Objective To study the prevention and treatment of vascular vagovagal reflexes (VVRs) in patients with cardiovascular disease during intervention. Methods The causes and results in 61 patients with VVRs during intervention of 2100 patients were analysed. Results In 61 patients with VVRs, there were 12 cases having vascular restriction, 7 cases with heart restriction, 42 cases with mixed type. All patients were recovered after treatment, no adverse reaction happened. Conclusions The major causes of VVRs during interventional treatment were mental tension, pain, low blood volume and expansive stimulation of hollow organs. Preventive measure and prompt treatment are necessary.

According to the current situation of the medical education in vocational colleges and the problems in the practical skills examination of the associate physician qualification for this type of medical students,the reformation of training and evaluating the practical skills of diagnosis for such students is studied in the paper.As a result,the clinical practical ability of the students is improved,and it can make the graduates obtain the graduation and qualification diploma successfully.

Objective To study the clinical effect of lienal polypeptide injection combined with chemotherapy on patients with advanced diffuse large B-cell lymphoma. Methods Sixty patients with advanced diffuse large B-cell lymphoma were randomly divided into investigative group (30 cases) and control group (30 cases). Patients in the investigative group were administrated with lienal polypeptide injections when undergoing chemotherapy, while patients in the control group were given only chemotherapy. The clinical effect and immune function in the two groups were compared. Results After chemotherapy, the average Karnofsky score and T cell subpopulations in the investigative group were higher than those in the control group (all P<0.05). At the same time, the rate of chemotherapy related hematologictoxicity in the investigative group was significantly lower than that in the control group (P<0.05). The response rates of investigative group and control group were 80 %(24/30) and 73 %(22/30), respectively, with no statistical significance (P=0.897). Conclusion During chemotherapy, the addition of lienal polypeptide injection will improve the immune function of patients with advanced diffuse large B-cell lymphoma, stimulate bone marrow function and improve the quality of life.

Objective: To investigate the clinical manifestations, pathological features, diagnosis and treatment of myeloid sarcoma, and to improve the understanding of myeloid sarcoma. Methods: The clinical data, diagnosis and treatment of 7 patients with myeloid sarcoma were retrospectively analyzed. Results: Of the 7 patients with myeloid sarcoma, 1 was male and 6 were female. In most patients, the local compression symptoms caused by painless local masses or masses were the first manifestations. One patient had lesions involving the cervix and vaginal bleeding was the first symptom. The lesions were extensive with 19 sites involved. The positive proportion of immunohistochemical staining was 6/6 for CD43, 6/7 for MPO, 4/5 for CD117, 4/4 for LCA, 3/5 for CD34 and 2/2 for CD99. Lymphocyte markers CD3 and CD20 were negative in all 7 patients. Conclusions Myeloid sarcoma is a rare hematological malignancy. Early diagnosis and active treatment are the key to improve prognosis. Current treatments include systemic chemotherapy, surgical resection, radiation therapy, and hematopoietic stem cell transplantation.

Objective To analyze driver genes status and its clinical characteristics of advanced lung adenocarcinoma, then evaluate the status of first-line treatment in a single centric real-world. Methods EGFR, ALK, ROS-1 gene in 204 advanced lung adenocarcinoma tissue were tested by ARMS-PCR method. And the relationship between driver genes status and clinical characteristics was analyzed as the first line treatment in real clinical practice. Results The positive rate of driver genes status in 204 advanced lung adenocarcinoma was 53.9％ (110/204) , including EGFR mutation 46.1％ (94/204) , ALK positive 6.4％ (13/204) and ROS1 positive 1.5％ (3/204). The driving genes status was significantly correlated with gender, smoking history, tumor staging and serosal invasion (P < 0.05). There were significantly differences among the proportion of first-line standard treatment in different subgroup (P = 0.000) , the first-line standard treatment rate of EGFR mutation, ALK/ROS1 positive and drive gene negative were 77.7％, 37.5％, and 46.8％ respectively. And the ratio of using 1 st generation EGFR-TKIs in all patients is 70.6％ (60/85). Conclusion More than half of advanced lung adenocarcinoma have driver genes changes, and EGFR-TKI first-line treatment has higher acceptability in real-word.

