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IntroductionHere, we provide a feasible, well-designed protocol of a randomised controlled trial for the assessment of the effects of a home-based multidisciplinary intervention on the severity of skin adverse drug reactions and health-related indicators in patients with non-small cell lung cancer (NSCLC) under epidermal growth factor receptor tyrosine kinase inhibitor (EGFR-TKI) therapy.Methods and analysisThe study will be a two-group, parallel randomised controlled trial conducted at patients’ homes by a multidisciplinary team in Zhengzhou in Henan Province, China. Patients with NSCLC who received EGFR-TKI therapy and experienced adverse skin reactions will be randomised and receive either ordinary care or home-based multidisciplinary interventions. The intervention will be divided into an intensive stage (6 weeks) and a maintenance stage (6 weeks) with baseline and follow-up assessment. Interventions in the intensive stage will include general interventions such as health education, follow-up, behaviour guide and social support and targeted interventions such as skill training, coping with adverse drug reaction and problem-solving. The measures that will be carried out in maintenance stage are continuous interventions consisted of an intensive intervention. The multidisciplinary team will be responsible for managing skin adverse drug reactions as required at patients’ homes. Data collection and analysis will be performed by researchers at baseline, the end of the sixth week of intervention and the third month after the intervention. The primary outcome is the degree of skin adverse drug reactions, while the secondary outcomes, for example, self-management ability, quality of life, outpatient visits and health economics indicators, will also be presented.Ethics and disseminationThis study was reviewed and approved by the Ethics Committee of Zhengzhou University (No. ZZUIRB-2020-97). Findings will be available to patients, clinicians, nurses, pharmacists, community medical staff, funders and health policymakers through peer-reviewed publications, social media and patient support groups.Trial registration numberChinese Clinical Trials Registry (ChiCTR2000040643).

Purpose: This study was to investigate the work experience of newly recruited male nurses during the COVID-19 pandemic. Methods: With a phenomenological approach, this qualitative study was adopted semistructured interviews by phone or video calls. A total of 9 male nurses newly recruited for the COVID-19 wards in Chinese hospitals were interviewed for this study. And Colaizzi's method was applied for evaluation in the data analysis. Results: Based on our findings, three themes were extracted. First, the newly recruited male nurses showed negative emotions at the beginning of COVID-19 epidemic, which was caused by changes in working conditions and content, but also prompted the nurses to change the way of coping with the crisis. Second, they gradually mastered the working skills and psychological training to cope with COVID-19 and developed a positive attitude toward life and a high sense of professional responsibility. Finally, we learned about their needs to respond to public health emergencies such as the COVID-19 pandemic. Conclusion: COVID-19 is a disaster for all of humanity. The newly recruited male nurses are an important force in emergency rescue. Although they suffered from short-term negative emotions, they quickly adapted to the crisis. In order to better prepare for future emergencies, the disaster response capacity of newly recruited male nurses needs to be further improved. In addition, newly recruited male nurses have a strong demand for timely and personalized career development guidance.

Background The adverse reactions (ADRs) of targeted therapy were closely associated with treatment response, clinical outcome, quality of life (QoL) of patients with cancer. However, few studies presented the correlation between ADRs of targeted therapy and treatment effects among cancer patients. This study was to explore the characteristics of ADRs with targeted therapy and the prognosis of cancer patients based on the clinical data. Methods A retrospective secondary data analysis was conducted within an ADR data set including 2703 patients with targeted therapy from three Henan medical centers of China between January 2018 and December 2019. The significance was evaluated with chi-square test between groups with or without ADRs. Univariate and multivariate logistic regression with backward stepwise method were applied to assess the difference of pathological characteristics in patients with cancer. Using the univariate Cox regression method, the actuarial probability of overall survival was performed to compare the clinical outcomes between these two groups. Results A total of 485 patients were enrolled in this study. Of all patients, 61.0% (n = 296) occurred ADRs including skin damage, fatigue, mucosal damage, hypertension and gastrointestinal discomfort as the top 5 complications during the target therapy. And 62.1% of ADRs were mild to moderate, more than half of the ADRs occurred within one month, 68.6% ADRs lasted more than one month. Older patients (P = 0.022) and patients with lower education level (P = 0.036), more than 2 comorbidities (P = 0.021), longer medication time (P = 0.022), drug combination (P = 0.033) and intravenous administration (P = 0.019) were more likely to have ADRs. Those with ADRs were more likely to stop taking (P = 0.000), change (P = 0.000), adjust (P = 0.000), or not take the medicine on time (P = 0.000). The number of patients with recurrence (P = 0.000) and metastasis (P = 0.006) were statistically significant difference between ADRs and non-ADRs group. And the patients were significantly poor prognosis in ADRs groups compared with non-ADRs group. Conclusion The high incidence of ADRs would affect the treatment and prognosis of patients with cancer. We should pay more attention to these ADRs and develop effective management strategies.

