Objective:To explore the chain mediating effect of escape motivation and flow experience between frustration and online game addiction.Methods:Stratified cluster sampling method was used to randomly select 740 students from 5 universities in Beijing.Frustrate mental state scale (FMSS), escape subscale of online game motivation scale (OGMS), game flow scale (GFS), and the game addiction subscale of different types of internet addiction scale (DTIAS) were used for investigation. SPSS 25.0 software and PROCESS macro program model 6 were used to analyze the data and test the mediation effect.Results:Frustration (62.94±15.84) was positively correlated with escape motivation(6.89±2.34), flow experience(20.36±7.38), and online game addiction(16.05±6.62) ( r=0.30, 0.19, 0.39, all P<0.01). Escape motivation was positively correlated with flow experience and online game addiction ( r=0.51, 0.50, both P<0.01), while flow experience was positively correlated with online game addiction ( r=0.51, all P<0.01). The direct effect of frustration on game addiction was 0.23 (95% CI=0.17-0.30). Frustration indirectly affects game addiction through two paths. The single mediating effect of escape motivation was 0.07 (95% CI=0.05-0.11), and the chain mediating effect of escape motivation and flow experience was 0.05 (95% CI=0.04-0.08). Conclusion:Frustration not only directly affects online game addiction, but also indirectly affects online game addiction through escape motivation and flow experience.

Objective:To evaluate the vital signs changes,influence factors in different grades of hy-pertension patients during the treatment of acute pulpitis,in order to obtain the risk prevention measures. Methods:In this study,90 different grades of hypertension patients with acute pulpitis were recruited from February 201 4 to February 201 5 in the Department of Oral Emergency,Peking University School and Hospital of Stomatology.The information about the patients’general health,oral treatment,life signs of change information was collected.Patients were divided into high risk group,middle risk group, and low risk group (30 patients for each group).Results:(1 )Compared with the preoperative,systolic blood pressure (90%),diastolic blood pressure (80%),heart rate increase (1 00%)were increased in the high risk group.The increase rates of the middle risk group and the low risk group were significantly lower than those of the high risk group (P<0.01 ).At the same time,the systolic blood pressure of 1 /4 (26.7%)patients in high risk group increased more than 20 mmHg (1 mmHg=0.1 33 kPa),and the diastolic blood pressure of 2/5 patients in high risk group increased more than 1 0 mmHg,the difference was statistically significant compared with the other two groups (P<0.05).(2)Compared with the pre-operative,the average increase of the maximum peak were increased [systolic blood pressure (1 8.0 ± 1 .5)mmHg,diastolic blood pressure (8.0 ±1 .7)mmHg],the mean of heart rate changes [(7.0 ± 0.3)beats per minute]was also increased in the high risk group,while these two indicators were de-creased in the low risk group and the middle risk group.The electrocardiogram (ECG)was changed in 6 cases during the treatment in the high risk group.No significantly changed were observed in the low risk group and the middle risk group.(3 ) Compared the risk assessment in preoperative with that in postoperative,in the middle risk group,23 cases were evaluated as medium risk in final evaluation,6 as low risk,and 1 as high risk (risk assessment increased);in the high risk group,20 cases were evaluated as high risk,7 as very high risk,and 3 as medium risk (risk assessment decreased).Conclusion:Oral treatment is very safe for patients with hypertension,but the risk factor,target organ damage,and com-plications will also increase the risk of cardiovascular events in elderly patients during the acute pulpitis treatment.Dentist should take some measures to avoid the risks.

Objective To explore the patients satisfaction with participation in medical and nursing decision making and the influencing factors among cancer patients, and to provide a basis for developing better medical care services. Methods Totally 159 cancer patients were recruited from Beijing Cancer Hospital, and then were investigated with the general information questionnaire, the patients′ expectation for participation in clinical decision making scale, the patients′ competence for participation in clinical decision making scale, and the patients′satisfaction with participation in medical and nursing decision making questionnaires. Results The total score of patients′satisfaction with participation in medical and nursing decision making were (45.92±3.91) and (34.25±3.31) respectively. Compared with female patients, male patients had higher satisfaction with medical decision making (46.45±3.24&44.87±4.84) and nursing decision making (34.68 ± 2.93&33.42 ± 3.84) (t=2.416, P=0.017;t=2.275, P=0.024);and compared with melanoma patients, lung cancer patients had higher satisfaction with medical decision making (46.51 ± 2.69&43.33 ± 7.07, P=0.002);compared withⅢstage patients, Ⅳstage patients had higher satisfaction with nursing decision making(34.97±2.24&32.40±4.56, P<0.01). Meanwhile, the satisfaction with participation in decision making was significantly positively associated with patients′ expectation and competence for participation in clinical decision making. Conclusions Patients′satisfaction for decision making may vary from different gender, tumor types, disease stages, and patients′expectation and competence. Health care providers still further strength patients′ knowledge and initiative of decision making, and then improve patients′satisfaction with participation in decision making.

