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.

(-)-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.

ObjectiveTo study the effect of salmon calcitonin in treating knee osteoarthritis.MethodsFortyeight cases of knee osteoarthritis were randomly divided into four groups,twelve cases each group.A group:acetaminophen+glucosamine hydrochloride,B group:meloxicam+glucosamine hydrochloride,C group:salmon calcitonin + glucosamine hydrochloride,D group:salmon calcitonin.Acetaminophen and meloxicam can stop as pain symptoms disappeared.Other drugs were treated for 12 weeks.A follow up was carried out to compare visual analogue score and 12-item short form health survey.ResultsTwelve weeks later,A,B,C,D four groups' visual analogue score decreased from before treatment 5.6±1.2,5.5±1.2,5.4±1.0,5.1±l.2 to 1.9±0.8,1.2±0.7,0.8±0.6,0.9±0.7,12-item short form health survey score from before treatment - 23.4±3.1,- 23.8±3.0,-24.8 ±3.8,-22.4±2.8 to -15.1±4.7、- 14.5±4.7,-9.3±6.2,-10.2±5.3.There was significant difference before and after treatment in every group(P＜ 0.05).The visual analogue scores of B,C and D group outweigh A group's (P＜ 0.05).A and B groups'scores of 12-item short form health survey were lower to C and D groups' ( P ＜ 0.05 ).ConclusionsSalmon calcitonin can relieve pain in treating knee osteoarthritis.

ObjectiveTo assess the impact of nutrition education on the outcomes and dietary intake during pregnancy.MethodsFrom January 2007 to December 2008,240 healthy pregnant outpatients were selected from Jining First People's Hospital.Subjects were randomly and equally divided into the intervention group and control group,and the intervention group received nutrition education till labor.Through the comparison of two groups,the impact of nutrition education on the outcomes and dietary intake was assessed.ResultsBirth weight of the newborn infauts was significantly lower in the intervention group than the control group( (3.15 ±0.81 )kg vs (3.33 ± 0.56)kg,t =2.04,P ＜ 0.05).Compared with the control group,the incidence rate of anemia was lower in the intervention group (45.8％ vs 59.8％,x2 =4.56,P ＜0.05).The intervention group had higher proportion of supplementation in iron,folic acid and compound vitamins (P ＜ 0.05).Significant differences were also observed in the frequency of intake fried food,pork,poultry,milk,soybean milk and fresh fruits (P ＜ 0.05).ConclusionNutrition education can improve the outcomes and dietary intake during pregnancy.

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 investigate the effects of nicergoline on the treatment of posterior circulation ischemia vertigo (PCIV).Methods A total of 87 patients with PCIV were randomly treated either with nicergoline (45 cases) or betahistine (42 eases).Dizziness assessment rating scale (DARS) and dizziness handicap inventory (DHI) were used to evaluate the changes of manifestations before treatment,after 7 days and 8 weeks treatment with nicergoline,meanwhile transcranial Doppler ultrasound (TCD) and brainstem auditory evoked potential (BAEP) were observed to assess the effects.Results After 7 days of treatment,the scores of DARS and DHI were decreased significantly in nicergoline group (DARS:15.6±2.1 ; DHI:38.3± 11.4) and control group (DARS:14.3±4.4; DHI:39.5±14.7) compared with the scores before treatment (DARS:24.9±7.3,22.5 ±9.7; DHI:55.8±19.7,57.5±19.3) (all P＜ 0.05),and the treatment efficiency was 71.1％ (32/45),61.9％ (26/42).After 8 weeks of treatment,the scores of DARS and DHI were also decreased significantly in nicergoline group (DARS:8.9 ±3.9; DHI:26.3± 12.8) and control group (DARS:9.9±4.7; DHI:35.8±13.1) compared with the scores before treatment (all P＜ 0.05),and the treatment efficiency was 93.3％ (42/45),78.6％ (33/42).There was significantly differences in the scores of DHI and treatment efficiency between the two groups at 8 weeks (t =2.169,P＜ 0.05,and x2=3.98,P＜ 0.05),but no differences at 7 days (both P＞ 0.05).In consistent with the remission of the clinical symptoms,nicergoline group significantly recovered from both low blood diffusion in the verbal-basal artery system and extended peak latency(PL) and inter peak latency(IPL) in the auditory pathway examined by TCD and BAEP individually at 8 weeks,especially in the upper part of the brainstem (P＜0.05).Conclusions Nicergoline is very effective in the treatment of PCIV and could alleviate the subclinical ischemia to get long time benefits.

