[Salivary carcinoma showing thymus-like differentiation: clinicopathological analysis of 7 cases].

Objective: To analyze the clinicopathological features of salivary carcinoma with thymus-like differentiation(CASTLE). Methods: Cases diagnosed with salivary CASTLE from January 2020 to December 2023 were collected and selected from the Department of Oral Pathology, Shanghai Ninth People's Hospital,Shanghai Jiao Tong University School of Medicine. A total of 7 cases of salivary CASTLE were identified. All the cases originated from parotid. There were 3 males and 4 females. The patients' age range was 11-70 years.The clinical, microscopic, immunohistochemical and prognostic features of these cases were analyzed. Results: The duration of disease ranged from 1 month to 1 year, and 1 patient had facial numbness and 1 with swelling sensation occasionally. Radiographically, 4 cases showed malignant signs. Microscopically, 4 cases involved in parotid gland, and all the tumors had different degrees of lymphoid tissue background. The tumor cells arranged in nests, 5 cases with lymphoepithelial carcinoma-like and 2 cases with squamous cell carcinoma morphology. The tumor cells expressed CD5 and CD117 proteins diffusely in lymphoepithelial carcinoma-like cases. However, the tumor cells expressed CD5 diffusely and CD117 focally in cases with squamous cell carcinoma morphology. All the cases had no Epstein-Barr virus infection. Among the 6 patients with follow-up information, all of them underwent postoperative radiotherapy, and none of them had local recurrence and lymph node metastasis. Conclusions: Salivary CASTLE is a rare tumor, it should be distinguished from lymphoepithelial carcinoma and squamous cell carcinoma. The patients often have better prognosis and CD5 protein expression has a valuable role in the differential diagnosis.

[Analysis of clinicopathological characteristics of IgG4-related sialadenitis].

Objective: To analyze the clinicopathological characteristics of IgG4-related sialadenitis (IgG4-RS). Methods: A total of 40 cases diagnosed with IgG4-RS were collected from the Department of Oral Pathology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine from January 2019 to December 2022. Among them, there were 26 males and 14 females. The age range was 29-77 years old [(59.4±11.8) years old], with 23 patients being older than 60 years. The lesion site, imaging manifestations, histopathological features, serological test and treatment information of patients were collected. The expression of IgG4 and IgG proteins was detected by immunohistochemistry. Results: Submandibular region swelling was the most common initial symptom of IgG4-RS (38/40, 95.0%). All the patients having serum IgG4 levels> 1.35 g/L. Serum IgG4 levels were significantly increased in patients aged>60 years (Z=-2.45, P=0.014) and those involving multiple glands (Z=-2.04, P=0.042). Thirty six cases received major salivary gland biopsy, and all the cases showed dense lymphocyte and plasma cell infiltration. Lymphoid follicle, storiform fibrosis and obliterative phlebitis were seen in 88.9% (32/36), 63.9% (23/36), 30.6% (11/36) of the cases, respectively. Twenty one cases received labial salivary gland biopsy, 66.7% (14/21) showed lymphocyte and plasma cell infiltration, 19.0% (4/21) had lymphoid follicle structures, and 33.3% (7/21) showed no obvious histological abnormalities. No signs of fibrosis or obliterative phlebitis were observed in all labial salivary gland biopsies. And 95.0% (38/40) of cases had IgG4 positive plasma cell>10/HPF, 82.5% (33/40) of cases had IgG4/IgG positive plasma cell ratio>40%. All the patients had a decrease in serum IgG4 levels after glucocorticoid treatment, but only 21.4% (6/28) of cases had reduced to normal levels (≤1.35 g/L), and there were still significant fluctuations in serum IgG4 levels thereafter. Conclusions: IgG4-RS has a predilection for middle-aged and elderly male patients, and serum IgG4 levels are significantly related to the patient's age and whether multiple glands are involved. Labial salivary gland biopsy cannot replace submandibular gland for histopathological evaluation. It is a common phenomenon that serum IgG4 levels cannot restored to normal levels after glucocorticoid treatment. This study provides certain assistance for clinical and pathological diagnosis of IgG4-RS. This study is beneficial for further understanding IgG4-RS and improving the clinical and pathological diagnosis of the disease.

Copper recovery from printed circuit boards leaching solution with bioelectricity generation using microbial fuel cell.

