As an important part of tumor microenvironment, neutrophils are poorly understood due to their spatiotemporal heterogeneity in tumorigenesis. Here we defined, at single-cell resolution, CD44-CXCR2- neutrophils as tumor-specific neutrophils (tsNeus) in both mouse and human gastric cancer (GC). We uncovered a Hippo regulon in neutrophils with unique YAP signature genes (e.g., ICAM1, CD14, EGR1) distinct from those identified in epithelial and/or cancer cells. Importantly, knockout of YAP/TAZ in neutrophils impaired their differentiation into CD54+ tsNeus and reduced their antitumor activity, leading to accelerated GC progression. Moreover, the relative amounts of CD54+ tsNeus were found to be negatively associated with GC progression and positively associated with patient survival. Interestingly, GC patients receiving neoadjuvant chemotherapy had increased numbers of CD54+ tsNeus. Furthermore, pharmacologically enhancing YAP activity selectively activated neutrophils to suppress refractory GC, with no significant inflammation-related side effects. Thus, our work characterized tumor-specific neutrophils in GC and revealed an essential role of YAP/TAZ-CD54 axis in tsNeus, opening a new possibility to develop neutrophil-based antitumor therapeutics.
Humans ; Animals ; Mice ; Adaptor Proteins, Signal Transducing/metabolism* ; Transcription Factors/metabolism* ; Stomach Neoplasms/pathology* ; Neutrophils/pathology* ; Signal Transduction/genetics* ; YAP-Signaling Proteins ; Tumor Microenvironment ; Hyaluronan Receptors/genetics*

Objective:To explore status of nutritional knowledge, attitude and practice of tumor nursing staff and analyze the influencing factors.Methods:Using the convenient sampling method, a total of 800 nurses from Cancer Hospital of Chinese Academy of Medical Sciences and Peking Union Medical College were selected as the research objects from January to February 2021. General data questionnaire, Nutrition Knowledge, Attitude and Practice Questionnaire for Tumor Nursing Staff and Nutrition Knowledge Acquisition Way Questionnaire for Tumor Nursing Staff were used to investigate. A total of 800 questionnaires were sent out and 797 were valid.Results:For 797 tumor nursing staff, the total score of Nutrition Knowledge, Attitude and Practice Questionnaire for Tumor Nursing Staff was (63.50±14.87) . The passing rate was 62.0% and the excellent rate was 13.8%. The results of multivariate analysis showed that professional title, educational background and department were the influencing factors of nutrition knowledge, attitude and practice of tumor nurses ( P<0.05) . Conclusions:Tumor nursing staff have positive attitudes and practice towards nutrition therapy, but their knowledge of nutrition needs to be strengthened. It is necessary to carry out nutrition-related training based on influencing factors.

MicroRNAs (miRNAs) are a class of non-coding RNA molecules that regulate gene expression after transcription and participate in various pathophysiological processes in the skin. In recent years, it has been reported that changes in miRNA expression profiles are related to some inflammatory skin diseases. For example, miR-203, miR-146a and miR-21 are upregulated in psoriatic lesions, miR-155 and miR-146a are upregulated in atopic dermatitis lesions, miR-21, miR-223, miR-142-3p and miR142-5p are upregulated in allergic contact dermatitis lesions; however, miR-146a and miR-155 are downregulated in peripheral blood of patients with systemic lupus erythematosus, and miR-223 is downregulated in dermatomyositis lesions. This review summarizes relationships of miRNAs with the occurrence and development of some inflammatory skin diseases.

In recent years, the category of atopic dermatitis (AD) has been updated in domestic and foreign guidelines, and elderly AD has been added as a subtype. The pathogenesis of elderly AD is related to heredity, skin barrier dysfunction, immune dysregulation and lifestyle. Most elderly AD patients have atypical clinical symptoms, and misdiagnosis is very common. To fully understand the pathogenesis and clinical characteristics of elderly AD, and to formulate individualized diagnosis and treatment plans based on clinical characteristics, are particularly important for improving the quality of life of patients and reducing the burden of the disease.

