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.

ObjectiveTo observe the effects of Yishen-Huoxue-Huatan capsule on carotid artery intima-media thickness (IMT),carotid atherosclerosis plaque area and the level of serum lipids,plasma endothelin (ET) and nitric oxide (NO) in patients with carotid atherosclerosis.Methods126 patients with carotid atherosclerotic were randomly assigned to treatment group and control group.Patients in treatment group was treated by yishen huoxue huatan capsule,and patients in control group was treated by zocor.Each patient was treated for 24 weeks.ResultsAfter the treatment,carotid IMT [respectively (0.81±0.11)mm,(1.10± 0.27)mm],atherosclerotic plaque area [respectively (11.21 ± 9.3)mm2,(16.53± 6.9)mm2] in both the treatment group and the control group were significantly lower compared with the same group before treatment (P＜0.05),and the treatment group was better than the control group (P＜0.05); serum cholesterol (TC),respectively [ (4.51 ± 0.37) mmol/L,(5.15 ± 0.20) mmol/L],triglyceride (TG) [respectively ( 1.77± 0.09) mmol/L,(1.79 ± 0.36) mmol/L],high-density lipoprotein cholesterol (HDL-C) [respectively (1.28 ± 0.26) mmol/L,(1.27 ±0.36) mmol/L],low-density lipoprotein cholesterol (LDL-C) [ (2.50± 0.30) mmol/L,(3.10± 0.39) mmol/L] in the treatment group and the control group were improved significantly (P＜0.05) compared with the same group before treatment,and the TC and LDL-C levels in the treatment group were significantly lower than the control group (P＜0.05); plasma ET [respectively (67.26± 14.13) ng/L,(79.38± 11.54)ng/L] NO [respectively (71.65± 111.64)μmol / L,(60.64±14.02)μmol/L] in the treatment group and the control group were higher than those in the same group before treatment (P＜0.05),and the plasma ET levels in the treatment group was significantly lower than the control group (P＜0.05),while the plasma NO level was significantly higher(P＜ 0.05).ConclusionYishen-Huoxue-Huatan capsule is effective in the treatment of carotid atheroselerosis.

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 .

BACKGROUND:Exosome, a kind of cystic vesicle with bilayer structure, is widely distributed in the body fluids. Exosomes are involved in various cel ular communications, and its contents including proteins, short chain peptides, DNA, RNA, phospholipids, and miRNA are resistant to degradation.
OBJECTIVE:To clarify the characters of exosomes, and to investigate the possibility of exosomal miRNAs as biomarkers for different diseases to provide a new strategy for clinical diagnosis.
METHODS:A computer-based search of CNKI and PubMed databases was performed by the first author for articles related to exosomal miRNAs. The keywords were“exosome, microvesicles, extracel ular vesicles, miRNA, biomarker, early diagnosis, progrosis”in Chinese and English, respectively. Total y 50 eligible articles were included in result analysis.
RESULTS AND CONCLUSION:After reviewing researches of exosomes in different diseases, we can confirm that exosomes broadly participant in physiological and pathological process of various system diseases. The abnormal expression of exosomal micro-RNAs has been identified in many studies, indicating the exosomal micro-RNAs have a great potential to be biomarkers for disease diagnosis. Further studies should focus on extracting the contents of exosomes, the pathogenesis of exosomes is involved in and screening the appropriate exosomal miRNAs for early diagnosis.

Objective To construct and identify the shRNA plasmid vector targeting nuclear factor erythroid-2-related factor 2 (Nrf2),and to collect the strongest RNAi effect of Nrf2 shRNA sequence.Methods Nrf2 gene was targeted gene.Three shRNA sequences were designed by software and synthesized by chemical method: shRNA-1,shRNA-2 and shRNA-3.The double strand shRNA oligo was ligated to the vector.The construct was verified by sequencing analysis.BV2 cells were transfected with expressing shRNA plasmid vectors using Lipofectamine 2000.The expression of Nrf2 in the levels of mRNA was detected by real-time PCR,and Western Blot was adopted to abserve the expression of Nrf2 protein.Results Sequencing analysis suggested that the shRNA vectors targeting Nrf2 possessed correct nucleotide sequence and read frame.The result of Real-time PCR and Western Blot showed that the sequence of shRNAi-3 could more effectively knockdown the expression level of Nrf2 than the others.Conclusions The shRNA vectors targeting Nrf2 are successfully constructed and the shRNA can signidicantly inhibit the expression of Nrf2.These findings could provide an experimental basis for further study on Nrf2 signaling pathway in stroke field.

