AIM: To establish a RP-HPLC method for simultaneous determination of the dl-tetrahydropalmatine and imperatorin in Yuanhu Zhitong Prescription (Rhizoma Corydalis, Radix Angelicae Dahuricae). METHODS: dl- tetrahydropalmatine and imperatorin were extracted with ether and determined by HPLC using a BDS C 18 column(5?m,4.6?250mm),phosphate buffer(pH6.6)-methanol(39∶61) as a mobile phase. The mobile rate was at 1mL?min -1 and detection wavelength was at 280nm. RESULTS: The relationship between the concentration and the peak area of dl-tetrahydropamaltine and imperatorin were good linear relation, respectively. Either of correlation coefficient approached 0.999. CONCLUSION: This method can be used to determine the concentration of dl-tetrahydropalmatine and imperatorin in the preparation of Yuanhu Zhitong Prescription.

The Lazarus phenomenon is defined as delayed ROSC,or ROSC after failure of CPR and cessation of all the emergency medical care,including the cessation of chest compression,mechanical ventilation,and venous fluid resuscitation.It was first reported in 1982 and 53 cases of Lazarus phenomenon have been reported in the medical literature so far.Even though Lazarus phenomenon is rare and the pathophysiological mechanisms are poorly understood,several possible mechanisms are still proposed,which could be rational to explain this phenomenon,such as auto-PEEP,hyperkalemia,alkalosis,delayed action of drugs,etc.In most cases,it was reported that ROSC occurred within 10 minutes after cessation of medical effort.Therefore,before the announcement of death of patient,it is mandatory to monitor those patients for at least 10 minutes after the cessation of CPR.However,more explicit studies seem to be necessary to gain a better understanding of this phenomenon.

Mortality is a key index for assessing technical level and treatment quality of hospital. We filtered and analyzed the literatures about the influence of nurse factors on patient mortality out of China in recent years to guide the study within China. We found the nurse factors impacting mortality included workload, configuration of nursing staff, education status and working environment. Those findings point out the direction of the research on relationship between nurse factors and patient mortality in China, which has great significance.

Objective To study the protective effects of resveratrol against hepatic stellate cells (HSCs) and liver fibrogensis.Methods HSCs were isolated from liver of SD rats.The reactive oxygen output in HSCs under resveratrol in different concentrations was tested by DCFH-DA kit.The proliferation of HSCs was tested by CCK-8 test kit.Smoothmuscle α-actin (α-SMA) expression of HSCs was evaluated by Western blotting.The activity-related genes were measured by PCR.The models of liver fibrogenes were established.Resveratrol in different concentrations was administrated intraperitoneally.Liver was studied by pathology and SMA staining.Hydroxyproline content of liver and levels of collagen Ⅲ and hyaluronic acid in serum were tested.Results HSCs were isolated from liver and cultured successfully.Resveratrol inhibited the generation of the reactive oxygen.Proliferation and activation of HSCs was inhibited by resveratrol (0.536 ±0.052,0.411 ±0.047,0.327 ±0.063,0.312 ±0.032,F =12.776,P ＜0.05) (103 ±7,90 ±7,63 ± 4,53 ± 3,F =62.179,P ＜ 0.05).Resveratrol inhibited the expression of genes (myogenic determination gene MyoD,collagen 11 and collagen Ⅰ) in HSCs(122 ± 5,96 ± 3,68 ± 3,60 ± 3,F =180.600,P＜0.05) (100±8,82 ±3,53 ±3,51 ±2,F=77.451,P ＜0.05) (170 ±3,147 ±4,92 ±3,90 ±2,F =462.878,P ＜ 0.05).Resveratrol downregulated the level of hydroxyproline,collagen Ⅲ and hyaluronic acid (358.3 ± 20.2,320.5 ± 15.3,290.3 ± 24.5,F =23.929,P ＜ 0.05) (32.8 ± 3.1,28.9 ±1.3,25.3±1.8,F=20.050,P＜0.05)(276.3 ±17.8,225.3 ±28.3,195.4 ±11.2,F=18.585,P＜0.05).Conclusions Resveratrol can inhibit the proliferation and activation of HSCs and downregulate the fibrogensis level of the liver of rats.

