Cardiopulmonary arrest is one of the most critical situations,posing a serious threat to life.With the development of medical technology, the rate of return of spontaneous circulation after cardiac arrest has been improved.However, many children suffer from multiple organ dysfunction because of the long hypoxia time from cardioplumonary arrest, so the rate of long-term survival is relatively low and the long-term outcome is still not satisfactory.Therefore, how to make cardiopulmonary resuscitation more effective is the focus of current research.This article reviews the related factors that affect the outcome of resuscitation, providing references for the treatment of cardiopulmonary arrest in children.

Background One of the important machanisms of all trans retinoic acid (ATRA) is to regulate the expression of connexin (Cx) gene.ATRA inhibits the proliferation and differentiation of retinoblastoma (RB) cells,which is related to Cx43.However,the control site of ATRA and its effect on RB tumor in vivo have not been identified.Objective This study was to investigate the effect of ATRA on Cx43 expression in RB cells and its approach mechanisms.Methods ATRA solution of 1 × 10 2 mol/L was prepared with ethanol and formulated into 1×10 5,1×10-6and 1 × 10 7 mol/L of solution with culture medium further.Human RB cell line (HXO-RB44) was cultured and treated with different concentrations of ATRA for 2,4 and 6 days,respectively.The expressions of Cx43 protein and mRNA in RB cells were detected by Western blot and reverse transcription PCR (RT-PCR),respectively.RB models were established by injecting HXO-RB44 cell suspension into anterior chamber in the right eyes of 15 athymic mice.Eleven successful models were divided into the blank control group,negative control group and 1 × 10-5 mol/L ATRA group,and 0.5％ normal saline solution with athymic or 1 ×10-5 mol/L ATRA solution was injected into the anterior chamber in the negative control group and 1 × 10-5 mol/L ATRA group in the 3-day interval for 3 weeks.The model eyes were examined under the slit lamp microscope.The eyeballs were extracted at the end of the experiment for hematoxylin and eosin staining.Results Western blot assay showed that the absorbance values of Cx43 protein (ACx43/AGAPDH) were increased gradually as time lapse of ATRA treatment among the groups (Ftime =71.31,P =0.00; Fgroup =7.66,P =0.00).The expressions of Cx43 protein were significantly higher in the 1 × 10 5 mol/L ATRA group after 2 days,1 × 10-6 mol/L ATRA group after 4 days,1 × 10-7 mol/L ATRA group after 6 days than those in the blank control group at various time points (t =3.34,P＜0.01 ;t =2.33,P＜0.05;t =3.12,P＜ 0.01).RT-PCR showed that the absorbance values of Cx43 mRNA (ACx43mRXA/Aβ-actin) were significantly enhanced as the prolong of treatment time of ATRT among the groups (Ftime =90.90,P =0.00 ; Fgroup =6.86,P =0.00).The expressions of Cx43 mRNA were significantly higher in the 1 × 10-5 mol/L ATRA group after 2 days,1 × 10 6 mol/L ATRA group and 1 ×10-7 mol/L ATRA group after 4 days than those in the blank control group at various time points (t=3.57,P＜0.01 ;t=6.31,P＜0.01 ;t=2.22,P＜0.05).RB models were successfully created in 11 eyes on the 6-9 days following the intrachamber injection of RB cell suspension.The RB cells were filled with chamber in the blank control group 20 days after injection,and RB only occupied half of the anterior chamber in the 1 × 10-5 mol/L ATRA group.Histopathological examination exhibited that the RB cells were seen in the anterior and posterior chamber as well as vitreous in the blank control group,however,the cells were only found in the anterior chamber in the 1 × 10 5 mol/L ATRA group.Conclusions ATRA can inhibit the growth of RB in vitro and in vivo by inducing the expression of Cx43 gene in transcription process.

