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.

OBJECTIVES: To investigate the status and the related factors of nursing behaviors for pressure injury, and to provide the evidence for standardizing pressure injury management. METHODS: A total of 1 039 clinical nursing staff from 4 general hospitals in Changsha from December 1 to 30, 2017 were selected by a stratified random sampling procedure. Nurses' demographic information such as age, gender, title, educational attainment, and department were collected. We investigated the status of nursing behaviors on pressure injury by a self-designed questionnaire, assessed nurses' knowledge of pressure injury and nurses' attitude of pressure injury using the Pressure Ulcer Knowledge Test and Attitude towards Pressure Ulcer Prevention Instrument, respectively, compared the nursing behaviors on pressure injury with different backgrounds, used multiple linear regression to analyze the influential factors for nursing behaviors on pressure injury, and conducted the Pearson correlation analysis for nurses' knowledge, attitude, and behaviors on the pressure injury. RESULTS: The overall nursing behaviors score on pressure injury was 155.96±17.29. The 5 dimensional scores from high to low were: risk assessment (4.42±0.49), prevention actions (4.40±0.50), risk understanding (4.35±0.52), injury assessment and interventions (4.27±0.55), and health education (4.25±0.63). A significant difference was found in the nursing behavior scores of pressure injury among ages, lengths of service, education, and training times (all ˂0.05). There was no correlation between nurses' knowledge and behaviors (=0.606). The nurses' attitude was positively correlated with their behaviors (=0.307, ˂0.001), and the nurses' knowledge was also positively correlated with their attitudes (=0.212, ˂0.001). The results of multiple linear regression showed that the length of service (≤5 years), training times (1-2 times), education (diploma or below), the scores of nurses' knowledge, and the scores of nurses' attitude were independent influencial factors of nurses' behaviors on pressure injury. CONCLUSIONS The nursing staff in the general hospital of Changsha has a high level of nursing behaviors on pressure injury, and they has good sense of responsibility and confidence. However, personal competence in pressure injury is insufficient and still needs to be improved. The nursing managers should focus on the nurses' attitude and training frequency, increasing the experience in nursing the pressure injury and practical level, and arouse the highly educated nurses' enthusiasm and sense of accomplishment to prevent pressure injury, thus reducing the incidence of pressure injury.
Attitude of Health Personnel ; China ; epidemiology ; Cross-Sectional Studies ; Health Knowledge, Attitudes, Practice ; Hospitals, General ; Humans ; Nursing Staff, Hospital ; Pressure Ulcer ; epidemiology ; etiology ; Surveys and Questionnaires

To understand the development of medical social work in China, and provide reference and basis for promoting medical social work in the next stage.
 Methods: A random sampling method was used to survey and analyze the data from questionnaires distributed to hospitals at or above the second level in China.
 Results: Medical social work had been carried out in all parts of the country, but the development was not balanced with the establishment of specialized agencies accounting for about 7.9% of the total survey. Only 17.5% of the hospitals carried out medical social work as a routine work. The medical social work service mainly included volunteer operation and management, patient psychological counseling, and so on.
 Conclusion: The development of medical social work in hospitals in China is still in its infancy, and the regional development is not balanced. Lack of professionals, unclear responsibilities of medical social workers and low social identity of medical social work are the main factors restricting development.
Asian Continental Ancestry Group ; China ; Hospitals ; Humans ; Social Work ; Surveys and Questionnaires

To develop an intervention protocol for children's unintentional injury risk behaviors, and to evaluate the feasibility of the protocol.
 Methods: By theoretically analyzing the influential factors for children's unintentional injury risk behaviors, children's cognitive development characteristics and the social learning theory, an intervention protocol was established on the basis of changing the unintentional injury attribution and negative information transmission of risk behavior consequences. A primary school in Changsha city was selected by random cluster sampling. A community-based randomized controlled trial was conducted on the selected students once a week for 5 consecutive weeks. The scores of unintentional injury risk behavior before intervention, 3 months and 6 months after intervention, and the frequency before intervention and 6 months after intervention, were collected and compared.
 Results: A total of 194 children were included in the study: 98 in the intervention group; 96 in the control group; 96 (49.5%) boys and 98 (50.5%) girls between 7 and 8 years old. The scores of unintentional injury risk behavior for children in the intervention group at 3 and 6 months after intervention were 14.42±5.67 and 14.14±8.95, respectively, lower than those before the intervention (16.85±8.48) and in the control group (P=0.001). The number of minor unintentional injuries in the intervention group decreased from 119 to 56, and the number of children suffering 2 or more injuries dropped from 34 to 10 (P<0.001) at 6 months after the intervention, while both of them were lower than that in the control group (P=0.011). Similar changes were observed in some slight or more serious unintentional injuries (P=0.030).
 Conclusion: The protocol for changing the attribution to unintentional injury and negative information transmission for risk behavior consequences was proved to effectively reduce children's unintentional injury risk behaviors and relevant events.
Child ; China ; Cognition ; Female ; Humans ; Male ; Risk-Taking ; Schools ; Students ; Wounds and Injuries ; prevention & control

