Objective:To develop and verify the validity of a questionnaire on nutrition and immune-related adverse events in patients with liver cancer and received immune therapy. To provide a survey and evaluation tool for targeted health education, improving compliance and quality of life.Methods:Based on the knowledge attitude practice (KAP) theory, the preliminary draft of questionnaire was determined by literature search and 30 patients with liver cancer who received immunotherapy at Haikou People′s Hospital were selected for pre survey. The expert consultation was conducted by associate chief physicians from the department of hepatobiliary surgery and the department of oncology, the nutritionists and specialist nurses from the department of gastroenterology. According to the consultation results, the questionnaire was modified into the test version. It was estimated that the minimum sample size required for structural validity evaluation was 322 cases. Patients with liver cancer who received immunotherapy at Haikou People′s Hospital were recruited by convenience sampling, and the test version questionnaire were filled in. According to random number table method, the patients were divided into 2 groups. Exploratory and confirmatory factors analysis of the questionnaire were conducted respectively. The reliability of the questionnaire was evaluated by Cronbach′s α coefficient, split half reliability and retest reliability. Results:The completion time of the pre-survey questionnairein was (9.57±7.57) min. A total of 407 test questionnaires were distributed, and 400 were recovered, and the recovery rate of test questionnaire was 98.28%.The final questionnaire consisted of 27 items in 3 dimensions (knowledge, attitude, and practice), including 9 items of knowledge dimension, 10 items of attitude dimension and 8 items of practice dimension. Three factors were extracted in exploratory factors analysis with a cumulative variance contribution rate of 65.265%. In validation factor analysis, the chi-square freedom ratio was 3.956, the root mean square error of approximation was 0.086, the root mean square residual was 0.076, the comparative fit index was 0.871, and the incremental fit index was 0.872. The main indicators of the questionnaire fit were all with in the acceptable range. The total Cronbach′s α coefficient, split-half reliability and test-retest reliability of this questionnaire were 0.935, 0.834, 0.933, respectively. Conclusions:The questionnaire has good reliability and validity, and can be used as a preliminary assessment tool to understand the current status of knowledge, attitude, and practice of nutritional and immune-related adverse events in patients with liver cancer who received immunotherapy.

Objective:To develop and verify the validity of a questionnaire on nutrition and immune-related adverse events in patients with liver cancer and received immune therapy. To provide a survey and evaluation tool for targeted health education, improving compliance and quality of life.Methods:Based on the knowledge attitude practice (KAP) theory, the preliminary draft of questionnaire was determined by literature search and 30 patients with liver cancer who received immunotherapy at Haikou People′s Hospital were selected for pre survey. The expert consultation was conducted by associate chief physicians from the department of hepatobiliary surgery and the department of oncology, the nutritionists and specialist nurses from the department of gastroenterology. According to the consultation results, the questionnaire was modified into the test version. It was estimated that the minimum sample size required for structural validity evaluation was 322 cases. Patients with liver cancer who received immunotherapy at Haikou People′s Hospital were recruited by convenience sampling, and the test version questionnaire were filled in. According to random number table method, the patients were divided into 2 groups. Exploratory and confirmatory factors analysis of the questionnaire were conducted respectively. The reliability of the questionnaire was evaluated by Cronbach′s α coefficient, split half reliability and retest reliability. Results:The completion time of the pre-survey questionnairein was (9.57±7.57) min. A total of 407 test questionnaires were distributed, and 400 were recovered, and the recovery rate of test questionnaire was 98.28%.The final questionnaire consisted of 27 items in 3 dimensions (knowledge, attitude, and practice), including 9 items of knowledge dimension, 10 items of attitude dimension and 8 items of practice dimension. Three factors were extracted in exploratory factors analysis with a cumulative variance contribution rate of 65.265%. In validation factor analysis, the chi-square freedom ratio was 3.956, the root mean square error of approximation was 0.086, the root mean square residual was 0.076, the comparative fit index was 0.871, and the incremental fit index was 0.872. The main indicators of the questionnaire fit were all with in the acceptable range. The total Cronbach′s α coefficient, split-half reliability and test-retest reliability of this questionnaire were 0.935, 0.834, 0.933, respectively. Conclusions:The questionnaire has good reliability and validity, and can be used as a preliminary assessment tool to understand the current status of knowledge, attitude, and practice of nutritional and immune-related adverse events in patients with liver cancer who received immunotherapy.

