Triple-negative breast cancer is therapeutically challenging due to the low expression of tumor markers and 'cold' tumor immunosuppressive microenvironment. Here, we present a dual-targeting peptide-drug conjugate (PDC) for tumor inhibition. Our PDC efficiently and selectively delivers cytotoxic Monomethyl Auristatin E (MMAE) into tumor cells via C-X-C chemokine receptor type 4 (CXCR4) and folate receptor 1 (FOLR1) for synergistic inhibition of growth and metastasis. Our results show that the dual-targeting PDC has potent antitumor activity in cultured human cells and several murine transplanted tumor models without apparent toxicity. The combination of dual-targeting PDC and radiotherapy modulates the tumor immunosuppressive microenvironment by increasing CD8⁺ T cell infiltration and attenuating the proportion of myeloid-derived suppressor and regulatory T cells. Therefore, our dual-targeting PDC represents a promising new strategy for cancer therapy that rebalances the immune system and promotes tumor regression.

Objective Building a TCM health management and clinical research integration platform for knee osteoarthritis,promoting the integration of traditional Chinese medicine with internet and mobile health technology,driving the digitalization of TCM-enabled knee osteoarthritis health management strategies,and providing a convenient digital platform for the efficient conduct of TCM clinical research on knee osteoarthritis.Methods Using a combination of literature review and market research,a preliminary framework for the platform's functions and services was established.Then,17 patients with knee osteoarthritis were interviewed through a convenient sampling method to identify their needs and preferences,and design the platform's functional modules and service flow.In the development and testing phase,a multidisciplinary team consisting of professional development engineers,data scientists,and clinical experts conducted multiple rounds of discussions to ensure the scientificity,feasibility,and convenience of the platform's function and service development.Results The integrated platform of traditional Chinese medicine health management and clinical research for knee osteoarthritis is built.The traditional Chinese medicine health management module includes features of health education,evaluation and exercise training,etc.The scientific research module includes patient self-report outcome data collection and remote quality control,etc.,which can provide the whole process service integrating health management and remote intelligent clinical trial.Conclusion Building an integrated platform of TCM health management and clinical research will provide more convenient and effective health management solutions for patients with knee osteoarthritis.

Objective To investigate the benefits and challenges of the reform in evidence-based obstetric nursing practice in clinical nursing,therefore to provide a reference for initiating and keeping the reform in evidence-based nursing practices.Methods A method of descriptive phenomenological research was conducted between January and February 2024 in our hospital on 10 selected clinical nurses by purposive sampling.An outline for interviews was developed based on literature review and expert interviews,followed by semi-structured interviews with the nurses.Core themes were extracted with Colaizzi's seven-step analysis.Results Three themes and 12 sub-themes were summarised in this study.The 3 core themes that were identified among the nurses included:acceptance of evidence-based nursing practice reform(with 3 domains regarding knowledge,decision-making and action),perception of the benefits of the reform in evidence-based nursing practice(with 5 domains regarding the professionalism and scientific nature of clinical nursing,improvement of patient experience and nursing outcomes,enhancement of nursing quality and safety,promotion of innovation in on-the-job training and education,and facilitation of collaboration within the nursing team),and perception in the challenges of reform in evidence-based nursing practice(with 4 domains regarding the stress and challenges,doubts and resistance,poor cooperation between doctors and nurses,and risks in clinical decision-making).Conclusion The acceptance regarding reform in evidence-based nursing practice varies among the nurses.It is necessary to promote the acceptance,provide the targeted guidance and intervene in the factors of benefits and challenges among the nurses,hence to facilitate a smooth implementation of the reform in evidence-based nursing practice.

Objective To analyze the level of occupational health literacy (OHL) and mental health status in key populations in Jiangsu Province, and explore the impact of OHL on occupational stress, depressive symptoms, anxiety symptoms and insomnia symptoms. Methods A total of 11 181 workers from Jiangsu Province from April to December 2023 were selected as the research subjects using a combination of stratified cluster random sampling and probability proportional sampling method. The OHL levels of the workers, as well as their occupational stress, depression symptoms, anxiety symptoms and insomnia symptoms, were investigated using the Occupational Health Literacy Questionnaire of National Key Populations (including Occupational Health Literacy Scale, Core Occupational Stress Scale, Patient Health Questionaire-9, Generalized Anxiety Disorder 7-item Scale, and Self-Sleep Management Questionnaire). Results The OHL level of the research subjects was 41.7%, and the literacy levels of the four dimensions of occupational health legal knowledge, basic knowledge of occupational health protection, basic skills of occupational health protection, and healthy working style and behavior were 40.6%, 76.4%, 28.0% and 54.4%, respectively. The detection rates of occupational stress, depression symptoms, anxiety symptoms and insomnia symptoms were 21.8%, 17.7%, 26.4% and 29.6%, respectively. The result of multivariable logistic analysis showed that participants with adequate OHL had a lower risk of occupational stress, depressive symptoms, anxiety symptoms, and insomnia symptoms than those without adequate OHL (all P<0.01) after controlling individual and occupational confounding factors. The odds ratios and their 95% confidence intervals were 0.448(0.402-0.499), 0.664(0.593-0.742), 0.705(0.639-0.777) and 0.885(0.809-0.969), respectively. Conclusion OHL is an independent influencing factor for occupational stress, depressive symptoms, anxiety symptoms and insomnia symptoms in key populations from Jiangsu Province. Effective measures should be taken to improve the OHL level of workers, to reduce the risks of occupational stress, depressive symptoms, anxiety symptoms and insomnia symptoms.

