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 investigate the epidemiological characteristics of hand -foot -mouth disease (HFMD in Weihai of Shandong province,during 2015,and provide reference for HFMD control and prevention. Methods We analyzed data of HFMD cases in Weihai during 2015 by descriptive epidemiology.Results A total of 8 526 HFMD cases were reported in Weihai during this period,including 64 severe cases but no deaths.The reported morbidity was 304.57 /lakh.The vast majority of patients were 0 -5 years old,representing 89.16% of the patients. Most patients were in preschools or scattered home care environments,accounting for 59.60% and 35.74%, respectively.There were clearly more boys than girls,with a male to female ratio of 1.39:1,which was statistically significant(χ2 =15.013,P <0.001).Compared with the incidence of the national level,all districts in Weihai are with high incidence of HFMD,especially in Huancui district(584.02 /lakh).The cases mainly occurred during June, July.The clinical presentation was characterized by fever and various kinds of vesicles or papules at the hand,foot, mouth or buttocks.Conclusion HFMD is one of the serious health hazards communicable disease to the children under 5 years old in Weihai.According to HFMD epidemiology characteristic,immunization and treatment strategies of HFMD should be further improved.

The cases of cardiac arrest are increasing because of the increased incidence of cardiovascular diseases. Cardiopulmonary resuscitation (CPR) is the necessary measure to rescue these patients. But the success rate of recovery is still low. Acid-base disturbance is one of the important factors affecting the recovery effect. Overseas and domestic studies in recent years focused on the acid-base changes and mechanism in CPR have founded that it exits extraordinary hypercapnia and CO2 spike, which have important guidance to the clinical work. The research for the arterial blood gas analysis during CPR, changes in the exact time, and treatment of hypercapnia and acid-basic change in different etiology and different populations were very few, therefore the a lot of clinical data is needed to accumulate for further study.

Bronchopulmonary dysplasia (BPD) is a chronic pulmonary disease which seriously affects the survival and long term quality of life in premature infants. Its pathogenesis is not yet clear. In recent years, the role of pulmonary vascular dysplasia in BPD has received increasing attention and evolved into a“vascular hypothesis”of the pathogenesis of BPD. Angiogenesis therapy based on this hypothesis has also made some progress in the treatment of BPD. This paper brielfy reviews the current research situation in this ifeld.

BACKGROUND:Exosome, a kind of cystic vesicle with bilayer structure, is widely distributed in the body fluids. Exosomes are involved in various cel ular communications, and its contents including proteins, short chain peptides, DNA, RNA, phospholipids, and miRNA are resistant to degradation.
OBJECTIVE:To clarify the characters of exosomes, and to investigate the possibility of exosomal miRNAs as biomarkers for different diseases to provide a new strategy for clinical diagnosis.
METHODS:A computer-based search of CNKI and PubMed databases was performed by the first author for articles related to exosomal miRNAs. The keywords were“exosome, microvesicles, extracel ular vesicles, miRNA, biomarker, early diagnosis, progrosis”in Chinese and English, respectively. Total y 50 eligible articles were included in result analysis.
RESULTS AND CONCLUSION:After reviewing researches of exosomes in different diseases, we can confirm that exosomes broadly participant in physiological and pathological process of various system diseases. The abnormal expression of exosomal micro-RNAs has been identified in many studies, indicating the exosomal micro-RNAs have a great potential to be biomarkers for disease diagnosis. Further studies should focus on extracting the contents of exosomes, the pathogenesis of exosomes is involved in and screening the appropriate exosomal miRNAs for early diagnosis.

