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 evaluate left ventricular torsion and untwisting in patients with coronary artery disease by speckle tracking imaging. Methods Study population consisted of 48 patients, who were diagnosed coronary artery disease initially and received one of coronary arteriography, coronary artery spiral computerized tomography, radionuclide imaging, interventional therapy and bypass surgery. High frame rate (≥60 frame/s) two-dimensional dynamic images of the left ventricular apical long-axis views and parasternal short-axis views at basal and apical levels were recorded. Rotation was measured in the left ventricular short-axis views using 2D strain software. Left ventricular torsion was defined as relative rotation degree between the apical level and basal level. Patients were divided into three groups according to clinic final diagnosis [myocardial infarction ( MIN) group, n = 19; myocardial ischemia ( MIS) group, n =19; normal coronary artery (Contrast) group, n - 10]. Results In MIS group,peak rotation value and rotation value at aortic valve closure in basal level were smaller than those in apical level. Untwisting rate reduced in MIN group. There was linear correlation between left ventricular peak torsion and end-diastolic diameter. There was aslo linear correlation between left ventricular peak torsion and eject fraction. Left ventricular peak rotation at basal level was correlative to eject fraction. Left ventricular untwisting rate had linear correlation to eject fraction, and also had correlation to peak torsion. Conclusions In patients with myocardial ischemia, left ventricular rotation value at apical level is larger than that at basal level. Left ventricular diastolic function is injured severely in patients with myocardial infarction. Untwisting rate is a quantitative index to evaluate myocardial diastolic function.

The increasing magnetic strengths used for magnetic resonance imaging (MRI) combined with a greater number of MRI patients with cochlear implants (CIs) raises possible safety issues.This paper reviews the interactions between MRI and CI,and assesses MRI compatibility and safety of CIs at 0.2,0.3,1.0,1.5 and 3.0 tesla (T).In a word,CIs represent a significantcontraindication to MRI.Only after careful evaluation of the individual risk and careful preparations can an MRI be safely performed.

(-)-Epigallocatechin-3-gallate (EGCG),a natural medicine with anti-neoplastic activity,significantly prevent cancers via inhibiting tumor cell proliferation,suppressing angiogenesis and promoting apoptosis,etc.Furthermore,the new discoveries about anti-tumor mechanisms of EGCG in digestive system,reproductive system and respiratory system shorten the course of EGCG application in clinical.

ObjectiveTo study the effect of salmon calcitonin in treating knee osteoarthritis.MethodsFortyeight cases of knee osteoarthritis were randomly divided into four groups,twelve cases each group.A group:acetaminophen+glucosamine hydrochloride,B group:meloxicam+glucosamine hydrochloride,C group:salmon calcitonin + glucosamine hydrochloride,D group:salmon calcitonin.Acetaminophen and meloxicam can stop as pain symptoms disappeared.Other drugs were treated for 12 weeks.A follow up was carried out to compare visual analogue score and 12-item short form health survey.ResultsTwelve weeks later,A,B,C,D four groups' visual analogue score decreased from before treatment 5.6±1.2,5.5±1.2,5.4±1.0,5.1±l.2 to 1.9±0.8,1.2±0.7,0.8±0.6,0.9±0.7,12-item short form health survey score from before treatment - 23.4±3.1,- 23.8±3.0,-24.8 ±3.8,-22.4±2.8 to -15.1±4.7、- 14.5±4.7,-9.3±6.2,-10.2±5.3.There was significant difference before and after treatment in every group(P＜ 0.05).The visual analogue scores of B,C and D group outweigh A group's (P＜ 0.05).A and B groups'scores of 12-item short form health survey were lower to C and D groups' ( P ＜ 0.05 ).ConclusionsSalmon calcitonin can relieve pain in treating knee osteoarthritis.

