Gastric cancer (GC) has one of the highest mortality rates of malignancies globally. Currently, ciRS-7, a novel circular RNA, has emerged as a potential sponge for miR-7. However, few studies on ciRS-7 in GC have been performed. In this study, we investigated the clinical significance and function of ciRS-7 in GC. First, the expression levels of ciRS-7 in 102 primary GC tissues and the matched para-carcinoma tissues were evaluated and the clinical relevance was confirmed in an independent validation cohort (n ¼ 154). Second, the effects of ciRS-7 on miR-7, PTEN, and PI3K were evaluated. Finally, the function of ciRS-7 in GC was analyzed with cell lines and nude mice. The expression of ciRS-7 was significantly upregulated in GC tissues compared with the matched para-carcinoma tissues (P ¼ 0.0023), and the upregulation of ciRS-7 was linked to poor survival in the testing (P ¼ 0.0143) and validation cohort (P ¼ 0.0061). Multivariate survival analysis revealed that ciRS-7 was probably an independent risk factor of overall survival (P < 0.05). Furthermore, overexpression of ciRS-7 blocked the miR-7-induced tumor suppression in MGC-803 and HGC-27 cells and led to a more aggressive oncogenic phenotype, via antagonizing miR-7-mediated PTEN/PI3K/AKT pathway. ciRS-7 may act as a prospective prognostic biological marker and a promising therapeutic target for GC.

Background Test anxiety has been widely found in medical students. Emotion regulation and psychological resilience have been identified as key factors contributing to anxiety. However, studies on relationships were limited. This study investigated the links between psychological resilience, emotion regulation, and test anxiety in addition to exploring the differences about socio-demographic factors. Methods A sample of 1266 medical students was selected through cross-sectional survey from a medical university in China during 2019. Data were obtained by network technique using designed questionnaire, which assesses the level of test anxiety, emotion regulation and psychological resilience, respectively. Results Medical students experienced test anxiety at different levels, 33.7% of these were seriously. It revealed significant effects of the gender and academic performance on test anxiety. Results of logistic regression indicated that test anxiety was significantly associated with emotion regulation and psychological resilience (p < 0.01). Psychological resilience played a mediating role on the relationship between emotion regulation and test anxiety. Conclusions These findings highlight the importance of psychological resilience and emotion regulation in understanding how psychological resilience relates to test anxiety in medical students. Resilience-training intervention may be developed to support students encountering anxiety during the exam.

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Objectives To compare the clinical and angiographic characteristics of high-risk and low-risk spontaneous coronary artery dissection (SCAD) patients to determine the optimal treatment strategy. Background SCAD is a rare and emerging cause of acute coronary syndrome and sudden cardiac death, especially in young female patients. However, the indication of percutaneous coronary intervention (PCI) in patients with SCAD remains elusive. Methods We evaluated the clinical and angiographic characteristics of all SCAD patients admitted to our center from 2012 to 2020. The outcomes of the high-risk and low-risk SCAD patients according to the location of the lesion segment with dissection or intramural hematoma were compared. Further analyses were performed to evaluate the vessel healing or residual dissection in the patients receiving the follow-up angiography. Results A total of 81 SCAD patients were enrolled in the present study, in which 38 patients were categorized as high-risk group, defined as involvement of the left main artery or proximal segment of any main coronary artery. PCI was the more common treatment approach in the high-risk group (68.4%), while conservative treatment was more common in the low-risk group (62.8%). The incidence of major adverse cardiac events, defined as cardiac death, myocardial infarction, unstable angina pectoris, severe arrhythmias, or heat failure, within 1 year follow-up was similar between the two groups. 57 patients (70.4%) received the follow-up angiography after 1 year. The high- and low-risk groups had a similar rate of vessel healing among the PCI treatment patients. However, more patients achieved spontaneous healing in the low-risk group than the high-risk group among the conservative treatment patients (86.4% vs. 33.3%, p < 0.05). Conclusions Conservative management remains the recommended treatment strategy for the low-risk SCAD patients. PCI could be considered in high-risk SCAD patients with favorable clinical outcomes and vessel healing. Characterization of lesion anatomy may be an important indicator for treatment decision.

Background: Medical students experience a considerable amount of anxiety due to exams. Emotion regulation and psychological resilience are established protective factors of individual mental health, however, the investigations for the effects of anxiety were limited. The goal of the present study was to examine the relationship of psychological resilience and emotion regulation with test anxiety and the associated factors of them among medical students. Methods: In this cross-sectional survey, a simple random sampling methods was used to select the participants. Information from a sample of 1266 medical students was collected by self-reporting questionnaires. Logistic regression was applied to test the associations between test anxiety and emotion regulation, resilience. Bootstrap were conducted to explore the mediating role of resilience. Results: Our important results were that the prevalence of problematic test anxiety among medical students to be 71.4%, 33.7% was high test anxiety. Gender and academic performance correlated significantly with test anxiety, emotion regulation, and psychological resilience. There were correlations between test anxiety and various dimensions of emotion regulation and psychological resilience ( P<0.01 ). Emotion regulation and psychological resilience predicted emerging test anxiety. The mediating role of psychological resilience was identified for the effects of emotion regulation on test anxiety. Conclusions: Findings suggest that emotion regulation affected test anxiety through psychological resilience, which may provide insights for clinical psychologists, raise their awareness of the importance of cultivating and improving medical students' psychological resilience, and prompt them to offer psychological support to students with test anxiety as early as possible. The combination of curing and self-healing can solve the root cause of the problem and truly apply psychological research to improving the mental health of the general public. Keywords: Psychological resilience, Test anxiety, Emotion regulation, Medical student