BACKGROUND: The survival rate of patients after cardiac arrest (CA) remains lower since 2010 International Consensus on Cardiopulmonary Resuscitation (CPR) and Emergency Cardiovascular Care (ECC) was published. In clinical trials, the methods and techniques for CPR have been overly described. This article gives an overview of the progress in methods and techniques for CPR in the past years. DATA SOURCES: Original articles about cardiac arrest and CPR from MEDLINE (PubMed) and relevant journals were searched, and most of them were clinical randomized controlled trials (RCTs). RESULTS: Forty-two articles on methods and techniques of CPR were reviewed, including chest compression and conventional CPR, chest compression depth and speed, defibrillation strategies and priority, mechanical and manual chest compression, advanced airway management, impedance threshold device (ITD) and active compression-decompression (ACD) CPR, epinephrine use, and therapeutic hypothermia. The results of studies and related issues described in the international guidelines had been testified. CONCLUSIONS: Although large multicenter studies on CPR are still difficult to carry out, progress has been made in the past 4 years in the methods and techniques of CPR. The results of this review provide evidences for updating the 2015 international guidelines.

Objective:To survey the enablement level of elderly patients in the community and its influencing factors.Methods:A total of 460 patients aged ≥60 years visiting Changfeng and Fenglin Community Health Service Centers of Shanghai during September 3 to 15, 2018 were invited for a questionnaire survey. A self-made health status questionnaire, Patient Enablement Instrument (PEI), Chinese Health Questionnaire (CHQ-12), the Consultation and Relational Empathy Measure (CARE) were applied for survey.Results:All valid 460 questionnaires were retrieved. The positive rate of patient enablement was 73.91% (340/460). The median score for PEI was 3, Q1 was 0 and Q3 was 6. The univariate analysis showed that patient′s gender( Z=-2.32, P=0.02), age ( H=9.73, P<0.01), reason for visit ( H=42.06, P<0.01), health status in the past year ( H=8.28, P=0.02), consultation time ( H=22.92, P<0.01), sufficiency of communication with the doctor as patient thought ( H=41.83, P<0.01), detailed inquisition ( H=81.11, P<0.01), attending a contracted doctor ( Z=-3.42, P=0.04), the satisfaction of the visit ( H=38.64, P<0.01), total score of CHQ-12 ( Z=-2.01, P=0.04) and the score of CARE were significantly associated with the enablement level of the patient after the visit ( H=288.06, P<0.01). Multivariate linear regression showed that age 60-79( P=0.03), visit for acute disease( P<0.01), good or moderate health status in past year ( P<0.01), communication with the doctor<3 min or 3-<5 min ( P<0.01), sufficient or moderate time for communication with the doctor as patient thought ( P<0.01), detailed or moderate inquisition( P=0.03 or P=0.01), attending a contracted doctor ( P<0.01), CHQ-12 ≥4 ( P<0.01), middle or high CARE score ( P<0.01)were associated with the enablement of elderly patients after visit, with a cumulative contribution rate of 73.40%( F=50.08, P<0.01). Conclusion:The level of enablement of elderly patients after visiting the general outpatient clinic of the community health service center is relatively low. Patient′s age, types of disease, health status and the time of communication with the doctor, the sufficiency of communication time as patient thought, the detailed inquisition, attending a contracted doctor, the mental health status, and the empathy expression of the doctor are associated with the enablement of patients.

Objective To observe the long-term effect of combined intestine/auxiliary liver transplantation in rat.Methods Male Lewis rats were used. Total small bowel and 60 % liver were transplanted en bloc with an aortic segment that contained the celiac axis and superior mesenteric artery ensuring the blood supply to the graft. The end-to-side anastomosis was made between donor infrahepatic vena cava (IHVC) and recipient IHVC. The recipient small bowel was resected and the intestine continuity was restored. Sham control (laporotomy only) and transplantation groups were included. Ten rats in each group were followed-up for 18 months and then sacrificed. Liver function tests, terminal deoxynuleotidyl transferase-mediated 2'-deoxyuridine 5'-triphosphate (dUTP) nick end labeling (TUNEL) staining and proliferating cell nuclear antigen (PCNA) staining of liver tissue were evaluated.Results Sixteen rats survived over the operation. There were no significant differences in liver function tests between the sham control group and transplantation group. The grafted liver was hypertrophic and native liver did not regenerate 18 months following transplantation with an increased liver/body weight ratio. TUNEL-staining showed no significant differences among grafted liver, native liver of the recipient rat in transplantation group and the liver of the rat in control group. PCNA-staining revealed that the native liver in transplantation group had a lower proportion of TUNEL-positive hepatocytes. Conclusion This experimental study confirmed the long-term consequences of combined intestine-auxiliary liver transplantation, and the results suggest that liver/body weight ratio can be increased.