Objective To investigate the clinical value of simultaneous assessment of cardiac troponin I,Btype natriuretic peptide,and C-reactive protein in prediction of long-term cardiac outcome after cardiac surgery.Methods 224 patients undergoing cardiac surgery were included and followed up within 12 months after surgery.Serial blood samples were drawn in all patients the day before surgery,at the end of surgery,and 6,24,and 120h after surgery.Major adverse cardiac events within 12 months after surgery were chosen as study endpoints and were defined as malignant ventricular arrhythmia,myccardial infarction,congestive heart failure,the need for myocardial revascularization,and/or death from cardiac cause.Predictive ability of each cardiac biomarker was assessed using logistic regression.Results Accuracies of C-reactive protein,cardiac troponin I,and B-type natriuretic peptide,considered as continuous variables to predict the occurrence of major adverse cardiac events were limited(area under receiver operating characteristic curve:0..54[0.47 ～0.60],P =0.42,0.62[0.55 ～0,68],P =0.01,and 0.68[0.61 ～0.74],P ＜0,001,respectively).When biomarkers were considered as 75％ specificity dichotomized variables,evaluated C-reactive protein(＞ 180mg/L),cardiac troponin I(＞ 3.5ng/ml),and B-type natriuretic peptide (＞ 880pg/ml)were independent predictors of major adverse cardiac events(odds ratio:2.14[1.03 ～4.49],P =0.043,2.37 [1.25 ～ 5.64],P =0.011,and 2.65 [1.16 ～ 4.85],P =0.018,respectively) in a multivariate model including the European System for Cardiac Operative Risk Evaluation score.Conclusion Simultaneous measurement of cardiac troponin I,B-type natriuretic peptide,and C-reactive protein improves the risk assessment of long-term adverse cardiac outcome after cardiac surgery.

Objective To examine the academic emotions and its relationship with academic self-efficacy among secondary special school students. Methods 352 secondary special school students were collected as the subjects.All subjects were tested with academic emotions questionnaire and academic self-efficacy questionnaire and analyzed the result of the test by multivariate analysis of variance,correlation analysis and linear regression analysis. Results Scores on enjoyment,anxiety,anger,depression,total scores on positive-high arousal academic emotions and negative-high arousal academic emotions of secondary special school girls(27.88±3.84,24.77±5.03,18.03±3.37,18.14±3.65,59.33±7.98,57.48±10.49,respectively)were higher than those of boys(26.41±4.55,22.38±5.71,17.01±3.91,16.07±3.94,57.46±9.20,53.45±11.76,respectively),(P<0.05).The academic emotions' differences among different grades of secondary special school students were not significant(F-(1,348)=1.275,P=0.226).The interaction of gender and grade on academic emotions was not significant(F-(1,348)=1.057,P=0.397).Academic emotions and academic self-efficacy was interrelated(r=-0.513～0.685).The result of multiple regression analysis showed that each factor of academic self-efficacy played a significant predictor role on academic emotions(β=-0.631～0.462,P<0.01). Conclusion The academic emotions' differences between secondary special school boys and girls are significant. Academic self-efficacy is closely related to academic emotions.

Objective To assess global systolic function of left ventricle (LV) using speckle tracking echocardiography in patients who are left volumetric overload and to establish the correlativity between strain and left ventricle end-diastolic volume index (LVEDVI). Methods Seventy-seven patients who were left volumetric overload and 30 normal volunteers were enrolled in this study. Respective 3 high frame rate (＞ 100 frames/s) 2D images were recorded from the left ventricular short axis views: the levels of mitral valve annulus, papillary muscle and apex. Three global peak systolic radical strain and strain rate were measured using 2D strain imagirg. LVEDV was obtained by two-plane Simpson method and LVEDVI was obtained by normalized LVEDV with surface body area. Patients were divided into 6 groups: transitionalgroup,group A (LVEDVI:90- 120 ml/m2),group B (LVEDVI: 121 - 150 ml/m2 ),group C (LVEDVI:151 -180 ml/m2),group D (LVEDVI: 181 - 210 ml/m2),and group E (LVEDVI＞210 ml/m2). Patients were divided into two groups by left ventricular ejection fraction (LVEF): group Ⅰ (LVEF≥ 50 % ), group Ⅱ (LVEF＜50％). Results①Compared with normal control group,GRS,GRSr in transitional group showed no change at three short axis levels (P ＞0.05). The above parameters in group A, B and C were significantly higher than those in normal control group( P ＜0. 01 ). In transitional group,group A,B and C,GRS, GRSr of three short axis gradually increased with LVEDVI augmentation. Compared with group A, B,C,D and normal control group,the above parameters of 3 short aixs in group E were decreased( P ＜0. 01 ),which gradually decreased in group C, D, E with LVEDVI augmentation. ②GRS,GRSr of 3 short axis views in group Ⅰ were more significantly high than those in group Ⅱ and normal control group. The parameters above were significantly low in group Ⅱ ( P ＜0.01). ③In group A,B,C,GRS of papillary muscle and apex levels were correlated positively to LVEDVI ( rpapillary muscle = 0.55,0.64,0.76 and rspex = 0. 74, 0. 79,0.71,P ＜0.05) ; In group D, there was no correlativity between GRS of papillary muscle and LVEDVI( r =- 0.35, P ＞ 0.05) while negative correlativity was established in apex level( r = - 0.73, P ＜ 0. 05). In group E,the negative correlativity was found between GRS of papillary muscle and LVEDVI( r = -0. 70,P ＜0.05) while no correlativity was established in apex level( r = - 0.39, P ＞0. 05). GRS of mitral valve annulus was correlated positively to LVEDVI in group A, B( r = 0.79, 0.77, P ＜ 0.05) and had no correlativity in group C,D. The negative correlativity between them was found in group E( r = - 0. 54, P ＜0.05). At LVEDVI: 180- 190 ml/m2 ,GRS of papillary muscle and apex level reach the peak point about 93% and 62% ;GRS of mitral valve annulus level reach the peak about 63% at LVEDVI 150 - 160 ml/m2.Conclusions Radial strain,strain rate change periodically with LV volume overload. Wall motion of left ventricle can be evaluated accurately by speckle tracking echocardiography, which provide useful modality for evaluation cardiac systolic function.