Early-onset colorectal cancer (EOCRC) shows a different epidemiological trend compared to later-onset colorectal cancer, with its incidence rising in most regions and countries worldwide. However, the reasons behind this trend remain unclear. The etiology of EOCRC is complex and could involve both genetic and environmental factors. Apart from Lynch syndrome and Familial Adenomatous Polyposis, sporadic EOCRC exhibits a broad spectrum of pathogenic germline mutations, genetic polymorphisms, methylation changes, and chromosomal instability. Early-life exposures and environmental risk factors, including lifestyle and dietary risk factors, have been found to be associated with EOCRC risk. Meanwhile, specific chronic diseases, such as inflammatory bowel disease, diabetes, and metabolic syndrome, have been associated with EOCRC. Interactions between genetic and environmental risk factors in EOCRC have also been explored. Here we present findings from a narrative review of epidemiological studies on the assessment of early-life exposures, of EOCRC-specific environmental factors, and their interactions with susceptible loci. We also present results from EOCRC-specific genome-wide association studies that could be used to perform Mendelian randomization analyses to ascertain potential causal links between environmental factors and EOCRC.
Humans ; Colorectal Neoplasms/etiology* ; Risk Factors ; Genome-Wide Association Study ; Genetic Predisposition to Disease/genetics*

Objective:To investigate the changes in brain functional network and structural-functional network coupling in children with drug-resistant epilepsy (DRE), and to analyze their correlation with cognitive function, disease duration, and age of onset.Methods:This study was a cross-sectional study. Clinical and imaging data of 19 children with DRE who received consultation and treatment at the Affiliated Hospital of Zunyi Medical University from August 2021 to August 2023 (DRE group) were prospectively included. Another 27 age-and sex-matched healthy children were collected as the healthy control group. All subjects had 3D-T 1WI, T 2 fluid-attenuated inversion recovery, diffusion tensor imaging (DTI), resting-state functional magnetic resonance imaging (rs-fMRI) scans and Wechsler Intelligence Scale assessments. Independent sample t-test and Mann-Whitney U test were used to analyze the global and local topological attributes, as well as the structural-functional coupling (SFC) values at the whole brain and modular levels in two groups. Correlations between abnormal resting state brain functional network indicators and the Wechsler Intelligence Scale score [verbal comprehension index (VCI), perceptual reasoning index (PRI), working memory index (WMI), processing speed index (PSI), full scale intelligence quotient (FSIQ)], disease duration and age of onset was evaluated using a Spearman or Pearson correlation analysis. Results:Compared to the healthy control group, DRE group exhibited decreased VCI, PRI, WMI, PSI, FSIQ and the differences were all statistically significant (all P<0.05). Both brain functional networks had small world attributes. There was a statistically significant difference in the area under the curve of sparsity of degree centrality (DC) in the left pallidum between the DRE group and healthy control group (2.998±0.942, 4.992±1.945, t=-4.07, FDR corrected P<0.05). Compared with the control group, the DRE group had decreased SFC within the limbic network (LN) ( P<0.05), increased SFC within the sensorimotor (SMN) ( P<0.05), decreased SFC between the default mode network-LN ( P<0.05), and increased SFC between the SMN-attentional network (AN) ( P<0.05). There was no statistically significant difference in SFC at the whole brain level between the two groups. Correlation analysis indicated that DC in left pallidum in DRE group negatively correlated with the PSI ( r=-0.537, P=0.018), and SFC between the SMN and AN demonstrated a negative correlation with age of onset ( r=-0.537, P=0.018). Conclusion:The altered DC in left pallidum may be related to cognitive impairment in children with DRE, providing biomarker information for the study of neural mechanisms in children with DRE.

