Objective:To design real-time transmission system for pre-hospital emergency electrocardiogram(ECG) so as to provide specialty and accurate diagnostic analysis about ECG before patient achieved at hospital and to shorten the waiting time for diagnosis and treatment after they achieved at hospital.Methods: 4G network and virtual private dial-up network(VPDN) were used to real-time transmit ECG data of patient from ambulance to hospital so as to doctors of ECG department and emergency room can analyze the detecting reporter, choose plan of emergency guidance and prepare operation and treatment for patientsaccording to the received ECG data in time.Results: The situations of emergency patients have been grasped and been primarily confirmed before they achieved hospital, therefore, the doctors could made relative preparation for fast and specially treating patients after they once achieved hospital.Conclusion: The real-time transmission system of pre-hospital emergency ECG can remedy the shortage of technical strength of pre-hospital emergency team, and shorten the treating time of emergency patients, and increase the success rate of rescue.

Periostin is a highly conserved functional protein, which plays an important role in the process of vascular injury and myocardial fibrosis. In recent years, there have been more and more studies on the peirostin protein in cardiovascular diseases. This article summarizes the present understanding regarding the relationship between periostin and cardiovascular disease.

Asbestos ; toxicity ; Humans ; Occupational Exposure ; adverse effects ; Pulmonary Alveolar Proteinosis

BACKGROUND:Many in vivo and in vitro experiments indicate that implantation of exogenous basic fibroblast growth factor can significantly promote the process of bone formation, but the in vivo degradation of exogenous basic fibroblast growth factor affects the therapeutic efficacy.
OBJECTIVE:To observe the effects of basic fibroblast growth factor-transfected mesenchymal stem cells which transfected using molecular biology techniques combined with al ogeneic bone in the repair of critical-size bone defects in sheep.
METHODS:Al ogeneic bone with basic fibroblast growth factor-transfected bone marrow mesenchymal stem cells, bone marrow mesenchymal stem cells combined with al ogeneic bone material stents, al ograft bone material,β-tricalcium calcium material were respectively implanted into critical-size bone defects in sheep. After 4, 8 and 12 weeks, histological and immunohistochemical staining was performed.
RESULTS AND CONCLUSION:At 12 weeks after implantation of al ogeneic bone with basic fibroblast growth factor-transfected bone marrow mesenchymal stem cells as tissue engineering bone, there were many cartilage-like structures in the operative binding region and a large amount of osteoblast-like cells in the center of operative region, and there was more material degradation in the entire operative area as compared with other groups;there were fibrous connective tissues ful of the pores, and osteoclast-like cells were commonly seen around the implant material;bone sialoprotein and col agen type Ⅰ expression were strongly positive. In the other three groups, although the cartilage-like structure appeared in the binding region, dead bone structure was found in the central area, and bone sialoprotein and type Ⅰ col agen expression was weak. These findings indicate that al ogeneic bone with basic fibroblast growth factor-transfected bone marrow mesenchymal stem cells can basical y repair critical-size bone defects in sheep.