Recovery of valuable metals via leaching printed circuit boards (PCBs) has gained moment recently. This work studied the Microbial fuel cell (MFC) performances for recovery of Cu from a Cu2+ solution by examining key operating parameters. A dual-chamber MFC with 6 cm × 6 cm × 7 cm dimensions was constructed. Both anode and cathode electrodes were made of a carbon cloth sheet. The anodic and cathodic chambers were separated by a Nafion membrane. The highest Cu recovery efficiency was 99.7% after 240 h batch mode operation, yielding 102 mW/m2 MFC power density output using 1 g/L Cu2+ solution as the catholyte (initial pH 3) and an anolyte containing 1 g/L sodium acetate inoculated with a sludge from a wastewater treatment plant's anaerobic pond, with 2 cm distance between the electrodes made of polyacrylonitrile polymer. The highest open circuit voltage, current density (based on cross-section cathode area) and power density with an external load of 1 kΩ was 555 mV, 347 mA/m2 and 193 mW/m2, respectively. Additionally, recovery of Cu in the leachate of PCBs using sulfuric acid leaching after 48 h was performed and the highest Cu recovery was 50% in 48 h.

[Evaluation of p16/Ki-67 double-stained immunohistochemistry in diagnosis of human papilloma virus-positive oropharyngeal squamous cell carcinoma].

Objective: To explore the diagnostic value of p16/Ki-67 double-stained immunohistochemistry in the diagnosis of human papilloma virus (HPV)-positive oropharyngeal squamous cell carcinoma(opscc) and find out the optimal index to improve the accuracy of HPV detection. Methods: A total of 153 cases, from May 2014 to May 2020, diagnosed OPSCC in Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, were selected. This cohort included 130 males and 23 females, aged (58.6±10.0) years old. HPV RNA in situ hybridization was chosen as the gold standard to detect their HPV status. p16 immunohistochemistry and p16/Ki-67 double-stained immunohistochemistry were performed on all cases, and the p16/Ki-67 double positive index including 20%, 40%, and 60% were used as the thresholds to compare their sensitivity, specificity, and positive prediction value (PPV), negative prediction value (NPV) and prognosis prediction ability. Results: Among the 153 patients with OPSCC, 114 were HPV-negative and 39 were HPV-positive, and the HPV infection rate of OPSCC patients was 25.5% (39/153). Only 58.1% (36/62) of single p16 positive cases were HPV-positive, and the prognosis of patients could not be distinguished using p16 immunohistochemistry only. Using p16/Ki-67 double staining, the accuracy of HPV positive diagnosis has been improved. The HPV diagnostic ability was the highest when the p16/Ki-67 double positive index was 40% (sensitivity=86.8%, specificity=94.8%, PPV=84.6%, NPV=95.6%, area under the curve=0.897), which could distinguish the prognosis of patients (P=0.012). Conclusions: The p16/Ki-67 double-stained immunohistochemistry can improve the accuracy of HPV positive diagnosis rate and diagnosis of HPV-positive oropharyngeal cancer is the most accurate when the double-positive index is 40% as the threshold to judge HPV status and could serve as better surrogate marker for HPV detection.

[Association between serum sex hormone-binding globulin and non-alcoholic steatohepatitis].

Objective: To investigate the association between serum sex hormone-binding globulin (SHBG) and non-alcoholic steatohepatitis (NASH). Methods: In this cross-sectional study, a total of 371 middle-aged and young obese patients who were hospitalized and underwent liver puncture in Nanjing Drum Tower Hospital from January 2016 to April 2021 were included. The population was divided into control group (n=43) and non-alcoholic fatty liver disease (NAFLD) group (n=328) based on the non-alcoholic fatty liver disease activity score. Subjects in NAFLD group were further divided into non-alcoholic fatty liver (NAFL) (n=60), uncertain-NASH (n=172), and NASH (n=96). Serum SHBG was tested in patients with NAFLD who were divided into three subgroups according to tertiles. The liver pathological characteristics in different SHBG level subgroups were compared. The risk factors of NASH were analyzed by logistic regression. The prediction model of NASH noninvasive diagnosis was established by forward stepwise regression, and the diagnostic value of non-invasive model for NASH was evaluated by receiver operating characteristic (ROC) curve. Results: The median age in patients were (32±10) years old with a body mass index of (39.16±6.58) kg/m², including 236 females (63.6%). Serum SHBG level [M (Q1, Q3)] in NAFLD group was significantly lower than that in control group [16.90 (11.43, 23.00) vs. (23.45 (15.40, 31.22) mmol/L, P<0.05], and progressively diminished in NAFL, uncertain-NASH and NASH subgroups [(22.24±10.47), (20.57±19.58), (15.80±8.74) mmol; P for trend<0.05]. Compared with the high-leveled SHBG subgroup, the steatosis score (2.09±0.80 vs. 1.51±0.72, P<0.01) and lobular inflammation score (1.10±0.68 vs. 0.85±0.68, P<0.05) were significantly higher in the low-leveled SHBG group. Multivariate logistic regression analysis indicated that lower serum SHBG level was an independent risk factor for NASH (OR=2.527, 95%CI: 1.296 to 4.928, P<0.05). The area under ROC curve of SHBG combined with aspartate aminotransferase in predicting NASH in NAFLD patients was 0.752 (95%CI: 0.696 to 0.809). Conclusion: Low serum SHBG level is associated with NASH.