Objective To investigate the effects of nicergoline on the treatment of posterior circulation ischemia vertigo (PCIV).Methods A total of 87 patients with PCIV were randomly treated either with nicergoline (45 cases) or betahistine (42 eases).Dizziness assessment rating scale (DARS) and dizziness handicap inventory (DHI) were used to evaluate the changes of manifestations before treatment,after 7 days and 8 weeks treatment with nicergoline,meanwhile transcranial Doppler ultrasound (TCD) and brainstem auditory evoked potential (BAEP) were observed to assess the effects.Results After 7 days of treatment,the scores of DARS and DHI were decreased significantly in nicergoline group (DARS:15.6±2.1 ; DHI:38.3± 11.4) and control group (DARS:14.3±4.4; DHI:39.5±14.7) compared with the scores before treatment (DARS:24.9±7.3,22.5 ±9.7; DHI:55.8±19.7,57.5±19.3) (all P＜ 0.05),and the treatment efficiency was 71.1％ (32/45),61.9％ (26/42).After 8 weeks of treatment,the scores of DARS and DHI were also decreased significantly in nicergoline group (DARS:8.9 ±3.9; DHI:26.3± 12.8) and control group (DARS:9.9±4.7; DHI:35.8±13.1) compared with the scores before treatment (all P＜ 0.05),and the treatment efficiency was 93.3％ (42/45),78.6％ (33/42).There was significantly differences in the scores of DHI and treatment efficiency between the two groups at 8 weeks (t =2.169,P＜ 0.05,and x2=3.98,P＜ 0.05),but no differences at 7 days (both P＞ 0.05).In consistent with the remission of the clinical symptoms,nicergoline group significantly recovered from both low blood diffusion in the verbal-basal artery system and extended peak latency(PL) and inter peak latency(IPL) in the auditory pathway examined by TCD and BAEP individually at 8 weeks,especially in the upper part of the brainstem (P＜0.05).Conclusions Nicergoline is very effective in the treatment of PCIV and could alleviate the subclinical ischemia to get long time benefits.

More and more studies have indicated that the relationship between vitamin D pathway and asthma,and the mechanisms include multiple abnormal aspects of vitamin D pathway leading to abnormal em-bryonic development and immune system disorders and so on. This review summarizes the relationship between vitamin D,vitamin D binding protein,vitamin D receptors,related gene polymorphisms and the immune system to describe the pathogenesis of asthma.

Objective To investigate the clinical value of simultaneous assessment of cardiac troponin I,Btype natriuretic peptide,and C-reactive protein in prediction of long-term cardiac outcome after cardiac surgery.Methods 224 patients undergoing cardiac surgery were included and followed up within 12 months after surgery.Serial blood samples were drawn in all patients the day before surgery,at the end of surgery,and 6,24,and 120h after surgery.Major adverse cardiac events within 12 months after surgery were chosen as study endpoints and were defined as malignant ventricular arrhythmia,myccardial infarction,congestive heart failure,the need for myocardial revascularization,and/or death from cardiac cause.Predictive ability of each cardiac biomarker was assessed using logistic regression.Results Accuracies of C-reactive protein,cardiac troponin I,and B-type natriuretic peptide,considered as continuous variables to predict the occurrence of major adverse cardiac events were limited(area under receiver operating characteristic curve:0..54[0.47 ～0.60],P =0.42,0.62[0.55 ～0,68],P =0.01,and 0.68[0.61 ～0.74],P ＜0,001,respectively).When biomarkers were considered as 75％ specificity dichotomized variables,evaluated C-reactive protein(＞ 180mg/L),cardiac troponin I(＞ 3.5ng/ml),and B-type natriuretic peptide (＞ 880pg/ml)were independent predictors of major adverse cardiac events(odds ratio:2.14[1.03 ～4.49],P =0.043,2.37 [1.25 ～ 5.64],P =0.011,and 2.65 [1.16 ～ 4.85],P =0.018,respectively) in a multivariate model including the European System for Cardiac Operative Risk Evaluation score.Conclusion Simultaneous measurement of cardiac troponin I,B-type natriuretic peptide,and C-reactive protein improves the risk assessment of long-term adverse cardiac outcome after cardiac surgery.

