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 assess global systolic function of left ventricle (LV) using speckle tracking echocardiography in patients who are left volumetric overload and to establish the correlativity between strain and left ventricle end-diastolic volume index (LVEDVI). Methods Seventy-seven patients who were left volumetric overload and 30 normal volunteers were enrolled in this study. Respective 3 high frame rate (＞ 100 frames/s) 2D images were recorded from the left ventricular short axis views: the levels of mitral valve annulus, papillary muscle and apex. Three global peak systolic radical strain and strain rate were measured using 2D strain imagirg. LVEDV was obtained by two-plane Simpson method and LVEDVI was obtained by normalized LVEDV with surface body area. Patients were divided into 6 groups: transitionalgroup,group A (LVEDVI:90- 120 ml/m2),group B (LVEDVI: 121 - 150 ml/m2 ),group C (LVEDVI:151 -180 ml/m2),group D (LVEDVI: 181 - 210 ml/m2),and group E (LVEDVI＞210 ml/m2). Patients were divided into two groups by left ventricular ejection fraction (LVEF): group Ⅰ (LVEF≥ 50 % ), group Ⅱ (LVEF＜50％). Results①Compared with normal control group,GRS,GRSr in transitional group showed no change at three short axis levels (P ＞0.05). The above parameters in group A, B and C were significantly higher than those in normal control group( P ＜0. 01 ). In transitional group,group A,B and C,GRS, GRSr of three short axis gradually increased with LVEDVI augmentation. Compared with group A, B,C,D and normal control group,the above parameters of 3 short aixs in group E were decreased( P ＜0. 01 ),which gradually decreased in group C, D, E with LVEDVI augmentation. ②GRS,GRSr of 3 short axis views in group Ⅰ were more significantly high than those in group Ⅱ and normal control group. The parameters above were significantly low in group Ⅱ ( P ＜0.01). ③In group A,B,C,GRS of papillary muscle and apex levels were correlated positively to LVEDVI ( rpapillary muscle = 0.55,0.64,0.76 and rspex = 0. 74, 0. 79,0.71,P ＜0.05) ; In group D, there was no correlativity between GRS of papillary muscle and LVEDVI( r =- 0.35, P ＞ 0.05) while negative correlativity was established in apex level( r = - 0.73, P ＜ 0. 05). In group E,the negative correlativity was found between GRS of papillary muscle and LVEDVI( r = -0. 70,P ＜0.05) while no correlativity was established in apex level( r = - 0.39, P ＞0. 05). GRS of mitral valve annulus was correlated positively to LVEDVI in group A, B( r = 0.79, 0.77, P ＜ 0.05) and had no correlativity in group C,D. The negative correlativity between them was found in group E( r = - 0. 54, P ＜0.05). At LVEDVI: 180- 190 ml/m2 ,GRS of papillary muscle and apex level reach the peak point about 93% and 62% ;GRS of mitral valve annulus level reach the peak about 63% at LVEDVI 150 - 160 ml/m2.Conclusions Radial strain,strain rate change periodically with LV volume overload. Wall motion of left ventricle can be evaluated accurately by speckle tracking echocardiography, which provide useful modality for evaluation cardiac systolic function.

Objective To evaluate the clinical efficacy of neo-adjuvant chemotherapy in the treatment of cervical cancer. Methods A total of 32 patients,of which 12 cases of Ⅰ b2,8 cases of Ⅱ a,5 case of Ⅱ b and 7 cases of Ⅲ, were all treated with 2 - 3 cycles of PF chemotherapy before treatment with cisplatin 100 mg/m2, d 1;5-fluorouracil 1000 mg/m2 ,d1-5. The chemotherapy was performed for 3 weeks followed by three weeks rest as one cycle. Results Short-term effect was 81.3% (26/32), with 3 cases of Ⅰ b2 and 1 cases of Ⅱ a had been completely relieved after 2 - 3 cycles of chemotherapies. Simultaneously, chemotherapy improved the removal rate of surgery. Among these 32 patients, there were 4 cases achieved complete response (CR) ,22 cases achieved partial response (PR) ,5 case of stable disease ( SD), 1 cases of progressive disease(PD). The overall response rate( CR +PR) was 81.3% (26/32) ,and the control rate ( CR + PR + SD) was 96. 9% (31/32). The main adverse events included myelosuppression and gastrointestinal response, which were all tolerable. Conclusions The neo-adjuvant chemotherapy reduced the size of cancer,which can improve removal rate of surgery and the quality of life.

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.

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.

Objective The metabolomics methods were applied to discover the serum differences metabolites in patients with lupus nephritis (LN),and to establish the diagnostic model and study the metabolic pathways change due to the interference of LN and explore the pathogenesis of LN.Methods Positive and negative ions mode of ultra high performance liquid chromatography-high resolution mass spectrometry (HPLS-HRMS) were used to analyze the serum samples of 38 LN patients and 35 healthy controls,respectively.Both univariate and multivariate data analysis were performed with SPSS software (V17.0,Chicago,USA) and SIMCA-P+ package (V12.0,Umetrics,Sweden),respectively.A supervised pattern recognition method,orthogonal partial least squares-discriminant analysis (OPLS-DA),was employed to study the metabolomics differences between control group and LN patients group.The metabolic pathways were analyzed by Metabo Analyst 3.0.Results LN patients and healthy controls could be well separated by OPLS-DA model Q2 of 0.583.Eighteen compounds (theophylline,oxidized glutathione,capric acid,norvaline,hippuric acid,sphingosine,sorbitol,cortisol,pyrrole-2-carboxylic acid,deoxycholic acid,tryptamine,5-aminolevulinic acid,glucose 6-phosphate,riboflavin,cortisone,taurine,creatinine,glycerophosphocholine) were initially identified as potential serum metabolic markers to distinguish LN patients from healthy people.Alternated metabolism pathways included citrate metabolism,pyrimidine metabolism and amino acid metabolism.Conclusion Through analysis of the metabolic pathways of different metabolites,the significant impact of LN on citrate metabolism,pyrimidine metabolism and amino acid metabolism pathways are identified.Some of the different metabolites are involved in the process of immunization.These results will benefit the early intervention and treatment of LN and the research of the mechanism of pathogenesis.

More and more studies have indicated that the relationship between vitamin D pathway and asthma,and the mechanisms include multiple abnormal aspects of vitamin D pathway leading to abnormal em-bryonic development and immune system disorders and so on. This review summarizes the relationship between vitamin D,vitamin D binding protein,vitamin D receptors,related gene polymorphisms and the immune system to describe the pathogenesis of asthma.