[Hydroxynitone suppresses hepatic stellate cell activation by inhibiting TGF-ß1 phosphorylation to alleviate CCl4-induced liver fibrosis in rats].

OBJECTIVE: To investigate the effect of hydronidone on CCl4-induced liver fibrosis in rats and explore the possible mechanism. METHODS: Sixty-six male SD rats were randomized into 5 groups, including a control group (n=10), a liver fibrosis model group (n=20), 2 hydronidone dose groups (100 and 250 mg/kg; n=12), and a pirfenidone (250 mg/kg) treatment group (n= 12). Rat models of liver fibrosis were established by subcutaneous injection of CCl4 in all but the control group. Hydronidone and pirfenidone were given daily at the indicated doses by intragastric administration for 6 weeks. After the treatments, serum samples were collected from the rats for detecting liver function parameters, and hydroxyproline content in the liver tissue was determined. Inflammation and fibrosis in the liver tissue were observed using HE staining and Sirius Red staining. In the cell experiment, human hepatic stellate cell line LX-2 was stimulated with TGF-ß1 and treated with hydronidone or pirfenidone, and the expression levels of α-SMA, collagen type I and phosphorylated Smad3, phosphorylated p38, phosphorylated ERK1/2 and phosphorylated Akt were detected with Western blotting. RESULTS: In the rat models of liver fibrosis, treatment with hydronidone obviously improved the liver functions, reduced the content of hydroxyproline in the liver tissue, and significantly alleviated liver fibrosis (P < 0.05). In LX-2 cells, hydronidone dose-dependently decreased the expression levels of α-SMA and collagen type I. In TGF- ß1-stimulated cells, the phosphorylation levels of Smad3, P38, ERK, and Akt increased progressively with the extension of the treatment time, but this effect was significantly attenuated by treatment with hydronidone (P < 0.05). CONCLUSION: Hydronidone can inhibit the phosphorylation of the proteins in the TGF-ß signaling pathway, thereby preventing TGF-ß1-mediated activation of hepatic stellate cells, which may be a possible mechanism by which hydronidone alleviates CCl4-induced liver fibrosis in rats.

Measurement of Two-Particle Correlations of Hadrons in e

The measurement of two-particle angular correlation functions in high-multiplicity e^{+}e^{-} collisions at sqrt[s]=10.52 GeV is reported. In this study, the 89.5 fb^{-1} of hadronic e^{+}e^{-} annihilation data collected by the Belle detector at KEKB are used. Two-particle angular correlation functions are measured in the full relative azimuthal angle (Δϕ) and three units of pseudorapidity (Δη), defined by either the electron beam axis or the event-shape thrust axis, and are studied as a function of charged-particle multiplicity. The measurement in the thrust axis analysis, with mostly outgoing quark pairs determining the reference axis, is sensitive to the region of additional soft gluon emissions. No significant anisotropic collective behavior is observed with either coordinate analyses. Near-side jet correlations appear to be absent in the thrust axis analysis. The measurements are compared to predictions from various event generators and are expected to provide new constraints to the phenomenological models in the low-energy regime.

[Programmed death ligand 1 expression and CD8+T lymphocyte infiltration in salivary gland lymphoepithelial carcinoma].