ObjectiveTo observe the effects of Yishen-Huoxue-Huatan capsule on carotid artery intima-media thickness (IMT),carotid atherosclerosis plaque area and the level of serum lipids,plasma endothelin (ET) and nitric oxide (NO) in patients with carotid atherosclerosis.Methods126 patients with carotid atherosclerotic were randomly assigned to treatment group and control group.Patients in treatment group was treated by yishen huoxue huatan capsule,and patients in control group was treated by zocor.Each patient was treated for 24 weeks.ResultsAfter the treatment,carotid IMT [respectively (0.81±0.11)mm,(1.10± 0.27)mm],atherosclerotic plaque area [respectively (11.21 ± 9.3)mm2,(16.53± 6.9)mm2] in both the treatment group and the control group were significantly lower compared with the same group before treatment (P＜0.05),and the treatment group was better than the control group (P＜0.05); serum cholesterol (TC),respectively [ (4.51 ± 0.37) mmol/L,(5.15 ± 0.20) mmol/L],triglyceride (TG) [respectively ( 1.77± 0.09) mmol/L,(1.79 ± 0.36) mmol/L],high-density lipoprotein cholesterol (HDL-C) [respectively (1.28 ± 0.26) mmol/L,(1.27 ±0.36) mmol/L],low-density lipoprotein cholesterol (LDL-C) [ (2.50± 0.30) mmol/L,(3.10± 0.39) mmol/L] in the treatment group and the control group were improved significantly (P＜0.05) compared with the same group before treatment,and the TC and LDL-C levels in the treatment group were significantly lower than the control group (P＜0.05); plasma ET [respectively (67.26± 14.13) ng/L,(79.38± 11.54)ng/L] NO [respectively (71.65± 111.64)μmol / L,(60.64±14.02)μmol/L] in the treatment group and the control group were higher than those in the same group before treatment (P＜0.05),and the plasma ET levels in the treatment group was significantly lower than the control group (P＜0.05),while the plasma NO level was significantly higher(P＜ 0.05).ConclusionYishen-Huoxue-Huatan capsule is effective in the treatment of carotid atheroselerosis.

Objective To investigate the effects of nicergoline on the treatment of posterior circulation ischemia vertigo (PCIV).Methods A total of 87 patients with PCIV were randomly treated either with nicergoline (45 cases) or betahistine (42 eases).Dizziness assessment rating scale (DARS) and dizziness handicap inventory (DHI) were used to evaluate the changes of manifestations before treatment,after 7 days and 8 weeks treatment with nicergoline,meanwhile transcranial Doppler ultrasound (TCD) and brainstem auditory evoked potential (BAEP) were observed to assess the effects.Results After 7 days of treatment,the scores of DARS and DHI were decreased significantly in nicergoline group (DARS:15.6±2.1 ; DHI:38.3± 11.4) and control group (DARS:14.3±4.4; DHI:39.5±14.7) compared with the scores before treatment (DARS:24.9±7.3,22.5 ±9.7; DHI:55.8±19.7,57.5±19.3) (all P＜ 0.05),and the treatment efficiency was 71.1％ (32/45),61.9％ (26/42).After 8 weeks of treatment,the scores of DARS and DHI were also decreased significantly in nicergoline group (DARS:8.9 ±3.9; DHI:26.3± 12.8) and control group (DARS:9.9±4.7; DHI:35.8±13.1) compared with the scores before treatment (all P＜ 0.05),and the treatment efficiency was 93.3％ (42/45),78.6％ (33/42).There was significantly differences in the scores of DHI and treatment efficiency between the two groups at 8 weeks (t =2.169,P＜ 0.05,and x2=3.98,P＜ 0.05),but no differences at 7 days (both P＞ 0.05).In consistent with the remission of the clinical symptoms,nicergoline group significantly recovered from both low blood diffusion in the verbal-basal artery system and extended peak latency(PL) and inter peak latency(IPL) in the auditory pathway examined by TCD and BAEP individually at 8 weeks,especially in the upper part of the brainstem (P＜0.05).Conclusions Nicergoline is very effective in the treatment of PCIV and could alleviate the subclinical ischemia to get long time benefits.

The paper described the main function modules, system architecture, key technology and reservation business process of the appointment register platform system; security measure of the reservation platform system, as evidenced by the access of third-party payment interface, multi-tier data service, digital safety network among others which are designed to ensure the security and operability of the system.

BACKGROUND: In spite of some good successes of nickel-titanium alloy have been achieved in orthopaedic surgery, there are still serious limitations in clinical application, such as potential leakage of elements and ions, which could be toxic to cells, tissues and organs. OBJECTIVE: To review the research progress and the exiting problems of nickel-titanium shape memory alloy in orthopaedics and to provide theoretical supports for safe use of the alloy in clinical practice.METHODS: A computer-based online search of Springerlink and CNKI was performed for articles published between 2003 and 2010 both in Chinese and English. The search was conducted respectively with the key words of "nickel-titanium shape memory alloy (NiTi-SMA), biocompatibility, modifications, orthopaedics". Researches regarding nickel-titanium shape memory alloy and its properties, clinical applications, corrosion performance, biocompatibility, corrosion resistance by surface/structure modifications and the long-term challenges were included. Irrelevant or repetitive articles were excluded. RESULTS AND CONCLUSION: Nickel-titanium shape memory alloy has special value in medical field due to favorable shape-memory and superelasticity. However, due to the nickel toxicity, it is of great importance to elevate corrosion resistance of nickel-titanium alloy. The modifications of the alloy are the main focus and direction for further research.