Ten-Day Vonoprazan-Amoxicillin Dual Therapy vs Standard 14-Day Bismuth-Based Quadruple Therapy for First-Line Helicobacter pylori Eradication: A Multicenter Randomized Clinical Trial.

INTRODUCTION: Whether 10-day short-course vonoprazan-amoxicillin dual therapy (VA-dual) is noninferior to the standard 14-day bismuth-based quadruple therapy (B-quadruple) against Helicobacter pylori eradication has not been determined. This trial aimed to compare the eradication rate, adverse events, and compliance of 10-day VA-dual regimen with standard 14-day B-quadruple regimen as first-line H. pylori treatment. METHODS: This prospective randomized clinical trial was performed at 3 institutions in eastern China. A total of 314 treatment-naive, H. pylori -infected patients were randomly assigned in a 1:1 ratio to either 10-day VA-dual group or 14-day B-quadruple group. Eradication success was determined by 13 C-urea breath test at least 4 weeks after treatment. Eradication rates, adverse events, and compliance were compared between groups. RESULTS: Eradication rates of VA-dual and B-quadruple groups were 86.0% and 89.2% ( P = 0.389), respectively, by intention-to-treat (ITT) analysis; 88.2% and 91.5% ( P = 0.338), respectively, by modified ITT analysis; and 90.8% and 91.3% ( P = 0.884), respectively, by per-protocol (PP) analysis. The efficacy of the VA-dual remained noninferior to B-quadruple therapy in all ITT, modified ITT, and PP analyses. The incidence of adverse events in the VA-dual group was significantly lower compared with that in the B-quadruple group ( P < 0.001). Poor compliance contributed to eradication failure in the VA-dual group ( P < 0.001), while not in the B-quadruple group ( P = 0.110). DISCUSSION: The 10-day VA-dual therapy provided satisfactory eradication rates of >90% (PP analysis) and lower rates of adverse events compared with standard 14-day B-quadruple therapy as first-line H. pylori therapy. TRAIL REGISTRATION NUMBER: ChiCTR2300070100.

Effect of mPEG-PLGA on Drug Crystallinity and Release of Long-Acting Injection Microspheres: In Vitro and In Vivo Perspectives.

PURPOSE: Traditional progesterone (PRG) injections require long-term administration, leading to poor patient compliance. The emergence of long-acting injectable microspheres extends the release period to several days or even months. However, these microspheres often face challenges such as burst release and incomplete drug release. This study aims to regulate drug release by altering the crystallinity of the drug during the release process from the microspheres. METHODS: This research incorporates methoxy poly(ethylene glycol)-b-poly(lactide-co-glycolide) (mPEG-PLGA) into poly(lactide-co-glycolide) (PLGA) microspheres to enhance their hydrophilicity, thus regulating the release rate and drug morphology during release. This modification aims to address the issues of burst and incomplete release in traditional PLGA microspheres. PRG was used as the model drug. PRG/mPEG-PLGA/PLGA microspheres (PmPPMs) were prepared via an emulsification-solvent evaporation method. Scanning electron microscopy (SEM), powder X-ray diffraction (PXRD), and differential scanning calorimetry (DSC) were employed to investigate the presence of PRG in PmPPMs and its physical state changes during release. RESULTS: The addition of mPEG-PLGA altered the crystallinity of the drug within the microspheres at different release stages. The crystallinity correlated positively with the amount of mPEG-PLGA incorporated; the greater the amount, the faster the drug release from the formulation. The bioavailability and muscular irritation of the long-acting injectable were assessed through pharmacokinetic and muscle irritation studies in Sprague-Dawley (SD) rats. The results indicated that PmPPMs containing mPEG-PLGA achieved low burst release and sustained release over 7 days, with minimal irritation and self-healing within this period. PmPPMs with 5% mPEG-PLGA showed a relative bioavailability (Frel) of 146.88%. IN CONCLUSION: In summary, adding an appropriate amount of mPEG to PLGA microspheres can alter the drug release process and enhance bioavailability.

Dynamic Simulations of Interaction of the PEG-DPPE Micelle-Encapsulated Short-Chain Ceramides with the Raft-Included Membrane.

