Objective To analyze the clinicopathological characteristics and prognosis of different subtypes of breast cancer patients with bone metastasis.Methods For this study, we recruited 300 primary breast cancer patients with bone metastasis treated at the Department of Oncology, the First Affiliated Hospital of Xi`an Jiaotong University, between September 1, 2007 and September 1, 2011.We also retrospectively analyzed their clinical and follow-up data.Results The percentage of Luminal A, Luminal B, human epidermal growth factor receptor-2 (HER-2) overexpression and triple negative subtypes in all the bone metastatic breast cancer patients was 59.0％, 16.0％, 13.7％ and 11.3％, respectively.Age, tumor size and histologic grade significantly differed among the four subtypes (P<0.05).However, there were no significant differences in menopausal status, lymph node metastasis, histological type or lymphovascular invasion among different subtypes (P>0.05).The median survival time of Luminal A breast cancer patients with bone metastasis was 28.6 months, longer than Luminal B (26.9 months), HER-2 overexpression (20.9 months) and triple negative breast cancer patients (12.0 months) with bone metastasis.The overall survival significantly differed among the patients with four subtypes of breast cancer.Conclusion Different subtypes of breast cancer patients with bone metastasis have different clinical characteristics and prognosis.Luminal A breast cancer patients with bone metastasis have better prognosis whereas triple negative subtype has poorer prognosis.

Objective:To explore the impact of clinical nurses ' humanistic care knowledge reserve on their hu-manistic care ability .Methods:With the method of convenience sampling , a questionnaire survey was conducted among 1200 clinical nurses in post in 8 three grade hospitals in Shaanxi province .We analyzed the correlation be-tween nurses ' humanistic knowledge reserve and humanistic careability and sifted the independent influencing fac -tors of nursing humanistic care ability .Results:The total score of humanistic care ability was negatively associated with the four variables(P<0.05), such as thinking of the influence of humanistic care on their career development and so on, and was positively associated with other two variables (P<0.05), such as the main source of humanis-tic knowledge .Among them , four factors , such as thinking of the influence of humanistic care on their career de-velopment , the main source of humanistic knowledge and so on , were the independent influencing factors of nur-ses' humanistic care knowledge reserve .Conclusion: Nursing schools and hospitals should improve nurse ' s hu-manistic care ability by establishing the nursing concept of humanistic care , adding humanistic care courses , strengthening humanistic care education and carrying out humanistic care training and continuing education .

HMGB1's role in tumors is complex and diverse,and it exerts its biological function by combining with different receptors.One of the receptors is called RAGE,which is localized to the cell membrane and binds to HMGB1 released outside the cell.The HMGB1/RAGE axis promotes tumor development,moreover,tumor development and its drug resistance are closely related to inflammation.This article mainly reviews the molecular mechanism of HMGB1/RAGE axis in pro-inflammatory and protumor effects in pancreatic,colorectal and liver cancers.We also summarize the research progress of papaverine and its derivatives for the treatment of HMGB1/RAGE axis in tumor inflammation,with aims of providing new ideas for exploring the molecular mechanism of action in tumor inflammation,and providing a new theoretical basis for the research of HMGB1/RAGE axis therapeutics.

Objective:To explore the multiple mediation effects of the positive and negative affect between emotional intelligence and life satisfaction in military personnel.Methods:Totally 967 male military personnel aged 17 to 34 years were investigated with the Schutte's Emotional Intelligence Scale (SSEIS),the Positive Affect and Negative Affect Scale (PANAS) and Life Satisfaction Index A (LSIA).The relationship among these variables was analyzed by using path analysis and Bootstrap test.Results:Totally 68.7％ military personnel were satisfied with their lives.Path analysis showed that emotional intelligence had indirect effects on life satisfaction through the mediation effects of positive affect and negative affect (x2/df=8.88,GFI =0.98,AGFI =0.94,NFI =0.98,IFI =0.98,TLI =0.95,CFI =0.98,RMSEA =0.09).Bootstrap test showed that the mediational path through positive affect and negative affect with the effect size were 31.5％ and 14.8％,and the total mediational effect size was 46.3％.Conclusion:It suggests that positive affect and negative affect may have mediating effects on the relationship between emotional intelligence and life satisfaction among military personnel.

