The Micron-Droplet-Confined Continuous-Flow Synthesis of Freestanding High-Entropy-Alloy Nanoparticles by Flame Spray Pyrolysis.

Alloying multiple immiscible elements into a nanoparticle with single-phase solid solution structure (high-entropy-alloy nanoparticles, HEA-NPs) merits great potential. To date, various kinds of synthesis techniques of HEA-NPs are developed; however, a continuous-flow synthesis of freestanding HEA-NPs remains a challenge. Here a micron-droplet-confined strategy by flame spray pyrolysis (FSP) to achieve the continuous-flow synthesis of freestanding HEA-NPs, is proposed. The continuous precursor solution undergoes gas shearing and micro-explosion to form nano droplets which act as the micron-droplet-confined reactors. The ultrafast evolution (<5 ms) from droplets to <10 nm nanoparticles of binary to septenary alloys is achieved through thermodynamic and kinetic control (high temperature and ultrafast colling). Among them, the AuPtPdRuIr HEA-NPs exhibit excellent electrocatalytic performance for alkaline hydrogen evolution reaction with 23 mV overpotential to achieve 10 mA cm-2, which is twofold better than that of the commercial Pt/C. It is anticipated that the continuous-flow synthesis by FSP can introduce a new way for the continuous synthesis of freestanding HEA-NP with a high productivity rate.

Flame Spray Pyrolysis Synthesis of Ultra-Small High-Entropy Alloy-Supported Oxide Nanoparticles for CO2 Hydrogenation Catalysts.

The synthesis of high-entropy alloys (HEAs) with ultra-small particle sizes has long been a challenging task. The complex and time-consuming synthesis process hinders their practical application and widespread adoption. This study presents the novel synthesis of TiO2 nanoparticles loaded with a quinary high-entropy alloy through flame spray pyrolysis (FSP) for the first time. The extremely fast heating rate of flame combustion makes the precursor fast pyrolysis gasification, high temperature in the flame field promotes the metal vapor mixing uniformly, and the fast quenching process can reduce the particle aggregation sintering, the ultra-small particle size of HEA firmly attached to the TiO2 surface. The catalysts prepared via this gas-to-particle pathway exhibit excellent performance in CO2 hydrogenation, achieving a conversion rate of 62% at 450 °C, and maintaining their activity for over 220 h without significant particle agglomeration. This finding provides valuable insights for the future design of catalytically active materials with enhanced activity and long-term stability.

Confined Synthesis of Noble Metal Clusters Assisted by Liquid Film for Photocatalytic CO2 Reduction.

The important concept of confined synthesis is considered a promising strategy for the design and synthesis of definable nanostructured materials with controllable compositions and specific morphology, such as highly loaded single-atom catalysts capable of providing abundant active sites for photocatalytic reactions. In recent years, researchers have been working on developing new confined reaction systems and searching for new confined spaces. Here, we present for the first time the concept of a bubble liquid film as a novel confined space. The liquid film has a typical sandwich structure consisting of a water layer, sandwiched between the upper and lower surfactant layers, with the thickness of the intermediate water layer at the micro- and nanometer scales, which can serve as a good confinement. Based on the above understanding and combined with the photodeposition method, we successfully confined synthesized Ag/TiO2, Au/TiO2, and Pd/TiO2 photocatalysts in liquid film. By HAADF-STEM, it can be seen that the noble metal morphologies are all nanoclusters of about 1 nm and are highly uniformly dispersed on the TiO2 surface. Compared with photodeposition in solution, we believe that the surfactant molecular layer restricts a limited amount of precursor to the liquid film, avoiding the accumulation of noble metals and the formation of large particle size nanoparticles. The liquid film, meanwhile, restricts the migration path of noble metal precursors, allowing for thorough in situ photodeposition and enables the complete and uniform dispersion of noble metal precursors, greatly reducing the photodeposition time. The uniform loading of the three noble metals proved the universality of the method, and the catalysts showed high activity for photocatalytic CO2 reduction. The rates of reduction of CO2 to CO over the Ag/TiO2 photocatalytic reached 230 µmol g-1 h-1.This study provides a new idea for the expansion of the confined reaction system and a reference for the study of liquid film as the confined space.

