U.S. stocks are struggling mostly higher as traders look past another plunge in China.
Hospital operator HCA Holdings jumped 7 percent Monday, the most in the Standard & Poor's 500 index, after raising its profit forecast.
The Dow Jones industrial average gained 52 points, or 0.3 percent, to 16,393 as of 11:45 a.m. Eastern time.
The S&P 500 index edged up two points, or 0.1 percent, to 1,923. The Nasdaq composite slipped four points, or 0.1 percent, to 4,637.
Energy and mining companies fell as prices of oil, copper and other commodities sank. Mining company Freeport-McMoRan slumped 18 percent.
In China, the Shanghai composite fell 5.3 percent.
Bond prices fell. The yield on the 10-year Treasury note rose to 2.15 percent.