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.

Programmed cell death 1 (PD-1) is an important negative costimulatory molecule discovered in recent years, which is expressed on the surface of T and B cells and plays an important role in the regulation of cellular immune response and immune tolerance.After the combination of PD-1 and its receptor programmed cell death 1 ligand 1 (PD-L1), negative regulatory signals are transmitted to suppress the immune response.Under the activation of stimulating factors, PD-1 and PD-L1 are combined to weaken the conduction of downstream signaling pathways such as PI3K/Akt and ERK through recruitment of phosphorylated SHP2, thereby inhibiting the proliferation of T cells and the production of cytokines, inhibiting the immune response and participating in the occurrence and development of a large number of inflammatory diseases.PD-1 in the field of ophthalmology research is still in its infancy.As far as we know, PD-1 participates in ocular inflammatory diseases such as uveitis, sympathetic ophthalmia, allergic conjunctivitis, also is involved in corneal transplant rejection, optic nerve crush injury and optic myelitis, diabetic retinopathy, thyroid related ophthalmopathy, melanoma and other diseases, thus preventing the interactions between PD-1 and its receptor PD-L1 may become a new potential target for the treatment of ocular tumor, inflammation, autoimmune and neurodegeneration disease.In this article, the latest research progress of PD-1 and its receptor PD-L1 in the pathogenesis of ocular diseases were reviewed.

ObjectiveTo observe the effect of work simulated training for workers suffered from work-related injuries.Methods65 injured workers joined a 2.8-month (on average) training program by applying the BTE PRIMUS work simulated training system, with six-month follow up period after discharge.ResultsDuring the six-month follow up after discharge, 29(44.62%) workers returned to the same company with the same job,24(36.92%) workers returned to the same company but changed job,6 (9.22%)works changed company and changed job ,6(9.22%)works didn't return to work.ConclusionWork simulated training program can improve injured workers'working ability and help them return to work.

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.

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.

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.