OBJECTIVE:To observe clinical efficacy and ADR of Houttuynia cordata eye drops combined with Olopatadine eye drops in the treatment of allergic conjunctivitis. METHODS:160 eyes with allergic conjunctivitis were randomly divided into observation group and control group,with 80 eyes in each group. The control group was given olopatadine eye drops,and observa-tion group was additionally given H. cordata eye drops(medication interval>10 min)on the basis of control group. Both groups were treated for 14 days. Symptoms and signs of 2 groups were observed and scored before treatment and 14 d after treatment. Ef-fective rates of 2 groups were calculated,and the occurrance of ADR was observed. RESULTS:Compared with before treatment, symptoms and sings score of 2 groups were decreased,with statistical significance (P<0.01 or P<0.05);the decrease of two score in observation group were more significant than in control group,with statistical significance (P<0.05);effective rates of control group and observation group were 37.50%and 77.50%,with statistical significance(P<0.05). CONCLUSIONS:H. corda-ta eye drops combined with olopatadine eye drops can ameliorate clinical symptoms and signs of allergic conjunctivitis patients sig-nificantly,and improve therapeutic efficacies without obvious ADR.

Objective To evaluate the significance of ST/TP relative value in electrocardiogram in diagnosis of hypocalcemia.Methods ST/TP relative value in electrocardiogram in 61 children with hypocalcemia and 31 normal children were detected by NIHOH KOHDEN CardiofaxQ ECG-9130P electrocardiogram machine designed by Japanese futian company.Calcium ion was checked out by clinic electrolyte equipment.Results There was significant difference of ST/TP relative value between patients with hypocalcemia and normal children(P

AIM: To develop a method for determining ginsenoside Rb_1,Rc,Rb_2 and Rd in Shenqi Granules (Radix Rhizoma Ginseng,Radix Astragali,Rhizoma Atractylodis macrocephalae,Poria,etc.) by microbore LC.METHODS: Microbore liquid chromatography was applied.Microsil C_(18) column( 150 mm×1.0 mm) was used with the mobile phase containing acetonitrile-water for gradient elution.The flow rate was 50 μL/min,and the detection wavelength was set at 220 nm.RESULTS : The relationships between the concentrations and the peak areas of these for components were all linear.The recoveries were 98.14% for ginsenoside Rb_1,98.04% for ginsenoside Rc,98.79% for ginsenoside Rb_2,and 97.97% for ginsenoside Rd respectively.The relative standard deviations (RSD) were 0.67%,0.99%,0.75%,and 1.46%,respectively.CONCLUSION: This method is simple,convenient and can be used for quality control.

Objective To investigate the effect of lateral ventricle transplantation of neurotrophic factor-transfected cells derived from Glia cell line on vascular dementia in rats and gene expression of Drebrin in hippocampal region.Methods By using gene clone technique,the GDNF gene was transfected into SH-SY5Y cell lines.104 adult male Sprague-Dawley rats weighing (200± 20) gram were divided into groups:transplanted group,injected group,control group,all of which accepted operation by permanent ligation of left common carotid artery and clipping right common carotid artery repeatedly to build up model of vascular dementia,and sham operation group which accepted no ligation or clipping.6 rats from each group were decapitated on the third day,seventh day and tenth day after transplanting treatment were for fluorescence detection.The rest 20 rats in each group were used to detect learning and memory functions by Morris water maze on the third day and decapitated on the fourth day after transplanting treatment.Then GDNF level in temporal lobe were detected by enzyme-linked immunosorbent assay (ELISA),while Drebrin mRNA and protein levels in hippocampal region were detected by real time-PCR and Westernblot respectively.Results There was strong fluorescent light detected around lateral ventricle of rats in transplanted group on the third day after transplantation,which faded on the seventh day and disappeared on the tenth day.The learning and memory functions of rats in transplanted group were improved significantly.The escape latency was shorter in transplanted group than in injected group and control group [(34.89±4.15) s vs.(43.86±6.95) s,(50.89±3.66) s,both P＜0.05],while shuttle times through the third quadrant were more often in transplanted group than in injected group and control group [(11.00±1.49) vs.(9.26 ±1.38),(8.04 ± 1.12),both P＜0.05].GDNF level and Drebrin mRNA and protein levels were higher in transplanted group than in injected group and control group [GDNF:(315.71±27.43) vs.(256.26±19.90),(141.95±21.33),Drebrin mRNA:(5.54±0.35) vs.(3.10±0.33),(1.32±0.23),Drebrinprotein:(0.55±0.05) vs.(0.43±0.06),(0.26±0.06),all P＜0.05].Conclusions GDNF-transfected cells could survive in the lateral cerebral ventricle of rats for about seven days.The method for treating vascular dementia through the technique of transplanting GDNF-transfected cells is certain feasible,which has a better therapeutic effect than GDNF-injection directly into lateral cerebral ventricle.The therapeutic effect of GDNF on vascular dementia may be related to its action of regulating neural plasticity.

