Objective To investigate the pharmacological hypothermic effect of WIN55, 212-2 on neuronal apoptosis after cardiopulmonary resuscitation. Methods Cardiac Arrest ( CA ) was induced in Sprague-Dawley rats.Five minutes after onset of CA, cardiopulmonary resuscitation ( CPR) was carried out.At 30 minutes post-resuscitation, the animals were randomized into three groups (n=10 in each group): (1) WIN55, 212-2 hypothermia group [W group, WIN55, 212-2, 1 mg/(kg· h)].(2) Normothermia group (NT group, 5%DMSO);(3) WIN55, 212-2 with normothermia group (W+NT group, WIN55, 212-2, 1 mg/(kg· h).Animals in WIN55, 212-2 hypothermia group and WIN55, 212-2 with normothermia group were dealt with continuous intravenous infusion of WIN55, 212-2 [1 mg/(kg· h)] for 4 h, while rats in NT group were infused with equal volume of 5% DMSO instead.The survival time and neurological deficit score ( NDS) were observed.The CA models were established in three groups.After rats were sacrificed, the brains were harvested for detecting histopathological changes and apoptosis of neural cell at 24 h, 48 h and 72 h after ROSC respectively.Five animals of each group were chosen randomly ( random number ) .Results Body temperatures of rats in W group decreased from 37°C to 34°C in 4 hours.Accumulated survival rate in W group was higher than that in the other two groups ( P=0.02) .NDS was significantly improved in W group than that in the other two groups ( P<0.05) .Morphological change in W group was less serious than that in the other two groups.The number of neuron apoptosis in W group was smaller than that in the other two groups.Conclusions WIN55, 212-2 inducing pharmacologically hypothermia during post-resuscitation prolonged survival and improved cerebral function in rat cardiac arrest models.The beneficial effects of WIN55, 212-2 were associated with ameliorating the histopathological damage in brain and alleviating the neuron apoptosis.

Objective Objectives To investigate the gender difference affecting the efficacy of cardiopulmonary resuscitation (CPR) in the mouse cardiac arrest (CA) model.Methods CA was induced in 30 Kunming mice (15 male and 15 female) by trans-oesophageal cardiac pacing for 4 minutes.Epinephrine was then administrated intra-artery,and CPR was performed.The time required for restoration of spontaneous circulation (ROSC) was observed,but if ROSC failed to appear at 10 minutes after CPR,resuscitation was discontinued.Blood pressure and electrocardiograms of resuscitated animals were invasively monitored for an additional 60 minutes.Blood pressure,heart rate,the restoration of spontaneous respiration (ROSR) and survival time were observed and recorded.Results All 15 female mice and 14 of 15 male mice had ROSC.There were no significant differences in the time required for ROSC,ROSR,and survival between the two groups [(50±17)svs.(46±12)s; (2.4±1)minvs.(2.5±1)min; 28 (1,72)h vs.16 (3,72)h,P ＞ 0.05)].Moreover,neither blood pressure nor heart rate showed significant differences one hour after ROSC between the two groups.Conclusions Sex differences did not affect the efficacy of CPR,but the precise mechanism is still unclear,and further investigations are required.

Objective To compare the effects between vasopressin and epinephrine during cardiopulmonary resuscitation(CPR)in a mouse model of cardiac arrest(CA).Method Transoesophageal cardiac pacing was performed so as to elicit cardiac arrest in 30 Kunming male mice.Four minutes after the initiation of cardiac pacing,the animals were prospectively randomized into three groups in equal number(n=10/group),namely,control group(saline 0.2 mL intra-arterial),vasopressin group(vasopressin 0.4U/kg intra-arterial)and epinephrine group(epinephrine 0.04 mg/kg intra-arterial),then CPR was initiated.Restoration of spontaneous circulation (ROSC)was observed.If ROSC failed to appear at 10 minutes after CPR,resuscitation was discontinued.Electrocardiogram and blood pressure of resuscitated animals were invasively monitored for an additional 60 minutes.Electrocardiogram and blood pressure.and the restoration of spontaneous respiration and survival time were observed and recorded.Results Rates of ROSC in vasopressin group and epinephrine group were significantly higher than those in saline group(9/10,10/10 vs.3/10,P＜0.05,P＜0.01 respectively),and there was signilieant difference between vasopressin and epinephrine group.All resuscitated mice treated with epinephrine restored sponlaneous respiration after ROSC,while only 4 of 9 animals trealed with vasopressin did(P＜0.05).Survival time of anireals in epinephrine group was longer than that in vasopressin group or in saline group(P＜0.05,P＜0.05,respectively).Conclusions Both vasopressin and epinephrine increase the rates of ROSC.Epinephrine 0.04 mg/kg improved respiratory function and results in a longer survival time compared with vasopressin 0.4 U/kg in this mouse model.and the precise mechanism is not clear and further investigation is required.

