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Engineering hyaluronic acid-based nanoassemblies for monoclonal antibody delivery-design,characterization,and biological insights

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Nano Research 2024年第10期17卷 9111-9125页

作者： Ana M.López-Estévez Y.Zhang mar.a Medel Iker Arriaga Lucía sanjurjo Cristian Huck-Iriart Nicola G.A.Abrescia mar.a j.Vicent Defang Ouyang Dolores Torres mar.a j.sé Alonso Center for Research in Molecular Medicine and Chronic Diseases(CiMUs) University of Santiago de CompostelaSantiago de Compostela 15782Spain Department of Pharmacology Pharmacy and Pharmaceutical TechnologySchool of PharmacyUniversity of Santiago de CompostelaSantiago de Compostela 15782Spain Health Research Institute of santiago de Compostela(IDIs) Santiago de Compostela 15782Spain state Key Laboratory of Quality Research in Chinese Medicine Institute of Chinese Medical Sciences(ICMS)University of MacaoMacao 999078China Polymer Therapeutics Laboratory and CIBERONC Prince Felipe Research Centre Valencia E-46012Spain structure and Cell Biology of Viruses Lab CIC bioGUNEBasque Research and Technology Alliance(BRTA)Derio 48160Spain ALBA synchrotron Light source Experiments DivisionCerdanyola del VallèsBarcelona 08290Spain IKERBAsQUE Basque Foundation for ScienceBilbao 48009Spain

The current spotlight of cancer therapeutics is shifting towards personalized medicine with the widespread use of monoclonal antibodies(mAbs).Despite their increasing potential,mAbs have an intrinsic limitation related to their inability to cross cell membranes and reach intracellular *** offers promising solutions to overcome this limitation,however,formulation challenges *** challenges are the limited loading capacity(often insufficient to achieve clinical dosing),the complex formulation methods,and the insufficient characterization of mAb-loaded ***,we present a new nanocarrier consisting of hyaluronic acid-based nanoassemblies(HANAs)specifically designed to entrap mAbs with a high efficiency and an outstanding loading capacity(50%,w/w).HANAs composed by an mAb,modified HA and phosphatidylcholine(PC)resulted in sizes of~100 nm and neutral surface *** modeling identified the principal factors governing the high affinity of mAbs with the amphiphilic HA and *** composition and structural configuration were analyzed using the orthogonal techniques cryogenic transmission electron microscopy(cryo-TEM),asymmetrical flow field-flow fractionation(AF4),and small-angle X-ray scattering(sAXs).These techniques provided evidence of the formation of core-shell nanostructures comprising an aqueous core surrounded by a bilayer consisting of phospholipids and amphiphilic *** vitro experiments in cancer cell lines and macrophages confirmed HANAs’low toxicity and ability to transport mAbs to the intracellular *** reproducibility of this assembling process at industrial-scale batch sizes and the long-term stability was *** conclusion,these results underscore the suitability of HANAs technology to load and deliver biologicals,which holds promise for future clinical translation.

关键词： monoclonal antibody nanoparticles hyaluronic acid characterization particle size computational modeling

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Reuse of port industrial heritage in tourist cities:shipyards as case studies

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Frontiers of Architectural Research 2024年第1期13卷 164-183页

作者： mar.a j.Andrade Eduardo jiménez-Morales Rachel Rodríguez-Ramos Pablo martínez-Ramírez Department of Art and Architecture School of ArchitectureMalaga UniversityMalaga 29013Spain

The progressive deindustrialisation of many western cities since the 1980s has led to many industrial zones linked to port activities being abandoned or falling into *** such as Barcelona,Naples,Lisbon,Amsterdam,and Hamburg have port industrial complexes of high tangible and intangible heritage value that could totally or partially disappear,resulting in an irreparable loss of their scientific,architectural,social,technological,and historical *** that in mind,Adaptive Reuse(AR)of the built heritage allows the industrial memory of the ports to be preserved by turning them into new functional centres within the existing urban *** occurs in the context of the contemporary challenges of those cities,such as touristification,the circular economy and climate change,while guaranteeing the life cycle of those *** article analyses two case studies—the Nederlandsche scheepsbouw Maatschappij(NDsM)and the Rotterdamsche Droogdok Maatschappij(RDM)shipyards,both in the Netherlands—in order to contribute to the knowledge of AR of Port Industrial *** are two examples of good practices in port industrial heritage interventions,where the factors behind their acclaim can be easily highlighted.A multi-scale methodology is therefore used and tailored to the case of port industrial heritage,based on analysing previous studies of the heritage in different spheres and on different scales.A relationship matrix tool is thus *** enables a comparative study to be conducted,using key variables and indicators,and considering qualitative and quantitative *** provides extensive output information for each case study,which is summarised in the most favourable factors for the success of the AR of this port industrial heritage.

