In recent years, there have been increasing reports of anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis and myelin oligodendrocyte glycoprotein-antibody disease (MOG-Ab disease) appearing simultaneously or sequentially in the same patient. Some scholars have collectively referred to this kind of disease as the overlapping syndrome of MOG-Ab disease and anti-NMDAR encephalitis (MNOS). The clinical manifestations, treatment and prognosis of these syndromes are different from simple anti-NMDAR encephalitis or MOG-Ab disease. However, due to lack of understanding, clinicians tend to diagnose these syndromes as simple anti-NMDAR encephalitis or MOG-Ab disease, resulting in delayed the disease and affected prognosis. In order to strengthen the understanding of MNOS, this paper reviews MNOS from etiological hypothesis, characteristics of affected population, clinical manifestations, imaging manifestations, antibody characteristics in disease progression and treatment, so as to provide reference for the diagnosis and treatment in the future.

The incidence and mortality rate of digestive system tumors showed an increasing trend year by year, which seriously threatens human life and health. Recent years, studies have found that urothelial carcinoma embryonic antigen 1 (UCA1)is a long non-coding RNA (lncRNA), its expression significantly increased in a variety of digestive system tumor tissues or cells such as gastric cancer, colorectal cancer and esophageal cancer. In addition, UCA1 can interact with miRNAs to affect the proliferation,migration, invasion, epithelial-to-mesenchymal transition (EMT), apoptosis and drug resistance of tumor cells. The research progress of the action mechanism of lncRNA UCA1 and miRNAs in digestive system tumors (including gastric cancer, colorectal cancer and esophageal cancer) is reviewed, and the application of lncRNA UCA1 as a new biomarker and therapeutic target is prospected in present paper.

Objective To study the clinical features, treatment plan, treatment strategy and prognosis of renal clear cell carcinoma in nasal cavity and paranasal sinuses. Methods Five cases of renal clear cell carcinoma in nasal cavity and paranasal sinuses from 2005 to 2020 were retrospectively analyzed. The clinical features, such as age, gender, location of disease, duration of disease and so on, were analyzed. The clinical manifestations, treatment plan and prognosis were fully discussed, and the literature results analyzed comprehensively. Results All the 5 patients were male, and the onset age of nasal cavity and paranasal sinuses ranged from 49 to 81 years old. All the 5 patients had recurrent epistaxis, and one of them was accompanied with visual loss. The site of the disease was maxillary sinus in 2 cases, ethmoid sinus and sphenoid sinus in 1 case, ethmoid sinus and frontal sinus in 2 cases.One case with nasal tumor as the first symptom, renal cell carcinoma was found during comprehensive physical examination, and then the renal cell carcinoma was treated with B-ultrasound-guided intraperitoneal perfusion and microwave ablation; four cases with nasal tumor occurred later than renal cell carcinoma, and all had radical operation of kidney in early years. All the 5 patients underwent radical resection of nasal cavity and paranasal sinus tumor. Among them, 3 cases were treated with oral targeted drugs,and 1 case was treated with local radiotherapy, but all of them had no obvious effect. As of July 2020, 1 patient lost contact, 2 patients died and 2 patients survived with tumor. Conclusions Renal clear cell carcinoma in nasal cavity and paranasal sinuses is a rare disease. The main clinical symptoms were severe epistaxis and invasion of adjacent tissues and organs. This disease had no obvious effect on radiotherapy, targeted drug therapy and immunotherapy. Radical resection of nasal cavity can relieve the clinical symptoms and improve the quality of life.

Myocardial fibrosis is a common pathological process from various cardiovascular diseases to heart failure, and multiple signal pathways are jointly involved in the development and progression of myocardial fibrosis. AMP-activated protein kinase (AMPK) is a trimer complex widely distributed in human body, which is a central regulator of energy homeostasis involving the regulation of various metabolic responses and signaling pathways in vivo. AMPK interacts with the network of signal pathways related to myocardial fibrosis and jointly mediates the complex pathophysiological changes of myocardial fibrosis. Intervention of AMPK signal pathway provides a new therapeutic idea for the prevention and treatment of myocardial fibrosis. This paper summarizes the role and possible mechanisms of AMPK in different diseases related to cardiac fibrosis. The mutual effects of AMPK in several signaling pathways is also discussed; then further talks about the potential correlations between three kinds of commonly used clinical drugs and AMPK aiming to provide a new idea for the clinical treatment of myocardial fibrosis.

