Objective To evaluate the prognosis and influencing factors of unprotected left main coronary artery lesion intervention with drug-eluting stents.Methods Forty-five patients with unprotected left main coronary artery disease were treated with percutaneous coronary intervention (PCI).According to whether the lesions involving the distal left main bifurcation,the patients were divided into two 2 groups:nonbifurcation lesion group (26 cases) with opening or body disease,bifurcation lesion group (19 cases) with involving the distal left main or anterior descending artery,circumflex openings.Fifteen patients were guided by intravascular ultrasound (IVUS) during PCI,and 13 patients were reviewed by coronary angiography at (9.5 ±6.3) months after PCI.Results All the 45 patients were successful.There were 42 patients successfully finished the follow-up study for the average of 8-48 (19.9 ± 10.2) months,non-bifurcation lesion group was 24 cases,bifurcation lesion group was 18 cases.The incidence of recurrent angina pectoris during the follow-up period in bifurcation lesion group was significantly higher than that in non-bifurcation lesion group [6/18 vs.12.5％ (3/24)],there was statistical difference (P ＜ 0.05),but there was no statistical difference in the incidence of major adverse cardiac events (MACE) between 2 groups [3/18 vs.12.5％ (3/24),P ＞ 0.05].Single-variable analysis results showed that MACE in IVUS guided during PCI was less than that in non-IVUS guided during PCI [1/15 vs.18.5％(5/27)],there was statistical difference (P ＜0.05).In 13 patients who reviewed by coronary angiography,4 patients were found in-stents restenosis,all in bifurcation lesion group,the rate of restenosis in double stents was 3/6,in simple stents was 1/4.Conclusions PCI with drug-eluting stents is safe and feasible for the treatment of selective left main coronary artery lesion,it could bring the better short and long-term outcomes.IVUS guided PCI could significantly reduce MACE.

ObjectiveTo explore the relationship of rejection sensitivity,social inhibition and negative affect in army recruits.Methods358 recruits were measured with rejection sensitivity questionnaire,type D personality scale,and positive affect and negative affect scale.Results(1)The score of intimates' rejection sensitivity was highest(9.33±3.88),peers' rejection sensitivity was in the middle(8.59±3.27),teachers' rejection sensitivity was lowest(6.79±2.90),with statistical significance(F(2,355)=53.76,P<0.01).(2)Rejection sensitivity had significantly positive correlation with social inhibition(r=0.346,P<0.01).Negative affect had significantly positive correlation with rejection sensitivity (r=0.233,P<0.01) and social inhibition(r=0.351,P<0.01).(3)Social inhibition partially mediated the relationships between rejection sensitivity and negative affect(the value of mediating effect was 45.7%).ConclusionRejection sensitivity has direct effects on negative affect and indirect effects through social inhibition.

Objective To observe treatment efficacy of chinese and western medicine treatment for reflux esophagitis. Methods 60 cases with reflux esophagitis were divided into treatment group and control group,treated for 1 month. Results Treatment group the total effective rate was 96. 67%, control group, the total effective rate was 86. 67%. Treatment group and control group treatment results were significantly different( P < 0. 05 ), the difference has statistical significance. The results showed that the treatment group was significantly better than the control group. Conclusion TCM-WM treatment of reflux esophagitis, symptoms could be markedly improved, worthy of further prmotion.

Objective To compare the prognosis effect of different Helicobacter pylori (Hp)eradication methods in patients with chronic gastritis.Methods One hundred and twenty patients with chronic gastritis diagnosed by gastroscopy and pathology examination were divided into sequential therapy group (36 cases),triple-combined therapy group (34 cases),Hp positive without eradication group (30cases) and Hp negative group (20 cases) according to the Hp infection status.All patients were followed up by gastroscopy,biopsy and rapid urease test before and after therapy.Results The Hp eradication rate in sequential therapy group was 94.44％ (34/36),in triple-combined therapy group was 73.53％ (25/34),and there was statistical difference (x2 =5.775,P =0.016).The symptoms scores and gastroscopy scores after therapy in the four groups were significantly lower than those before therapy,and there were statistical differences (P ＜ 0.05).The symptoms scores and gastroscopy scores after therapy in sequential therapy group were significantly lower than those in triple-combined therapy group,and there were statistical differences (P ＜0.05).The symptoms scores and gastroscopy scores after therapy in sequential therapy group,triple-combined therapy group and Hp negative group were significantly lower than those in Hp positive without eradication group [(0.84 ± 0.60),(1.34 ± 0.59),(1.49 ± 0.62) scores vs.(2.98 ± 0.54) scores,(0.47 ± 0.37),(0.83 ± 0.35),(0.96 ± 0.75) scores vs.(1.22 ± 0.40) scores],and there were statistical differences (P ＜ 0.05).Conclusions The Hp eradication rate of sequential therapy is higher than that of triple-combined therapy.The two therapy methods can both improve the symptoms score and gastroscopy score,but the symptoms after sequential therapy are relieved faster compared with triple-combined therapy.