OBJECTIVE:To optimize the formulation of indomethacin-loading solid lipid nanoparticle(SLN). METHODS:Us-ing indomethacin as model drug,glyceryl behenate as oil phase,poloxamer 188 and polyethylene glycol-12-hydroxystearic acid as emulsifier,with turbidity,entrapment efficiency and drug loading amount as index,Box-Behnken response surface methodology was used to optimize the amount of oil phase,emulsifier-oil phase ratio,drug-oil phase ratio. The physicochemical properties of SLNs were characterized by SEM and DSC. RESULTS:The optimal formulation was as follows as oil phase of 0.91%,emulsifier-oil ratio of 1∶1,drug-oil phase ratio of 1∶5. The turbidity,entrapment efficiency and drug loading amount of prepared nanoparticle were 1 025-1 030 NTU,98.94%-99.08%,2.43%-2.46%,respectively;particle size and polydispersity index(PDI)were 181.5-182.3 nm and 0.340-0.341(n=3). The results of DSC showed that indomethacin was not present in crystalline state dispersed into SLNs. CONCLUSIONS:The optimal formulation is screened successfully,and indomethacin-loaded SLNs have been prepared.

Objective To observe the effect of electroacupuncture and nerve and tendon gliding exercises on mild to moderate carpal tunnel syndrome.Methods Forty patients with mild to moderate carpal tunnel syndrome were randomly divided into an observation group and a control group,each of 20.Both groups were given neurotrophic drugs.The observation group was additionally provided with electroacupuncture and nerve and tendon gliding exercises,while the control group was given routine health education for 4 weeks.The Boston carpal tunnel syndrome questionnaire (BCTQ),a visual analogue scale (VAS),thumb and middle finger to wrist motor conduction velocity (MCV),sensory nerve action potentials (SNAPs),median nerve distal motor latency (DML) and the amplitude of compound muscle action potential (CMAP) of the musculi abductor pollicis brevis were evaluated.Results There were no significant differences in any of the measurements between the two groups before the treatment.After four weeks of treatment,significantly better improvement was observed in the average SCV of the thumb and wrist,the SCV of the digitus medius and wrist,the SNAP of the thumb and wrist,the SNAP of the digitus medius and wrist,the DML of the nervus medianus and the CMAP of the abductor pollicis brevis in the observation group compared to before the treatment and compared to the control group.Moreover,there was a significant decrease in the observation group's average BCTQ symptom score and function score and in their VAS ratings.However,in the control group significant differences were only found in the average SCV of the thumb and wrist,the DML of the nervus medianus and in their VAS ratings.Conclusions Electroacupuncture and nerve and tendon gliding exercises can significantly relieve symptoms and restore hand function.They are worth applying in clinical practice.

Background and purpose. Chemotherapy is a standard treatment for patients with advanced stage non-small cell lung cancer (NSCLC) However, platinum based chemotherapeutic regimen haves high toxicity profile to normal tissues. Lobaplatin (LBP) is a new third-generation antitumour platinum drug. Studies abroad have shown that Iobaplatin has an anticancer activity similar to cisplatin with better tolerance and is more effective for those who are resistant to cisplatin. This study was aimed to observe the effectiveness and toxicities of lobaplatin combined with vinorelbine (NVB) for the treatment of advanced NSCLC. Methods: Sixty-four patients pathologically diagnosed as clinical stage Ⅲ_B-Ⅳ NSCLC who did not receive treatment before, were randomly assigned to two groups. NL group (NVB+LBP): LBP at a dose of 30 mg/m~2 intravenous infusion on day 1, and NVB at a dose of 25 mg/m~2 intravenous infusion on days 1 and 8. NP group (NVB+DDP): Cisplatin (DDP) at a dose of 30 mg/m~2 intravenous infusion on day 1, 2 and 3 and NVB at a dose of 25 mg/m~2 intravenous infusion on days 1 and 8. Treatments were repeated every 21-28 days for 3 cycles. Results: For 34 patients of NL group, there were CR (1 cases), PR(13 cases), NC(15 cases), and PD(5 cases). The overall response rate (RR) was 41.2%, disease control rate (DCR) was 85.3%. In NP group: RR was 43.3%, DCR was 83.3% (X~2=0.05, P>0.05). Median overall survival time was 8.6 months and 8.9 months for NL group and NP group, respectively. The main toxicities in NL group were myelosuppression. Digestive toxicity such as anorexia, nausea,vomiting were less than those in the NP group (X~2=7.43, P<0.05), Peripheral hour,toxicity, serious liver and renal toxicity were not observed in NL group. Conclusion: Compared with cisplatin plus vinorelbine, domestic lobaplatin with vinorelbine yielded similar efficacies for NSCLC, but had less toxicity and well tolerate.