Objective:To investigate the expression of Leucine-rich repeat-containing G protein-coupled receptor 5(LGR5) in endometrial cancer(EC) and their relationship with clinicopathological characteristics.Methods:Immunohistochemistry were performed to measure the LGR5 expression in EC(n =90) and normal endometrium tissue(n =30).The expression of LGR5 and its relationship with clinicopathological characteristics were analyzed.Results:The expression of LGR5 was significantly higher in EC than that in normal tissue (63.3％ vs 23.3％,P＜0.001).The expression of LGR5 in ＜ 1/2 myometrium infiltration group was higher than in ≥1/2 myometrium infiltration group(72.5％ vs 33.3％,P =0.001).There was no significant difference between the expression of LGR5 in different group of age,histological type,histological differentiation,cervical stroma invasion,lymph node metastasis,FIGO stage(P ＞ 0.05).Multivariate analysis showed that LGR5 was an independent influential factor of myometrium infiltration (OR =0.163,95％ CI 0.034 ～ 0.772,P =0.022).Conclusions:LGR5 is up-regulated in EC,and is correlated to myometrium infiltration.LGR5 may play an important role in EC tumorigenesis.

Objective To study the anti-aging effect of total saponins of Polygala tenuifolia (PTS). Methods The effects of total saponins of Polygala tenuifolia on oxygen free radicals were investigated by the methods of scavenging hydroxyl radical, superoxide radical and DPPH oxygen free radicals in vitro. The photoaging model of mice skin was established to observe the effect of total saponins of Polygala tenuifolia on mouse skin pathology. Results In the experiment of antioxidation in vitro, the total saponins of Polygala tenuiflora significantly scavenged hydroxyl free radicals (P<0.05, P<0.001) and superoxide radical (P<0.01) at 6.0 and 12.0mg/mL, DPPH free radicals (P<0.001). In the light aging experiment, the light aging model of mice skin was established successfully in group B (model + medium tea oil). Compared with group B, the density of the skin epidermis in D group (30 min before irradiation, 6mg/mL PTS) was thickened, the elastic fibers were arranged uniformly and tightly, the collagen fibers proliferated significantly and densely, and the inflammatory cells infiltration was not found. The treatment effect was most remarkable in group G (30min after irradiation, PTS 12mg/mL PTS), and the skin of the mice was thickened, the elastic fibers were evenly arranged, the collagen fibers had some hyperplasia, evenly distributed, and there was no infiltration of inflammatory cells, which had significant therapeutic effect. Conclusion The total saponins of Polygala tenuifoliahas significant antioxidant activity and anti - light aging effect.

Hereditary multiple exostoses (HME) is an autosomal dominant genetic disease characterized by multiple benign cartilage-capped tumors primarily at the juxta-epiphyseal region of the long bone or on the lfat bones. Because the tumor can interfere with normal epiphysis, it causes bone deformities. The clinical features include short stature, the mechanical axis deviation, and function impairment. Recent studies showed that EXT gene mutation was associated with HEM. The EXT gene was involved in the biosynthesis of heparin sulfate. The gene mutations resulted in abnormal chondrocyte differentiation. This paper reviews the research progress in clinical manifestation, pathogenesis, biochemistry, the genotype-phenotype correlations, and treatment in HME.

Objective To measure the expressions of TXNIP,STAMP2 and GATA3 in diabetes patients with breast cancer and to determine the changes of oxidative stress indexes before and after surgery.Methods The expression levels of TXNIP,STAMP2 and GATA3 mRNA in cancer tissues and adjacent normal tissues were measured in 45 diabetes patients with breast cancer.The levels of serum oxidative stress indexes including MDA,MPO,SOD and TAC were detected and compared before and after surgery.Results The expressions of TXNIP,STAMP2 and GATA3 mRNA and their protein levels in cancer tissues were lower than those in adjacent normal tissues (P<0.05).The positive expression rate of the three indexes were 60%,66.7% and 73.3%,higher than that of TXNIP protein with 2.2% in the adjacent normal tissues(P<0.05).The TXNIP,STAMP2 and GATA3 protein positive rate of breast cancer tissue were related to differentiation,lymph node metastasis and clinical grades (P<0.05).Serum MDA and MPO levels increased first and then decreased.SOD and TAC showed a trend of decrease first and then increase.The turning point is 6 d after surgery.Conclusion TXNIP,STAMP2,GATA3 and serum oxidative stress indicators may be the indicators for diagnosis and treatment of breast cancer in diabetes patients.