Objective To study the clinical effect of cemented long stem prosthesis and memory alloy embracing fixator in the treatment of type B2 periprosthetic fractures.Methods Fom April 2014 to April 2016,102 cases of peripheral B2 periprosthetic fractures patients were selected and randomly divided into bone cement long stem prosthesis revision surgery(group A) and revision of cemented long stem prosthesis combined with memory alloy embracing fixator(group B),each group with 51 cases.Clinical efficacy was evaluated according to Beals and Tower criteria,used Harris score to evaluate the hip the joint function,used the Visual Analogue Scale(VAS) score to evaluate the pain,after follow-up of 40 months,the clinical curative effect of 2 groups of patients,fracture healing time,complications and Harris score and VAS score were observed.Results The excellent rate of B group was significantly higher than that of A group,with statistical significance(90.2% vs.72.5%,χ2=5.239,P<0.05).Fracture healing time of group B was shorter than that of group A,with statistically significant ((10.2±2.5) weeks vs.(21.3±8.9) weeks,t=8.575,P<0.05).Harris the score of group B was higher than the group A,with statistically significant((89.9±13.5) points vs.(71.2±18.9) points,t=5.750,P<0.05).VAS score of group B was significantly lower than the group A,with statistically significant((1.23±0.25) points vs.(5.98±1.08) points,t=30.600,P<0.05).There were no complications such as infection,nonunion,loss of reduction and loosening of internal fixation in the 2 groups.Conclusion Revision of cemented long stem prosthesis combined with memory alloy embracing fixator is an ideal methods for the treatment of type B2 periprosthetic femoral fractures,which provides a good initial stability for fracture healing.

The graduates of Traditional Chinese Medicine Institutions face greater pressure in recent years' severe employment situation.It is an effective way to develop career education for students to achieve a good career planning and placement.The paper mainly discusses the status of career education in the Traditional Chinese medicine institutions,the mode establishment,the core latitude and the significance of career education.

Objective To evaluate left ventricular torsion and untwisting in patients with coronary artery disease by speckle tracking imaging. Methods Study population consisted of 48 patients, who were diagnosed coronary artery disease initially and received one of coronary arteriography, coronary artery spiral computerized tomography, radionuclide imaging, interventional therapy and bypass surgery. High frame rate (≥60 frame/s) two-dimensional dynamic images of the left ventricular apical long-axis views and parasternal short-axis views at basal and apical levels were recorded. Rotation was measured in the left ventricular short-axis views using 2D strain software. Left ventricular torsion was defined as relative rotation degree between the apical level and basal level. Patients were divided into three groups according to clinic final diagnosis [myocardial infarction ( MIN) group, n = 19; myocardial ischemia ( MIS) group, n =19; normal coronary artery (Contrast) group, n - 10]. Results In MIS group,peak rotation value and rotation value at aortic valve closure in basal level were smaller than those in apical level. Untwisting rate reduced in MIN group. There was linear correlation between left ventricular peak torsion and end-diastolic diameter. There was aslo linear correlation between left ventricular peak torsion and eject fraction. Left ventricular peak rotation at basal level was correlative to eject fraction. Left ventricular untwisting rate had linear correlation to eject fraction, and also had correlation to peak torsion. Conclusions In patients with myocardial ischemia, left ventricular rotation value at apical level is larger than that at basal level. Left ventricular diastolic function is injured severely in patients with myocardial infarction. Untwisting rate is a quantitative index to evaluate myocardial diastolic function.