Cardiovascular diseases (CVDs) remain the cause of millions of deaths in the world annually. Despite the great progress in therapies, which are available for patients with CVDs, some limitations including drug complications still exist. Hence, the endocannabinoid system (ECS) was proposed as a new avenue for CVDs treatment. The cardiovascular action of cannabinoids is complex as they not only affect vasculature and myocardium directly via specific receptors but also exert indirect effects through the central and peripheral nervous system. The growing interest in phytocannabinoid studies has been broadened the knowledge about their molecular targets as well as therapeutical properties, nonetheless, some areas of their actions are not yet fully recognized. The purpose of this review is to summarize and update the cardiovascular actions of the most potent phytocannabinoids and the potential therapeutic role of ECS in CVDs, including ischemic reperfusion injury, arrhythmia, heart failure, hypertension as well as cardiac complications associated with the novel coronavirus SARS-CoV-2 infections.

Background: Mental disorders during pregnancy are common, with long-lasting negative effects on mother and child. The combination with psychosocial symptoms, barriers on population and healthcare level and lack of long-term evidence make treatment challenging. To overcome this, there is raising awareness for collaborative care. Objectives: Review perinatal mental health interventions and analyse the impact of collaborative care. Search strategy: Two independent reviewers searched for RCT’s in Pubmed, Embase and PsycINFO. Selection criteria: Trials studying the effect of psychological or pharmacological interventions on the mental health of pregnant women with psychiatric and/or psychosocial symptoms. Data collection and analysis: Two reviewers independently abstracted data and assessed study quality and risk of bias. Each study was scored on collaborative care criteria: multi-professional approach to patientcare, structured management plan, scheduled patient follow-ups, enhanced interprofessional communication. Main results: 35 studies were included. Most trials studied the effect of cognitive behavioural therapy and interpersonal psychotherapy on perinatal depression. Almost all interventions met at least one collaborative care criteria. Interventions were mostly provided by multiple professionals, but interprofessional communication rarely took place. Interventions that met more criteria did not more often show a positive effect on maternal mental health. Conclusions: There is lack of research on perinatal psychiatric disorders other than depressive and on long-term treatment outcomes. Collaborative care is partly implemented in most current interventions, but more trials (including interprofessional communication) are needed to be conclusive whether collaborative care is a key component in perinatal mental healthcare. Funding: None Keywords: pregnancy, mental disorders, psychosocial, collaborative care

Cricoid chondronecrosis is a rare life-threatening complication of endotracheal intubation. Herein we present a patient with a history of severe brain injury, who developed a cricoid chondronecrosis after ICU stay. We discuss the diagnosis of the condition, the causative factors, treatment through a literature review.

Interstitial and cornual pregnancies remain the most difficult types of ectopic pregnancy to diagnose and treat. Traditionally, the treatment of interstitial pregnancy has been interventional; a surgical approach that may even extend to a hysterectomy or uterine cornual resection via laparotomy. Recently, and hopefully increas¬ingly, more conservative approaches have been suggested, such as cornuostomy instead of cornual resection and laparoscopy in place of laparotomy, for preserving uterine integrity for future fertility. We present a step-by-step surgical approach that we have implemented in cases of cornual pregnancy in our department.

In order to explore the relationship between lung and intestinal injury and microorganisms in piglets caused by PRV infection.36 piglets were randomly divided into the blank group and the exposed group (or PRV group). PBS and PRV 1mL/Piggy were given by nasal drip at 0d, and the clinical symptoms were recorded every day. Three piglets in each group were sacrificed at 0d, 12h, 24h, 3d, 10d and 14d, respectively. The lungs, colon and contents were collected to observe the pathological sections and assess damage. The antigenic localization and expression of PRV, TLR4, NF-κB and MYD88 were detected by immunohistochemistry, the contents of sIgA, IFN-γ and IL-2 were determined by ELISA, and the microorganisms in lung and colon were analyzed by 16SrDNA. Accordingly, the correlation between lung and intestinal damage was highly significant (P<0.01). The expression of PRV in lung and colon was positively correlated with injury, with highly significant differences. The expression of TLR4, MYD88 and NF-κB was positively correlated with lung and intestinal injury. Besides, the levels of IFN-γ and sIgA were correlated with the injury, with significant differences. The species richness, diversity and evenness of microorganisms in lung and colon of the exposed group were reduced. There was a new Mycoplasma phylum in intestinal tract, and the correlation between lung flora and injury was higher than that in colon. In summary, it is evident that PRV infection with lung injury alters the intestinal TLR4-MYD88-NF-κB pathway, generating an inflammatory response, and lung and intestinal injury and microbial changes promote each other and drive disease progression.

