The American Heart Association published a new guideline for cardiopulmonary resuscitation in Oct 2010.One of the most important recommendations is the sequence change of cardiopulmonary resuscitation from ABC to CAB.As pediatrician,we should understand the background of these changes,and give the most reasonable treatment to improve the success rate of resuscitation according to the different locations,different circumstances and different obiects.

Objective To explore prognostic factors associated with early and late recurrences after surgery for patients with gastric adenocarcinoma.Methods 214 patients who underwent curative resection for gastric adenocarcinoma were divided into 2 groups according to recurrence time:an early recurrence group included 143 patients who died within 2 years after surgery,and a late reeurrence group included 71 patients who died more than 2 years after surgery.Indexes such as age,sex,tumor site,tumor size,tumor pathology classification,Borrmann type,TNM staging,lymph node metastasis,operation type and postoperative adjuvant chemotherapy were compared.Results Single factor analysis showed that the tumor diameter,Borrmann type,TNM staging,lymph node metastasis,operation type,adjuvant chemotherapy were asoceiated with postoperative recurrence( test value were 8.32,16.21,24.90,5.22,17.23 and 3.61,respectively;all P ＜ 0.05 ).Multifactor analysis showed that tumor diameter and TNM staging is recurrent independent factors( relative risk were 5.642 and 6.211,respectively ;all P ＜ 0.05 ).Conclusion Tumor size and TNM staging are the most important factors for predicting the timing of recurrence after curative resection for gastric adenocarcinoma.Clinical practice should pay attention to follow up for patients with tumor diameter≥5cm,TNM Ⅲ-Ⅳ stage,especially within two years.

Objective To investigate the influences of photochemotherapy with psoralen and ultraviolet A (PUVA) on skin photoaging and its possible mechanism. Methods HE stain, Verhoeff stain, electron microscopy, enzyme cytochemistry and immunocytochemistry were used to study influences of PUVA on the skin photoaging with characteristic biological markers in the non-lesion back skin of patients with psoriasis vulgaris. Results After treatment with PUVA, the degenerated collagen and elastic fibers were increased with derangement profile in dermis, and fibroblasts displayed growth suppression and morphological changes of cell senescence with a permanent switch of mitotic to stably postmitotic phenotypes, of group B and group A, the positive rates of SA-?-Gal were 13.6 % and 0.00 % and the positive rates of p16 protein were 81.8 % and 42.9 % respectively, there were significant differences between group B and group A(? 2=21.412, P

It is a brief introduction of necessity of uniform guidelines for pediatric emergency and critical care.Uniform guidelines are very important for development of discipline,safety of patients,protection of medical staff and administration.Uniform guidelines should be enacted according to our national condition with a scientific attitude of rigorous and gravity.

Objective To discuss the feature of the ultrasonic image of the fetal congenital absence of the radius. Methods Five cases with congenital absence of the radius were examined by colour Doppler sonography and compared with normal fetuses. Results There were four characteristics of ultrasonic imaging:①The length of three radius was 0 cm in the six disabled limbs,others were 4 time s shorter than the normal identical pregnant fetuses. ②All the disabled limbs showed that the forearm was short and bent, and the hand was lopsided. ③All the cases were combined with hydramnios. ④Three abnormal fetuses were combined with other deformies.Conclusions Ultrasound is superior to other methods in diagnosing fetus congenital absence of the radius.

Objective To study the adverse effects of outdoor air pollution on children's respiratory system health in Anshan city. Methods 1951 children were randomly selected from three areas with different degree of air pollution in Anshan city. The parents of the children were asked to answer a questionnaire about their children's respiratory health and home environment. The data of health were collected included persistent cough, persistent phlegm, asthma, current asthma, wheeze, and wheeze symptom. Results The prevalence rates of persistent cough, persistent phlegm, asthma, current asthma, wheeze and wheeze symptom were 9.48%, 4.82%, 1.33%, 0.92%, 6.30% and 4.97% respectively. Outdoor air pollution was a risk factor for persistent cough and persistent phlegm. The respiratory symptoms increased as the house became near to the main traffic lines. Combined effect of susceptible factor and outdoor air pollution was obvious, the prevalence rates of respiratory diseases were higher in the susceptible children who were influenced by the other risk factors compared with those who were not influenced by the same factors. Conclusion Outdoor air pollution is an important factor which will damage children's respiratory system in Anshan city.

In order to study the antibacterial activity of Chinese medicinal herbs to Ureaplasma ure- alyticum(Uu),we examined the inhibitory effect of 156 Chinese medicinal herbs to 14 standard strains of Uu by microdilution method in vitro.The results showed that Uu had a higher sensitivity to Cortex phellodendri,Radix angelicae dahuricae,Fructus kochiae,Radix et rhizoma rhei(MIC_(90)≤7.81mg of dried medicinal herbs/ml);a moderate sensitivity to Radix glycyrrrhizae,Radix isatidis,Rhizoma cop- tidis,Herba andrographitis,Herba houttuyniae(15.63≤MIC_(90)≤62.5);a lower sensitivity to Cortex meliae,Herba leonuri(62.5250).It is our opinion that Chinese medicinal herbs are of momentous signfi- cance in the treatment of Uu infection.

Objective: To investigate the effects of folic acid (FA), vitamin B6 (VB6) and B12 (VB12) on plasma homocysteine (Hcy) and antioxidative activities in focal cerebral ischemia rats. Method: Rats were randomly divided into four groups including sham operation (Sham), middle cerebral artery occlusion model (MCAO), MCAO+FA and MCAO+FA +VB6+VB12(MCAO+CV). MCAO model was induced by operation. Plasma Hcy, serum and brain SOD and GSH-Px activities and MDA content in rats were measured before and 28 d after supplementation and 24 h after ischemia or only after ischemia. Results: Plasma Hcy in MCAO+FA and MCAO+CV group were significantly lower than those in Sham and MCAO groups after supplementation and ischemia, and the MCAO+CV group lower than MCAO+FA group. Serum and brain SOD and GSH-Px activities were significantly higher, and MDA contents lower in MCAO+FA and MCAO+CV groups than those in MCAO group. Conclusion: Supplementing FA, VB6 and VB12 can reduce plasma Hcy, improve antioxidative abilities and decrease the injury by oxidative stress following cerebral ischemia.

Objective To explore the influence of human resources management in emergency department on nurse's anxiety.Methods Self-Rating Anxiety Scale(SAS)was used to investigate 300 nurses in the emergency department in nine secondary level hospitals of Longgang District.Division of human resource management in these hospitals were examined and the correlation between them was statistically analyzed.Results In addition to the three hospitals,nurses anxiety status of the other six hospitals score showed different levels of anxiety,the average scores were above 50,but the hospitals,that the ratio of the three anxiety condition score was less than 50,moderate to severe anxiety were still more than 20.0％,and other six hospitals was up to 66.7％.In the human resource management to achieve excellent and qualified hospital,the anxiety rate was significantly lower than the substandard hospitals.At the same time there was close correlation between the situation of human resource management and nurses anxiety situation.Conclusions Emergency nurses generally have high anxiety,and in hospitals with poor human resource management,career anxiety is even more obvious.That is to say the anxiety of nurses is closely related to emergency department management of human resources.