Reticulophagy is a process that selectively clears endoplasmic reticulum through autophagy. Selective degradation of stress endoplasmic reticulum and aggregate-prone proteins is important to maintain endoplasmic reticulum homeostasis.Reticulophagy receptors mediate selective recognition of endoplasmic reticulum by autophagosomal membrane to promote the elimination of endoplasmic reticulum by lysosome. Reticulophagy is associated with human diseases, therefore, further investigation is required to reveal its molecular mechanism. This review focuses on the most recent advances related to mechanisms and physical relevance of reticulophagy.

Exosomes are microcapsules with a diameter of 30-150 nm, which contain such active substances as proteins,lipids, metabolites, microRNAs (miRNAs) and long non-coding RNAs (lncRNAs), and promote tumorigenesis and development by mediating intercellular communication and regulating tumor microenvironment. miRNAs and lncRNAs are the important components of non-coding RNAs, which play an important role in the occurrence and development of breast cancer mediated by exosomes. The present paper mainly summarized the role of exosomal miRNAs and lncRNAs derived from breast cancer cells in breast cancer progression, microenvironment and drug resistance, the effects of exosomal miRNAs and lncRNAs derived from breast cancer microenvironment on the development of breast cancer, and the clinical potential of exosomal miRNAs and lncRNAs as biomarkers in breast cancer.

Irritable bowel syndrome (IBS) is the most common functional bowel disease, and diarrhea-predominant IBS(IBS-D) is the most common type of IBS in our country. There are many causes of IBS, among which abnormal bile acid metabolism and intestinal flora disorder are the main pathogenic factors. Abnormal bile acid metabolism and intestinal flora disorders are found in patients with IBS-D. Intestinal flora is critical in the regulation of bile acid synthesis. Disorders of intestinal flora may lead to abnormal bile acid metabolism. Studies have pointed out that bile acid pathway (farnesoid X receptor, FXR) agonists can improve IBS-D symptoms by regulating receptor bile acid metabolism and intestinal flora. The interaction and corresponding mechanism of bile acid-intestinal flora and IBS-D were summarized in present paper.

Virus is one of the common pathogens of intraocular infection. The testing of viral nucleic acid in the intraocular fluid currently becomes an important means for the diagnosis of the suspected intraocular virus infection. Viral nucleic acid testing for confirmed patients is also clinically valuable in adjusting the follow-up treatment regimen, determining therapeutic endpoint,and predicting therapeutic effect. To obtain stable, reliable, and effective results, sample collection of intraocular fluid and laboratory testing procedures of viral nucleic acid should be standardized. To normalize and standardize viral nucleic acid testing of intraocular fluid and to facilitate the accurate diagnosis and treatment of intraocular viral infection, we reached a consensus on the testing process and its clinical application from aspects of laboratory construction standards, specific testing procedures, standardized quality control systems, and clinical application value.

Objective To investigate the expression and clinical significance of blood basophil CD16 and CD32 in asthma-chronic obstructive pulmonary disease overlap (ACO) and chronic obstructive pulmonary disease (COPD). Methods COPD and ACO patients in the Third Affiliated Hospital of Jinzhou Medical University from December 2019 to December 2020 (set as COPD group and ACO group) and recruited healthy volunteers (set as healthy control group) were selected as research objects. General information including gender, age, medical history, age at onset, body mass index (BMI) and smoking history, and peripheral venous blood were collected. The expressions of CD16 and CD32 in basophil granulocyte enriched groups were detected by flow cytometry. The expression level of tumor necrosis factor-α (TNF-α) in plasma was determined by ELISA. Results Compared with healthy control group, the proportion of CD16⁺CCR3⁺ cells, CD16⁺CD123⁺HLA-DR^- cells and CD16⁺CCR3⁺CD123⁺HLA-DR^-cells in peripheral blood mononuclear cell population of ACO group and COPD group were increased (P<0.05), the proportion of CD32⁺CD123⁺HLA-DR^- cells and CD32⁺CCR3⁺CD123⁺HLA-DR^- cells in COPD group increased (P=0.003, P=0.030), the proportion of CD32⁺CD123⁺HLA-DR^- cells and CD32⁺CCR3⁺CD123⁺HLA-DR^- cells in ACO group decreased (P=0.019, P=0.031).The CD32 mean fluorescence intensity (MFI) of CCR3⁺ cells and CCR3⁺CD123⁺HLA-DR^- cells was lower in ACO group than in healthy control group (P=0.006, P=0.047). The plasma TNF-α expression level was higher in ACO group than in healthy control group with statistically significant difference (P=0.036). Conclusion Basophil granulocyte source CD16 and CD32 may play an important role as the pathogenesis of ACO and COPD, and TNF-α is involved in the pathogenesis of ACO, which may provide a new target for the subsequent clinical treatment of ACO and COPD.

