Objective:To investigate the effect of regional cerebral oxygen saturation (rSO 2) combined with neurophysiological blood pressure monitoring on brain protection and myocardial protection during carotid endarterectomy (CEA) in patients with carotid stenosis and coronary heart disease. Methods:One hundred patients with carotid artery stenosis complicated with coronary heart disease treated in Jinhua Central Hospital from June 2021 to June 2022 were randomly divided into control group and experimental group. All patients were scheduled to undergo CEA. Fifty patients in the control group were administered with empirically increasing basic blood pressure by 20% - 30%, and 50 patients in the experimental group were administered with blood pressure under the guidance of rSO 2 combined with motor evoked potentials (MEPs) and somatosensory evoked potentials (EPS). The neurological function indexes of the two groups [neuron specific enolase (NSE), central nerve specific protein (S100-β)], myocardial function indicators [cardiac troponin I (cTnI), B-type natriuretic peptide (BNP)], clinical indicators (eye opening time, extubation time, recovery room stay time, hospital stay) and the incidence of postoperative complications [delirium (POD), cognitive dysfunction (POCD), neurological impairment] were compard between the two groups. Results:Two sets of postoperative NSE and S100-β both increased ( P<0.05), but NSE and S100 in the experimental group after surgery were lower than those in the control group: (0.82 ± 0.14) μg/L vs. (1.18 ± 0.28) μg/L, (290.13 ± 27.25) mg/L vs. (301.98 ± 28.56) mg/L, the differences were statistically significant ( P<0.05). After surgery, cTnI and BNP increased in both groups ( P<0.05), but the cTnI and BNP in the experimental group were lower than those in the control group: (2.87 ± 0.74)] μg/L vs. (3.36 ± 0.83) μg/L, (3.01 ± 0.85) μg/L vs. (3.89 ± 0.92) μg/L, the differences were statistically significant ( P<0.05). The opening time, extubation time, recovery room stay time, and hospitalization time in the experimental group were shorter than those in the control group: (16.79 ± 3.15) min vs. (20.55 ± 3.83) min, (29.38 ± 4.66) min vs. (40.14 ± 4.57) min, (66.82 ± 15.80) min vs. (89.35 ± 24.78) min, (11.24 ± 4.89) d vs. (14.56 ± 6.74) d, there were statistical differences ( P<0.05). The incidence of postoperative complications in the experimental group was lower than that in the control group: 12.00% (6/50) vs. 28.00% (14/50), there was statistical difference ( P<0.05). Conclusions:The application of rSO 2 combined with neurophysiological blood pressure monitoring in CEA of patients with carotid artery stenosis and coronary heart disease has a good effect, which has brain protection and myocardial protection, can shorten the recovery time of anesthesia and hospitalization time, and reduce the incidence of postoperative complications.

Objective To assess whether pregnancy affects the survival of pregnancy-associated breast cancer (PABC), compared with non-PABC. Methods We retrospectively analyzed the data of PABC patients.PABC cases and non-PABC cases were matched with 1:2 according to T stage, molecular classification, age of onset and year of diagnosis.The Kaplan-Meier method was used to estimate DFS and OS, and Log rank test was used for comparison.Cox regression analysis was used to evaluate the risk factors that affect the prognosis of PABC. Results We enrolled 35 patients in the PABC group (pregnancy: 10;postpartum: 25), and 70 patients in the non-PABC group.The median follow-up time was 68.5 and 70.7 months, respectively.The 5-year DFS was 51.6% in the PABC group, and that of the non-PABC group was 72.8%(χ²=4.72, P=0.029);the 5-year OS of the PABC group and the non-PABC group were similar (χ²=1.769, P=0.183).Cox regression analysis showed that pregnancy was an independent risk factor for DFS of PABC patients (P=0.011). Conclusion Patients with breast cancer during pregnancy have a higher risk of recurrence.Further research is necessary to diagnose pregnancy-associated breast cancer earlier and adopt measures to improve the curative effect.

Lipid metabolism disorders contribute to hyperlipidemia and hepatic steatosis. It is ideal to develop drugs simultaneous improving both hyperlipidemia and hepatic steatosis. Nitazoxanide is an FDA-approved oral antiprotozoal drug with excellent pharmacokinetic and safety profile. We found that nitazoxanide and its metabolite tizoxanide induced mild mitochondrial uncoupling and subsequently activated AMPK in HepG2 cells. Gavage administration of nitazoxanide inhibited high-fat diet (HFD)-induced increases of liver weight, blood and liver lipids, and ameliorated HFD-induced renal lipid accumulation in hamsters. Nitazoxanide significantly improved HFD-induced histopathologic changes of hamster livers. In the hamsters with pre-existing hyperlipidemia and hepatic steatosis, nitazoxanide also showed therapeutic effect. Gavage administration of nitazoxanide improved HFD-induced hepatic steatosis in C57BL/6J mice and western diet (WD)-induced hepatic steatosis in Apoe ^-/- mice. The present study suggests that repurposing nitazoxanide as a drug for hyperlipidemia and hepatic steatosis treatment is promising.

