau), Dr. B. Spohn, Dr. H. Winter (Günzburg), Dr. L. Flitsch- Kiefner (Hagen), Prof. Dr. B. Osten, Dr. C. Wand, Dr. R. Fiedler (Halle), Dr. E. Wilbrandt, Dr. M. Schulz (Heringen), Dr. H. Strauss, Dr. B. Rendenbach (Hermeskeil), Dr. F. Himmelsbach (Ingelheim), Dr. A. Klemm, Dr. M. Gerold, Prof. Dr. H. Sperschneider ( Jena), Dr. H.W. Huhn (Kassel Oberzwehrener Straße), J. Kopp, Dr. M. Marx (Kelheim), Prof. Dr. M. Vlaho, Dr. W. Wessely (Kirn ZH zu Bad Kreuznach), Dr. K. Bausewein, Dr. H. Ehrich (Kitzingen), Dr. J. Hafels (Köln Barbarossaplatz), Dr. N. Thaller (Kreuth), Priv.-Doz. Dr. J. Beige, Dipl.-Med. G. Glombig (Leipzig Delitzscher Straße), Dr. M. Sommer (Lichtenfels), Prof. Dr. T. Lenz (Ludwigshafen), Dr. C. Brendel (Müchen Elsenheimer Straße), Dr. B. Zangerl (Münster), Dr. G. Richter, Dr. S. Guwa (Neuwied), Dr. G. Huss, Dr. U. Rothenpieler (Nördlingen), Dr. B. Bautsch (Norderney), Dr. N. Bockreiss (Oberschleißheim), Dr. D. Becker (Oberstaufen), Dr. H. Baudenbacher, Dr. D. Herrmann (Ochsenfurt), Dr. H. Lange (Pfaffenhofen), Dr. A. Baus (Seelow), Prof. Dr. M. Haag-Weber, M. Geyer (Straubing), Dr. R. Strupp (Trier Friedrich-Wilhelm-Straße), Dr. B. Rendenbach (Trier Kutzbachstraße), Dr. B. Gieshoff (Wesel), Dr. W. Haaf (Wismar)     

Intercultural caring-an abductive model

The aim of this study was to increase the understanding of caring from a transcultural perspective and to develop the first outline of a theory. The theoretical perspective includes Eriksson's theory of caritative caring. Texts on caring by the transcultural theorists, including Campinha-Bacote, Kim-Godwin, Leininger and Ray, are analysed using content analysis. The overall theme that resulted from this analysis was that caring is a complex whole. Three main categories of caring emerged: inner caring, outer caring and the goal of caring. Inner caring consists of caring is a relationship, and caring and culture are seen in different dimensions. Outer caring refers to caring affected by educational, administrative and social and other structures. The goal of caring consists of caring leading to change towards health and well-being. The main categories include categories and subcategories that are compared with Eriksson's theory of caritative caring.
A model for intercultural caring is generated abductively. Caring and culture appear in three dimensions: caring as ontology independent of context; caring as a phenomenon emphasised differently in different cultures; caring as nursing care activities is unique. Caring alleviates suffering and leads to health and well-being. This model describes caring from an intercultural perspective as a mutual but asymmetric relationship between the nurse and the patient, including the patient's family and community. The patient's cultural background and acculturation influence caring. The cultural background, cultural competence and organisation of the nurse also influence caring. Caring is seen as a complex whole. This study integrates Campinha-Bacote's, Kim-Godwin's, Leininger's and Ray's views of caring with Eriksson's caritative caring and presents caring from a transcultural perspective in a new way as a model for intercultural caring, which can benefit nursing care, education, research and administration.