Objective To explore the effect of individualized intraoperative blood pressure management strategy on postoperative neurocognitive function of elderly patients undergoing major abdominal surgery. Methods Two-hundred and ten elderly patients, admitted in the Second Affiliated Hospital of Anhui Medical University from September 2018 to September 2020 and undergone elective major abdominal surgery, were randomly divided into individualized group and control group with random number table method. In individualized group, the SBP was maintained within ±10% of the basic value; while in control group,the SBP was maintained ≥90 mmHg or decreased not exceed 40% of the basic value. The patient's SBP, diastolic blood pressure(DBP), mean arterial pressure (MAP), heart rate (HR) and bispectral index (BIS) of EEG were recorded before induction of anesthesia (T₀), start of surgery (T₁), 30 min (T₂), 60 min (T₃), 90 min (T₄), 120 min (T₅) and 150 min (T₆) after surgery and at the end of the operation (T₇). The basic neurocognitive function of the patients was evaluated with the Simple Intelligent Mental State Scale (MMSE) 1 day before the operation, and the scores of the Chinese revised delirium diagnostic scale (CAM-CR) and MMSE scores were recorded on the 1st, 3rd and 7th day after the operation. The cognitive function telephone questionnaire (TICS-m)was scored 1 month after surgery, and the length of hospital stay and serious complications were recorded. Results Compared with that in control group, the proportion of patients using norepinephrine increased significantly [72.4% (76/105) vs. 19.0%(20/105), P<0.001], and the placement time of drainage tube and postoperative hospital stay shortened significantly [(10.9±3.5) d vs. (12.8±5.0) d, P=0.039; (21.0±5.6) d vs. (23.6±6.2) d, P=0.038] in individualized group. No significant differences existed between the two groups in operation time, total infusion volume, bleeding volume, urine volume and first postoperative ventilation time (P>0.05). Compared with T₀, SBP, MAP and BIS decreased significantly at T₁-T₇, HR decreased significantly at T₁-T₆ (P<0.05)in the both groups, DBP decreased significantly at T₁-T₃ and T₅-T₇ in individualized group (P<0.05), and at T₁-T₇ in control group(P<0.05). Compared with control group, SBP and MAP increased significantly at T₁-T₇ in individualized group (P<0.05), and DBP increased significantly at T₄ (P<0.05). Compared with control group, the MMSE score increased significantly on the 1st and 3rd day after operation [(24.0±2.8) points vs. (22.8±2.7) points, P=0.032; (24.7±2.7) points vs. (23.6±2.4) points, P=0.037], and the CAM-CR score decreased significantly [(15.4±3.6) points vs. (17.2±4.2) points, P=0.040; (12.8±2.7) points vs. (14.2±3.1)points, P=0.028] in individualized group. No significant differences existed between the two groups in the MMSE and CAM-CR scores on the 7th day, the VAS scores on the 1st and 3rd day, and the TICS-m scores at 1 month after operation, as well as the incidence of serious complications (P>0.05). Conclusion Individualized management of elderly patients undergoing major abdominal surgery to maintain SBP fluctuations within ±10% of the basic value during operation can help improvement of early postoperative neurocognitive function and shortening the length of hospital stay, but had no significant effect on neurocognitive function at one month after operation.