Objective To compare the impact of intra-arterial versus intravenous administration of epinephr-ine on the efficacy CPR in mice. Methods Transoesophageal cardiac pacing was performed to induce cardiac arrest for 4 minitues in 20 Kunming male mice. The mice were then randomized to two groups (n = 10 in each group), and received epinephrine of 0.02 mg/kg via either carotid artery (IA-gro) or jugular vein (IV-gro) injection. Chest compression and ventilation were performed; and the rate of restoration of spontaneous circulation (ROSC) and survival time were recorded. CPR was stopped if spontaneous circulation was not restored within 10 minutes. Results There was no significant difference in the rates of ROSC between IA-gro and IV-gro (10/10 vs. 8/10, P>0.05), nor in the time of ROSC or survival time [51 ± 13 s vs. 62 ± 24 s; 8.5 (6.0, 17.0) h vs. 6.5 (2.8, 21.3) h, P > 0.05]. Conclusions Neither intra-arterial nor intravenous administration of epinephrine has no obvious impact on the efficacy of CPR in mice.

This paper discusses the effectiveness of tutor-postgraduate communication in terms of frequency,approach,activeness and content by analyzing the questionnaire filled by the postgraduate students who graduate in 2013 in Peking University Health Science Center.3 suggestions were put forward to enhance the efficiency and quality of tutor-postgraduate communication,including guideline from tutors,active involvement of graduates and facilitation of Scientific research management.

Objective To study the changes of plasma cystatin C level (PcyC),and evaluate the effects of the joint use of atorvastatin and probucol on PcyC and severity of coronary lesion in patients with borderline lesion of coronary artery.Methods One hundred and thirty consecutive patients with borderline coronary lesion assessed by quantitative coronary angiography were enrolled into borderline coronary lesion group (BCL),and another 136 subjects without coronary lesion were enrolled as controls (CTR).And in the meantime,the subjects in BCL group were randomized (closed envelope method) into routine treatment subgroup ( RTT,n =60),and combined treatment subgroup in which patients were treated with atorvastatin 20 mg plus probucol 1.0 g daily in addition to routine medication ( CBT,n =70) for 6 months.There were no statistical differences in basic clinical features between two subgroups.PcyC,high-sensitive C-reactive protein (hs-CRP),total cholesterol (TC),low-density lipoprotein cholesterol (LDL-C),high-density lipoprotein cholesterol ( HDL-C ) and triglycerides (TG) were determined.Of them,104 patients in BCL group rechecked by coronary angiography.Comparison of biomarkers carried out between two groups by using a number of independent-sample t-test and analysis of variance.For enumeration data,chi-square test was used to compare mean values of biomarkers between groups. P ＜ 0.05 was considered statistically significant.Results PcyC levels were significantly higher in BCL group than those in CTR group ( P ＜ 0.05 ).Compared with RTT subgroup,levels of PcyC,TC,LDL-C,TG and hs-CRP were more significantly decreased in CBT subgroup (P ＜ 0.05,P ＜ 0.01 ).Moreover,there was a trend of slight decrease in the mean percent of stenosis (MPS) of coronary artery with borderline lesion in RTT subgroup treated for 6 months,whereas more marked decrease in the MPS of coronary artery with borderline coronary lesion in CBT subgroup treated for 6 months ( P ＞ 0.05 ; P ＜ 0.05 ).Conclusions Cystatin C plays an important role in the pathogenesis of coronary artery,and PcyC is associated with severity of coronary lesion,the combination of atorvastatin and probucol decreases the PcyC level,and it may be the treatment of choice for borderline lesion of coronary artery.