Objective To explore central mechanism of metformin(MET)in salt -sensitive hypertensive rats by assessing the effect of metformin on inflammation and oxidative stress in hypothalamic paraventricular nucleus (PVN),sympathetic nerve activity and blood pressure.Methods Eight -week -old male Dahl salt -sensitive rats were divided into 4 groups:the normal -salt diet control group[0.3% NaCl +intracerebroventricular(ICV)artificial cerebrospinal fluid(aCSF)],the normal -salt diet with MET group(0.3% NaCl +ICV MET 25μg/d],the high -salt diet control group (8% NaCl +ICV aCSF),the high -salt diet with MET group (8% NaCl +ICV MET 25μg/d). Mean arterial pressure(MAP)was determined every week by a tail -cuff occlusion.After 6 weeks,all rats were eutha-nized,and blood and brain tissues were collected.Then,the plasma norepinephrine(NE,an indicator of sympathetic activity)was detected by enzyme linked immune sorbent assay(ELISA).The expression levels of interleukin(IL)-1β,IL -10 and NOX -2[a subunit of NAD(P)H oxidase],superoxide dismutase(SOD)in the PVN were detected by immunofluorescence,immunohistochemistry and Western blot methods.Reactive oxygen species(ROS)was detec-ted by dihydroethidium(DHE)staining.Results The MAP level of high -salt diet with metformin group was attenu-ated compared with that of the high -salt diet control group[(129.55 ±6.52)mmHg vs.(154.47 ±6.57)mmHg, F =121.90,P <0.05].The change of plasma NE level of high -salt diet with metformin group was lower compared with that of the high -salt diet control group[(364.57 ±30.73)pg/mL vs.(547.68 ±25.08)pg/mL,F =179.24, P <0.05].The expression levels of IL -1β,IL -6,NOX -2 and ROS were markedly higher in high -salt diet with metformin than those of the high -salt diet control group(F =27.80,21.20,22.48,31.99,all P <0.05),which of IL -10 and SOD was lower(F =17.69,23.69,all P <0.05).Conclusion Metformin may attenuate blood pressure in salt -sensitive hypertensive rats,at least partly via decreasing inflammatory molecules and inhibiting oxidative stress in the PVN,subsequently inhibiting sympathoexcitation.

50.0%.CONCLUSION:The extensive use of antibacterials results in increased drug resistance,while rational use of antibiotics is the key of decreasing drug resistance and multidrug resistance.It is of great importance to analyze the variation of bacterial drug resistance in area hospital.

BACKGROUND: Hydroxyapatite/β-tricalcium phosphate biphasic ceramic bone has good cel compatibility, but its mechanical properties are poor. OBJECTIVE: To construct chitosan/ or calcium alginate/biphasic ceramic bone scaffolds and to detect their mechanical properties and cytocompatibility. METHODS: Different concentrations of chitosan (2%, 4%, 7%, 10%) or calcium alginate (3%, 4%, 5%, 7%) were mixed with biphasic ceramic bone to prepare chitosan/biphasic ceramic bone scaffold and calcium alginate/biphasic ceramic bone scaffold. Their morphology and structure, coagulation time, anti-dissolution properties, shear force, compressive strength and cel compatibility were detected. RESULTS AND CONCLUSION: (1) Coagulation time: with the concentration increase, the initial and final setting time of these two kinds of composite scaffolds were prolonged to some extent. (2) Scanning electron microscopy: these two kinds of composite scaffolds showed porous microstructures with different pore sizes. (3) Anti-dissolution properties: the calcium alginate/biphasic ceramic bone scaffold (3%, 4%, 5%, 7%) and chitosan/biphasic ceramic bone scaffold (7%, 10%) had good anti-dissolution properties in the liquid. (4) Mechanical strength: with the concentration increase, the shear force and compressive strength of the calcium alginate/biphasic ceramic bone scaffold were reduced. (5) Cel compatibility: the cytotoxicity of chitosan/ or calcium alginate/biphasic ceramic bone scaffolds was graded as 0-1 or 2-3, respectively. These results show that the chitosan/biphasic ceramic bone scaffold has better mechanical properties and cel compatibility than the calcium alginate/biphasic ceramic bone scaffold.

Two hundred women with singleton pregnancy at full term undergoing cesarean section with combined spinal-epidural anesthesia were randomly assigned into 2 groups (n=100 in each group). During anesthesia the polyvinyl chloride epidural catheter was used in control group and the wire-reinforced epidural catheter was used in study group.The results showed that the number of patients in whom blood or blood-tinted fluid was withdrawn from epidural catheter was significantly lower in study group than that in control group.The domestic wire-reinforced epidural catheter can reduce the incidence of blood vessel injury induced by insertion of epidural catheter.

