Despite decades of laboratory and clinical trials,breast cancer remains the main cause of cancer-related disease burden in women.Considering the metabolism destruction effect of metformin(Met)and cancer cell starvation induced by glucose oxidase(GOx),after their efficient delivery to tumor sites,GOx and Met may consume a large amount of glucose and produce sufficient hydrogen peroxide in situ.Herein,a pH-responsive epigallocatechin gallate(EGCG)-conjugated low-molecular-weight chitosan(LC-EGCG,LE)nanoparticle(Met-GOx/Fe@LE NPs)was constructed.The coordination between iron ions(Fe3+)and EGCG in this nanoplatform can enhance the efficacy of chemodynamic therapy via the Fenton reaction.Met-GOx/Fe@LE NPs allow GOx to retain its enzymatic activity while simultaneously improving its stability.Moreover,this pH-responsive nanoplatform presents controllable drug release behavior.An in vivo biodistribution study showed that the intracranial accumulation of GOx delivered by this nano-platform was 3.6-fold higher than that of the free drug.The in vivo anticancer results indicated that this metabolism destruction/starvation/chemodynamic triple-combination therapy could induce increased apoptosis/death of tumor cells and reduce their proliferation.This triple-combination therapy approach is promising for efficient and targeted cancer treatment.

Objective:To investigate the application effect of early emergency nursing teaching for eye battle injuries guided by the deep teaching concept.Methods:A total of 64 ophthalmic nurses who participated in early emergency nursing training for eye battle injuries were divided into control group with 26 nurses and observation group with 38 nurses. For the control group, list-based self-directed learning was used for theoretical teaching, and the traditional demonstration teaching method was used for the teaching of operational skills; for the observation group, the deep teaching concept was used for teaching design from the aspects of promoting understanding, inspiring reflection, and providing immersive experience, and it is also used to implement theoretical and practical teaching. The two groups were compared in terms of general information, theoretical scores, operational skill scores, and core competency scores before and after implementation. SPSS 22.0 was used for the t-test and the chi-square test. Results:There were no significant differences between the two groups in the general information including age, years of working in ophthalmology, education background, and professional title. Before implementation, there were no significant differences between the two groups in theoretical score, operational skill score, and core competency score, and compared with the control group after implementation, the observation group had significantly better theoretical score [(90.13±5.87) vs. (81.73±4.68), P<0.001] and scores of two operational skills [(95.63±2.81) vs. (87.31±4.51), P<0.001; (96.24±2.74) vs. (89.08±4.50), P <0.001]. Compared with the control group in terms of Competency Inventory for Registered Nurse, the observation group had significantly better scores of critical thinking [(34.00±1.93) vs. (30.58±3.01), P<0.001] and clinical nursing ability [(32.13±1.65) vs. (28.35±2.28), P<0.001]. Conclusions:The teaching method based on the deep teaching concept helps to enhance the knowledge, emergency skills, clinical reflection, and nursing abilities of ophthalmic nurses in the early emergency treatment of eye battle injuries and can improve the ideological awareness and training readiness of military clinical nurses.

Objective:To explore the characteristics of delay discounting and non-systematic response data in intertemporal choice of adults with attention deficit hyperactivity disorder(ADHD),and to explore the best data processing strategy for delay discounting task.Methods:Totally 108 adults with ADHD meeting the diagnostic cri-teria of the Diagnostic and Statistical Manual of Mental Health Disorder,Fifth Edition(DSM-5)and 87 gender matched normal controls were enrolled.ADHD symptoms were assessed using the ADHD Symptom Rating Scale,the delay discounting task was used to measure the delay discounting rate,and a model-free algorithm was used to i-dentify non-systematic response data.Results:There was no significant difference in the proportion of non-systemat-ic response data between ADHD group and normal control group(P＞0.05).In the data sets using different data screening strategies,the delay discounting rates were higher in the ADHD group than in the normal control group(Ps＜0.05).The delay discounting rates were positively correlated with the hyperactive impulse scores(r=0.24,P=0.001),the inattention scores(r=0.20,P＜0.01)and the total scores of ADHD symptom Rating Scale(r=0.22,P＜0.01).Conclusion:Adults with ADHD prefer to obtain immediate small rewards in intertemporal choice.The immediate preference of intertemporal choice may be mainly related to hyperactive impulsive symp-toms.Exclusion strategy of non-systematic response data may be more applicable to delay discount task research.

