Objective:To assess the effectiveness of Buzzy? device in alleviating pain and anxiety in children during puncture-related operation,and to provide more comprehensive intervention option for puncture-related management of children.Methods:Randomized controlled trials(RCTs)about the application of Buzzy? device in puncture-related pain and anxiety of children were searched from China National Knowledge Infrastructure(CNKI),Wanfang,VIP,PubMed,Embase and Web of Science(WOS)databases.The retrieval time was from the establishment of the database to July 2023.In the interventions measures,the control groups used different methods that included standard care group,ShotBlocker device group and distraction card group.The obtained 528 relevant literatures were implemented literature selection and data extraction by two independent reviewers according to the established inclusion and exclusion criteria.RevMan5.4 and Stata17.0 software were adopted to conduct Meta-analysis for the pain and anxiety of main outcome indicators,and the success rate of the first puncture,parents'satisfaction and adverse events of secondary outcome indicators in the literatures.Results:A total of 20 eligible studies that could meet the conditions were included,involving 2 876 children,including 1 110 children in the Buzzy? device group and 1 766 children in the control group.The Buzzy? device group was better than the standard care group and the distraction card group in alleviating puncture-related operation pain in children,and the differences of that among them were statistical significance(Z=7.18,2.13,P<0.05),and was better than the standard care group in anxiety,and the difference was statistical significance(Z=5.00,P<0.05).The Buzzy? device group and the distraction card group were better than standard care group and Shotblocker device group in satisfaction,and the difference was significant(x2=63.236,P<0.05).The interventions in the Buzzy? device group and other groups did not have effect on the success rate of the first puncture and incidence of adverse event.Conclusion:The Buzzy? device can alleviate pain and anxiety of children during puncture operation,and improve children's satisfaction for puncture operation.It does not affect the success rate of puncture,and there is not adverse events in its operation.

Objective:To assess the effectiveness of Buzzy? device in alleviating pain and anxiety in children during puncture-related operation,and to provide more comprehensive intervention option for puncture-related management of children.Methods:Randomized controlled trials(RCTs)about the application of Buzzy? device in puncture-related pain and anxiety of children were searched from China National Knowledge Infrastructure(CNKI),Wanfang,VIP,PubMed,Embase and Web of Science(WOS)databases.The retrieval time was from the establishment of the database to July 2023.In the interventions measures,the control groups used different methods that included standard care group,ShotBlocker device group and distraction card group.The obtained 528 relevant literatures were implemented literature selection and data extraction by two independent reviewers according to the established inclusion and exclusion criteria.RevMan5.4 and Stata17.0 software were adopted to conduct Meta-analysis for the pain and anxiety of main outcome indicators,and the success rate of the first puncture,parents'satisfaction and adverse events of secondary outcome indicators in the literatures.Results:A total of 20 eligible studies that could meet the conditions were included,involving 2 876 children,including 1 110 children in the Buzzy? device group and 1 766 children in the control group.The Buzzy? device group was better than the standard care group and the distraction card group in alleviating puncture-related operation pain in children,and the differences of that among them were statistical significance(Z=7.18,2.13,P<0.05),and was better than the standard care group in anxiety,and the difference was statistical significance(Z=5.00,P<0.05).The Buzzy? device group and the distraction card group were better than standard care group and Shotblocker device group in satisfaction,and the difference was significant(x2=63.236,P<0.05).The interventions in the Buzzy? device group and other groups did not have effect on the success rate of the first puncture and incidence of adverse event.Conclusion:The Buzzy? device can alleviate pain and anxiety of children during puncture operation,and improve children's satisfaction for puncture operation.It does not affect the success rate of puncture,and there is not adverse events in its operation.

