Find a way out: bereavement support in Taiwan hospice

Goals of work The aim of the study was to explore one of the possibilities to enhance bereavement care in Taiwan hospice due to insufficient attention and resources. Meanwhile, a theoretical assumption about the relationship between anticipatory grief and postdeath grief was made and examined.Patients and methods Through convenience sampling, 109 most bereaved families of terminally ill cancer patients were included. Data were collected by the Anticipatory Grief Scale (Theut SK et al (1991) Caregivers anticipatory grief in dementia: a pilot study. Int J Aging Hum Dev 32:113–118), Perinatal Grief Scale (Potvin L, Lasker J, Toediter T (1989) Measuring grief: a short version of the Perinatal grief scale. J Psychopathol Behav Assess 11:29–45), and a background information sheet.Main results Anticipatory grief was correlated with postdeath grief significantly but mildly. Age was associated with anticipatory grief, not with postdeath grief. However, relationship and gender did not statistically relate to anticipatory grief and postdeath grief.Conclusions Although anticipatory grief could predict postdeath grief, the result was not encouraging enough. Prevention is still the best way not only for the bereaved in theoretical point of view but also for hospice staff in practical application. However, how to screen out high-risk bereaved family in order to provide help in advance require more effort.     

Systemic inflammatory response after endoluminal stenting of the descending thoracic aorta

The effect of the underlying pathology on postoperative inflammation after stenting of the thoracic aorta has not been described. A retrospective review of patients undergoing thoracic aortic stents was performed. Patients with large degenerative aneurysms developed pyrexia and significantly raised CRP in the first 5 days after the procedure compared with the rest of the cohort. Endoluminal stenting of large degenerative descending thoracic aortic aneurysms is associated with post-implantation systemic inflammatory response.     

2007年成都地区17所医院神经系统药物利用状况分析

目的:了解2007年成都地区17所医院神经系统药物的使用情况,比较神经系统药物使用状况,为临床合理应用提供参考.方法:采用限定日剂量(DDD)的方法,对成都地区2007年17所医院神经系统用药的销售金额、用药频度(DDDs)等进行统计分析;结果:2007年成都地区17所医院神经系统用药总金额为14923.14万元,占所有药物销售总额的9.82%,位居第二.主要包括新一代抗精神失常药、解热镇痛药、麻醉药、中枢神经兴奋药等.且静脉麻醉药物异丙酚销售金额占静脉麻醉药物市场98%.结论:神经系统药物在临床治疗中发挥着越来越重要的作用.     

Expression of nicotinic acetylcholine receptor subunit genes in non-small-cell lung cancer reveals differences between smokers and nonsmokers

Nicotine and its derivatives, by binding to nicotinic acetylcholine receptors (nAChR) on bronchial epithelial cells, can regulate cellular proliferation and apoptosis via activating the Akt pathway. Delineation of nAChR subtypes in non-small-cell lung cancers (NSCLC) may provide information for prevention or therapeutic targeting. Expression of nAChR subunit genes in 66 resected primary NSCLCs, 7 histologically non-involved lung tissues, 13 NSCLC cell lines, and 6 human bronchial epithelial cell lines (HBEC) was analyzed with quantitative PCR and microarray analysis. Five nonmalignant HBECs were exposed to nicotine in vitro to study the variation of nAChR subunit gene expression with nicotine exposure and removal. NSCLCs from nonsmokers showed higher expression of nAChR alpha6 (P < 0.001) and beta3 (P = 0.007) subunit genes than those from smokers, adjusted for gender. In addition, nAChR alpha4 (P < 0.001) and beta4 (P = 0.029) subunit gene expression showed significant difference between NSCLCs and normal lung. Using Affymetrix GeneChip U133 Sets, 65 differentially expressed genes associated with NSCLC nonsmoking nAChR alpha6beta3 phenotype were identified, which gave high sensitivity and specificity of prediction. nAChR alpha1, alpha5, and alpha7 showed significant reversible changes in expression levels in HBECs upon nicotine exposure. We conclude that between NSCLCs from smokers and nonsmokers, different nAChR subunit gene expression patterns were found, and a 65-gene expression signature was associated with nonsmoking nAChR alpha6beta3 expression. Finally, nicotine exposure in HBECs resulted in reversible differences in nAChR subunit gene expression. These results further implicate nicotine in bronchial carcinogenesis and suggest targeting nAChRs for prevention and therapy in lung cancer.     

Exploring influences on pharmacists’ and students’ ethical reasoning in a changing practice landscape in Australia

International Journal of Clinical Pharmacy - Background Practising pharmacists continuously develop their ethical reasoning skills, which evolve with practice experience and exposure to challenging...     

Epigenetic Modifications of Nrf2 by 3,3′-diindolylmethane In Vitro in TRAMP C1 Cell Line and In Vivo TRAMP Prostate Tumors

3,3′-diindolylmethane (DIM) is currently being investigated in many clinical trials including prostate, breast, and cervical cancers and has been shown to possess anticancer effects in several in vivo and in vitro models. Previously, DIM has been reported to possess cancer chemopreventive effects in prostate carcinogenesis in TRAMP mice; however, the in vivo mechanism is unclear. The present study aims to investigate the in vitro and in vivo epigenetics modulation of DIM in TRAMP-C1 cells and in TRAMP mouse model. In vitro study utilizing TRAMP-C1 cells showed that DIM suppressed DNMT expression and reversed CpG methylation status of Nrf2 resulting in enhanced expression of Nrf2 and Nrf2-target gene NQO1. In vivo study, TRAMP mice fed with DIM-supplemented diet showed much lower incidence of tumorigenesis and metastasis than the untreated control group similar to what was reported previously. DIM increased apoptosis, decreased cell proliferation and enhanced Nrf2 and Nrf2-target gene NQO1 expression in prostate tissues. Importantly, immunohistochemical analysis showed that DIM reduced the global CpG 5-methylcytosine methylation. Focusing on one of the early cancer chemopreventive target gene Nrf2, bisulfite genomic sequencing showed that DIM decreased the methylation status of the first five CpGs of the Nrf2 promoter region, corroborating with the results of in vitro TRAMP-C1 cells. In summary, our current study shows that DIM is a potent cancer chemopreventive agent for prostate cancer and epigenetic modifications of the CpG including Nrf2 could be a potential mechanism by which DIM exerts its chemopreventive effects.