Objective : To investigate the expression of Keratin 14(KRT14) in Basal-like Breast Cancer(BLBC) and its biological functions and mechanisms. Methods : The expression levels of KRT14 mRNA in BLBC and para-cancer breast tissues were analyzed using The Cancer Genome Atlas(TCGA) database. qPCR, Western blot(WB), and immunohistochemistry were employed to detect KRT14 expression in BLBC and adjacent normal tissues, and its correlation with clinicopathological features was analyzed. KRT14 overexpression and knockdown were performed in breast cancer cells, and cell scratch and transwell assays were performed to evaluate changes in migration and invasion abilities. To investigate the expression of proteins related to the Wnt/β-catenin signaling pathway, including catenin Beta 1(β-catenin), wingless-type MMTV integration site family, member 1(Wnt1), matrix metallopeptidase 7(MMP7), and cellular myelocytomatosis viral oncogene homolog(c-Myc), as well as the cellular localization of β-catenin, WB and immunofluorescence(IF) techniques were employed. Additionally, a Wnt/β-catenin signaling pathway inhibitor was used to verify the mechanism of action of KRT14. Results : The expression of KRT14 was significantly higher in BLBC tissues compared to normal tissues(P<0.05), and was associated with higher T stage and histological grade(P<0.05). The overexpression of KRT14 significantly enhanced the migration and invasion abilities of breast cancer cells, while the knockdown of KRT14 significantly reduced those abilities(P<0.01). The overexpression of KRT14 can increase the expression levels of Wnt/β-catenin pathway-related proteins β-catenin, Wnt1, MMP7, and c-Myc, thereby activating the Wnt/β-catenin pathway. Moreover, the inhibition of this pathway can eliminate the effects of KRT14 on cell migration and invasion. Conclusion The high expression of KRT14 in BLBC may promote the migration and invasion of breast cancer cells through the Wnt/β-catenin signaling pathway.

Objective : To investigate the expression of(heat shock protein a member 8,HSPA8) in breast cancer and its effect on tumor biological behaviors. Methods: Bioinformatics analysis and immunohistochemistry assays were used to detect the expression of HSPA8 in breast cancer and adjacent non-tumor breast tissues,and the relationship between its expression and clinicopathological characteristics of breast cancer patients was analyzed.Correlation between HSPA8 expression and prognosis of breast cancer patients was analyzed by Kaplan-Meier Plotter database.HSPA8 knockdown and over expression breast cancer stabilized cells were constructed,respectively.CCK-8,clone formation,Transwell,cell scratch,Western blot and immunofluorescence assay were used to detect the effects of HSPA8 on the proliferation,invasion and migration of breast cancer cells,and its effect on epithelial-mesenchymal transition(EMT). Results : Bioinformatics analysis and immunohistochemistry assay revealed that the expression of HSPA8 in breast cancer tissues was higher than that in adjacent non-tumour tissues(P<0.05),and its expression level of the protein was significantly and positively correlated with the tumor size,histological grade,lymph node metastasis and Ki-67 proliferation index(P<0.05).The Kaplan-Meier survival curve showed that high expression of HSPA8 was significantly associated with poor prognosis in breast cancer patients(P<0.05).CCK-8,clone formation,transwell,cell scratch,Western blot and immunofluorescence assay showed that knockdown of HSPA8 expression could significantly inhibit the proliferation,invasion,migration function and EMT of breast cancer cells(P<0.05),while overexpression of HSPA8 could significantly promote the proliferation,invasion,migration function and EMT of breast cancer cells(P<0.05). Conclusion HSPA8 is highly expressed in breast cancer tissues,which is closely related to disease progression and the malignant phenotype of breast cancer,suggesting that HSPA8 may be a potential biological target for breast cancer treatment.