Objective: To compare the predictive accuracy of the Gaussian and FMF algorithms for preeclampsia (PE) and small for gestational age fetuses (SGA). Design: Secondary analysis of a prospective cohort study. Setting: Tertiary referral hospital. Population: 2641 singleton pregnancies attending routine first-trimester scan from October 2015 to September 2017. Methods: Maternal characteristics, mean arterial blood pressure (MAP), and mean uterine artery pulsatility index (UtAPI) were recorded at the first-trimester scan. Serum placental growth factor (PlGF) and pregnancy-associated plasma protein-A (PAPP-A) were assessed between 8+0 and 13+6 weeks of gestation. Main outcome measures: The areas under the curve (AUC) for the predictive performance for early-onset (delivery <34 weeks) and preterm (delivery <37 weeks) PE, and early-onset (delivery <32 weeks) and preterm (delivery <37 weeks) SGA, were calculated with the Gaussian and FMF algorithms, and were subsequently compared. Results: Among the 2641 participants, 30 (1.14%) developed preterm PE, including 11 (0.42%) early-onset PE. Among the 2483 newborns, 44 (1.77%) were preterm SGA, including eight (0.32%) early-onset SGA. The FMF and the Gaussian algorithm showed a similar predictive performance for most outcomes and marker combinations. Conclusions: This study shows that the first-trimester Gaussian and FMF algorithms have similar performances for PE and SGA prediction. Accuracy of the FMF algorithm was similar to that reported in the original studies, adding evidence to its external validity. Funding: none Keywords: preeclampsia, screening, PlGF, early-onset preeclampsia, uterine artery Doppler, first trimester Tweetable abstract: The first-trimester Gaussian and FMF algorithms have similar predictive performances for preeclampsia and small-for-gestational-age fetuses.

Thioredoxin-1 (Trx1) is an important regulator of cellular redox homeostasis with redox-active dithiol; it is induced in response to various stress conditions (e.g. oxidative damage, infection/inflammation, metabolic dysfunction, irradiation and chemical exposure). In multiple studies, Trx1 has shown excellent anti-inflammatory and immunomodulatory effects when used to treat animal models of various human inflammatory disorders. This review focusses on the protective roles and effect mechanisms of Trx1 in relation to allergic diseases such as allergic asthma, contact dermatitis, food allergies, allergic rhinitis and drug allergies. Trx1 plays important roles in allergic diseases through processes such as anti-oxidation, inhibition of macrophage migration inhibitory factor (MIF), regulation of Th1/Th2 immune balance, modulation of allergic inflammatory cells and suppression of complement activation. The regulatory actions of Trx1 differ from glucocorticoid-based mechanisms, which regulate inflammatory reactions in association with suppression of immune responses. Furthermore, Trx1 exerts a beneficial effect on the glucocorticoid resistance of allergic inflammation by inhibiting the production and internalisation of MIF. According to the research discussed here, we suggest that Trx1 has the potential for future success in translational research.

