Objective To explore the related functional mechanism of Xihuang pill containing serum inter-vention in breast cancer cells based on microRNA(miR)21-5p targeting FAM13A gene.Methods Bioinfor-matics websites was used to predict potential miRNAs of FAM13A gene,double luciferase reporter experi-ments were conducted to verify the binding site relationship between FAM13A and predicted miRNAs.The Xihuang pill containing serum was prepared,and human breast cancer MDA-MB-231 cells were cultured.The proliferation of MDA-MB-231 cells was interfered by the Xihuang pill containing serum with different dilution ratios by CCK-8 test,and the best dilution ratio concentration of Xihuang pill containing serum to inhibit the proliferation of breast cancer cells was selected.Real time fluorescence quantitative PCR(RT-qPCR)was ap-plied to detect the relative expression levels of FAM13A mRNA,as well as the relative expression levels of miR21-5p,in MDA-MB-231 cells after intervention with Xihuang pill containing serum.Cell proliferation(Edu)assay and cell apoptosis detection(TUNEL)assay were used to detect the effects of Xihuang pill con-taining serum intervention on cell proliferation and apoptosis function in MDA-MB-231 cells.The siRNA lentiviral transfection on MDA-MB-231 cells was performed to knock down the FAM13A gene,and Edu assay and TUNEL assay were used to detect changes in proliferation and apoptosis ability of MDA-MB-231 cells af-ter lentiviral transfection.The expression level of miR21-5p in MDA-MB-231 cells after FAM13A gene knock-out was detected by RT-qPCR technology.Results Target Scan online website predicted the potential miR-21-5p binding sequence in the 3'UTR of FAM13A mRNA,and dual luciferase reporter assay confirmed the in-teraction between miR-21-5p and FAM13A.After intervention of MDA-MB-231 cells with Xihuang pill drug containing serum,RT-qPCR results showed that compared with the control group(NC group),the Xihuang pill drug containing serum group(XHW group)downregulated the expression levels of FAM13A mRNA(P＜0.05),and upregulated the expression level of miR21-5p(P＜0.05).Compared with the NC group,the XWH group showed reduced cell proliferation ability and promoted cell apoptosis.(P＜0.05).After silencing the FAM13A gene in MDA-MB-231 cells,compared with the control group(shCtrl group),the shFAM13A group showed a significant decrease in cell proliferation ability and promoted cell apoptosis.The RT-qPCR re-sults showed that compared with the shCtrl group,the expression level of miR21-5p was significantly upregu-lated in the shFAM13A group(P＜0.05).Conclusion Xihuang pill could participate in the anti-tumor treat-ment of breast cancer by regulating miR21-5p to affect the expression level of FAM13A gene.

Objective:To investigate the related factors that affect the timing and prognosis of early tracheostomy in patients with multiple rib fractures.Methods:A retrospective case series study was conducted on medical data of 222 patients with multiple rib fractures who underwent tracheostomy in Affiliated Hospital of Yangzhou University from February 2013 to October 2019，including 160 males and 66 females，with the age of 18 to 85 years ［（49.5 ± 16.3）years］. According to the practice management guidelines for tracheostomy timing and the use of propensity score matching technology，there were 118 patients with tracheostomy within 7 days of tracheal intubation （early group） and 104 patients with tracheostomy after 7 days of tracheal intubation （late group） before matching，and there were 87 patients in early group and 87 patients in late group after matching. Data were compared between groups including the gender，age，underlying disease，injury severity score （ISS），Glasgow coma score （GCS），number of fractured ribs，total number of rib fractures （NTRF），first rib fracture，flail chest，traumatic brain injury，combined injuries （spine，maxillofacial，sternum），acute respiratory distress syndrome （ARDS），volume fraction of pulmonary contusion（VPC），blood lactic acid （within 24 hours of admission），hemothorax，pneumothorax，mechanical ventilation time，duration of tracheostomy，time from tracheal intubation to incision，length of hospital stay，length of stay in ICU，closed thoracic drainage，number of fiberoptic bronchoscopy，multi-drug resistant bacteria infection，ventilator-associated pneumonia，antibiotic use time，duration of sedative and analgesic drugs used and 28-day mortality. The multivariate Logistic regression analysis was used to predict independent risk factors for early tracheostomy. The Pearson method was used to compare the relationship between multiple factors. The receiver operating characteristic （ROC） curve was used to predict indicators that affect the prognosis of patients with early tracheostomy，and calculate the best cut-off value. The Kaplan-Meier single factor and COX multivariate survival were used to analyze the relevant factors affecting the 28-day mortality of patients.Results:（1） In early group，the NTRF，ARDS and VPC were higher than those in late group，and the time from tracheal intubation to incision and 28-day mortality rate were lower than those in late group （ P < 0.05），while the two groups showed no significant differences in the gender，age，underlying diseases and ISS （ P > 0.05）. （2） The multivariate Logistic regression analysis showed that there was statistical significance in NTRF （ OR = 1.775，95% CI 1.439-2.188），ARDS（ OR = 3.740，95% CI 1.441-9.711），VPC （ OR = 1.087，95% CI 1.052-1.124） （ P < 0.05）； the Pearson method analysis showed a significant correlation between VPC and NTRF （ r = 0.369， P < 0.05） and a low degree of correlation between ARDS and VPC （ r = 0.179， P < 0.05），but there was no significant correlation between ARDS and NTRF （ r = 0.132， P > 0.05）. （3） The ROC curve analysis showed that the area under the curve （AUC） of the VPC and NTRF ［AUC = 0.832 （95% CI 0.770-0.893），AUC = 0.804 （95% CI 0.740-0.868）］ were significantly higher than those of the number of rib fractures ［AUC = 0.437（95% CI 0.352-0.523），GCS ［AUC = 0.519 （95% CI 0.432-0.605）］ and ISS ［AUC = 0.484 （95% CI 0.398-0.571）］ （ P < 0.05）. After calculating the Yorden index，the best cut-off value for VPC was 23.9，and the best cut-off value for NTRF was 8.5. （4） The Kaplan-Meier single factor and multivariate COX model survival analysis showed that the 28-day survival ratio of patients with early tracheostomy was significantly better than that of late tracheostomy （ P < 0.05）. Conclusions:The NTRF，ADRS and VPC are independent risk factors for the timing and prognosis of early tracheostomy. There is a significant correlation between VPC and NTRF. The VPC ≥ 23.9% and or NTRF ≥ 8.5 can be used to predict early tracheostomy in patients with multiple rib fractures. Early tracheostomy may benefit the 28-day survival of patients with multiple rib fractures.