Objective? To compare predicted incidence of chemotherapy induced nausea and vomiting (CINV) by doctors, nurses and patients with its actual incidence. Methods? We used the prospective paired design to select 320 patients with the induced vomiting plan of medicine department at Peking Union Medical College Cancer Hospital by convenience sampling, and we allocated 72 doctors and 48 responsibility nurses for patients. The predicted chemotherapy induced nausea and vomiting scale was filled in by doctors, nurses and patients as required to understand the incidence of CINV predicted by them. After patients completed their chemotherapy, the Chinese version of MASCC antiemesis tool (MAT) was filled out by nurses to investigate the actual incidence of CINV. Results? The paired chi-square test showed that the incidence of acute and delayed CINV were 38.75% and 61.25% respectively. There was no statistical difference between the incidence of acute CINV predicted by doctors, nurses as well as patients and the actual incidence (P＞0.05). There was also no statistical difference between the incidence of delayed CINV predicted by nurses and the actual incidence (P＞0.05). Doctors and patients all underestimated the incidence of delayed CINV with a statistical difference (P＜0.05). The consistency between the incidence of acute as well as delayed CINV predicted by doctors, nurses, patients and the actual incidence was poor with Kappa value ranging from 0.02 to 0.34. A total of 54.93% to 57.77% of doctors and nurses predicted that CINV could be controlled well lower than that (about 70%) of patients with statistical differences (P＜0.05). Conclusions? There is still much improvement space for control of delayed CINV. Medical staff should take effective measures to improve the level of estimate and the level of CINV symptom management, and to improve the quality of life among patients.

Objective? To compare the evaluation result of 10 symptoms including poor appetite in cancer patients during chemotherapy from the patients and their nurses, in order to improve the assessment and judgment ability of the responsible nurses on the symptoms of patients undergoing chemotherapy through the analysis of the result. Methods? The study was performed in the chemotherapy unit of a cancer ClassⅢGrade A hospital in Beijing. By convenience sampling, a total of 192 patients undergoing chemotherapy from October 2017 to January 2018 and the nurses (n=16) who were primarily responsible for their care were selected as participants. Symptom assessments were completed by the use of the Edmonton Symptom Assessment System (ESAS). Results? Patients and nurses showed poor agreement in Depression, Anxiety and Shortness of breath (ICC＜ 0.4) and moderate agreement (0.4 ≤ICC＜ 0.75) in other symptoms. Wilcoxon signed rank test was used to compare the results of symptom assessment between patients and responsible nurses. Among the 10 entries in ESAS, there was no statistical difference between the results in poor quality of life (Z=-1.627, P=0.104), however, there were statistical differences in all the rest 9 entries (P＜0.05) among which the nurses scored higher than the patients in the entry of anxiety and depression. Conclusions? Responsible nurses' perception on physical symptoms was better than that of psychological symptoms, and there was overestimation and underestimation in the severity of symptoms. It is necessary for the nurses to teach the patients how to use standard assessment tools and through health education, raise the patients' awareness of reporting their symptoms.

Objective To explore the clinical symptom clusters in breast cancer patients with anthracycline treatment, which could provide evidence for prevention. Methods The M.D.Anderson Symptom Inventory of Chinese version (MDASI-C) was applied to assess clinical symptoms in 506 breast cancer patients received anthracycline therapy during their 1stto 4thcycle chemotherapy.Thirteen symptoms were analyzed using main-component analysis and variance orthogonal rotation. The exploratory factor analysis was conducted to find factors value greater than 1. Results The number of symptoms with incidence rate more than 50% was 5, 6, 7 and 9 during the 1stto the 4thcycle, respectively. Fatigue, poor appetite, and nausea were the most common symptoms, and the incidence of these symptoms were 92.5% to 97.1% ,84.8% to 95.1% and 81.1% to 91.3% with the increasing cycle of chemotherapy.Three factors value greater than 1 were detected during the 1stto 2ndcycle chemotherapy by exploratory factor analysis.The cumulative variance contribution rates were 63.233% and 61.434% in the 1stand 2ndcycle, respectively. The main symptom clusters concentrate on fatigue and digestive tract symptoms, including fatigue, sleep disturbance, hypersomnia, nausea, vomit, poor appetite, dry mouth. Two factors value greater than 1 were detected during 3rdto4thcycle in chemotherapy. The cumulative variance contribution rates were 62.660% and 61.148% in the 3rdand 4thcycle, respectively. The main symptom clusters concentrate on psychological and nervous system symptoms including sadness, pain, dry mouth, numbness, hypersomnia, shortness of breath, amnesia and so on. The Cronbach α of cluster symptoms from the 1stto the 4thcycle chemotherapy was between 0.829 to 0.911. Conclusions Symptom clusters vary with the cycles of chemotherapy in breast cancer patients treated with anthracycline. Nurses should provide targeted intervention measures to improve symptom and enhance quality of life, according to specific situation.

Patients with advanced cancer are often accompanied by a variety of symptoms due to disease or treatment,and it is necessary to choose a scientific assessment tool to assess and manage these symptoms. The Edmonton symptom assessment scale (ESAS)is a brief,easy to complete,and comprehensive assessment tool for the common symptoms of patients with advanced cancer. ESAS has been translated into many languages and it is widely used in many countries. In the course of using,the structure and contents of the original scale are adjusted,and the ESAS is more perfect,besides,its reliability and validity are validated,and it is used in the research of evaluation by others.

