Objective:To construct advanced practice competencies for nurses in tumor prevention and early screening and promote nurses' professional role in cancer prevention and treatment.Methods:A literature review was conducted to draft advanced nursing practice competencies in tumor prevention and early screening. A first-round expert consultation questionnaire was developed, followed by two rounds of Delphi expert consultations involving 25 experts from 10 hospitals and institutions nationwide engaged in clinical nursing, nursing management, clinical medicine, genetics, and epidemiological research in tumor prevention and screening.Results:Advanced practice competencies for nurses in tumor prevention and early screening were formulated around seven aspects: communication, health promotion and education counseling, clinical practice, professional development, ethical decision-making, evidence-based practice and research, and leadership.Conclusions:Core competencies necessary for nurses to engage in advanced practice in tumor prevention and early screening were established, thus providing a basis for enhancing their role in cancer care.

BACKGROUND:As a member of bone morphogenetic proteins,growth differentiation factor-5 shows promising potential in the application of cartilage and bone repair.The affinity of growth differentiation factor-5 onto bone tissue determines protein use efficiency,so it is of great significance to prepare growth differentiation factor-5 with bone targeting capability. OBJECTIVE:To modify growth differentiation factor-5 using bisphosphonates and investigate the effects of modified protein on the growth of preosteoblasts in mice. METHODS:Pamidronate disodium/growth differentiation factor-5 complex was prepared using chemical crosslinking to couple growth differentiation factor-5 with pamidronate disodium.The functional groups and structures of the complex were characterized using Fourier transform infrared spectroscopy and circular dichromatography.To determine the bone targeting in vitro,the binding of the modified growth differentiation factor-5 with calcium phosphate and in vitro release amount of growth differentiation factor-5 were measured with an ELISA kit.Growth differentiation factor-5(control group)and the pamidronate disodium/growth differentiation factor-5 complex(experimental group)were co-cultured with preosteoblasts MC3T3-E1.Individually cultured cells were blank controls.The effect of the complex on cell proliferation and differentiation was evaluated. RESULTS AND CONCLUSION:(1)The infrared spectroscopy and circular dichromatography results indicated that the bisphosphonate/growth differentiation factor-5 complex was successfully prepared without significant changes in the protein secondary structure.In vitro protein adsorption results showed that growth differentiation factor-5 adsorption on calcium phosphate was increased by about one time after coupling with a bisphosphonate.In the presence of cysteine,growth differentiation factor-5 could be released from the bisphosphonate/growth differentiation factor-5 complex.(2)CCK-8 assay results showed that the absorbance value of the experimental group cultured for 4 and 7 days was higher than that of the control group and blank control group(P<0.000 1).After 7 days of culture,the expression of alkaline phosphatase in the experimental group was significantly higher than that in the control group and blank control group(P<0.000 1).After 13 days of culture,the content of calcium nodules in the experimental group was significantly higher than that in the control group and the blank control group(P<0.000 1).The results of qRT-PCR showed that the mRNA expression of alkaline phosphatase,osteocalcin and Runx2 in the experimental group was higher than that in the control group and the blank control group after 7 days of culture(P<0.01,P<0.001,P<0.000 1).(3)These findings exhibit that bisphosphonate modification can enhance the binding capacity of growth differentiation factor-5 to calcium phosphate as well as improve its biological activity.

OBJECTIVE To study the effects of transferrin-targeting peptide T7 （7pep） on intracellular transportation of polyethylene glycol-polycaprolactone （PEG-PCL） micelles in human cervical cancer HeLa cells. METHODS Using coumarin-6 （C6） as fluorescent indicator probe， both coumarin-6 （C6）-loaded PEG-PCL （PEG-PCL-C6） micelles and 7pep-modified PEG- PCL （7pep-PEG-PCL-C6） micelles were prepared by film-dispersion method. The particle size， polydispersity index and appearance morphology were compared between two types of micelles； the real-time uptake of two types of micelles by HeLa cells was compared， and the colocalization of two types of micelles with early endosomes （EE）， endocytic recycling compartments （ERC） and late endosomes （LE） after entry into the cells was observed. RESULTS The particle sizes of PEG-PCL-C6 and 7pep-PEG-PCL- C6 micelles were（75.0±2.3）and（82.0±1.5）nm； the polymer dispersity indexes were 0.17±0.20 and 0.17±0.32， respectively， with a regular spherical appearance. The colocalization results showed that entry speed and amount of 7pep-PEG-PCL-C6 micelles were significantly faster/more than those of PEG-PCL-C6 micelles. 7pep-PEG-PCL-C6 micelles entered EE faster than PEG-PCL-C6 micelles， while PEG-PCL-C6 micelles entered ERC at a faster rate than 7pep-PEG-PCL-C6 micelles， and both PEG-PCL-C6 micelles and 7pep-PEG-PCL-C6 micelles tended to accumulate gradually in LE； Pearson coefficient， signal overlap ratio， and colocalization ratio of 7pep-PEG-PCL-C6 micelles with LE were significantly lower 60 minutes after entering the cell than those 30 minutes after entering the cell （P＜0.05 or P＜0.01）. CONCLUSIONS Targeting 7pep modification can increase the entry speed and amount of PEG-PCL-C6 micelles， and also alter their intracellular transportation behavior.