Highly reusable Bi2O3/electron-Cu-shuttle in-situ immobilized polyacrylonitrile fibrous mat for efficient photocatalytic degradation of methylene blue and rhodamine B dyes.

Organic semiconductor-based photocatalysts have been alluring due to their edge over inorganic photocatalysts. In this study, a reusable copper-bismuth oxide/polyacrylonitrile (Cu-Bi2O3/PAN) fibrous mat was prepared by fast-process flame spray pyrolysis and electrospinning for photocatalytic degradation of methylene blue (MB) and rhodamine B (RhB) dyes. The results confirmed a well-defined morphology of Cu-Bi2O3/PAN fibers and good coordination of flame-made Cu-Bi2O3 particles with the functional groups of PAN. The Cu-Bi2O3/PAN fibrous mat exhibits remarkable photocatalytic performance of 96.2% MB and 98.6% RhB degradation, with a reaction rate as high as about 4.5- and 10.2-times than that of flame-made Cu-Bi2O3 particles and PAN under neutral condition, even after 10 cycles. The Cu-Bi2O3/PAN exhibits complete degradation of MB and RhB in 90 and 150 min under alkaline and slightly acidic conditions, respectively. The synergistic effect of Cu-Bi2O3 and coordination bond between particles and functional groups of PAN promoted carrier migration, suppressed recombination of carriers and provided abundant radicals on the surface of the mat. Superoxide and hydroxyl radicals were the major active species involved in the degradation of RhB and MB, respectively. This work provides an insight into designing the Cu-metal-shuttle based photocatalysts to optimize fibrous mat application in water remediation.

Pd Single-Atom Loaded Ce-Zr Solid Solution Catalysts Prepared by Flame Spray Pyrolysis for Efficient CO Catalytic Oxidation.

Single-atom catalysts (SACs) exhibit remarkable catalytic activity at each metal site. However, conventionally synthesized single-atom catalysts often possess low metal loading, thereby constraining their overall catalytic performance. Here, a flame spray pyrolysis (FSP) method for the synthesis of a single-atom catalyst with a high loading capacity of up to 1.4 wt.% in practice is reported. CeZrO2 acts as a carrier and provides a large number of anchoring sites, which promotes the high-density generation of Pd, and the strong interaction between the metal and the support avoids atom aggregation. Pd-CeZrO2 series catalysts have excellent CO oxidation performance. When 0.97 wt.% Pd is added, the catalytic activity is the highest, and the temperature can be reduced to 120 °C. This work presented here demonstrates that FSP, as an inherently scalable technique, allows for elevating the single-atom loading to achieve an increase in its catalytic performance. The method presented here more options for the preparation of SACs.

Rich-Carbonyl Carbon Catalysis Facilitating the Li2 CO3 Decomposition for Cathode Lithium Compensation Agent.

The active lithium loss of lithium-ion batteries can be well addressed by adding a cathode lithium compensation agent. Due to the poor conductivity and electrochemical activity, lithium carbonate (Li2 CO3 ) is not considered as a candidate. Herein, an effective cathode lithium compensation agent, the recrystallized Li2 CO3 combined with large specific surface area disordered porous carbon (R-LCO@SPC) is prepared. The screened SPC makes it easier for nano-sized Li2 CO3 to adsorb and decompose on carbon substrate, meantime, exposing plenty of catalytic active sites of C═O, which can significantly improve the electrochemical activity and conductivity of Li2 CO3 , thus greatly reducing the decomposition potential of Li2 CO3 (4.0 V) and releasing high irreversible capacity (580 mAh g-1 ) compared to the unmodified Li2 CO3 (nearly no capacity above 4.6 V). Meantime, the Li2 CO3 can disappear completely without any by-product after the initial cycle accompanied by partially dissolved in electrolyte, optimizing the composition of SEI. The resultant lithium compensation agent applied to LMFP//graphite full cell exhibits a 19.1% increase in energy density, enhancing the rate and cycling performance, demonstrating great practical applications potential in high energy density lithium-ion batteries.

Long-lifespan Zinc-ion Capacitors Enabled by Anodes Integrated with Interconnected Mesoporous Chitosan Membranes through Electrophoresis-driven Phase Separation.