Objective:To explore the effects of phased goal directed fluid therapy (GDFT) during anesthesia surgery on tissue perfusion and cognitive function in patients undergoing radical lung cancer surgery.Methods:A total of 108 lung cancer patients were prospectively selected and randomly divided into a control group and a study group using a random number table method. The control group received classical restrictive liquid therapy, while the study group received staged GDFT. We compared the surgical time, intraoperative blood loss, colloid fluid dosage, crystalloid fluid dosage, total output, and urine volume between two groups of patients; Two groups of patients were compared in terms of oxygenation index (OI), respiratory index (RI), central venous oxygen saturation (ScvO 2), lactate (Lac), central venous arterial carbon dioxide partial pressure difference (Pcv-aCO 2), oxygen supply index (DO 2I), and oxygen uptake rate (O 2ERe) before anesthesia induction (T 0), before single lung ventilation (T 1), 1 hour of single lung ventilation (T 2), immediate resumption of dual lung ventilation (T 3), 30 minutes of dual lung ventilation (T 4), and after surgery (T 5); The Mini Mental State Examination (MMSE) was used to evaluate the cognitive function scores of two groups of patients 1 day before surgery and 1 and 3 days after surgery, while recording the incidence of cognitive dysfunction (POCD) and pulmonary complications (including pulmonary infection, acute lung injury, pulmonary embolism, pulmonary edema, atelectasis, etc.) within 3 days after surgery. Results:The amount of crystal fluid and urine output in the research group was significantly lower than that in the control group, while the amount of colloidal fluid was significantly higher than that in the control group (all P<0.05). The OI of the study group T 1-T 5 was significantly higher than that of the control group, while the RI of T 2-T 5 was significantly lower than that of the control group (all P<0.05). The ScvO 2 of the study group T 1 to T 5 was significantly higher than that of the control group, and the Lac was significantly lower than that of the control group (all P<0.05); The MMSE scores of both groups of patients were significantly lower than those before surgery on day 1 and 3 after surgery, and the MMSE scores of the study group were significantly higher than those of the control group on day 1 and 3 after surgery (all P<0.05). The incidence of POCD within 3 days after surgery in the study group was 16.67%(9/54), lower than 37.04%(20/54) in the control group (χ 2=5.704, P=0.017); The incidence of pulmonary complications in the study group was lower than that in the control group (5.56% vs 22.22%, χ 2=4.955, P=0.026). Conclusions:The application of staged GDFT during anesthesia in patients undergoing radical lung cancer surgery can further improve tissue perfusion, improve microcirculation and oxygen supply-demand balance of systemic organs and tissues, including the brain, alleviate perioperative brain function damage, and reduce the occurrence of postoperative POCD compared to conventional liquid therapy.

Objective:To investigate the clinicopathological characteristics of acidophil stem cell pituitary neuroendocrine tumors (PitNET)/adenoma.Methods:Five cases of acidophil stem cell PitNET/adenoma were diagnosed between May 2022 and July 2023 at the Second Hospital of Hebei Medical University, Shijiazhuang, China. The clinicopathological features of the tumor were analyzed by using histology, immunohistochemistry, and electron microscopy. The relevant literature was reviewed.Results:There were 1 male and 4 females, aged from 23 to 69 years. Patient 3 was 55 years old at the time of diagnosis and first surgery, and relapsed 5 years later. The patients′ median age was 32 years. Patients 1 and 5 showed elevated blood prolactin, with various degrees of hormonal symptoms except Patient 3, who showed only tumor compression symptoms. Imaging studies showed that all cases involved the sellar floor. The tumors of Patients 1, 2 and 5 were closely related to the cavernous sinus segment of the internal carotid artery. The tumors exhibited a diffuse growth pattern with chromophobic to slightly acidophilic cytoplasm. A few of tumor cells showed chromophobic cytoplasm. The nucleoli were conspicuous. Intranuclear inclusion bodies and variably-sized clear vacuoles were observed occasionally. Under electron microscope, marked mitochondrial abnormalities were observed, including increased mitochondria number, expanded hypertrophy, and absence of mitochondrial ridge fracture. Some mitochondrial matrices were dense, while some were vacuolated.Conclusions:Acidophil stem cell PitNET/adenoma is a rare type of pituitary adenomas/PitNETs. It often has a more clinically aggressive manner with immature cells, diffuse expression of PIT1, prolactin, and varying degrees of growth hormone expression. Because of the obvious diversity of their clinical hormone status and hormone immune expression, the diagnosis of this type tumor is still a challenge.

Objective To explore the effect of enhanced external counterpulsation(EECP)on ser-um vascular endothelial growth factor(VEGF)level and cardiopulmonary function in patients with stable angina pectoris(SAP).Methods A prospective double-blind controlled trial was con-ducted on 300 SAP patients admitted to Departments of Cardiovascular Medicine and Geriatrics of Jincheng People's Hospital from January 2021 to December 2023.They were randomly divided in-to study group(150 cases)and control group(150 cases).Coronary angiography or coronary CT angiography indicated that there were 101,101 and 98 cases,respectively,of one-,two-and three-vessel diseases.The patients of both groups were given conventional drug therapy(secondary pre-ventive drug for coronary heart disease),and those of the study group received EECP therapy ad-ditionally.The changes in serum VEGF level and related indicators of cardiopulmonary exercise test before and after one course of standardized treatment(36 h)were observed and compared be-tween the two groups.Results The VEGF level was significantly higher in the patients with three-vessel disease than those with two-and one-vessel diseases(P＜0.05).The level was obvi-ously increased in the study group and control group after intervention than before(238.41±82.57 ng/L vs 218.75±82.58 ng/L,224.47±85.08 ng/L vs 218.96±83.04 ng/L,P＜0.01),and the former group obtained better improvement of VEGF than the latter group(P＜0.01).The level in the study group and the control group with one-,two-and three-vessel lesions was notably higher than those before intervention(P＜0.05,P＜0.01).The study group with one-,two-and three-vessel lesions had statistical differences in the VEGF level after intervention when compared with that in the control group(P＜0.01).The levels of Peak VO2/kg and VO2/kg@AT were sig-nificantly increased in both groups after intervention than before(P＜0.01),with those of the study group notably higher than those of the control group[19.87±5.18 ml/(kg·min)vs 17.15±5.18 ml/(kg·min),P＜0.01;14.33±2.24 ml/(kg·min)vs 12.81±1.57 ml/(kg·min),P＜0.01].Conclusion EECP treatment is helpful to increase VEGF level and improve cardiopul-monary function in SAP patients.