A 73-year-old male patient with right lung squamous cell carcinoma developed edema of bilateral lower limbs, poor appetite, and oliguria after targeted treatment with afatinib 30 mg once daily orally for 80 days. The laboratory tests showed serum creatinine 658 mmol/L, blood urea 26.8 mmol/L, urine protein (++++), and urine occult blood (+++). Renal biopsy showed renal tubular injury, some cells appearing as crescents, and mild IgA deposition. Acute kidney failure was diagnosed, which was considered to be caused by afatinib. Afatinib was stopped and symptomatic treatments including hemodialysis, glucocorticoids, anticoagulants, diuretics, etc. were given. Twelve days later, the edema in both lower limbs was alleviated;19 days later, his daily urine volume was approximately 800 ml; 99 days later, his renal function indicators tended to be normal. The patient did not receive targeted treatment again.

A 73-year-old male patient with right lung squamous cell carcinoma developed edema of bilateral lower limbs, poor appetite, and oliguria after targeted treatment with afatinib 30 mg once daily orally for 80 days. The laboratory tests showed serum creatinine 658 mmol/L, blood urea 26.8 mmol/L, urine protein (++++), and urine occult blood (+++). Renal biopsy showed renal tubular injury, some cells appearing as crescents, and mild IgA deposition. Acute kidney failure was diagnosed, which was considered to be caused by afatinib. Afatinib was stopped and symptomatic treatments including hemodialysis, glucocorticoids, anticoagulants, diuretics, etc. were given. Twelve days later, the edema in both lower limbs was alleviated;19 days later, his daily urine volume was approximately 800 ml; 99 days later, his renal function indicators tended to be normal. The patient did not receive targeted treatment again.

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.

Objective:To investigate the effect of self-help cognitive behavioral intervention on the recovery of patients with generalized anxiety disorder.Methods:A total of 123 patients with generalized anxiety disorder were recruited from a comprehensive hospital in Hunan province. The patients were randomly assigned into control group( n=62) and intervention group( n=61) according to random number table. The patients in the control group were received routine treatment alone, while the patients in the intervention group were received routine treatment and WeChat-based self-help cognitive behavioral therapy. The generalized anxiety disorder(GAD-7), self-rating depression scale(SDS), WHO quality of life scale(WHOQOL-BREF), Pittsburgh sleep quality index(PSQI) and medication adherence scale(MARS) were used to measure the anxiety, depression, quality of life, sleep quality and medication compliance at three time points: before intervention (T1), after intervention (T2) and during follow-up (T3). The SPSS 21.0 was used to analyze the data.Mean±standard deviation, frequency and constituent ratio were used to describe the data based on the type of data. Repeated measure ANOVA was used to compare the between-group variation, time effect and interaction effect of two groups at 3 time points. Results:The anxiety score of intervention group at T1, T2, T3 were (12.74± 2.02), (7.13± 1.48), (6.57±1.73) respectively, and the anxiety score of the control group were (12.08±2.11), (11.11±3.27), (10.11±3.33) respectively. Compared with the control group, the score of anxiety in the intervention group was significantly decreased at T2 and T3 ( P<0.05). Compared with control group, the sleep quality and quality of life of intervention group were significantly improved at T2, T3 ( P<0.05), and the medication compliance of the intervention group was significantly improved at T3 ( P<0.05). Conclusion:Self-help cognitive behavioral intervention can decrease anxiety significantly and improve the quality of life, sleep quality, and medication compliance in patients with generalized anxiety disorder.