The advancement of highly secure and inexpensive aqueous zinc ion energy storage devices is impeded by issues, including dendrite growth, hydrogen evolution and corrosion of zinc anodes. It is essential to modify the interface of zinc anodes that homogenizes ion flux and facilitates highly reversible zinc planarized deposition and stripping. Herein, by coupling zinc ion coordination with acid-base neutralization under the driving of electrophoresis, manageable mesoscopic phase separation for constructing chitosan frameworks was achieved, thereby fabricating interconnected mesoporous chitosan membranes based heterogeneous quasi-solid-state electrolytes integrated with anodes. The framework is constructed by twisted chitosan nanofiber bundles, forming a three-dimensional continuous spindle-shaped pore structure. With this framework, the electrolyte provides exceptional ion conductivity of 25.1 mS cm-1 , with a puncture resistance strength of 2.3 GPa. In addition, the amino groups of chitosan molecule can make the surface of the framework positively charged. Thus, reversible zinc planarized deposition is successfully induced by the synergistic effect of stress constraint and electrostatic modulation. As a result, as-assembled zinc ion capacitor has an excellent cycle life and sustains the capacity by over 95 % after 20000 cycles at a current density of 5 A g-1 . This research presents a constructive strategy for stable electrolytes-integrated zinc anodes.

Prediction of prognostic and immune therapy response in lung adenocarcinoma based on MHC-I-related genes.

OBJECTIVES: The study investigated the prognostic and immune predictive potential of major histocompatibility complex class I (MHC-I) in lung adenocarcinoma (LUAD). MATERIALS AND METHODS: With The Cancer Genome Atlas (TCGA)-LUAD and Gene Expression Omnibus datasets (GSE26939, GSE72094) as the training and validation sets, respectively, we used Cox regression analysis to construct a prognostic model, and verified independence of riskscore. The predictive capacity of the model was assessed in both sets using the receiver operating characteristic curve and Kaplan-Meier survival curves. Immune analysis was performed by using ssGSEA. Additionally, immune checkpoint blockade therapy was assessed by using immunophenoscore, Tumor Immune Dysfunction and Exclusion score. Based on the cMAP database, effective small molecule compounds were predicted. RESULTS: A prognostic model was established based on 8 MHC-I-related genes, and the predictive capacity of the model was accurate. Immune analysis results revealed that patients classified as high-risk had lower levels of immune cell infiltration and impaired immune function. The low-risk group possessed a better response to immune checkpoint blockade therapy. Theobromine and pravastatin were identified as having great potential in improving the prognosis of LUAD. CONCLUSION: Overall, the study revealed MHC-I-related molecular prognostic biomarkers as robust indicators for LUAD prognosis and immune therapy response.

Simultaneous Detection of Citric Acid and Oxalic Acid Based on Dual Spectrum and Biomimetic Peroxidase for Urolithiasis Screening with a Fully Automatic Urine Analyzer.

Urolithiasis stands as a prevalent ailment within the urinary system, with hyperoxaluria and hypocitraturia being the most frequent manifestations characterized by excessive oxalic acid (OA) and deficient citric acid (CA) levels in urine. Detecting these compounds in urine quantitatively holds paramount importance for early urolithiasis screening. Existing methodologies fall short in achieving simultaneous and on-site identification of OA and CA, posing challenges for accurate urolithiasis screening. Addressing this concern, the study successfully accomplishes the concurrent identification of OA and CA in urine through a combination of dual-spectral analysis and biomimetic peroxidase utilization. Bovine serum albumin and dithiothreitol-modified copper nanoclusters (BSA-DTT-CuNCs) are employed as biomimetic peroxidases, effectively mitigating interference and enabling the simultaneous determination of OA and CA. The quantification range spans from 0 to 12 mm for OA and 0.5 to 2.5 mm for CA, with detection limits of 0.18 and 0.11 mm, respectively. To facilitate swift and on-location urine analysis, a fully automated urine analyzer (FAUA) is introduced that streamlines the process of biomarker pretreatment and identification within urine samples. Validation with real urine samples from urolithiasis patients demonstrates the method's diagnostic precision, highlighting the dual-spectral technique and analyzer's promising role in urolithiasis screening.