To promote the technical training and scientific popularization of cardiopulmonary resuscitation (CPR) in China, the Cardiopulmonary Resuscitation Specialized Committee of Chinese Research Hospital Association combined with the Science Popularization Branch of the Chinese Medical Association wrote "2018 National consensus on cardiopulmonary resuscitation training in China". The formation was based on the general outline about "2016 National consensus on cardiopulmonary resuscitation in China", and to implement the important strategies included the "three pre" policy, prevention, precognition, and pre-warning, before the cardiac arrest (CA); the "three modernization" methods, standardized, diversified and individualized, during the CA; and the "three life" strategies, the rebirth, the extra and the extended, after the CA; and also combined with the concrete National conditions and clinical practice of China area. The document summarized the evidence of published science about CPR training till now, and recommend the establishment of "the CPR Training Triangle" according to the Chinese National conditions. The bases of the triangle were system, training and person, the core of which was CPR science. The main contents were: (1) The "three training" policy for CPR training: the cultivation of a sound system, which included professional credibility, extensive mobilization and continuous driving force, and the participation of the whole people and continuous improvement; the cultivation of scientific guidelines, which included scientific content, methods and thinking; and the cultivation of a healthy culture, which included the enhancement of civic quality, education of rescue scientifically, and advocate of healthy life. (2) The "three training" program of CPR training: training professional skills, which included standard, multiple, and individual skills; training multidimensional, which included time, space, and human; and training flexible, including problem, time, and innovation oriented. (3) The "three party" direction of CPR training, the application for achievement translation, which included scientific translations, skill propagators, and cultural advocates; the precision disseminators, which included accurate communication sources, channels, and dissemination of the audience; and theoretical innovation guides, which included scientific, popular science and communication theory. That integrated the wisdom of scholars, melt the thought of genius, and created the act of envoy for Chinese and foreign CPR training. The training program should be suitable for different trainee, no matter who is trainer or trainee. The release of the expert consensus on the 2018 CPR training will make the National CPR education into the new training era with definite direction, clear target and fully standard of China.
Cardiopulmonary Resuscitation ; China ; Consensus ; Heart Arrest ; Humans

Objective To prepare a targeted antitumor drug delivery system using large-inner-diameter multi-walled carbon nanotubes (LID-MWCNTs) for sustained release and to study its performance. Methods LID-MWCNTs were puri?fied and oxidized,then use nanocarriers and USTs as homologous blockers. Folic acid and fluorescent labels were conjugat?ed onto the external surfaces of nanocarriers. CDDP (cisplatin) was encapsulated and ultrashort tubes (USTs) were employed to block the drug entry/exit paths. The microstructure of resulted drug delivery system (DDS) was observed, while drug load?ing efficiency and drug release profile in vitro were determined. The tumor-targeting property and cytotoxicity of DDS were also assessed. Results LID-MWCNT based sustained release targeted drug delivery system was established. Drug loading efficiency of CDDP@UST-FA-LID-MWCNTs was as high as 70.97%. A typical biphasic sustained release pattern was dem?onstrated, and the accumulating release time was 18 h. DDS exhibited a certain kind of tumor-targeting property, and inhibit?ed proliferation of tumor cells in a dose-dependent manner. Conclusion CDDP@UST-FA-LID-MWCNT drug delivery system exhibited an improved drug loading efficiency and a sustained drug release profile. It could specifically target the tu?mor cells and had a significant antitumor effect.

Objective To investigate the impact and significance of the vagus nerve intervention on the atrial electrical emodeling.Methods 30 mongrel dogs were given metoprolol in order to eliminate the effects of sympathetic nerve on atrial electrical remodeling;observe the atrial effective refractory period (ERP) and atrial fibrillation susceptible window(VW) in the high right atrial(SA) and coronary sinus (CS) by the vagus nerve stimulation(VS) or vagus nerve stimulation(Non-VS) before and after using atropine and after atrial electrical remodeling was observed.Results Before using vagus nerve blocking agents atropine,ERP shortened significantly [(54.83 ± 46.23) ms] and VW increased significantly [(19.86±13.23) ms] after VS,this time with atrial fibrillation-prone ; After using atropine,ERP increased significantly [(112.33 ± 9.63) ms] under VS,did not induce atrial fibrillation; After atrial electrical remodeling,the value of ERP was no significant difference under basis and VS (t =2.116,0.853,all P ＞0.05).Conclusion VS can increase the atrial electrical remodeling,an increase of atrial fibrillation susceptibility;vagus nerve block can reduce atrial electrical remodeling and atrial fibrillation susceptibility decreased.

