Prevalence of mental health problems in frontline healthcare workers after the first outbreak of COVID-19 in China: a cross-sectional study.

BACKGROUND: More than 210,000 medical workers have fought against the outbreak of Coronavirus Disease 2019 (COVID-19) in Hubei in China since December 2019. However, the prevalence of mental health problems in frontline medical staff after fighting COVID-19 is still unknown. METHODS: Medical workers in Wuhan and other cities in Hubei Province were invited to participate a cross-sectional and convenience sampling online survey, which assessed the prevalence of anxiety, insomnia, depression, and post-traumatic stress disorder (PTSD). RESULTS: A total of 1,091 responses (33% male and 67% female) were valid for statistical analysis. The prevalence was anxiety 53%, insomnia 79%, depression 56%, and PTSD 11%. Healthcare workers in Wuhan were more likely to face risks of anxiety (56% vs. 52%, P = 0.03) and PTSD (15% vs. 9%, P = 0.03) than those in other cities of Hubei. In terms of educational attainment, those with doctoral and masters' (D/M) degrees may experience more anxiety (median of 7.0, [interquartile range (IQR) 2.0-8.5] vs. median 5.0 [IQR 5.0-8.0], P = 0.02) and PTSD (median 26.0 [IQR 19.5-33.0] vs. median 23.0 [IQR 19.0-31.0], P = 0.04) than those with lower educational degrees. CONCLUSIONS: The mental problems were an important issue for the healthcare workers after COVID-19. Thus, an early intervention on such mental problems is necessary for healthcare workers.

Adjuvant effects of Chinese medicinal tonics on gastric, liver, and colorectal cancers-OMICs-based contributions to understanding their mechanism of action.

Gastric, liver, and colorectal cancers belong to gastrointestinal (GI) cancers, one of the most threatening diseases in the world. The tonics class in Chinese medicines plays a critical role in antigastrointestinal cancer as adjuvants. However, it is a challenge to study the effects and underlying mechanisms of tonics due to their multiple components and multiple targets; OMICs were introduced to facilitate the investigation of the complex mixture of tonics. In this review, the online databases PubMed, ProQuest, Web of Knowledge, China National Knowledge Infrastructure (CNKI), Chongqing VIP, and Wanfang were retrieved from 1 January 2011 to 31 May 2022, in an aim to summarize and discuss the research progress of the effects and, especially, the underlying mechanisms of tonics for antigastrointestinal cancers via OMICs. The results showed that through the combination of OMICs and other technologies, tonics have been used for gastrointestinal cancer by targeting cancer hallmarks, enhancing body resistance to carcinogenesis, enhancing therapeutic effects, and/or decreasing side effects. In conclusion, tonics may play a promising role in gastric, liver, and colorectal cancers as adjuvants and can be well investigated via the combination of OMICs and other technologies, which deserves further study.

Gambogenic acid induces proteasomal degradation of CIP2A and sensitizes hepatocellular carcinoma to anticancer agents.

Cancerous inhibitor of protein phosphatase 2A (CIP2A) is an oncoprotein that is overexpressed in many human malignancies. It regulates phosphorylated AKT and stabilizes c­Myc in cell proliferation and tumor formation, suggesting that CIP2A plays an essential role in the development of cancer. In the present study, we report that a natural compound, gambogenic acid (GEA), induced the degradation of CIP2A via the ubiquitin­proteasome pathway. Interestingly, the combination of GEA and proteasome inhibitors potentiated the accumulation of ubiquitinated CIP2A and aggresome formation. In addition, GEA exhibited an inhibitory effect on cell proliferation and CIP2A­downstream signaling molecules (c­Myc and pAKT). Furthermore, GEA and CIP2A silencing enhanced the chemosensitivity of hepatocellular carcinoma cells to anticancer agents, suggesting that a combination of a CIP2A inhibitor and anticancer agents could be a valuable clinical therapeutic strategy. These results indicate that GEA is a CIP2A inhibitor that interferes with the ubiquitination and destabilization of CIP2A, providing a promising strategy to enhance the combinational therapy for hepatocellular carcinoma.