Virtual Reality in Clinical Nursing Practice Over the Past 10 Years: Umbrella Review of Meta-Analyses.

Background: Virtual reality (VR) has shown promising levels of effectiveness in nursing education, pain management, and rehabilitation. However, meta-analyses have discussed the effects of VR usage in nursing unilaterally and inconsistently, and the evidence base is diffuse and varied. Objective: We aimed to synthesize the combined evidence from meta-analyses that assessed the effects of nurses using VR technology on nursing education or patient health outcomes. Methods: We conducted an umbrella review by searching for meta-analyses about VR intervention in clinical nursing practice on Web of Science, Embase, Cochrane, and PubMed, and in reference lists. Eligible studies were published in English between December 1, 2012, and September 20, 2023. Meta-analyses of ≤2 intervention studies and meta-analyses without 95% CI or heterogeneity data were excluded. Characteristic indicators, population information, VR intervention information, and 95% CIs were extracted. A descriptive analysis of research results was conducted to discern relationships between VR interventions and outcomes. I2 and P values were used to evaluate publication bias. AMSTAR (A Measurement Tool to Assess Systematic Reviews) 2 and the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) checklist were used to appraise literature quality. Results: In total, 768 records were identified; 74 meta-analyses were included for review. The most reported VR study conditions were neuronursing (25/74, 34%), pediatric nursing (13/74, 18%), surgical and wound care (11/74, 15%), oncological nursing (11/74, 15%), and older adult nursing (10/74, 14%). Further, 30% (22/74) of meta-analyses reported publication bias, and 15% (11/74) and 8% (6/74) were rated as "high" based on AMSTAR 2 and the GRADE checklist, respectively. The main outcome indicators among all included meta-analyses were pain (37/214, 17.3%), anxiety (36/214, 16.8%), cognitive function (17/214, 7.9%), balance (16/214, 7.5%), depression (16/214, 7.5%), motor function (12/214, 5.6%), and participation in life (12/214, 5.6%). VR treatment for cognition, pain, anxiety, and depression was effective (all P values were <.05), while the utility of VR for improving motor function, balance, memory, and attention was controversial. Adverse effects included nausea, vomiting, and dizziness (incidence: range 4.76%-50%). The most common VR platforms were Pico VR glasses, head-mounted displays, the Nintendo Wii, and the Xbox Kinect. VR intervention duration ranged from 2 weeks to 12 months (typically ≥4 wk). VR session length and frequency ranged from 5 to 100 minutes and from 1 to 10 times per week, respectively. Conclusions: VR in nursing has positive effects-relieving patients' pain, anxiety, and depression and improving cognitive function-despite the included studies' limited quality. However, applying VR in nursing to improve patients' motor function, balance, memory, and attention remains controversial. Nursing researchers need to further explore the effects and standard operation protocols of VR in clinical practice, and more high-quality research on VR in nursing is needed.

Association between the weight-adjusted waist index and stroke: a cross-sectional study.

BACKGROUND: The weight-adjusted waist index (WWI) is a new measure of obesity, and this study aimed to determine the association between the WWI and stroke. METHODS: Using the National Health and Nutrition Examination Survey (NHANES) 2011-2020 dataset, cross-sectional data from 23,389 participants were analysed. The correlation between the WWI and stroke was investigated through multivariate logistic regression and smoothing curve fitting. Subgroup analysis and interaction tests were also carried out. RESULTS: The research involved 23,389 participants, of whom 893 (3.82%) had a stroke. The fully adjusted model revealed a positive correlation between the WWI and stroke [1.25 (1.05, 1.48)]. Individuals who were in the highest quartile of WWI exhibited a 62% higher likelihood of experiencing a stroke than those in the lowest quartile [1.62 (1.06, 2.48)]. Subgroup analysis and interaction tests revealed that this positive correlation was similar in different population settings (all P for interaction > 0.05). CONCLUSION: A higher WWI was associated with a higher prevalence of stroke. The results of this study underscore the value of the WWI in stroke prevention and management.

Isotropic Microstrain Relaxation in Ni-Rich Cathodes for Long Cycling Lithium Ion Batteries.