The lipid raft subdomains in cancer cell membranes play a key role in signal transduction, biomolecule recruitment, and drug transmembrane transport. Augmented membrane rigidity due to the formation of a lipid raft is unfavorable for the entry of drugs, a limiting factor in clinical oncology. The short-chain ceramide (CER) has been reported to promote drug entry into membranes and disrupt lipid raft formation, but the underlying mechanism is not well understood. We recently explored the carrier-membrane fusion dynamics of PEG-DPPE micelles in delivering doxorubicin (DOX). Based on the phase-segregated membrane model composed of DPPC/DIPC/CHOL/GM1/PIP2, we aim to explore the dynamic mechanism of the PEG-DPPE micelle-encapsulating DOXs in association with the raft-included cell membrane modulated by C8 acyl tail CERs. The results show that the lipid raft remains integrated and DOX-resistant subjected to free DOXs and the micelle-encapsulating ones. Addition of CERs disorganizes the lipid raft by pushing CHOL aside from DPPC. It subsequently allows for a good permeability for PEG-DPPE micelle-encapsulated DOXs, which penetrate deeper as CER concentration increases. GM1 is significant in guiding drugs' redistributing between bilayer phases, and the anionic PIP2 further helps DOXs attain the inner bilayer surface. These results elaborate on the perturbing effect of CERs on lipid raft stability, which provides a new comprehensive approach for further design of drug delivery systems.

Nontargeted metabolomic insights into the behavioral effects of 5-MeO-MiPT in zebrafish (Danio rerio).

5-Methoxy-N-methyl-N-isopropyltryptamine (5-MeO-MiPT) is a novel psychoactive substance exhibiting a tryptamine structure. Despite its increasing prevalence, the environmental impact of 5-MeO-MiPT remains unexplored. Our prior investigation revealed that 5-MeO-MiPT induced inhibited spontaneous movement and prompted anxiety-like behavior in adult zebrafish-a validated toxicological model. To elucidate this phenomenon and establish a correlation between metabolomics and behavioral changes induced by 5-MeO-MiPT, zebrafish were administered varying drug concentrations. Zebrafishes were subjected to injections of different 5-MeO-MiPT concentrations. Subsequent metabolomic analysis of endogenous metabolites affected by the drug unveiled substantial variations in metabolic levels between the control group and the drug-injected cohorts. A total of 22 distinct metabolites emerged as potential biomarkers. Further scrutiny identified seven pathways significantly influenced by 5-MeO-MiPT. A focused exploration into amino acid metabolism, lipid metabolism, and energy metabolism unveiled that the metabolic repercussions of 5-MeO-MiPT on zebrafish resulted in observable brain damage. Notably, the study identified a consequential disruption in the liver-brain pathway. The comprehensive metabolomic approach employed herein effectively discerned the impact of 5-MeO-MiPT on zebrafish metabolism. This approach also shed light on the mechanism underpinning the anxiety-like behavior observed in zebrafish post-drug injection. Specifically, our findings indicate that 5-MeO-MiPT induces brain damage, particularly within the liver-brain pathway.

Doctors' and Patients' Perceptions of Impacts of Doctors' Communication and Empathy Skills on Doctor-Patient Relationships During COVID-19.

BACKGROUND: During the COVID-19 pandemic, the performance of Chinese doctors may have led to improved doctor-patient relationships (DPRs). However, it is unclear how doctors and patients perceived the impact of doctors' communication and empathy skills on DPRs during the COVID-19 pandemic. OBJECTIVE: To examine the perceptions of doctors and patients on how doctors' communication skills and empathy skills influence DPRs during COVID-19. MAIN MEASURES: Doctors' and patients' perceptions of doctors' communication skills were measured using the Chinese version of the SEGUE Framework. To measure empathy skills and DPRs, the Jefferson Scale of Empathy and Difficult Doctor-Patient Relationship Questionnaire were administered to doctors, and the Consultation and Relational Empathy Measure and Patient-Doctor Relationship Questionnaire were administered to patients. RESULTS: A total of 902 doctors and 1432 patients in China were recruited during the pandemic via online or offline surveys (overall response rate of 69.8%). Both doctors and patients rated doctors' empathy skills as more impactful on DPRs than communication skills. Doctors believed that only their empathy skills influenced DPRs. But patients believed that there was a significant bi-directional relationship between doctors' communication and empathy skills and these two skills interacted to directly and indirectly influence DPRs, and doctors' empathy had a greater mediating effect than their communication. CONCLUSIONS: During COVID-19, there were both similarities and differences between Chinese doctors' and patients' views on how doctors' communication and empathy skills influenced DPRs. The greater effect of doctors' empathy skills suggests that both doctors and patients attach more importance to doctors' empathy in doctor-patient interactions. The bi-directional effect on patient outcomes suggests that both doctors' communication and empathy skills are important to patients' perceptions of DPRs.

