Cardiac arrest in children is one of the most critical clinical situations,posing a serious threat to life.With the progress of cardiopulmonary resuscitation and the advanced life support technology,children's cardiac arrest survival rate is higher than before,but many of the survivors suffer from neurological sequelae.Since the causes of out-hospital cardiac arrest and in-hospital cardiac arrest are different,their prognosis and influence factors are also different.Death risk factors for cardiac arrest in children are cancer,hepatic insufficiency,acute renal failure,sepsis,systemic inflammatory response syndrome,etc.Cardiopulmonary resuscitation,as the main emergency treatment of cardiac arrest,is also one of the main factors affecting survival of cardiac arrest child.

BACKGROUND: There are various methods for management of allogeneic bone, xenogeneic bone and various tissue engineered materials, but there is no ideal method for treatment of insufficient bone mass following jaw defects. OBJECTIVE: To observe the repair efficiency of bone composite and biomembrane following large mandibular defect and mandibular defect combined with tooth luxation in animal studies. DESIGN, TIME AND SETTING: The controlled observational animal study was performed at the Animal Laboratory of Zhejiang University from March to July 2006. MATERIALS: The mixed proportion of Bio-oss material and autologous bone powder was 1:1. The proportion of recombinant human bone morphogenetic protein-2 freeze-dry powder dissolved in autologous fresh blood was 0.25 mg:1 mL. Bone powder mixture was moistened by blood containing human bone morphogenetic protein to stick on the medicine spoon for moulding easily. METHODS: Ten New Zealand rabbits were selected. Consecutive bone defects (15 mm×6 mm×5 mm) were made in the inferior border of bilateral mandible body. Bone composite and Bio-gide membrane were randomly implanted into one side (bone composite + Bio-gide membrane group). Another side was directly sutured as blank control group. The remaining 30 rabbits were considered bone composite + Bio-gide membrane + implantation tooth group. A bone defect (15 mm×6 mm×8 mm) was made at the upper site of inferior border of mandible, with the combination of tooth luxation. Bone composite and Bio-gide membrane were implanted, and the luxation teeth were implanted into the original site. MAIN OUTCOME MEASURES: Implantation site, composite conjugation, loose of bone formation and implanted teeth were generally observed. New bone formation at the bone defect site was observed using radiograph and histological method. RESULTS: At 12 weeks following surgery, a bone defect, which was smaller than the original bone, was found at the mandibular defect site in the blank control group. New bones were visible in the mandibular defect site in the bone composite + Bio-gide membrane group. Radiograph demonstrated that the density of defect bone site was similar to normal bone tissue. Histological method revealed that bone implant formed board-shaped bone. No significant loose was detected in implanted teeth of 17 rabbits in the bone composite + Bio-gide membrane + implantation tooth group. Radiograph demonstrated that no transparent area was found in the root tip of 13 rabbits. Histological method showed replacement resorption in 13 rabbits. CONCLUSION: Bone composite combined with Bio-gide membrane for repairing large mandibular defect obtained good efficiency. The outcome of autologous tooth implantation is acceptable in the near future.

Objective To observe the effects of Compound Uncaria Hypotensive Tablets on expressions of MCP-1 and MMP-9 of vascular remodeling in spontaneously hypertensive rats (SHR); To discuss it possible mechanism of action. Methods Totally 24 12-week old male SHR were randomly divided into SHR model group, Compound Uncaria Hypotensive Tablets group, and positive medicine group, with 8 rats in each group. Another 8 WKY rats were set as normal control group. Medication groups were given relevant medicine for gavage for successive 6 weeks. Noninvasive tail cuff method was used to observe blood pressure; morphological changes in thoracic aorta and renal artery were observed by HE staining; immunohistochemistry was used to detect the protein expressions of MCP-1 and MMP-9 in thoracic aortic wall. Results Protein expressions of MCP-1 and MMP-9 in thoracic aortic wall of SHR model group were significantly higher than those of normal control group (P<0.01); Compared with the SHR model group, protein expressions of MCP-1 and MMP-9 in thoracic aortic wall decreased significantly in the medication groups (P<0.05, P<0.01); Compared the Compound Uncaria Hypotensive Tablets group and positive medicine group, there was no obvious difference in protein expressions of MCP-1 and MMP-9 in thoracic aortic wall. Conclusion Compound Uncaria Hypotensive Tablets can reduce the blood pressure of SHR, reduce inflammation reaction, and regulate vascular remodeling, which mechanism may be related to down-regulation of expressions of MCP-1 and MMP-9 in SHR aortic endothelial cells.

