Objective To investigate the correlation of oxygen extraction rate (ERO2) with blood lactate clearance rate and cardiac output (CO) in the early stage of post-restoration of spontaneous circulation (ROSC) in patients resuscitated from cardiogenic cardiac arrest,and to analyze the relationship between the ERO2 and prognosis.Methods Fourteen patients successfully resuscitated from in-hospital cardiogenic cardiac arrest in the emergency ICU from October 2012 to January 2014 were retrospectively analyzed.These patients were assigned to survival group (n =5) or death group (n =9) as per the outcome at 72 h after ROSC.At admission (0 h),3,6 and 12 h after ROSC,arterial blood and venous blood were drawn to detect ERO2 and lactate clearance rate.Cardiac output (CO) was measured by thoracic impedance method,APACHE Ⅱ scores were assessed,and survival time was recorded.Results The patients in the death group died during the period of 12-72 hours after ROSC.The significantly decreased ERO2 at 6 h and 12 h after ROSC,and decreased blood lactate clearance rate and decreased CO at 3 h,6 h and 12 h after ROSC were found in the death group compared with the survival group (all P ＜ 0.05).The ERO2 at 6 h and 12 h after ROSC was significantly positively related to blood lactate clearance rate (r =0.857,r =0.947,both P ＜ 0.05) and CO (r =0.968,r =0.936,both P ＜ 0.05) at 3 h,6 h and 12 h after ROSC.The ERO2 at 6 h and 12 h after ROSC was significantly negatively related to APPACHE Ⅱ score (r =-0.970,r =-0.973,both P ＜ 0.05);APPACHE Ⅱ scores were significantly negatively correlated with blood lactate clearancerates (r=-0.880,r=-0.899,r=-0.850,all P＜0.05) and CO (r=-0.876,r=-0.922,r=-0.916,all P＜0.05) at 3 h,6 h and 12 h after ROSC.Conclusions The ERO2 at 6h after ROSC may be used to assess the severity and prognosis of patients resuscitated from cardiogenic cardiac arrest.

Objective:To explore the antioxidant activity of natural plant ingredients lemon essential oil(LEO),limonene(LIM) and tea polyphenol(TP).Methods:The UV-Vis spectrometry was used to determine the 3 agents on the scavenging activity of 1 ,1 diphenyl-2-trinitrobenzene hydrazine free radicals(DPPH·)and hydroxyl free radical (·OH).Results:LEO,LIM and TP showed scavenging effect on the 2 kinds of free radicals.The (DPPH·)scavenging effect:LEO(IC50 =0.01 4)>TP(IC50 =0.01 4)>LIM (IC50 =0.002);the (·OH)scavenging effect:TP(IC50 =0.079)>LEO(IC50 =0.01 3)>LIM(IC50 =0.004).In a certain con-centration range,scavenging effect was increased with the concentration increase.Conclusion:As a nontoxic natural extract,lemon essential oil has strong antioxidant activity.

Objective:To explore the effects of the natural plant ingredients lemon essential oil(LEO),limonene(LIM)and tea poly-phenols(TP)on the cell surface hydrophobicity and adherence of Streptococcus mutans(S.mutans).Methods:S.mutans were treated by sub-minimal inhibitory concentration(MIC)levels of LEO,LIMand TP respectively.Adsorption to hexadecane was used to measure the hydrophobic interaction of S.mutans.A classical 96-cell microtitre plate production assay using crystal violet staining was employed to visualize the adherence of S.mutans to hard tissue surface.Results:LEO,LIMand TP at sub-MIC levels could inhibit the cell sur-face hydrophobicity and adherence of S.mutans in a dose-dependent manner(P <0.05).At 1 /2 MIC and 1 /20 MIC,the inhibitary effect of LEO was stronger than that of LIMand TP(P <0.05).Conclusion:LEO may possess anticariogenic potential.

The worldwide COVID-19 pandemic has made numerous people realize the danger of major infectious diseases, as well as the scarcity and finiteness of medical resources as strategic resources. Traditionally, medical resources are allocated based on the principles of "benefit maximization", "first come, first served", "fairness" and "transparent and reasonable decision-making". Nevertheless, the COVID-19 pandemic broke this rule, and made it difficult to choose in the condition of overwhelmed medical resources. By exploring the allocation criteria of scarce medical resources and the triage, this paper explains the formation reasons of futile treatment, analyzes the countermeasures and basic principles for hospitals at the peak of pandemic, proposes the triage treatment and collective decision-making, so as to improve the efficiency of treatment.

