Annals of palliative medicine
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An increasing number of jurisdictions around the world are legalizing assisted dying. This creates a particular challenge for the field of palliative care, which often precludes producing premature death by the injection or self-administration of lethal medications upon a patient's voluntary request. A 2019 systematic scoping review of the literature about the relationship between palliative care and assisted dying in contexts where assisted dying is lawful, found just 16 relevant studies that included varied and combined stances ranging from complete opposition, to collaboration and integration. Building on that review, the present study was conducted in Quebec (Canada), Flanders (Belgium), and Oregon (USA), with the objective of exploring the relationship between palliative care and assisted dying in these settings, from the perspective of clinicians and other professionals involved in the practice. ⋯ No clear and uniform relationship between palliative care and assisted dying can be identified in any of the three locations. The context and practicalities of how assisted dying is being implemented alongside access to palliative care need to be considered to inform future laws. We seek a better understanding of whether and in what ways assisted dying presents a threat to palliative care.
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Hypoxaemia in post-surgical patients of esophageal cancer (EC) is common in thoracic departments. However, few studies have investigated the role of high-flow nasal cannula (HFNC) compared with conventional oxygen therapy (COT). ⋯ HFNC can improve the hypoxemia of patients after esophagectomy, increase the flow of sputum, reduce the incidence of PPC and anastomotic leakage.
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Compared with standard care alone, early integration of specialist palliative care in the treatment of patients with advanced cancer offers significant benefit with respect of symptom control, healthrelated quality of life and survival. The early integration of specialist palliative care means that patients receive palliative care concurrent with, or shortly after, the diagnosis of advanced cancer. ⋯ Over half of the cancer patients in general practice who are referred for specialist palliative care are done so very late. General practitioners appear to need encouragement for the early integration of palliative care for patients with advanced cancer and to initiate early referrals to palliative care teams.
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Network pharmacology is widely used in mechanistic studies of traditional Chinese medicines (TCMs). The present study aimed to predict the target and signaling pathway of Baihe Decoction in the intervention of coronary heart disease (CHD) based on a network pharmacology approach and molecular docking. ⋯ This study has preliminarily revealed the mechanism of Baihe Decoction in the treatment of CHD. The components of TCM may intervene in the processes of CHD occurrence and development by regulating cardiomyocytes and antioxidative stress, and by participating in inflammation and immune response. Moreover, in the clinical syndrome differentiation of TCM, Baihe Decoction can be used as the main drug to treat CHD and angina pectoris due to qi stagnation and blood stasis caused by emotional discomfort.
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Although anxiety disorders are one of the most common mental illness in population, antianxiety drugs often only have single action targets, require long-term use, and are associated with many adverse reactions and dependencies. Professor Yan Zhaojun from Shandong Provincial Hospital of Traditional Chinese Medicine (TCM) has applied the modified Renshu Powder, a TCM formula, to treat anxiety disorders, with satisfactory outcomes. Here, we investigated the mechanism of action of two core herbs (prepared Rehmannia root and Chinese arborvitae kernel) in the Renshu Powder in the treatment of anxiety disorders by using network pharmacology approaches. ⋯ The mechanism of action of the prepared Rehmannia root-Chinese arborvitae kernel in treating anxiety disorders involves multiple ingredients, multiple targets, and pathways.