Liver transplantation has become an important means of treating end-stage liver diseases. However, due to various factors, liver transplant recipients are in a state of fatigue for a long time. Fatigue can lead to poor health conditions, changes in normal social functions, an increase in negative emotional states, a decrease in quality of life, and even a possible decrease in survival rate. In order to strengthen the attention of medical staff to liver transplant recipients′ fatigue, timely detection and early effective interventions, this article will review the concept, survey tools, current status, related influencing factors, and intervention measures of fatigue in liver transplant recipients, in order to provide theoretical basis for improving fatigue symptoms in liver transplant recipients.

Objective:To summarize the echocardiographic features and outcomes in fetuses with congenital ventricular outpouching (CVO).Methods:This retrospective study enrolled ten fetuses diagnosed with CVO by fetal echocardiography in the Affiliated Hospital of Qingdao University and Qingdao Women and Children's Hospital from January 2015 to April 2022. Clinical data were analyzed, including echocardiographic features, other intracardiac and extracardiac malformations, karyotypes, and pregnancy outcomes. Data were analyzed by descriptive statistics.Results:All ten cases were single, including eight ventricular diverticula and two ventricular aneurysms. Five cases had the anomaly in the left ventricular and the other five in the right. Five cases were isolated malformations, and the other five were complicated by other intra- or extracardiac malformations. A pathogenic copy number variation was detected in one case. Three pregnancies were terminated, and one was lost to follow-up. The other six fetuses were born alive and showed no obvious clinical symptoms or abnormalities in growth and development during 3-70 months of follow-up. The right ventricular diverticulum spontaneously disappeared in one case. One case with the right ventricular aneurysm was also diagnosed with noncompaction of the left ventricular myocardium by echocardiography at six months.Conclusions:Fetal CVO presents with typical echocardiographic features and can be diagnosed prenatally. Regular follow-up during pregnancy is recommended to observe the sizes of outpouchings and the occurrence of complications in fetuses with CVO after excluding other structural and chromosomal abnormalities to avoid unnecessary termination. Attention should also be paid to postnatal follow-up.

Objective:To explore the effect of out-of-hospital nursing based on gratitude extension-construction theory on self-management efficacy of young and middle-aged patients undergoing percutaneous coronary intervention (PCI) .Methods:A total of 136 young and middle-aged patients who underwent PCI in Coronary Heart Disease Ward of Department of Cardiology in Henan Provincial People's Hospital were selected as the research objects by the convenient sampling method. The patients were randomly divided into the control group and the observation group by the envelop method, with 68 patients in each group. The control group received routine out-of-hospital nursing, while the observation group received out-of-hospital nursing based on gratitude extension-construction theory. Self-management efficacy was compared before and after intervention between the two groups.Results:After intervention, the scores for self psychological management, self-management confidence, self-management behavior, self-management cognition and self-management information in the observation group were higher than those in the control group, and the differences were statistically significant ( P<0.01) . Conclusions:Out-of-hospital nursing based on gratitude extension-construction theory can significantly improve self-management efficacy of young and middle-aged patients undergoing PCI.

Objective:To explore the effects of "rain classroom" wisdom teaching on geriatric students′ autonomous learning ability and self-efficacy.Methods:From June to August, 2021, 61 nursing students who practiced in the department of gerontology of the Second Xiangya Hospital, Central South University were selected as research subjects, and divided into experimental group (30 students) and control group (31 students) by random number table method. In the experimental group, wisdom teaching based on "Rain classroom" was carried out at the same time as conventional teaching, while in the control group, conventional teaching was carried out, and the teaching effect was evaluated by the independent learning ability measurement scale and academic self-efficacy scale of nursing students.Results:The score of autonomous learning ability of nursing students in the experimental group was 68.55 ± 11.06, and that in the control group was 74.29 ± 9.16. The difference between the two groups was statistically significant ( t = -2.01, P<0.05). The academic self-efficacy scores of nursing students in experimental group and control group were 52.27 ± 11.56 and 52.64 ± 9.28 respectively. There was no significant difference between the two groups ( P>0.05). Conclusions:The wisdom teaching of "rain classroom" improves the independent learning ability of geriatric nursing students, and attaches importance to the cultivation of self-efficacy of nursing students, and the improvement of self-efficacy needs further research.

