Background Both demoralization and depression are common forms of psychological distress in cancer patients. This study aimed to investigate the severity of demoralization in Chinese cancer patients and to explore the factors influencing depression and demoralization and their effects on quality of life to better understand the differences and the relationship between demoralization and depression. Methods Cross‐sectional study design, in‐patients sequentially recruited from a tertiary‐level cancer hospital in Beijing between January 2016 and April 2016 completed Mandarin version of Demoralization Scale (DS‐MV), Patient Health Questionnaire‐9 (PHQ‐9), Revised Life Orientation Test (CLOT‐R), Beck Hopelessness Scale (BHS), and the 12‐items Short Form Health Survey, version 2 (SF‐12 V2) and provided socio‐demographic and clinical information. Results 296/424 (70.0%) of patients completed questionnaires. The mean score of DS is 30.4 (SD = 13.0). There are 28% (83/296) patients who experienced a low level of depression but a high level of demoralization. Resignation medical coping method (b = 0.279, P < .001), hopelessness (b = 0.492, P < .001), positive life orientation (b = −0.170, P < .001), and education level (b = −0.132, P < .001) were found to be predictors of demoralization, while only resignation medical coping method (b = 0.373, P < .001) and hopelessness (b = 0.350, P < .001) were found to be predictors of depression. Depression is a mediator between demoralization and physical aspects of quality of life (γ = −0.1604, LLCI = −0.244, ULCI = −0.080). Conclusion Demoralization is a prevalent psychiatric problem in Chinese cancer patients, and a large proportion of patients had low depression but high demoralization. Therefore, screening for demoralization in Chinese oncology practice is essential. A positive life orientation was found to be protective against demoralization.

Metal–organic frameworks (MOFs) with highly adjustable structures are an emerging family of electrocatalysts in two-electron oxygen reduction reaction (2e-ORR) for H2O2 production. However, the development of MOF-based 2e-ORR catalysts with high H2O2 selectivity and production rate remains challenging. Herein, an elaborate design with fine control over MOFs at both atomic and nano-scale is demonstrated, enabling the well-known Zn/Co bimetallic zeolite imidazole frameworks (ZnCo-ZIFs) as excellent 2e-ORR electrocatalysts. Experimental results combined with density functional theory simulation have shown that the atomic level control can regulate the role of water molecules participating in the ORR process, and the morphology control over desired facet exposure adjusts the coordination unsaturation degree of active sites. The structural regulation at two length scales leads to synchronous control over both the kinetics and thermodynamics for ORR on bimetallic ZIF catalysts. The optimized ZnCo-ZIF with a Zn/Co molar ratio of 9/1 and predominant {001} facet exposure exhibits a high 2e– selectivity of ∼100% and a H2O2 yield of 4.35 mol gcat –1 h–1. The findings pave a new avenue toward the development of multivariate MOFs as advanced 2e-ORR electrocatalysts.

Hydrogels can be formed via physical entanglement, noncovalent interactions, and chemical cross-linking. By rational design at the molecular level, enhanced physicochemical properties, such as shear thinning, self-healing, and responsive capacities may be afforded to hydrogels. Of note, considerable efforts have been devoted to engineering stimuli-responsive hydrogels, [2] since their formation, degradation, multiscale shape, architecture, and functions can be easily and precisely manipulated via different physical, chemical, and biological signals in spatiotemporally controlled and/or programmed manners. In this aspect, different exogenous and endogenous bio-physicochemical triggers are generally utilized to precisely control hydrogel formation/ degradation, finely tune the mechanics of hydrogels, and dynamically modulate hydrogel microenvironment. [2d,3] Hydrogels responsive to temperature, light, electrical/magnetic fields, ultrasound, mechanical forces, pH, redox potentials, and biochemical agents have been extensively examined for on-demand therapeutic delivery of drugs and cells to treat different acute and chronic diseases, [3a,4] for which controlled release of molecular and cellular payloads is mainly achieved by triggering transitions between hydrogel and solution phases or hydrogels and solid states. Also, stimuli-responsive hydrogels have been Functional hydrogels responsive to physiological and pathological signals have extensive biomedical applications owing to their multiple advanced attributes. Herein, engineering of functional hydrogels is reported via transformable nanoparticles in response to the physiologically and pathologically acidic microenvironment. These nanoparticles are assembled by a multivalent hydrophobic, pH-responsive cyclodextrin host material and a multivalent hydrophilic guest macromolecule. Driven by protons, the pH-responsive host-guest nanoparticles can be transformed into hydrogel, resulting from proton-triggered hydrolysis of the host material, generation of a hydrophilic multivalent host compound, and simultaneously enhanced inclusion interactions between host and guest molecules. By in situ forming a hydrogel barrier, the orally delivered transformable nanoparticles protect mice from ethanol-or drug-induced gastric injury. In addition, this type of nanoparticles can serve as responsive and transformable nanovehicles for therapeutic agents to achieve triggerable and sustained drug delivery, thereby effectively treating typical inflammatory diseases, including periodontitis and arthritis in rats. With combined advantages of nanoparticles and hydrogels, together with their good in vivo safety, the engineered transformable nanoparticles hold great promise in tissue injury protection and site-specific/local delivery of molecular and cellular therapeutic agents.

Postoperative epidural adhesion remains a clinically challenging problem in spine surgery. Currently there are no effective and safe antifibrotic and antiadhesion biomaterials that have been specifically developed for this complication in clinical practice. Herein we designed and engineered an advanced antiadhesion hydrogel with multiple functionalities, including temperature-responsive gelation, self-healing, tissue adhesiveness, antioxidation, anti-inflammation, and antifibrosis. This multifunctional supramolecular hydrogel can be facilely constructed by integrating three functional modules, i.e., a thermosensitive triblock copolymer, poloxamer 407 (PX); a reactive oxygen species-eliminating and anti-inflammatory nanoparticle (TPCD NP); and an adhesion-enhancing compound, tannic acid (TA). The optimal formulation (PXNT) was hierarchically screened based on in vitro properties and in vivo activities. Therapeutically, local treatment with PXNT hydrogel effectively prevented epidural fibrosis and adhesion after laminectomy in both rats and rabbits. Of note, PXNT hydrogel showed more beneficial efficacy than different control thermosensitive hydrogels and a commercially available barrier product, Interceed. Mechanistically, PXNT hydrogel significantly attenuated local oxidative stress, inhibited inflammatory responses, and reduced fibrotic tissue formation. Moreover, treatment with PXNT hydrogel did not cause systemic adverse effects and neurological symptoms. Consequently, PXNT hydrogel is a highly promising biomaterial for preventing postlaminectomy epidural adhesion and adhesions after other surgeries.