关键词： Industrial heritage Port-city Adaptive reuse Best practices Circular economy HUL Touristification

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Intestinal anti-inflammatory effect of a plant sterol food supplement in experimental murine colitis and cell co-culture models

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Food science and Human Wellness 2024年

作者： Mussa Makran Antonio Cilla Rosa mar.a Giner mar.a Carmen Recio Luisa Tesoriere Alessandro Attanzio Guadalupe Garcia-Llatas Nutrition and Food science Area， Faculty of Pharmacy and Food sciences， University of Valencia.Av.Vicente Andrés Estellés s/n Department of Pharmacology， Faculty of Pharmacy and Food sciences， University of Valencia.Av.Vicente Andrés Estellés s/n Department of Biological， Chemical and Pharmaceutical sciences and Technologies， University of Palermo

The potential of a plant sterol food supplement （Ps-Fs） in addressing intestinal inflammation in vivo and in vitro was evaluated. As in vivo model， C57BL/6j mice were exposed to 1.5% dextran sulfate sodium in three 5-day periods， with 10-day rest intervals in between， daily reciving Ps-Fs （35 mg Ps/kg）. The in vitro approach involved a bi-cameral system with 8-day-differentiated Caco-2 （apical） and RAW264.7 cells （basolateral）. The bioaccessible fraction of Ps-Fs， obtained after INFOGEsT 2.0 simulated gastrointestinal digestion， was added to the apical part （90 min）， followed by stimulation with lipopolysaccharide （1 μg/mL， 24 h）. Ps-Fs alleviated rectal bleeding and rebalanced pro- (tumor necrosis factor α， interleukin （IL）-6， and IL-8) and anti-inflammatory cytokines （IL-10）. Additionally， Ps-Fs ameliorated histopathological damage and enhancing occludin expression. A reduction in oxidative stress was evidenced by decreased myeloperoxidase activity and reactive oxygen species production. The anti-inflammatory mechanism included suppressing cyclooxygenase 2 expression， reducing prostaglandin E2production， and inhibiting the phosphorylation and nuclear translocation of the nuclear factor κB p65 subunit. This study reveals the potential of Ps-Fs as a therapeutic intervention for colitis. The alignment between in vivo and in vitro outcomes substantiates the appropriateness of the co-culture model to evaluate the anti-inflammatory activity of foods.

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American tegumentary leishmaniasis mimicking myiasis and granulomatous vasculitis:A case report

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Asian Pacific journal of Tropical Medicine 2024年第10期17卷 473-476,I0001,I0002页

作者： Victoria j Arrieta Gastón Morea Leticia M Tennerini mar.a Vsanchez Esteban s Lozano Diego E Cargnelutti Instituto de Medicina y Biología Experimental de Cuyo(IMBECU) Consejo Nacional de Investigaciones Científicas y Técnicas(CONICET)Universidad Nacional de Cuyo(UNCuyo)MendozaArgentina Hospital Luis C.Lagomaggiore MendozaArgentina Facultad de Ciencias Médicas(FCM) Universidad Nacional de Cuyo(UNCuyo)MendozaArgentina

Rationale:American tegumentary leishmaniasis comprises cutaneous and mucocutaneous manifestations caused by parasitic infections by various Leishmania *** report details the clinical interventions for a patient with American tegumentary leishmaniasis in Mendoza,Argentina,a non-endemic *** concerns:A 43-year-old male was admitted to a tertiary care hospital in Mendoza,Argentina Republic with a history of progressive nasal discharge,septal perforation,facial pain,and *** treatment for presumed nasal myiasis and vasculitis with granulomatosis,symptoms ***:American tegumentary ***:Intravenous liposomal amphotericin ***:Follow-up at 30 days showed no recurrence of symptoms with a remar.able clinical improvement of the nasal ***:This case sheds light on the necessity of accurate identification for timely intervention and the need to recognize the diverse manifestations of American tegumentary leishmaniasis to avoid misdiagnosis.

