Objective:Preliminary explore the safety and efficacy of using only vitamin K antagonists without antiplatelet therapy after left ventricular assist devices (LVAD) implantation.Methods:This is a cohort study. Patients who underwent HeartCon LVAD implantation in TEDA International Cardiovascular Hospital from September 2020 to September 2022 were included. Oral warfarin sodium was given on postoperative days 1 to 2, with the target international standardized ratio (INR) of 2.0 to 2.5. Follow-up until September 2022, survival, INR level and occurrence of bleeding and thrombosis were recorded. Survival analysis was performed by the Kaplan-Meier method (censored for heart transplantation).Results:A total of 22 patients, including 16 male patients (72.7%), aged (51.0±13.3) years, were included. The duration of HeartCon LVAD support was (458±166) days and the INR during support was 2.28±0.26. One patient underwent the heart transplant at 307 d after implantation. One patient (4.5%) occured cardiac tamponade, two patients (9.1%) occured hemorrhagic stroke, five patients (22.7%) occured gastrointestinal bleeding, four patients (18.2%) occured gingival hemorrhage, two patients (9.1%) occured epistaxis, one patient (4.5%) occurred ischemic stroke, one patient (4.5%) occured pump thrombosis, and one patient (4.5%) occured aortic valve thrombosis. The survival rates were 100%, 95%, 95%, and 95% at 3 months, 6 months, 1 year, 2 years after implantation respectively.Conclusion:The single antithrombotic strategy using warfarin (target INR 2.0-2.5) without antiplatelet for patients with implantations of HeartCon type LVAD may be safe and effective.

Objective To investigate the status quo of fear of disease progression(FoP)in patients after pituitary neuroendocrine tumour surgery and analyse the medication effects of positive coping style on disease perception and FoP.Methods Convenient sampling method was used to select 345 patients with pituitary neuroendocrine tumours who underwent surgical operations in the neurosurgery department of a Grade IIIA hospital in Shanxi Province from January 2022 to January 2023 as the research objects.A general data questionnaire,disease perception questionnaire,medical coping style questionnaire and fear of progression questionnaire-short form(FoP-Q-SF)were used in the investigation.Pearson correlation was employed to analyse the correlations of the disease perception,active coping style and FoP among the patients.Structural equation models were used to analyse the mediating effects of positive coping styles on disease perception and FoP.Results The FoP score of patients after pituitary neuroendocrine tumour surgery was found at(35.02±4.92).FoP was positively correlated with the disease perception(r=0.672,P<0.01),and negatively with the active coping style(r=-0.679,P<0.01).Positive coping styles were positively correlated with disease perception(r=-0.610,P<0.01).Disease perception not only had a direct effect on FoP,but also had an indirect effect on FoP via active coping style,with an intermediate effect value of 0.202(P<0.001),accounting for 25.5%of total effect.Conclusion Postoperative positive coping style in patients with pituitary neuroendocrine tumour is a mediating variable between the disease perception and FoP.Medical staff should dynamically assess and early identify coping styles of patients and adopt personalised guidance programs,therefore to guide the patients to actively cope with the disease,so as to reduce the negative disease perception and alleviate the fear of disease progression of the patients.

Objective To investigate the role of long non-coding RNA(lncRNA)-ROR in mediating epithelial-mesenchymal transformation(EMT)and its impact on radiotherapy resistance in nasopharyngeal carcinoma cells.Methods Nasopharyngeal carcinoma cells CNE2 were divided into blank group,negative control(NC)group and lncRNA-ROR siliencing group;or were divided into blank group,radiotherapy group,radiotherapy+NC group,and radiotherapy+lncRNA-ROR overexpression group(radiotherapy treated with 6 Gy radiation for 24 h).The CNE2 proliferation was detected by cell counting kit 8 method.The cell migration was detected by cell scratch test and Transwell cell migration test.The apoptosis ratio was detected by flow cytometry,and the apoptosis-related proteins and epithelial-mesenchymal transition proteins were detected by Western blotting.Results Compared with the blank group and NC group,the proliferation ability of nasopharyngeal carcinoma cells CNE2 was decreased after inhibition of lncRNA-ROR expression for 48 and 72 h(all P＜0.05).The mobility of CNE2 cells after lncRNA-ROR expression inhibition was lower than that in the NC group(P＜0.05).The migration ability of CNE2 cells in the radiotherapy+lncRNA-ROR overexpression group was higher than that in the radiotherapy group and radiotherapy+NC group(both P＜0.05).Compared with the radiotherapy group and radiotherapy+NC group,the apoptosis rates of CNE2 cells in the radiotherapy+lncRNA-ROR overexpression group was decreased(both P＜0.05).After lncRNA-ROR inhibition,the expression of activated caspase 3 and caspase 9 proteins was increased(both P＜0.05),while the expression of activated caspase 3 and caspase 9 proteins was decreased in the radiotherapy+overexpressed lncRNA-ROR group(both P＜0.05).Inhibition of lncRNA-ROR increased the expression of epithelial marker proteins(E-cadherin,β-catenin),and decreased the expression of interstitial marker proteins(N-cadherin,vimentin).The epithelial marker protein expression was decreased and interstitial marker protein expression was increased in CNE2 cells in the radiotherapy+lncRNA-ROR overexpression group compared with the radiotherapy group and radiotherapy+NC group(all P＜0.05).Conclusion lncRNA-ROR can affect the radiotherapy resistance of nasopharyngeal carcinoma cells by regulating their proliferation,migration,apoptosis and EMT,and it is a potential target for reversing the radiotherapy resistance of nasopharyngeal carcinoma cells.