Aims: The optimal dose of imatinib on survival in the adjuvant treatment of patients with resected GISTs remains unsettled. Therefore, this study aimed to assess the impact of the adjustment of dose based on imatinib plasma trough concentrations (Cmin) on the prognosis of GIST based in the adjuvant setting. Methods: We conducted a retrospective cross-sectional study of GIST patients treated with imatinib. Simultaneously, the blood samples at steady-state of the aforementioned patients were obtained for the determination of imatinib Cmin. Inverse probability of treatment weighting (IPTW) was used for reducing selection bias in baseline characteristics. Kaplan–Meier analyses and multivariate Cox proportional hazards were used to evaluate the association of the different dosages of imatinib with recurrence-free survival (RFS). Results: A total of 79 patients were identified in this study. Of these patients treated with imatinib 200 mg/d (n=8), 300 mg/d (n=33), 400 mg/d (n=37), and 600 mg/d (n=1)the mean±standard deviation (SD) imatinib Cmin was 704±299ng/mL, 1153±473.3ng/mL, and 1246±491.3ng/mL, respectively. Additionally, imatinib Cmin of 200-mg/day group was significantly lower than groups of 300- (P=0.036) and 400-mg/day (P=0.016), no significant difference in the Cmin of 300- and 400 -mg/day group (P=0.427) (Fig 3). Before and after adjustment by propensity score-based IPTW, no significant difference in recurrence-free survival between the Conclusions: Our findings provide a new insight that imatinib Cmin may be used as a potential biomarker, to assist in the evaluation of the safety, and efficacy of individualized dosage adjustments in the adjuvant setting.

Aim of the work: to determine whether there is a correlation between the perineural invasion (PNI) and the cervical nodal metastasis of laryngeal squamous cell carcinoma (SCC). Material and methods: This study was conducted on 30 patients who have laryngeal SCC in the period from December 2019 till September 2020. Surgical resection was performed followed by histopathological examination to detect the presence of PNI, which was then correlated to the cervical nodal metastasis. Results: 26.7% (8/30) of our patients had PNI. There was a statistical significance between PNI and the cervical nodal metastasis (P value = 0.018). Conclusion: PNI is a strong histologic predictor of cervical nodal metastasis. Keywords: Laryngeal squamous cell carcinoma; Perineural invasion; nodal metastasis. Key points • Most of the head and neck cancer patients are pathologically diagnosed squamous cell carcinoma. • Tumor recurrence causes the vast majority of the mortalities. • perineural invasion is one of the major factors for tumour recurrence. • perineural invasion may occur centripetally or as skip lesions. • perineural invasion is a well-known route of tumor spread in diverse human malignancies.

：Thyroid hormones have been widely accepted to have complex effects on myocardium by regulation of ion channel, autonomic nervous system, non-specific inflammatory infiltration, therefore predisposing to reversible myocardium damage and multiple arrhythmias [1-3]. However, atrial fibrillation (AF), advanced to irreversible complete heart block, QT (QTc) prolongation, torsade de pointes (TdP), ventricular flutter and fibrillation (VF) have never been reported at the same time in a patient with hyperthyroidism before.

Bell pepper ( Capsicum annuum L.) is a tradable and desirable crop; however, its perishable nature requires low-temperature handling. [Paradoxically](javascript:;), cold causes chilling injury (CI) and postharvest waste. Current knowledge about CI in pepper is limited. The mechanism of CI is multi-faceted; thus, this study focused on fatty acid desaturation and identified an upstream nuclear transcription factor (TF) CaMYB340 belonging to the R2R3 MYB subfamily that negatively regulates fatty acid desaturation and the ICE-CBF pathway, and is induced by low temperature (4°C) at the DNA and transcriptional levels. Specifically, McrBC treatment and bisulfite sequencing PCR indicate that exposure to cold triggers DNA methylation on one of the CHH sites in the CaMYB340 promoter. This epigenetic event at least partly contributes to the upregulation of CaMYB340 transcripts. Increased expression of CaMYB340 results in the formation of protein complexes with CaMYB340, CabHLH93, and CaMYB1R1 that in turn downregulates the expression of downstream genes. For peppers held at low temperature, transient overexpression of CaMYB340 reduced unsaturated fatty acid (FA) content and membrane fluidity, resulting in cold-induced poor peel texture. Overall, these results underscore the intricacy of transcriptional networks in plants and highlight the role of CaMYB340 in CI occurrence in pepper fruits.