关键词： Leishmania American tegumentary leishmaniasis Diagnosis methods Myasis Vasculitis and granulomatosis Case report

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Prevalence of and risk factors for erectile dysfunction in young nondiabetic obese men:results from a regional study

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Asian journal of Andrology 2020年第4期22卷 372-378页

作者： mar.a Molina-Vega Maite Asenjo-Plaza mar.a j.sébanderas-donaire mar.a Dolores Hernández-Ollero silvia Rodríguez-Moreno juan jálvarez-Millán Pablo Cabezas-sanchez Fernando Cardona-Díaz juan Alcaide-Torres Lourdes Garrido-sánchez Daniel Castellano-Castillo Francisco j Tinahones j.séC Fernández-García Department of Endocrinology and Nutrition Virgen de la Victoria University Hospital(IBIMA)Málaga UniversityMálaga 29010Spain Centro de Investigación Biomédica en Red de la Fisiopatología de la Obesidad y Nutrición(CIBEROBN) Instituto de Salud Carlos IIIMadrid 28029Spain Cruz de Humilladero Primary Care Center Málaga 29010Spain Teatinos Primary Care Center Málaga 29010Spain Chemical sanitary Consulting(CQs Lab) Madrid 28003Spain

Erectile dysfunction(ED),a condition closely related to cardiovascular morbidity and mortality,is frequently associated with *** this study,we aimed to determine the prevalence of ED and evaluate the associated risk factors in a cohort of 254 young(18–49 years)nondiabetic obese(body mass index[BMI]≥30 kg m−2)men from primary *** function(International Index of Erectile Function[IIEF-5]questionnaire),quality of life(Aging Males'symptoms[AMs scale]),and body composition analysis(Tanita MC-180MA)were *** testosterone was determined using high-performance liquid chromatography–mass *** logistic regression analysis was used to study the factors associated with *** prevalence was 42.1%.subjects with ED presented higher BMI,waist circumference,number of components of the metabolic syndrome,AMs score,insulin resistance,and a more unfavorable body composition than those without *** logistic regression analysis showed that a pathological AMs score(odds ratio[OR]:4.238,Psity(BMI≥40 kg m−2,OR:2.602,P=0.005,compared with BMI 30–34.9 kg m−2),high-density lipoprotein(HDL)-cholesterol levels(OR:0.956,P=0.004),and age(OR:1.047,P=0.016)were factors independently associated with *** conclusion,we demonstrate that,in a primary care-based cohort of nondiabetic young obese men,ED affected>40%of subjects.A pathological AMs score,the degree of obesity,and age were positively associated with ED,while elevated HDL-cholesterol levels were inversely associated with the odds of presenting *** prospective studies are needed to evaluate the long-term consequences of ED in this population.

关键词： Aging Males'symptoms score erectile dysfunction International Index of Erectile Function-5 questionnaire obesity testosterone

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Multi-environment BsA-seq using large F3 populations is able to achieve reliable QTL mapping with high power and resolution: An experimental demonstration in rice

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The Crop journal 2024年第2期12卷 549-557页

作者： Yan Zheng Ei Ei Khine Khin mar Thi Ei Ei Nyein Likun Huang Lihui Lin Xiaofang Xie Min Htay Wai Lin Khin Than Oo Myat Myat Moe san san Aye Weiren Wu College of Life sciences Fujian Agriculture and Forestry UniversityFuzhou 350002FujianChina Fujian Provincial Key Laboratory of Crop Breeding by Design Fujian Agriculture and Forestry UniversityFuzhou 350002FujianChina Key Laboratory of Genetics Breeding and Multiple Utilization of CropsMinistry of EducationFujian Agriculture and Forestry UniversityFuzhou 350002FujianChina Department of Botany Mawlamyine UniversityMon StateMawlamyineMyanmar Department of Botany Dagon UniversityNorth DagonYangonMyanmar

