Objective To investigate the hemodynamic effects of naloxone in post-resuscitation dog from cardiac arrest. Methods Ventricular fibrillation (VF) was induced, and cardiac output(CO) was measured in 25 dogs before and 6 hours after successful resuscitation from 3 minutes VF. 25 dogs were randomly divided into control group(n=6), CPR group (n=12) and naloxone(NLX) group (n=7). Results Six dogs finished 6-hour experiment in both CPR and NLX groups, and the others did not finish the whole experiment. The time of restoration of spontaneous circulation was not significantly different between CPR group and NLX group. The mean artery pressure(MAP) of CPR group was lower than that of control group in 4, 6 hours after successful resuscitation. The MAP of NLX group was higher than that of CPR group in 2,4 and 6 hours after successful resuscitation, and no significantly different compared with that of normal group. CO in both CPR and NLX groups was lower than that in control group after successful resuscitation. CO in NLX group was higher than that in CPR group in 1 to 6 hours after resuscitation. Conclusion There is myocardial dysfunction in post-resuscitation dog from cardiac arrest. Naloxone can improve their hemodynamic status.

To understand the status of the knowledge and skills of the medical staff by using the questionnaire,the authors analyzed the differences and inadequate ness of the first-aid knowledge and skills among the hospital's new recruits to explore how to carry out a targeted first-aid knowledge and skills training.

Objective To investigate the role of micro-RNAs (miR-101 and miR-125a-5p) in autophagy of lipopolysaccharide (LPS) derived human THP-1 macrophages.Methods Human monocytic leukemia cell line THP-1 was cultured in vitro,and it was differentiated into macrophages after being induced with phorbol (50 μg/L) for 48 hours.THP-1 macrophages were stimulated with LPS in 0,250,500,1 000 μg/L respectively for 12 hours,miR-mimic was transfected into THP-1 macrophages as induced by Lipofectamine RNAiMAX,and the transfection efficiency of miRNA was determined with fluorescence microscopy.Enzyme linked immunosorbent assay (ELISA) was used to determine the levels of tumor necrosis factor-α (TNF-α) and monocyte chemotaxis protein-1 (MCP-1) in the supernatants of culture.Western Blot was used to detect the protein expressions of autophagy proteins ATG4D,Beclin1,and LC3 Ⅱ.The expression levels of miR-101 and miR-125a-5p were determined by quantitative reverse transcription-quantitative polymerase chain reaction (RT-qPCR).Results ① The releasing levels of TNF-α and MCP-1 induced by LPS with 250,500,1 000 μg/L were significantly increased as compared the cells without LPS stimulation [TNF-α (ng/L):1 336.1 ± 18.5,1 340.6±24.8,1 364.5± 14.9 vs.47.6±4.4;MCP-1 (ng/L):996.3 ±51.3,934.6±84.3,974.2±69.5 vs.21.3±6.5,all P ＜ 0.01],but no significant differences were found among the three LPS stimulation groups.The protein expressions of ATG4D,Beclin1 and LC3 1Ⅱ were up-regulated in the presence of different LPS concentrations (0,250,500,1 000 μg/L) for 12 hours in THP-1 macrophages (when compared with the cells without LPS stimulation,t value of ATG4D was 8.103,38.410,52.020,P value was 0.015,0.001,＜ 0.001;t value of Beclin1 was 3.026,5.328,3.482,P value was 0.047,0.034,0.037;t value of LC3 Ⅱ was 3.836,6.200,4.665,P value was 0.018,0.003,0.010),and the optimal concentration was 500 tg/L LPS.When THP-1 macrophages were stimulated with 500 μg/L LPS for 12 hours,the expression levels of miR-101 and miR-125a-5p were down-regulated significantly as compared with the cells without LPS stimulation [miR-101 (2-△ △Ct):0.68 ± 0.08 vs.1.95 ±0.26,t =8.047,P =0.001;miR-125a-5p (2-△ △Ct):0.23 ± 0.06 vs.1.69± 0.42,t =5.975,P =0.004].② The higher transfection efficiency was showed under fluorescence microscope.Westem Blot results showed the protein expressions of ATG4D,Beclin1 and LC3 Ⅱ were down-regulated as induced by an over-expression of miR-101 or miR-125a-5p in THP-1 macrophages,and more obviously down regulated by co-transfected with miR-101 and miR-125a-5p (compared with negative control group,t value was 14.550,5.855,14.180,P value was 0.005,0.014,＜ 0.001).Conclusion miR-101 and miR-125a-5p can inhibit the autophagy in LPS challenged THP-1 macrophages,and the potential mechanism might be related to target regulation of ATG4D.