Objective To investigate the effects of intra-articular hyaluronan(HA)injection on the expression of cartilage oligomeric matrix protein(COMP)in synovium of strenuous running rats,and investigate the possibility of predicting the effectiveness of HA based on COMP in synovium.Methods 36 healthy male Wistar rats were randomly divided into control group,strenuous running group and strenuous running group and HA injection group.Strenuous running group and HA injection group were intra- articularly injected with HA once a week for 5 consecutive weeks.The histological changes of synovium of knee joint was examined by H.E.staining and immunohistochemical expression of COMP in three groups after 6 weeks' strenuous running.Results Synovial inflammation was less severe in strenuous running and HA injection group than strenuous running group(t =7.15,P ＜0.01).The immunohistochemical expression of COMP in rats'synovium of knee joint in strenuous running and HA injection group was significantly lower than that in rats'synovium in strenuous running group(t = 6.30,P ＜ 0.01).Conclusions Intra- articular HA injection suppressed synovitis,and the expression of COMP in synovium could be used to predict the effectiveness of HA.

Objective To discuss the short-term effect of Sextant system fixation for thoracolumbar fractures without neurological deficit in the field comprehensive operation rescue shelter.Methods There were 32 patients with thoracolumbar fractures without neurological deficit which rescued by our hospital.Those patients included 18 males and 14 females, with average age of (25.54±2.86) years old.All patients were undergoing internal fixation with Sextant system in the field comprehensive operation rescue shelter.Clinical and surgical evaluation including surgery time,intraoperative blood loss,postoperative ambulation time and wound healing time were observed.Functional outcomes of pre-operation and postoperation 3-days were evaluated by visual analog scale(VAS) and Oswestry disability index(ODI).Cobb angle and front height of fracture vertebral body were compared between pre-operation and postoperation 3-days.Results The operation time was (96.55±14.15)minutes, intraoperative blood loss was (45.25±3.55)mL, postoperative ambulation time was (1.20±0.61)days.There were statistical differences in terms of Cobb angle,front height of fracture vertebral body,VAS and ODI between pre-operation and postoperation 3 days.Conclusion The Sextant system fixation in the field comprehensive operation rescue shelter is a timely,safe and effective method for thoracolumbar fractures without neurological deficit,which is deserved to utilize at the scene when war or disaster urgency treatment.

Objective:To investigate effects of the modified adhesion retention on the surrounding tissues of dental implant.Methods:182 patients with tooth defects were randomly divided into 2 groups,The patients in control group (n =89) received the traditional retention,in the test group(n =93) received modified adhesion retention.The bone loss at the near and far edges of the implant,alveolar bone height and thickness,the pictorial view of pink esthetic score variables(PES),the modified plaque index(mPLI),the modified sulcus bleeding index (mSBI) and the satisfaction were recorded and compared 1 year after treatment.Results:Compared with control group,the test group showed less bone loss(P＜0.05),more alveolar bone height and thickness(P＜0.05).The satisfaction of the comfort,chewing and language function,retention,esthetics,PES,mPLI and mSBI improved to varying degrees(P＜0.05).Conclusion:The modified adhesion retention is more effective than the traditional retention in stabilizing the bone support of implant and reduce bacterial infection.

Objective To explore the effects of adipose tissue-derived stem cells (ADSCs) on the proliferation and invasion of pancreatic cancer cell lines in vitro.Methods ADSCs were isolated and co-cultured with pancreatic cancer cells.The proliferation and invasion of pancreatic cancer cells was tested by CCK-8 test kit.Stromal cell derived factor (SDF-1),vascular endothelial growth factor(VEGF),matrix metalloproteinase(MMP-9)and transforming growth factor-β (TGF-β1)in the culture medium were assayed by ELISA.The expression of cytokines in pancreatic cancer cells and ADSCs were detected by qRT-PCR.CCK-8 test kit was used to measure the AMD3100 regulation for the co-culture of ADSCs and pancreatic cancer cells.Results ADSCs can promote the proliferation and invasion of pancreatic cancer cells (all P ＜0.05); more SDF-1,VEGF,MMP-9 and less TGF-β1 was secreted by ADSCs than by pancreatic cancer cells(SDF-1:1100±100 vs.0 vs.0,F=389.134,P＜0.01;VEGF:140±4 vs.99±5 vs.93 ±4,F=174.102,P ＜0.05;MMP-9:61.8 ±4.2 vs.43.5 ±2.8 vs.54.5 ±3.0,F=76.279,P＜0.05;TGF-β1:20.6 ±3.0 vs.35.6 ±2.6 vs.41.3 ±5.5,F =79.338,P ＜0.05).ADSCs promote the expression of VEGF and MMP-9 in pancreatic cancer cells(VEGF:63.7 ±5.9 vs.50.6 ±4.1,t =7.536,P＜0.05; MMP-9:mRNA(55.8±3.6 vs.42.7 ±3.1,t =8.279,P＜0.05).AMD3100 significantly downregulates these growth-promoting effects of ADSCs on pancreatic cancer cells(SW1990:1.539 ±0.140 vs.1.361±0.066,t=2.835,P＜0.05;PANC-1:1.376±0.100 vs.1.281±0.031,t=2.860,P＜0.05).Conclusions ADSCs promote the proliferation and invasion of pancreatic cancer cells.