Immune checkpoint inhibitors have been approved for clinical application in China. However, the increased immune-related adverse event (irAE) needs more attention. This review summarized the incidence, characteristic clinical manifestation and treatment of irAEs associated with programmed cell death protein-1(PD-1) and programmed cell death ligand-1(PD-L1) inhibitors. To have a deep insight into irAE, the potential mechanisms, the different incidences of cancer types, influencing factors and the direction of future research were also discussed here to provide guidance for clinical oncologist to identify and monitor irAE.

As a ligand-dependent transcription factor,retinoid-associated orphan receptor γt(RORyt)that controls T helper(Th)17 cell differentiation and interleukin(IL)-17 expression plays a critical role in the pro-gression of several inflammatory and autoimmune conditions.An emerging novel approach to the therapy of these diseases thus involves controlling the transcriptional capacity of RORyt to decrease Th17 cell development and IL-17 production.Several RORyt inhibitors including both antagonists and inverse agonists have been discovered to regulate the transcriptional activity of RORyt by binding to orthosteric-or allosteric-binding sites in the ligand-binding domain.Some of small-molecule inhibitors have entered clinical evaluations.Therefore,in current review,the role of RORyt in Th17 regulation and Th17-related inflammatory and autoimmune diseases was highlighted.Notably,the recently developed RORyt inhibitors were summarized,with an emphasis on their optimization from lead compounds,ef-ficacy,toxicity,mechanisms of action,and clinical trials.The limitations of current development in this area were also discussed to facilitate future research.

Indirect energy metabolism measurement is the gold standard for providing nutritional support for critical illness. The accuracy of the measurement data directly affects the outcome of the disease. In order to study the influence of sampling delay on the accuracy of energy metabolism measurement under mechanical ventilation, the Matlab/Simulink platform and respiratory electrical model were used for simulation and quantitative analysis. The results show that the error of indirect energy metabolism measurement increases with the increase of sampling delay, the error of sampling delay in mechanical ventilation mode is larger than that of spontaneous breathing, and the error of sampling delay in PCV mode of mechanical ventilation is larger than that in VCV mode. Therefore, there should be different sampling delay compensation strategies under severe mechanical ventilation and its different control modes.
Computer Simulation ; Critical Illness ; Energy Metabolism ; Humans ; Respiration, Artificial

A lung diffusion function detection system is designed. Firstly, the controllable collection of air, test gas source and calibration gas source was based on single-breath method measurement principle. Secondly, pulmonary diffusing capacity for carbon monoxide (D_lCO) was calculated by gas concentration measured by the non-dispersive infrared sensor to measure, the gas flow measured by the differential pressure sensor, and the temperature, humidity and atmospheric pressure sensors to test and evaluate the quantitative detection and evaluation of lung diffusion function. Moreover, a preliminary verification of the lung diffusion function detection system was implemented, and the results showed that the error of the lung carbon monoxide diffusion and the alveolar volume did not exceed 5%. Therefore, the system has high accuracy and is of great value for early screening and accurate assessment of COPD.
Carbon Monoxide ; Lung ; Pulmonary Diffusing Capacity/methods*