Objective To explore the design and clinical application of the bedsheet with postural markers during gastroscopy.Methods A total of 100 outpatients who underwent gastroscopy for the first time in Digestive Endoscopy Center of The First Affiliated Hospital of Naval Medical University from November to December 2021 were selected as research objects by convenience sampling coin method.They were randomly divided into experimental group(n=54)and control group(n=46).The bedsheets with postural markers were used in the experimental group,and ordinary disposable sheets were used in the control group during gastroscopy.One-time success rate of postural placement,time from guidance to completion of postural placement,and patient satisfaction were compared between the 2 groups.Results The time from guidance to completion of postural placement in the experimental group was shorter than that in the control group([7.07±2.44]vs[18.36±5.12]),and the one-time success rate of postural placement(96.30% vs 13.04% )and patient satisfaction([95.76±4.32]vs[68.46±7.59])in the experimental group were significantly higher than those in the control group(P<0.01).Conclusion The clinical application of bedsheets with postural markers during gastroscopy can significantly increase the efficiency of postural placement,shorten the guidance time before operation,maximize the utilization rate of examination beds,and improve patient satisfaction.

The nursing experience of a pregnant woman with stillbom fetus with a septic shock to cardiac arrest at 30 weeks of pregnancy was summarized.The critical points of nursing include first aid nursing of cardiac arrest during pregnancy,preparation of transport plan to ensure ECMO combined with CVVH to support cesarean section,anti-infection nursing of fetal death complicated with septic shock,precise implementation of target temperature management,individualized anti-coagulation nursing under multiple factors interference.After 31 days of careful treatment and nursing,the patient's condition was stable,discharged smoothly,and the patient recovered well after 5 months of follow-up.

Objective To investigate the potential factors influencing the occurrence of major adverse cardiovascular events (MACE) in patients with acute myocardial infarction (AMI) after percutaneous coronary intervention (PCI) and develop an efficient and accurate predictive model. Methods Clinical data of AMI patients treated in the emergency department of Jining Medical University Affiliated Hospital between January and December 2020 were retrospectively collected. Patients were divided into two groups based on the occurrence of in-hospital MACE,the MACE group and the non-MACE group. Clinical indicators of the two groups were compared,and statistically significant variables were selected for inclusion in a multivariate logistic regression analysis. Based on this analysis,a nomogram model was constructed to predict the risk of in-hospital MACE in AMI patients after PCI. The model's predictive accuracy was evaluated using the receiver operating characteristic (ROC) curve,and the goodness of fit was assessed using the Hosmer-Lemeshow test. Results A total of 583 patients were included after screening based on inclusion and exclusion criteria,of whom 85 (14.58％) experienced in-hospital MACE. Univariate analysis showed that compared to the non-MACE group,the MACE group had higher values for age,Killip classification,myoglobin (MYO),brain natriuretic peptide (BNP),white blood cell count (WBC),prothrombin time (PT),T-wave changes on electrocardiogram (ECG),abnormal wall motion on echocardiography,ischemia duration greater than 6 hours,the number of MACE before PCI,and left anterior descending artery stenosis. In contrast,the number of patients with a history of oral antiplatelet medication use,coronary artery disease (CAD),family history of CAD,admission systolic blood pressure,and left ventricular ejection fraction (LVEF) were lower in the MACE group. Multivariate analysis indicated that Killip classification,BNP,ischemia duration greater than 6 hours,and MACE before PCI were independent risk factors for in-hospital MACE in AMI patients after PCI,while pre-onset use of antiplatelet medications and LVEF were independent protective factors. The nomogram model constructed based on independent risk factors demonstrated good predictive ability,with an area under the ROC curve (AUC) of 0.817,a sensitivity of 81.48％,and a specificity of 67.66％. The Hosmer-Lemeshow test confirmed the model's good fit (x2=1.937,P=0.983). Conclusion The nomogram model developed in this study effectively assesses the risk of in-hospital MACE in AMI patients after PCI,providing a valuable tool for predicting patient outcomes post-PCI.

