Objective To investigate the physiological responses of healthy youth to doing chest compression as a feedback of quality of CPR after their rapid ascent to high altitude and to evaluate the feedback in the intervention effects of CPR.Methods Prospective,single sample,before-after comparison method was used in this study.Fifteen young adults from plains natives were enrolled as trial subjects in this study.All of them received basic life support training course in advance.In Chongqing (259 m above sea level),subjects performed empiric chest compressions on the model body for 4 minutes followed by feedback compressions for 4 minutes after at least 30 minutes rest.Compression depth,rate and other compression quality parameters were measured and recorded at each turn of compressions with an AED PLUS device.Subjects performed empiric compressions based on their knowledge and experiences,and practiced feedback compressions according to the audiovisual guidance of AED PLUS device.Blood pressure,heart rate and SpO2 were taken before and after each turn of compressions.One week after arrival to Lhasa (3658 m above sea level) by flight,all subjects were asked to do the same procedure as did in Chongqing to see their physiological response to.Paired t tests or Wilcoxon matched pair rank test were used for comparisons of measurements before and after trials.Results Systolic pressures,diastolic pressures,heart rates at baseline in Lhasa were significant different from those in Chongqing,including systolic pressure (125.9 ±9.5) mmHg vs.(112.7 ±13.4) mmHg,diastolic pressure (75.3 ±7.7) mmHg vs.(64.2 ±7.3) mmHg,heart rate (86.3 ± 13.0) beat/min vs.(72.7 ± 11.6) beat/min,SpO2 (90.4 ± 1.7)％ vs.(97.8 ±0.9)％,all P ＜ 0.01.In Lhasa,empiric compressions only caused an increase in heart rate (91.1 ± 14.9) beat/min vs.(86.3 ± 13.0) beat/min,P ＜ 0.01.However,feedback compressions resulted in a significant decrease in SpO2 [(88.3 ± 3.4) ％ vs.(90.6 ± 1.9) ％,P ＜ 0.01] as well as change of systolic pressure [(130.9 ± 11.7) mmHg vs.(120.1 ± 11.9) mmHg,P ＜0.05] and heart rate [(87.9 ± 17.5) beat/min vs.(80.9 ± 11.7) beat/min,P ＜0.05].In Lhasa,the compression quality during feedback compressions was closer to guideline recommendation than that during empiric compressions.The median (interquartile range) of composite qualification rate was 43.6％ (55.9％) vs.0.6％ (5.3％) during feedback compressions and empiric compressions respectively,P ＜ 0.01.Conclusions Compression quality decreased significantly among youth after rapid ascent to high altitude.Feedback techniques for CPR could effectively guide the rescuer to improve their CPR quality,but it may be at the expense of more physical consumption.

Objective To investigate the management of acute limb ischemia.Methods The clinical data of 28 patients with acute limb ischemia were retrospectively analyzed.Four patients with arterial embolism underwent embolectomy.one patient with pseudoaneurysm underwent false aneurysm resection and revascularization with PTFE,23 patieuts wiht arterial occlusive disease were treated by multiple means such as embolectomy,bypass,primary amputation,endovascular interventions,and pharmacologic therapy(n=23).Results The 5 patients with arterial embolism or pseudoaneurysm were all treated successfully.In the 23 patients with arterial occlusive disease,5(21.7%) were treated successfully,12(52.2%) were improved,and 6(26.1%) had ineffective treatment.No inpatient died,but 4 patients underwent amputation.During follow-up of 6-45 months,there were 4 deaths and other 5 amputations.Conclusions Proper intervention of patients with acute limb ischemia should be chosen according to clinical evaluation of the illness,and includes embolectomy and revascularization,to get limb or life salvage.

Objective To discuss the application of cybernetics in hemodialysis nursing. Methods Cybernetics was applied to the standardized nursing quality management in 35 hemodialysis patients, namely to establish hemodialysis standard, weight the executive condition, correct deviation.The feed-forward control was emphasized in combination with the feedback control forming the feed forward-feedback control sys-tern in order to tighten the effect of the control. The dialysis indices before and after the intervention was compared. Results The average hematocfit and urea reduction rate greatly increased after cybernetics was applied to the standardized nursing quality management in 35 hemodialysis patients, but no change was seen in urea elimination index after the intervention. Conclusions Nursing quality can be enhanced by the application of cybernetics in hemodialysis.