Bulked-segregant analysis by deep sequencing(BsA-seq) is a widely used method for mapping QTL(quantitative trait loci) due to its simplicity, speed, cost-effectiveness, and efficiency. However, the ability of BsA-seq to detect QTL is often limited by inappropriate experimental designs, as evidenced by numerous practical studies. Most BsA-seq studies have utilized small to medium-sized populations, with F2populations being the most common choice. Nevertheless, theoretical studies have shown that using a large population with an appropriate pool size can significantly enhance the power and resolution of QTL detection in BsA-seq, with F_(3)populations offering notable advantages over F2populations. To provide an experimental demonstration, we tested the power of BsA-seq to identify QTL controlling days from sowing to heading(DTH) in a 7200-plant rice F_(3)population in two environments, with a pool size of approximately 500. Each experiment identified 34 QTL, an order of magnitude greater than reported in most BsA-seq experiments, of which 23 were detected in both experiments, with 17 of these located near41 previously reported QTL and eight cloned genes known to control DTH in rice. These results indicate that QTL mapping by BsA-seq in large F_(3)populations and multi-environment experiments can achieve high power, resolution, and reliability.

关键词： BsA-seq QTL mapping Large F3 population Multi-environment experiment Cross-validation

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Physical activity and amyloid beta in middle-aged and older adults:A systematic review and meta-analysis

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journal of sport and Health science 2024年第2期13卷 133-144页

作者： mar.a Rodriguez-Ayllon Patricio solis-Urra Cristina Arroyo-ávila Miriam álvarez-Ortega Pablo Molina-García Cristina Molina-Hidalgo Manuel Gómez-Río Belinda Brown Kirk I.Erickson Irene Esteban-Cornejo Department of Epidemiology Erasmus University Medical Center RotterdamRotterdamGD 3015the Netherlands Department of Physical Education and sports Faculty of Sport SciencesSport and Health University Research Institute(iMUDS)University of GranadaGranada 18071Spain Faculty of Education and social sciences Universidad Andres BelloVina del Mar 2531015Chile Department of Nuclear Medicine Virgen de las Nieves University HospitalInstitute of Biosanitary Research of Granada(IBS)Granada 18014Spain Physical Medicine and Rehabilitation service Virgen de las Nieves University HospitalInstitute of Biosanitary Research of Granada(IBS)Granada 18014Spain Department of Psychology University of PittsburghPittsburghPA 15260USA Centre for Healthy Ageing Health Futures InstituteMurdoch UniversityMurdochWA 6150Australia school of Medical and Health sciences Edith Cowan UniversityJoondalupWA 6027Australia Advent Health Research Institute Neuroscience Institute OrlandoOrlandoFL 32803USA Physiopathology of Obesity and Nutrition Research Center(CIBERobn) Institute of Health Carlos Ⅲ(ISCⅢ)Madrid 28029Spain

Background:One of the pathological hallmarks distinguishing Alzheimer’s disease from other dementias is the accumulation of amyloid beta(Aβ).Higher physical activity is associated with decreased dementia risk,and one potential path could be through Aβlevels *** aimed to explore the relationship between physical activity and Aβin middle-aged and older ***:A systematic search of PubMed,Web of science,PsycINFO,Cochrane Central Register of Controlled Trials,and sPORTDiscus was performed from inception to April 28,*** were eligible if they included physical activity and Aβdata in adults aged 45 years or ***-level metaanalyses of intervention and observational studies were performed to examine the role of physical activity in modulating Aβ***:In total,37 articles were included(8 randomized controlled trials,3 non-randomized controlled trials,4 prospective longitudinal studies,and 22 cross-sectional studies).The overall effect size of physical activity interventions on changes in blood Aβwas medium(pooled standardized mean difference=-0.69,95%confidence interval(95%CI):-1.41 to 0.03;I^(2)=74.6%).However,these results were not statistically significant,and there were not enough studies to explore the effects of physical activity on cerebrospinal fluid(CsF)and brain Aβ.Data from observational studies were examined based on measurements of Aβin the brain using positron emission tomography scans,CsF,and *** physical activity was positively associated with Aβonly in the CsF(Estimate r=0.12;95%CI:0.05-0.18;I^(2)=38.00%).Conclusion:Physical activity might moderately reduce blood Aβin middle-aged and older ***,results were only near statistical significance and might be interpreted with caution given the methodological limitations observed in some of the included *** observational studies,higher levels of physical activity were positively associated with Aβonly in ***,further research is needed t

关键词： Aging Cognitive impairment Dementia Exercise PET

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Provenance and tectonic setting of sandstones of the Lomas Coloradas Formation, Cabullona Group, sonora, México: Constraints on petrography and geochemistry