OBJECTIVE:To study the stability of Tramadol hydrochloride,Fentanyl citrate and Ondansetron hydrochloride in-jection in 0.9% Sodium chloride injection. METHODS:At room temperature [(25±1)℃],three injections were poured into infu-sion bag of disposable analgesia pump,and diluted with 0.9% Sodium chloride injection. The changes in precipitation,turbidity, color and pH value of the mixture were observed. The relative percentage of three injections within 72 h were determined by HPLC method. RESULTS:There was no significant change in the pH value and appearance of the mixture. Relative percentage of tramad-ol hydrochloride,fentanyl citrate and ondansetron hydrochloride were all higher than 97% within 72 h. CONCLUSIONS:The mix-ture of Tramadol hydrochloride,Fentanyl citrate and Ondansetron hydrochloride injection in 0.9% Sodium chloride injection keep stable within 72 h under room temperature.

0.05). CONCLUSION The PCNA labeling index may reflect the proliferating condition of NIP, but does not have relationship with NIP recurrence. And the role of p27 in the development of NIP needs more investigation.

Objective To establish a sensitive and specific liquid chromatography method for the determination of loganin and morroniside in rat serum containing Liuwei Dihuang Formula(LDF).Methods Loganin and morroniside were extracted from the rat serum using SPE column,then separated on a C_(18)column.A HPLC method for determining serum concentration of mor- roniside and loganin in rats before and after administration LDF was established.Results A good linear calibration curve of lo- ganin and morroniside was obtained.The recovery of the method was in the range of 95 %～105 %.The extracted recovery was more than 75 % ,and within-day and intra-day precisions were less than 12 %.Conclusion This method is sensitive, simple and rapid for monitoring of drug level in the study on pharmacokinetics and different combination of LDF.

Objective To perform the sample survey on the recognition degree of abdominal compartment syndrome (ACS) among domestic pediatric healthcare providers (PHCP) Methods Three hundred self‐designed questionnaires were distributed to the participants at the twelfth Chinese Medical Association Congress of Pediatric Critical Care Medicine in November 2011 .Results A total of 194 effective questionnaires were reclaimed with the recovery rate of 64 .7% .28 .9% (56/194)of respondents did not heard of ACS .49 .5% (96/194)of them heard of ACS ,but did not contact ACS .Only 21 .6% (42/194)of respondents were well fa‐miliar with ACS .Among the medical staffs who were aware of ACS (familiar or just heard of ) ,only 7 .2% (10/138)knew the real definition of ACS .83 .3% (35/42) of respondents who were familiar with ACS used the intravesical route to measure the intra -ab‐dominal pressure(IAP) .However ,only 57 .1% (20/35)of respondents knew the correct saline volume for measuring IAP .Conclusion The recognition degree of ACS is low among domestic PHCP .It is necessary to strengthen the ACS related education among do‐mestic PHCP for increasing the awareness of ACS and promoting its treatment .

Objective To investigate the clinical characteristics,treatment and prognosis of hepatoblastoma (HB) patients with the central nervous system (CNS) metastasis.Methods The clinical data of 12 patients with CNS metastasis who were admitted to Beijing Tongren Hospital,Capital Medical University from January 2011 to June 2016 were retrospectively analyzed.The clinical features,treatment and prognosis of HB patients with CNS metastasis were summarized.Results (1) Clinical features:all 12 patients were diagnosed as stage-Ⅳ patients according to postoperative Children's Oncology Group (COG) stage system.The primary positions of extrahepatic metastatic characteristics were as follows:lung metastasis in 12 cases,bone metastasis in 3 cases,and adrenal metastasis in 2 cases,right atrial metastasis in 1 case,and abdominal lymph node metastasis in 1 case.Fetal and epithelial mixed type was the most common type in pathologic Pathologic classification of HB (50％,6/12 cases).CNS metastasis was detected in all 12 cases during the course of treatment.Brain metastasis were found in 11 cases of CNS imaging features,and 1 case had spinal metastatic tumors.(2) The treatment for CNS metastasis:all cases were given chemotherapy-based comprehensive treatment after being diagnosed as CNS metastasis of HB.Ten cases of CNS metastasis were treated by maintenance chemotherapy and 2 cases received chemotherapy plus intracranial tumor resection.(3) The prognosis of HB with CNS metastasis:the follow-up time was from 7 months to 54 months in 12 HB cases with CNS metastasis,and the median follow-up time was 20 months.The survival time of HB was 1-15 months,and the median survival time was 3.5 months after the diagnosis of CNS metastasis.Two cases of CNS metastasis were given intracranial tumor resection and chemotherapy and were followed up to June 2016,and survival time was 15 months and 5 months respectively.The survival time of other 10 cases without intracranial surgery was 1-6 months,and the median survival time was 3 months.By drawing survival function curve and applying Log-Rank test for CNS transfer children,the survival time of patients given intracranial tumor resection and chemotherapy was longer than those without surgery (P ＜ 0.05).Conclusions The occurrence of CNS metastasis occurred in HB patients in phase-Ⅳ patients with pulmonary metastasis.The most common site of CNS metastasis is brain metastasis,which is hematogenous metastatic pathway,and 1 case of spinal cord metastasis was considered as the local invasion and metastasis.For HB cases with CNS metastasis,the survival time is short and the prognosis is poor,but the survival time might be prolonged for the phase-Ⅳ patients with intracranial tumor resection.