Rheumatoid arthritis (RA) is an autoimmune disease characterized by severe synovial inflammation and cartilage damage. Despite great progress in RA therapy, there still lacks the drugs to completely cure RA patients. Herein, we propose a reprogrammed neutrophil cytopharmaceuticals loading with TNFα-targeting-siRNA (siTNFα) as an alternative anti-inflammatory approach for RA treatment. The loaded siTNFα act as not only the gene therapeutics to inhibit TNFα production by macrophages in inflamed synovium, but also the editors to reprogram neutrophils to anti-inflammatory phenotypes. Leveraging the active tendency of neutrophils to inflammation, the reprogrammed siTNFα/neutrophil cytopharmaceuticals (siTNFα/TP/NEs) can rapidly migrate to the inflamed synovium, transfer the loaded siTNFα to macrophages followed by the significant reduction of TNFα expression, and circumvent the pro-inflammatory activity of neutrophils, thus leading to the alleviated synovial inflammation and improved cartilage protection. Our work provides a promising cytopharmaceutical for RA treatment, and puts forward a living neutrophil-based gene delivery platform.

Objective:To deeply study and explore the cognitive and barrier factors of clinical nurses' nutrition management in patients with pressure injury (PI), and provide evidence for developing quantifiable standardized management model and strengthening individualized nutrition management.Methods:A semi-structured in-depth interview was conducted with 11 nurses. The NVivo10.0 software and Colaizzi's 7-step analysis of phenomenological data were used to analyze interview data.Results:The study summarized four themes that hindered nutrition management: subjective judgment bias; education training lags behind and radiates one-sided; lack of policy and configuration; conflict between workload, roles and perceptions.Conclusions:There are many obstacles to the implementation of nutrition management in patients with PI. An objective, feasible and standardized nutrition management plan should be established, support should be provided by policy, configuration and information system, and relevant knowledge training and multi-team cooperation should be strengthened to improve patient life.

Objective To characterize the clinical,electrophysiology and neuropathological features of 4 cases with immune-mediated necrotizing myopathy (IMNM).Methods We retrospectively analyzed the clinical,electrophysiology,neuropathological characteristics of 4 IMNM patients with muscular and skin biopsy in our department during 4 years (from January 2011 to January 2014).Results Among these 4 patients,2 were men and 2 were women (aged 37 to 58 years) with disease duration ranging from 1 month to 60 months.Two patients were with acute onset and 2 with chronic onset.All 4 patients had proximal muscle weakness with three patients with cervical flexor muscle weakness and one with respiratory muscles weakness and noninvasive ventilator assisted respiration.One patient had interstitial lung disease.The anti-signal recognition particle antibodies were strong positive in all 4 patients.Muscle biopsy showed group necrotizing and regenerating fibers in one patient and few scattered necrotizing and regenerating fibers in the other 3 patients.Both muscle fiber hypertrophy and muscle fiber atrophy together with proliferation of connective tissue on endomysium could be viewed in all 4 patients.However,very few inflammatory cells were detectable in patients.One patient was treated with corticosteroids and the other three were treated with combination of corticosteroids and immunosuppressant drugs.Conclusions IMNM is characterized by heterogeneity at disease onset,severity and ilnvolvement of muscles with,however,similary pathological changes including the presence of numerous necrotic and regenerating fibers with little or none inflammation.Corticosteroid and/or immunosuppressant is effective for patients.