Pd-Catalyzed Asymmetric Oxidative C-H/C-H Cross-Coupling Reaction between Ferrocenes and Azoles.

The asymmetric C-H bond functionalization reaction is one of the most efficient and straightforward methods for the synthesis of optically active molecules. Herein, our work discovered a Pd-catalyzed asymmetric oxidative C-H/C-H cross-coupling reaction of ferrocenes with azoles such as oxazoles and thiazoles. Mono-N-protected amino acid as chiral ligands with palladium(II) has been demonstrated as an effective catalytic system in a weakly azine-directed asymmetric C-H bond functionalization reaction. This method offers a powerful strategy for constructing various substituted planar chiral ferrocenes via a dual C-H bond activation pathway in medium yields (up to 70%) with good enantioselectivity (up to 95.3:4.7 er) under mild conditions.

Self-Association of ACE-2 with Different RBD Amounts: A Dynamic Simulation Perspective on SARS-CoV-2 Infection.

Transmissibility of SARS-CoV-2 initially relies on its trimeric Spike-RBDs to tether the ACE-2 on host cells, and enhanced self-association of ACE-2 engaged with Spike facilitates the viral infection. Two primary packing modes of Spike-ACE2 heteroproteins exist potentially due to discrepant amounts of RBDs loading on ACE-2, but the resultant self-association difference is inherently unclear. We used extensive coarse-grained dynamic simulations to characterize the self-association efficiency, the conformation relevance, and the molecular mechanism of ACE-2 with different RBD amounts. It was revealed that the ACE-2 hanging two/full RBDs (Mode-A) rapidly dimerized into the heteroprotein complex in a compact "linear" conformation, while the bare ACE-2 showed weakened self-association and a protein complex. The RBD-tethered ectodomains of ACE-2 presented a more upright conformation relative to the membrane, and the intermolecular ectodomains were predominantly packed by the neck domains, which was obligated to the rapid protein self-association in a compact pattern. Noted is the fact that the ACE-2 tethered by a single RBD (Mode-B) retained considerable self-association efficiency and clustering capability, which unravels the interrelation of ACE-2 colocalization and protein cross-linkage. The molecular perspectives in this study expound the self-association potency of ACE-2 with different RBD amounts and the viral activity implications, which can greatly enhance our comprehension of SARS-CoV-2 infection details.

Correction: Delivery mechanism of doxorubicin by PEG-DPPE micelles on membrane invasion by dynamic simulations.

Correction for 'Delivery mechanism of doxorubicin by PEG-DPPE micelles on membrane invasion by dynamic simulations' by Lina Zhao et al., Phys. Chem. Chem. Phys., 2023, 25, 16114-16125, https://doi.org/10.1039/D2CP05946K.

Delivery mechanism of doxorubicin by PEG-DPPE micelles on membrane invasion by dynamic simulations.