Ca 2+/CaM signal transduction pathway is well known to help plants to adapt to the environmental stress. However, our knowledge on the function proteins of Ca 2+/CaM pathway in peanut remains limited. Here, using yeast two hybrid methods, we identified a novel calmodulin4 (CaM4) binding protein S-adenosyl-methionine synthetase1 (SAMS1) in peanut. The expressions of AhSAMS1 were obviously induced by Ca 2+, ABA and salt stress. To elucidate the function of AhSAMS1, physiological and phenotypic analyses were applied between wild type and transgenic materials. Overexpression of AhSAMS1 significantly increased Spd and Spm synthesis while decreased the contents of ethylene, thus eliminating excessive ROS in the transgenic lines under salt stress. Consistent with the induced expressions of SOS and NHX genes, AhSAMS1 reduced the uptake of Na + and the leakage of K + from mesophyll cells, and was less sensitive to salt stress during early seedling growth. Transcriptomics combined with epigenetic regulation uncovered the relationships between DEGs and DMRs, which raised the salt tolerance and plants growth. Together, our findings support a model in which the role of AhSAMS1 on ROS-dependent regulation of ion homeostasis was enhanced by Ca 2+/CaM while AhSAMS1-induced methylation was regulated by CaM, thus providing a novel strategy to enhance plant salt tolerance.

Four divergent groups of duck astroviruses (DAstVs) have been identified that infect domestic ducks. In March 2021, a fatal disease characterized by visceral urate deposition broke out in 5-day-old Beijing ducks on a commercial farm in Guangdong province, China. The pathogen was confirmed to be a duck astrovirus. The complete genome sequence of this DAstV was obtained by virome sequencing and amplification. Phylogenetic analyses and pairwise comparisons demonstrated that this DAstV represented a novel group of avastrovirus. Thus, we designated this duck astrovirus as DAstV-5 JM strain. DAstV-5 JM shared genome sequence identities of 15–45% with other avastroviruses. Amino acid identities with proteins from other avastroviruses did not exceed 59% for ORF1a, 79% for ORF1b, and 60% for ORF2. The capsid region of JM shared genetic distances of 0.596 to 0.695 with the three official avastrovirus species. In summary, we determined that the DAstV-5 JM strain, causing gout in ducklings, is a novel species of avastrovirus.

Background: In children suspected of asthma, diagnosis is confirmed via variable expiratory airflow limitation. This study aimed to evaluate the pulmonary function characteristics in children suspected of asthma without bronchodilator response (BDR) and bronchial hyperresponsiveness (BHR). Methods: We utilised two separate real-world retrospective observational cohorts of children who underwent both spirometry and bronchial provocation testing for asthma. Spirometry parameters were collected and compared between definite asthma, probable asthma, and non-asthma groups. The original cohort comprised 1199 children who visited the Severance Hospital (Seoul, Korea) between January 2017 and December 2019. The external cohort included 105 children who visited the Gangnam Severance Hospital between January 2000 and December 2017. Results: Probable asthma accounted for 16.8% and 32.4% of the original and external cohorts, respectively. Baseline forced expiratory volume in 1 second (FEV 1), FEV 1/forced vital capacity (FVC), forced expiratory flow at 25-75% of FVC (FEF 25-75), and FEF 75 showed stepwise decrements from non-asthma, probable asthma, to definite asthma patients ( P < 0.001). The probable asthma group showed significantly higher odds of abnormal FEV 1/FVC (OR, 2.24 [95%CI, 1.43-3.52]) and FEF 25-75 (OR, 2.05 [95%CI, 1.13-3.73]) than the non-asthma group and lower odds of abnormal FEV 1 (OR, 0.05 [95%CI, 0.01-0.19]), FEV 1/FVC (OR, 0.27 [95% CI, 0.18-0.41]), FEF 25-75 (OR, 0.17 [95%CI, 0.11-0.28]), and FEF 75 (OR, 0.14 [95%CI, 0.08-0.24]) compared to the definite asthma group. The external cohort was consistent with the original cohort. Conclusions: We show evidence of airway dysfunction in children for whom a high clinical suspicion of asthma exists without evidence of BDR and BHR.