To explore the experience of non-small-cell lung cancer patients with targeted therapy-related skin adverse drug reactions.This is a descriptive quantitative study conducted in a comprehensive hospital in Henan, China. Purposive sampling was used to recruit patients with non-small-cell lung cancer and with targeted therapy-related skin adverse drug reactions. In total, 23 patients were approached when the data were saturated. Face-to-face interviews were conducted by an independent researcher using a semi-structured interview guide. Interview data were transcribed and analyzed by qualitative inductive content analysis.Based on the analysis, four main categories were identified according to patients' descriptions of their experience: a lack of self-management ability, psychological and emotional problems, a barrier to social participation, and a need for social support. Suffering from persistent symptoms, insufficient knowledge, skills and strategies for skin adverse drug reaction management, psychological problems, social avoidance/withdrawal, and reduced willingness to work were core experiences that would affect patients' compliance with treatment, prognosis, and the overall quality of life.This study revealed the real experience of patients with non-small-cell lung cancer and with targeted therapy-related skin adverse drug reactions which contributed to the development of targeted interventions to manage skin adverse reactions.

Nucleic acid precipitation is important for virtually all molecular biology investigations. However, despite its crucial role, a systematic study of the influence factors of nucleic acid precipitation has not been reported. In the present work, via rational experimental design, key factors of nucleic acid precipitation, including the type of nucleic acid, temperature and time of incubation, speed and time of centrifugation, volume ratio of ethanol/isopropanol to nucleic acid solution, type of cation-containing salt solution and type of coprecipitator, were comprehensively evaluated in an attempt to maximize the efficiency of nucleic acid precipitation. Our results indicate that the optimal conditions of each influence factor of nucleic acid precipitation may vary in accordance with the chemistry, structure and length of nucleic acids.

Purpose This study was to assess the status of quality of life and explore the possible factors correlated with quality of life among non-small cell lung cancer (NSCLC) patients with skin adverse drug reactions under targeted therapy. Methods We performed a cross-sectional study including 536 NSCLC patients with skin adverse drug reactions by targeted therapy in cancer outpatient clinics of three hospitals in China between May 2020 and May 2021. And we collected data with structured questionnaires and identified the relationships among coping style, self-management and quality of life by Pearson correlation analysis and multiple linear regression algorithm. Results The total score of quality of life was 46±12.84 in 536 NSCLC patients with skin adverse drug reactions undergoing targeted therapy. In multiple linear regression analysis, we identified the significant factors associated with quality of life including age, education level, combination of medicine, Charlson Comorbidity Index (CCI), stages of disease, facing, yield, symptom management, daily activity management, psychological and emotional management, self-efficacy and self-management (P < 0.05). Conclusions NSCLC patients with skin adverse drug reactions undergoing targeted therapy generally had a compromised quality of life. And the critical factors that affected the status of quality of life were age, education level, co-morbidity, the combinatorial application of drugs and stage of disease, self-management and coping styles.

The status and associated factors of the health-related quality of life of non-small-cell lung cancer (NSCLC) patients under targeted anti-cancer therapy have not been investigated. Self-management and coping style have been proven to be closely related to patients' health-related quality of life. Based on these observations, this study was designed to firstly assess the status of health-related quality of life, and then explore the relationships among coping styles, self-management, and health-related quality of life of NSCLC patients with skin adverse drug reactions under targeted therapy.We performed a cross-sectional study including 536 NSCLC patients with skin adverse drug reactions under targeted therapy in cancer clinics of three hospitals in China between May 2020 and May 2021. Structured questionnaires, including the Functional Assessment of Cancer Therapy-Epidermal Growth Factor Receptor Inhibitor 18, Cancer Patient Self-management Evaluation Scale, and Medical Coping Modes Questionnaire, were used to collect data. Relationships among coping style, self-management, and health-related quality of life were identified by Pearson correlation analysis and a multiple linear regression algorithm.The total score of health-related quality of life was 46 ± 12.84 in 536 NSCLC patients with skin adverse drug reactions undergoing targeted therapy. Health-related quality of life was positively correlated with self-management (r = 0.785, P 0.01) and facing (r = 0.807, P 0.01) and negatively correlated with yield (r = - 0.718, P 0.01), avoidance (r = - 0.711, P 0.01), and the severity of skin adverse reactions (r = - 0.722, P = 0.000). Via multiple linear regression analysis, we identified some significant factors associated with health-related quality of life, including age, education level, combination of medicine, Charlson Comorbidity Index, stages of disease, facing, yield, symptom management, daily activity management, psychological and emotional management, self-efficacy, and self-management (P 0.05).NSCLC patients with skin adverse drug reactions undergoing targeted therapy generally had a compromised health-related quality of life. The critical factors that were associated with the status of health-related quality of life were age, education level, comorbidity, the combinatorial application of drugs, stage of disease, self-management, and coping styles.