Exploiting micelles of polyethylene glycol-dipalmitoylglycerophosphoethanolamine (PEG-DPPE) as a drug delivery approach is of great promise for improving therapeutic targeting and the half-lives of drugs. To optimize the micelle carriers, pending issues concerning the kinetics underlying the carrier-membrane interplay and the specific contributions of the micelle hydrophobic/hydrophilic components remain to be addressed. Relying on MARTINI coarse-grain (CG) molecular dynamics simulations, we explored the carrier-membrane fusion dynamics of PEG-DPPE micelles with different PEG repetitions in delivering doxorubicin (DOX). A bilayer model composed of 20% phosphatidylglycerol (POPG) and 80% phosphatidylcholine (POPC) was constructed to mimic anionic cancer cell membranes. The CG model of DOX was pioneeringly constructed herein, and it was found to distribute at the hydrophilic/hydrophobic interface of the PEGylated micelles, in agreement with experimental results. The free DOXs cause insignificant disorder of the membrane organization, whereas the PEG-DPPE micelles encapsulating DOX lead to a remarkable membrane invasion supported by the order parameter of the lipid acyl carbon tails and the membrane permeation free energy of DOX. The carrier-bilayer interaction shows a stepwise form attributed to the rearrangement of the zwitterionic/anionic lipids upon the absorption of the DOX-micelle complex on a membrane locality, which initiates the rapid release of DOX to the bilayer interior. Benefiting from the enhanced micelle-membrane interplay, the PEG1250-DPPE micelles result in severe bilayer breakage and deeper membrane insertion of DOX compared to the PEG2000-DPPE micelles. This study provides new theoretical insights into the mechanism of PEG-DPPE micelles in delivering drugs through membranes, which is of benefit for further optimization of PEGylated delivery systems.

The impact of COVID-19 on health literacy among Chinese rural residents.

The outbreak of the Coronavirus disease 2019 (COVID-19) pandemic is an opportunity to improve the health literacy of rural residents. This study aims to explore the levels of health literacy among rural residents during the COVID-19 pandemic and investigate the effects of COVID-19-related variables on the health literacy of rural residents. A total of 882 rural residents aged 15-69 years in Shaanxi province participated in this study and completed the questionnaires about health literacy and COVID-19-related variables. These results showed that although overall health literacy and three aspects of health literacy among rural residents were low and lower than those of Chinese national residents, there was no significant difference in health literacy about safety and emergency between rural residents and Chinese national residents. Additionally, COVID-19-related variables significantly predicted health literacy (i.e. scientific health, safety and emergency and infectious disease prevention). Importantly, unlike other types of health literacy, the effect of a COVID-19-related variable (i.e. the frequency of exposure to news about the COVID-19 pandemic) on infectious disease prevention was only slightly smaller than the effect of high education on infectious disease prevention, and low education was no longer a significant predictor of infectious disease prevention. To conclude, rural residents in Shaanxi province have low health literacy. Education is a major factor affecting the health literacy of rural residents, and the frequency of exposure to news about the pandemic may compensate for the negative impact of low education on health literacy.

The preparation and characterisation of tasteless core-shell clarithromycin microcapsules.

This study aims to fabricate core-shell clarithromycin (CAM) microcapsules to cover up the bitter taste of CAM by spray drying with aqueous polymer dispersion. Water dispersion of Eudragit EPO and Surelease® were innovatively used to encapsulate CAM into microcapsules via a one-step spray-drying method. The inlet air temperature, airflow rate, CAM-polymer ratio, and particle size of CAM were optimised based on drug content and T6% (the time taken for the drug to release equal to 6% w/w). The powder properties were assessed by measuring particle size and microstructure using SEM, FT-IR, and PXRD. Furthermore, selected batch was assessed for their drug content, encapsulation efficiency, in vitro release, bitterness, and stability studies. EPO-Surelease® (1: 4) microcapsules had an average diameter (D50) of 37.69 ± 3.61 µm with a span of 2.395. The drug contents and encapsulation efficiency of EPO-Surelease®(1:4) were 10.89% and 63.7%, respectively. EPO-Surelease® (1:4) microcapsules prepared by spray drying with aqueous polymer dispersion can effectively mask the bitter taste of CAM.

The Formation Mechanism of Trust in Patient from Healthcare Professional's Perspective: A Conditional Process Model.

Based on an integrated model of doctor-patient psychological mechanisms, the formation mechanism of doctor--patient trust was systematically demonstrated from the healthcare professional (HCP)'s perspective integrating intergroup relations (expectations), interpersonal relations (communication), and psychosocial (stereotypes). The results of a survey of 3000 doctors and nurses from 14 provinces in eastern, central, and western China support the rationality of an integrated model of doctor-patient psychological mechanisms. The establishment of doctor-patient trust is influenced by the direct role of primary intergroup factors, the indirect role of immediate interpersonal interactions, and the moderating role of social psychology. Specifically, (1) doctor-patient trust is directly predicted by HCP's expectation and indirectly influenced by communication; (2) stereotypes regulate the relationship between HCP's expectation, communication, and doctor-patient trust: the activation of positive stereotypes enhances the positive relationship among the three; Negative stereotypes only positively contribute to mediated pathway-communication behaviors and have a weaker facilitation effect compared to positive stereotypes.

