Objective To study the influence of autoblood cardioplegia on ATPase in neonatus myocardium with congenital heart disease and approach the mechanism of self-blood cardioplegia in protecting the myocardium in neonatus.Methods There were 30 cases of neonatus with congenital heart disease with body weight less than 8 kg,including 2 cases of ventricular septal defect(VSD),11 of VSD with severe pulmonary hypertension(PH),9 cases of USD with ASD,2 cases of atrial septal defect (ASD),6 of VSD and FPO.30 neonatus were divided into autoblood cardioplegic solution group(group A,n=10),allograft blood cardioplegic solution group (group B,n=10)and crystalloid cardioplegic solution group(group C,n=10).The biopsies were taken from right atrium just before arrested and after heart self-recovery to measure ATPase.Results Comparing with preoperative one,Na+-K+-ATPase creased obviously after operation in group A,B ,C (P＜0.05 ).There had no significant difference among the three groups before operation (P＞0.05).After operation,myocardial cell's Na+-K+-ATPase,Ca2+-ATPase and Ca2+Mg2+-ATPase in group A were decreased obviously as compared with that in group B and C (P＜0.05).Conclusion There is slight influence of autobloed cardioplegia on ATPase in neonatus with congenital heart disease,which can give a good protection to the myocardium in neonatus.

Objective:To evaluate the effect of mechanical chest compression device in patients with cardiac arrest.Methods:The relevant literatures about mechanical cardiopulmonary resuscitation and manual cardiopulmonary resuscitation were systematically searched from China Knowledge Network (CNKI), VIP, Wanfang, PubMed, Web of Science and other databases. The effective data were extracted and analyzed by RevMan5.3 software.Results:A total of 20 clinical studies involving 29 727 patients were included, of which 11 104 patients received mechanical cardiopulmonary resuscitation and 18 623 patients received traditional manual cardiopulmonary resuscitation. The results of meta-analysis showed that mechanical cardiopulmonary resuscitation could not effectively improve the restoration of spontaneous circulation (ROSC) rate, admission survival rate, discharge survival rate and neurological prognosis in patients with cardiac arrest compared with manual cardiopulmonary resuscitation. ROSC occurrence rate ( RR=1.10, 95% CI: 0.99-1.23, P<0.01), admission survival rate ( RR=1.01, 95% CI: 0.95-1.08, P=0.67), discharge survival rate ( RR=1.00, 95% CI: 0.86-1.15, P=0.14), and good neurological function rate ( RR=0.81, 95% CI: 0.61-1.06, P=0.69) showed no significant differences between the mechanical cardiopulmonary resuscitation and manual cardiopulmonary resuscitation. Conclusions:Mechanical chest compression device has no advantage compared with manual cardiopulmonary resuscitation. Mechanical cardiopulmonary resuscitation is not recommended to completely replace manual chest compression in cardiopulmonary resuscitation.

ssociated genes,especially down-regulated expression of T cell mediated function genes,in patients with PE indicates that the etiology of PE might be related to viral infection.

Objective To explore the prenatal ultrasound image features and clinical significance of fetal ductus venosus abormalities . Methods Fifteen fetuses with ductus venosus abormalities diagnosed by prenatal ultrasonography at Peking University T hird Hospital were retrospective review . T he prenatal findings ,umbilical shunting type ,perinatal outcomes ,and autopsy reports were analyzed . Results Fourteen fetuses were found with absence of ductus venosus . In 6 fetuses the umbilical vein connected to the portal vein ,5 fetuses the umbilical vein connected to the inferior vena cava and 3 fetuses the umbilical vein connected to the right atrium . T he remaining 1 fetus was found obliteration of ductus venosus . Absence of ductus venous showed no normal ductus venous and the umbilical vein almost always drained directly into portal vein ,inferior vena cava or right atrium . Obliteration of ductus venous showed normal ductus venous was replaced by a tiny echogenic string without blood flow . T hree cases had intracardiac and extracardiac abnormalities ; 4 cases had extracardiac abnormalities only ; 8 of these ,ductus venosus abormality were isolated . T wo cases had trisomy 21 syndrome . Four patients underwent legal termination of pregnancy ; 2 were intrauterine fetal death ; and 8 carried to term wit normal outcome ; the remaining one underwent operation due to extracardiac abnormality and postoperative course was uneventful . Conclusions Prenatal ultrasound can be used to diagnose fetal ductus venosus abormalities . Hemodynamic depends on umbilical venous drainage site and diameter . T he prognosis for this group of anomalies depends on the chromosomal abnormalities and additional findings . Chromosome and ultrasonic monitoring are suggested for following pregnancy .

