Post-cardiac arrest syndrome (PCAS) is one of the most common medical emergencies in children.The fatality rate and disability rate are extremely high.Pathogenesis of PCAS remains incompletely clear,and clinical manifestation is complicated.The treatment is mainly limited to supportive care.In recent years,the phases of PCAS are defined according to the pathophysiological changes and clinical prognosis.Investigators also made some advances in the fields of pathophysiological changes and clinical treatment of brain damage and myocardial damage.For the treatment of PCAS,early therapeutic hypothermia,glucose control and seizure control,and reasonable cardiopulmonary support are promoted.In this article,we reviewed the advances in the above fields and the latest advance on the management of PCAS in foreign countries.

Objective To analyze the change of disease spectrum and the direct cause of death in Xi'an Children's Hospital emergency patients in the past 2 years.Methods The cases of death in 130 emergency cases from 2009 to 2010 were retrospectively analyzed.Results The main causes of death in 2009 were pneumonia,congenital heart disease,asphyxia,neonatal pulmonary hemorrhage and intracranial hemorrhage.Meanwhile,The main cause of death in 2010 were pneumonia,asphyxia,viral encephalitis,congenital heart disease and neonatal pulmonary hemorrhage,which significantly changed compared with 2009.Major direct causes of death were found:respiratory failure in 25 cases (27.5％),heart failure in 17 patients ( 18.7％ ),shock in 17patients ( 18.7％ ),asphyxia in 16 cases ( 17.5％ ),and hernia in 16 cases ( 17.5％ ),Conclusion In order to reduce the mortality rate of emergency patients,we should strengthen health care,actively manage pulmonary infection,systemic infection,and shock,control heart failure,and prevent aspiration.

OBJECTIVE: To conduct a quantitative analysis of volatile constituents from Tamarix ramosissima.METHODS: The volatile constituents were extracted from T.ramosissima using solid phase microextraction and identified using GC-MS combined with Kvotas retention index.RESULTS: 34 constituents were separated from T.ramosissima and 25 constituents were identified.The relative mass content of volatile constituents was determined by peak area normalization method,accounting for 89.50% of total peak area.The main chemical constituents were pentadecane (16.83%),nonanal (12.45%),hexadecane (8.20%),tetradecane (8.08%) and hexanal (7.37%).The result showed hydrocarbon (37.11%),aldehyde (27.56%),ketone (8.89%) and alcohol (8.04%) were the main constituents.CONCLUSION: The study can provide scientific basis for the further development of T.ramosissima.

Objective To investigate the relationship between bone mineral density (BMD) and the changes of serum adiponectin (APN) level in elderly men.Methods A total of 240 elderly men was enrolled in this study.Measurement of BMD of lumbar spine with dual energy X-ray absorptiometry was performed.All subjects were divided into three groups (normal,osteopenia,and osteoporosis) according to the T value of BMD.Serum APN level was tested using enzyme-linked immunosorbent assay (ELISA),meanwhile were recorded as bone lurnover markers.Results (1) The level of serum APN in osteopenia group was lower than in normal group,the level of serum APN in osteoporosis group was significantly lower than in osteopenia group,while the level of serum APN in osteoporosis group was significantly lower than in normal group (all P ＜ 0.05).(2) Serum APN was positively correlated with T value of BMD (r =0.475,P ＜0.01).(3) The stepwise multiple linear regression analysis showed serum APN,25-hydroxyvitamin D,β-isomerized carboxyterminal propeptide (β-CTX),and osteocalcin could enter into the equation.Conclusions Serum APN might play an important role in pathogenesis of osteoporosis in elderly men.

OBJECTIVE:To investigate the effect of the extracts of Polygonum lapathifolium on the activity of ?-glucosidase.METHODS:Soxhlet extraction was applied to extract overground part of P.lapathifolium,and the inhibition effect of extracts on ?-glucosidase was determined with 96-microplate-based method,and the inhibitory kinetic characteristics of methanol extract was investigated using Lineweaver-Burk method.RESULTS:The extracts from P.lapathifolium showed good inhibitory activity.The methanol extract had the highest inhibitory activity (IC50=2.13 ?g?mL-1)followed by ethyl acetate extract (IC50=3.826 ?g?mL-1),petroleum ether extract (IC50=230.86 ?g ? mL-1).And they were all higher than that of acarbose (IC50=1 103.01 ?g?mL-1) as positive control.Inhibitory kinetics test indicated that methanol extract was noncompetitive inhibitor.CONCLUSION:The extracts of P.lapathifolium have good inhibition effect on the activity of ?-glucosidase with a good prospect of development and utilization.

Objective To evaluate the effectiveness of low-dose erythromycin for the treatment of feeding intolerance in preterm infants in China.Methods In this study,random clinical trials on the treatment of feeding intolerance in preterm infants with intravenous low-dose erythromycin published were searched at Chinese Journal Full-text Database,Chongqing Weipu Database and Wanfang database by using the methods of Cochrane systematic review.At the same time the information from related journals,professional data and network were hand-searched.The publishing deadline for the literatures reviewed in this study was August 2012.Statistical analysis of clinical data was performed by using RevMan 4.2 software provided by the Cochrane Collaboration.Results A total of 9 studies were included.The results showed that compared with the group of comprehensive therapy,the group of low-dose erythromycin was superior in the following aspects with significant differences(P ＜ 0.05):the average length of hospital stay,time of parenteral nutrition,time to full feeding,the incidence rate of feeding intolerance (Z =3.44,P =0.000 6 ; Z =6.78,P ＜0.000 01 ; Z =3.96,P ＜ 0.000 1 ; Z =2.51,P =0.01).Conclusion Low-dose erythromycin therapy for feeding intolerance in preterm infants is superior to the comprehensive therapy.It provides a prospective therapeutic method for feeding intolerance in preterm infants.However,large scale,multicenter and well-designed clinical trials should be adopted to confirm the conclusions.