The Effects of Physicians' Communication and Empathy Ability on Physician-Patient Relationship from Physicians' and Patients' Perspectives.

Physician communication (PC) is central to influencing physician-patient relationship (PPR), and physician empathy (PE) is central to PC. A comprehensive and objective assessment of the mechanisms underlying PPR from the two-way perspective of physicians and patients are important for social development. However, the relationship between these three variables under the two-way perspective is not clear. To examine the effectiveness of PC in predicting PPR from a two-way perspective of physicians and patients and the underlying mechanisms that influence PPR. We selected 2665 physicians and 2983 patients in China and examined the effect of physician empathy on PPR and the mediating role of PC between PE and PPR using structural equation modeling. The results of the physician self-assessment showed that the link between PC and PPR was not significant, while the results of the patient other assessment showed that physician communication was not only effective in predicting the doctor-patient relationship but also mediated the relationship between physician empathy and PPR; further analysis of the underlying mechanisms affecting PPR revealed that the results of the physician self-assessment showed that PC mediated the relationship between perspective-taking and PPR; however, the results of the patient other assessment showed that physician However, patient ratings showed that PC mediated the relationship between perspective-taking and PPR, as well as between empathic concern and PPR. However, patient ratings indicate that PC mediates the relationship between perspective-taking and PPR and between empathic concern and the PPR.

Evaluation of Emulsifying Ability of Phospholipids by Langmuir Monolayers and Stability of High Oil Ratio O/W Emulsions.

High oil ratio fat emulsion injections are prone to poor emulsification, rapid creaming, and other quality problems; therefore, the selection of emulsifiers with high emulsifying ability is crucial for the production of fat emulsions. The existing methods used to evaluate the emulsifying ability of emulsifier are to evaluate the emulsifying ability from the emulsifier itself. In the study, Langmuir monolayer selected the most miscible phospholipid with oil phase from the alternative three phospholipids by studying the molecular interaction between oil phase and phospholipid at the air/water interface. The miscibility and thermodynamic stability analyses of the different oil phase/phospholipid mixed monolayers were performed, and the data from [Formula: see text] and [Formula: see text] concluded that all three oil phases had the strongest molecular interaction with E80 and the best miscibility. The emulsions were then prepared and analyzed by the results of particle size, ζ-potential, and stability of the emulsions, where the surface free energy in the stability test echoed the results reflected by the [Formula: see text] values in the thermodynamic stability test. These results indicate that Langmuir monolayers can be used to study the interaction between oil phase and emulsifier, thus providing new ideas for evaluating the emulsifying ability of phospholipids.

Co-delivery of gemcitabine and cisplatin via Poly (L-glutamic acid)-g-methoxy poly (ethylene glycol) micelle to improve the in vivo stability and antitumor effect.

PURPOSE: The intention of the study was to co-delivery gemcitabine and cisplatin with totally different nature by prodrug and micelle strategy to improve its in vivo stability and antitumor effect. METHODS: A prodrug of gemcitabine (mPEG-PLG-GEM) was synthesized through the covalent conjugation between the primary amino group of gemcitabine and the carboxylic group of poly (L-glutamic acid)-g-methoxy poly (ethylene glycol) (mPEG-PLG). It was prepared into micelles by a solvent diffusion method, and then combined with cisplatin through chelation to prepare gemcitabine and cisplatin co-loaded mPEG-PLG micelles (mPEG-PLG-GEM@CDDP micelles). RESULTS: Gemcitabine and cisplatin in each micelle group were released more slowly than in solutions. In addition, pharmacokinetics behaviors of them were improved after encapsulated in prodrug micelles. T1/2z of gemcitabine and cisplatin encapsulated in micelles were prolonged to 6.357 h (mPEG-PLG-GEM), 10.490 h (mPEG-PLG@CDDP), 5.463 h and 12.540 h (mPEG-PLG-GEM@CDDP) compared with GEM@CDDP solutions (T1/2z = 1.445 h and 7.740 h). The ratio of synergy between gemcitabine and cisplatin (3:1 ~ 1:1(n/n)) was guaranteed in the systemic circulation, thus improving its antitumor effect. The results of biochemical analysis showed that GEM@CDDP-Sol was more toxic to kidneys and marrow compared with mPEG-PLG-GEM@CDDP micelles. CONCLUSIONS: By prodrug strategy, gemcitabine and cisplatin with totally different nature were prepared into micelles and obtained a better pharmacokinetic behavior. And the dual drug delivery system performed a better in vivo stability and antitumor effect compared with each single drug delivery system in the experiment. Scheme. Schematic of mPEG-PLG-GEM@CDDP micelles' formation and action process.