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journal of Palaeogeography 2024年第4期13卷 839-861页

作者： j.Madhavaraju D.G.Noriega-Montoya E.Ramirez-Montoya C.M.Gonz alez-Le on john s.Armstrong-Altrin Estaci on Regional del Noroeste Instituto de GeologíaUniversidad Nacional Aut onoma de Mexico Ingeniería en Geociencias Universidad Estatal de Sonora Posgrado en Ciencias de la Tierra Estaci on Regional del NoroesteInstituto de GeologíaUniversidad Nacional Aut onoma de Mexico Universidad Nacional Aut onoma de Mexico Instituto de Ciencias del Mar y LimnologíaUnidad de Procesos Oce anicos y CosterosCiudad Universitaria

The sedimentary rocks of the Cabullona Group are well exposed in the Cabullona Basin of northeastern sonora, Mexico, which represent syntectonic sedimentation associated with Laramide-style deformation during the Campanian-early Maastrichtian. The sandstones of the Lomas Coloradas Formation deposited at the upper part of the Cabullona Group. Petrography and geochemical(major, trace, and rare earth elements) studies were carried out on the sandstones to interpret the palaeoweathering, provenance,and tectonic setting of the Lomas Coloradas Formation sandstones. Most of the sandstone modal analysis data plotted in the QFL and Qm FLt ternary diagrams fall into the fields of dissected arcs and recycled orogens,respectively. Geochemically the sandstones are classified as litharenites while few samples plot into the arkosic field. The chondrite-normalized REE diagrams for sandstones have LREE-enriched, relatively flat HREE patterns with negative Eu anomalies. CIA values and the A-CN-K diagram indicate a low intensity of chemical weathering in the source area. The tectonic setting diagram suggests both arc and rift settings for the studied sandstones. The bivariate and ternary diagrams and elemental ratios suggest a felsic source for the Lomas Coloradas Formation. The average REE patterns of the studied sandstones are comparable with REE patterns of the granite from the Caborca block, the rhyolite and granite of the Tarahumara Formation, and the Mesozoic felsic volcanic rocks. The modeled mixture of 40% Proterozoic granite, 30% Triassic arc, 10% jurassic arc, and 20% Laramide arc represents the probable source rocks for the Lomas Coloradas Formation.

关键词： Provenance Petrography Geochemistry Lomas Coloradas Formation Cabullona Group México

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Global wild rice germplasm resources conservation alliance:World Wild-Rice Wiring

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Molecular Plant 2024年第4期17卷 516-518页

作者： Xiaoming Zheng Disna Ratnasekera jiayu Fan Robert j.Henry Beng-Kah song Kenneth M.Olsen Bal Krishna j.shi mar.a Celeste N.Banaticla-Hilario Tonapha Pusadee Adane Getachew Melaku Yeyinou Laura Estelle Loko Koukham Vilayheuang Gavers K.Oppong samuel Aduse Poku Peterson W.Wambugu song Ge Aldo Merotto junior Ohn mar.aung Ramaiah Venuprasad Ajay Kohli Wenbin Zhou Qian Qian National Key Facility for Crop Gene Resources and Genetic Improvement Institute of Crop SciencesChinese Academy of Agricultural SciencesBeijing 100081China sanya National Research Institute of Breeding in Hainan Chinese Academy of Agricultural SciencesBeijing 100081China International Rice Research Institute DAPO Box 7777Metro Manila 4031Philippines Department of Agricultural Biology Faculty of AgricultureUniversity of RuhunaMatara 81000Sri Lanka Yazhouwan National Laboratory No.8 Huanjin RoadYazhou DistrictSanya CityHainan Province 572024China Hainan University Haikou 570228China ARC Centre of Excellence for Plant success in Nature and Agriculture University of QueenslandBrisbaneQLD4072Australia school of science Monash University Malaysia47500 Bandar SunwaySelangor 47500Malaysia Department of Biology Washington University in St.LouisSt.LouisMO 63130-4899USA National Agriculture Genetic Resources Center(Genebank) KhumaltarPO Box 3055KathmanduNepal Plant Biology Division Insttute of Biological SciencesUniversity of the Pilippines Los BanosLos BanosLaguna 4031Philippines Division of Agronomy Department of Plant and Soil SciencesFaculty of AgricultureChiang Mai UniversityChiang Mai 50200Thailand Bio and Emerging Technology Institute Addis Ababa 1165Ethiopia National University of sciences TechnologiesEngineering and Mathematics(UNSTIM)Dassa-ZouméBP 14Benin National Genebank Rice and Cash Crops Research CenterNAFRIVientiane 0605Lao PDR Plant sciences and the Bioeconomy Rothamsted ResearchHarpenden AL52JQUK UK Future Food Beacon of Excellence and school of Biosciences and University of Nottingham Nottingham LE125RDUK Department of Plant and Environmental Biology University of GhanaAccraGhana Kenya Agricultural and Livestock Research Organization Genetic Resources Research InstituteNairobi 00200Kenya Institute of Botany Chinese Academy of SciencesBeijing 100093China Federal University of Rio Grande do sul UFRGSPorto Alegre 91501-970RSBrazil Department of Agricultur