Objective To investigate the regulatory networks of DNA methylation profiles in STEMI by methylation microarrays.Methods A total often male patients with STEMI and ten male healthy controls were recruited.Methyl-DNA immunoprecipitation and Nimblegen HG18 Meth 385K promoter plus CpG island microarrays were used to identify differentially methylated regions.And several bioinformatics analysis tools which included chromosomal assignment, gene ontology analysis and pathway analysis with SignalMap and The Database for Annotation, Visualization and Integrated Discovery were used to high-throughput analysis.Results Compared with healthy controls, DMRs of STEMI is 1 634, There are 1 480 (90.57％), 131 (8.02％) and23 (1.41％) methylated sites were separately located on High CpG-containing promoter, Intermediate CpG-containing promoter and Low CpG-containing promoter;Gene Ontology and Pathway analysis expressed DNA methylated genes of signaling pathway in MI identified glycerophespholipid metabolism, cysteine and methionine metabolism, Dilated cardiomyopathy, Arrhythmogenic right ventricular cardiomyopathy, regulation of actin cyteskeleton, calcium signaling pathway.However, the signal pathway about lipid metabolism is shown no significant difference.Conclusions Bioinformatics tools could provide the quick and high-throughput analysis of data from methylation microarray and enable the function classification of differentially expressed genes of STEMI.

ObjectiveTo investigate the degree of acceptance of Emergency Medicine and the abilities of first aid in senior medical students, and study the methods of how to improve their abilities and skills.MethodsA random sample survey methodology.ResultsA total of 146 medical students of clinical medicine were surveyed.99.32％ of student believed that emergency medicine was essential and necessary in their learning process.The knowledge of first aid would play important role for their future work.55.48％ of students considered that there were partial overlaps in teaching content in emergency medicine and internal medical and surgery.Senior medical students accessed to knowledge mainly through books,followed by the Internet,television and newspapers and their first aid knowledge and skills were poor.ConclusionEmergency medical teaching should be focused on highlighting its characteristics.The visualization of the operation and standardized assessment will help to strengthen students' mastery of first-aid knowledge and skills.

Objective To compare the therapeutic effects in respect of ventilatory response and the change of hemodynamics of two modes of mechanical ventilation [ proportional assist ventilation (PAV) vs.Bi-level positive airway pressure ventilation (BiPAP) ] on patients with acute cardiogenic pulmonary edema (ACPE).Methods Thirty-two patients diagnosed as ACPE were recruited from May 2008 to April 2009.After conventional therapy ( cardiotonic,diuretic,vasodilators,oxygen) were ineffective for half an hour,32 patients were randomly divided into three groups:control group ( 12 cases kept conventional treatment without mechanical ventilation),BiPAP group ( 12 cases were treated with BiPAP mode of non-invasive mechanical ventilation plus conventional treatment) and PAV group (8 cases were treated with PAV mode of non-invasive mechanical ventilation along with conventional treatment ).Results PaO2,RR and oxygenation index were improved significantly in three groups after 1 hour treatment ( P ＜ 0.05 ).While PaO2 and oxygenation index in noninvasive ventilation groups were higher than those in control group ( P ＜0.05 ).The time required for amelioration of dyspnea in noninvsaive ventilation groups was shorter than that in control group ( P ＜ 0.05 ).The peak airway pressure and the index of degree of comfort ( VAS score,auxiliary respiratory muscles score) in PAV group were lower than those in BiPAP group (P ＜ 0.05 ).Conclusions Both modes of noninvasive mechanical ventilations could improve the oxygenation and relief of dyspnea in patients with ACPE.PAV and BiPAP had the similar effect in patients with ACPE.The synchronization and comfort in PAV group were better than those in BiPAP group.The PAV mode of noninvasive mechanical ventilation was well accepted by patients with ACPE.