Objective To investigate the effect of mild hypothermia on the myocardial and microcirculation dysfunction induced by epinephrine during early post-resuscitation in a rat model of cardiac arrest and cardiopulmonary resuscitation (CPR).Methods Transesophageal cardiac pacing was performed in order to elicit cardiac arrest for 5 min in SD male rats.Totally 40 rats were randomly (random number) divided into 4 groups (n=10):normothermic control group (N),normothermic epinephrine group (N+E),hypothermic control group (H),and hypothermic epinephrine group (H+E).Chest compression was then initiated.Epinephrine (0.02 mg/kg) or saline was administrated at 1 min during CPR.Restoration of spontaneous circulation (ROSC) was recorded,and the rates of ROSC were observed.Myocardial and microcirculatory function were observed at 1,2,3,and 4 h during early post-resuscitation.Serum lactate level was assessed at baseline and ROSC 4 h.Results The ROSC rates were 10/10 in the H+E group,9/10 in the N+E group,4/10 in the H group,and 1/10 in the N group,respectively.Ejection fraction (EF)and cardiac output (CO) in the H+E group were significantly higher than that of other groups (P＜0.05).Total vessel density,perfused vessel density,proportion of perfused vessels,and microvascular flow index in the H+E group were also significantly higher than those of other groups during early post-resuscitation.The serum lactate level in the H+E group was significantly lower than that in the N+E and H groups..Conclusions Both epinephrine and mild hypothermia can improve the success rate of resuscitation.However,mild hypothermia can improve the epinephrine induced myocardial and microcirculatory dysfunction during postresuscitation in the rat cardiac arrest.

Objective To evaluate the relationship between plasma cystatin C concentration (PcyC) and coronary artery diseases (CAD). Method A total of 126 subjects with CAD evidenced by coronary angiography admitted from April 2007 to March 2009 were divided into three groups: stable angina pectoris (SAPs, n = 34),unstable angina pectoris (UAPs, n = 56) and acute myocardial infarction (AMIs, n = 36), according to the diag-nostic criteria of CAD set by WHO. Another 34 subjects without CAD were taken as controls. There were no statis-tical differences in demographics among four groups. Serum lipids profile, uric acid (UA), PcyC and high-sensi-tive C-reactive protein (hs-CRP) were determined. And in the meantime, all patients were followed up for six months and adverse cardiovascular events were recorded. Comparisons were made between groups with a number of independent-sample t -tests. Data were processed with analysis of variance to test the differences in means among four groups, and the means were compared with chi-square test. Statistical significance was established at a P val-ue of less than 0.05. Results Cystatin C levels were significantly higher in UAPs than that in SAPs and in controls (P < 0.05), but were much lower than that in AMIs (P < 0.05). And much higher concentration of hs-CRP was found in UAPs (P < 0.05) and in AMIs (P < 0.01). Cystatin C was positively and significantly corre-lated with age, hs-CRP, WBC, creatinine and UA (r > 0, P < 0.05), whereas a significantly negative correla-tion with high-density lipoprotein cholesterol was found (r = - 0.227, P < 0.05). These coefficients were obvi-ously high for creatinine (r = + 0. 612), and WBC (r = + 0.459). During the period of six-month follow-up, 26 patients with adverse cardiovascular events were found, and had significantly higher cystatin C levels than 22 con-trols at admission (P < 0.01). Conclusions Cystatin C plays a pivotal role in the course of CAD, and the PcyC is a strong predictor for the risk of cardiovascular events.