Objective To investigate the influence of circadian rhythm,gender and stain on the tail suspension test in mice.Methods The immobility time of male and female Kunming,BALB/C and C57BL/6 mice in daytime or night were analyzed.Results ① The immobility time of Kunming mice during the day ( ( 114.24 ±11.18)s) was significantly more than that at night ( (65.39 ± 19.17)s).② The immobility time of male BALB/C mice( (68.57 ± 11.27 ) s) was significantly less than that of female BALB/C mice( ( 113.33 ± 3.87 ) s).③ The immobility time of C57BL/6 mice was significant more than that of Kunming and BALB/C mice under the same condition.Conclusions Circadian rhythm,gender and strain could significantly affect the immobility time of mice in tail suspension test.To increase the sensitivity and reliability of the tail suspension test,male Kunming and female BALB/C mice should be tested during the daytime.Compared to Kunming and BALB/C mice,the results of C57BL/6 mice were more stable.

Based on the intermolecular interaction, a molecularly imprinted polymer electrochemical sensor with specific identification of cavity on gold electrode surface was proposed with o-aminophenol as functional monomers and morin as template molecule. The performance and effect of MIP were investigated by cyclic voltammetry ( CV) and differential pulse voltammetry ( DPV) . Factors affecting the properties of sensor, such as polymeric membrane ratio, scanning cycles, elution time and adsorption time were investigated. Substances which had a similar structure to morin was used to compared the selective response. The result showed that the sensor had a good selectivity to morin. Under the optimized experiment conditions, the current response of the imprinted sensor was linear to the concentration of morin in the range of 0 . 05-1 . 7 μmol/L with linear equation as follows: I(μA)= 1. 0800lgc(mol/L)+ 9. 3599(R=0. 9934), and the detection limit of 0. 1 μmol/L. The sensor was used to determine the content of morin in black tea samples, and the recoveries of standard addition were between 104 . 0% and 108 . 0%.

Objective To observe the efficacy of de novo combination therapy lamivudine plus adefovir , lamivudine monotherapy and entecavir monotherapy in HBeAg-positive CHB patients with genotype B/C. Methods A total of 182 treatment-naive CHB patients in line with treatment standards of Chinese CHB prevention and treatment guidelines were randomly assigned to three groups and treated with lamivudine plus adefovir or lamivudine monotherapy or entecavir monotherapy for 48 weeks. Results Patients in three groups presented no difference in baseline levels. After treatment by three therapies , the group of lamivudine plus adefovir showed a higher biochemical response rates (12 week P < 0.01, 24 week P < 0.01, 48 week P < 0.01), HBeAg-serological rates(12 week P < 0.01, 24 week P < 0.05, 48 week P < 0.05) and completely virological response rates (12 week P < 0.05, 24 week P < 0.05, 48 week P < 0.05) than lamivudine group. In terms of biochemical response rates , the group of lamivudine plus adefovir had certain advantages when compared with entecavir group. Conclusion De novo combination therapy lamivudine plus adefovir is a good antiviral strategy for chronic hepatitis B patients with B/C genotype viral infection in China.

At present,domestic and foreign have not yet formed a unified understanding of telemedicine.The distribution of medical resources in our country is not balanced,the grassroots or remote areas are lack of medical resources,especially high quality human resources,thus our country has the inner demand of developing on telemedicine.Due to the lagging of legislation and policy,telemedicine puts forward many legal and ethical challenges on the practicing qualification of physicians,the practicing registration of physicians,the protection of the rights of patients' informed consent and privacy,and so on.We should carefully distinguish the behavior of health counseling or diagnoses & treatment in telemedicine,in order to clarify the legal relationships among of the invitational medical institution,invitee medical institution,and patient,it will be the basis of bearing of legal liability.

