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.

BACKGROUND: In spite of some good successes of nickel-titanium alloy have been achieved in orthopaedic surgery, there are still serious limitations in clinical application, such as potential leakage of elements and ions, which could be toxic to cells, tissues and organs. OBJECTIVE: To review the research progress and the exiting problems of nickel-titanium shape memory alloy in orthopaedics and to provide theoretical supports for safe use of the alloy in clinical practice.METHODS: A computer-based online search of Springerlink and CNKI was performed for articles published between 2003 and 2010 both in Chinese and English. The search was conducted respectively with the key words of "nickel-titanium shape memory alloy (NiTi-SMA), biocompatibility, modifications, orthopaedics". Researches regarding nickel-titanium shape memory alloy and its properties, clinical applications, corrosion performance, biocompatibility, corrosion resistance by surface/structure modifications and the long-term challenges were included. Irrelevant or repetitive articles were excluded. RESULTS AND CONCLUSION: Nickel-titanium shape memory alloy has special value in medical field due to favorable shape-memory and superelasticity. However, due to the nickel toxicity, it is of great importance to elevate corrosion resistance of nickel-titanium alloy. The modifications of the alloy are the main focus and direction for further research.

The paper described the main function modules, system architecture, key technology and reservation business process of the appointment register platform system; security measure of the reservation platform system, as evidenced by the access of third-party payment interface, multi-tier data service, digital safety network among others which are designed to ensure the security and operability of the system.

(-)-Epigallocatechin-3-gallate (EGCG),a natural medicine with anti-neoplastic activity,significantly prevent cancers via inhibiting tumor cell proliferation,suppressing angiogenesis and promoting apoptosis,etc.Furthermore,the new discoveries about anti-tumor mechanisms of EGCG in digestive system,reproductive system and respiratory system shorten the course of EGCG application in clinical.

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.

It was found that there was a significant increase of the number of circulating leucocytes 2h after a subcutaneous injcetion of isoprenaline and severe myocardial necrosis occurred after consecutive injections for 3 d.Cytoxan-induced depletion of leucocytes resulted in an obvious decrease of the percentage of myocardial necrosis.In the control.the neutrophilic phagocytosis was enhanced and their release of acid phosphatase elevated greatly,which indicates that the neutrophils are in an activated state.After the.neutrophils were inhibited with dexamethasone or indomethacint significant reduction of the contents of prostaglandin E2 and malondialdehyde and an increase of superoxide dismutase activty in the myocardium were observed and consequently myocardial necrosis was greatly alleviated.Our findings suggest that neutrophils might play an important role in the pathogenesis of myocardial infarction through the release of lysosomal enzymes and the production of oxygen-derived free radicals and certain metabolites of arachidonic acid,and proper regulation of the neutrophilic functions could exert prophylactic effects on myocardial infarction.This might be a promising direction to look for more effective drugs to treat myocardial infarction.

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 investigate preventive effect of physiotherapy inflatable mattress with replacement sheets on patients with pressure ulcer. Methods:Eight hundred cases of patients at high risk of pressure ulcer were randomly divided into A group (Conventional bed unit, 405 cases), B group (Physiotherapy inflatable mattress with replacement sheets, 395 cases), which observed skin changes in patients with pressure ulcer and the incidence of pressure ulcers. Conduct evaluation on nursing service satisfaction of patients. Through the Newcastle nursing service satisfaction scale. Results:The rate of pressure ulcer of A group is 6.42%, the rate of pressure ulcer of B group is 3.54%. The rate of pressure ulcer in B group was significantly lower than that in A group. The patients in B group on nursing service satisfaction improved significantly than that of A group. Conclusion: Physiotherapy inflatable mattress with replacement sheets mode not only can save manpower, and can reduce the occurrence of pressure ulcers in critically ill patients, and improve nursing service satisfaction at the same time.

Objective To investigate different scoring systems in predicting the severity of acute pancreatitis(AP).Methods The clinical data of 1 56 patients with AP were retrospectively reviewed.Ser-um c-reactive protein(CRP)levels were measuredat admission.According to the Chinese guidelines for the management of acute pancreatitis(2007),all the patients were categorizedas either mild acute pancre-atitis(MAP)or severe acute pancreatitis(SAP).Ranson,acute physiology and chronic health evaluation (APACHE)-Ⅱ,bedside index for severity in acute pancreatitis(BISAP),and computed tomography se-verity index(CTSI)scoring systemswere calculated according to the corresponding grading standardsin all patients.Patients were divided into MAP group(APACHEⅡ <8,Ranson <3,BISAP <2,CTSI <3 and CRP <21 .4)and SAP group (APACHEⅡ≥8,Ranson≥3,BISAP≥2,CTSI≥3 and CRP≥21 .4)ac-cording to the scoring results.ROC curve was used to compare the difference among the systems.Results Among the 1 56 patients,21 (1 3.5%)were classified as SAP and 1 35 as (86.5%)MAP.AUCs for Ranson,BISAP,APACHEⅡ,CTSI,and CRP in predicting SAP were 0.69 (95%CI:0.62-0.76),0.74 (95%CI:0.66-0.80),0.78 (95%CI:0.70-0.84),0.69 (95%CI:0.61 -0.76),and 0.68 (95%CI:0.57-0.78),respectively.There were no significant differences among these scoring systems.Conclusion There were no significant differencesin predicting the severity of AP among these scoring systems. Therefore,the early prediction of SAP should consider multiple scoring systems,and the referential signifi-cance of accessing and applying a simpler laboratory indicator deserves further studies.