OBJECTIVE To analyze the results of speech-evoked auditory brainstem response(s-ABR)tests in patients with presbycusis and explore the mechanisms of speech coding in these patients.METHODS Thirty patients with presbycusis(presbycusis group),30 elderly individuals with normal hearing(elderly normal group),and 30 young adults with normal hearing(young control group)were recruited.The s-ABR was elicited using a 40 ms duration complex speech stimulus/da/,and the characteristics of s-ABR were analyzed in each group.RESULTS The latencies of waves V and A in the presbycusis group were significantly prolonged compared to both the elderly normal group and the young control group(P<0.05).However,there was no statistically significant difference in the latencies of waves between the elderly normal group and the young control group(P>0.05).The amplitude of wave A and the slope of the V-A complex wave in the presbycusis group were significantly lower than those in the young control group(P<0.05),while no statistically significant differences were observed in the amplitudes of other waves.CONCLUSION The characteristics of s-ABR in patients with presbycusis suggest that these patients have poor synchronization in response to stimulus timing and deficiencies in coding high-frequency and rapidly changing auditory information,which may be one of the mechanisms underlying the decline in speech abilities in patients with presbycusis.

Objective:To develop the Puerperal Delivery Trauma Perception Scale and test its reliability and validity.Methods:Based on the theory of unpleasant symptoms and combining literature review, semi-structured interview, and group discussion, an item pool was created. The initial version of the scale was formed through Delphi expert consultation and pre-investigation. A convenience sampling method was used to select 304 puerperal women from seven Grade-A tertiary hospitals in Wuhan for reliability and validity testing of the scale in January and February 2024.Results:The Puerperal Delivery Trauma Perception Scale includes seven dimensions and 34 items. The Cronbach's α coefficient of the scale was 0.929, the split-half reliability was 0.874, and the test-retest reliability was 0.932. Exploratory factor analysis extracted seven common factors, with a cumulative variance contribution rate of 71.221%.Conclusions:The Puerperal Delivery Trauma Perception Scale has good reliability and validity and can be used to assess the trauma perception of puerperal women in China.

Objective To investigate the benefits and challenges of the reform in evidence-based obstetric nursing practice in clinical nursing,therefore to provide a reference for initiating and keeping the reform in evidence-based nursing practices.Methods A method of descriptive phenomenological research was conducted between January and February 2024 in our hospital on 10 selected clinical nurses by purposive sampling.An outline for interviews was developed based on literature review and expert interviews,followed by semi-structured interviews with the nurses.Core themes were extracted with Colaizzi's seven-step analysis.Results Three themes and 12 sub-themes were summarised in this study.The 3 core themes that were identified among the nurses included:acceptance of evidence-based nursing practice reform(with 3 domains regarding knowledge,decision-making and action),perception of the benefits of the reform in evidence-based nursing practice(with 5 domains regarding the professionalism and scientific nature of clinical nursing,improvement of patient experience and nursing outcomes,enhancement of nursing quality and safety,promotion of innovation in on-the-job training and education,and facilitation of collaboration within the nursing team),and perception in the challenges of reform in evidence-based nursing practice(with 4 domains regarding the stress and challenges,doubts and resistance,poor cooperation between doctors and nurses,and risks in clinical decision-making).Conclusion The acceptance regarding reform in evidence-based nursing practice varies among the nurses.It is necessary to promote the acceptance,provide the targeted guidance and intervene in the factors of benefits and challenges among the nurses,hence to facilitate a smooth implementation of the reform in evidence-based nursing practice.