Objective To analyse the results of Zephir semiconstrained or Window dynamic cervical plates with autogenous cortical bone graft in treating the cervical spondylotic myelophathy(CSM). Methods A retrospective review was performed with 43 patients who underwent anterior cervical discectomy, autogenous cortical bone graft with endplate retaining, fixation with Zephir or Window cervical plates. Follow-up period ranged from 0.5 to 4.0 years (in average of 22 months). The clinical effect, the fusion rate, the intervertebral height and the degeneration of adjacent levels were observed. Results The JOA score after operation was significant higher than that before operation (P

Objective To discuss the clinical characteristics of the Acu te Traumatic Spondylolisthesis (ATS). Methods 7 cases of ATS treated from 1990 t o 2002 were analyzed retrospectively. One case with slight symptoms was treated without operation and others were treated with open reduction and internal fixat ion of the graft. The ages of the patients ranged from 13 to 57 years, with an a verage of 26.9 years. Results All patients were followed up for an average of 5 .2 years. By Henderson standard, the result was excellent in 6, and good in 1. C onclusions Compared with non-acute traumatic spondylolisthesis,ATS involves de finite trauma accompanied with soft tissue lesion and small articular fractures. There is no sclerosis manifestation in x-ray and CT. Isthmic fractures can alw ays be seen during operation. Operation is needed in most cases.

BACKGROUND:Calcium phosphate bone cement has been applied to clinical surgery because of its good biocompatibility and osteoconduction. However poor mechanical properties and lack of osteoinductivity limit its wide application.
OBJECTIVE:To develop calcium phosphate cement incorporated with N-acetylcysteine (NAC) loaded silk fibroin microspheres (SFM), which is a kind of new injectable bone graft material with slow-release function, and evaluate its physical and chemical properties and cel compatibility.
METHODS: Empty SFMs were prepared with emulsion solvent evaporation to absorb NAC solution of different concentrations by NAC-SFM and the concentration of NAC at the maximum drug loading ratio was determined. Then, NAC-SFM was loaded into calcium phosphate bone cement to test the drug release propertiesin vitro. MC3T3-E1 osteoblasts were cultured on the surface of NAC-SFM calcium phosphate bone cement and cel attachment and growth were observed by scanning electron microscope. Additionaly, MC3T3-E1 cels were cultured with three kinds of bone cement extracts (calcium phosphate cement, SFM-calcium phosphate cement, NAC-SFM-calcium phosphate cement, as wel as cultured in theα-minimum essential medium containing a volume fraction of 10% fetal bovine serum and 1% penicilin-streptomycin double antibody as the control. MTS assay was used to evaluate cel proliferation.
RESULTS AND CONCLUSION:Microspheres in the composite bone cement presented with smooth surface, same size, diffused distribution and no obvious destroy. Thus, the SFM could remain stable in the reaction process of the composite bone cement. The double slow release system which contained silk fibroin microspheres and calcium phosphate bone cement showed a significant decrease in the cumulative release percentage of NAC within the first 24 hours compared with the control group (P < 0.05). In the next 28 days, the release speed of NAC was significantly lower in the NAC-SFM-calcium phosphate cement group than the calcium phosphate cement group (P< 0.05). In addition, different extracts had no significant cytotoxicity to the growth of MC3TC-E1 cels. Thus, the NAC-SFM-calcium phosphate cement has good cytocompatibility, which provide a new insight into the development of bone repair biomaterials.

BACKGROUND:Calcium phosphate cements (CPCs) possess the bio-degradation and osteoconduction, and its final hydration product, hydroxyapatite, is the main inorganic constituent of bones. However, its poor mechanical property makes it unable to be used for repairing weight-bearing bone defects. OBJECTIVE:To develop a kind of bioactive bone cements with decent biomechanical property and biocompatibility. METHODS:6%silk fibroin aqueous solutions containing different concentrations of N-acetylcysteine (0, 10 and 25 mmol/L) were prepared. Each cement sample was prepared by mixing the curing liquid andα-tricalcium phosphate powder with the ratio of 0.4 mL:1 g;α-tricalcium phosphate powder mixed with ddH2O as control group. The compressive strength, setting time of the cements were measured. The crystal components of the cements were characterized using X-ray diffraction and the microstructure was observed using scanning electron microscope. MC3T3-E1 cel s were seeded onto the material in each group, and cel morphology was observed under scanning electron microscope at 24 hours. MC3T3-E1 cel s were cultured in the extract of each material, cel proliferation was detected at 1, 3, 5 and 7 days, and the lactate dehydrogenase level was detected at 1 and 3 days. RESULTS AND CONCLUSION:X-ray diffraction and scanning electron microscope showed that the final hydration products ofα-tricalcium phosphate in al specimens were hydroxyapatite. When the concentration of N-acetylcysteine was 25 mmol/L, the compressive strength of the material reached (49.39±1.68) MPa, with the initial setting time of (21.77±1.07) minutes and the final setting time of (31.88±1.69) minutes. There was no significant difference in cel morphology among cements. These results suggest that the cement containing N-acetylcysteine exhibites good biocompatibility and high mechanical strength.