Cardiac arrest has high morbidity and mortality and is hard to be accepted by family members.It is related to a series of economy and social problems.Resuscitation science is aimed to study the epidemiology,pathophysiology,mechanisms,and management of the sudden states of illnesses or injuries which result in impending or actual cessation of oxygen delivery.After 40 years research,the current hot issues in this area included cell injury,the role of automatic external defibrillation and mild therapeutic hypothermia.Research on these focuses will improve survival rate after cardiopulmonary resuscitation.

Post-resuscitation multiple organ dysfunction syndrome(PR-MODS) is a major cause of low survival rate in patients with cardiac arrest.To fully understand the concept of PR-MODS is beneficial for estimating the state of illness,adjusting the therapy and eventually increasing the survival rate.This article reviews the development of PR-MODS concept and compares it with MODS of other causes,including their pathogeny,pathology,mechanism,diagnosis and therapy.

Objective To explore the effective mechanism of tumor necrosis factor-?(TNF-?) and interlukin-8(IL-8) in experimental lung damage by observing changes of TNF-? and IL-8 concentration in lung tissue during abdominal infection. Methods The cecal ligation and perforation were utilized to make the abdominal infection in rats.The rats were sacrificed respectively at 0,24,48,72,96 and 120 hours after operation. The pulmonary vascular permeability and the amount of different cells in bronchoalveolar lavage fluid(BALF) were examined. The concentrations of TNF-? and IL-8 in BALF, lung tissue and plasma were assayed. Results The pulmonary vascular permeability and the neutrophil percentage of BALF increased progressively. The concentrations of TNF-? and IL-8 significantly increased in plasma, lung tissue and BALF. Significant correlation was respectively present between the TNF-? levels and the IL-8 levels in lung and BALF. The levels of TNF-? and IL-8 in lung and BALF were not correlated respectively with those in plasma. Conclusions TNF-? and IL-8 may be implicated in the inflammatory reaction of lung during early stage of abdominal infection. Lung injury derived from intestinal infection could be early discovered through assaying TNF-? and IL-8 concentration in BALF.

Objective:To investigate the mechanism of lung injury after cardiopulmonary resuscitation(CPR) in rats. Methods: Cardiac arrest was induced by asphyxiation(succinylcholine) and ice-cold 0.5 mol/L KCl in rats and CPR was carried out 5 min after arrest. Sixteen adult male Sprague-Dawley rats were randomly allocated into 2 groups:control group(n=8) and CPR group(n=8). The blood gas analysis,serum level of tumor necrosis factor ?(TNF-?),lung tissue wet mass/dry mass ratio(W/D),lung malondialde-hyde(MDA) content and myeloperoxidase(MPO) activities were measured 3 h after CPR. The histological appearances of the lungs were observed under light and electron microscope. Results: Compared to the control group,the lung W/D,serum TNF-?,pulmonary MDA and MPO activity increased dramatically in CPR group while PaO 2 decreased 3 h after resuscitation(P

Objective To investigate the effects of hypotonic sodium chloride hetastarh 40 injection(HSCH)on the expression of PMN Fas following hemorrhagic shock,and to explore the effective role and mechanisms of HSCH on hemorrhagic shock.Methods Modified Wiggers canine hemorrhagic shock model was used.Expression of Fas in PMN was measured by flow cytometry.Results The levels of PMN Fas expression during hemorrhagic shock were significantly lower than those in control group(P

The paper focuses on the (Primary Diagnosis at Grassroots Level,PDGL),and the current pilot situation and consequence of PDGL,analyzes the problems during the progresses,and dissects the conflicts of interest among the relative stakeholders.At last,the paper provides the corresponding countermeasures to the future development of PDGL.

Objective To observe the clinical effectiveness of calcium sodium phosphosilicate desensitizer for the treatment of root-dentin hypersensitivity.Methods This was a randomized,single-blind,placebo controlled pilot study.135 subjects,a total of 215 teeth with a confirmed diagnosis of root-dentin hypersensitivity were randomly divided into three groups:group 1 (patients treated with 100％ calcium sodium phosphosilicate powder with 7％ calcium sodium phosphosilicate toothpaste),group 2 (patients treated with a placebo powder with 7 ％ calcium sodium phosphosilicate toothpaste),group 3 (patients treated with a placebo powder vith 0.11％ NaF toothpaste).Two standard test stimuli,cool air and cold water,were applied to sensitive root surfaces.Subjects recorded the intensity of sensitivity in response to each stimulus on a visual analogue scale (VAS) at baseline,immediately after powder application and after 2,4 and 6 weeks of twice-daily product use.Results The VAS values stimulated by cool air immediately,and 2,4 and 6 weeks after the treatment were [[(4.87±1.98),(3.85±1.09),(2.03±1.16),(0.59±0.51),respectivly] in Group 1; [(6.35±1.84),(4.83±0.75),(3.17±1.12),(1.45±0.91),respectively] in Group 2; [(6.83±0.78),(6.73±1.54),(5.441.58),(4.18±0.98),respectively] in Group 3.The VAS values stimulated by cold water immediately,and after 2,4 and 6 of treatment were [(6.43±1.01),(4.95±1.21),(3.06±0.86),(1.38±0.92),respectively] in Group 1; [(7.72±0.56),(5.65±0.69),(3.81±0.41),(2.17±0.58),respectively] inGroup2; [(8.380.89),(8.17±1.02),(7.99±0.74),(6.46±0.77),respectively] in Group 3.Compared with before treatment,there were significant differences in VAS values stimulated by the two tests at all time points in Group 1,and after 2,4 and 6 weeks of treatment in Group 2 (all P ＜0.05).Group 3 had significant differences in VAS values stimulated by cool air after 4 and 6 weeks of treatment,and had a significant difference in VAS values stimulated by cold water after 6 weeks of treatment (all P＜0.05).There were significant differences between group 1 and group 2 in the hypersensitivity reduction over baseline by two stimuli at all time point.Conclusions The 7％ calcium sodium phosphosilicate toothpaste shows a good performance in relieving the root dentin hypersensitivity.Moreover,the 100％ calcium sodium phosphosilicate powder can enhance the effectiveness of the 7％ calcium sodium phosphosilicate toothpaste.