Objective:To explore the effects of different health education methods on patients with enterostomy using a network Meta-analysis, so as to provide a theoretical basis for patients with enterostomy to choose the health education method.Methods:Randomized controlled trials (RCTs) on the effects of different health education methods in patients with enterostomy were electronically searched in PubMed, Web of Science, Embase, Cochrane Library, Medline, CINAHL, China National Knowledge Infrastructure, China Biology Medicine disc, VIP, and WanFang Data, supplemented by other manual search methods. The search period was from database establishment to May 31, 2023. This study extracted data, conducted methodological quality evaluation, and used Stata 15.0 software for network Meta-analysis.Results:A total of 30 RCTs were included, involving 7 health education methods. The probability ranking of the network Meta-analysis showed that in terms of enhancing self-care ability, the effects were ranked from high to low as personalized education, internet platform education, nursing pathway education, visual education, mind mapping education, peer support education, and routine health education. In terms of promoting the level of stoma adaptation, the order of effects from high to low was visual education, internet platform education, peer support education, and routine health education. In terms of improving quality of life, the order of effects from high to low was internet platform education, personalized education, peer support education, and routine health education.Conclusions:Personalized education has certain advantages in enhancing the self-care ability of patients with enterostomy, visual education is advantageous in promoting the social adaptation of patients, and internet platform education has certain advantages in improving the quality of life. This study can effectively guide clinical nurses to choose appropriate health education methods based on the purpose of health education, in order to heighten the effectiveness of patient health education.

Objective:To investigate the effect of infused CD34 + cell count on hematopoietic recovery and prognosis of non-Hodgkin lymphoma (NHL) patients after autologous peripheral blood hematopoietic stem cell transplantation (APBSCT). Methods:The data of 60 NHL patients who underwent APBSCT from May 2010 to May 2016 in the Affiliated Cancer Hospital of Shanxi Medical University was retrospectively analyzed, including 32 B-NHL patients and 28 T-NHL patients. The patients were grouped according to the receiver operating characteristic curve (ROC) threshold, and the hematopoietic reconstruction after transplantation was analyzed. The relationship between the infused CD34 + cell count and prognosis was analyzed. The prognostic factors were analyzed using univariate and multivariate analyses. Results:The CD34 + cell count threshold was determined to be 4.35×10 6/kg based on ROC. In CD34 + cell count≥ 4.35×10 6/kg group (20 cases) and CD34 + cell count < 4.35×10 6/kg group (40 cases), the granulocyte recovery time was (9.9±1.2) d and (12.5±3.7) d ( P = 0.031), and the platelet recovery time was (9.4±1.7) d and (13.8±2.9) d ( P = 0.012). The 3-year overall survival(OS) rates in CD34 + cell count ≥ 4.35×10 6/kg group and CD34 + cell count < 4.35×10 6/kg group were 85.0% and 55.0% ( P = 0.024), and the 3-year PFS rates were 85.0% and 57.5% ( P = 0.016). In B-NHL patients, the 3-year PFS rates in CD34 + cell count ≥ 4.35×10 6/kg group (11 cases) and CD34 + cell count < 4.35×10 6/kg group (21 cases) were 81.8% and 42.9% ( P = 0.037), respectively. In T-NHL patients, the 3-year OS rates in CD34 + cell count ≥ 4.35×10 6/kg group (9 cases) and CD34 + cell count < 4.35×10 6/kg group (19 cases) were 77.8% and 36.8% ( P = 0.049), respectively. Univariate survival analysis showed that the predictive factors of both OS and PFS included age > 60 years old, Ann Arbor stage Ⅲ-Ⅳ, international prognostic index (IPI) score > 2 and infused CD34 + cell count < 4.35×10 6/kg (all P < 0.05). Multivariate analysis showed that IPI score and infused CD34 + cell count were both independent predictive factors of PFS ( RR = 0.333, 95% CI 0.112-0.994, P = 0.049; RR = 0.190, 95% CI 0.047-0.773, P = 0.020), and IPI score was an independent predictive factor of OS ( RR = 0.095, 95% CI 0.011-0.837, P = 0.034). Conclusion:The infused CD34 + cell count affects the hematopoietic reconstruction time and component blood transfusion after APBSCT, and has certain predictive value for the prognosis of NHL patients.

Objective The aim of this study was to investigate the expression of microRNA-150(miR-150)in human epi-thelial ovarian cancer cells and its effect on proliferation,apoptosis,invasion and metastasis of human epithelial ovarian cancer cells. Methods The expression level of miR-150 in cells from each treatment group was detected by Real-Time PCR(qRT-PCR);effects of proliferation,apoptosis,invasion and metastasis of epithelial ovarian cancer cells was investigated by MTT,flow cytometry, and transwell assays. Results Compared with normal ovarian epithelial cells(T29),the expression of miR-150 was significantly de-creased in epithelial ovarian cancer cells(A2780 and OVCAR3)(P<0. 01); After transfection miR-150 mimic,the expression of miR-150 in A2780 and OVCAR3 cells was significantly increased(P<0. 01);After 3 d of transfection,the OD values of the miR-150mimicgroup(A2780:1.12±0.03;OVCAR3:1.91±0.03)werelowerthanthatintheblankgroup(A2780:2.35±0.09;OVCAR3:2.63 ±0.07)and the miR-150 NC group(A2780:2.18 ±0.07;OVCAR3:2.43 ±0.11)(P<0.01);The apoptotic rate in the miR-150 mimic group(A2780:16. 10 ± 0. 58% ;OVCAR3:15. 16 ± 1. 30% ) were significantly increased when compared to the blank group(A2780:10. 07 ± 0. 66%;OVCAR3:3. 81 ± 0. 24%) and the miR -150 NC group(A2780:10. 36 ± 1. 08%;OVCAR3:4.89 ±0.07%)(P<0.01);The number of transmembrane cells in the miR-150 mimic group(A2780:38.67 ±2.03;OVCAR3:28. 67 ± 2. 03)was higher than that in the blank group(A2780:76. 30 ± 7. 45;OVCAR3:55. 67 ± 3. 18)and the miR-150 NC group(A2780:74. 33 ± 5. 78;OVCAR3:56. 33 ± 3. 84)(P<0. 01). Conclusion The decreased expression of miR-150 in epi-thelial cancer cells may be one of the mechanisms of proliferation,invasion and metastasis of epithelial ovarian cancer. Up-regulation of miR-150 may inhibit the proliferation of epithelial ovarian cancer cells and promote apoptosis to reduce the abilities of invasion and metastasis in epithelial ovarian cancer cells.