BACKGROUND: Fibrous scaffolds prepared by electrospinning possess similar structure to extracellular matrix, and exhibit convenience in introducing bioactive ceramics into polymer matrices, which have distinct superiority in making bone tissue scaffolds materials.OBJECTIVE: To evaluate the bioactivity of gas-jet/electrospun nanosized hydroxyapatite (nHAP)/poly (3-hydroxybutyrate) (PHB) scaffolds for being used as bone tissue engineering scaffolds.DESIGN, TIME AND SETTING: The in vitro cytology experiment was performed at the State Key Laboratoty of Oral Diseases,Sichuan University between March 2008 and April 2009.MATERIALS: The gas-jet/electrospun PHB and 10% nHAP/PHB scaffolds were prepared.METHODS: Rats bone marrow-derived mescenchymal stem cells were incubated on the nHAP/PHB scaffolds were served as experimental group, incubated on the PHB scaffolds were as control group, and cells incubated on cell culture plate were consided to be blank control group.MAIN OUTCOME MEASURES: mRNA transcript expression of bone-related markers, including alkaline phosphatase, type I collagen, and osteocalcin, were quantified utilizing reverse transcription-polymerase chain reaction (RT-PCR) at day 14 after culture.RESULTS: After 14 days, the bone-related markers were expressed in three groups, and had higher transcript levels in the cells cultured on the nHAP/PHB scaffolds than those on the PHB scaffolds and cell culture plate.CONCLUSION: The gas-jet/electrospun nHAP/PHB scaffolds present good bioactivity in vitro and have the potential to be used in bone tissue engineering.

Objective:To explore influence of position of myocardial infarction and coronary artery lesions in patients with acute ST elevation myocardial infarction (STEMI) ,and the relationship among heart failure ,arrhythmia and severity of coronary artery lesion .Methods :Clinical data of 224 patients ,who hospitalized in our hospital because of STEMI and received coronary angiography from Jan 2009 to Jun 2011 ,were retrospectively analyzed .General data of patients were collected ,and SYNTAX score was used to reflect severity of coronary artery lesion ,and the rela‐tionship among heart failure ,arrhythmia and SYNTAX scores were analyzed .Results:Incidence rate of heart fail‐ure in patients with infarction relate artery left anterior descending artery (LAD) AND/or left main coronary artery (LM) was significantly higher than that of patients with right coronary artery (RCA) (57.0% vs .39.7% , P=0.017) ,incidence rate of arrhythmia in patients with RCA was significantly higher than that of patients with left circumflex artery (LCX) (37.0% vs .6.3% , P=0.016);incidence rates of arrhythmia (48.4% ) ,shock (54.8% ) were highest in patients with inferior wall/right ventricle than those of other position , P<0.05 or <0.01.SYNTAX scores in patients with heart failure and arrhythmia were significantly higher than those of patients without heart failure and arrhythmia respectively [ (18.7 ± 9.1) scores vs .(15.4 ± 8.6) scores ,(19.7 ± 9.0) scores vs .(16.1 ± 8.8) scores , P<0.01 both] .Conclusion:Incidence rates of heart failure ,cardiogenic shock and arrhythmia are related to coronary artery lesions position and degree and myocardial infarction position in STEMI patients .

BACKGROUND:Poly(3-hydroxybutyrate) is approved as its excel ent biocompatibility, biodegradability and piezoelectric properties, but there are also some deficiencies, such as high breakability and poor hydrophilicity. METHODS:Poly(3-hydroxybutyrate) was mixed with different mass percentages of nanohydroxyapatite (0, 10%, 20%and 30%) to prepare new composite fibrous scaffolds through electrospinning process. The microstructure, group composition, crystal ine phase distribution, thermal properties and surface wettability of the scaffolds were detected. RESULTS AND CONCLUSION:Under the scanning electron microscope, with the increase of nano-hydroxyapatite content, more and more nano-hydroxyapatite particles were distributed evenly on the composite fiber surface;the fiber surface was basical y covered with nano-hydroxyapatite particles at the content of 30%, and the roughness of the fiber surface also increased. Results from differential scanning calorimetry and X-ray diffraction showed that the nano-hydroxyapatite reduced the crystal inity of poly(3-hydroxybutyrate) and the crystal tacticity, and this phenomenon became more evident with the increase of nano-hydroxyapatite content. Additional y, the higher the content of nano-hydroxyapatite content, the lower the contact angle and the higher the hydrophily. These findings indicate that the nano-hydroxyapatite/poly(3-hydroxybutyrate) ultrafine-fibrous scaffold using electrospinning technology can effectively improve the surface wettability and crystal inity of the material as wel as the material hydrophily and brittleness, and the higher the content of nano-hydroxyapatite, the more obvious the effect.