Cross-cultural adaptation, validity and reliability of the Chinese Version of Miller Behavioral Style Scale.

BACKGROUND: Health education basing on patients' information-seeking styles can improve the effectiveness of health education and patients' health outcomes. The Miller Behavioral Style Scale (MBSS) is widely used to identify individual's information-seeking styles, but the Chinese version is lacking. The study aim was to translate and culturally adapt the MBSS into Chinese version and test the content validity, construct validity and internal consistency reliability of the Chinese version of MBSS (C-MBSS). METHODS: The forward-back-translation procedure was adopted in the translation of the MBSS. Content validity was assessed in a panel of experts. In a sample of 1343 individuals including patients, patients' caregivers, university students, and medical staff, reliability and construct validity were assessed using Cronbach's alpha coefficient and factor analysis. The measurement invariance across samples was tested using multigroup confirmatory factor analysis (MGCFA). Floor and ceiling effects were checked. RESULTS: The C-MBSS achieved conceptual and semantic equivalence with the original scale. The item-level content validity index (I-CVI) of each item ranged from 0.78 to 1, and the averaging scale-level content validity index (S-CVI/ Ave) was 0.95. The exploratory factor analysis resulted in 2-factor assumption for each hypothetical threat-evoking scenario. Confirmatory factor analysis demonstrated a good fit between theoretical model and data, which provided confirmatory evidence for the second-order factor structure of 2-factor solution (Monitoring and Blunting). The Cronbach's alpha coefficients for the Monitoring and Blunting sub-scales of the C-MBSS were 0.75 and 0.62 respectively. MGCFA results supported the measurement invariance for the Monitoring sub-scale of the C-MBSS across samples. No floor or ceiling effects occurred. CONCLUSIONS: This study indicates that the C-MBSS has good content and construct validity. The Monitoring sub-scale of the C-MBSS had acceptable internal consistency reliability while the Blunting sub-scale had unsatisfactory one, which suggest that the Monitoring sub-scale of the C-MBSS can be used to identify individuals' information-seeking styles in Chinese contexts across different populations.

Urban-rural differences in the association between long-term exposure to ambient air pollution and obesity in China.

INTRODUCTION: Ambient air pollution might increase the risk of obesity; however, the evidence regarding the relationship between air pollution and obesity in comparable urban and rural areas is limited. Therefore, our aim was to contrast the effect estimates of varying air pollution particulate matter on obesity between urban and rural areas. METHODS: Four obesity indicators were evaluated in this study, namely, body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR), and waist-to-height ratio (WHtR). Exposure to ambient air pollution (e.g., particulate matter with aerodynamic diameters 1.0 µm [PM1], PM2.5, and PM10) was estimated using satellite-based random forest models. Linear regression and logistic regression models were used to assess the associations between air pollution particulate matter and obesity. Furthermore, the effect estimates of different air pollution particulates were contrasted between urban and rural areas. RESULTS: A total of 36,998 participants in urban areas and 31, 256 in rural areas were included. We found positive associations between long-term exposure to PM1, PM2.5, and PM10 and obesity. Of these air pollutants, PM2.5 had the strongest association. The results showed that the odds ratios (ORs) for general obesity were 1.8 (95% CI, 1.64 to 1.98) per interquartile range (IQR) µg/m3 increase in PM1, 1.89 (95% CI, 1.71 to 2.1) per IQR µg/m3 increase in PM2.5, and 1.74 (95% CI, 1.58 to 1.9) per IQR µg/m3 increase in PM10. The concentrations of air pollutants were lower in rural areas, but the effects of air pollution on obesity of rural residents were higher than those of urban residents. CONCLUSION: Long-term (3 years average) exposure to ambient air pollution was associated with an increased risk of obesity. We observed regional disparities in the effects of particulate matter exposure from air pollution on the risk of obesity, with higher effect estimates found in rural areas. Air quality interventions should be prioritized not only in urban areas but also in rural areas to reduce the risk of obesity.

