Cardiopulmonary arrest is one of the most critical situations,posing a serious threat to life.With the development of medical technology, the rate of return of spontaneous circulation after cardiac arrest has been improved.However, many children suffer from multiple organ dysfunction because of the long hypoxia time from cardioplumonary arrest, so the rate of long-term survival is relatively low and the long-term outcome is still not satisfactory.Therefore, how to make cardiopulmonary resuscitation more effective is the focus of current research.This article reviews the related factors that affect the outcome of resuscitation, providing references for the treatment of cardiopulmonary arrest in children.

Background One of the important machanisms of all trans retinoic acid (ATRA) is to regulate the expression of connexin (Cx) gene.ATRA inhibits the proliferation and differentiation of retinoblastoma (RB) cells,which is related to Cx43.However,the control site of ATRA and its effect on RB tumor in vivo have not been identified.Objective This study was to investigate the effect of ATRA on Cx43 expression in RB cells and its approach mechanisms.Methods ATRA solution of 1 × 10 2 mol/L was prepared with ethanol and formulated into 1×10 5,1×10-6and 1 × 10 7 mol/L of solution with culture medium further.Human RB cell line (HXO-RB44) was cultured and treated with different concentrations of ATRA for 2,4 and 6 days,respectively.The expressions of Cx43 protein and mRNA in RB cells were detected by Western blot and reverse transcription PCR (RT-PCR),respectively.RB models were established by injecting HXO-RB44 cell suspension into anterior chamber in the right eyes of 15 athymic mice.Eleven successful models were divided into the blank control group,negative control group and 1 × 10-5 mol/L ATRA group,and 0.5％ normal saline solution with athymic or 1 ×10-5 mol/L ATRA solution was injected into the anterior chamber in the negative control group and 1 × 10-5 mol/L ATRA group in the 3-day interval for 3 weeks.The model eyes were examined under the slit lamp microscope.The eyeballs were extracted at the end of the experiment for hematoxylin and eosin staining.Results Western blot assay showed that the absorbance values of Cx43 protein (ACx43/AGAPDH) were increased gradually as time lapse of ATRA treatment among the groups (Ftime =71.31,P =0.00; Fgroup =7.66,P =0.00).The expressions of Cx43 protein were significantly higher in the 1 × 10 5 mol/L ATRA group after 2 days,1 × 10-6 mol/L ATRA group after 4 days,1 × 10-7 mol/L ATRA group after 6 days than those in the blank control group at various time points (t =3.34,P＜0.01 ;t =2.33,P＜0.05;t =3.12,P＜ 0.01).RT-PCR showed that the absorbance values of Cx43 mRNA (ACx43mRXA/Aβ-actin) were significantly enhanced as the prolong of treatment time of ATRT among the groups (Ftime =90.90,P =0.00 ; Fgroup =6.86,P =0.00).The expressions of Cx43 mRNA were significantly higher in the 1 × 10-5 mol/L ATRA group after 2 days,1 × 10 6 mol/L ATRA group and 1 ×10-7 mol/L ATRA group after 4 days than those in the blank control group at various time points (t=3.57,P＜0.01 ;t=6.31,P＜0.01 ;t=2.22,P＜0.05).RB models were successfully created in 11 eyes on the 6-9 days following the intrachamber injection of RB cell suspension.The RB cells were filled with chamber in the blank control group 20 days after injection,and RB only occupied half of the anterior chamber in the 1 × 10-5 mol/L ATRA group.Histopathological examination exhibited that the RB cells were seen in the anterior and posterior chamber as well as vitreous in the blank control group,however,the cells were only found in the anterior chamber in the 1 × 10 5 mol/L ATRA group.Conclusions ATRA can inhibit the growth of RB in vitro and in vivo by inducing the expression of Cx43 gene in transcription process.

Objective To investigate the epidemiological characteristics of hand -foot -mouth disease (HFMD in Weihai of Shandong province,during 2015,and provide reference for HFMD control and prevention. Methods We analyzed data of HFMD cases in Weihai during 2015 by descriptive epidemiology.Results A total of 8 526 HFMD cases were reported in Weihai during this period,including 64 severe cases but no deaths.The reported morbidity was 304.57 /lakh.The vast majority of patients were 0 -5 years old,representing 89.16% of the patients. Most patients were in preschools or scattered home care environments,accounting for 59.60% and 35.74%, respectively.There were clearly more boys than girls,with a male to female ratio of 1.39:1,which was statistically significant(χ2 =15.013,P <0.001).Compared with the incidence of the national level,all districts in Weihai are with high incidence of HFMD,especially in Huancui district(584.02 /lakh).The cases mainly occurred during June, July.The clinical presentation was characterized by fever and various kinds of vesicles or papules at the hand,foot, mouth or buttocks.Conclusion HFMD is one of the serious health hazards communicable disease to the children under 5 years old in Weihai.According to HFMD epidemiology characteristic,immunization and treatment strategies of HFMD should be further improved.