Objective To evaluate the role of delta and kappa opioid receptors in sufentanil preconditioning (SPC)-induced attenuation of myocardial ischemia-reperfusion (I/R) injury in rats.Methods Forty adult male Sprague-Dawley rats,aged 2-3 months,weighing 250-330 g,were randomly divided into 5 groups (n =8 each) using a random number table:sham operation group (group S),group I/R,group SPC,δ receptor antagonist naltrindole + SPC group (NTD + SPC group),and κ receptor antagonist nor-binaltorphimine (nor-BNI) + SPC group (BNI + SPC group).Myocardial I/R was induced by 30 min occlusion of left anterior descending branch of coronary artery followed by 120 min reperfusion.In group SPC,5 min infusion of sufentanil 3μg/kg was repeated 3 times at 5 min interval before myocardial ischemia.In NTD + SPC group,naltrindole 5 mg/kg was intravenously injected,at 10 before SPC.In BNI + SPC group,nor-BNI 5 mg/kg was injected intravenously at 15 min before SPC.Arterial blood samples were collected at 120 min of reperfusion for measurement of the serum cardiac troponin I (cTnI) and creatine kinase isoenzyme-MB (CK-MB) concentrations.The rats were then sacrificed and hearts removed for determination of myocardial infarct size (IS) and area at risk (AAR).IS/AAR ratio was calculated.Results Compared with S group,the serum cTnI and CK-MB concentrations were significantly increased in I/R,NTD + SPC and BNI + SPC groups,and the serum CK-MB concentrations were increased in SPC group,and IS/AAR ratio was increased in I/R group (P ＜ 0.05 or 0.01).The serum cTnI and CK-MB concentrations were significantly lower in SPC,NTD + SPC and BNI + SPC groups and IS/AAR ratio was lower in SPC and BNI + SPC groups than in I/R group,and higher in NTD + SPC and BNI + SPC groups than in SPC group (P ＜ 0.05 or 0.01).Conclusion Both κ and δ opioid receptors mediate SPC-induced attenuation of myocardial I/R injury in rats.

Objective To observe the therapeutic effect of rhubarb combined with Probiotics for treatment of patients with severe acute pancreatitis (SAP) accompanied by acute lung injury (ALI). Methods A prospective randomized controlled trial was conducted. Sixty patients with SAP and ALI were randomly divided into a rhubarb group and a combination of rhubarb and Probiotics group (combined group), 30 cases in each group. Both groups were treated with conventional therapy. On that therapeutic base, the patients in rhubarb group were treated with rhubarb 3 g·kg-1·d-1 (Raw rhubarb in boiling water 200 mL was cooked for 30 minutes, then the decoction was divided into two parts to be infused through nasal jejunal tube, retaining for 1 hour);while in the combined group, beside the above rhubarb therapy, the patients were additionally given Probiotics [Clostridium butyric acid:Chang Lekang capsule, once 1 grain (0.42 g), twice a day] through nasal jejunal tube. The therapeutic course was 14 days in the two groups. The plasma endotoxin levels, oxygenation index, and acute physiology and chronic health evaluationⅡ(APACHEⅡ) score were observed before and after treatment for 7 days and 14 days, respectively. After treatment for 30 days, the time of intestine functional recovery and mechanical ventilation, number of damaged organs, number of infectious sites, number of pancreatic pseudocysts, length of intensive care unit (ICU) stay and 30-day fatality rate were observed in the two groups. Results With the prolongation of treatment, the plasma level of endotoxin and APACHEⅡscore in the two groups were gradually reduced, and the oxygenation index was gradually increased after treatment for 7 days and 14 days in the two groups compared with those before treatment, and there were statistically significant differences in above indexes on the 14th day after treatment between combined group and rhubarb group [endotoxin (μg/L): 19.16±1.90 vs. 21.20±1.05, oxygenation index (mmHg, 1 mmHg = 0.133 kPa): 369.50±5.45 vs. 341.50±7.36, APACHE Ⅱscore:11.84±0.60 vs. 13.00±0.86, P<0.05 or P<0.01]. The length of intestine functional recovery in the combined group was longer than that in the rhubarb group (days: 5.63±1.75 vs. 5.02±1.54), the number of damaged organs (2.08±0.74 vs. 2.70±1.11), the number of infectious sites (1.93±0.64 vs. 2.23±0.83), the number of pancreatic pseudocysts (1.22±0.34 vs. 1.63±0.11) and the mortality rate [10.0%(3/30) vs. 13.3%(4/30)] in the combined group were lower than those of the rhubarb group, but there were no statistically significant differences between two groups (all P > 0.05). The times of mechanical ventilation (days: 13.40±1.76 vs. 15.60±1.28) and the length of ICU stay (days:16.13±1.25 vs. 17.63±1.30) were significantly shorter in combined group than those in rhubarb group (both P<0.05). Conclusion Rhubarb combined with Probiotics for treatment of patients with SAP and ALI can promote their recovery of lung function and shorten their length of ICU stay.

Aim To investigate the relationship between GABAA receptor or NMDA receptor and the amnestic effect induced by etomidate.Methods Amnestic model was established by intraperitoneal injection of etomidate(3 mg?kg-1) in mice before intracerebroventricular injection of different doses of bicuculline or NMDA,then the error times,step down latency and step through latency were observed and recorded in the step down test and step through test.Results Bicuculline(2,4 ?g) instead of NMDA by intracerebroventricular injection could decrease the error times and increase the step down latency and step through latency of amnestic mice in the step down test and step through test.Conclusion GABAA receptor rather than NMDA receptor may be an important target for the amnestic effect induced by etomidate.