Objective To analyze the effects of five proteins secreted by Chlamydia trachomatis on the phagocytosis of macrophages and dendritic cells derived from bone marrow cells of C3H/HeJ mice. Methods Glutathione S-transferase ( GST)-CT311, GST-GIgA, GST-cHtrA, GST-OmcBc and GST-Pgp3 proteins were prepared through an Escherichia coli prokaryotic expression system and purified by GST Mag-Beads. Chlamydia membrane protein GST-IncA was also prepared as a control. Proteins of interest were ob-tained by cleaving off GST-tag with PreScission protease. Macrophages (MΦ) and dendritic cells (DC) were prepared from bone marrow cells of C3H/HeJ mice and pretreated with either 100 μg/ml or 500 μg/ml of the above proteins. LPS was used as a control to testify the specificity of the proteins' functions. Four hours after pretreatment,fluorescent beads were added to culture media to evaluate the changes in phagocytosis with direct immunofluorescence assay. Results LPS and low concentration (100 μg/ml) of these proteins had no significant influence on the phagocytosis of DC and MΦ,while high concentration (500 μg/ml) of Pgp3, cHtrA and CT311 could significantly promote the phagocytosis of DC and MΦ. Conclusion Pgp3, cHtrA and CT311 can promote the in vitro phagocytosis of DC and MΦ,which may facilitate the in vivo dissemina-tion of Chlamyida trachomatis.

Objective:To understand the characteristics of sexualized drug use (SDU) among men who have sex with men (MSM) in Chengdu and classify their behavioral patterns by applying the two-step cluster (TSC) algorithm and by exploring the association between SDU patterns and high risk sexual behaviors, in order to provide a reference basis for the development of HIV prevention interventions.Methods:Supported by an MSM-friendly organization in Chengdu from December 2021 to February 2022, MSM were recruited by on-site survey and peer referral to collect information on sociodemographics, SDU characteristics, sexual behaviors, STD diagnosis, and HIV status. TSC was performed to classify the characteristics of SDU, and the differences between groups were compared. Chi-square test and multiple binary logistic regressions were used to identify the relationship between SDU clusters and HIV-related risk sexual behaviors.Results:A total of 727 MSM were surveyed, and 39.8% (289/727) of the respondents reported SDU experience with a same-sex partner in the last six months. TSC clustered SDU-MSM into three behavioral pattern groups. There were significant differences in monthly income, types of drugs used for SDU, mode, frequency, polydrug use, multiple sexual partners, non-adherence to condom use, and group sex among the three groups of SDU-MSM ( P<0.05). Multivariate binary logistic regression analysis showed that the third category of SDU-MSM was 2.22 (95% CI: 1.06-4.66) times more likely than the first category not to use condoms consistently; the third and second categories were 2.82 (95% CI: 1.18-6.77) times and 8.78 (95% CI: 3.42-22.42) times. Conclusions:The prevalence of SDU among MSM in Chengdu was more than 1/3, and different SDU clustering pattern was associated with high-risk sexual behaviors. MSM with higher SDU frequency, drug use, and polydrug abuse are more difficult to adhere to condom use and more likely to have group sex and high risk sexual behaviors, increasing the risk of STD and HIV infection, and need to strengthen SDU surveillance and intervention.

Objective To explore the good death status of terminally ill cancer patients from the nurses' perspective and identify associated factors. Methods A cross-sectional survey was conducted among the nurses in charge of the patients within 3 months after their death to evaluate the status quo of patients with end-stage cancer from the perspective of nurses, using anonymous questionnaire. Using convenient sampling method, 101 competent nurses from 209 patients with end-stage tumors who died in a hospital from October 2017 to January 2018 were selected. The nurses were investigated with nurses' general information questionnaire, patient information questionnaire and Good Death Inventory (GDI). Single factor analysis, Pearson correlation and multivariate linear regression analysis were used to analyze the influencing factors of good death in patients with end-stage cancer. Results The total score of GDI was (243.00±39.21). Among GDI, the three lowest scores were independence (7.43±4.25), physical and psychological comfort (8.17±4.82), and religious and spiritual comfort (8.53±4.72);while the three highest scores were being respected as an individual (18.32±2.76), good relationship with medical staff (18.23±2.59), and natural death (17.97±3.42). There were significant differences in patients' death status among different departments, medical payment methods, professional training experience of competent nurses and treatment methods within 3 months before death (t=17.351, 2.158, -2.679, -2.993;P＜0.05). Pearson correlation analysis showed that nurse working life was positively correlated with the total score of GDI (r=0.953, P＜0.01). Regression analysis showed that the factors influencing the good death of patients with end-stage cancer were the department of oncology medicine, the way of treatment and the professional training experience of nurses (P＜0.05). Conclusions The overall status of good death of terminally ill cancer patients is poor. To strengthen the palliative care training about the knowledge and skills helps to improve the nursing quality of end-of-life care and achieve the goal of good death.