Objective:To investigate the immune effects of Clostridium difficile toxoid B (CdtB) vaccine formulated with different mucosal adjuvants through microneedle immunization, and to provide ideas for the prevention and treatment of Clostridium difficile infection. Methods:CdtB vaccine was prepared with purified Clostridium difficile toxin B(TcdB) after formaldehyde detoxification. Female BALB/c mice were immunized with different doses of vaccine alone or in combination with mucosal adjuvants. The titers of specific serum IgG and fecal IgA were detected at 0 d, 7 d, 14 d, 28 d and 42 d after immunization. The protective effects of CdtB vaccine were evaluated by cell neutralization assay and Clostridium difficile challenge infection. Results:(1) With the increase of immune dose, the mice immunized with CdtB vaccine alone by microneedle not only produced better serum specific IgG, but also had higher level of IgA in feces. (2) When the mice were immunized with CdtB vaccine containing LT or CTB adjuvant by microneedle, the trend of serum specific IgG titer in each group increased with the increase of immune dose, especially in the group containing LT adjuvant. There were significant differences in the trend of specific IgA titer in feces between the adjuvant groups and the group without adjuvant, but the adjuvant effect was not obvious. (3) No significant difference in serum IgG titer was observed between the mice immunized with 10 μg CdtB by microneedle or intraperitoneal injection, but microneedle immunization significantly increased fecal IgA level. (4) The neutralization titers of specific antibodies in mouse serum after immunization and the test results of challenge protection in mice confirmed that the use of CdtB vaccine had certain protective effects.Conclusions:CdtB vaccine had better immune effects in mice through microneedle immunization, but the adjuvant effects of LT and CTB were not significant.

Objective The aim of this study was to investigate the expression of miR-455-5p in epithelial ovarian cancer and its effect on the development of epithelial ovarian cancer. Methods The miRNA expression data of normal ovarian epithelial tis-sues and epithelial ovarian cancer tissues GSE83693 were downloaded from the GEO database. Differential expression analysis was used to obtain differential expression data of miRNAs in epithelial ovarian cancer. The expression of miR-455 -5p was analyzed whether there is difference expression between normal ovarian epithelium and epithelial ovary cancer tissues; qRT-PCR was used to verify the differential expression prediction results; bio-informatics software was used to analyze the KEGG pathway enrichment and GO gene function annotation of miR-455-5p target genes,and to explore the disorders of dyregulated miR-455-5p in the devel-opment of epithelial ovarian cancer. Results A total of 101 cases of differentially expressed miRNAs were screened,34 cases were up-regulated and 67 cases were down-regulated. Among them,miR-455-5p was down-regulated significantly(P<0. 01),and the different fulds were -2. 9019. The results of qRT-PCR showed that the expression of miR-455-5p in epithelial ovarian cancer cells(SKOV-3,OVCAR-3 and A2780)was significantly lower than that in normal ovarian epithelial cells(IOSE-80),and the dif-ferential expression was statistically significant(P<0. 05). The results of KEGG pathway enrichment analysis showed that miR-455-5p regulated target genes mainly involved in five pathways,including TGF-β signaling pathway,Hippo signaling pathway,ECM-receptor interaction,transcriptional dysregulation pathway in cancer,and chronic granule cellular leukemia,which were associated with tumors. GO functional annotation analysis showed that the target genes regulated by miR-455-5p in the above pathway was mainly involved in protein phosphorylation,promoted cell proliferation and migration,inhibited apoptosis,promoted epithelial-mesenchymal transition,regulated transcription and regulated cell cycle,etc. ,which associated with tumorigenesis. Conclusion The expression of miR-455-5p is down-regulated in epithelial ovarian cancer. The miR-455-5p target genes are involved in the pathogenesis and function of epithelial ovarian cancer,and are associated with the development of epithelial ovarian cancer.