Malignant tumors are one of the main causes of human death worldwide and pose a serious threat to human health. The current treatment methods are mainly the combination of chemotherapeutics， surgery， radiotherapy， or hormone therapy. The treatment process has limitations such as multidrug resistance， non-selective targeting of cancer cells， and drug toxicity. With the development and application of traditional Chinese medicine （TCM）， Chinese medicine has the characteristics of multi-angle and multi-mechanism coordination and slight toxic and side effects. It can effectively inhibit tumor proliferation， differentiation， and metastasis， and avoid drug resistance， serving as the focus of current tumor treatment research. Hedysari Radix， one of the genuine medicinal materials in Gansu province， is a tonic Chinese medicine with a wide range of pharmacological effects such as anti-inflammation， immune regulation， anti-oxidation， prevention and treatment of diabetic complications. In the majority of the ancient works on herbs of the past dynasties， Hedysari Radix was included under the item of Astragali Radix and used as Astragali Radix. Hedysari Radix is superior to Astragali Radix in enhancing immunity， scavenging free radicals， and resisting liver fibrosis. Studies have found that the effective components of Hedysari Radix have a prominent anti-tumor effect and a significant inhibitory effect on various malignant tumors such as liver cancer， bladder cancer， gastric cancer， breast cancer， and colorectal cancer. They can also combine with clinical anti-cancer drugs to reduce the toxic and side effects of chemotherapy drugs and improve the tolerance of patients during chemotherapy. On the basis of current research， this study summarized the mechanism of Hedysari Radix active components in inducing cell apoptosis， blocking cell cycle， inhibiting tumor cell proliferation， migration， and invasion， regulating micro mRNA （miRNA）， inducing cell autophagy， enhancing immune regulation， as well as reducing toxicity and enhancing efficiency and sensitization with clinical chemotherapeutics， and systematically explained the anti-tumor mechanism of Hedysari Radix active components， aiming to provide a basic reference for the further exploration of the anti-tumor mechanism of Hedysari Radix and the further development and utilization of its effective components.

Objective:To explore the effect of pain nursing based on acknowledge, introduce, duration, explanation, thank you (AIDET) communication model on postoperative pain and psychological resilience of patients with tibial fractures.Methods:From January 2019 to April 2021, convenience sampling was used to select 98 patients with tibial fractures from Shanxi Provincial People's Hospital as the study subject. A total of 56 patients who received routine nursing before May 2020 were assigned to the control group, and 42 patients who received pain nursing based on AIDET communication model after May 2020 were assigned to the observation group. All patients received nursing intervention from 12 nurses in the department. The scores of the Self-Rating Anxiety Scale (SAS) , Pittsburgh Sleep Quality Index (PSQI) , Self-Rating Depression Scale (SDS) , and Connor-Davidson Resilience Scale (CD-RISC) , as well as the pain before and after 10 days of intervention between two groups of patients were compared. The ambulation time, hospital stay, and fracture healing time between the two groups of patients were compared.Results:After intervention, the SAS, SDS, and PSQI scores of the observation group were lower than those of the control group ( P<0.05) , while the scores of all dimensions of CD-RISC were higher than those of the control group ( P<0.05) , and the differences were statistically significant. The severity of pain in the observation group was lower than that in the control group, and the difference was statistically significant ( P<0.05) . After follow-up, the ambulation time and fracture healing time in the observation group were shorter than those in the control group with statistical differences ( P<0.05) . Conclusions:AIDET communication model-based pain nursing in patients with tibial fractures can alleviate negative emotions and postoperative pain, and promote postoperative recovery.

