Objective Based on the international standard cardio-pulmonary resuscitation curriculum, the aim of the study is to investigate the effectiveness and importance of the layered cardio-pulmonary resuscitation emergency training. Method A total of 219 trainee including clinical medical personnel , auxiliary medical personnel and medical staff with standardized training were enrolled . Training included watching course video, team practice and class discussion, and the theoretical score and operation marks before and after layered cardio-pulmonary resuscitation training were compared. Theoretical score were compared by paired T-test, and operation pass ratio was determined byχ2 analy-sis. Results The pre- and post-training theoretical score of medical staff with standardized training, auxiliary medical personnel, and clinical medical personnel were 66.60±7.82 vs. 88.60±6.37;61.60± 7.44 vs. 86.90±5.80;73.45±6.83 vs. 94.75±5.04 respectively. The pre- and post-training operation pass ratio of marks of medical staff with standardized training, auxiliary medical personnel, and clinical medical personnel were 31.1%/85.2%;32.0%/90.7%;59.0%/96.4% respectively. Conclusion There are differences in both the theory and operation results of medical personnel at different levels before and after the training of cardiopulmonary resuscitation. The more targeted and layered training is much effective in cardio-pulmonary resuscitation emergency training.

0.05), but were highly significant at doses of 100 ?mol/L or above (P

Objective To evaluate the effect of a nurse-lead rehabilitation training on quality of life and psychotic symptoms of schizophrenia inpatients. Methods Totally 190 schizophrenia inpatients were divided into the intervention group (96 cases) and the control group (94 cases). In addition to rehabilitation activities which can be chosen freely, the schizophrenia in the intervention group received rehabilitation training including medication training, life skills training, social skill training and physical training, while the schizophrenia in the control group could only chose rehabilitation activities freely. The quality of life and the psychotic symptoms of the schizophrenia while enrolled and discharged were evaluated. Results No significant difference was found in the score of Schizophrenia Quality of Life Scale (SQLS) and Brief Psychiatric Rating Scale (BPRS) between the two groups(P>0.05)while enrolled. The scores of SQLS, psychosocial and motivation/energy in the control group were 30.22 ± 17.21, 30.22 ± 17.21 and 18.28± 9.33, while 21.41±14.63,19.76± 18.85 and 15.95± 8.80 in the intervention group one month after intervention, the difference was significant (t=-2.14,-2.19,-1.99,P<0.05). The scores of BPRS and hostile suspiciousness in the control group were 26.39 ± 6.37 and 4.11 ± 1.87 , while 23.67 ± 6.37 and 3.44± 1.26 in the intervention group one month after intervention, the difference was significant (t=-2.33,-2.54, P<0.05). Conclusions The nurse-lead rehabilitation training can improve the quality of life and psychotic symptoms of schizophrenia inpatients.

Central poststroke pain (CPSP) is a neuropathic pain syndrome that can occur after stroke.This syndrome is characterized by pain and sensory abnormalities in the body parts that correspond to the stroke lesion.CPSP occurs ia 1％-12％ of stroke patients.A definite diagnosis of CPSP is difficult,mainly because of the variable clinical picture,the frequent concurrence of several pain types,and the lack of clear diagnostic criteria for CPSP.Management of the CPSP is challenging.This article reviews the diagnostic evaluation and treatment of CPSP.

Objective To develop the questionnaire of medication adherence in patients with schizophrenia.Methods Delphi method was used in this study.The questionnaire of medication adherence in patients with schizophrenia was developed based on two rounds of consultation among 14 experts.Results The questionnaire of medication adherence in patients with schizophrenia consisted of 3 dimensions,7 items of each dimension.Conclusions The questionnaire can be used as the tool of evaluation of medication adherence in patients with schizophrenia.Further theoretical and empirical study is needed to verify the questionnaire.