Objective Building a TCM health management and clinical research integration platform for knee osteoarthritis,promoting the integration of traditional Chinese medicine with internet and mobile health technology,driving the digitalization of TCM-enabled knee osteoarthritis health management strategies,and providing a convenient digital platform for the efficient conduct of TCM clinical research on knee osteoarthritis.Methods Using a combination of literature review and market research,a preliminary framework for the platform's functions and services was established.Then,17 patients with knee osteoarthritis were interviewed through a convenient sampling method to identify their needs and preferences,and design the platform's functional modules and service flow.In the development and testing phase,a multidisciplinary team consisting of professional development engineers,data scientists,and clinical experts conducted multiple rounds of discussions to ensure the scientificity,feasibility,and convenience of the platform's function and service development.Results The integrated platform of traditional Chinese medicine health management and clinical research for knee osteoarthritis is built.The traditional Chinese medicine health management module includes features of health education,evaluation and exercise training,etc.The scientific research module includes patient self-report outcome data collection and remote quality control,etc.,which can provide the whole process service integrating health management and remote intelligent clinical trial.Conclusion Building an integrated platform of TCM health management and clinical research will provide more convenient and effective health management solutions for patients with knee osteoarthritis.

Objective:To develop the Puerperal Delivery Trauma Perception Scale and test its reliability and validity.Methods:Based on the theory of unpleasant symptoms and combining literature review, semi-structured interview, and group discussion, an item pool was created. The initial version of the scale was formed through Delphi expert consultation and pre-investigation. A convenience sampling method was used to select 304 puerperal women from seven Grade-A tertiary hospitals in Wuhan for reliability and validity testing of the scale in January and February 2024.Results:The Puerperal Delivery Trauma Perception Scale includes seven dimensions and 34 items. The Cronbach's α coefficient of the scale was 0.929, the split-half reliability was 0.874, and the test-retest reliability was 0.932. Exploratory factor analysis extracted seven common factors, with a cumulative variance contribution rate of 71.221%.Conclusions:The Puerperal Delivery Trauma Perception Scale has good reliability and validity and can be used to assess the trauma perception of puerperal women in China.

Objective To investigate the expression of long non-coding RNA(LncRNA)nuclera-enriched autosomal transcript(NEAT1)in children with retinoblastoma(Rb)and the effect of down-regulation of NEAT1 in Rb cell Y79 on cell biological function.Methods A total of 83 children with Rb who were diagnosed and treated in Huangshi Central Hospital from March 2015 to March 2021 were collected as the research object.During the same period,50 healthy children(control group)were selected in the children's health center.Quantitative real-time polymerase chain reaction(qRT-PCR)was used to detect the expression of NEAT1 in serum.The differences in the expressions of NEAT1 in serum between Rb children and the control group,and the differences in the expressions of NEAT1 in serum among Rb children with different clinical indicators,were analyzed.Y79 cells were cultured and were divided into si-NEAT1 group(transfected with interference sequence of NEAT1),si-NC group(transfected with control sequence)and Ctl group(only add transfection reagent).The qRT-PCR,MTT,flow cytometry and Transwell were used to detect the NEAT1 expression,cell proliferation,apoptosis,migration and invasion.Results The expression level of NEAT1 in the serum of children with Rb(1.43±0.28)was higher than that in the control group(1.01±0.21),with significant difference(t=9.116,P＜0.001).The expression levels of NEAT1 in serum of children with Rb with Intraocular International Retinoblastoma classification(IIRC)stage CDE,poor differentiation,optic nerve infiltration and lymph node metastasis were higher than those in children with Rb with AB,medium to high differentiation,no optic nerve infiltration and lymph node metastasis,with significant differences(t=2.190～3.693,all P＜0.05).The area under the curve for diagnosing Rb based on NEAT1 expression in serum was 0.882(95％CI:0.826～0.937).When the expression level of NEAT1 was 1.20,the sensitivity and specificity were 80.00％and 79.52％,respectively.Compared with the si-NC group(1.03±0.09)and the Ctl group(1.02±0.15),the expression level of NEAT1 in the si-NEAT1 group(0.35±0.06)was decreased,with significant differences(t=14.829,9.994,all P＜0.001).The absorbance A values in the si-NEAT1 group at 24,48,72 and 96h were significantly lower than those in the si-NC group and the Ctl group(t=si-NC=2.796～4.362,tCtl=2.641～5.555,all P＜0.05),while the apoptosis rate in the si-NEAT1 group was significantly higher than those in the si-NC group and the Ctl group,and the differences were statistically significant(t=4.999,3.915,all P＜0.05).Compared with the si-NC group and the Ctl group,the number of migrating cells(116.50±9.35 vs 132.00±7.32,134.00±7.95)and the number of invasive cells(96.33±8.94 vs 117.67±12.39,119.17±10.05)in the si-NEAT1 group were reduced,and the differences were statistically significant(tsi-NC=3.196,3.421,tCtl=3.492,4.159,all P＜0.05).Conclusion The expression level of NEAT1 in the serum of children with Rb was elevated,which may have a certain diagnostic value for children with Rb.Silencing the expression of NEAT1 in Y79 cells could reduce cell proliferation,accelerate cell apoptosis,and inhibit cell migration and invasion.