Lipase derived from Candida antractica is the most widely used enzyme for catalyzing various reactions. This paper reports the growth and enzyme kinetics of Candida antarctica MTCC-2706 for lipase production, which is one of the fundamental steps in bioprocess design, optimization, and scale-up studies. A hybrid machine learning (ML) aided experimental approach is proposed here to evaluate growth kinetics in which, different ML models were built to predict the growth curves at various substrate concentrations using a substantially smaller set of experimental samples. Comparative assessment of model performances revealed the superiority of gradient boosting regression (GBR) in predicting the growth curves. GBR-based growth kinetics was found to be fitted well with Monod’s model. Further, the activity and enzyme kinetics of lipase produced was investigated by considering the hydrolysis of p-nitrophenyl butyrate. The maximum lipase activity resulted was 24.07 U at 44 hrs. The deviation and R2 values of Monod’s and Michaelis-Menten’s models were 1.4% and 2.25%, and 0.96 and 0.99, respectively. The proposed ML-based approach is found to be efficient in predicting the growth kinetics with reduced experimental effort, time and resources (~50%) as compared to conventional method and its application can be extended to any other microbial processes.

Avian study in the southern Gulf of Lake Tana and head of the Blue Nile River, Ethiopia was conducted from June 2016 to April 2017 during the wet and dry seasons to examine species composition, relative abundance, and habitat association of birds. The study area was classified based on its vegetation cover and composition and the point count method was used to gather information about the occurrence of avian species and their relative abundances. A total of 131 avian species belonging to 15 orders and 53 families were identified. The wet and dry seasons data indicated that 122 and 108 avian species, respectively, were recorded. Agapornis tranta and Oriolus monachal are endemic birds of Ethiopia and Eritrea that are occurring in the study area. Moreover, two Intra-African migrant, Threskiornis aethiopicus and Milves migrans, and two Palearctic migrant, Delichon urbicum and Motacilla flava were identified in the area. The highest avian diversity was recorded in the Debremariam wetland (H’=3.96), while the lowest was at the adjacent areas of Lake Tana (H’=3.22). The relative abundance score showed that 54.8% of the avian species were uncommon and there was a significant difference in the relative abundance of birds between the wet and dry seasons (p<0.05). Different anthropogenic activities and urbanization are the main threats to the conservation of birds in the southern Gulf of Lake Tana. Therefore, appropriate management actions should be designed and implemented to ensure the conservation of birds in the Lake and its adjacent habitats. Keywords: Blue Nile, endemic, Lake Tana, species diversity, point count

The DMY gene is deleted in all males of the Sanya population (SY-medaka) of the Hainan medaka, Oryzias curvinotus, as recently reported by us. However, due to limited knowledge regarding their population genetic background, the cause of the deletion is yet to be understood. Herein, we resequenced the whole genome of four populations, including SY-medaka. A total of 32,826,105 SNPs were identified and the complete mitochondrial genomes of all individuals were assembled. We found that the genetic differentiation is highest between SY-medaka and the other populations. Further analysis shows that SY-medaka are the most strongly affected by environmental selection. The population history of Oryzias curvinotus also shows that the Sanya population size is at a low level in the context of the last 100,000 years. By combining the divergence time tree with paleogeographic evidence, we show that the SY-medaka migrated from the Eurasian continent. Moreover, we screened some potential genomic regions, and the genes contained in these regions may explain the potential mechanism of the selection process of the Sanya population. In conclusion, our study can provide new clues for the adaptation process of medaka in the new environment of Sanya and the mechanism of male DMY gene deletion.

