Purpose To investigate the effect and molecu-lar mechanism underlying SOX9 during esophageal squamous cell carcinoma(ESCC)cells.Methods Immunohistochemistry(IHC)was used to detect the expression of SOX9 in ESCC tis-sues and adjacent normal tissues.The correlation of SOX9 ex-pression with clinicopathological features and prognosis of ESCC was analyzed.The differentially expressed genes in Eca109-Vec-tor and Eca109-SOX9 cells were detected by Affymetrix miRNA array.qRT-PCR was used to determine the differential gene in TE-1 and TE-1-siSOX9 cells.The relationship between SOX9 and active/unphosphorylated β-catenin levels was detected by Western blot.The effects of Wnt inhibitor LGK974 on the prolif-eration of ESCC cells were detected by CCK-8.Results SOX9 was highly expressed in ESCC(4.58±3.04)as compared with that in adjacent normal tissues(1.56±2.08,P＜0.001).SOX9 was related to histopathological grade and invasion depth(P＜0.05).Kaplan-Meier analysis indicated high SOX9 expres-sion in ESCC was significantly correlated with shorter overall sur-vival(P＜0.05).Transcriptome profiling and qRT-PCR analysis suggested that SOX9 contributed to the regulation of AXIN2,FZD7 and WNT5A.Overexpression of SOX9 in Eca109 cells in-creased active/unphosphorylated β-catenin levels,whereas silen-cing SOX9 caused a decrease.Significant attenuation of cell pro-liferation was observed at various concentrations of LGK974 with-out affecting SOX9 expression on SOX9-expressing cell lines.As expected,this inhibitory effect was not obvious in Eca109-Vector cells when compared with Eca109-SOX9 cells treated with the same concentration of LGK974.Conclusion SOX9 is highly ex-pressed in ESCC and SOX9-mediated Wnt/β-catenin signal path-way activation at least partially contributes to the SOX9-induced ESCC growth.These findings suggest that SOX9 is a promising prognostic marker and therapeutic target for ESCC.

Objective To explore the factors influencing the image quality of thyroid CT and the application value of optimization schemes in reducing streak artifacts in thyroid CT examinations.Methods A retrospective review of the data of 141 patients who underwent thyroid enhanced CT examinations was conducted to analyze the factors affecting image quality.After determining the influencing factors,a self-controlled study was conducted on 48 patients who underwent thyroid CT examinations to analyze the feasibility of the optimization scheme.Results The patients'body mass index(BMI),neck circumference,pharynx-jaw angle,and pharynx-jaw angle-to-neck circumference ratio showed statistically significant differences in their impact on image quality(P<0.05).Compared to the conventional scheme,the optimization scheme showed significantly higher subjective and objective image evaluations.The optimization scheme also significantly improved the diagnostic performance of the images,with statistically significant differences(P<0.05).There was no statistically significant difference in radiation dose between the two positions(P>0.05).Conclusion The optimization scheme can effectively reduce streak artifacts in thyroid CT examinations.