Perceptions of patients undergoing percutaneous coronary intervention on pre-operative education in China: A qualitative study.

OBJECTIVES: To explore the perceptions of patients undergoing percutaneous coronary intervention (PCI) regarding their pre-operative health education. METHODS: A qualitative study using semi-structured, in-depth interviews was conducted in one cardiology unit in China from July 2019 to December 2019. Purposeful sampling of 17 patients undergoing PCI was interviewed about their perceptions of pre-operative health education. Thematic analysis of the transcribed data was then used to identify the themes. RESULTS: Four themes emerged from the data:(a) triple roles of pre-operative education with the categories of relief (reliving fear); burden (leading to stress); and meaningless (changing nothing); (b) family member involvement with the categories of shared responsibility and family members' duty; (c) facilitators in the process of pre-operative health education with the categories of emotional support, plain language and individualized pre-operative education; (d) inhibitors in the process of pre-operative health education with the categories of contradiction and threatening words. CONCLUSIONS: Pre-operative health education for patients undergoing PCI should be aligned with the individual patients' information-seeking styles and personal differences, emphasizing individualized patient education. Traditional Chinese philosophy should be considered in the practice of pre-operative education for patients undergoing PCI, which emphasizes family member involvement; at the same time, patient empowerment and self-care should also be stressed. In addition, emotional support and plain language from health professionals are important in pre-operative health education for patients undergoing PCI; contradiction should be avoided, and threatening words should be used with caution and with consideration for cultural variations during pre-operative education for patients undergoing PCI.

Childhood maltreatment and self-harm in Chinese adolescents: moderation and mediation via resilience.

BACKGROUND: Published studies examining the association between childhood maltreatment (CM) and self-harm (SH) among adolescents have been accumulated. It is possible that resilience serves as a moderator or mediator in CM-SH association, nevertheless, this topic has never been thoroughly investigated. METHODS: In this population-based cross-sectional study, we surveyed 3146 students aged 10-17 in southwest China. The Childhood Trauma Questionnaire (CTQ), the Modified version of Adolescents Self-Harm Scale (MASHS), and the Resilience Scale for Chinese Adolescents (RSCA) were used to measure CM, SH, and resilience. Correlational analyses, hierarchical multivariate linear regression, and structural equation modeling (SEM) were performed to test the moderation and mediation of resilience in CM-SH association. RESULTS: Findings revealed that, resilience with its five dimensions, CM, and SH were significantly correlated with each other. Resilience partially moderated and mediated the association between CM and SH. Besides, among all dimensions of resilience, emotion regulation, interpersonal assistance, and family support presented the strongest mediation in CM-SH association. CONCLUSIONS: Our results highlight the importance of resilience in CM related SH among Chinese teenagers. Resilience-oriented intervention could be considered in SH intervention measures for adolescents who had experienced CM.

Preparation of mPEG-b-PLA/TM-2 Micelle Lyophilized Products by Mixed Lyoprotectors and Antitumor Effect In Vivo.

The objective of this study was to encapsulate the poorly water-soluble drug TM-2 into polymer micelles using mPEG2k-b-PLA2.4k to increase its aqueous solubility and improve its therapeutic effect for liver cancer. Furthermore, in order to achieve long-term storage, the micelle solution was successfully freeze-dried. This study theoretically clarified the possibility of enhancing the water solubility of TM-2 using mPEG2k-b-PLA2.4k micelles as well as the protective effects of mixed lyoprotectants. Differential scanning calorimetry (DSC), X-ray diffraction (XRD), and scanning electron microscopy (SEM) were performed, which showed that the drug has a good affinity with the polymer (χ = 0.489) according to Flory-Huggins theory and that lyoprotectants reduced the crystallinity of PEG in mPEG2k-b-PLA2.4k and played a space-protective role in the lyophilization process. In vivo experiments showed that micellization could improve the drug bioavailability and give a high therapeutic effect with a tumor inhibition rate of 84.5% under the tolerated dose.