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 To investigate the clinical characteristics of inguinal abscess caused by Actinotignum schaa-lii(A.schaalii),and improve the clinical recognition and attention on skin and soft tissue infection caused by this bacterium.Methods Clinical data of a patient with inguinal abscess caused by A.schaalii were reviewed.Biologi-cal characteristics of the bacterium were observed,and antimicrobial susceptibility testing was conducted.PubMed database was retrieved using"Actinobaculum schaalii"and"Actinotignum schaalii"as keywords.Meanwhile,Chi-na National Knowledge Infrastructure,Wanfang,and VIP databases were retrieved using corresponding Chinese re-trieval terms.Clinical data of skin or soft tissue infections caused by A.schaalii were summarized and analyzed.Results After literature retrieval and screening,38 cases from 13 literatures were finally included,out of which 33 patients with A.schaalii infection were treated with antimicrobial agents and/or incision drainage,and the treat-ment effect was good.Conclusion A.schaalii is an opportunistic pathogen.There are few reports on skin or soft tissue infections caused by it.Currently,the identification of this bacterium relies on mass spectrometry technology or gene sequencing.Clinical attention should be paid to the detection of this bacterium,and appropriate antimicrobial agents should be selected for its treatment.

Objective To investigate the clinical characteristics of inguinal abscess caused by Actinotignum schaa-lii(A.schaalii),and improve the clinical recognition and attention on skin and soft tissue infection caused by this bacterium.Methods Clinical data of a patient with inguinal abscess caused by A.schaalii were reviewed.Biologi-cal characteristics of the bacterium were observed,and antimicrobial susceptibility testing was conducted.PubMed database was retrieved using"Actinobaculum schaalii"and"Actinotignum schaalii"as keywords.Meanwhile,Chi-na National Knowledge Infrastructure,Wanfang,and VIP databases were retrieved using corresponding Chinese re-trieval terms.Clinical data of skin or soft tissue infections caused by A.schaalii were summarized and analyzed.Results After literature retrieval and screening,38 cases from 13 literatures were finally included,out of which 33 patients with A.schaalii infection were treated with antimicrobial agents and/or incision drainage,and the treat-ment effect was good.Conclusion A.schaalii is an opportunistic pathogen.There are few reports on skin or soft tissue infections caused by it.Currently,the identification of this bacterium relies on mass spectrometry technology or gene sequencing.Clinical attention should be paid to the detection of this bacterium,and appropriate antimicrobial agents should be selected for its treatment.

Objective:To explore the effect of levodopa on inhibitory control in Parkinson disease patients using the paced random number generation task (RNG).Methods:The study included 47 patients diagnosed with Parkinson disease in the Movement Disorder Clinic of the Department of Neurology at Dalian Friendship Hospital between March 2020 and June 2022, and 45 healthy volunteers with normal cognitive function were recruited from the Physical Examination Center of the same hospital and matched in terms of age, gender and education.All subjects performed the paced RNG task twice within two days, converting the results into continuous number sequences measure values and random number sequences measure values.SPSS 22.0 software was used for statistical analysis, and mixed-design ANOVA was used to compare the performance of the two groups of subjects in the paced RNG task during medication/withdrawal.The minimum clinical importance difference (MCID) was calculated to evaluate whether statistically significant medication effects have clinical significance.Results:(1)Medication and cognitive load had an interaction effect on the random number sequences measure values ( F=15.15, P=0.03), which showed that the random number sequences measure values increased under on-medication status and slow rate (off-medication: (44.79±16.33), on-medication: (51.95±21.82); t=4.25, P=0.02), and the difference in the combined standard deviation of random digits seriation measurements between on-medication and off-medication at a slow rate (7.16) was greater than that of MCID (3.29).(2) The main effect of cognitive load on the continuous number sequences measure values was statistically significant ( F=65.97, P<0.001), and scores for rapid rate were higher (rapid: (71.45±37.98); slow: (36.33±16.17)). Conclusion:Levodopa can improve inhibitory cognitive control in patients with Parkinson disease under low cognitive load.

Objective: To explore the relationship between dieting and binge eating with non suicidal self-injury (NSSI) among secondary vocational school students, so as to provide a scientific basis for the development of effective interventions to prevent NSSI. Methods: From October to December 2023, 2 364 students were selected by stratified cluster random sampling method from nine secondary vocational schools in Guizhou Province to conduct a self administered questionnaire survey. Unconditional binary Logisitic regression was used to analyze the relationship between dieting, binge eating behaviours, and the co-occurrence of the two and NSSI among secondary vocational school students, and were stratified by sex. Results: The detection rate of NSSI among secondary vocational school students in Guizhou Province was 27.5%, 6.8% of secondary vocational school students reported dieting, 10.5% reported binge eating behaviour, and 2.9% showed both dieting and binge eating behaviours. The adjusted model of unconditional binary Logistic regression showed that the presence of dieting ( OR =2.37), binge eating behaviour ( OR =2.31), and the co-occurrence of both ( OR =2.60) were associated with higher risk of NSSI among secondary vocational school students; stratified analysis by gender showed that both males and females with dieting, binge eating and coexistence of dieting and binge eating behaviours were at increased risk of NSSI (females: OR =2.27, 2.26, 2.78 ; males: OR =2.15, 2.08, 2.02) ( P <0.01). Conclusions Dieting and binge eating behavior of secondary vocational school students will increase the risk of NSSI. When preventing and intervening NSSI problems of secondary vocational school students, it should pay more attention to eating habits.