Objective To evaluate the effect of acupuncture combined nerve block for surgery using meta-analysis.Methods We searched the data of randomized controlled trial (RCT) in Pubmed,Cochrane library,Embase,CNKI,VIP and Wanfang from the construction of database to May 2017.All RCTs that met the standards of acupuncture combined nerve block for patients undergoing surgery were collected.The meta-analysis was performed by Review Manager 5.3.Results Five trials containing 382 patients were included in this meta-analysis.Compared with nerve block alone,the pooled data showed that acupuncture combined nerve block reduced the fluctuation of intraoperative blood pressure (MD=-13.62,95％CI-15.41--11.84,P＜0.001) and heart rate (MD=-6.49,95％CI-8.61--2.36,P＜0.001),and VAS scores 8 h (MD=-1.07,95％CI -1.38--0.75,P＜0.001),12 h (MD=-1.11,95％CI-1.30--0.93,P＜0.001) and 24 h (MD=-0.15,95％ CI-0.25--0.04,P =0.006) after operation in the experimental group.Conclusion Acupuncture combined nerve block possibly improves the hemodynamic parameters and postoperative pain of patients undergoing surgery.

Objective:To explore the effects and molecular mechanism of circ_001598 on biological behavior of breast cancer (BC) cells.Methods:Sevoflurane in different concentrations were used to treat BC cells and the cell activity and apoptosis were detected. qRT-PCR was used to determine the relative expression of Circ_001598 and miR-588 in BC tissue and cells. The effects of Sevoflurane on Circ_001598, miR-588 expression was detected. Dual luciferase reporter gene assay was used to detect the relationship between Circ_001598 and miR-588. The expression of Circ_001598, miR-588 in BC cells was intervened, then cell activity and apoptosis level was detected by using MTT and flow cytometry individually.Results:Sevoflurane inhibited cell activity of BC cells, and promoted cell apoptosis. Circ_001598 was increased in BC tissue and cells, but Sevoflurane could down-regulate the expression of Circ_001598 (all P<0.05) . Overexpression of Circ_001589 partially saved the effects of Sevoflurane on cell viability and apoptosis. Circ_001598 negatively regulated miR-588 in BC cells. miR-588 expression was down-regulated in BC tissue and cells, but Sevoflurane up-regulated the expression level of miR-588 in BC cells (all P<0.05) . miR-588 transfection partially offseted the effects of Circ_001598 on Sevoflurane induced BC cells apoptosis. Conclusion:Sevoflurane affects BC cell viability and apoptosis via regulating Circ_001589/miR-588.

Ankylosing spondylitis (AS) is a chronic inflammatory disease characterized by inflammation of the sacroiliac joints and the spinal attachment point and is the most common type of spondyloarthritis (SpA). The pathogenesis of AS is related to both the immune system and the skeletal system. The main pathological changes include enthesitis, osteogenesis changes, osteolytic bone destruction, and immune system changes. Bone cells interact with immune cells, secrete a series of inflammatory factors, and jointly regulate the pathogenesis of AS. The imbalance of various immune cells in AS and the changes in inflammatory cytokines lead to a disorder of bone metabolism. At the same time, the osteocytes express various inflammatory cytokines, which leads to an imbalance of the immune system. The interaction between the immune system and the skeletal system has become a hot spot in the pathogenesis of AS. Understanding the bone immunological mechanism of AS will help to understand the exact pathogenesis of the disease and explore new treatment methods for it. In this review, the changes of various immune cells and inflammatory cytokines in AS and their effects on the skeletal system, as well as the changes of various osteocytes in the skeletal system and their effects on the immune system, were reviewed, and the latest progress in the treatment of AS was summarized.