Objective:To identify the latent profiles of transition shock among newly employed nurses and explore its influencing factors.Methods:This study was a cross-sectional study. Using the convenience sampling method, 215 newly employed nurses were selected as the research subjects. The General Information Questionnaire for Newly Employed Nurses, the New Nurse Transition Shock Evaluation Scale, and the Adversity Quotient Scale were used for the survey. The method of latent profile analysis was adopted to identify the types of nurses' transition shock.Results:There were three categories of transition shock among newly employed nurses. Among them, there were 134 nurses (62.32%) with moderate transition shock, 37 nurses (17.21%) with low-level transition shock and positive psychology, and 44 nurses (20.47%) with high-level transition shock and lack of knowledge and skills. Gender, whether being an only child, reasons for choosing a career, and adversity quotient were the influencing factors of the latent profiles of nurses' transition shock ( P<0.05) . Conclusions:The transition shock of newly employed nurses is at a moderate level, with three latent types: moderate transition shock type, low-level transition shock-positive psychology type, and high-level transition shock-lack of knowledge and skills type. Managers should formulate detailed intervention strategies according to the influencing factors of different categories to reduce the level of transition shock among newly employed nurses.

Objective:To investigate the changes in brain functional network and structural-functional network coupling in children with drug-resistant epilepsy (DRE), and to analyze their correlation with cognitive function, disease duration, and age of onset.Methods:This study was a cross-sectional study. Clinical and imaging data of 19 children with DRE who received consultation and treatment at the Affiliated Hospital of Zunyi Medical University from August 2021 to August 2023 (DRE group) were prospectively included. Another 27 age-and sex-matched healthy children were collected as the healthy control group. All subjects had 3D-T 1WI, T 2 fluid-attenuated inversion recovery, diffusion tensor imaging (DTI), resting-state functional magnetic resonance imaging (rs-fMRI) scans and Wechsler Intelligence Scale assessments. Independent sample t-test and Mann-Whitney U test were used to analyze the global and local topological attributes, as well as the structural-functional coupling (SFC) values at the whole brain and modular levels in two groups. Correlations between abnormal resting state brain functional network indicators and the Wechsler Intelligence Scale score [verbal comprehension index (VCI), perceptual reasoning index (PRI), working memory index (WMI), processing speed index (PSI), full scale intelligence quotient (FSIQ)], disease duration and age of onset was evaluated using a Spearman or Pearson correlation analysis. Results:Compared to the healthy control group, DRE group exhibited decreased VCI, PRI, WMI, PSI, FSIQ and the differences were all statistically significant (all P<0.05). Both brain functional networks had small world attributes. There was a statistically significant difference in the area under the curve of sparsity of degree centrality (DC) in the left pallidum between the DRE group and healthy control group (2.998±0.942, 4.992±1.945, t=-4.07, FDR corrected P<0.05). Compared with the control group, the DRE group had decreased SFC within the limbic network (LN) ( P<0.05), increased SFC within the sensorimotor (SMN) ( P<0.05), decreased SFC between the default mode network-LN ( P<0.05), and increased SFC between the SMN-attentional network (AN) ( P<0.05). There was no statistically significant difference in SFC at the whole brain level between the two groups. Correlation analysis indicated that DC in left pallidum in DRE group negatively correlated with the PSI ( r=-0.537, P=0.018), and SFC between the SMN and AN demonstrated a negative correlation with age of onset ( r=-0.537, P=0.018). Conclusion:The altered DC in left pallidum may be related to cognitive impairment in children with DRE, providing biomarker information for the study of neural mechanisms in children with DRE.

Objective:To identify the latent profiles of transition shock among newly employed nurses and explore its influencing factors.Methods:This study was a cross-sectional study. Using the convenience sampling method, 215 newly employed nurses were selected as the research subjects. The General Information Questionnaire for Newly Employed Nurses, the New Nurse Transition Shock Evaluation Scale, and the Adversity Quotient Scale were used for the survey. The method of latent profile analysis was adopted to identify the types of nurses' transition shock.Results:There were three categories of transition shock among newly employed nurses. Among them, there were 134 nurses (62.32%) with moderate transition shock, 37 nurses (17.21%) with low-level transition shock and positive psychology, and 44 nurses (20.47%) with high-level transition shock and lack of knowledge and skills. Gender, whether being an only child, reasons for choosing a career, and adversity quotient were the influencing factors of the latent profiles of nurses' transition shock ( P<0.05) . Conclusions:The transition shock of newly employed nurses is at a moderate level, with three latent types: moderate transition shock type, low-level transition shock-positive psychology type, and high-level transition shock-lack of knowledge and skills type. Managers should formulate detailed intervention strategies according to the influencing factors of different categories to reduce the level of transition shock among newly employed nurses.