Objective:To analyze the willingness-to-pay (WTP) for the treatment of acute facial inflammatory dermatoses with red and yellow light from light-emitting diodes (LEDs), and to evaluate their cost-effectiveness.Methods:A questionnaire survey was conducted on outpatients with or without acute facial inflammatory dermatoses, which mainly manifested as erythema and swelling, in Department of Dermatology, Xiangya Hospital from August 2019 to June 2020. The WTP for the treatment of acute facial inflammatory dermatoses of varying severity with red and yellow light from LEDs were investigated, clinical data on the prevalence of facial skin diseases, previous medical visits and quality of life were collected, and a benefit-cost analysis was conducted. Logistic regression analysis was conducted to investigate factors influencing the patients′ WTP for the LED treatment.Results:The median WTP of the subjects was 200, 300 and 300 RMB yuan for 1-session treatment of three cases of acute facial inflammatory dermatoses of increasing severity assumed to require 1-, 3-, and 5-session LED treatments respectively, and the WTP for 1-session treatment of case 2 and case 3 was higher than the cost of 1-session LED treatment (217 RMB yuan). The subjects with high family incomes (≥ 100 000 RMB yuan/year) were significantly more willing to pay for the treatment than those with low family incomes (< 100 000 RMB yuan/year) (case 1: 40.46% vs. 27.50%, χ2 = 7.00, P = 0.008; case 2: 60.69% vs. 44.5%, χ2 = 9.75, P = 0.002; case 3: 51.20% vs. 48.8%, χ2 = 6.54, P = 0.011), and the subjects who never suffered from facial inflammatory dermatoses were significantly more willing to pay for the treatment than those who ever suffered (case 1: 35.49% vs. 28.82%, χ2 = 1.56, P = 0.212; case 2: 56.10% vs. 42.34%, χ2 = 5.92, P = 0.015; case 3: 68.32% vs. 56.75%, χ2 = 4.58, P = 0.032). No significant difference in the WTP was observed among patients with different facial dermatoses, different degrees of impairment on quality of life, or different treatment experience (all P>0.05) . Conclusion:The cost of red and yellow light from LEDs for the treatment of acute facial inflammatory dermatoses manifesting as erythema and swelling was highly acceptable in this population, and it was worthy of clinical promotion.

Since December 2019, severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection has gradually spread all over the world. With the implementation of class B infectious disease management policy for coronavirus disease 2019 (COVID-19), China has experienced a pandemic. For patients receiving a time-sensitive or emergency surgery, SARS-CoV-2 infection may increase the risk of postoperative pulmonary complications. An appropriate perioperative mechanical ventilation strategy, such as lung protective ventilation strategy, is particularly important for preventing postoperative pulmonary complications in patients undergoing general anesthesia. In addition, how to protect medical personnel from being infected is also the focus we need to pay attention to. This article will discuss the perioperative mechanical ventilation strategy for COVID-19 patients and the protection of medical personnel, in order to provide reference for the development of guidelines.

Objective:To investigate the application of PDCA cycle management combined with "three-step" bedside teaching in respiratory nursing teaching.Methods:A total of 80 nursing students who studies in Department of Respiratory Medicine, Beijing Chaoyang Hospital Affiliated to Capital Medical University, were included as subjects, and they were divided into control group and observation group using a simple random number table, with 40 students in each group. The students in the control group received traditional teaching, while those in the observation group received PDCA cycle management combined with "three-step" bedside teaching. The two groups were compared in terms of the scores of theoretical knowledge, operation skills, and physical examination, comprehensive clinical nursing ability, and degree of satisfaction with teaching. SPSS 22.0 was used to perform the chi-square test and t-test. Results:The observation group had significantly higher scores of theoretical knowledge, operation skills, and physical examination than the control group ( P<0.05). Compared with the control group, the observation group had significantly higher scores of nursing consultation, physical examination, diagnosis, nursing measures, health consultation, humanistic care, organizational effectiveness, and overall evaluation ( P<0.05). The observation group had a significantly higher degree of satisfaction with teaching than the control group ( P<0.05). Conclusion:PDCA cycle management combined with "three-step" bedside teaching in respiratory nursing teaching can improve the assessment scores of theoretical knowledge, operation skills, and physical examination among nursing students, enhance their comprehensive clinical nursing abilities, and increase the degree of satisfaction.

