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 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 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.

AIM: To evaluate the effect of Shenfu injection on hemodynamics of hypovolemic shock patients and oxygen delivery by transesophageal Doppler echocardiography (Hemosonic 100 TM). METHODS: The transesophageal probe was placed in 32 patients with hypovolemic shock. 50 mL Shenfu injection were intravenously administered within 5 min. The parameters, including ABF, SVa, Acc, LVETi and TSVRa, were recorded at interval of 5, 10, 20, 30, 60 and 120 min. Meanwhile, MAP was measured at the same interval. Arterial and venous blood gases were taken at the beginning and 30, 60 and 120 min of the trial. DO2, VO2 and ERO2 were calculated. RESULTS: Acc, SVa, ABF increased while TSVRa decreased at 10 min after administration of Shenfu injection ( P

Objective:To investigate the effects of Chinese medicine prescriptions Gancaofuzi-tang and Tongbi-fang on adjusting the dynamic expression of related cytokines and further ameliorating the histopathology of synovitis in rats with Ⅱ collagen induced arthritis(CIA).Methods:The experimental Wistar rat model of CIA was set up successfully.The rats divided into five groups in random: normal(N),Gancaofuzi-tang treatment(GF),Tongbi-fang treatment(TB),Puwei western medicine treatment(PW) and model control(C).The different medicine was affused into stomach 1.5 ml/rat,once daily.The rats were sacrificed after 6 weeks of medicine administration.Foot swelling degrees of the rats were measured every other day,and then calculate swelling rates.Getting blood after 3 weeks of treatment from rat's innercanthus to detect the level of serum Sialic Acid(SA) and the level of serum IL-2 and TNF-? by ELISA.The synovial histopathology was observed with HE staining under optical microscope.Results:Gancaofuzi-tang and Tongbi-fang significantly decreased swelling rate of joints in CIA rats.The pathology of synovisl tissues was markedly ameliorated.After administration for 3 weeks,the levels of serum SA,IL-2 and TNF-? of the rats in GF and TB groups were significantly decreased compared with the control.Continuous administration for 6 weeks,the levels of the targets in GF and TB rats reached to near the normal level.Conclusion:All the results demonstrate that Gancaofuzi-tang and Tongbi-fang play anti-inflammatory and immunoregulatory roles in CIA rats through inhibiting activation of some inflammatory mediators,adjusting related cytokines expression,then eliminating the joint swelling and improving synovitis pathology,which might be looked as immune suppression effects similar to NSAID medicine.

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.

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.

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.