Objective To investigate the effect of T cell immunoreceptor with Ig and ITIM domains (TIGIT) on the function of CD8⁺ T cells in the lungs of Plasmodium infected mice. Methods The lungs of the mice infected with Plasmodium yoelii were isolated, weighed and photographed after 12 days' infection. After dissolution, lung lymphocytes were isolated, counted and stained, and then the contents of CD8⁺ and TIGIT⁺CD8⁺ T cells were detected by flow cytometry. The expressions of L selectin (CD62L), CD69, programmed death 1 (PD-1), CD25, and C-X3-C motif chemokine receptor 1 (CX3CR1) on TIGIT⁺CD8⁺ T cells were detected by flow cytometry. After stimulation with phorbol 12-myristate 13-acetate (PMA) and ionomycin, the ability of TIGIT⁺CD8⁺T cells to secrete interferon γ(IFN-γ), interleukin 21 (IL-21), IL-4, IL-17, and IL-10 was detected. Results The body mass of mice with Plasmodium infection was reduced. The lungs became darker, and the ratio of the lung mass to body mass was significantly increased. Compared with the normal mice, the percentages and absolute quantity of CD8⁺ and TIGIT⁺CD8⁺ T cells in the lungs of the infected mice were significantly increased. The percentage of TIGIT⁺CD8⁺ T cells expressing CD62L in the infected group was significantly lower, while the percentage of the CD69, PD-1, and CX3CR1 cells were significantly higher than that of TIGIT⁺CD8⁺ T cells from the normal mice. The percentages of TIGIT⁺CD8⁺ T cells secreting IL-21, IL-4, IL-17 and IL-10 cells in the infected group were significantly lower. Conclusion The lung lesions from mice with Plasmodium infection are obvious, the numbers of TIGIT⁺CD8⁺ T cells increase, and these cells express a variety of activation-related molecules, but the ability to secrete cytokines is reduced.
Animals ; Mice ; CD8-Positive T-Lymphocytes ; Cytokines/metabolism* ; Interferon-gamma/metabolism* ; Interleukin-10/metabolism* ; Interleukin-17/metabolism* ; Interleukin-4/metabolism* ; Lung/metabolism* ; Malaria/metabolism* ; Plasmodium yoelii/metabolism* ; Programmed Cell Death 1 Receptor/metabolism*

BACKGROUND: The clinical trials of new anti-tumor drugs are prospering in China. The acceptance of clinical trials in patients is an important factor affecting the speed and quality of clinical trials. Previous studies have investigated the acceptance of clinical trials in those cancer patients, who have never participated in a trial. This study is designed to investigate and compare the acceptance and related causes of clinical trials in cancer patients who have once participated in a clinical trial or not. METHODS: From June 2018 to April 2019, a standardized questionnaire-based survey was conducted among two groups of cancer patients classified by history of clinical trial participation in Cancer hospital, Chinese Academy of Medical Science, mainly focusing on their overall acceptance of clinical trials and related considerations, including the role of attending doctors, as well as group differences between the two participants. RESULTS: A total of 538 patients were enrolled with an average age of 53.5 years old, 51.1% of whom were males, and 43.3% of whom have never participated in a clinical trial. Overall, 502 patients (93.3%) were willing to or recommend their relatives or friends to participate in clinical trials, and patients with history of clinical trial participation had higher willingness (96.6% vs 90.8%, P=0.008). Patients were most likely to be motivated by expectation of optimal treatment (100.0% vs 99.3%) for both those who had once participated in a clinical trial or those not, respectively followed by financial burden reduction (56.0%) and recommendation by attending doctor (43.7%). The main reasons for unwillingness-to-participate for those who had once participated in a clinical trial were abandoning other treatment options, divided into control group or additional visits, while for those who had never participated in a clinical trial, ineffective treatment or serious adverse reactions were their main concerns. In the decision-making of clinical trial participation, 88% patients highly valued the role of recommendation by attending doctors. Among patients without trial participation history, 60.9% of those had no unwillingness-to-participate expressed that recommendation by attending doctors would change their decisions. The study also reported patients' preferences for information and access to clinical trials. CONCLUSIONS The acceptance of clinical trials in cancer patients in our hospital is generally high, especially in patients who had a history of trial participation. It's of substantial significance to give full play to the role of doctors in improving the acceptance of clinical trials of cancer patients in China.