Objective:To investigate and evaluate the efficacy of HeartCon left ventricular assist device (LVAD) in the treatment of adult patients with end-stage heart failure (ESHF).Methods:A prospective and observational study was conducted. Patients with ESHF who underwent LVAD implantation in the department of cardiac surgery of Teda International Cardiovascular Hospital from September 2020 to August 2021 were selected. The left ventricular end-diastolic diameter (LVEDD), left ventricular ejection fraction (LVEF), New York Heart Association (NYHA) classification, N-terminal pro-B type natriuretic peptide (NT-proBNP), and six minute walk distance (6MWD) before operation and 90 days after operation were compared. The incidence of equipment failures and major adverse events within 90 days after operation were recorded.Results:A total of 20 patients with ESHF were included, with 15 males and 5 females. Patients' age ranged from 20 to 67 years old, with an average of (50.2±13.6) years old. The range of body weight was 49.8-106.1 kg, with an average of (67.9±15.5) kg, and the body surface area (BSA) was from 1.49 to 2.32 m 2, with an average of (17.6±0.22) m 2. The operation process of all the patients were successful. The length of hospital stay ranged from 33 to 90 days, and the average was 56.0 (42.8, 75.0) days. Complications within 90 days after operation as follows, 2 cases with pericardial tamponade (10%), 1 case with cerebral hemorrhage (5%), 1 case with mediastinum infection (5%), 3 cases with acute renal injury (AKI, 15%), 5 cases with gastrointestinal bleeding (25%). There were no mechanical failure of LVAD and hemolysis events, right ventricular failure (RVF), cerebral infarction and death occurred. Compared with preoperative, the LVEDD significantly decreased (mm: 67.50±13.98 vs. 77.40±9.73), LVEF significantly increased (%: 34.80±9.76 vs. 22.70±5.62), NT-proBNP significantly decreased (ng/L: 2 028.65±1 752.05 vs. 4 796.45±4 355.40), 6MWD significantly increased (m: 385.20±144.12 vs. 85.81±63.50) at 90 days after operation, and the differences were statistically significant (all P < 0.05). 18 cases (90%) of the 20 patients reached NYHA classification Ⅰ and 2 cases (10%) reached NYHA classification Ⅱ, which were significantly improved compared with those before surgery (all patients' NYHA classification were Ⅳ before surgery). Conclusion:HeartCon LVAD can effectively improve the life quality of patients with ESHF, which has been proved safe and effective in clinical trials, but its long-term effects and complications need further observation and study.

Objective:To evaluate the effect of reducing mAs on image quality when different target/filter combinations are used in digital mammography.Methods:In different target/filter combinations, based on the mAs of automatic exposure control(AEC), the reduction of mAs by 10%, 20%, 30%, 40% and 50% respectively were used to expose the phantom with 4.4 cm thickness. The contrast to noise ratio(CNR), signal to noise ratio(SNR), figure of merit(FOM)and average glandular dose(AGD) of the resulting image were calculated. While the image quality was ensured, the optimal mAs and the corresponding AGD under the two target/filter combination were conducted by calculating the FOM. The image features of three tissues of phantom were subjectively evaluated, and the relationship between the calculated AGD and displayed AGD was compared. The mAs that meets the image quality requirements is corresponded with the density exposure gear, and the average values of the mAs for two method were calculated and compared.Results:In two targets/filters combinations, the displayed AGD was less than the calculated AGD, and Mo/Mo was underestimated by 22.5% to 23.7%. The calculated and displayed AGD values were statistically different ( F=4 982.86, 5 555.48, P<0.05). W/Rh was underestimated by 13.1% to 14.2%. The calculated and displayed AGD values were statistically different ( F=18 859.09, 15 973.55, P<0.05). In the Mo/Mo combination, when the mAs was reduced by 20%, the FOM could be increased by 9.6% for the maximum value, and the calculated AGD was decreased by 18.8%. In the W/Rh combination, when the mAs was reduced by 10%, the FOM was increased by 5.1% for the maximum value, and the calculated AGD was decreased by 11.9%. While the image quality was ensured, the mAs was reduced by 30% for evaluating simulated fibers, and by 20% for evaluating simulated specks in the two targets/filter combinations. For evaluating simulated masses, Mo/Mo combination reduced the mAs by 40%, and the W/Rh combination reduced the mAs by 30%. And the image quality scores in above were not significantly different from those in AEC method ( P>0.05). The density exposure gear(-1 to -3) could correspond with the reduced mAs(10%-30%). Conclusions:Under different target/filter combination, the tube mAs could be reduced when the image quality was ensured.