Telephone follow-up is one of the important ways to follow up patients. High-quality follow-up can benefit both doctors and patients. However, clinical research-related follow-up is often faced with problems such as time-consuming, laborious and poor patient compliance. The authors belong to a team that has been committed to the study of patient-reported outcomes for a long time. The team has carried out long-term follow-up of symptoms, daily function and postoperative complications of more than 1 000 patients after lung cancer surgery, and accumulated certain experience. In this paper, the experience of telephone follow-up was summarized and discussed with relevant literatures from the aspects of clarifying the purpose of clinical research follow-up, understanding the needs of patients in follow-up, and using follow-up skills.

Objective:The research aims to determine the potential mediating role of psychological insecurity based on the correlation between death anxiety and obsessive-compulsive symptoms in college students during the pandemic of Covid-19 pandemic. The effects of negative coping styles were also investigated.Methods:The objective was achieved using a convenient sampling method. There were a total of 523 participants including 368 girls and 155 boys, aged 16-30 (19.93±2.19) years from Renmin University of China. Participants completed online the Chinese Version Templer Death Anxiety Scale, Self-Rating Feeling of Insecurity Scale, Symptom Checklist-90-Obsessive Compulsive and Simplified Coping Style Questionnaire. Mediational analysis with multiple regression was conducted to reveal the potential roles of psychological insecurity as a mediation factor. Negative coping style was used as a moderator between death anxiety and obsessive-compulsive symptoms, and a simple slope was used to further analysis.Results:Pearson correlation analysis showed that there were significant correlations between death anxiety, obsessive-compulsive symptoms, psychological insecurity, and negative coping style ( r=0.12-0.40, P<0. 01). Death anxiety was positively related to obsessive-compulsive symptoms (β=0.30, t=7.09, P<0.01).This correlation remained significant when psychological insecurity was introduced as a mediating factor (β=0.22, t=5.33, P<0.01). Negative coping style could moderate the relationship of death anxiety and obsessive-compulsive symptoms. Simple slope analysis showed that a higher tendency of negative coping style was associated with the enhanced impact of death anxiety on obsessive-compulsive symptoms (simple slope=0.27, P<0.01 and simple slope=0.08, P=0.17) for high negative coping style individuals and low-score ones, respectively. Conclusions:This research revealed that death anxiety could trigger obsessive-compulsive symptoms by increasing psychological insecurity; overall, higher levels of negative coping styles reinforce the relationship between death anxiety and obsessive-compulsive symptoms.

Objective:The research aims to determine the potential mediating role of psychological insecurity based on the correlation between death anxiety and obsessive-compulsive symptoms in college students during the pandemic of Covid-19 pandemic. The effects of negative coping styles were also investigated.Methods:The objective was achieved using a convenient sampling method. There were a total of 523 participants including 368 girls and 155 boys, aged 16-30 (19.93±2.19) years from Renmin University of China. Participants completed online the Chinese Version Templer Death Anxiety Scale, Self-Rating Feeling of Insecurity Scale, Symptom Checklist-90-Obsessive Compulsive and Simplified Coping Style Questionnaire. Mediational analysis with multiple regression was conducted to reveal the potential roles of psychological insecurity as a mediation factor. Negative coping style was used as a moderator between death anxiety and obsessive-compulsive symptoms, and a simple slope was used to further analysis.Results:Pearson correlation analysis showed that there were significant correlations between death anxiety, obsessive-compulsive symptoms, psychological insecurity, and negative coping style ( r=0.12-0.40, P<0. 01). Death anxiety was positively related to obsessive-compulsive symptoms (β=0.30, t=7.09, P<0.01).This correlation remained significant when psychological insecurity was introduced as a mediating factor (β=0.22, t=5.33, P<0.01). Negative coping style could moderate the relationship of death anxiety and obsessive-compulsive symptoms. Simple slope analysis showed that a higher tendency of negative coping style was associated with the enhanced impact of death anxiety on obsessive-compulsive symptoms (simple slope=0.27, P<0.01 and simple slope=0.08, P=0.17) for high negative coping style individuals and low-score ones, respectively. Conclusions:This research revealed that death anxiety could trigger obsessive-compulsive symptoms by increasing psychological insecurity; overall, higher levels of negative coping styles reinforce the relationship between death anxiety and obsessive-compulsive symptoms.