Developing isotropic-dominated microstrain relaxation is a vital step toward the enhancement of cyclic performance and thermal stability for high-energy-density Ni-rich cathodes. Here, a microstructure engineering strategy is employed for synthesizing the elongated primary particles radially aligned Ni-rich cathodes only by regulating the precipitation rates of cations and the distributions of flow field. The as-obtained cathode also exhibits an enlarged lattice distance and highly exposed (003) plane. The high aspect ratio and favorable atomic arrangement of primary particles not only enable isotropic strain relaxation for effectively suppressing microcrack formation and propagation, but also facilitate Li-ion diffusion with greatly reduced Li/Ni mixing. Consequently, it shows obvious superiority in the high-rate, long-cycle life, and thermal stability compared with the conventional counterparts. After modification, an exceptionally long life is achieved with a capacity retention of 90.1% at 1C and 84.3% at 5C after 1500 cycles within 3.0-4.3 V in a 1.5-Ah pouch cell. This work offers a universal strategy to achieve isotropic strain distribution for conveniently enhancing the durability of Ni-rich cathodes.

[Using Liver Function Indicators to Predict Massive Blood Transfusion in Orthotopic Liver Transplantation].

Objective: To explore the predictive effect of preoperative liver function indicators for intraoperative massive blood transfusion in orthotopic liver transplantation and to establish a prediction model. Methods: We retrospectively analyzed the relevant data of 607 patients who underwent orthotopic liver transplantation in the Department of Liver Surgery, West China Hospital, Sichuan University between January 1, 2015 and June 30, 2021. According to the intraoperative transfusion volume of leukocyte-reduced red blood cells in additive solution, the patients were divided into a massive blood transfusion (MBT) group and a non-massive blood transfusion (NMBT) group. Univariate and multivariate logistic regressions were performed to analyze the risk factors of intraoperative MBT in orthotopic liver transplantation, the calibration of the predictive model was assessed by Hosmer-Lemeshow test, and the discrimination power of the predictive model was measured by area under the curve ( AUC) of the receiver operating characteristic (ROC) curve. Results: According to the results of logistic regression, alanine transaminase (ALT), aspartate transaminase (AST), total bilirubin (TBIL), direct bilirubin (DBIL), albumin (ALB), and Child-Pugh score showed no correlation with the risk of MBT in orthotopic liver transplantation operation. Platelet count (PLT) (odds ratio [ OR]=0.90, 95% confidence interval [ CI]: 0.09-0.19, P=0.02), international normalized ratio (INR) ( OR=19.43, 95% CI: 7.64-19.44, P<0.01), prothrombin time (PT) ( OR=1.43, 95% CI: 1.25-1.63, P<0.01), and activated partial thromboplastin time (APTT) ( OR=0.92, 95% CI: 0.90-0.95, P<0.01) were identified as the risk factors of intraoperative MBT in orthotopic liver transplantation. The Hosmer-Lemeshow test showed that the predictive model had good calibration ( χ 2=9.06, P=0.48) and discrimination power ( AUC=0.80, 95% CI 0.766-0.834, P<0.01). Conclusion: A predictive model based on the preoperative PLT, INR, PT, and APTT of patients undergoing orthotopic liver transplantation was established and can be used to predict the risk of intraoperative MBT in liver transplantation patients.

[An Integrated Audio-Visual-Olfactory Virtual Reality False Feeding Device: Research, Development, and Design].