The paper conducts a case study of Tongji Medical College, Huazhong University of Science&Technology, introduces the application and management status of various cards, elaborates the one-card integration program for the management of staffs in the hos-pital and discusses the problems needing attention and the application effect.It is noted that the one-card solution facilitates the simpli-fication of the work process, the improvement of management efficiency and the reduction of management costs.

More and more studies have indicated that the relationship between vitamin D pathway and asthma,and the mechanisms include multiple abnormal aspects of vitamin D pathway leading to abnormal em-bryonic development and immune system disorders and so on. This review summarizes the relationship between vitamin D,vitamin D binding protein,vitamin D receptors,related gene polymorphisms and the immune system to describe the pathogenesis of asthma.

Bronchopulmonary dysplasia (BPD) is a chronic pulmonary disease which seriously affects the survival and long term quality of life in premature infants. Its pathogenesis is not yet clear. In recent years, the role of pulmonary vascular dysplasia in BPD has received increasing attention and evolved into a“vascular hypothesis”of the pathogenesis of BPD. Angiogenesis therapy based on this hypothesis has also made some progress in the treatment of BPD. This paper brielfy reviews the current research situation in this ifeld.

Hereditary multiple exostoses (HME) is an autosomal dominant genetic disease characterized by multiple benign cartilage-capped tumors primarily at the juxta-epiphyseal region of the long bone or on the lfat bones. Because the tumor can interfere with normal epiphysis, it causes bone deformities. The clinical features include short stature, the mechanical axis deviation, and function impairment. Recent studies showed that EXT gene mutation was associated with HEM. The EXT gene was involved in the biosynthesis of heparin sulfate. The gene mutations resulted in abnormal chondrocyte differentiation. This paper reviews the research progress in clinical manifestation, pathogenesis, biochemistry, the genotype-phenotype correlations, and treatment in HME.

Objective To evaluate efficacy and safety of escitalopram in treating depression .Methods In this randomized , single-blind, citalopram parallel controlled, fixed dosage study, the study group was treated with escitalopram tablet 10mg/d and the control group with citalopram tablet 20mg/d.Observation duration was 6 weeks.Hamilton Rating Scale for Depression ( 17-item HAMD),Clinical Global Impression (CGI) and Hamilton Rating Scale for Anxiety (HAMA) were used to measure the efficacy.Items including Treatment Emergent Symptoms Scale (TESS), lab examination and vital signs for assessment of safety .Results Eighty-eight patients were randomly divided into study group (43 patients) and control group (45 patients).After 6 weeks treatment, a signif-icant greater reduction in HAMD 17 ,CGI-SI and HAMA total score was found for both study group and control group showing significant difference with their baseline ( P <0.01 );but there were no significant difference between two groups ( P >0.05 ) .However , after 1 week treatment , the HAMD17 and CGI-SI score reductions between two groups were significant difference ( P <0.01 ) .The score of HAMA was no significant difference between two groups ( P >0.05 ) .In study group , the positive response rates was 81.4%,and in controls was 80.8%, there was no significant difference between two groups ( P >0.05 ) .There was no significant difference about the incidence of adverse reaction between two groups ( P >0.05 ) .Conclusions Escitalopram is a safe and effective antidepressant as citalopram , however , it has a more rapid reaction than the latter .

Objective To observe the clinical efect of Weisu particle combined with Mosapride in the treat-ment of the functional dyspepsia .Methods According to the digital table ,64 patients were divided into two groups in random,32 cases were treated by Weisu particle combined with Mosapride in treat group ,33 cases treated by Mosa-pride in control group .Both have a course of 4 weeks treatment .Results The efective rate of the treat ment group′was/96.87%which was better than that of the control group′(s 68.75%)(χ2=4.68,P<0.05).Conclusion The thera-peutic method of Weisu particle combined with Mosapride have a better clinical effect than that of domperidone only used .

Objective To investigate the efficacy of low dose thalidomide combined with chemotherapy in treatment of multiple myeloma(MM)and the clinical curative effect of the treatment method.Methods From June 2010 to June 2012,80 patients were diagnosed with multiple myeloma as the research object in Traditional Chinese Medicine Hospital of Haining,randomly divided into control group and observation group,with 40 cases in each group.The control group adopted conventional chemotherapy,the observation group were given low dose thalidomide combined with conventional chemotherapy.The clinical effect and adverse drug reactions were compared. Results The total effective rate of observation group (87.5%)was significantly higher than that of control group(65.0%)(P<0.05).The adverse reactions were 87.5%(35/40)in observation group and 100.0%(40/40)in control group,there was no significant difference between the two groups.The mean progression-free survival(PFS)and overall survival(OS)in observation group(5.5 ±1.2 months;1 1.5 ±2.4 months)were higher than those in control group(3.7 ±0.8 months;8.5 ±1.3 months)(P<0.05 ). Conclusion Low dose thalidomide combined with conventional chemotherapy in the treatment of multiple myeloma can improve clinical effect and decrease recurrence rate,with high safety and less adverse reactions.