Objective:To analyze the research status of the midwifery in China from 2012 to 2021, and to explore the research hotspots and research trends in the midwifery in China in the past 10 years.Methods:The CiteSpace software was used to analyze the time distribution, authors, institutions and keywords of related studies in the field of midwifery published in nursing core journals in China. The search period was from January 2012 to December 2021.Results:A total of 442 articles were included, with the largest number of papers published in 2014 and 2015, and no increase in the number of papers published after 2016. The core author group in the field of midwifery was basically formed, with close cooperation among authors and high output from the five cooperative groups, but little cooperation among teams. Cooperative research with regional institutions began to take shape, and inter-regional collaborative research was relatively scarce. The hotspot keywords in the field of midwifery were "midwife", "pregnant woman", "natural childbirth", "obstetric nursing" and "delivery outcome".Conclusions:The development of research in the field of midwifery in China is slow, and cooperation between teams, institutions and regions needs to be further strengthened in the future. Strengthening the capacity building of midwifery professionals is the key direction of future research, and obstetric nursing is the main trend of future research.

Objective:To explore the current situation of the partnership between pediatric nurses and children's parents, and analyze the influencing factors of the partnership from the perspective of pediatric nurses and children's parents respectively, so as to provide a basis for improving the partnership between pediatric nurses and children's parents.Methods:This study was a cross-sectional study. From January 2021 to January 2022, 595 pediatric nurses and 590 parents of hospitalized children from three ClassⅢ Grade A hospitals in Zhengzhou were selected as the research object by convenience sampling. The General Information Questionnaire and the Pediatric Nurse Parent Partnership Scale were used to investigate the subject and evaluate the cooperation between them in caring for children. Single factor analysis and multiple linear regression were used to analyze the influencing factors of the partnership between pediatric nurses and children's parents. Totals of 595 pediatric nurses' questionnaires were distributed, 587 valid questionnaires were recovered, and the valid recovery rate was 98.66% (587/595) . Totals of 590 parents' questionnaires were distributed, 583 valid questionnaires were recovered, and the valid recovery rate was 98.81% (583/590) .Results:The total scores of pediatric nurses and children's parents' partnership were (136.98±19.56) and (143.20±22.09) , respectively. Multiple linear regression analysis showed that working years, upbringing experience, personal monthly income and departments were the influencing factors of pediatric nurse partnership ( P<0.05) ; and education level, average monthly income of the family and the disease course were the influencing factors of the children's parents' partnership ( P<0.05) . Conclusions:The partnership between pediatric nurses and parents of children in Zhengzhou is above average. The partnership between pediatric nurses and children's parents is affected by various factors of both sides. Attention should be paid to the partnership between pediatric nurses with low seniority, no upbringing experience and low personal income and parents with low education level, low family income level and long course of disease, and the partnership should be improved through certain interventions, so as to provide high-quality nursing services for children.

Objective:To explore the effect of team positive psychological intervention on psychological state and coping style of nurses after being impacted by life events.Methods:From September 2020 to January 2021, 84 nurses who had suffered life events in Shanxi Provincial People's Hospital were selected by the convenient sampling method. According to the enrollment time, they were divided into the experimental group ( n=42) and the control group ( n=42) . The nurses in the control group were not give external intervention measures, while nurses in the experimental group adopted team positive psychological intervention. After 6 weeks of intervention, the Chinese version of Psychological Resilience Scale, Symptom Checklist 90 (SCL-90) and Simple Coping Style Questionnaire were used to compare changes in the psychological resilience level, mental health level and coping style of nurses in the two groups. Results:After intervention, the scores of toughness, strength and optimism dimensions and the total scores of Psychological Resilience Scale in the experimental group were significantly higher than those in the control group, and the differences were statistically significant ( P<0.05) . The total score of SCL-90 in the experimental group was significantly lower than that in the control group, and the difference was statistically significant ( P<0.05) . The score of positive coping dimension of nurses in experimental group was significantly higher than that in control group, and the score of negative coping dimension was significantly lower than that in control group, and the differences were statistically significant ( P<0.05) . Conclusions:Team positive psychological intervention can improve psychological resilience and mental health level of nurses who are impacted by life events. At the same time, it can also encourage them to adopt active coping methods to face problems, which is conducive to improving quality of nursing.