Construction and analysis of a reliable five-gene prognostic signature for colon adenocarcinoma associated with the wild-type allelic state of the COL6A6 gene.

Background: Tumors emerge by acquiring a number of mutations over time. The first mutation provides a selective growth advantage compared to adjacent epithelial cells, allowing the cell to create a clone that can outgrow the cells that surround it. Subsequent mutations determine the risk of the tumor progressing to metastatic cancer. Some secondary mutations may inhibit the aggressiveness of the tumor while still increasing the survival of the clone. Meaningful mutations in genes may provide a strong molecular foundation for developing novel therapeutic strategies for cancer. Methods: The somatic mutation and prognosis in colon adenocarcinoma (COAD) were analyzed. The copy number variation (CNV) and differentially expressed genes (DEGs) between the collagen type VI alpha 6 chain (COL6A6) mutation (COL6A6-MUT) and the COL6A6 wild-type (COL6A6-WT) subgroups were evaluated. The independent prognostic signatures based on COL6A6-allelic state were determined to construct a Cox model. The biological characteristics and the immune microenvironment between the two risk groups were compared. Results: COL6A6 was found to be highly mutated in COAD at a frequency of 9%. Patients with COL6A6-MUT had a good overall survival (OS) compared to those with COL6A6-WT, who had a different CNV pattern. Significant differences in gene expression were established for 593 genes between the COL6A6-MUT and COL6A6-WT samples. Among them, MUC16, ASNSP1, PRR18, PEG10, and RPL26P8 were determined to be independent prognostic factors. The internally validated prognostic risk model, constructed using these five genes, demonstrated its value by revealing a significant difference in patient prognosis between the high-risk and low-risk groups. Specifically, patients in the high-risk group exhibited a considerably worse prognosis than did those in the low-risk group. The high-risk group had a significantly higher proportion of patients over 60 years of age and patients in stage III. Moreover, the tumor immune dysfunction and exclusion (TIDE) score and the expression of human leukocyte antigen (HLA) family genes were all higher in the high-risk group than that in the low-risk group. Conclusions: The allelic state of COL6A6 and the five associated DEGs were identified as novel biomarkers for the diagnosis and prognosis of COAD and may be therapeutic targets in COAD.

Effects of sevoflurane and propofol on postoperative nausea and vomiting in patients with colorectal cancer placed under general anesthesia: a systematic review and meta-analysis.

Background: This study sought to explore the effects of sevoflurane and propofol on postoperative nausea and vomiting (PONV) in patients with colorectal cancer (CRC). Sevoflurane inhalation anesthesia has the advantages of short induction time, stable hemodynamic, stable anesthesia maintenance and short recovery time, and its anesthetic effect is similar to that of propofol, so it is worthy of comparative analysis. Methods: The PubMed, Cochrane, Web of Science, Embase, clinical research register and CQVIP databases were searched to retrieve the data of randomized controlled trials (RCTs) published between October 2000 and October 2021 on the effects of sevoflurane and propofol on nausea and vomiting after laparoscopic surgery in patients with CRC. Applying the inclusion criteria, the literature selection, data extraction, and quality evaluation assessments were carried out for the included articles. The I2 test was used to evaluate the heterogeneity between the studies, and the meta-analysis was performed using RevMan 5.2.6 software provided by Cochrane. Results: A total of 12 RCTs were included in this meta-analysis. There was statistically significant differences in changes in postoperative heart rate [odds ratio (OR) =3.55, 95% confidence interval (CI): 2.40, 5.27, P<0.00001, I2=0%, Z=6.30], mean artery pressure (MAP) (OR =2.58, 95% CI: 2.04, 3.26, P<0.00001, I2=58%, Z=7.87), the incidence of PONV (OR =1.73, 95% CI: 1.38, 2.17, P<0.00001, I2=46%, Z=4.78), and the incidence of postoperative disturbance of consciousness (OR =2.09, 95% CI: 1.62, 3.07, P<0.00001, I2=63%, Z=5.67) between the experimental group and the control group. Conclusions: Combining anesthesia with sevoflurane and propofol had good prevention and treatment effects for PONV in patients with CRC who underwent a laparoscopy and had a moderate central sedation effect.

Depressive State in the Emergency Department During COVID-19: A National Cross-Sectional Survey in China.