Elevated red cell distribution width contributes to a poor prognosis in patients with esophageal carcinoma.

BACKGROUND: The red cell distribution width (RDW) has also been reported to reliably reflect the inflammation and nutrition status and predict the prognosis across several types of cancer, however, the prognostic value of RDW in esophageal carcinoma has seldom been studied. METHODS: A retrospective study was performed to assess the prognostic value of RDW in patients with esophageal carcinoma by the Kaplan-Meier analysis and multivariate Cox regression proportional hazard model. All enrolled patients were divided into high RDW group (≧15%) and low RDW group (<15%) according to the detected RDW values. RESULTS: Clinical and laboratory data from a total of 179 patients with esophageal carcinoma were retrieved. With a median follow-up of 21months, the high RDW group exhibited a shorter disease-free survival (DFS) (p<0.001) and an unfavorable overall survival (OS) (p<0.001) in the univariate analysis. The multivariate analysis revealed that elevated RDW at diagnosis was an independent prognostic factor for shorter PFS (p=0.043, HR=1.907, 95% CI=1.020-3.565) and poor OS (p=0.042, HR=1.895, 95% CI=1.023-3.508) after adjustment with other cancer-related prognostic factors. CONCLUSION: The present study suggests that elevated preoperative RDW(≧15%) at the diagnosis may independently predict poorer disease-free and overall survival among patients with esophageal carcinoma.

Recent progress on anti-liver fibrosis candidates in patents of herbal medicinal products.

Liver fibrosis is a common cause of chronic failure of liver function, which is characterized by extracellular matrix accumulation and disruption of normal tissue architecture. Liver fibrosis-dependent mechanisms of hepatocarcinogenesis have drawn much attention. Herbal medicines are one of the strategies against liver fibrosis and a way to prevent hepatocellular carcinoma (HCC). Herbal medicines are usually used as official drugs in China, Japan and other parts of Asia. In this review, we retrieved and summarized current progress of anti-liver fibrosis candidates in USA, European and worldwide patents of herbal medicines in recent ten years. The pure compounds, fractions in single herbs and composite formulae were analyzed and discussed. The results indicated that herbal medicinal products can have potential on antiliver fibrosis. Further studies should focus on the structure modification of natural compound by computer-assisted drug design, quality control by acceptable worldwide guidelines, and mechanisms of action, drug metabolism and translational research.

Inhibition of tetramethylpyrazine on P-gp, MRP2, MRP3 and MRP5 in multidrug resistant human hepatocellular carcinoma cells.

Some membrane transporters in liver, such as P-glycoprotein, multidrug resistance-associated protein 2 (MRP2), MRP3, and MRP5 can lead to a complex multidrug resistance (MDR) to antineoplastic agents. How to inhibit these proteins is still an issue. Tetramethylpyrazine is a bioactive constituent isolated from the root of Ligusticum chuanxiong Hort, a Chinese herb. Recent studies showed that it can enhance the chemosensitivity effects of a drug on human hepatocellular carcinoma cells, acting as a multidrug resistance modulator. In this study, the reversal effect of TMP on MDR was evaluated and its activity mechanism in vitro was explored. The IC50 value shows that TMP reversed the multidrug resistance of BEL-7402/ADM cells 9.23-fold (P<0.01) at the concentration of 600 microM. The mean fluorescence intensity of ADM in BEL-7402/ADM cells with TMP was found to be 163.78+/-39.5% (P<0.01) versus in BEL-7402/ADM cells without TMP by flow cytometry and 126.73+/-28.72% in BEL-7402/ADM cells with TMP versus in BEL-7402/ADM cells without TMP (P<0.01) by high performance liquid chromatography, respectively. It was also found that the mRNA level of multidrug resistant gene MDR1, MRP2, MRP3 and MRP5 and the level of the proteins they encode were decreased after treatment with TMP, indicating that TMP can effectively reverse the MDR in BEL-7402/ADM cells, and its activity mechanism may be correlated with the down-regulation of expression in these transporters.