Objective To explore predictive value of endometrial receptivity and pregnancy outcome by hysteroscopy examination at the phase of implantation window in unexplained infertile women.Methods From Oct.2007 to Mar.2009,93 unexplained infertile women underwent hysteroscopy examination at 7-9 days after a spontaneous ovulation in Family Planning Research Institute of Guangdong Province.According to the endometrial glandular openings and vascular shape,79 cases without pathological endometrial changes were divided into 60 cases in good endometrium group and 19 cases in poor endometrium group.The following clinical parameters were analyzed and compared between two groups,including endometrial configuration,thickness,secretion,the development and number of pinopodes,vascular distribution,and the level of sex hormone,leukemia inhibitory factor (LIF) and glycodelin in the uterine flushing,and pregnancy outcome.Results (1)There was no statistical difference in the level of serum estrogen and progesterone at the phase of implantation window,which were (518 ± 176)pmol/L,(40 ±20)nmol/L in good group and (513 ±244) ptnol/L,(37 ± 19) nmol/L in poor group (P<0.05).The endometrium thickness at periovulatroy and implantation window days (1.06 ±0.10)cm/(1.16 ± 0.08)cm in good group did not show significant difference with (0.93 ±0.12) cm /(1.02 ±0.10) cm in poor group (P>0.05).The proportion of type A,B and C endometrium at periovulatory days were 63% (12/19),37% (7/19) and 0 (0/19) in good group and 23% (14/60),77% (46/60) and 0 (0/60) in poor group.When compared with those of type A or B between two groups respectively,it all showed statistical difference (P<0.05).However,at phase of implantation window,endometrium configurations were all type B at both groups.(2)90% (17/19)of women in good group and 7% (4/60)of women in poor group showed normal endometrial secretion function,which showed significant differences (P< 0.01).(3)The percentage of fully developed pinopodes and abundant pinopodes [84% (16/19) and 90% (17/19)] in good group were significantly higher than 42% (25/60)and 57% (34/60) in poor group (P<0.05).(4) The level of CD_(34) expression and microvessel density[MVD; (40.1 ± 1.2) positive unit(PU) and(21.7 ±4.0)/high power field (HP)] in good group were significantly higher than(18.1 ± 1.3) PU and (8.5 ± 1.3)/HP in poor group (P< 0.01).(5)The level of LIF and glycodelin in uterine flushing [(72 ± 54)ng/L and (196 ±20)μg/L] in good group were significantly higher than (15±16) ng/L and (116 ±26) μg/L in poor group (P<0.05).(6) The rate of clinical pregnancy,spontaneous abortion and term delivery were 74% (14/19),0 (0/14) and 100% (14/14) in good group and 23% (14/60),14% (2/14) and 86% (12/14) in poor group,the rate of clinical pregnancy and term delivery in good group were significantly increased when compared with those in poor group (P<0.01).Conclusions Hysteroscopy examination at the phase of implantation window could reflect the development of glandular openings and vasculature.It is a preferable method to evaluate the endometrial receptivity and predict pregnancy outcome.

Objective　To investigate the correlation between degree of deeper infiltration of NPC on CT scan,prognosis and expression of P53 protein,in order to further recognize bilogical features of NPC.Methods　Collect 70 NPC biopsy specimens,which had performed CT scan before radiotherapy and had detailed clinical records.The expression of P53 protein was examined by means of S-P immunohistochemical technique.The correlation between expression of P53 protein and peripheral deeper infiltration and prognosis was analysed in detailed.Results　The results of these cases showed that the positive rate of over expression P53 were 68.57%,which had no relation with the histological types and pathological grades.The positive rate of P53 in Ⅱ、Ⅲ types had a higher positive rate than that of the Ⅰ type of NPC.Expression of P53 protein had no relation with neck lymph node metastasis,but had significant correlation with the size of metastatic lymph node,which is the positive rate of P53 in diameter of metastatic lymph node ＜4 cm was higher than that of diameter ≥4 cm.Expression of P53 had no relation with local recurrence and distant metastasis after radiotherapy.Conclusion　With the tumor infiltrating the deeper layer of nasopharynx,the positive rate of P53 expression is more and more high,and degree of malignant is increasing.The three types on CT scan represents the biological features of NPC.