Objectives To study the value of CT and MRI in diagnosing focal nodular hyperplasia (FNH).Methods The CT and MRI findings of 16 patients with FNH confirmed histopathologically were analyzed retrospectively.Both plain and dynamic enhanced CT scannings were performed in all the patients.Plain and dynamic enhanced MRI were carried out in 9 patients.Results (1) There were 16 patients with 19 lesions,and 8 lesions were in the left lobe,5 lesions in the right lobe,4 lesions between the left/right lobes and 2 lesions in the caudate lobe.The morphology of the lesions showed 15 lesions to have clear boundaries and 4 lesions to have fuzzy boundaries.The tumor diameters varied from 2.2 to 9.6 cm,(average 4.3 cm).(2) Sixteen patients underwent CT examination.On plain CT,the lesions were isotonic (n＝ 5),or slightly low-density (n=11).In 7 lesions,there was a slit-like,stellate-shaped low density central scar.Nine patients underwent MRI examination.On T2WI,6 lesions showed slightly higher signal while the remaining 3 lesions showed iso-signal.On T1WI,4 lesions showed slightly lower signal,3 lesions showed iso-signal and 2 lesions showed slightly higher signal while in 1 lesion the local signal showed reduction in anti-phase 1.A central scar was seen in 6 lesions which showed high signal on T2WI,and low signal on T1WI.(3) Enhanced CT: 15 lesions were significantly enhanced and 1 lesion showed mild enhancement at the arterial phase.For the patients with mild enhancement,the scar in the center of the lesion showed no enhancement.In all lesions,the central scar did not enhance.In 5 lesions,enhancements of thickened and torturous arteries were seen.In all the lesions with enhancement,the enhancement was reduced at the portal venous phase,with 12 lesions showing slightly higher density,3 lesions isodensity and 1 lesion low-density.Three lesions showed mild enhancement of the central scar.All the substantial parts of the lesions with enhancement declined at the delay phase,with 3 lesions showing slightly higher density,9 lesions of isodensity and 4 lesions slightly low density.In 7 lesions with central scar delayed enhancement,they showed slightly higher density.Nine patients underwent MRI enhancement and the enhancement characteristics were similar to CT,but the arterial phase magnitude was higher than that of CT.In 4 lesions,the central scar began to enhance at the portal venous phase,while 6 lesions continued to enhance,thus showing slightly higher signal at the delay phase.In a large lesion,there was persistent delayed enhancement in the capsule.(4) On DWI,6 lesions showed inhomogeneous,slightly hyperintensity with the center showing a slit-like low signal area.Three lesions showed iso-signal.The ADC values of the lesions were (1.31±0.08)× 10-3 mm2/s,and the normal liver parenchyma were (1.22± 0.14)× 10-3 mm2/s,(difference not statistically significant).Conclusions CT and MRI using plain and dynamic enhanced scans could show fully and accurately the pathological features and the characteristics of blood supply of FNH.The characteristic signs on both CT and MRI make an accurate diagnosis of FNH.MRI when compared with CT was slightly better.A combined use of both CT and MRI has an important value in the diagnosis of FNH.

Objective To analyze the clinicopathologic data and operative parameters of 209 elderly co-lon cancer patients treated by radical resection between January 2002 and December 2011 ,and to investigate the factors related to recurrence and metastasis after colon cancer radical resection in elderly patients .Methods We used univariate and multivariate analysis of Cox regression ,including 14 variables:age,gender,disease duration, hospitalization duration,surgeon experience,operation duration,laparoscopicsurgery,tumor location,tumor size, gross morphology ,differentiate degree ,depth of bowel wall invasion ,lymph node involvement and obstruction .The survival curve was obtained by Kaplan -Meier method.Results Univariate analysis showed that tumor size (RR=2.658,P<0.0001),gross morphology(Infiltrating type,RR=3.407,P=0.0054),degree of differentiation (RR=0.32,P<0.0001) were associated with tumor relapse and metastasis .Multivariate analysis showed that gender(RR=0.585,P=0.0359),tumor size(RR=2.364,P<0.0001),degree of differentiation (Infiltrating type,RR=0.246,P=0.0437),gross morphology(RR=0.31,P<0.0001)were the significant factors.Conclu-sion Gender,tumor size,degree of differentiation,gross morphology were the independent factors of recurrence and metastasis of colon cancer after radical resection in elderly patients .Targeted follow -up for high -risk groups will improve patients′life quality and prolong their survival time .