Objective Vaccines including pneumococcal and influenza vaccines are recommended in patients with immunosuppressive treatment. However, vaccine coverage remains extremely low. Our study was to investigate vaccination uptake, knowledge, attitude and practice (KAP) towards certain vaccinations among these patients, and to identify the factors influencing willingness to be vaccinated. Methods A cross-sectional survey was conducted among patients with rheumatic diseases in a tertiary hospital in China. Baseline assessments were completed by using questionnaires including vaccination uptake and KAP towards certain infections and vaccinations. Results 235 patients completed the study. Mean age was 39.69 years old, while 66.4% were females. Only 6.4% of the participants once had taken vaccine in recent five years. One patient had influenza vaccination, and none ever took pneumococcal vaccine. 3.8% had doctor's recommendation on taking influenza, pneumococcal or herpes zoster vaccine. Major reasons given for not being vaccinated included "unnecessary" (8.9%) and "troublesome to take vaccines" (8.5%). Patients would take influenza or pneumococcal vaccines if they had heard of them before, had knowledge of infection, and had belief in vaccine's safety and reliability (p < 0.05). Conclusion Vaccine coverage among people with rheumatic diseases was low in China. Methods to improve KAP toward infections and vaccinations should be taken.

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Background: The combination of chemotherapy with radiotherapy serves as a common therapeutic strategy in clinics. However, it is unsatisfactory due to its poor therapeutic efficiency and severe side-effects originating from chemotherapy-exerted systemic toxicity as well as radiation-induced injury. Purpose: Hence, Berberine (Ber), an isoquinolin alkaloid with low toxicity and protective effects against radiotherapy, was used as a novel chemotherapeutic agent for chemo-radiotherapy of liver cancer. Patients and methods: We preloaded Ber into folic acid targeting Janus gold mesoporous silica nanocarriers (FA-JGMSNs) for overcoming the poor bioavailability of Ber. Furthermore, FA-JGMSNs were not only employed as radiosensitizers for expanding radiotherapeutic effect, but also used as photothermal agents for supplementing chemo-radiotherapeutic effect by local photothermal therapy. Results: In vitro and in vivo experiemtal results demonstrated the highly efficient anti-tumor effect, good biosafety as well as the effective protection of normal tissue of this nanoplatform. Conclusion: Based on its superb performance, we believe our work provided a feasible strategy for triple-therapies of liver cancer.

Background: The objective of this study was to explore the prevalence of change in bone mineral density (BMD) and the potential risk factors for osteopenia and osteoporosis in rheumatic patients.Methods: An analytical cross-sectional study design was carried out. For this study, one thousand and seven rheumatic patients were recruited and further accepted for data collection and blood and BMD tests. The potential risk factors for osteopenia and osteoporosis in rheumatic patients were further analyzed by using both logistic regression analysis and random forest (RF) analysis.Results: 41.1% of the male patients aged 50 years or above and 50.8% of postmenopausal patients were osteoporotic in their lumbar spine. Among these patients, the prevalence of osteoporosis in the femoral neck and total hip was 19.4% and 8.9% in men, and 27.6% and 16.5% in women respectively, while more than half of the rheumatic patients had osteopenia in the femoral neck and total hip. For men younger than 50 years and premenopausal women, BMD were lower than the health population in the femoral neck (16.5% and 18.3% respectively) and the total hip (17.4% and 10.4% respectively). Older age, body mass index (BMI) <18.5 kg/m 2 , female sex and glucocorticoid use were associated with lower BMD in the lumbar spine, femoral neck, and total hip of patients. In RF analysis, age was ranked as the most important factor for osteopenia in the lumbar spine, femoral neck, and total hip of patients, followed by glucocorticoid use and BMI.Conclusions: More interventions should be given to osteopenia patients because of the higher prevalence when compared with osteoporosis patients. Older age, BMI <18.5 kg/m 2 , female sex and glucocorticoid use were associated with lower BMD in rheumatic patients. The results from the logistic regression can be supplemented by random forest analysis.