Objective To evaluate the role of MCP/DAF expression in the spinal cord in the development of neuropathic pain (NP) induced by chronic constrictive injury (CCI) of the sciatic nerve in rats.Methods Twenty-four Sprague-Dawley rats transfected with MCP/DAF,weighing 200-250 g,were randomly divided into 2 groups (n =12 each) using a random number table:sham operation of transfected rat group (Rsham group) and CCI of transfected rat group (RCCI group).Twenty-four healthy male Sprague-Dawley rats,weighing 200-250 g,were randomly divided into 2 groups (n =12 each) using a random number table:sham operation of normal rat group (Nsham group) and CCI of normal rat group (NCCI group).The right sciatic nerve was exposed and 4 loose ligatures wen placed on the sciatic nerve at 1 mm intervals with 4-0 catgut in RCCI and NCCI groups.The right sciatic nerve was only exposed in Rsham and Nsham groups.Paw withdrawal threshold to yon Frey filament stimulation (PWT) and paw withdrawal latency to nociceptive thermal stimulation (PWL) were measured at 1 day before operation (baseline) and 1,3 and 7 days after operation.The animals were sacrificed after measurement of pain threshold on 7 days after operation and the L4,5 segment of the spinal cord was removed for determination of the expression of OX-42 (by immuno-histochemistry) and MCP mRNA and DAF mRNA (by RT-PCR).Results Compared with Nsham group,the PWT and PWL were significantly decreased on 1,3 and 7 days after operation,the expression of OX-42 was up-regulated,and the expression of MCP mRNA and DAF mRNA was down-regulated in NCCI group (P ＜ 0.05),and no significant changes were found in the PWT and PWL on 1,3 and 7 days after operation and expression of OX-42(P ＞ 0.05),and the expression of MCP mRNA and DAF mRNA was up-regulated in Rsham and RCCI groups (P ＞ 0.05).Compared with NCCI group,the PWT and PWL were significantly increased on 1,3 and 7 days after operation,the expression of OX-42 was down-regulated,and the expression of MCP mRNA and DAF mRNA was up-regulated in RCCI group (P ＜ 0.05).Conclusion Up-regulation of MCP/ DAF expression in the spinal cord can inhibit the development of NP in rats and regulation of activation of microglias in the spinal cord is involved in the mechanism.

PUMA (p53 up-regulated modulator of apoptosis) is a recently discovered Bcl-2 family member which could be rapidly induced by p53 and has strong pro-apoptotic effects.PUMA has attracted much attention in the research of life science.PUMA expression results in potent growth suppression of some cancer cells through induction of apoptosis.PUMA can also significantly sensitize some cancer cells to chemotherapeutic agents and irradiation through induction of apoptosis.PUMA is potentially useful in gene therapy of tumor.But recently,researchers have also found that PUMA participates in the process of carcinogenesis and possessed important biological functions.

AIM To investigate whether pioglitazone can protect cortical neurons from lipopolysaccharides(LPS)-induced neurotoxicity and the mechanisms responsible for this protective effect. METHODS After 7 d cultures，cultured cortical neurons were incubated with LPS 10 mg·L~(-1) for 4-24 h with or without other drugs. In co-incubation experiments, other drugs were added to the neurons 30 min or 1 h prior to incubation with LPS. The cell viability was assessed by MTT assay. The neuronal apoptosis was quantified by scoring the percentage of cells with apoptotic nuclear morphology after Hoechst 33258 staining. The cultured cells were then fixed on the 7th day and immunocytochemically stained with phosphorylated JNK1 antibody. The protein expressions of active caspase 3 and phosphorylated JNK1 were measured by Western blot. Nitric oxide (NO) generation was measured by Griess method. RESULTS The decrease of cell viability and the increase of apoptotic cells in cultured cortical neurons were observed incubated with LPS for 24 h compared with the normal controls. The cell viability of cortical neurons was decreased from (100.0±10.9)% in the normal control group to (72.3±2.1)% in the LPS-treated group and the apoptotic cell percentages were increased from (11.5±4.2)% in the normal control group to (39.5±8.2)% in the LPS group. LPS induced the increases in phospho-JNK1, active caspase 3 expression, and NO generation. Pioglitazone 0.01, 0.1 and 1 μmol·L~(-1), respectively inhibited LPS-induced decrease in cell viability and increase of apoptotic morphology, active caspase 3 expression in cultured neurons. In LPS+pioglitazone 1 μmol·L~(-1) group, cell viability was （97.8±9.7）%, the apoptotic cells percentage was (20.6±5.0)%, NO generation (6.8±1.3)μmol·L~(-1). Furthermore, pioglitazone also inhibited LPS-induced the increase in JNK1 phosphorylation and NO generation. JNK inhibitor SP600125 5 μmol·L~(-1) significantly inhibited LPS-induced neurotoxicity, cell viability was increased from (72.3±2.1)% to (109.8±11.8)%, the apoptotic cells percentage from (39.5±8.2)% decreased to (19.1±4.8)%, NO generation from （21.1±5.0）μmol·L~(-1) decreased to（4.0±1.3）μmol·L~(-1). The PPARγ antagonist GW9662 10 μmol·L~(-1) did not reverse the effects of pioglitazone. In LPS+pioglitazone 1 μmol·L~(-1)+GW9662 10 μmol·L~(-1) group, cell viability was (90.7±6.9)%, the apoptotic cells percentage was (23.4±4.1)%, and NO concentration was (5.8±0.7)μmol·L~(-1). CONCLUSION Pioglitazone protects cortical neurons against LPS insult at least via inhibiting JNK activity and NO generation, but not PPARγ activation.