BACKGROUND: LY01005 (Goserelin acetate sustained-release microsphere injection) is a modified gonadotropin-releasing hormone (GnRH) agonist injected monthly. This phase III trial study aimed to evaluated the efficacy and safety of LY01005 in Chinese patients with prostate cancer. METHODS: We conducted a randomized controlled, open-label, non-inferiority trial across 49 sites in China. This study included 290 patients with prostate cancer who received either LY01005 or goserelin implants every 28 days for three injections. The primary efficacy endpoints were the percentage of patients with testosterone suppression ≤50 ng/dL at day 29 and the cumulative probability of testosterone ≤50 ng/dL from day 29 to 85. Non-inferiority was prespecified at a margin of -10%. Secondary endpoints included significant castration (≤20 ng/dL), testosterone surge within 72 h following repeated dosing, and changes in luteinizing hormone, follicle-stimulating hormone, and prostate specific antigen levels. RESULTS: On day 29, in the LY01005 and goserelin implant groups, testosterone concentrations fell below medical-castration levels in 99.3% (142/143) and 100% (140/140) of patients, respectively, with a difference of -0.7% (95% confidence interval [CI], -3.9% to 2.0%) between the two groups. The cumulative probabilities of maintaining castration from days 29 to 85 were 99.3% and 97.8%, respectively, with a between-group difference of 1.5% (95% CI, -1.3% to 4.4%). Both results met the criterion for non-inferiority. Secondary endpoints were similar between groups. Both treatments were well-tolerated. LY01005 was associated with fewer injection-site reactions than the goserelin implant (0% vs . 1.4% [2/145]). CONCLUSION: LY01005 is as effective as goserelin implants in reducing testosterone to castration levels, with a similar safety profile. TRIAL REGISTRATION ClinicalTrials.gov, NCT04563936.
Humans ; Male ; Antineoplastic Agents, Hormonal/therapeutic use* ; East Asian People ; Gonadotropin-Releasing Hormone/agonists* ; Goserelin/therapeutic use* ; Prostate-Specific Antigen ; Prostatic Neoplasms/drug therapy* ; Testosterone

Objective:To investigate the risk factors of cardiovascular diseases and related epidemic characteristics in the elderly in Guangxi, so as to provide basis for the prevention and treatment of cardiovascular diseases.Methods:Adopting cluster-based stratified sampling, permanent residents over 60 years old meeting one of the following criteria were enrolled in this study: Disease history of myocardial infarction, percutaneous coronary intervention, coronary artery bypass surgery, stroke.Hypertension, dyslipidemia; Ten-year cardiovascular disease risk ≥20%.Results:(1)Among 68, 324 respondents, 29, 542(43.2%)were males and 38, 782(56.8%)were females; 20999 high-risk subjects were detected, including 9486 males(32.1%)and 11513 females(29.7%); (2)The prevalence of hypertension was 50.2%(male 51.20%, female 49.4%, P<0.05); The prevalence of diabetes mellitus was 24.1%(male 24.1%, female 24.1%, P>0.05, ); (3)The smoking rate was 14.0%(male 32.1%, female 0.1%, P<0.05); (4)The overweight rate was 42.2%(male 44.6%, female 40.4%, P<0.05); obesity rate was 9.0%(male 8.6%, female 9.3%, P<0.05)(5)The mean total cholesterol level was 4.70 mmol/L(4.49 mmol/L for men, 4.90 mmol/L for women, P<0.05), the mean low density lipoprotein cholesterol was 2.73 mmol/L(2.63 mmol/L for males, 2.82 mmol/L for females( P<0.05). Conclusions:The detection rate of cardiovascular high risk subjects in Guangxi is 30.7%.The prevalence rate of hypertension and smoking in Guangxi are lower than that in the whole country; The control rate of diabetes in the elderly in Guangxi is generally low.The overweight rates of the elderly in Guangxi are higher in males than in females, but the obesity rate of females is higher than that of males; The levels of TC and LDL-C in elderly females in Guangxi were significantly higher than those in males.