Objective: Balb/c mice infected with respiratory syncytial virus(RSV) were used to investigate the metabolic changes in cecal luminal content. Methods: A total of 13 female Balb/c mice were randomly divided into Case group(n=7) and control(Ctrl) group(n=6). Animals in Case group were infected with RSV by using intranasal method, while mice in Ctrl group were treated with DMEM medium. Mice were anesthetized with intraperitoneal administration of 10% chloral hydrate and the cecal luminal contents were harvested under sterile conditions. Metabolite concentrations were measured by UPLC-QTOF/MS system. Univariate and multivariate statistical analysis were used to identify differential metabolites between Case and Ctrl groups. Results: The overall base peak chromatogram between Case and Ctrl groups had a clear disparity, and PCA and OPLS-DA analysis showed obviously discrepancy based overall metabolomic profile. L-serine, 2-ketobutyric acid, Oleic acid and Chenodeoxycholic acid glycine conjugate were enriched in Case group, whereas L-methionine, L-tyrosine and Nicotinic acid were depleted. Pathway analysis showed lysine degradation, Cysteine and methionine metabolism were enriched. Conclusion Lung injury induced by RSV infection may cause the endogenous metabolism disorder of cecal contents.

Objective:To determine the adverse effects of continuous circulatory support on liver and kidney function in experimental animals using left ventricular assist devices (LVAD).Methods:Six healthy experimental sheep were selected and implanted with HeartCon type LVAD. The liver and kidney indexes of experimental sheep before and 70 days after operation were detected, including urea (UREA), creatinine (CREA), alanine aminotransferase (ALT), aspartate aminotransferase (AST) and total bilirubin (TBIL), and the functional changes of liver and kidney were evaluated.Results:The preoperative levels of UREA, CREA, ALT, AST and TBIL in the six experimental sheep were (4.60±1.51) mmol/L, (94.80±23.10) μmol/L, (16.20±6.87) U/L, (82.60±17.33) U/L, and (0.52±0.25) μmol/L, respectively. Compared with the indexes before the LVAD implantation, there was no significant change in CREA levels in experimental sheep after the implantation (all P>0.05). After the implantation, the levels of UREA, ALT, AST and TBIL increased to varying degrees within 1 to 14 days after the implantation. At the end of the study, the levels of UREA, ALT, AST and TBIL have returned to the preoperative levels, and the differences were not statistically significant (all P>0.05). Conclusions:Within the 70 days of continuous circulatory support with HeartCon-type LVAD, no evidence of adverse effects of continuous flow LVAD on the liver and kidney function of experimental animals was found. HeartCon-type LVADs are able to provide adequate circulatory support to maintain proper end-organ function.

Objective:To investigate the diagnostic value of synthetic MRI methods in the differentiation of benign and malignant breast lesions.Methods:Clinical and imaging data of 93 breast patients confirmed by pathology in the Second Affifiliated Hospital of Xi′an Jiaotong University from May 2019 to April 2020 were analyzed retrospectively. All patients underwent synthetic MRI technique, and the quantitative parameters of T 1, T 2, and proton density (PD) values were measured. Independent samples t-test and Wilcoxon test were used to compare the differences in clinical and imaging characteristics between the benign and malignant breast lesions. ROC curve was used for the comparison of the diagnostic efficacy of the quantitative parameters in differentiating malignant from benign breast lesions. Results:Of the 93 patients with breast lesions, 62 cases were malignant and 31 cases were benign. The quantitative T 2 values for benign and malignant lesions were 103 (93, 126)ms and 83 (77, 90)ms respectively, and the quantitative PD values were 87.7 (72.7, 96.7)pu and 73.5(63.3, 79.4)pu respectively. There were statistically significant differences between benign and malignant lesion( P<0.05). Taking quantitative T 2 values of 90.5 ms and PD values of 84.8 pu as the cut-off value, the area under the ROC curve in differentiating benign from malignant breast lesions were 0.87 and 0.75, accuracy values were 80.6% and 78.5%, specificity values were 87.1% and 54.8%, sensitivity values were 77.4% and 90.3% respectively. Conclusion:Synthetic MRI methods can be applied in the examination of breast lesions and has the potential to be an effective diagnostic method for the differential diagnosis between benign and malignant lesions of breast.