This paper reviewed the research progress on pathogenesis and evaluation of dysphagia, swallowing training, and all kinds of swallowing standards among patients after laryngectomy so as to provide a reference and basis for the development of swallowing rehabilitation nursing standard in patients after laryngectomy.

Objective:To develop training course about care of the dying for cancer patients based on the CARES framework and explore its clinical application effect.Methods:Based on the CARES framework, the first draft of training course about care of the dying for cancer patients was constructed. From November 2021 to January 2022, the Delphi method was used to conduct two rounds of expert correspondence with 23 experts nationwide, forming the final version of training course about care of the dying for cancer patients. From January to March 2022, 235 oncology nurses from Beijing Cancer Hospital were selected as research objects by the convenient sampling method, and were given training course about the care of the dying for cancer patients. The Evaluation Questionnaire on Training Course about Care of the Dying for Cancer Patients was used to evaluate the satisfaction of nurses to the course setting and implementation.Results:The final training course about care of the dying for cancer patients included 7 first-level indicators, 16 second-level indicators and 44 third-level indicators. The overall satisfaction rate of training course about care of the dying for cancer patients in oncology nurses was 100.00% (235/235) .Conclusions:The development process of training course about care of the dying for cancer patients based on CARES framework is standardized, and the students have high satisfaction with the course setting and implementation process, which can be used as an educational resource for clinical nurses to improve professional nursing ability in the dying period.

Objective:To summarize the etiological characteristics and clinical treatment effects of 17 patients with medication-related osteonecrosis of the jaw (MRONJ).Methods:The clinical data of 17 patients with MRONJ admitted to the Department of Oral and Maxillofacial Surgery, the First People′s Hospital of Jinzhong, Shanxi Province, from July 2016 to December 2019 were retrospectively analyzed, including 9 males and 8 females, aged (63.6±9.6) years old (43-82 years old). Descriptive analysis of the primary disease, onset factors, site of disease, clinical manifestations, treatment methods, and treatment effects was conducted through follow-up for at least 1 year.Results:Among the primary diseases of the 17 cases, 12 were malignant tumors, and 5 were osteoporosis. There were 13 cases with a history of a trigger event (tooth extraction or unsuited removable denture). Six cases occurred in the maxilla, 10 cases occurred in the mandible, and 1 case involved both the upper and lower jaws. For the most common medication used, bisphosphonate was used in 16 cases including 5 cases with concomitant use of angiogenesis-inhibiting drugs. There was 1 case resulted from receptor activator of NF-κB ligand (RANKL) monoclonal antibody application. The duration of medication application was (10.1±3.9) months (3-18 months). All 17 cases were treated surgically. Totally 15 patients healed well after surgical treatment and the other 2 patients, who had poor soft tissue healing after surgery, healed well after a second operation.Conclusions:Tooth extraction might be a major trigger factor for the onset of MRONJ in the mandible. The disease was more possibly occured in the mandible than in the maxilla. Appropriate surgical treatment could achieve a good clinical outcome.

Objective:To evaluate the quality of domestic and foreign hospice care practice guidelines for cancer patients, so as to provide a basis for the future development of scientific and systematic hospice care guidelines for cancer patients or the formulation of evidence-based nursing practice plans for hospice care of cancer patients in China.Methods:Practice guidelines on hospice care for cancer patients were systematically retrieved from domestic and foreign databases, guidelines and professional society websites from the establishment of the database to July 25, 2020. Two investigators screened the guidelines strictly according to the inclusion and exclusion criteria, and evaluated the methodological quality of the included guidelines by using the currently internationally recognized guideline evaluation tool, the Appraisal of Guidelines for Research and Evaluation version Ⅱ (AGREE Ⅱ) .Results:A total of 14 guidelines were included for quality analysis, 9 guidelines were Grade A, 1 guidelines was Grade B, and 4 guidelines were Grade C. The average standardized scores of the 6 areas in AGREEⅡ of the 14 guidelines from high to low were scope and purpose (91.87%) , clarity (83.73%) , stakeholder (72.82%) , applicability (66.81%) , rigor (63.84%) and independence (58.04%) . The subject content analysis of 9 Grade A guidelines showed that common topics in the practice guidelines for hospice care of cancer patients included forming interdisciplinary teams, identification of end-of-life patients, assessment of end-of-life needs, end-of-life communication, providing of individualized nursing, end-of-life symptom management, bereavement support, support and training for nurses.Conclusions:Evidence-based guidelines for hospice care of cancer patients are lacking in China. The existing practice guidelines for hospice care of cancer patients in foreign countries are of high quality and cover a comprehensive range of topics, which can provide a reference for our country to formulate hospice care guidelines in line with national conditions or to transform the best evidence into our country's hospice care practice.