Objective To evaluate the effect of airway pressure release ventilation (APRV) in patients with acute lung injury/acute respiratory distress syndrome (ALI/ARDS), to evaluate the extent of ventilator-induced lung injury (VILI), and to explore its possible mechanism. Methods A prospective study was conducted in the Department of Critical Care Medicine of the First Hospital of Hebei Medical University from December 2010 to February 2012. The patients with ALI/ARDS were enrolled. They were randomly divided into two groups. The patients in APRV group were given APRV pattern, while those in control group were given lung protection ventilation, synchronized intermittent mandatory ventilation with positive end-expiratory pressure (SIMV+PEEP). All patients were treated with AVEA ventilator. The parameters such as airway peak pressure (Ppeak), mean airway pressure (Pmean), pulse oxygen saturation (SpO2), mean arterial pressure (MAP), heart rate (HR), central venous pressure (CVP), arterial blood gas, urine output (UO), the usage of sedation and muscle relaxation drugs were recorded. AVEA ventilator turning point (Pflex) operation was used to describe the quasi-static pressure volume curve (P-V curve). High and low inflection point (UIP, LIP) and triangular Pflex volume (Vdelta) were automatically measured and calculated. The ventilation parameters were set, and the 24-hour P-V curve was recorded again in order to be compared with subsequent results. Venous blood was collected before treatment, 24 hours and 48 hours after ventilation to measure lung surfactant protein D (SP-D) and large molecular mucus in saliva (KL-6) by enzyme linked immunosorbent assay (ELISA), and the correlation between the above two parameters and prognosis on 28 days was analyzed by multinomial logistic regression. Results Twenty-six patients with ALI/ARDS were enrolled, and 22 of them completed the test with 10 in APRV group and 12 in control group. The basic parameters and P-V curves between two groups were similar before the test. After 24 hours and 48 hours, mechanical ventilation was given in both groups. The patients' oxygenation was improved significantly, though there were no significant changes in hemodynamic parameters. The Pmean (cmH2O, 1 cmH2O = 0.098 kPa) in APRV group was significantly higher than that in control group (24 hours: 24.20±4.59 vs. 17.50±3.48, P < 0.01; 48 hours: 18.10±4.30 vs. 15.00±2.59, P < 0.05). After ventilation for 24 hours, the ratio of patients with increased Vdelta in APRV group was higher than that in control group (90% vs. 75%), but without statistical difference (P > 0.05). The SP-D level (μg/L) in serum in APRV group showed a tendency of increase (increased from 19.70±7.34 to 27.61±10.21, P < 0.05), in contrast there was a tendency of decrease in control group (decreased from 21.83±7.31 to 16.58±2.90, P > 0.05), the difference between the two groups was statistically significant (P < 0.05). After 48-hour ventilation, SP-D in APRV group was decreased, but no change was found in control group, and no significant difference was found as compared with that of the control group (16.45±8.17 vs. 17.20±4.59, P > 0.05). There was no significant difference in serum KL-6 between the two groups before and after ventilation. The SP-D and KL-6 levels in serum were unrelated with 28-day survival rate of the patients. The odds ratio (OR) of SP-D were 0.900 [95% confidence interval (95%CI) = 0.719-1.125], 1.054 (95%CI = 0.878-1.266), 1.143 (95%CI = 0.957-1.365), and the OR of KL-6 were 1.356 (95%CI = 0.668-2.754), 0.658 (95%CI = 0.161-2.685), 0.915 (95%CI = 0.350-2.394) before the test, 24 hours and 48 hours after ventilation (all P > 0.05). Conclusions APRV was similar to lung protective ventilation strategy in oxygenation and improvements in the lung mechanics parameters. APRV with a higher Pmean can recruit alveolar more effectively, and it had no impact on hemo-dynamics, but might exacerbate VILI.

According to the widely use of peripheral inserted center catheters , this paper reflects ethical issues form the aspects such as the evaluation before catheter is lack of standards , the access and appraisal system is lax , the continuation of care does not reach and lack of humanistic care aspects .Furthermore , the article points out that the scientific assessment , grasping the indications strictly , strengthening the norms , stricting access system , taking the initiative to follow -up, strengthening health education , the professional ethics , the humanistic care and so on, can ensure the safety of patients and improve nursing service level as a whole .