Objective:To explore the application of nursing of theory education combined with experience education in the rehabilitation of patients with idiopathic pulmonary artery hypertension (IPAH) .Methods:Nursing of theory education combined with experience education was carried out in Department of Respiratory Medicine in Affiliated Hospital of Jining Medical University in December 2017. Using the convenient sampling method, 53 patients with IPAH who were admitted from August 2016 to December 2017 were selected as the control group and they were given routine nursing. A total of 53 IPAH patients who were admitted from January 2018 to May 2019 were selected as the research group, and they were given nursing of theory combined with experience education at basis of the control group. Before the intervention and 1 month after discharge from the hospital, patients in two groups were assesses by Exercise of Self-Care Agency (ESCA) scale, the MOS 36-item Short-Form Health Survey (SF-36) , 6 minutes walking distance (6MWD) and Borg Scale (BS) , and the occurrence of complications in the two groups during hospitalization and discharge for 1 month was recorded.Results:After 1 month of discharge, scores of self-care skills, self-care concept, self-care responsibilities and health knowledge and the total self-care score of ESCA were respectively (35.52±2.16) , (22.32±1.55) , (27.15±2.02) , (48.67±2.85) and (130.67±3.38) . Scores of physical functioning, role-physical, vitality, role-emotional, social functioning and mental health and overall health score of SF-36 were respectively (74.73±12.83) , (71.79±11.31) , (72.06±11.43) , (69.67±10.54) , (71.23±10.72) , (72.43±13.30) and (65.45±14.27) . The 6MWD distance was (512.67±86.85) m, and BS score was (3.79±0.85) . Compared with the control group, the differences were statistically significant ( P<0.01) . During hospitalization and one month after discharge, the complication rate of the research group was lower than that of the control group, and the difference was statistically significant ( P<0.05) . Conclusions:Nursing of theory education combined with experience education can improve the self-care ability of IPAH patients, improve their quality of life, and reduce the incidence of complications, which is worthy of clinical application.

Objectives:To analyze the level and related factors of quality of life, caregiver burden in primary caregivers of adolescents with depression, and to explore the relationship between quality of life and caregiver burden. Methods: Totally 180 caregivers of adolescents with depression were investigated in the Second Xiangya Hospital of Central South University in Changsha, Hunan province. The Hamilton Depression Scale-17 (HAMD-17), Short Form 36 Health survey Questionnaire (SF-36) and Zarit Caregiver Burden Interview (ZBI) were used to assess depressive symptoms of patients, the quality of life and caregiver burden of primary caregivers of adolescents with depression. Results:The scores of SF-36 dimensions were lower in caregivers than in the national norm (P ＜ 0.01). The average score of ZBI was (32 ± 15), while 73.7％ caregiver's burden was in the low and moderate level. The SF-36 scores were lower in caregivers taking care of patients with longer course of disease and suicide history, with lower education level, with lower family income (P ＜0.05). The ZBI scores were higher in those taking care of the patients in hospital, with a long course of disease, with higher HAMD scores, and those with major events in the past 3 months, and being on-the-job, (P ＜0.05). The caregiver burden (personal burden and role burden) of caregivers was negatively related to the scores of quality of life (physical health and mental health) (r=-0.56——0.24, Ps ＜0.01). Conclusion: The quality of life of caregivers of adolescents with depression is severely impaired, and they have obvious caregiver burden. The caregivers with lower education level, lower family income, and being on-the-job, with major events in the past 3 months, and those taking care of patients with a long course of disease, suicide history, and higher HAMD score may have heavy burden and low quality of life. The caregiver burden of caregivers of adolescents with depression is negatively related to their quality of life.

Objective: To study the antiemetic effect of the ethyl acetate extract with ethanol extraction of Galangal (hereinafter referred to as galangal extract) in allotriophagic Kaolin model rats.Methods: The rats were administered respectively with chemical drug cisplatin and apomorphine, and received the rotation stimulation as well.Three types of allotriophagic Kaolin models were established, and apomorphine, ondansetron and metoclopramide were used as the control drugs.The experimental rats were divided into 3 groups at low, medium and high dose of Galangal extract with prophylactic effect.The antiemetic effect was observed after the treatment.Results: Chemical drug cisplatin (3.0 mg·kg-1, intraperitoneal injection) and apomorphine (3.2 mg·kg-1,subcutaneous injection) and the rotation stimulation (centrifugal force of 3.4×g,60min) could induce allotriophagic vomiting in rats.The galangal extract at low (1 500 mg·kg-1), medium (4 500 mg·kg-1) and high (9 000 mg·kg-1) dose all fail to effectively inhibit the allotriophagic Kaolin behavior of rats caused by cisplatin, apomorphine and rotation(P>0.05).Conclusion: Galangal extract can not effectively inhibit the vomiting of allotriophagic Kaolin model rats.Probably, there is no correlation between the pharmacological effects of galangal extract and substance P, 5-hydroxytryptamine, dopamine as well as receptive zone of chemical vomiting inhibition.