Huiyue Zhou,1,&ast; Xin Wang,1,&ast; Dan Yu,2,&ast; Ruofei Du,1 Huaisong Wang,3 Jizhe Zhu,1 Haoning Zhang,1 Changying Chen,4 Tao Wang1,5– 7 1Nursing and Health School, Zhengzhou University, Zhengzhou, Henan, 450001, People’s Republic of China; 2Department of Gengral Surgery, The Second Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, 450001, People’s Republic of China; 3Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430022, People’s Republic of China; 4Department of Quality Control, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, 450001, People’s Republic of China; 5Cancer Centre, Telethon Kids Institute, Perth, WA, 6872, Australia; 6Medical School, University of Western Australia, Perth, WA, 6872, Australia; 7Department of Oncology, People’s hospital of Hebi, Hebi, Henan, 458010, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Tao Wang, Nursing and Health School, Zhengzhou University, Zhengzhou, Henan, 450001, People’s Republic of China, Email wangtaomary@zzu.edu.cn Changying Chen, Department of Quality Control, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, 450001, People’s Republic of China, Email changying@zzu.edu.cnObjective: Oral targeted antineoplastic drugs (OTADs) are becoming more and more acceptable for lung cancer treatment due to their advantages such as the convenience of administration and milder side effects. However, medication adherence represents a major issue for prolonged OTAD treatment. In this study, the factors associated with treatment adherence to OTAD were explored through the Adherence Influencing Factor Framework suggested by WHO. Based on these results, we further examined the potential factors related to social psychological cognition in OTAD adherence in patients with lung cancer.Methods: This qualitative study was conducted in public hospitals in Henan, China. Data were collected through semi-structured interviews with selected lung cancer patients. Face-to-face interviews were audio-recorded and transcribed for thematic analysis.Results: Of the 21 patients interviewed, 17 were males and 4 were females. The analysis of the data led to four themes, ie, patient-related factors (medication-taking introspection, family structure, weigh the pros and cons of OTAD treatment), medication-related factors (medication experience, adverse reactions, information access), physician/nurse-related factors (shared decision making, doctor’s reaction, nurse’s inquiry) and society-related factors (fear, stigma).Conclusion: Family structure, weigh the pros and cons of OTAD treatment, information access, shared decision making, nurse’s inquiry are potential factors affecting OTAD adherence in lung cancer patients. Providing drug information support to patients, inviting patients to join in shared decision-making and strengthening doctor-patient-nurse cooperation are important for improving medication adherence. Further research should be conducted to help healthcare providers to promote the medication adherence of lung cancer patients to OTAD treatment.Keywords: OTAD adherence, qualitative study, lung cancer, targeted cancer therapy

The SWI/SNF complex is a highly conserved chromatin remodeling complex and can hydrolyze ATP by its catalytic subunit BRG1 or BRM to reconstruct the chromatin. To investigate whether this ATP-dependent chromatin remodeling could affect the DNA conformation, we therefore regulated (knocked down or overexpressed) BRG1/BRM in the cells and applied Fourier transform infrared (FTIR) spectroscopy to probe DNA conformational changes. As a result, we found that BRG1/BRM was indeed associated with the DNA conformational changes, in which knockdown of BRG1/BRM reduced Z-DNA conformation, while overexpression of BRG1/BRM enhanced Z-DNA conformation. This Z-DNA conformational transformation was also verified using the Z-DNA-binding proteins. Therefore, this work has provided a direct analytical tool to probe Z-DNA transformation upon ATP-dependent chromatin remodeling.

Background: The adverse reactions (ADR) of targeted therapy were closely related to the treatment efficacy, quality of life (QoL) and prognosis of cancer patients. However, few studies analyzed the ADR of targeted therapy and their effects on cancer patients. This study was conducted to describe the incidence and characteristics of ADR in cancer patients with targeted therapy and outcomes associated with ADR based on hospital medical data.Methods: A retrospective secondary data analysis was conducted using ADR data in hospital medical record collected from a cohort (n=2,703 with targeted therapy) in three hospitals of Henan, China from January 2018 to December 2019. The type, classification, occurrence time and duration of ADR, medication compliance and drug application, QoL, disease progress and survival of patients were analyzed.Results: A total of 485 patients met the inclusion criteria. 296 (61.0%) patients had ADR during target therapy. The top five ADR in this study were damage to skin, fatigue, mucosal damage, hypertension and gastrointestinal discomfort. 62.1% of the ADR were mild to moderate, more than half of the ADR occurred within one month, 68.6% ADR lasted more than one month. Older patients (P=0.022) and patients with lower education level (P=0.036), more than 2 comorbidities (P=0.021), longer medication time (P=0.022), drug combination (P=0.033) and intravenous administration (P=0.019) were more likely to have ADR. Those who had ADR were more likely to stop taking (P=0.025), change (P=0.010), adjust (P=0.019), or not take the medicine on time (P=0.022), or undergo cancer recurrence (P=0.027) and show higher rates of metastasis (P=0.009) .Conclusion: The incidence of ADR in cancer patients during targeted therapy was high. Age, education level, comorbidity and medication strategy can affect ADR. Furthermore, ADR would affect the treatment and prognosis of patients. We should pay more attention to these ADRs and develop effective management strategies.