Objective:To analyze the long-term outcomes of hybrid arch repair(HAR) treating aortic arch pathologies.Methods:Between January 2009 and January 2018, 87 consecutive patients underwent HAR for aortic arch pathologies at Beijing Anzhen Hospital. 76 were males. 2 cases were in zone 0, 46 cases were in zone 1, and 39 cases were in zone 2. The zones of the aortic arch were defined following the Ishimaru classification.Results:Five(5.7%) operative death occurred. 13 patients(19.1%) died during the follow-up. The overall survival rate was 88.4%, 83.3%, 83.3%, 49.8% at 1, 3, 5, 10 year, respectively. Multivariate Cox proportional risk analysis showed that stroke( HR=20.626, 95% CI: 2.698-157.685, P=0.004) was an independent risk factor for short-term death. Stroke( HR=16.234, 95% CI: 4.103-64.229, P<0.001) and spinal cord infury( HR=11.060, 95% CI: 2.150-56.893, P=0.004) were independent risk factors for long-term death. Conclusion:In conclusion, HAR could be an alternative procedure for the patients that are not suitable for open repair under the premise of strict control of indications. In the future, the risk assessment system and uniform operational indications for HAR should be further established.

Early distinction of bipolar disorder (BD) from major depressive disorder (MDD) is difficult since no tools are available to estimate the risk of BD. In this study, we aimed to develop and validate a model of oxidative stress injury for predicting BD. Data were collected from 1252 BD and 1359 MDD patients, including 64 MDD patients identified as converting to BD from 2009 through 2018. 30 variables from a randomly-selected subsample of 1827 (70%) patients were used to develop the model, including age, sex, oxidative stress markers (uric acid, bilirubin, albumin, and prealbumin), sex hormones, cytokines, thyroid and liver function, and glycolipid metabolism. Univariate analyses and the Least Absolute Shrinkage and Selection Operator were applied for data dimension reduction and variable selection. Multivariable logistic regression was used to construct a model for predicting bipolar disorder by oxidative stress biomarkers (BIOS) on a nomogram. Internal validation was assessed in the remaining 784 patients (30%), and independent external validation was done with data from 3797 matched patients from five other hospitals in China. 10 predictors, mainly oxidative stress markers, were shown on the nomogram. The BIOS model showed good discrimination in the training sample, with an AUC of 75.1% (95% CI: 72.9%-77.3%), sensitivity of 0.66, and specificity of 0.73. The discrimination was good both in internal validation (AUC 72.1%, 68.6%-75.6%) and external validation (AUC 65.7%, 63.9%-67.5%). In this study, we developed a nomogram centered on oxidative stress injury, which could help in the individualized prediction of BD. For better real-world practice, a set of measurements, especially on oxidative stress markers, should be emphasized using big data in psychiatry.
Biomarkers/metabolism* ; Bipolar Disorder/metabolism* ; Depressive Disorder, Major/diagnosis* ; Early Diagnosis ; Humans ; Oxidative Stress

Objective:To explore the professional training provided by Neonatal Intensive Care Unit (NICU) physicians and nurses to the parents of children hospitalized in NICU and their actual participation in clinical care practice, and provide a reference for the further development of family integrated care model in line with my China's national conditions.Methods:This study is a cross-sectional study. From March to April 2019, totally 310 physicians and nurses staff in the NICU of 31 Class Ⅲ Grade A children's specialized hospitals in China were selected by stratified sampling and investigated with a self-made family participation in nursing care questionnaire. In this survey, questionnaires were distributed through the online platform. A total of 310 questionnaires were distributed, and 299 valid questionnaires were recovered, with an effective recovery rate of 96.45%.Results:The training rate and clinical practice rate of parents in China were 69.9%-95.7% and 59.2%-89.6%, respectively. The project consistency of parent participation in training and clinical practice was moderate, with Kappa values ranging from 0.383 to 0.739 ( P<0.05) . Conclusions:The extent and level of training and clinical practice care for parents by physicians and nurses in China have increased, but the development level of some basic nursing projects is low. In the future, the content, method and operation mechanism of family integrated care in line with China's national conditions should be developed while taking into account China's diagnosis and treatment system and cultural adaptability.