Wild relatives of crop are key genetic resources serving as diversity reservoirs for crop improvement under changing ***(Oryza sativa)is one of the most important crops in the world,providing staple food for half of the world's *** rice is thus a critical germplasm resource for sustained global food security,ensuring high production yields,improved quality,and stress resistance in the face of climate *** rice is closely related to domesticated rice and has a rich genetic diversity and exceptional adaptability to extreme *** has played a pivotal role in the history of rice hybridization and has become a key resource for rice breeding *** identification of wild-type cytoplasmic male sterility resources paved the way for the achievement of the“three lines”goal in hybrid rice,leading to a significant increase in rice *** addition,the use of resistance alleles found in wild rice is making rice production more resilient to losses caused by environmental ***,wild rice germplasm resources are threatened due to habitat destruction and other anthropogenic *** the same time,the lack of centralized distribution of wild rice has hampered the sharing of basic information on wild rice resources and the utilization and conservation of wild rice in each country,as well as collaboration among scientists.

关键词： germplasm breeding crops

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重症监护室护士限制治疗努力的能力:整合性综述

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International journal of Nursing sciences 2024年第1期11卷 143-154,I0003页

作者： Elvia R.Lopez-Panza Vanessa C.Pacheco-Roys Kelly j.Fernandez-Ahumada Diana C.Díaz-Mass mar.a Y.Exposito-Concepcion Elizabeth Villarreal-Cantillo Cesar I.Aviles Gonzalez Nursing Department Universidad del NorteBarranquillaColombia Nursing Program Faculty of Health SciencesUniversidad Popular del CesarValleduparColombia Clínica Valledupar ValleduparColombia Hospital Universidad del Norte SoledadColombia Department of Medical sciences and Public Health University of CagliariCittadella Universitaria di MonserratoCagliariItaly

目的在重症监护病房(IntensiveCareUnit,ICU),护土难免会遇到需要限制治疗努力(limiting therapeutie efort,LTE)的患者,尽管多数护士还缺乏为这些临终患者及其家庭提供支持的准备。本综述旨在描述ICU护士在LTE中需要具备的能力。方法对... 详细信息

目的在重症监护病房(IntensiveCareUnit,ICU),护土难免会遇到需要限制治疗努力(limiting therapeutie efort,LTE)的患者,尽管多数护士还缺乏为这些临终患者及其家庭提供支持的准备。本综述旨在描述ICU护士在LTE中需要具备的能力。方法对2010年--2023年发表的文献进行综述。系统检索了5个数据库:Medline、Wiley Online Library、sciELO、scienceDirect和Web of science。使用关键评估项目工具西班牙语版(Critical Appraisal skills Programme in spanish,CAsPe)作为评判性阅读工具。使用牛津循证医学中心(Center for Evidence-Based Medicine.,CEBM)评估工具确定证据级别和推荐强度。结果共纳入25篇文献。ICU护士LTE护理的能力包括对患者的直接护理、以家庭为中心的护理以及护士在团队中的作用。该综述确定了3个类别的能力:作为患者、家庭与跨学科团队之间维护者的能力,在LTE方面的决策能力,在患者生命末期治疗和护理干预的能力。结论ICU护士在LTE方面需要具备相应的能力,这对患者的生活质量死亡尊严以及患者家庭应对悲伤的全面支持至关重要。

关键词：重症监护家庭支持重症监护病房护士的作用安宁疗护专业能力

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