Purpose: The clinical use of 5-fluorouracil (5-FU), a potent antitumor agent, was limited by severe cardiotoxic effects. The present study was aimed to investigate the protective effects of resveratrol (Res) on 5-FU-induced cardiotoxicity and to explore its potential mechanisms. Methods: The cardiotoxicity model was intraperitoneal injection of 5-FU at the dose of 30 mg/kg for 7 consecutive days. Plasma enzymes activities, cardiac tissues were assessed after treatment with Res for 3 weeks. Ferrostatin-1 (Fer-1) was used as ferroptosis inhibitor. In H9c2 cardiomyocyte cells, cell viability, generation of reactive oxygen species (ROS), mitochondrial activity and cellular Fe2+ levels were measured. Western-blot assay was performed to evaluate the protein level of ferroptosis in vitro and in vivo. Results: In the mouse model, Res reduced 5-FU-induced cardiomyocyte injury (ferroptosis, myofibrillar loss and vacuolization). In addition, increased serum creatine kinase (CK), lactate dehydrogenase (LDH), malonaldehyde (MDA) and Fe2+ activity and decreased activities of glutathione (GSH) were observed in 5-FU group. These changes were prevented by treatment with Res. In H9c2 cardiomyocyte cells, Res increased the cell viability and attenuated cell ferroptosis as measured by DCFH-DA, TMRE, Calcein AM staining. In addition, 5-FU induced a reduction in GPX4, FTH1, Nrf2 and NQO1 and activation of TfR and P53 compared with the control group. However, Res treatment effectively inhibited these changes in ferroptosis associated proteins in vitro and in vivo. Conclusions: Res possessed the cardioprotective potential against 5-FU induced cardiotoxicity. Moreover, Res attenuates 5-FU-induced cardiotoxicity via inhibiting GPX4 dependent ferroptosis.

Objectives: To evaluate the tracheal compression caused by the vascular ring in fetuses with double aortic arch (DAA) using prenatal ultrasound and to analyze the relationship between tracheal compression and postnatal clinical symptoms. Design: Retrospective cohort study. Setting: Two fetal medical centre in China. Population: 26 fetuses with DAA diagnosed with prenatal ultrasound and 334 singleton pregnancies with normal fetuses. Methods: The tracheal compression—evaluated by comparing the tracheal internal diameter Z-scores against the GA—was assessed in the fetuses with DAA and in normal fetuses. The live-born infants with DAA were divided into symptomatic and asymptomatic groups for the comparative analysis of Z-scores. Results: 26 fetuses with DAA were diagnosed and 14 (53.8%) fetuses with DAA were delivered alive. Among the 14 live-born infants, 7 (50.0%) were symptomatic while 7 (50.0%) were asymptomatic. The tracheal internal diameter Z-scores were significantly lower in the DAA group than in the normal groups (-0.6 [-1.0, -0.1] vs. 0.0 [-0.3, 0.3], P<0.001). Compared to the asymptomatic group, the tracheal internal diameter Z-scores were significantly lower in the symptomatic group (-1.5 [-1.8, -1.1] vs. -0.6 [-0.9, -0.1], P=0.018). Conclusions: The clinical symptoms in the infants with DAA were associated with prenatal tracheal compression, which can be prenatally evaluated using ultrasound. If fetuses are diagnosed with DAA, prenatal surveillance of the tracheal internal diameters and comparison with Z-score reference ranges could provide pertinent information that would aid perinatal clinical management.

Objectives This study aimed: (a) to compare the effects of continuous and intermittent infusions of vancomycinon the pharmacodynamics/pharmacokinetics (PK/PD) at a dose of 40 mg.kg-1.d-1 in children; (b) to compare the outcomes and the frequency of the drug-related adverse effects in this population. Methods This single-center randomized controlled trial enrolled children, admitted to the intensive care unit over a period of 36 months (June 1, 2017–June 1, 2020), and required vancomycin therapy. These children were randomly assigned to the CIV and IIV groups. The demographic, indices of PK/PD, outcomes, and drug-related adverse effects were collected and analyzed. Results Of the 92 patients randomized, 90 were included in the analysis and 2 patients dropped out of the trial. The study was conducted on two groups: the IIV group (n = 50) and the CIV group (n = 40) and various parameters were compared. The plateau concentration in the CIV group was higher than the trough concentration in the IIV group (15.22 mg.L-1 vs. 6.25 mg.L-1, P < 0.05). The AUC0–24/MIC of the IIV group was lower (median 391.45, IQR 251.45–898.16) compared to that of the CIV group (429.60, IQR 220.92–769.20; P > 0.05). None of the two groups showed any significant difference in the clinical prognosis or the drug-induced nephrotoxicity. Conclusions Therefore, CIV can assist in attaining the target concentrations of vancomycin more quickly in critically ill children, without increasing the dosage. Also, the children subjected to CIV demonstrated no difference in clinical efficacy and the rate of drug-related nephrotoxicity.