Objective To investigate the awareness of osteoporosis and its influential factors in middle-aged and older people. Methods By using self-designed questionnaire, 354 middle-aged and old people were investigated as to their awarness of osteoporosis in Chajiao street community in Guangzhou. Among them, 58 people were measured the bone density in the calcaneal bone by Ultrasound. Results The average score of the questionnaire was 9.46 ± 5.13, and the accuracy was 39.4%. In the diagnosis and treatment, the accuracy was just 17.8%. The diet (the accuracy in 54%) and sport (the accuracy in 50.3%) were good. The statistical analyses showed the linear relationship between the T value of bone density and the age (P = 0.021), between the T value and the score (P = 0.047). Wilcoxon rank sum test found that the T value between female and male was significantly different (Z = -3.749, P < 0.000). With multiple linear regression analysis, the T value had a linear correlation with the score (F = 4.224, P = 0.045) positively. Conclusions Currently, the awareness of osteoporosis in the middle-aged and old people was inadequate. To better prevent osteoporosis, the propogation of knowledge and guidance provided by clinicians in osteoporosis should be improved necessarily and emergently.

Objective To investigate the response of mesenchymal stem cells in mice to mediumdose X-ray irradiation in vitro.Methods The mouse mesenchymal stem cell line C3H10T1/2 was submitted to 3.5 Gy X-ray irradiation.Hoechst33258 staining of adherent cells and Annexin V-FITC staining and flow cytometry analysis of suspension cells were performed respectively to assess cellular apoptosis at 3,6,12,24,48,72 h and 1 week after irradiation.SA-β-gal staining was performed to analyze the cellular senescence at 24,48,72 h and 1 week after irradiation.The mRNA level of both Fas with its ligand FasL and p53 with its downstream target p21 WAF1 were measured by Real-Time PCR analysis.The expression of Fas protein was determined by immunofluorescence staining.Results An increased apoptosis was observed at 3 h after irradiation with apoptosis rate 11.72％ ± 1.61％ ( t =9.01,P ＜0.01 ),the apoptosis rate reached the peak level at 12 h 20.52％ ± 1.96％ (t =16.27,P ＜ 0.01 ),and then declined progressively to normal level at 48 h 4.93％ ±0.46％ (t =2.26,P ＞0.05).The SA-β-gal positive rate of post-radiation cells at 72 h was 53.33％ ± 5.62％,significantly higher than that of normal control 3.24％ ± 0.39％ (t =17.77,P ＜ 0.01 ).The level of Fas,FasL mRNA was found to be elevated 3 h after irradiation with a peak at 12 h,and no differences were found l week later.The level of Fas protein was observed to reach the peak at 12 h after irradiation.The occurrence of peak level of Fas/FasL mRNA and protein was consistent with that of apoptosis of C3H10T1/2 cell.A transient up-regulation of p53,p21 WAF1 mRNA expression was found at 12 h after irradiation followed by a significant increase later at 72 h after irradiation.The occurrence of the two peaks of p53,p21WAF1 mRNA expression were coincident with that of cellular apoptosis and senescence,respectively.The levels of p53,p21WAF1 mRNA in senescence group were significantly higher than those of apoptosis group ( t =17.85,13.36,P ＜ 0.01 ).Conclusions The MSC cell line C3H10T1/2 was sensitive to medium-dose X-ray irradiation.Cell apoptosis occurred immediately after irradiation and cellular senescence happened at advanced stage.Both Fas/FasL and p53/p21 WAF1 signal pathway mediate the injury of C3H10T1/2 cell to medium-dose X-ray irradiation exposure.