Objective To explore whether CCL18 is involved in regulating the expression of miRNAs in breast cancer.Methods The expression profile of miRNAs in the breast cancer cell following CCL18 treatment was determined by miRNAs microarray analysis.Then we performed QRT-PCR and Luciferase Reporter Assay to validate the results from the miRNAs microassay.We used transient transfection to change the expression of miR98 and c-myc in breast cancer cells.We then used QRT-PCR and Western blot to analyze the mechanism by which CCL18 downregulates the expression of miR98 in breast cancer cells.Results miRNAs microarray analysis showed that cells treated with CCL18 differentially expressed 20 miRNAs genes compared with those in the control group. Our QRT-PCR and Luciferase Reporter Assay confirmed the result.The mRNA and protein expressions of C-myc and lin28 were increased after CCL18 stimulation in breast cancer cells.Transfection with c-myc siRNAs rescued the increase of lin28 and loss of miR98 expression caused by CCL18 stimulation.Our results also showed that CCL18 could upregulate the expression of N-Ras at post-transcription level.Conclusion CCL18 downregulates the expression of miR98 via N-Ras/c-myc/lin28 pathway.The downregulated miR98 increases the expression of N-Ras after transfection,which further activates c-myc/lin28 pathway and forms a positive feedback loop.

Objective:To explore the application effect of the modified presentation assimilation discussion combined with heuristic clinical medicine teaching in training of extracorporeal membrane oxygenation specialist nurses.Methods:The convenient sampling method was used to select 62 nurses who participated in training of extracorporeal membrane oxygenation specialist nurses in the Second Affiliated Hospital of Zhengzhou University from January to June 2023 as the research objects. A total of 30 nurses who participated in the 25th training session from January to March 2023 were selected as the control group, and 32 nurses who participated in the 26th training session from April to June 2023 were selected as the observation group. The control group received conventional training method, while the observation group received modified presentation assimilation discussion combined with heuristic clinical medicine teaching. The theoretical knowledge and operational skills of nurses, core competence of extracorporeal membrane oxygenation specialist nurses and training satisfaction were compared between the two groups after training.Results:After training, the scores of theoretical knowledge and operational skills, core competence of extracorporeal membrane oxygenation specialist nurses and training satisfaction in observation group were higher than those in control group, and the differences were statistically significant ( P<0.05) . Conclusions:The modified presentation assimilation discussion combined with heuristic clinical medicine teaching can improve the theoretical knowledge and operational skills of extracorporeal membrane oxygenation specialist nurses, and the nurses' training satisfaction is higher.

Objective:To construct an inter-hospital standardized transport scheme for patients supported by extracorporeal membrane oxygenation (ECMO) combined with modified early warning score (MEWS) and the transport checklist based on the theory of process reengineering.Methods:Through literature review, according to the actual situation of the Second Affiliated Hospital of Zhengzhou University, the MEWS scores and transport verification sheets were effectively combined to construct the inter-hospital standardized transport scheme for patients supported by extracorporeal membrane oxygenation. And according to the inter-hospital standardized transport scheme, the medical staff in the transport team were trained and assessed for ECMO patient transport knowledge. Using the convenient sampling method, a total of 223 ECMO patients admitted to the Second Affiliated Hospital of Zhengzhou University from January to December 2019 who were transported by conventional transport were selected as the control group. A total of 222 ECMO patients who were transported by the ECMO interhospital standardized transport scheme from January to December 2020 were selected as the observation group. This study Compared the incidence of adverse transport events in the two groups of and the transport knowledge of medical staff in the transport group before and after training.Results:The score of transport knowledge of ECMO patients of medical staff after training were higher than those before training, and the difference was statistically significant ( P<0.01) . The incidence of transport adverse events in the observation group was lower than that in the control group, and the difference was statistically significant ( P<0.05) . Conclusions:The standardized inter-hospital transport scheme for ECMO patients can form an efficient and safe standardized transport process, reduce the incidence of adverse transport events and improve the transport safety of ECMO patients.