Objective: To study the expression of programmed death ligand-1 (PD-L1) in tumor cells and CD8+T lymphocytes in tumor infiltrating lymphocytes, and to analyze the correlation of PD-L1 expression with infiltration of CD8+T lymphocytes and clinicopathologic features in salivary gland lymphoepithelial carcinoma (LEC). Methods: Forty-two cases of primary salivary LECs and 21 cases of secondary salivary LECs were enrolled at the Department of Oral Pathology, Shanghai Ninth People's Hospital, Shanghai Jiaotong University between 2015 and 2017. The expression of Epstein-Barr (EB) virus, PD-L1 and CD8 was examined using chromogenic in situ hybridization (CISH) and immunohistochemistry (IHC) staining. The data were analyzed using SPSS 23.0 software package. Results: EB virus was detected in 61 cases (61/63, 96.8%), including 42 (42/42, 100%) primary LECs and 19 (19/21, 90.5%) secondary LECs. The PD-L1 positive rate (score ≥1) was 97.6% (41/42), and its high-expression rate (score ≥20) was 78.6% (33/42) in primary LECs. The PD-L1 positive rate (score ≥1) was 71.4% (15/21), and its high-expression rate (≥20) was 38.1% (8/21) in secondary LECs. However, the PD-L1 positive rate (score ≥1, P=0.004) and high-expression rate (score ≥20, P=0.001) in primary LECs were higher than those in secondary LECs. There was no difference in the infiltration degree of CD8+T lymphocytes between primary and secondary LECs. There was a significant correlation between the expression of PD-L1 and CD8 in primary LECs (P=0.001) and in secondary LECs (P=0.048), respectively. Conclusions: There is PD-L1 expression in primary and secondary salivary LECs, while the expression rate is higher in primary LECs than secondary LECs. The combination of PD-L1 expression and CD8+T lymphocytes' presence suggest that most LEC patients might be responsive to immunotherapy, and primary LECs might be more significantly responsive than secondary LECs.

D-Tyrosine enhancement of microbiocide mitigation of carbon steel corrosion by a sulfate reducing bacterium biofilm.

Microbiocides are used to control problematic microorganisms. High doses of microbiocides cause environmental and operational problems. Therefore, using microbiocide enhancers to make microbiocides more efficacious is highly desirable. 2,2-dibromo-3-nitrilopropionamide (DBNPA) is a popular biodegradable microbiocide. D-Amino acids have been used in lab tests to enhance microbiocides to treat microbial biofilms. In this investigation, D-tyrosine was used to enhance DBNPA against Desulfovibrio vulgaris biofilm on C1018 carbon steel. After 7 days of incubation, the mass loss of coupons without treatment chemicals in the ATCC 1249 culture medium was found to be 3.1 ± 0.1 mg/cm2. With 150 ppm (w/w) DBNPA in the culture medium, the mass loss was reduced to 1.9 ± 0.1 mg/cm2 accompanied by a 1-log reduction in the sessile cell count. The 150 ppm DBNPA + 1 ppm D-tyrosine combination attained an extra 3-log reduction in sessile cell count and an additional 30% reduction in mass loss compared with 150 ppm DBNPA only treatment. The combination also led to a smaller maximum pit depth. Linear polarization resistance (LPR), electrochemical impedance spectrometry (EIS), and potentiodynamic polarization (PDP) tests corroborated the enhancement effects.

Patterns of repeated diagnostic testing for COVID-19 in relation to patient characteristics and outcomes.

BACKGROUND: Whilst the COVID-19 diagnostic test has a high false-negative rate, not everyone initially negative is re-tested. Michigan Medicine, a primary regional centre, provided an ideal setting for studying testing patterns during the first wave of the pandemic. OBJECTIVES: To identify the characteristics of patients who underwent repeated testing for COVID-19 and determine if repeated testing was associated with downstream outcomes amongst positive cases. METHODS: Characteristics, test results, and health outcomes for patients presenting for a COVID-19 diagnostic test were collected. We examined whether patient characteristics differed with repeated testing and estimated a false-negative rate for the test. We then studied repeated testing patterns in patients with severe COVID-19-related outcomes. RESULTS: Patient age, sex, body mass index, neighbourhood poverty levels, pre-existing type 2 diabetes, circulatory, kidney, and liver diseases, and cough, fever/chills, and pain symptoms 14 days prior to a first test were associated with repeated testing. Amongst patients with a positive result, age (OR: 1.17; 95% CI: (1.05, 1.34)) and pre-existing kidney diseases (OR: 2.26; 95% CI: (1.41, 3.68)) remained significant. Hospitalization (OR: 7.88; 95% CI: (5.15, 12.26)) and ICU-level care (OR: 6.93; 95% CI: (4.44, 10.92)) were associated with repeated testing. The estimated false-negative rate was 23.8% (95% CI: (19.5%, 28.5%)). CONCLUSIONS: Whilst most patients were tested once and received a negative result, a meaningful subset underwent multiple rounds of testing. These results shed light on testing patterns and have important implications for understanding the variation of repeated testing results within and between patients.