Objective: To resolve the problem of the lack of sensory stimulation from the colors and aromas of food when patients are given enteral nutrition support by tube feeding or simple oral administration, an immersive virtual reality (VR) sham feeding device integrating audio, visual, and olfactory sense perceptions was developed independently and the usability of the device was tested. Methods: Relying on the multidisciplinary cooperation of nursing, mechanical engineering, and computer science and using as a reference the characteristics of gastric tube and oxygen tube placement in clinical patients, we carried out 3D modeling and printing of the exterior framework of the odor box. Unity 3d.5.x, a mainstream virtual engine tool, was used to create scenarios. The device could create visual stimulation through 3 VR dining scenarios, 23 kinds of food, and comfortable dining environment. The sound of chewing was played to simulate the dining process and provide auditory stimulation. Through the independently researched and developed olfactory odor box, corresponding food aromas were sprayed out for olfactory stimulation. After the equipment prototype was created, 10 patients were recruited to perform users' subjective evaluation of the usability of the equipment. Results: A VR sham feeding device integrating audio-visual-olfactory stimulation was successfully developed. In the visual effect evaluation, all users commented that the vision was clear and unimpeded, and that the menu program could follow their rotation movement. Eight people considered the scenes to be rather realistic. In the auditory effect evaluation, all users stated that the volume of the sound was appropriate, and that they would hear a chewing sound being played when the food was approaching. In the olfactory effect evaluation, 9 people stated that they smelled the food aromas when the food was approaching, and that they thought the odor was real or partially real. On the whole, the equipment was convenient to use and all users thought that the equipment had clear presentation and could run stably and smoothly. No adverse reactions, such as dizziness, occurred in any users. Conclusion: Successfully presenting visual, auditory, and olfactory stimuli, the prototype device passed the subjective usability test. The prototype device effectively expands the application prospects of VR in the medical field. In the future, it will be applied to patient populations, including surgical patients, patients with eating disorders, obesity, and loss of appetite, and other patients who cannot take in food through their mouths. The prototype device provides new ideas for promoting enhanced recovery after surgery and improving patient experience.

Strong interlayer coupling in p-Te/n-CdSe van der Waals heterojunction for self-powered photodetectors with fast speed and high responsivity.

Self-driven photodetectors, which can detect optical signals without external voltage bias, are highly attractive in the field of low-power wearable electronics and internet of things. However, currently reported self-driven photodetectors based on van der Waals heterojunctions (vdWHs) are generally limited by low responsivity due to poor light absorption and insufficient photogain. Here, we report p-Te/n-CdSe vdWHs utilizing non-layered CdSe nanobelts as efficient light absorption layer and high mobility Te as ultrafast hole transporting layer. Benefiting from strong interlayer coupling, the Te/CdSe vdWHs exhibit stable and excellent self-powered characteristics, including ultrahigh responsivity of 0.94 A W-1, remarkable detectivity of 8.36 × 1012 Jones at optical power density of 1.18 mW cm-2 under illumination of 405 nm laser, fast response speed of 24 µs, large light on/off ratio exceeding 105, as well as broadband photoresponse (405-1064 nm), which surpass most of the reported vdWHs photodetectors. In addition, the devices display superior photovoltaic characteristics under 532 nm illumination, such as large Voc of 0.55 V, and ultrahigh Isc of 2.73 µA. These results demonstrate the construction of 2D/non-layered semiconductor vdWHs with strong interlayer coupling is a promising strategy for high-performance and low-power consumption devices.

Comparative Effects of Different Nutritional Supplements on Inflammation, Nutritional Status, and Clinical Outcomes in Colorectal Cancer Patients: A Systematic Review and Network Meta-Analysis.

Nutritional supplements have been widely used in colorectal cancer (CRC) patients. The aim of this network meta-analysis (NMA) was to compare the effects of different nutritional supplements on inflammation, nutritional status, and clinical outcomes in CRC patients. Four electronic databases were searched until December 2022. Randomized controlled trials (RCTs) comparing nutritional supplements of omega-3 fatty acids (omega-3), arginine, vitamin D, glutamine, probiotics, or their combinations with placebo or standard treatment were selected. The outcomes were inflammatory indicators, nutritional indicators, and clinical outcomes. A random-effects Bayesian NMA was performed to rank the effect of each supplement. In total, 34 studies involving 2841 participants were included. Glutamine was superior in decreasing tumor necrosis factor-α (MD -25.2; 95% CrI [-32.62, -17.95]), whereas combined omega-3 and arginine supplementation was more effective in decreasing interleukin-6 (MD -61.41; 95% CrI [-97.85, -24.85]). No nutritional supplements significantly maintained nutritional indicators in CRC patients. Regarding clinical outcomes, glutamine ranked highest in reducing the length of hospital stay (MD -3.71; 95% CrI [-5.89, -1.72]) and the incidence of wound infections (RR 0.12; 95% CrI [0, 0.85]), and probiotics were rated as best in reducing the incidence of pneumonia (RR 0.38; 95% CrI [0.15, 0.81]). Future well-designed RCTs are needed to further confirm these findings.