[Abstract] Objective: To explore the effect of lncRNA HOTAIR/miR-519d-3p/cyclin D1 (CCND1) axis on the proliferation and metastasis of breast cancer cells and its underlying mechanism. Methods: A total of 50 pairs of breast cancer tissues and corresponding para-cancer tissues resected from breast cancer patients in the Department of Breast Surgery, the Third Hospital of Nanchang from March 2017 to February 2019 were collected for this study. The expression level of HOTAIR in breast cancer tissues and paired paracancer tissues was detected by qPCR, in addition, the expressions of HOTAIR and miR-519d-3p in normal breast epithelial cells and breast cancer cell lines were also detected. Breast cancer SKBR3 cells were divided into NC group (without any treatment), si-HOTAIR group, mir-519d-3p mimics group, miR-519d-3p mimic+pcHOTAIR group, miR-519d-3p mimic+pcCCND1 group, and si-HOTAIR+ pcCCND1 group. The proliferation ability of SKBR3 cells was detected by CCK-8. Invasion and migration of SKBR3 cells were detected by Transwell. The expression levels of E-cadherin, N-cadherin, Vimentin and CCND1 in SKBR3 cells were detected by Western blotting. The targeting relationship between HOTAIR and miR-519d-3p, miR-519d-3p and CCND1 was detected by Dualluciferase reporter gene system. Results: HOTAIR was highly expressed in breast cancer tissues and cell lines, with the highest expression in SKBR3 cells. HOTAIR knockdown significantly inhibited the proliferation, invasion and migration of SKBR3 cells, as well as increased the expression level of E-cadherin and decreased the expression levels of N-cadherin and Vimentin. Dual-luciferase reporter gene assay showed that HOTAIR targetedly down-regulated the expression of miR-519d-3p, and miR-519d-3p targetedly downregulated the expression of CCND1. Further studies showed that knockout of HOTAIR inhibited the EMT, proliferation, invasion and migration of SKBR3 cells through enhancing the inhibitory effect of miR-519d-3p on CCND1 expression (all P<0.05). Conclusion: HOTAIR knockdown inhibits proliferation and metastasis of SKBR3 cells by regulating the axis of miR-519d-3p/CCND1.

The etiology of constricted ear malformation is unknown, while the clinical manifestations are diverse and the classification is complex. At present, there is no estabolished standard for the management of constricted ear. In addition to the conventional operations, some new surgical procedures have achieved ideal clinical outcomes. In this review, current surgical method for the correction of constricted ear were summarized according to the different clinical characteristics. The author hopes it provides reference for the optimal selection of surgical procedures.

The etiology of constricted ear malformation is unknown, while the clinical manifestations are diverse and the classification is complex. At present, there is no estabolished standard for the management of constricted ear. In addition to the conventional operations, some new surgical procedures have achieved ideal clinical outcomes. In this review, current surgical method for the correction of constricted ear were summarized according to the different clinical characteristics. The author hopes it provides reference for the optimal selection of surgical procedures.

Domestic and overseas studies onthe prominent eartreatment were reviewed and analyzed.Current progress of clinical therapy for prominent ear was summarized.The uniform clinical diagnosis and therapy of prominent earhave not been determined, due to its complicated and various therapeutic methods and unclear etiology. Reported therapies mainly include: (1)surgical therapy, which attains satisfactory therapeutic effect by adopting improved approaches, i. e. the combination of operations or the innovative methods based on Mustarde′s, Sterstrom′s and Converse′s surgical methods. (2)Non-surgical therapy, including ear splinting or molding, and laser-assisted cartilage reshaping(LACR). The non-surgical therapyisa hot research field, and is going to bepopularizedin the future.Research of etiology and non-surgical treatments may be helpful to provide abetter therapy strategy for prominent ear.

