Our purpose was to investigate the role of SOX9, a novel downstream molecule of beta-catenin, in colorectal cancer. Expression of SOX9 and beta-catenin was detected by immunostaining, quantitative real-time reverse transcription-polymerase chain reaction (Q-PCR), and Western blot in colorectal cancer. The correlation between SOX9 or beta-catenin expression and clinicopathologic parameters was also analyzed. Immunostaining, Q-PCR, and Western blot consistently confirmed SOX9 up-regulation in colorectal cancer compared with normal mucosa (P < .05). Immunostaining showed more SOX9+ cells in the lower zone of colonic crypts than in the upper zone (P < .05). Cancers with strong SOX9 immunostaining were significantly associated with a lower 5-year overall survival (40% [17/43] vs low expression, 69% [66/95]; P < .01). The Cox proportional hazards model showed that strong SOX9 expression was an independent adverse prognosticator in colorectal cancer (P < .05). The detection of SOX9 expression might contribute to predicting clinical outcomes for patients with colorectal cancer.
Highlights A high prevalence of probable PTSD (20.87%) was found about six months after the first local outbreak of COVID-19 among healthcare workers at the Central Hospital of Wuhan. Healthcare workers with negative COVID-19 tests, those with high Social Support Self-Rating Scale (SSRS) scores, and HCWs whose family members tested negative were less likely to have probable PTSD. High levels of psychiatric and somatic illness and insomnia were associated with probable PTSD.
Background The outbreak of COVID 19in December 2019 spread quickly and overwhelmed the local healthcare system of the epicenter. A total of 346 medical assistance teams with 42,600 reserve medics were mobilized from around the country for emergency assistance. This study aims to examine the incidence of mental health symptoms and predictors of Post-Traumatic Stress Disorders (PTSD) symptoms among the reserve medics working in Wuhan, the capital city of Hubei Province. Methods An anonymous survey was conducted from April 4–6, 2020 among the medics upon their returning home. A total of 225 surveys were returned with a response rate of 83%. The survey consisted of questionnaires about the medics' demographic information, social relations, mental health status (e.g. IES-R and DASS-21) and other work-related information. Mann-Whitney U Test, Kruskal-Wallis Test and hierarchical logistic regression models were used to examine the predictors of PTSD symptoms. Results During the stay in Wuhan, the medics experienced high levels of depression (46.7%), anxiety (35.6%) and stress symptoms (16.0%). Upon returning home, the overall prevalence of clinically concerned PTSD symptoms was as high as 31.6%. Further analyses revealed that PTSD symptoms and its subscales were significantly associated with age, collegial relationship and mental health status during their service. Conclusion The reserve medics reported a high prevalence of depression, anxiety and stress as well as clinically concerned PTSD symptoms. Comprehensive screening and intervention programs should be in place to help reserve medics cope with mental health challenges and build resilience during the COVID 19 pandemic.
KLF4 is associated with terminal differentiation in colorectal epithelium and drastically downregulated in colorectal adenomas and cancers via possible epigenetic modifications. Loss of KLF4 protein expression might contribute to assessing prognosis in colorectal cancer with lymph node metastasis.
ObjectivesGiven the increasing need of long-term care and the low occupancy rate of nursing homes in Shanghai, this study attempts to explore what factors influence older people’s intention to enrol in nursing homes.DesignA cross-sectional observational study based on the theory of reasoned action was conducted. Survey data were collected from subjects during face-to-face interviews. Structural equation modelling was employed for data analysis.SettingThis study was conducted in six community health service centres in Shanghai, China. Two service centres were selected in urban, suburban and rural areas, respectively.ParticipantsA total of 641 Shanghai residents aged over 60 were surveyed.ResultsStructural equation modelling analysis showed that the research model fits the data well (χ2/df=2.948, Comparative Fit Index=0.972 and root mean squared error of approximation =0.055). Attitude (β=0.41, p<0.01), subjective norm (β=0.28, p<0.01) and value-added service (β=0.16, p<0.01) were directly associated with enrolment intention, explaining 32% of variance in intention. Attitude was significantly influenced by loneliness (β=−0.08, p<0.05), self-efficacy (β=0.32, p<0.01) and stigma (β=−0.24, p<0.01), while subjective norm was significantly influenced by life satisfaction (β=−0.15, p<0.01) and stigma (β=−0.43, p<0.01).ConclusionsThis study advances knowledge regarding the influencing factors of older people’s intention to enrol in nursing homes. It suggests that Chinese older persons’ perceived stigma has the strongest indirect effect on their intention to enrol in nursing homes. This is unique to the Chinese context and has practical implications for eldercare in China and other Asian countries with similar sociocultural contexts.