Objective:To compare the predictive value of the HEART, TIMI and GRACE scores for major adversecardiovascular events (MACEs) at 7 and 28 days in patients with actue non-ST-segment elevation myocardial infarction (NSTEMI).Methods:More than 12 000 patients with chest pain from the Emergency Department of Zhongshan Hospital Affiliated to Fudan University from October 2017 to October 2018 were studied, including 566 patients with cardiogenic chest pain, 105 patients with ST-segment elevation myocardial infarction (STEMI) excluded and 15 patients lost to follow-up. Finally, 109 patients with NSTEMI and 337 non-myocardial patients with cardiogenic chest pain were enrolled. NSTEMI patients were divided into subgroups according to whether MACEs occurred. LSD t-test, Mann-Whitney U test or χ2 test were used to analyze and compare the differences between the two subgroups about the baseline data, clinical data, HEART, TIMI and GRACE scores at the time of visit. Multivariate logistic regression analysis was used to explore the independent factors of MACEs at 7 and 28 days. And the predictive values of different scores for 7-day MACEs and 28-day MACEs were compared in NSTEMI patients through the receiver operating characteristic (ROC) curve. Results:Compared NSTEMI patients with non-myocardial patients with cardiogenic chest pain, we found a statistically significant differences in sex, past history of coronary heart disease,≥3 risk factors for atherosclerosis, electrocardiogram, high-sensitivity troponin T (hs-cTnT), creatinine value, past history of myocardial infarction, HEART score, TIMI score and GRACE score. In further subgroup analysis of NSTEMI patients who were divided according to whether MACEs occurred, we found previous history of stroke and increased hs-cTnT were statistically different in 7 days after the onset of the disease. The multivariate analysis showed that the previous history of stroke and increased hs-cTnT were independent factors for the occurrence of MACEs at 7 days after the onset of NSTEMI; The previous history of stroke and increased hs-cTnT, electrocardiogram ST segment depression and TIMI score were statistically different at 28 days after the onset of NSTEMI. The multivariate analysis showed that the previous history of stroke and TIMI score were independent factors for the occurrence of MACEs at 28 days after the onset of NSTEMI patients. ROC curve indicated that the predictive value of TIMI score (AUC=0.715, 95% CI: 0.482-0.948) was better than HEART (AUC=0.659, 95% CI: 0.414-0.904) and GRACE scores (AUC=0.587, 95% CI: 0.341-0.833)in predicting MACEs in NSTEMI patients. Conclusions:HEART score, TIMI score and GRACE score can be used to evaluate NSTEMI patients. There is an independent predictive value on TIMI score for the occurrence of 28-day MACEs in NSTEMI patients.

Objective:To investigate the clinical characteristics of patients with acute aortic dissection (AAD) through a retrospective and observational study, and to construct an early warning model of AAD that could be used in the emergency room.Methods:The data of 11 583 patients in the Emergency Chest Pain Center from January to December 2019 were retrospectively collected from the Chest Pain Database of Zhongshan Hospital Affiliated to Fudan University. Inclusion criteria: patients with chest pain who attended the Emergency Chest Pain Center between January and December 2019. Exclusion criteria were 1) younger than 18 years, 2) no chest/back pain, 3) patients with incomplete clinical information, and 4) patients with a previous definite diagnosis of aortic dissection who had or had not undergone surgery. The clinical data of 9668 patients with acute chest/back pain were finally collected, excluding 53 patients with previous definite diagnosis of AAD and/or without surgical aortic dissection. A total of 9 615 patients were enrolled as the modeling cohort for early diagnosis of AAD. The patients were divided into the AAD group and non-AAD group according to whether AAD was diagnosed. Risk factors were screened by univariate and multivariate logistic regression, the best fitting model was selected for inclusion in the study, and the early warning model was constructed and visualized based on the nomogram function in R software. The model performance was evaluated by accuracy, specificity, sensitivity, positive likelihood ratio and negative likelihood ratio. The model was validated by a validation cohort of 4808 patients who met the inclusion/exclusion criteria from January 2020 to June 2020 in the Emergency Chest Pain Center of the hospital. The effect of early diagnosis and early warning model was evaluated by calibration curve.Results:After multivariate analysis, the risk factors for AAD were male sex ( OR=0.241, P<0.001), cutting/tear-like pain ( OR=38.309, P<0.001), hypertension ( OR=1.943, P=0.007), high-risk medical history ( OR=12.773, P<0.001), high-risk signs ( OR=7.383, P=0.007), and the first D-dimer value ( OR=1.165, P<0.001), Protective factors include diabetes( OR=0.329, P=0.027) and coronary heart disease ( OR=0.121, P<0.001). The area under the ROC curve (AUC) of the early diagnosis and warning model constructed by combining the risk factors was 0.939(95 CI:0.909-0.969). Preliminary validation results showed that the AUC of the early diagnosis and warning model was 0.910(95 CI:0.870-0.949). Conclusions:Sex, cutting/tear-like pain, hypertension, high-risk medical history, high-risk signs, and first D-dimer value are independent risk factors for early diagnosis of AAD. The model constructed by these risk factors has a good effect on the early diagnosis and warning of AAD, which is helpful for the early clinical identification of AAD patients.