The number of H7N9 bird flu cases was high and the situation was grim in guizhou province in 2017. To understand the molecular characteristics of the hemagglutinin gene (HA) and the risk of human infection with avian influenza virus A(H7N9) in Guizhou Province, 2017. Homology, genetic evolution and pivotal sites related to receptor binding regions, pathogenicity and potential glycosylation of 14 avian influenza viruses A(H7N9) were analyzed by a series of bioinformation softwares. It was cleared that there was 95.9%-100% similarity among 14 strains in nucleotide of the HA gene, and there were 96.8%-97.8% and 96.8%-97.9% similarities with vaccine strains A/Shanghai/2/2013 and A/Anhui/1/2013 recommended by WHO, respectively. Phylogenetic analysis showed that 14 HA genes were directly evolved in the Yangtze River Delta evolution branch, but they could be derived from five diffenrent strains. Then 13 of 14 strains cleavage site sequences of HA protein revealed they were low pathogenic avian influenza viruses, while A/Guizhou-Weining/CSY01/2017 was high pathogenic avian influenza virus. Mutation G186V at the receptor binding sites in the HA was found in all 14 strains, and mutation Q226L in 13 strains besides A/Guizhou-Weining/CSY01/2017. All five potential glycosylation motifs in the HA were conservative.

Objective To investigate the clinical efficacy and safety of carotid endarterectomy (CEA)and carotid artery stenting(CAS)for the treatment of carotid artery stenosis in the elderly.Methods Clinical data of 116 elderly patients aged over 65 years with carotid artery stenosis were retrospectively analyzed.Of 116 patients,73 patients underwent CAS(the CAS group) and 32 received CEA(the CEA group).The success rate,30-day perioperative complications and follow-up results were compared between the two groups.Results There was no significant difference in the success rate (96.8％ vs.100.0％,P ＞ 0.05),30-day perioperative complications,such as bradycardia (6.25％ vs.4.5％,x2 =0.228,P=0.663),acute myocardial infarction(0.0 vs.1.4％,x2 =0.432,P=0.511),transient hypotension(6.3％ vs.8.1％,x2 =0.114,P =0.735),ischemic stroke(6.3％ vs.6.8％,x2 =0.009,P =0.923),and cerebral hyperperfusion syndrome (18.8 ％ vs.10.8％,x2 =0.009,P =0.923),between the CEA and CAS groups.The incidence of persistent hypotension was lower in the CEA group than in the CAS group(3.1％ vs.17.6％,x2 =4.398,P=0.036).No significant difference was found in carotid artery restenosis(moderate:6.3％ vs.8.1％,x2 =0.114,P =0.735;severe:3.1 ％ vs.2.7％,x2=0.014,P=0.905)and ipsilateral stroke(3.1％ vs.5.4％,x2 =0.279,P=0.598)between the CEA and CAS groups at one-year fellow-up.Conclusions Both CEA and CAS have good effieacies in treating carotid artery stenosis in the elderly,while the incidence of persistent hypotension is higher with CAS than with CEA.

Objective To observe the effects of carotid artery stenting (CAS) on ophthalmic artery blood flow in patients with ischemic ophthalmopathy (IOP).Methods A prospective case-control study.Sixty IOP patients (60 eyes) who met inclusive criteria for CAS were enrolled in this study.There was 50％ stenosis of internal carotid artery on one side at least confirmed by color doppler flow imaging (CDFI).Among 60 eyes,there were 3 eyes with central retinal artery occlusion,15 eyes with retinal vein occlusion,37 eyes with ischemic optic neuropathy,5 eyes with ocular ischemia syndrome.The patients were randomly divided into CAS group (32 eyes of 32 patients) and medicine therapy group (28 eyes of 28 patients).The difference of age (t=1.804) and sex (x2=1.975) between two groups was not significant (P＞0.05).The examinations of fundus fluorescein angiography (FFA),CDFI and digital substraction angiography (DSA) were performed before,1 week and 6 months after treatment.The following parameters were recorded:arm-retinal circulation time (A-Rct),peak systolic velocity (PSV),end-diastolic velocity (EDV),and resistance index (RI) in the ophthalmic artery (OA) and central retinal artery (CRA),and the best corrected visual acuity (BCVA).Results There was no significant differences in A-Rct (t=1.354) and BCVA (t=0.376) between the two groups before treatment (P＞0.05).Also,there was no significant differences in PSV (t=-0.294,-2.446),EDV (t=0.141,-0.305),and RI (t=-0.222,-0.694) of OA and CRA between the two groups before treatment before treatment (P＞0.05).Compared with the medicine therapy group,the lower A-Rct was found in the CAS group at different time points after the treatment.The difference was significant on 1 week after treatment (t=-3.205,P＜0.05),but not on 6 months after treatment (t=1.345,P＞0.05).The BCVA of eyes in the two groups were increasing with the extending of time of therapy.Compared with the medicine therapy group,the better BCVA was found in the CAS group at different time points after the treatment (t=0.800,1.527;P＜0.05).Compared with the medicine therapy group,the higher PSV,EDV and lower RI of OA and CRA were found in the CAS group at different time points after the treatment.(P＜0.05).Conclusion Compared with conventional medicine therapy,CAS shows earlier effects in improving ocular hemodynamics for IOP patients with carotid artery stenosis,which benefits visual function improvement of the patients.