Chinese emergency department (ED) staff encountered significant mental stress while fighting the coronavirus disease 2019 (COVID-19) pandemic. We sought to investigate the prevalence and associated factors for depressive symptoms among ED staff (including physicians, nurses, allied health, and auxiliary ED staff). A cross-sectional national survey of ED staff who were on duty and participated in combating the COVID-19 pandemic was conducted March 1-15, 2020. A total of 6,588 emergency medical personnel from 1,060 hospitals responded to this survey. A majority of respondents scored above 10 points on the PHQ-9 standardized test, which is associated with depressive symptoms. Those aged 31-45, those working in the COVID-19 isolation unit, and those with relatives ≤ 16 or ≥70 years old at home all had statistically significant associations with scoring >10 points. Depressive symptoms among Chinese emergency medical staff were likely quite common during the response to the COVID-19 pandemic and reinforce the importance of targeted ED staff support during future outbreaks.

[A validation study of national early warning score in evaluation of death risk in elderly patients with critical illness].

Objective: To verify the validity and feasibility of national early warning score (NEWS) in evaluation of death risk in elderly patients with critical illness,in order to find out which scoring method is more suitable for elderly critical illness patients. Methods: A prospective case-control study was conducted. The critical illness patients aged over 60 years old with the length of hospital stay over 24 hours, and admitted to Department of Emergency of Qingdao Municipal Hospital from January to December 2015 were enrolled. The clinical data including in emergency and the actual outcome of patients were collected, and the patients were divided into death group and survival group according to 30-day outcome. Patients in the two groups were assessed by using NEWS and risk classification according to the first results of vital signs monitoring. Multivariate logistic regression model was used to analyze the relationship between the NEWS classification and the risk of death in elderly critical ill patients. Results: 1 950 emergency elderly patients with critical illness were enrolled, with 78 cases (4.0％) dead within 30 days and 1 872 survived (96.0％).Compared with the survival group, patients in death group were older (years:79.8 ± 10.8 vs.75.3 ± 8.9,t =4.335,P ＜0.001),and had higher acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score (22.9± 4.6 vs.18.2 ± 4.8,t =8.487,P ＜ 0.001),lower Glasgow coma scale (GCS) score (12.2 ± 4.5 vs.13.4 ± 5.2,t =-2.007,P =0.045),higher incidence of respiratory system diseases (29.5％ vs.17.9％,x 2 =12.742,P =0.013),higher NEWS score (11.2 ± 5.5 vs.3.9 ± 2.7,t =22.063,P ＜ 0.001),as well as higher proportion of patients with NEWS classification of high risk and very high risk (65.4％ vs.15.8％,x 2 =263.125,P ＜ 0.001).With the increase of NEWS risk classification, mortality rate was also increased, and the mortality rate in the patients with low, medium, high and very high risk were 0.81％ (9/1 108),3.63％ (18/496),5.83％ (13/223),30.89％ (38/123),respectively, with statistically significant difference (x 2 =179.741,P ＜ 0.001).It was showed by logistic regression analysis that the NEWS score of elderly patients with critical illness were positively correlated with 30-day death. The 30-day death risk of patients with middle risk, high risk and very high risk was 4.600,9.052 and 54.598 folds of the patients with low risk respectively. Conclusion: NEWS score can be used to assess the risk of death in emergency elderly patients with critical illness. NEWS risk classification can quantify and classify the risk of death in the elderly patients with critical illness.

[In vivo reflectance spectroscopy study of different clearing agents on human skin optical clearing].

The changes of skin tissue reflectance spectroscopy before and after being treated with the optical clearing agents of three different types of optical clearing within the wavelength rang of 400-1 000 nm, and the degree of changes in reflectance spectroscopy of each group skin during 0-60 min at 580 nm in vivo were real-time dynamically researched. The reflectance spectroscopy of skin tissue before and after being dealt by the optical clearing agents of glycerol, glucose and propylene glycol was measured using a USB-4000 fiber spectrophotometer at 0, 10, 20, 30, 40, 50 and 60 min. The results showed that the reflectance spectral intensity was distinctly decreased, but the reflectance was significantly increased gradually with the time prolonged. However, different optical clearing agents have different clearing progress. The relative decrease of reflectance of palm skin tissue before and after being dealt by the optical agents of 40% glycerol, 40% glucose and 40% propylene glycol during 10, 20, 30, 40, 50 and 60 min at the wavelength 580 nm is 5%, 7%, 9%, 10%, 11% and 12%, 9%, 13%, 16%, 19%, 21% and 22%, and 14%, 22%, 29%, 32%, 34% and 35%, respectively. The significant improvement in light transmittance and enhancement of light penetration through tissue was demonstrated for all solutions. The effect and processes of optical clearing of skin tissue is not only closely related to the choosing of the clearing agent type, but also related to the treatment time with the skin tissue. The clearing progress of different type optical clearing agent showed the order of 40% propylene glycol, 40% glucose and 40% glycerol.

