Objective To investigate the incidence,etiology and risk factors of cardiorespiratory arrest (CRA) in pediatric emergency room and preliminarily evaluate the efficacy of cardiopulmonary resuscitation (CPR).Methods The unified,standard in-hospital Utstein style was used for data collection with filling answers in the questionnaire.The survey items included the causes of cardiorespiratory arrest and the factors influencing the efficacy of CPR.The restoration of spontaneous circulation (ROSC) was used to evaluate short-term efficacy of CPR.Results Totally 182 380 patients aged from 28 days to 18 years were admitted to emergency room of Beijing Children' s Hospital between July 1,2008 and February 28,2010.Of them,237 patients (0.13％) were subjected to cardiorespiratory arrest,of which 169 patients received CPR and 88 patients (52.1％) got sustained ROSC.Neither sex nor age distribution affected ROSC.The primary cause of CRA and kind of initial abnormal rhythm of heartbeat leading to CRA were associated with the rate of ROSC.The rates of ROSC occurred in patients with or without pre-hospital transport were 64.1％ and 44.8％,respectively.The rate of ROSC was closely related to time consumed for getting ROSC by CPR,and as CPR durations were ≤ 10 min,10 to 30 min,and ＞ 30 min,the rates of ROSC were 67.5％,61.4％ and 30.5％,respectively.Multiple stepwise logistic regression analysis showed that kind of initial abnormal rhythm and CPR duration were associated with the rate of ROSC.Conclusions The incidence of CRA in emergency was 0.13％,and the rate of ROSC after CPR was 52.1％.The kind of initial abnormal rhythm of heartbeat and CPR duration were independent factors associated with the rate of ROSC.

Objective To investigate the high resolution CT (HRCT) findings of pleura invasion of lung adenocarcinoma (stageⅠ) presenting as mixture ground glass nodule (mGGN).Methods 20 cases of lung adenocarcinoma presenting as mGGN were confirmed by pathology.The correlation of those cases with pleural adjacent relation and the relation between the maximum diameter and pleural invasion were analyzed retrospectively.Results (1)The classification of mGGN adjacent to the pleura relationship:type Ⅰ,typical and atypical pleural retraction sign,10 cases of this type did not show pleural invasion;type Ⅱa,the mGGN contacted pleural for ground glass opacity,4 cases of this type showed no pleural invasion;type Ⅱb,the mGGN contacted pleural for solid elements,6 cases of this type were with pleural invasion.(2)The difference of the maximum diameter of mGGN in groups pleural invasion and non-invasion was not significant statistically (P=0.694).Conclusion The mGGN contacted pleural for solid composition is a reliable sign in diagnosis of pleural invasion.

This article elaborates some questions in the medical statistics experimental teaching and proposes several countermeasures such as: to strengthen teachers quality,to reform experiment teaching mode,to apply multimedia to teaching and to improve experiment examination forms.

This study examined the effect of tanshinone II A (TSN II A) on the cardiac fibrosis induced by transforming growth factor β1 (TGF-β1) and the possible mechanisms. Cardiac fibroblasts were isolated from cardiac tissues of neonatal Sprague-Dawley (SD) rats by the trypsin digestion and differential adhesion method. The cells were treated with 5 ng/mL TGF-β1 alone or pretreated with TSN II A at different concentrations (10(-5) mol/L, 10(-4) mol/L). Immunocytochemistry was used for cell identification, RT-PCR for detection of the mRNA expression of connective tissue growth factor (CTGF) and collagen type I (COL I), Western blotting for detection of the protein expression of Smad7 and Smad3, and immunohistochemistry and immunofluorescence staining for detection of the protein expression of phosphorylated Smad3 (p-Smad3), CTGF and COLI. The results showed that TGF-β1 induced the expression of CTGF, COL I, p-Smad3 and Smad7 in a time-dependent manner. The mRNA expression of CTGF and COL I was significantly increased 24 h after TGF-β1 stimulation (P<0.01 for all). The protein expression of p-Smad3 and Smad7 reached a peak 1 h after TGF-β1 stimulation, much higher than the baseline level (P<0.01 for all). Pretreatment with high concentration of TSN A resulted in a decrease in the expression of p-Smad3, CTGF and COL I (P<0.01). The protein expression of Smad7 was substantially upregulated after pretreatment with two concentrations of TSN II A as compared with that at 2 h post TGF-β1 stimulation (P<0.05 for low concentration of TSN I IA; P<0.01 for high concentration of TSN II A). It was concluded that TSN II A may exert an inhibitory effect on cardiac fibrosis by upregulating the expression of Smad7, suppressing the TGF-β1-induced phosphorylation of Smad3 and partially blocking the TGF-β1-Smads signaling pathway.