Pattern-recognition receptors in duck (Anas platyrhynchos): identification, expression and function analysis of toll-like receptor 3.

1. Innate immunity provides the first line of defence against pathogenic organisms through a myriad of germline encoded receptors called pattern-recognition receptors (PRRs). Toll-like receptor (TLR) 3, as an important member of PRRs, is indispensable for host defence against viral infection by recognising virus-derived RNAs. However, little is known about the structure and function of TLR3 in ducks (Anas platyrhynchos), a natural host for the avian influenza virus.2. This study cloned the full-length cDNA of duck TLR3 using reverse transcription polymerase chain reaction (RT-PCR) with rapid amplification of cDNA ends (RACE). The cDNA sequence of duck TLR3 was 4046 bp in length and encoded 895 amino acids. Multiple sequence alignment showed that duck TLR3 shared high similarity with that from other vertebrates.3. Quantitative real-time PCR (qRT-PCR) analysis suggested that TLR3 mRNA was constitutively expressed in all tissues tested, having higher levels in the kidney, liver, breast muscle, ovary and heart. After stimulation with viral- or bacterial-mimics, including LPS, poly(I:C), pam3CSK4, FLS-1, FLA-ST and R848, the TLR3 transcript was significantly upregulated. Meanwhile, overexpression of duck TLR3 significantly promoted the transcription of IFN-ß, IRF7, TRIF, Mx, STAT1 and STAT2 mRNA after stimulation with poly(I:C).4. These results suggested that TLR3 play an important role in resistance against viral and bacterial infections in ducks.

A NOVEL INTRAGENIC DELETION RELATED TO THE ARGININE VASOPRESSIN V2 RECEPTOR CAUSES NEPHROGENIC DIABETES INSIPIDUS.

BACKGROUND: Nephrogenic diabetes insipidus (NDI) is a disease characterized by a defective response to the antidiuretic hormone (ADH) of the renal collecting duct leading to a decline in the ability of the pro-urine concentration. CASE PRESENTATION: A 23-year-old man presented with an over 20-year history of polyuria concomitant with hydronephrosis. The diagnosis of NDI was established by gene analysis as well as a water-deprivation and vasopressin test. All exons of arginine vasopressin V2 receptor (AVPR2) gene were amplified and sequenced. A novel hemizygous intragenic inframe deletion, cDNA 255th bp to 263th bp in exon 2 of AVPR2, was identified. These relevant translations from the 85th amino acid Asp to 88th amino acid Val were missed and replaced by amino acid Glu. After treating the patient with hydrochlorothiazide, his symptoms improved significantly. CONCLUSION: The genetic analysis revealed a novel X-linked intragenic inframe deletion, AVPR2 gene cDNA 255th bp to 263th bp, causing NDI.

Ultrasound-assisted leaching of spent lithium ion batteries by natural organic acids and H2O2.

Ultrasound-assisted bioacid leaching was examined for the extraction of valuable metals from spent lithium ion batteries (LIBs). In this work, organic acids in lemon juice were used as the leaching agent together with H2O2. Three effective factors, namely solid/liquid (S/L) ratio, lemon juice percentage, and H2O2 volume percentage, were optimized using Response Surface Methodology (RSM). The optimal conditions were found to be 0.98% (w/v) S/L ratio, 57.8% (v/v) lemon juice and 8.07% (v/v) H2O2 in the leaching liquor, achieving recovery of 100% Li, 96% Co and 96% Ni. Furthermore, the individual effects of ultrasound, H2O2 and lemon juice on metal recovery were studied and the results showed that without H2O2 or lemon juice, the metal recovery rates decreased greatly while the absence of ultrasound reduced recovery rates to a much smaller extent, indicating that both H2O2 and lemon juice were essential in the leaching process. The effect of time on the metals recoveries was examined and results showed that Li and Co recovery reached 100% with the leaching time of 35 min. The modified shrinking core modeling results suggested that chemical reaction was the rate controlling step.