OBJECTIVETo design and fabricate the custom-made titanium mandibular condyle by the reverse engineering technology combined with selective laser melting (SLM) technology and to explore the mechanical properties of the SLM-processed samples and the application of the custom-made condyle in the temporomandibular joint (TMJ) reconstruction.

METHODSThe three-dimensional model of the mandibular condyle was obtained from a series of CT databases. The custom-made condyle model was designed by the reverse engineering software. The mandibular condyle was made of titanium powder with a particle size of 20-65 µm as the basic material and the processing was carried out in an argon atmosphere by the SLM machine. The yield strength, ultimate strength, bending strength, hardness, surface morphology and roughness were tested and analyzed. The finite element analysis (FEA) was used to analyze the stress distribution.

RESULTSThe complex geometry and the surface of the custom-made condyle can be reproduced precisely by the SLM. The mechanical results showed that the yield strength, ultimate strength, bending strength and hardness were (559±14) MPa, (659±32) MPa, (1 067±42) MPa, and (212±4)HV, respectively. The surface roughness was reduced by sandblast treatment.

CONCLUSIONSThe custom-made titanium condyle can be fabricated by SLM technology which is time-saving and highly digitized. The mechanical properties of the SLM sample can meet the requirements of surgical implant material in the clinic. The possibility of fabricating custom-made titanium mandibular condyle combined with the FEA opens new interesting perspectives for TMJ reconstruction.

Dental Materials ; Finite Element Analysis ; Hardness ; Humans ; Lasers ; Mandibular Condyle ; Prostheses and Implants ; Prosthesis Design ; Titanium

Objective:To evaluate the outcome of the patients receiving dispatcher-assisted cardiopulmonary resuscitation (DA-CPR) delivered by first-responders who witnessed the out-of-hospital cardiac arrest (OHCA) before the Emergency Medical Service (EMS) arrived.Methods:We performed a search of the relevant literature exploring major scientific databases. We assessed the quality of the included cohort study according to the Cochrane Handbook for Systematic Reviews of Interventions Version 5.1.0. Meta-analysis was performed on three outcome indicators (recovery of spontaneous circulation survival to hospital discharge and survival with favourable neurologic outcome) using the Revman5.3 software.Results:A total of 21 studies with 349 822 patients were selected for the meta-analysis, including 182 125 patients in the DA-CPR group and 167 697 in the CPR-only group. The meta-analysis showed no significant difference between the DA-CPR and CPR-only groups in ROSC [ RR=1.10, 95% confidence interval ( CI): 0.94-1.29, P=0.24], survival to hospital discharge ( RR=1.10, 95% CI: 0.90-1.34, P=0.34) and survival with favourable neurologic outcome ( RR=1.01, 95% CI: 0.79-1.28, P=0.97) of the patients in America, Japan and Korea. However, there was a significant difference between the DA-CPR and the CPR-only groups in ROSC ( RR=2.61, 95% CI:1.53-4.46, P=0.0005), survival to hospital discharge( RR=6.08, 95% CI: 1.84-20.04, P=0.003), and survival with favourable neurologic outcome( RR=9.76, 95% CI: 1.87-51.02, P=0.007) of the patients in China. Conclusions:The overall effect of DA-CPR is significantly different for each country. In detail, DA-CPR offers a survival advantage (Return of spontaneous circulation, survival to hospital discharge and survival with favourable neurologic outcome) over CPR alone in China but no advantage in developed countries.