Objective To summarize the etiological,clinical and imaging characteristics of cerebral venous sinus thrombosis (CVST) in children so as to provide the basis for early diagnosis and prompt treatment.Methods All the medical records including clinical manifestations,laboratory data,neuroimaging changes,treatment and short-term prognosis were analyzed retrospectively in 12 cases of CVST hospitalized in Children' s Hospital of Fudan University from Aug 2008 to May 2012.Results (1) Regarding the etiology:of the 12 cases,the causes of CVST were infection (2/12),intracranial tumor (1/12),nephrotic syndrome (2/12),cryptogenic disease (7/12).Seven out of all 12 cases without definite cause were presented subacute or chronic headache associated with progressive or acute exacerbation.Seven cases had been misdiagnosed.(2)Diagnosis:All 12 cases were made a definite diagnosis as CVST after neuroimaging examination of brain magnetic resonance imaging combined with magnetic angiography venography.(3) Short-term prognosis:all the patients were treated with anticoagulation,and 11 cases improved.Four of 7 cases with cryptogenic disease had different degrees of visual impairment,and no improvement were found after the treatment; One patient died although accepted digital subtraction angiography and balloon catheter technique.Conclusions Cerebral venous sinus thrombosis has no specific clinical manifestations and a high rate of misdiagnosis.Increased consideration and prompt magnetic angiography venography play a key role in the accurate diagnosis.Anticoagulation is safe and effective.

Objective To observe the therapeutic effect of Di'ao Xinxuekang (DAXXK) on myocardial ischemia-reperfusion injury in rats, and to explore its mechanisms. Methods The myocardial ischemia-reperfusion injury model was established by the ligation of descending coronary artery in rats. Then animals after the modeling were randomized into model group, DAXXK-d (31.5 mg/kg) group, DAXXK-g (63.0 mg/kg) group and Diltiazem (24.8 mg/kg) group. A separate sham group was used as control. The treatment group was given DAXXK once a day for 7 days. Cardiac function and cardiac configuration were measured by color Doppler ultrasound diagnostic method. Hemodynamics was measured by Millar catheter method. The arterial oxygen saturation and blood oxygen pressure were measured by i-STAT 300 blood gas analyzer. Inflammatory cytokines interleukin (IL)-1β, IL-6, tumor necrosis factor (TNF)-α, adhesion molecules VCAM-1, ICAM-1, and apoptosis-related protein Bcl-2, Bax were detected by ELISA. Myocardial apoptosis was measured using TUNEL method. Results Compared with model group, the left ventricular fractional shortening (FS), the systolic and diastolic function were improved, and the left ventricular pressure maximum rise/ fall rates (± LVdp/dtmax) were increased, in DAXXK group. DAXXK improved lung function, increased arterial oxygen pressure and oxygen content. The inflammatory cytokines IL-1β, IL-6, TNF-α and adhesion molecules ICAM-1 and VCAM-1 were decreased in DAXXK group. The myocardial swelling and inflammatory infiltration were relieved, myocardial apoptosis was reduced, the expression of Bcl-2 protein was increased and the expression of Bax protein was decreased in DAXXK group. Conclusion DAXXK can protect myocardial ischemia-reperfusion injury, which involved in the inhibition of apoptosis and reduction of inflammatory cytokines.