Pin site infection is the most common complication during external skeletal fixation. Its incidence ranges from 12% to 69%. Domestic and international guidelines and consensus recommend that patients be cared for by dressing change at pin sites during external fixation. However, there have been no standardized procedures in clinic for dressing change at pin sites. Therefore, this tutorial intends to propose for domestic nursing colleagues standardized procedures for dressing change at pin sites during external skeletal fixation, based on the guidelines and consensus published, relevant literature and our own working experience.

Objective:To investigate the status quo of psychological distress among parents of children with cancer and analyze its influencing factors.Methods:Totally 334 parents of pediatric oncology patients meeting the inclusion criteria were selected by convenience sampling from Hunan Children's Hospital between June and October 2022. A questionnaire survey was conducted using a general information questionnaire, Distress Thermometer, Social Support Rating Scale, and Mishel Uncertainty in Illness Scale-Family Member Form.Results:A total of 334 questionnaires were distributed, with 298 valid responses received, making the effective response rate 89.22%. The DT score of the 298 parents of pediatric oncology patients was (7.58±2.85). Multiple linear regression analysis revealed that parental gender, the impact of caregiving on income, economic pressure, uncertainty in illness, and social support were significant influencing factors of the parents' psychological distress ( P<0.05) . Conclusions:The psychological distress of parents of children with cancer is at a relatively high level and is influenced by multiple factors. Medical professionals can implement targeted interventions based on specific circumstances to alleviate the psychological distress of these parents.

Pin site infection is the most common complication during external skeletal fixation. Its incidence ranges from 12% to 69%. Domestic and international guidelines and consensus recommend that patients be cared for by dressing change at pin sites during external fixation. However, there have been no standardized procedures in clinic for dressing change at pin sites. Therefore, this tutorial intends to propose for domestic nursing colleagues standardized procedures for dressing change at pin sites during external skeletal fixation, based on the guidelines and consensus published, relevant literature and our own working experience.

Cross-Sectional Studies ; Urodynamics ; China

Objective : To investigate the effect of micro/nano hierarchical structures on the adhesion and proliferation of MC3T3-E1 cells, evaluate the drug delivery potential of titanium surfaces, and provide a reference for the modification of selected areas of titanium surfaces to enhance drug delivery and slow drug release. Methods : Pure titanium samples (10 mm in diameter and 2.5 mm in thickness) were randomly divided into a polished group (T), anodized group (TO), and micro/nano hierarchical structure group (FTO) according to the surface treatment of the titanium. The T group was polished, the TO group was treated with anodic oxidation technology, and the FTO group was treated by femtosecond laser etching combined with anodic oxidation technology. The three surface morphologies were observed by scanning electron microscopy (SEM), the wettability of the surface was measured by the contact angle, and the surface chemical composition was analyzed by X-ray energy dispersive spectroscopy (EDS). The depth of the FTO structure and the surface roughness were measured by confocal laser scanning microscopy (CLSM). MC3T3-E1 cell adhesion proliferation and differentiation on the surface of each group of samples was assessed by immunofluorescence staining, CCK-8, and semiquantitative analysis of Alizarin staining. A freeze-drying method was applied to load recombinant human bone morphogenetic protein-2 (rhBMP-2), and an enzyme-linked immunosorbent assay (ELISA) was used to assess the drug-loading potential of different surface structures. Results: SEM revealed that the surface of T group titanium plates showed uniform polishing marks in the same direction. The surface of the TO group was a nanoscale honeycomb-like titanium dioxide (TiO2) nanotube structure, and the FTO group formed a regular and ordered micro/nano layered structure. The contact angle of the FTO group was the smallest at 32° ± 1.7°. Its wettability was the best. The average depth of the first-level structure circular pores was 93.6 μm, and the roughness was 1.5-2 μm. The TO and FTO groups contained a high percentage of oxygen, suggesting TiO2 nanotube formation. The FTO group had the most significant surface cell proliferation (P<0.001) and the largest cell adhesion surface area (P<0.05). rhBMP-2 was slowly released for 14 d after loading in the FTO group and promoted extracellular matrix mineralization (P<0.001). Conclusion Titanium surface microprepared hierarchical structure has the effect of promoting MC3T3-E1 cell adhesion, proliferation, and osteogenic differentiation with drug loading potential, which is a new method of titanium surface treatment.