The immunotherapeutic effect elicited by photodynamic therapy (PDT) is attenuated by tumor defense mechanisms associated with glutamine metabolism, including the metabolic regulation of redox homeostasis and the limitation of the immunosuppressive tumor microenvironment (ITM). Herein, a carrier-free immunotherapeutic nanobooster C9SN with dual synergistic effects was constructed by the self-assembly of glutaminase (GLS) inhibitor compound 968 (C968) and photosensitizer Chlorin e6. C968-mediated GSH deprivation through inhibiting glutamine metabolism prevented PDT-generated reactive oxygen species from being annihilated by GSH, amplifying intracellular oxidative stress, which caused severe cell death and also enhanced the immunogenic cell death (ICD) effect. In addition, genome-wide analysis was carried out using RNA-sequencing to evaluate the changes in cell transcriptome induced by amplifying oxidative stress. Thereafter, neoantigens generated by the enhanced ICD effect promoted the maturation of dendritic cells, thereby recruiting and activating cytotoxic T lymphocytes (CTLs). Meanwhile, C9SN remodeled the ITM by blocking glutamine metabolism to polarize M2-type tumor-associated macrophages (TAMs) into M1-type TAMs, which further recruited and activated the CTLs. Ultimately, this immunotherapeutic nanobooster suppressed primary and distant tumors. This “kill two birds with one stone” strategy would shed light on enhancing tumor immunogenicity and alleviating tumor immunosuppression to improve the immunotherapeutic effect of PDT.

PurposeWe aimed to assess the current status of depressive symptoms and quality of life (QoL) among rural elderly in central China (Anhui Province) and explore their correlation and associated factors for depressive symptoms.MethodsA multi-stage random sampling method was used to obtain 3349 participants (aged ≥60): 1206 poor and 2143 non-poor. The 30-item Geriatric Depression Scale (GDS-30) and five-dimensional European quality of health scale (EQ-5D) were employed to evaluate depressive symptoms and QoL, respectively.ResultsThe prevalence of depressive symptoms was 52.9%, and that in the poor group (62.3%) was significantly higher than the non-poor group (47.6%). The GDS-30 score was 12.40 ± 7.089, and the poor group scored significantly higher (14.045 ± 6.929) than the non-poor group (11.472 ± 7.011). The EQ-5D score was 0.713 ± 0.186, and the poor group (0.668 ± 0.192) scored significantly lower than the non-poor group (0.738 ± 0.178). There was a significant negative correlation between depressive symptoms and QoL (r = −0.400, P-value <0.05). The following factors were associated with depressive symptoms: poverty, low EQ-5D score, female gender, older age, illiteracy, unemployed, chronic diseases, and hospitalization in previous year.ConclusionRural elderly in central China have a high prevalence of depressive symptoms and low QoL. Poverty was associated with a higher prevalence of depressive symptoms and lower QoL.

Background The shortage of primary medical staff is an important issue in the management of health human resources, and it is also a problem that all countries in the world need to face together. Since 2009, China has implemented a new series of medical system reforms and the shortage and loss of primary medical staff have been alleviated accordingly. However, China has a large population and it is difficult to distribute health human resources evenly across regions. This study aimed to explore the current status of turnover intention and its relationship with psychological capital, social support, and job burnout, as well as how these factors influence turnover intention of primary medical staff in Anhui province, China. Methods Using structured questionnaires to collect data, including demographic characteristics, turnover intention, psychological capital, social support, and Chinese Maslach Burnout Inventory scale. A total of 1152 primary medical workers of Anhui were investigated. Data were analyzed by t-test, analysis of variance (ANOVA), Pearson correlation analysis, and multiple linear regression model. Results Total scores of turnover intention, psychological capital, social support, and job burnout of subjects were 14.15 ± 4.35, 100.09 ± 15.98, 64.93 ± 13.23 and 41.07 ± 9.437, respectively. Multiple linear regression showed the related factors of turnover intention were age, job position, work unit, and scores of job burnout. Pearson correlation showed psychological capital and social support were negatively correlated with turnover intention, while the score of job burnout was positively correlated with turnover intention. Conclusion The improvement of psychological capital and social support and the reduction of job burnout may play an important role in reducing turnover intention of primary medical staff. Primary medical managers should strengthen the humanistic care for primary medical staff, optimize the incentive mechanism, and improve internal management of medical institutions for stability.

No abstract

No abstract