Background Breast cancer is the most common malignant tumor in women due to the disorder of genes and hormones. RUNX family has been involved in the regulation of different carcinogenic processes and signaling pathways with cancer, which is closely related to immunity and prognosis of breast cancer patients. Methods We evaluated the relationship between RUNX family and immune-related genes and the prognosis of breast cancer through analyzing TCGA database. A prognostic model was established and verified via cox proportional hazards regression model using R packages. Then, we obtained the relationship between the RUNX family and immune infiltration by TIMER database. Results The expression levels of RUNX family in tumor tissues were higher than that in normal breast tissues. We screened RUNX-regulated immune-related gene associated with breast cancer prognosis. RUNX family-regulated immune-related genes associated with the prognosis of breast cancer were screened. These predictors included PSME2, ULBP2, IL-18, TSLP, NPR3, TRDV1. And then a prognosis-related risk score model was built using the independent risk factors to provide a clinically appropriate method predicting the OS probability of the patients with breast cancer. The prognostic model we constructed performed well in the prognostic forecast, it could promote the development of prognostic assessment, and was associated with lower immune infiltration. Conclusion RUNX family could modulate the functions of immune cells, and these immune-related genes regulated by RUNX family could be promising prognostic biomarkers and therapeutic targets in breast cancer.

There are only six isolated living giant panda populations, and a comprehensive understanding their genetic health status is crucial for the conservation of this vulnerable species. Liangshan Mountains is one of the main distribution areas of living giant pandas and is outside the newly established Giant panda national Park. In this study, 971 giant panda fecal samples were collected in the heartland of Liangshan Mountains (Mabian Dafengding Nature Reserve: MB; Meigu Dafengding Nature Reserve: MG; and Heizhugou Nature Reserve: HZG). Microsatellite makers and mitochondrial D-loop sequences were used to estimate population size and genetic diversity. We identified 92 individuals (MB: 27, MG: 22, HZG: 43) from the three reserves. Our results showed that: 1) Genetic diversity of three giant panda populations was medium-low; 2) Quite a few loci deviated significantly from the Hardy-Weinberg equilibrium and almost all these deviated loci showed significant heterozygote deficiencies and inbreeding; 3) Three giant panda populations have substantial genetic differentiation with the most differentiation between MB and the two other populations; 4) a large amount of giant panda feces outside the three reserves were found, implying the existence of protection gap. These results indicated that the giant panda population in Liangshan Mountains is at an risk of genetic decline or extinction given stochastic events and urgent need of human management. This study revealed that high attention should be paid to the protection of these giant panda populations outside the Giant panda national Park, to ensure them survival in their distribution areas.

Objectives: The h-index is a measure of research output and contribution that shows strong correlation with academic promotion in medicine. The purpose of this paper is to clearly explain how h-index scores are calculated and how otolaryngologists can effectively and advantageously use these scores for their career development. Design: We performed an up-to-date PubMed literature review describing the design of h-index and how to use it effectively along with its role in academic medicine including otolaryngology. Results: H-index scores are used as a metric for scientific output which considers the number of publications and the number of times each paper was cited. Search engines can automatically calculate h-index scores for one’s work. Studies also revealed significant positive impacts h-index has from fellowship involvement which later translates to career advancement in academic medicine. Aspiring academic otolaryngologists should create a research profile to link and calculate h-index for publications, submit to well-read high impact journals for increased viewership and citations, and expand on foundational and personal research topics. Conclusions: Future studies should evaluate faculty and resident awareness of h-indices in the otolaryngology department to see how we can further address any underlying barriers. Otolaryngologists with the knowledge and tools necessary to maximize h-index scores and to produce high quality research in modern day medicine not only provides advantages in career development, but also brings significant contribution to the field of otolaryngology.

Point-of-care ultrasonography is a non-invasive, convenient, and reproducible method used in the diagnosis of patients admitted to the intensive care unit. We report a case of acute aortic dissection presenting as acute myocardial infarction and cerebral infarction confirmed through point-of-care ultrasonography. The patient received timely and effective treatment. However, the sensitivity of point-of-care ultrasonography cannot be overestimated, and CTA still needs to be combined.