DOX-loaded mesoporous hydroxyapatite modified by hyaluronic acid can achieve efficient targeted therapy for lung cancer.

It is a novel therapeutic strategy to suppress tumour growth and metastasis by regulating the interaction between bioactivity ions and the biological process of tumour cells. This study synthesised a mesoporous hydroxyapatite (MHAP)-based nanocarrier for targeted delivery of the anti-cancer drug doxorubicin (DOX). To further strengthen the targeting of DOX-loaded nanocarrier to tumour, HA that could specifically identify receptor on the surface of tumours was functionally modified. The drug release properties curve showed that the MHAP-HA@DOX complex showed pH-sensitive and sustained release properties. Also, the MHAP-HA@DOX complex represented high toxicity against lung cancer A549 cells. Besides, it displayed a significant inhibitory effect on tumour growth rate in tumour-bearing mice, while no evident toxicity for mice was observed. This nano-material is hoped to be an effective and novel nano-drug for lung cancer.

Issues in patients' experiences of enhanced recovery after surgery (ERAS) : a systematic review of qualitative evidence.

OBJECTIVE: To explore patients' experiences of enhanced recovery after surgery (ERAS) and to identify issues in the implementation of ERAS from the patient's perspective. DESIGN: The systematic review and qualitative analysis were based on the Joanna Briggs Institute's methodology for conducting synthesis. DATA SOURCES: Relevant studies published in four databases, that is, Web of Science, PubMed, Ovid Embase and the Cochrane Library, were systematically searched, and some studies were supplemented by key authors and reference lists. STUDY SELECTION: Thirty-one studies were identified, involving 1069 surgical patients enrolled in the ERAS programme. The inclusion and exclusion criteria were formulated based on the Population, Interest of phenomena, Context, Study design criteria recommended by the Joanna Briggs Institute to determine the scope of article retrieval. The inclusion criteria were as follows: ERAS patients' experiences; qualitative data; English language and published from January 1990 to August 2021. DATA EXTRACTION: Data were extracted from relevant studies using the standardised data extraction tool from Joanna Briggs Institute Qualitative Assessment and Review Instrument for qualitative research. DATA SYNTHESIS: The themes in the structure dimension are as follows: (1) patients cared about the timeliness of healthcare professionals' help; (2) patients cared about the professionalism of family care; and (3) patients misunderstood and worried about the safety of ERAS. The themes in the process dimension are as follows: (1) patients needed adequate and accurate information from healthcare professionals; (2) patients needed to communicate adequately with healthcare professionals; (3) patients hoped to develop a personalised treatment plan and (4) patients required ongoing follow-up services. The theme in the outcome dimension is as follows: patients wanted to effectively improve severe postoperative symptoms. CONCLUSIONS: Evaluating ERAS from the patient's perspective can reveal the omissions and deficiencies of healthcare professionals in clinical care so that problems in patients' recovery process can be solved in a timely manner, reducing potential barriers to the implementation of ERAS. PROSPERO REGISTRATION NUMBER: CRD42021278631.

[First-Class Nursing Discipline Construction Spearheads the Cultivation of First-Class Talents].

Cultivating first-class talents is a key task of the Double First-Class Initiative, a national plan to build a number of world-class universities and disciplines in China by the end of 2050. On the basis of reviewing the history of the development of the nursing discipline, we analyzed, herein, opportunities and challenges of nursing professional training under the strategic guidance of the Double First-Class Initiative. We proposed suggestions on the cultivation of first-class nursing professionals of the future by considering the following aspects, constructing a theoretical system of ideological and political education for nursing education with Chinese characteristics, exploring for ways to develop a nursing knowledge system and personnel training model around the axis of a life-course approach to health, building "nursing plus" interdisciplinary clusters to cultivate innovative talents with interdisciplinary integrated abilities, enhancing efforts to recruit and cultivate scientific and technological talents, optimizing in an all-round way the composition of qualified nursing personnel, gaining the support of first-class research platforms, and creating incubation centers for innovative and outstanding nursing professionals.