Obj ective In the body of stereotactic radiotherapy ( SBRT ) , using Cone Beam is the matc-hing precision of soft tissue and bone anatomy ,translation between evaluation organization and internal organiza-tion in the rotation of the lung cancer patients with tumor location error ,location correction .Methods Applica-tion varian companies in the United States has the airborne imaging system clinac -ix linear accelerator apparatus treatment of 8 cases of lung cancer patients .By CBCT and SBRT comparison before and after the treatment for each patient and evaluate internal instant translation and rotation of the body of the patients with SBRT postures , tumor location and tumor center of baseline shift score changes .Results Based on the difference between of the anatomy of the bone and soft tissue match position is 3.0 mm(0~8.3 mm).The patient′s tumor location in 3-d median change is 1.4 mm(0~12.2 mm)and 12.2 mm(0~13.2 mm).The median baseline offset between 3 d score is 2.2 mm(0~4.7 mm).The rest of the system error and random error about 1 °.Conclusion In Lung cancer SBRT transformation to improve treatment of lung tumor process , change the position of tumor center is mainly affected by the body′s internal organization instant translation and rotation .

Objective To analyze the clinic and pathological features of Castleman’s disease (CD),or an angiofollicular lymph node hyperplasia(ALNH) Method Retrospectively gave a review of 6 patients with CD in recent 15 years in PUMC Hospital Results 4 patients with multicentric Castleman’s disease (MCD) had systemic symptom including fever,anemia,edema and endocrine disorders M protein presented in 3 of them 3 patients with MCD had progressive polyneuropathy,with presenting distal symmetric weakness and numbness, areflexia Nerve conduction velocity was slow and action amplitude decreased significantly.Sural nerve biopsy showed a moderate? prominent axon degeneration with minimal vasculopathy 2 patients with localized CD (LCD) had no systemic or neurological complications Histological study of lymph tissue confirmed the diagnosis of CD,showing that there were subtype of hyaline vascular (HV) in 5 cases and plasma cell (PC) in 1 case Conclusion Multicentric Castleman’s disease should be associated with systemic and neurological involvement It might present with distal symmetric motor sensory axonal polyneuropathy The clinic feature should be a PEOMS syndrome with a poor prognosis

AIM To study the characteristics of Ca 2+ channel mediated store operated Ca 2+ influx on rat vascular smooth muscle. METHOD Fura 2 fluorescence technique was used to investigate the [Ca 2+ ] i change. RESULTS ① S nitrosocaptopril (CapNO,20～120 ?mol?L -1 ) produced a concentration dependent inhibitory effect on cyclopiazonic acid(CPA) induced [Ca 2+ ] i change. The maximal inhibitory effect(37%?17%) of CapNO was reached at a concentration of 80 ?mol?L -1 . The same concentration of Captopril had no effects. ② Inhibition rate of 80 ?mol?L -1 CapNO (The concentration of maximal effect, CME) on CPA induced [Ca 2+ ] i change was 30%?10%, subsequent addition of 1 ?mol?L -1 Nif (CME)did not further produced the decrease effect (54%?18%). subsequent addition of 20 ?mol?L -1 SK&F96365 (CME) further produced the decrease effect. The inhibitory effects of 20 ?mol?L -1 SK&F96365 were significantly different in the cases of CapNO and Nif pretreatment(24%?10%) and non treatment (54%?11%). ③ The inhibitory effects of 2 ?mol?L -1 tyrphostinAG490(AG490,CME) were significantly different in the cases of CapNO (CME) pretreatment (24%?9%)and non treatment (42%?10%). 80 ?mol?L -1 CapNO effect on CPA induced [Ca 2+ ] i changes in AG490 pretreatment condition(18%?7%) was different from that in non treatment case(37%?10%). CONCLUSION S nitrosocaptopril obviously inhibits the opening of SOCC and VDCC, which mediates store operated Ca 2+ influx. The inhibitory effects of CapNO is associated with both sensitive to and non sensitive to tyrosine kinase (Janus2).

Objective　To observe the therapeutic effect of combination of penetrating keratoplasty, cataract extraction and intraocular lenses implantation.Methods　Penetrating keratoplasty was performed simultaneously with cataract extraction and intraocular lenses implantation on 134 cases. Results　One hundred and twenty cases were recorded after following up for 0.5～12 years. Ninety-nine cases (82.5%)of the corneas remained clear. Twenty-one cases (17.5%)of the corneas failed.Ninety-two cases (76.7%)achieved a better visual acuity postoperatively.Eighty-nine eyes(74.2%)were not blind any longer. Conclusion　The combination of penetrating keratoplasty, cataract extraction and intraocular lenses implantation offers advantages of rapid and better rehabilitation of visual acuity with low complication rate.