Objective To study the factors affecting the activities of daily life (AOL) of patients after the first stroke of cerebral infarction in order to formulate the intervention strategy for improving the capability of ADL of patients. Method A total of 149 patients with the first stroke of cerebral infarction admitted from Oct. 2008 to Dec.2008 were enrolled in this study. The demographics of patients, cerebral infarction risk factors, apopletic score as per National Institute of Health stroke scale (NIHSS), white blood cell count (WBC) and plasma glucose (PG) were recorded on the first day of admission, and many other laboratory examinations were done on the next morning. The occurrences of infection in lung and urinary tract, and atrial fibrillation were recorded during hospi-talization. The NIHSS score and score of Glasgow Coma Scale (GCS) were taken within 24 hours after admission, on the 14th day and at the end of the third month after cerebral infarction respectively. Barthel index (BI) was taken in the second week as well as at the end of third month by follow-up in the OPD or by telephone. The correlation analysis and multiple linear stepwise regression analysis were used to find the risk factors. Results The PG level, WBC count and NIHSS score were independently associated with ADL in the second week as well as at the end of the third month after cerebral infarction. Besides, the urinary tract infection during hospital stay was also independently associated with ADL at the end of the third month after cerebral infarction. Conclusions The plasma glucose level, WBC count, NIHSS score and urinary tract infection are the risk factors. Positive measures should be taken to control these risk factors so as to improve the capability of ADL of the patients after cerebral infarction.

Objective To analyze the imaging features of testicular solid lesions.Methods The CT and MR findings of 18 cases of testicular solid lesions confirmed by pathology were retrospectively reviewed.The location,attenuation/signal,size,shape,edge,and enhancement patterns of lesions were analyzed.Results In all of the 18 cases,5 cases were seminomas,1 of them was huge with punctate calcification,4 of them had low signal separations in T2WI.Lymphomas were in 4 cases,and all of them were primary diffuse large B cell lymphoma;T2WI was priority with low signal.Solitary fibrous tumor was in 1 case,and the attenuation was lower than that of muscle.Embryo in sinus tumor were in 1 case,and the attenuation/signal was unhomogeneous;the continued enhancement liking grid was obviously seen after contrast injection.Nonspecific inflammatory masses were in 4 cases with involving epididymis in 2 cases,and the attenuation/signal was unhomogeneous.Tuberculous mass were in 3 cases,and 1 case with points of calcificationwas on the edge of lesion,2 cases characterized by short T2 signals.Conclusion It is possible to make an accurate diagnosis by the combination of clinical data with imaging features in most of the testicular solid lesions.

OBJECTIVE:To observe the effects of different concentration of human urinary kallikrein on blood pressure when used for acute cerebral infarction. METHODS: By a non-randomized historical control study,the blood pressure variation of 34 patients on day one after treatment with low concentration (0.06%) of human urinary kallikrein was observed,the occurrence of hypotension in this group was compared with that of another 47 patients (control) treated with high concentration (0.3%) of human urinary kallikrein. RESULTS: The reduction of blood pressure in low concentration group was less obvious than in the high-concentration group. However,hypotension was noted in both groups when angiotensin-converting enzyme inhibitor (ACEI) hypotensive drugs were used concomitantly. CONCLUSION: Human urinary kallikrein for acute cerebral infarction can transiently down-regulate blood pressure slightly,but its effect on blood pressure can be lowered by suitable reduction of its concentration;at any concentration,it can result in hypotension if used in combination with ACEI.