Ultrasound-assisted leaching of vanadium from fly ash using lemon juice organic acids.

In this work, vanadium (V) was selectively extracted from fuel-oil fly ash using a leaching process utilizing organic acids extracted from lemon juice with assistance from ultrasound and H2O2. Response Surface Methodology (RSM) was used to optimize the main operating factors. The V recovery was 88.7% at the optimal conditions: 27.9% (v/v) lemon juice, 10% (v/v) hydrogen peroxide (H2O2), solid/liquid (S/L) ratio 0.01% (w/v), ultrasound power 159 W at 20 kHz in 2 h, and initial temperature of 35 °C. The effect of time on the V recovery was examined. The maximum recovery was 100% after 3 h. Furthermore, the individual effects of ultrasound and H2O2 on V recovery were studied, and the results showed that without H2O2 and ultrasound, the V recovery decreased greatly, indicating that both factors were essential in the leaching process. According to the modified shrinking core model, test results indicated that mass diffusion was the controlling step of the overall reaction kinetics. The activation energy of the leaching reaction in the temperature range 25 to 65 °C was found to be 17.1 kJ mol-1.

Correction: Ultrasound-assisted leaching of vanadium from fly ash using lemon juice organic acids.

[This corrects the article DOI: 10.1039/C9RA09325G.].

[Safety of del Nido cardioplegia in coronary artery bypass grafting combined with heart valve replacement in adults].

Objective: To investigate the safety and myocardial protective effect of del Nido cardioplegia in coronary artery bypass grafting combined with heart valve replacement in adults. Methods: From April 2018 to April 2019, 84 patients undergoing coronary artery bypass grafting combined with heart valve replacement under cardiopulmonary bypass (CPB) in the Second Affiliated Hospital of Nantong University and Shanghai Chest Hospital were selected, and divided into del Nido cardioplegia (n=44) group and Thomas cardioplegia (n=40) group using a random number table. The concentration of troponin was measured before anesthesia induction and 2, 12 and 24 hours after the termination of CPB, respectively. Results: The preoperative characteristics of each group were similar, including age, underlying diseases, and body surface area (all P>0.05). The frequency of intraoperative cardioplegia infusion in the del Nido group was significantly lower than that in the Thomas group (P=0.03). Compared with the del Nido group, troponin concentration in the Thomas group increased significantly at 12 hours [(4.59±0.76) µg/L vs (2.20±0.53) µg/L, t=-16.653, P<0.001] and 24 hours [(6.70±0.97) µg/L vs (1.96±0.58) µg/L, t=-26.975, P<0.001] after CPB. No statistically significant differences were found in the postoperative recovery of cardiac autonomic rhythm (P=0.887), cardiac defibrillation (P=0.880), positive inotropic drugs (P=0.163) and left ventricular ejection fraction (P=0.338) between the two groups. Conclusions: It is safe to use del Nido cardioplegia in coronary artery bypass grafting combined with heart valve replacement in adults, which can reduce the frequency of cardioplegia infusion and simplify the surgical procedure. The trend of troponin concentration suggests that del Nido cardioplegia has a better myocardial protective effect.

[Application research on carotid arterial shunting during simultaneous coronary artery bypass grafting and carotid endarterectomy].

Objective: The optimal operative strategy in patients with asymptomatic severe carotid artery stenosis undergoing coronary artery bypass grafting (CABG) is unknown. We sought to investigate the safety of carotid arterial shunting during simultaneous CABG and carotid endarterectomy (CEA). Methods: The clinical data of patients undergoing synchronous combined CEA and CABG in the First Hospital of China Medical University between March 2017 and July 2019 was retrospectively studied. Patients with asymptomatic severe carotid artery stenosis ≥70% according to NASCET (North American Symptomatic Carotid Endarterectomy Trial) were required CABG surgery. During conventional CEA, carotid arterial shunting was used in all cases. Results: Ten patients were recruited. The average clamping time of carotid artery was 5 minutes. The average follow-up time was 10 months. We did not observe stroke, cerebral hyper perfusion syndrome, death and carotid restenosis. Conclusions: Carotid arterial shunting during synchronous combined CEA and CABG was helpful for obtaining good curative effect.