Objective To investigate the potential factors influencing the occurrence of major adverse cardiovascular events (MACE) in patients with acute myocardial infarction (AMI) after percutaneous coronary intervention (PCI) and develop an efficient and accurate predictive model. Methods Clinical data of AMI patients treated in the emergency department of Jining Medical University Affiliated Hospital between January and December 2020 were retrospectively collected. Patients were divided into two groups based on the occurrence of in-hospital MACE,the MACE group and the non-MACE group. Clinical indicators of the two groups were compared,and statistically significant variables were selected for inclusion in a multivariate logistic regression analysis. Based on this analysis,a nomogram model was constructed to predict the risk of in-hospital MACE in AMI patients after PCI. The model's predictive accuracy was evaluated using the receiver operating characteristic (ROC) curve,and the goodness of fit was assessed using the Hosmer-Lemeshow test. Results A total of 583 patients were included after screening based on inclusion and exclusion criteria,of whom 85 (14.58％) experienced in-hospital MACE. Univariate analysis showed that compared to the non-MACE group,the MACE group had higher values for age,Killip classification,myoglobin (MYO),brain natriuretic peptide (BNP),white blood cell count (WBC),prothrombin time (PT),T-wave changes on electrocardiogram (ECG),abnormal wall motion on echocardiography,ischemia duration greater than 6 hours,the number of MACE before PCI,and left anterior descending artery stenosis. In contrast,the number of patients with a history of oral antiplatelet medication use,coronary artery disease (CAD),family history of CAD,admission systolic blood pressure,and left ventricular ejection fraction (LVEF) were lower in the MACE group. Multivariate analysis indicated that Killip classification,BNP,ischemia duration greater than 6 hours,and MACE before PCI were independent risk factors for in-hospital MACE in AMI patients after PCI,while pre-onset use of antiplatelet medications and LVEF were independent protective factors. The nomogram model constructed based on independent risk factors demonstrated good predictive ability,with an area under the ROC curve (AUC) of 0.817,a sensitivity of 81.48％,and a specificity of 67.66％. The Hosmer-Lemeshow test confirmed the model's good fit (x2=1.937,P=0.983). Conclusion The nomogram model developed in this study effectively assesses the risk of in-hospital MACE in AMI patients after PCI,providing a valuable tool for predicting patient outcomes post-PCI.

Objective To explore the effect of enhanced external counterpulsation(EECP)on ser-um vascular endothelial growth factor(VEGF)level and cardiopulmonary function in patients with stable angina pectoris(SAP).Methods A prospective double-blind controlled trial was con-ducted on 300 SAP patients admitted to Departments of Cardiovascular Medicine and Geriatrics of Jincheng People's Hospital from January 2021 to December 2023.They were randomly divided in-to study group(150 cases)and control group(150 cases).Coronary angiography or coronary CT angiography indicated that there were 101,101 and 98 cases,respectively,of one-,two-and three-vessel diseases.The patients of both groups were given conventional drug therapy(secondary pre-ventive drug for coronary heart disease),and those of the study group received EECP therapy ad-ditionally.The changes in serum VEGF level and related indicators of cardiopulmonary exercise test before and after one course of standardized treatment(36 h)were observed and compared be-tween the two groups.Results The VEGF level was significantly higher in the patients with three-vessel disease than those with two-and one-vessel diseases(P＜0.05).The level was obvi-ously increased in the study group and control group after intervention than before(238.41±82.57 ng/L vs 218.75±82.58 ng/L,224.47±85.08 ng/L vs 218.96±83.04 ng/L,P＜0.01),and the former group obtained better improvement of VEGF than the latter group(P＜0.01).The level in the study group and the control group with one-,two-and three-vessel lesions was notably higher than those before intervention(P＜0.05,P＜0.01).The study group with one-,two-and three-vessel lesions had statistical differences in the VEGF level after intervention when compared with that in the control group(P＜0.01).The levels of Peak VO2/kg and VO2/kg@AT were sig-nificantly increased in both groups after intervention than before(P＜0.01),with those of the study group notably higher than those of the control group[19.87±5.18 ml/(kg·min)vs 17.15±5.18 ml/(kg·min),P＜0.01;14.33±2.24 ml/(kg·min)vs 12.81±1.57 ml/(kg·min),P＜0.01].Conclusion EECP treatment is helpful to increase VEGF level and improve cardiopul-monary function in SAP patients.