Aim To explore new grouping method of clinical pharmacology experiments. Methods Based on the principle of “minimize the unbalanced coefficient”,the sequential balanced coefficient method is to measure the comparability between groups through a very simple unbalanced index. Conclusion This method is simplied compute,convenienced manipulate and strong comparable between groups,which is especially applied to clinical pharmacology experiments.

Objective To investigate the efficacy and side-effect of docetaxel and cisplatin induction chemotherapy followed by concurrent chemoradiotherapy in locally advanced non-small cell lung cancer (NSCLC).MethodsEighty-six patients with histologically confirmed locally advanced NSCLC were randomized into induction chemotherapy followed by concurrent chemoradiotherapy (ICCRT)arm or concurrent chemoradiotherapy (CCRT) arm. Both arms were treated with intensity-modulated radiation therapy. Induction and concurrent chemotherapy regimen consist of docetaxel and cisplatin. Results Follow-up rate of the whole group is 100％.The response rate in the CCRT arm and ICCRT arm is 70％ and 80％ ( χ2 =1.26,P =0.261 ),respectively; and 1-,2-,3-year survival rate is 65％ and 85％,40％ and 50％,33％ and 44％ (χ2 =3.90,P=0.048),respectively; the median survival time and time to progression is 17.5 and 22.0 months and 14.0 and 19.0 months respectively.Major adverse effects are leukopenia (43 and 32 cases,χ2 =3.48,P =0.062),radiation esophagutis (26 and 20 cases,χ2 =0.12,P =0.730),anemia (26 and 16 cases,χ2 =2.34,P =0.126) and radiation pneumonitis (13 and 9 cases,χ2 =0.37,P =0.541 ).ConclusionsICCRT for locally advanced NSCLC can improve the overall survival rate and time to progression,induction chemotherapy did not increase side-effects.There was no difference in response rate between CCRT and ICCRT arm.

Objective To establish acute hepatotoxic model induced by Amanita exitialis and to study the characteristics of acute toxic liver failure induced by mushrooms containing peptide toxins,in hope for providing some help to experimental research on poisoning induced by mushrooms containing peptide toxins.Methods UPLC-MS/MS (Ultra performance liquid chromatography-tandem mass spectrometry) method was used to detect peptide toxins in Amanita exitialis.To establish acute toxic liver hepatic failure model,the beagles were fed with 60 mg/kg of lyophilized powder of Amanita exitialis fungus which encapsulated in starch capsules.Toxic sighs were observed,coagulation function,hepatic and renal function,liver histopathological morphology,peptide toxin concentration in plasma and urine were detected during the experiment.Results Total peptide toxins in Amanita exitialis was (3 482.6 ± 124.94) mg/ kg.All the beagles had toxic signs including vomiting and diarrhea in 12-48 h after ingestion.On 24 h after ingestion,the beagles' ALT,AST,TBIL,ALP,PT and APTT levels increased obviously.On 36 h after ingestion,the beagles' ALT,AST,PT and APTT values reached their peaks (ALT:283.2 ± 112.9 Kallmann unit;AST:223.9 ±93.8 Kallmann units;PT:132.9 ± 152.6 s;APTT:131.4 ± 153.9 s).On 48 h after ingestion,the beagles' TBIL and ALP levels reached their peaks (TBIL:23.3 ± 14.6 mol/L;ALP:274.5 ± 115.5 U/L).The beagles' TBIL,TP and APTT returned to normal 1 week after ingestion,their ALT,AST and ALP levels returned to normal 3 weeks after ingestion.Three dogs died during 24-72 h after ingestion.Liver histopathological morphology study showed hemorrhagic necrosis of hepatocytes.Peptide toxins can be detected in plasma within 24 h after ingestion.Peptide toxins can be detected in urine within 96 h after ingestion.Conclusion Amanita peptide toxins can cause hemorrhagic necrosis of liver cells and lead to acute liver failure.This model is consistent with clinical pathophysiological process of acute toxic liver failure induced by mushrooms containing peptide toxins,and it can be applied to the study of diagnosis and treatment of poisoning induced by mushrooms containing peptide toxins.