Objective To study the effects of Shen-fuinjection onthe activity of β-adrenoreceptor in SD rats with cardiopulmonary resuscitation. Method The exprimerit was done at emergency medical lab of Shanghai Changzheng hospital.Cardiac arrest was induced thngh asphyxiation(succinylcholine)and ice-cold 0.5 mol/L KCI in rats,and resuscitation began at five minutes after cardiac orrest.In this experiment,seventy-two male SD rats were randomizly divided into 9 groups:control group(sham group),routine treatment(O.5 h,2 h,4 h,6 h) groups.and Shen-fu treatment(O.5 h,2 h,4 h,6 h),and each group had 8 rats.Rats of Shen-fh treatment groups were injected with shen-fu(20 mL/kg,20 mL/h)during CPR.3H-prazosln Wag used to determine the activity of β-adrenoreceptor in myocyte. The data of the statistic analysiswere presentedin the for mofmeaj14-standard(4-5)deviation.One-way ANOVA was used for muhig Toup comparison,and t-test for comprarison between two groups.Results[3-adrenoreeeptor reached peak at0.5 h after CPR(247.81±8.91)fmol/mg,reached the lowest level at 4 h(104.17 4-13.87)fmol/mg,and returned to the normal level at 6 h(178.53±10.42)fmol/mg.In the eady period.-adrenorecepter activity in control group[O.5 h:(259.91-4-18.09)finol/mJ was similar to that in Shenfu treatment groups(P>O.05).In the late phase,adrenoreeeptor activity in the Shen-fu treatment groups[2 h:(173.04±18.77)fmol/mg,4 h:(148.72±13.88)finoL/mg]was significantly hi#er than that in the control groups(P<0.05).Conclusiom After CPR, ceplor activity firstly rises and then declines,and Shenfu injection Call significantly increase adrenoreceptor activity of mrs in the later period after CPR.

Objective To study the antimicrobial susceptiblity,clinical and bacteriological characteristics of enterobacter cloacae infection in ICU. Methods 83 cases of ICU infected with enterobacter cloacae were analyzed retrospectively. Results The elderly, hypoproteinemia,invasive operation,long-term hospitalization and the abuse of broad-spectrum antibiotics were the risk factors of infection with enterobacter cloacae. Besides highly sensitive to imipenem, the bacterium was resistant to most antibiotics, many of whose drug resistance ratio is over 50%. Conclusion The patients in ICU should be avoided the long-term abuse of broad-spectrum antibiotics and invasive operation.Bacterial culture and antibiotic susceptibility test should be carried out promptly. They could reduce the incidence of enterobacter cloacae infection.

Objective To investigate the effect and safety of long-term use of atorvastatin on carotid atherosclerosis in advanced elderly patients.Methods Totally 61 elderly patients with carotid atherosclerosis were permitted into study.They were treated with atorvastatin (20 mg/d) and followed-up for five years.The carotid atherosclerosis parameter and the serum levels of TC,TG,LDL-C,HDL-C,fasting blood glucose (FBG),ALT,AST,STB,CB,Bun,Cr and creatine kinase (CK) were measured before and 5 years after treatment.Results During fellow-up,2 patients died of severe pneumonia and 1 patient died of operation complications of intestinal obstruction,with mortality rate of 4.9％.2 patients (3.4％) gave up treatment because of muscle-related side-effect.Data was collected in 56 patients achieving study end.There was significant decrease in LDL-C (P＜0.05) and increase in HDL-C (P＜0.05),but there was no change in serum levels of TC,TG,FBG,ALT,AST,STB,CB,BUN,Cr and CK (P＜0.05) after 5 years.The total area of carotid atherosclerosis plaque was reduced [(0.63±0.41)cm2 vs.(1.07±0.67)cm2,P＜0.05] and echo of carotid atherosclerosis plaque was enhanced (2.67±0.52 vs.1.53±0.44,P＜0.01),but carotid intima-media thickness(IMT) appeared no change after five years.Conclusions Atorvastatin is safe in the treatment of advanced elderly patients,it can make carotid atherosclerosis plaque smaller and stable after long-term treatment.