Heparin and low molecular weight heparin have been widely used in clinical therapy as anticoagulants in cardiovascular disease and in hemodialysis. Crude heparin is usually prepared from porcine intestinal mucosa. Purified heparin is a mixture of polysaccharides consisting mainly of repeating GlcNS(6S)-IdoA2S disaccharides and other disaccharides with different GlcNAc/GlcNS±3S±6S-GlcA/IdoA±2S residues. Heparin injections are drugs prepared from heparin active pharmaceutical ingredient ( API ) that is prepared from crude heparin. Low molecular weight heparins are dominant heparin-based drugs used clinically, which are prepared by degrading heparin into smaller sizes. As a result, low molecular weight heparins are sharing the same major disaccharides but have different reducing and non-reducing ends. In current study, we focused on the disaccharide compositional analysis of clinically used heparin and heparin-based drugs. HeparinaseⅠ,II, and Ⅲ were used to degrade all heparin and heparin-based drugs including heparin sodium injection, Enoxaparin sodium injection, Nadroparin calcium injection, Dalteparin sodium injection, Fondaparinux sodium into disaccharides. All the degraded products were analyzed by strong anion high perforance liquid chromatography ( SAX-HPLC) coupled with an UV-detector. Commercially available unsaturated disaccharide standards were then used for structral identification. Furthermore, unusual disaccharides present in Nadroparin, Dalteparin, and Fondaparinux were confirmed by reversed-phase ion pair HPLC coupled with mass spectrometry. The developed method produced detailed structural information, which should be useful for quality control of heparin and heparin-based drugs.

As one of the cornerstones of modern cardiopulmonary resuscitation (CPR), ventilation received controversy and challenges in the past two decades. From 2000 to 2015, the changes in CPR guidelines of American Heart Association (AHA) showed that the position of ventilation declined gradually as compared to chest compressions. Chest compressions only CPR has been strongly advocated in recent years, especially in witnessed cardiogenic cardiac arrest (CA). Passive oxygenation and cardiocerebral resuscitation (CCR) also showed good effect in the early stage of cardiogenic CA. However, clinical validation in a larger context is still needed. An impedance threshold device (ITD) transiently blocks air from entering the lungs during recoil, decreases the intrathoracic pressure, facilitates venous return to the chest and increases coronary blood flow. However, the relevant research findings are not consistent, and the guidelines do not recommend routine use of ITD. Positive-pressure ventilation, which can increases intrathoracic pressure, affects the coronary perfusion pressure (CPP) and cerebral perfusion, is thought to be not only useless, but also has adverse effects within the first few minutes of CPR. This view is accepted by many scholars, however, ventilation is essential in late-start CPR, prolonged CPR and non-cardiogenic CA. Mechanical ventilation, especially special ventilation modes for CPR showed some prospects. Positive-pressure ventilation remains the gold standard in CPR in clinical practice at present. It was shown by existing research that hyperventilation significantly reduce the success rate of resuscitation, thus a consensus had been reached about avoiding hyperventilation. Currently, the number of studies on ventilation during CPR is very limited, and many of the conclusions are not consistent among studies. Therefore, more high-quality studies are needed in future to further clarify the application of ventilation during CPR.