Expression and clinical significance of syndecan-1 mRNA and HPA-1 mRNA in colorectal cancer detected with real-time fluorescent quantitative polymerase chain reaction.

BACKGROUND AND OBJECTIVE: Invasion and metastasis are the most common causes of mortality for patients with colorectal neoplasms, and blocking invasion and metastasis in a timely fashion has become a hot research focus. We investigated the expression of the messenger RNA of Syndecan-1 and HPA-1 in colorectal cancer, and their correlation with invasion and metastasis. METHODS: Real-time fluorescent quantitative polymerase chain reaction (PCR) was used to detect the expression of Syndecan-1 and HPA-1 in specimens from 49 patients with colorectal cancer, 49 paired adjacent colorectal neoplasms (2 cm from the carcinoma), and 49 surgical margins of paired normal colorectal mucosa tissue (5 cm from the carcinoma), to analyze their correlation with clinicopathologic characteristics of colorectal neoplasm. RESULTS: The expression of HPA-1 mRNA was significantly higher in colorectal cancer (40.56 +/- 11.75) than that in the paired adjacent colorectal neoplasms (18.28 +/- 11.33) and normal colorectal mucosa tissue (10.80 +/- 10.20) (all P < 0.001). The expression of HPA-1 mRNA was significantly higher in paired adjacent colorectal neoplasms than that in normal colorectal mucosa (P < 0.05). The expression of Syndecan-1 mRNA was significantly higher in normal colorectal mucosa (61.21 +/- 12.96) than in the paired adjacent mucosa (14.35 +/- 11.06) or colorectal cancer (10.12 +/- 8.58) (all P < 0.001). The expression of Syndecan-1 mRNA was significantly higher in the paired adjacent mucosa than that in colorectal cancer (P < 0.05). The decreased expression of Syndecan-1 mRNA and the increased expression of HPA-1 were closely associated with the degree of differentiation, the depth of infiltration, lymph node metastasis, vessel metastasis, and TNM staging of colorectal cancer (all P < 0.05). Spearman rank correlation analysis demonstrated a significant correlation between Syndecan-1 and HPA-1(r = -0.405, P < 0.05). CONCLUSIONS: The expression of Syndecan-1 mRNA was significantly highest in normal colorectal mucosa and the expression of HPA-1 mRNA was significantly highest in colorectal cancer. At the same time, the decreased expression of Syndecan-1 mRNA and the increased expression of HPA-1 mRNA can promote the invasion and metastasis of colorectal cancer. The determination of Syndecan-1 and HPA-1 may be of value in the treatment as well as in the prognosis of patients with colorectal cancer.

[Adjuvant effect of transcutaneous electrical acupoint stimulation in propofol-fentanyl anesthesia in partial mastectomy].

OBJECTIVE: To evaluate the adjuvant effect of transcutaneous electrical acupoint stimulation (TEAS) in propofol-fentanyl anesthesia in partial mastectomy. METHODS: Ninety patients undergoing partial mastectomy were randomly divided into 3 groups (n=30), namely group A with propofol-fentanyl anesthesia (PFVA), group B with PFVA and TEAS at Hegu-Laogong and Neiguan-WaiGuan acupoints, and group C with PFVA and TEAS at Hegu-Laogong, Neiguan-Waiguan, and bilateral Jianjing acupoints. The bispectral index (BIS), heart rate (HR), saturation of pulse oxygen (SpO2), blood pressure (BP), the reaction of patients to the incision and awakening quality were observed at different time points. Blood samples were obtained from the dorsal artery of the foot to determine the levels of adrenaline and beta-endorphin using the enzyme-linked immunosorbent assay before TEAS (entry into the OR in group A) and at 30 min after TEAS (30 min after entry into the OR in group A), 5 min after incision, end of the surgery and awakening. RESULTS: Thirty minutes after TEAS (or 30 min after entry into the OR in group A), BIS, BP and HR were all decreased significantly in groups B and C (P<0.05) but remained stable in group A (P>0.05). The plasma propofol concentration of groups B and C were significantly lower than that in group A, and group B had the highest plasma propofol concentration (P<0.05). The total dose of propofol in groups B and C were decreased by 19% and 27% in comparison with that in group A, respectively. Compared with the basal value, the content of beta-endorphin in groups B and C increased obviously 30 min after TEAS, being the highest in group C (P<0.05); the adrenaline level in groups B and C remained stable after TEAS (P>0.05). CONCLUSION: TEAS provides an adjuvant effect in propofol-fentanyl anesthesia and obviously enhances the analgesia effect.