Objective:To analyze the clinical characteristics of adult Chinese patients with syncope.Methods:This is a cross-sectional survey study. Patients with preliminary diagnosis of syncope in the Emergency Department, Geriatrics and Cardiology Outpatient Department, or Syncope Unit of 37 hospitals in 19 provinces, autonomous regions and the Hong Kong Special Administrative Region from June 2018 to March 2021 were included in this study. The clinical features of these patients with syncope were analyzed.Results:A total of 4 950 consecutive patients with syncope were included in this study. The age was (56.3±16.8)years, and 2 604 cases (52.6%) were male. The most common type of syncope was neurally mediated syncope (2 345 (47.4%)), followed by cardiac syncope (1 085 (21.9%)), orthostatic hypotensive syncope (311 (6.3%)), and unexplained syncope accounted for nearly one third (1 155 (23.3%)). Predisposing syncope was more common in patients under 65 years of age(2 066(72.4%) vs. 786(27.6%),χ 2=136.5, P<0.001). Presyncope was more common in patients with neurally mediated syncope (1 972(79.0%) vs.1 908(73.9%), χ 2=17.756, P<0.001). Premonitory symptoms were more common in women(1 837(80.0%) vs. 1 863(73.0%),χ 2=33.432, P<0.001). Presyncope syndrome was more common in patients under 65 years of age (2 482(77.8%) vs. 1 218(73.4%),χ 2=17.523, P=0.001). Cyanosis was more common in ≥65 years old patients (271(18.2%) vs. 369(12.7%), χ 2=23.235, P<0.001). Urinary incontinence was more common in old patients aged ≥65 years(252(15.2%) vs. 345(10.8%), χ 2=19.313, P<0.001). Family history was more common in patients with cardiogenic syncope compared with other types of syncope (264(24.3%) vs. 754(19.5%), χ 2=11.899, P=0.001). Hypertention(1 480(30.5%)), coronary heart disease(1 057(21.4%)), atrial flutter and atrial fibrillation(359(7.2%)), second degree atrioventricular block(236(4.8%)) were common complications of syncope. The proportion of patients with coronary heart disease was significantly higher in cardiac syncope than that of other types of syncope(417(38.4%) vs. 640(16.6%), χ 2=241.376, P<0.001). Other common complications included cerebrovascular diseases (551 (11.1%)) and diabetes mellitus (632(12.8%)). Conclusions:Neurally mediated syncope is the most common syncope in adult Chinese population. Patients with predisposing conditions and premonitory conditions are younger. Presyncope is more common in women. The proportion of family history and coronary heart disease is higher in patients with cardiogenic syncope.

Objective:To investigate the efficacy of Suchan-Yishen Decoction combined with western routine medicine on proteinuria due to chronic glomerulonephritis. Methods:A total of 86 patients with urinary protein, who met the inclusion criteria in Zhongshan people's hospital from January of 2017 to December of 2018, were selected and divided into two groups according to the random number table method with 43 patients in each group. The control group took valsartan capsule orally on the basis of conventional western medicine, and the observation group took Suchan-Yishen Decoctionon the basis of the control group. Both groups were treated continuously for two months. The CD3 +, CD4 +, CD8 + were determined by flow cytometry; the serum levels of interleukin (IL)-6, IL-17 and tumor necrosis factor (TNF)-α were determined by ELISA method. Results:The total effective rate was 88.4% (38/43) in the observation group and 67.4% (29/43) in the control group. The difference between the two groups was statistically significant ( χ2=4.324, P=0.038). After the treatment, levels of urinary protein (0.82 ± 0.13 g vs. 1.04 ± 0.17 g, t=6.009), BUN (6.12 ± 0.71 mmol/L vs. 6.60 ± 0.75 mmol/L, t=6.411) and SCr (82.87 ± 10.43 μmol/L vs. 94.11 ± 11.17 μmol/L, t=17.433) in the observation group at 24 h were all significantly lower than those of the control group ( P<0.01). After the treatment, levels of CD3 + and CD4 + in the observation group were significantly higher than those of the control group ( t values were 7.981, 8.904, respectively, all Ps<0.01), and level of CD8 + was significantly lower than that of the control group ( t=8.933, P<0.01). Serum levels of IL-6, IL-17, TNF-α in the observation group were significantly lower than those of the control group ( t values were 10.983, 49.005, 13.994, respectively, all Ps<0.01). Conclusions:The Suchan-Yishen Decoction combined with conventional western medicine can relieve the clinical symptoms of chronic glomerulonephritis patients, increase the therapeutic effect of proteinuria, correct the imbalance of T cell subgroup, and down-regulate serum levels of IL-6, IL-17, TNF-α.