OBJECTIVETo estimate the long-term outcomes and the prognostic factors of homoharringtonine, cytarabine, daunorubicin or idarubicin (HAD/HAI) as induction chemotherapy in de novo acute myeloid leukemia (AML).

METHODSThe CR rate, overall survival (OS) rate, relapse free survival (RFS) rate were retrospectively assayed in 143 de novo AML patients who received the HAD/HAI induction chemotherapy. The outcomes were compared among prognostic groups according to world health organization (WHO) classification, genetic prognosis and initial white blood cell (WBC) count. The role of consolidation chemotherapy consisting of middle-dosage Ara-C (MD-Ara-C) on long term survival was evaluated.

RESULTSOf 143 patients, 112 (78.3%) achieved CR after the first course of HAD/HAI induction treatment, and early death occurred in only one case. Notably, the CR rate of patients with an initial WBC count ≥100×10(9)/L was not significantly different from those with an initial WBC count<100× 10(9)/L (70.4% vs 80.2%, P=0.266). The CR rate for the patients with favorable, intermediate and unfavorable integrated genetics risk factors was 93.7%, 71.4% and 61.3%, respectively, the difference between groups was statistically significant (P=0.001). Patients with FLT3-ITD mutation obtained similar CR rate (70.6%) to that of patients with FLT3 wild type (79.3%, P=0.528).The estimated 5-year OS rate and 5-year RFS rate for all patients was 40.0% and 37.0%, respectively, with a median follow-up of 24 (range 1-104) months. The median survival time was 30 [95%CI (12, 48)] months. 5-year OS and 5-year RFS of the 96 patients who achieved CR after first course chemotherapy without undergoing allo-HSCT in complete remission was 47.0% and 38.0%, respectively. 5-year OS was significantly higher in MD-Ara-C consolidation group than in no MD-Ara-C consolidation group among CR patients without allo-HSCT (58.0%, 19.0%, respectively, P=0.004). In patients who obtained CR after first course and received MD-Ara-C consolidation without allo-HSCT, the 5-year OS of patients with hyperleukocytosis was not significantly lower than that of patients without hyperleukocytosis (55.5%, 58.8%, respectively,P=0.419). FLT3-ITD mutation patients showed similar 5-year OS to that of wild type FLT3 patients (51.4%, 60.2%, respectively, P=0.482). And furthermore, 5-year OS of favorable, intermediate and unfavorable integrated genetics groups were 59.1%, 62.5%, 51.9%, respectively (P=0.332) in this subgroup.

CONCLUSIONHAD/HAI induction chemotherapy with sequential consolidation of MD-Ara-C could obtain satisfactory CR rate and long-term survival rate in de novo AML, especially for patients with hyperleukocytosis or FLT3-ITD mutation. It yet remains to be verified by large sample, prospective studies.

Cytarabine ; therapeutic use ; Daunorubicin ; therapeutic use ; Harringtonines ; therapeutic use ; Humans ; Idarubicin ; therapeutic use ; Induction Chemotherapy ; Leukemia, Myeloid, Acute ; drug therapy ; Leukocyte Count ; Prognosis ; Prospective Studies ; Remission Induction ; Retrospective Studies ; Survival Rate

AIM: To explore whether necroptosis contributes to the high glucose (HG)-induced damage in hu-man umbilical vein endothelial cells (HUVECs).METHODS: The protein levels of receptor-interacting protein 3 (RIP3) and cleaved caspase-3 were detected by Western blot.The intracellular levels of reactive oxygen species (ROS) were deter-mined by DCFH-DA staining followed by photofluorography.Mitochondrial membrane potential (MMP) was measured by rhodamine 123 staining followed by photofluorography.RESULTS: Treatment of HUVECs with HG at different concentra-tions (10, 20 and 40 mmol/L glucose) for 24 h gradually enhanced the expression levels of RIP3.Treatment of HUVECs with HG (40 mmol/L glucose) for different time (3 h, 6 h, 9 h, 12 h and 24 h) also up-regulated the expression levels of RIP3, peaking at 9 h.Pretreatment of HUVECs with 20 μmol/L Z-VAD-FMK (an inhibitor of caspase) for 30 min before exposure to HG enhanced the expression level of RIP3.Pretreatment of HUVECs with 100 μmol/L necrostatin-1 (an inhi-bitor of necroptosis) for 1 h before exposure to HG alleviated the HG-induced injuries, such as a decrease in cell viability, an increase in ROS generation and dissipation of MMP, but up-regulated the protein level of cleaved caspase-3.CON-
CLUSION: Necroptosis mediates HG-induced injury in HUVECs.There is a negative interacting between necroptosis and apoptosis.