Objective To analyze the current research status of evidence-based nursing of burn in the mainland of China,in order to provide basis for the improvement of scientificity of burn nursing practice.Methods Chinese scientific articles on evidence-based nursing of burn in the mainland of China published from January 1997 to December 2015 were retrieved from Chinese Biology Medicine disc,Chinese Journals Full-text Database,Wanfang Database,and VIP Database.From the results retrieved,date with regard to publication year,region of affiliation of the first author,journal distribution,literature type,literature quality assessment,topic of evidence-based research,fund program support,implementation of evidencebased practice steps,and language and quantity of reference.Data were processed with Microsoft Excel software.Results A total of 50 articles conforming to the criteria were retrieved.(1) Articles about evidence-based nursing of burn arose in 2004.Compared with that in the previous year,there was no obvious increase in the number of relevant articles in each year from 2004 to 2011.The number of literature in 2012 was obviously increased than that in each year from 2004 to 2011,while the number of literature in each year from 2012 to 2015 was not obviously increased compared with that in the previous year.(2) The regions of affiliation of the first author were distributed in 13 provinces,3 minority autonomous regions,and 3 municipalities,with the largest distribution in East China,and Northwest China and Southwest China in the follow.(3) The articles were published in 32 domestic journals,with 9 (28.12％) nursing journals,5 (15.62％) burn medical related journals,and 18 (56.25％) other journals.Twenty (40％) articles were published in Source Journal for Chinese Scientific and Technical Papers.(4) Regarding the literature type,31 (62％) articles dealt with clinical experiences,17 (34％) articles dealt with scientific research,and 2 (4％) articles dealt with case report.(5) There were 21 quantitative study articles and 29 narrative study articles,all with low quality.(6) The topics of evidence-based research in these articles were mainly burn rehabilitation,burn nursing technology,pediatric burn,inhalation injury and airway management,and complications of burn injury.Only one study was supported by fund program.(7) Only one article described complete evidence-based practice steps.(8) The literature cited 57 English articles as references,with an average of 1.14,and 316 Chinese articles,with an average of 6.32.Conclusions The concept of evidence-based nursing of burn has been initially formed in the mainland of China.The number of relevant articles is on the rise,but the quality needs to be further improved.There is an urgent need to improve nurses' understanding of evidence-based nursing and their command of the method of evidence-based practice through on-job training,so as to improve the scientificity and effectiveness of burn nursing.

Objective To investigate the differential expression profiles of long non-coding RNAs (lncRNAs) in human liver cell line LO2 with stable expression of hepatitis B x (HBx) gene,and to screen out the lncRNAs which play an important role in HBV-related liver cancer.Methods The lncRNA microarray was used to establish the differential expression profiles of lncRNAs,and the methods such as scatter plots and cluster analysis were used to obtain the HBx-related lncRNAs with differential expression.The qRT-PCR was used to verify some lncRNAs with differential expression.The t-test was used to compare the expression of lncRNAs between the two microarray groups,and hierarchical cluster analysis was used for the original data of lncRNAs with differential expression.Results Compared with the control group transfected with blank plasmids (L02/pcDNA3.0),LO2/HBx cells had 323 lncRNAs with ＞ 2-fold upregulation and 421 lncRNAs whose expression was reduced by more than 50％ (P ＜ 0.05).The results of qRT-PCR verified 4 upregulated lncRNAs (TCONS 00006195,ENST00000557524,NR_037597,and ENST00000539975) and 3 downregulated lncRNAs (ENST00000508424,ENST00000447433,and uc001lva.4),which were consistent with the results of microassay.Conclusion HBx-related lncRNAs are successfully screened out,which lays a foundation for further investigation of the role of lncRNAs in the pathogenesis of liver cancer.

Objective To evaluate serum Slit2 protein level in patients with chronic severe hepatitis B,and the re-lation with extent of liver damage and prognosis of patients.Methods In February-July 2014,patients with chronic hepatitis B(chronic hepatitis group)and chronic severe hepatitis B(chronic severe hepatitis group)in an infectious department were observed,healthy volunteers were as control group,and patients in chronic severe hepatitis group were subdivided into recovery subgroup and non-recovery subgroup based on whether patients had recovered.Serum Slit2 protein,prothrombin activity (PTA),total bilirubin (TBIL),and alanine transaminase (ALT)levels were detected and compared.Results A total of 157 patients (chronic hepatitis group,n =93;chronic severe hepatitis group,n=64)and 10 healthy volunteers were included in the study .Slit2 protein levels were significantly different among three groups(F =5.596,P =0.004),serum Slit2 protein levels in chronic hepatitis group and chronic severe hepatitis group were (4.90±1 .07)ng/mL and (3.09±1 .00)ng/mL respectively,both were higher than (2.10± 0.60)ng/mL in healthy control group (both P <0.05);serum Slit2 protein level in chronic severe hepatitis group was significantly lower than chronic hepatitis group (P <0.05).Serum Slit2 protein level in non-recovery subgroup of chronic severe hepatitis group was significantly lower than recovery subgroup ([1 .88±0.67]ng/mL vs [2.96± 1 .32]ng/mL,t=2.319,P =0.032).Serum Slit2 protein level in patients with chronic hepatitis B was positively correlated with PTA level(r=0.33,P <0.05),but negatively correlated with serum TBIL level (r =-0.46,P <0.05)and ALT level (r=-0.32,P <0.05).Conclusion Serum Slit2 protein level is an important index which can re-flect the prognosis of patients with chronic severe hepatitis,low serum Slit2 level suggests the poor clinical prognosis.