Objective To determine the anti-lung cancer effect of koumine(KOU)and total alkaloids of Gelsemium elegans Benth(TAG)and investigate the underlying mechanism.Methods After low,medium and high concentrations(100,150,200 μg/mL)of KOU were used to treat human lung adenocarcinoma cell lines A549 and SPCA1,Live Cell Imaging and Analysis by Sartorius colony formation assay was employed to detect the cell proliferation.The transplanted tumor model of lung cancer cells in mice was constructed and divided into model group(model group),cyclophosphamide group(CTX group,20 mg/kg),KOU group(2 mg/kg)and TAG group(0.5 mg/kg).After the mice of the CTX,KOU and TAG groups were intraperitoneally injected with 0.1 mL/10 g corresponding agents every other day for 10 d,the growth of lung cancer solid tumors was observed grossly and with HE staining,immunohistochemical(IHC)assay and TUNEL staining to and calculate the tumor size and growth inhibitory rate.RNA sequencing analysis was performed on A549 cells treated with TAG for 48 h to screen the differentially expressed genes(DEGs)between the treatment group and the control group,and the obtained DEGs were further analyzed with Kyoto Encyclopedia of Genes and Genomes(KEGG)and Gene Ontology(GO)functional enrichment analyses.RT-qPCR was applied to further analyze and verify the expression of related genes.Results Live Cell Imaging and Analysis fitted that the confluence of A549 and SPCA1 cells was decreased and the number of cells in the treated groups was observed to decrease,with poor growth.The results of colony formation assay confirmed that KOU reduced the number of cell clones,especially at a dose of 200 μg/mL(P＜0.01).Animal experiments showed that KOU and TAG treatment inhibited the tumor growth by 24.55％and 36.08％,respectively.TAG treatment resulted in significantly decreased tumor size when compared with the model group(P＜0.05).RNA sequencing analysis revealed that there were totally 2 793 DEGs,including 1 433 up-regulated genes and 1 360 down-regulated ones.Enrichment analysis displayed that the DEGs were mainly enriched in IL-17 signaling pathway,tumor necrosis factor signaling pathway and P53 signaling pathway.The results of RT-qPCR were consistent with the results of RNA sequencing analysis.The expression levels of GADD34,ZFP36,GADD45 A,GADD45 B and TP53INP2 genes were significantly increased in the TAG group(P＜0.01).Conclusion Alkaloids of Gelsemium elegans Benth inhibits the proliferation of lung cancer in vivo and in vitro.Transcriptomics find that KOU and TAG inhibit multiple DEGs and pathways of lung cancer.

An 82-year-old male patient with cerebral infarction received an IV infusion of cinepazide maleate 320 mg + 0. 9% sodium chloride injection once daily for 30 consecutive days. The patient' s neutrophil count(NEUT)was 5. 7 × 109 / L before treatments and 2. 4 × 109 / L on day 28 of treatments. An interval of 5 days later,cinepazide maleate was given again at the same dosage. On day 6 of second use of cinepazide maleate,the patient's NEUT decreased to 0. 2 × 109 / L. Cinepazide maleate was stopped and mecobalamin(500 μg,twice daily),folic acid(5 mg,once daily),and leucogen(20 mg,twice daily) were given. Two days later,the patient's NEUT decreased to 0. Recombinant human granulocyte colony stimulating factor 200 μg twice daily was injected subcutaneously. Two days later,the patient' s NEUT increased to 4. 5 × 109 / L. The patient received cinepazide maleate combined with 15 kinds of drugs at the same time because he suffered from several kinds of diseases. During 18 months of follow-up,the patient did not take cinepazide maleate again and most other combination drugs were used continuously and neutropenia did not recur. It was considered that cinepazide maleate induced the patient's acute agranulocytosis.

An 82-year-old male patient with cerebral infarction received an IV infusion of cinepazide maleate 320 mg + 0. 9% sodium chloride injection once daily for 30 consecutive days. The patient' s neutrophil count(NEUT)was 5. 7 × 109 / L before treatments and 2. 4 × 109 / L on day 28 of treatments. An interval of 5 days later,cinepazide maleate was given again at the same dosage. On day 6 of second use of cinepazide maleate,the patient's NEUT decreased to 0. 2 × 109 / L. Cinepazide maleate was stopped and mecobalamin(500 μg,twice daily),folic acid(5 mg,once daily),and leucogen(20 mg,twice daily) were given. Two days later,the patient's NEUT decreased to 0. Recombinant human granulocyte colony stimulating factor 200 μg twice daily was injected subcutaneously. Two days later,the patient' s NEUT increased to 4. 5 × 109 / L. The patient received cinepazide maleate combined with 15 kinds of drugs at the same time because he suffered from several kinds of diseases. During 18 months of follow-up,the patient did not take cinepazide maleate again and most other combination drugs were used continuously and neutropenia did not recur. It was considered that cinepazide maleate induced the patient's acute agranulocytosis.