Background Traditional exercise [supervised exercise (SE)] intervention has been proved to be one of the most effective ways to improve metabolic health. However, most exercise interventions were on a high-cost and small scale, moreover lacking of the long-term effect due to low engagement. On the other hand, it was noteworthy that gamification and social incentives were promising strategies to increase engagement and sustain exercise interventions effects; as well as mobile technologies such as WeChat also can provide an appropriate platform to deploy interventions on a broader, low-cost scale. Thus, we aim to develop a novel exercise intervention (‘S&G exercise intervention’) that combines SE intervention with gamification and social incentives design through WeChat, with the aim of improving metabolic health and poor behaviors among overweight and obesity children. Methods We propose a randomized controlled trial of a ‘S&G exercise intervention’ among 420 overweight and obese children who have at least one marker of metabolic syndrome. Children will be randomized to control or intervention group in a 1:1 ratio. The exercise intervention package includes intervention designs based on integrated social incentives and gamification theory, involving targeted essential volume and intensity of activity (skipping rope) as well as monitoring daily information and providing health advice by WeChat. Participants will undertake assessments at baseline, at end of intervention period, in the follow-up time at months 3,6,12. The primary outcome is outcome of metabolic health. Secondary outcomes include behavioral (e.g., diary physical activity, diet) and anthropometric measures (e.g., body fat rate and muscle mass). Discussions This will be the first study to design an exercise intervention model that combines traditional supervised exercise (SE) intervention with gamification and social incentives theory through WeChat. We believed that this study could explore a low-cost, easy-to-popularize, and effective exercise intervention model for improving metabolic health and promote healthy among obese children. Furthermore, it will also provide important evidence for guidelines to prevent and improve metabolic health and health behaviors. Trial registration 10-04-2019;Registration number: ChiCTR1900022396 .
Editor's key points † Induction of an isoelectric EEG by anaesthetics has been implicated in neuroprotection, and might be clinically useful or detrimental in specific situations. † The potency of sevoflurane in producing an isoelectric EEG was determined in adult human subjects before surgical incision. † The minimal alveolar concentration (MAC) of sevoflurane for isoelectric EEG was 3.5 vol%, which is about 2.1 times the MAC for skin incision. Background. We determined the minimal alveolar concentration (MAC) of sevoflurane inducing an isoelectric EEG in 50% of adult subjects (MACie). Methods. We included 31 middle-aged subjects; 30 subjects finished the study protocol and received sevoflurane at preselected concentrations according to a modified Dixon 'up-anddown' design starting at 1.7 vol% with 0.2 vol% steps size. General anaesthesia was induced and maintained with sevoflurane; tracheal intubation was facilitated with cisatracurium. After a period of 30 min before skin incision, the state of isoelectric EEG was considered as significant when a burst suppression ratio of 100% lasted for .1 min. The haemodynamic responses to skin incision and the vasopressor requirement to maintain stable haemodynamic status were also analysed according to the EEG state. Results. MACie was 3.5% (95% confidence interval, 3.4-3.7%) in middle-aged subjects. When compared with subjects not in isoelectric EEG state, subjects in isoelectric EEG state received more phenylephrine to maintain stable haemodynamics (10 of 10 compared with 7 of 20 subjects, P¼0.001) and experienced less sympathetic responses to skin incision (1 of 10 compared with 11 of 20 subjects, P¼0.024). Conclusions. MACie for sevoflurane was 2.1 times MAC for immobilization in phenobarbital premedicated middle-aged adults. Sevoflurane-induced isoelectric EEG state is associated with significant cardiovascular depression but reduced haemodynamic responses to skin incision.
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