Objective To detect the protective role of high mobility group box-1 protein (HMGB1 )antibody in concanavalin A(ConA)-induced liver injury in mice.Methods The healthy male Balb/c mice were grouped into con-trol group (saline injection),model group(ConA injection)and experimental group(ConA+HMGB1 antibody injec-tion).After 6 hours of injection,mice blood was collected for detecting alanine transaminase (ALT)and HMGB1 , liver tissue was used to do HE stain,Tunel,and immunofluorescence detection.Results Pathological inflammation in experimental group was slighter than model group.The levels of ALT and HMGB1 in mice serum were (52.00± 8.34)U/L and (7.54 ±0.53)ng/mL in control group,(5 551 .50 ±1 445.74)U/L and (18.06 ±1 .65 )ng/mL in model group,(1 977.40±654.89)U/L and (10.77±0.71)ng/mL in experimental group,respectively;the expres-sion levels of HMGB1 mRNA and HMGB1 (relative value)in liver tissue were 1 .886±0.253 and 0.086±0.028 in control group,4.718±0.341 and 0.268±0.043 in model group,3.005 ±0.331 and 0.116±0.008 in experimental group,respectively;the expression levels of ALT and HMGB1 in serum,as well as HMGB1 mRNA and HMGB1 in liver tissue of experimental group were all lower than model group(all P <0.001).Apoptosis and HMGB1 migra-tion in the liver cell (normalized)were 1 ±0 and 1 ±0 in control group,4.67 ±0.33 and 4.50 ±0.22 in model group,2.67±0.21 and 2.33 ±0.21 in experimental group,respectively;apoptosis and HMGB1 migration in liver tissue of experimental group were both lower than model group(both P <0.001).Conclusion HMGB1 antibody can improve the pathological injury of liver tissue,and protect mice liver against the injury induced by ConA.

Objective To evaluate the clinical value of epicardial echocardiographic examination in cardiac valve surgery.Methods Epicardial echocardiography were performed in 46 patients undergoing valvular plasty or valvular replacement surgery to estimate the function of valve and left ventricle and residual shunt during cardiac surgery.Results Twelve cases of 46(26.1％)showed abnormality during cardiac surgery.Two cases of 15 patients performed valvuloplasty were changed to valvular replacement because of remarkable regurgitation of native valves.There was 1 case of periprosthetic leakage,3 cases of left atrial appendage thrombus,1 case of patent foramen ovale and 5 cases of low ejection of left ventricle in all 31 cases of valvular replacement.Conclusions Epicardial echocardiograpyc examination is an effective examination in cardiac valve surgery with clearly image,simplicity operation and promptness.

The aim of this study was to investigate the effect of Paris saponin Ⅰ (PS Ⅰ ) on human gastric carcinoma cell growth and apoptosis and to explore the potential mechanisms.The proliferation of SGC7901 cells was monitored by the MTT cell viability assay,while the nuclear morphology of apoptotic cells was assessed by Hoechst 33258 staining.Flow cytometry was performed to analyze the cell cycle progression of propidium iodide (PI)-stained SGC7901 cells and the apoptotic rate of annexin V/PI-stained cells.Western blotting was used to examine the expression of several cell cycle proteins,including cyclin B1 and Cdkl,and the apoptosis-regulated proteins Bcl-2,Bax,cytochrome c,procaspase-9,and procaspase-3.The MTT assay demonstrated that PSⅠ could induce significant doseand time-dependent inhibition of SGC7901 cell proliferation.Marked morphological changes,including condensation of chromatin,nuclear fragmentation and apoptotic bodies were clearly shown on Hoechst 33258 staining.PSⅠ treatment also resulted in the disruption of the cell cycle at G2/M and the induction of apoptosis.Following PSⅠ treatment,the cell cycle-related proteins cyclin B 1 and Cdk1 were downregulated.Expression of the pro-apoptotic protein Bax was increased,while anti-apoptotic protein Bcl-2decreased.PSⅠ treatment resulted in elevated cytoplasmic cytochrome c and activation of the apoptotic proteases caspase-9 and caspase-3.These data indicate that PSⅠ acts as an inhibitor of proliferation in SGC7901 cells by inducing cell cycle arrest and mitochondria-dependent apoptosis.PSⅠ is a potential therapeutic agent against human gastric carcinoma.