OBJECTIVETo investigate the Western Area Surge (WAS) program in the Ebola outbreak of Sierra Leone, and to analyze its implementing effect.

METHODSThe subject of this study was 3,813 laboratory confirmed Ebola hemorrhagic fever (EHF) cases reported in Sierra Leone from November 19, 2014 through January 27, 2015, a period before and after the implementation of the WAS program. To analyze and make conclusions according to the working experience of China Mobile Laboratory Reponses Team in the fight of Ebola outbreak, using WHO published EHF case definition to make diagnosis and compare the number of bed numbers, confirmed EHF cases, samples tested, and positive rates before and after implementation of WAS program.

RESULTSFrom the implementation of WAS program on 17th December 2014 to half a month later, the total numbers of Ebola holding and treatment centers increased from 640 to 960, six additional laboratories were established. On January, 2015, another two laboratories from America and The Netherlands were established. The numbers of samples tested one month before and after WAS program were 7,891 and 9,783, respectively, with an increase of 24.0 percent, while the positive rate of Ebola virus decreased from 22.2% (1,752/7,891) to 11.0% (1,077/9,783). The positive rate of blood samples decreased from 39.6% (248/626) in the month before WAS program to 27.4% (131/478) (χ2=17.93, P<0.001) in the mother after WAS program, the positive rate of blood samples 22.7% (103/454) to 10% (62/609) (χ2=31.03, P<0.001), accordingly. After 3 weeks of WAS program, in addition to Western Area, another four hotspots in Sierra Leone had also reported a significant decrease of the numbers of confirmed EVD cases. Forty-two days after implementation of WAS program, the daily number of laboratory confirmed EHF cases decreased from 63 to 10.

CONCLUSIONWAS program played a vital role in controlling the EHF outbreak rapidly in Sierra Leone. It could also provide guidance for the control similar large infectious diseases outbreak in the future.

BACKGROUND: In recent years, the technique of uniportal video-assisted thoracoscopic surgery has been developed. As a new surgical method, its feasibility and safety have not been generally recognized. The aim of this study is to review the technology in the treatment of lung cancer patients in stage I to part of stage IIIa. METHODS: The clinical data of patients accepted thoracoscopic resection of lung cancer by a same medical group from May 2018 to March 2019 in The First Affiliated Hospital of Soochow University were retrospectively analyzed. After remove of cases that did not meet the requirements, the patients were divided into uniportal group (55 cases) and biportal group (87 cases). The clinical data of the two groups were collected and statistically analyzed. RESULTS: All the 142 patients underwent lobectomy and systemic lymph node dissection. There is no perioperative death in both groups. There was no significant difference in age, location of tumors, pathological type, size of tumors and pathological tumor-node-metastasis (pTNM) staging between uniportal group and biportal group (P>0.05). The operation time [(167.65±43.85) min vs (181.71±51.28) min], the intraoperative bleeding volume [(57.45±50.19) mL vs (87.47±132.54) mL], the indwelling time of drainage tube [(4.82±2.82) d vs (5.84±3.43) d] and the hospital stay [(6.91±3.88) d vs (7.74±3.87) d] were less in uiportal group compared to biportal group, though no significant difference occurred (P>0.05 ). The total drainage volume of uniportal group was significantly lower than that of biportal group [(1,064.82±776.38) mL vs (1,658.71±1,722.38) mL], and the visual analogue score of 24 hours and 72 hours after operation [(4.73±0.73) points vs (5.25±0.74) points; (2.16±0.71) points vs (2.55±0.86) points] were lower in uniportal group (P<0.05). CONCLUSIONS Uniportal video-assisted thoracoscopic radical resection of lung cancer is safe and feasible for stage I to part of stage IIIa lung cancer patients.

BACKGROUND: Although previous studies have shown that meteorological factors such as temperature are related to the incidence of bacillary dysentery (BD), researches about the non-linear and interaction effect among meteorological variables remain limited. The objective of this study was to analyze the effects of temperature and other meteorological variables on BD in Beijing-Tianjin-Hebei region, which is a high-risk area for BD distribution. METHODS: Our study was based on the daily-scale data of BD cases and meteorological variables from 2014 to 2019, using generalized additive model (GAM) to explore the relationship between meteorological variables and BD cases and distributed lag non-linear model (DLNM) to analyze the lag and cumulative effects. The interaction effects and stratified analysis were developed by the GAM. RESULTS: A total of 147,001 cases were reported from 2014 to 2019. The relationship between temperature and BD was approximately liner above 0 °C, but the turning point of total temperature effect was 10 °C. Results of DLNM indicated that the effect of high temperature was significant on lag 5d and lag 6d, and the lag effect showed that each 5 °C rise caused a 3% [Relative risk (RR) = 1.03, 95% Confidence interval (CI): 1.02-1.05] increase in BD cases. The cumulative BD cases delayed by 7 days increased by 31% for each 5 °C rise in temperature above 10 °C (RR = 1.31, 95% CI: 1.30-1.33). The interaction effects and stratified analysis manifested that the incidence of BD was highest in hot and humid climates. CONCLUSIONS This study suggests that temperature can significantly affect the incidence of BD, and its effect can be enhanced by humidity and precipitation, which means that the hot and humid environment positively increases the incidence of BD.
Beijing/epidemiology* ; China/epidemiology* ; Dysentery, Bacillary/epidemiology* ; Humans ; Humidity ; Temperature