The paper conducts a case study of Tongji Medical College, Huazhong University of Science&Technology, introduces the application and management status of various cards, elaborates the one-card integration program for the management of staffs in the hos-pital and discusses the problems needing attention and the application effect.It is noted that the one-card solution facilitates the simpli-fication of the work process, the improvement of management efficiency and the reduction of management costs.

Objective To evaluate efficacy and safety of escitalopram in treating depression .Methods In this randomized , single-blind, citalopram parallel controlled, fixed dosage study, the study group was treated with escitalopram tablet 10mg/d and the control group with citalopram tablet 20mg/d.Observation duration was 6 weeks.Hamilton Rating Scale for Depression ( 17-item HAMD),Clinical Global Impression (CGI) and Hamilton Rating Scale for Anxiety (HAMA) were used to measure the efficacy.Items including Treatment Emergent Symptoms Scale (TESS), lab examination and vital signs for assessment of safety .Results Eighty-eight patients were randomly divided into study group (43 patients) and control group (45 patients).After 6 weeks treatment, a signif-icant greater reduction in HAMD 17 ,CGI-SI and HAMA total score was found for both study group and control group showing significant difference with their baseline ( P <0.01 );but there were no significant difference between two groups ( P >0.05 ) .However , after 1 week treatment , the HAMD17 and CGI-SI score reductions between two groups were significant difference ( P <0.01 ) .The score of HAMA was no significant difference between two groups ( P >0.05 ) .In study group , the positive response rates was 81.4%,and in controls was 80.8%, there was no significant difference between two groups ( P >0.05 ) .There was no significant difference about the incidence of adverse reaction between two groups ( P >0.05 ) .Conclusions Escitalopram is a safe and effective antidepressant as citalopram , however , it has a more rapid reaction than the latter .

Objective To observe the clinical efect of Weisu particle combined with Mosapride in the treat-ment of the functional dyspepsia .Methods According to the digital table ,64 patients were divided into two groups in random,32 cases were treated by Weisu particle combined with Mosapride in treat group ,33 cases treated by Mosa-pride in control group .Both have a course of 4 weeks treatment .Results The efective rate of the treat ment group′was/96.87%which was better than that of the control group′(s 68.75%)(χ2=4.68,P<0.05).Conclusion The thera-peutic method of Weisu particle combined with Mosapride have a better clinical effect than that of domperidone only used .

Objective To explore the hypoglycemic effects of Viola tianshanica Maxim.Methods Extraction conditions by orthogonal design research,in total flavonoids as index by reflux extraction for Viola tianshanica Maxim extracted.Established mouse model of diabetes with streptozotocin(STZ),reused Viola tianshanica Maxim extract for hypoglycemic experiment.The mice were divided into high dose group,middle dosage group,low dose group,blank control group,positive control group and normal mice group,15 mice in each group.The mice blood glucose and body weight of the different groups were observed.Results Viola tianshanica Maxim in a high concentration had significantly hypoglycemic effect in diabetic mice,average blood glucose level decreased from (18.4±5.8)mmol/L to (11.6±3.4)mmol/L,and the concentration of the extract could reduce the level of blood glucose in diabetic mice,average blood glucose level decreased from (24.8±5.6)mmol/L to (18.5±4.6)mmol/L,the differences were statistically significant(all P<0.05).Conclusion Viola tianshanica Maxim crude extract has a certain hypoglycemic effect.

Objective To study the present development of human resource allocation and development trends of traditional Chinese medicine.Methods Literature review was used to study the present development of such human resources in China.Results As of 2015, TCM institutions accounted for 4.73 percent of the total medical institutions in China, and Chinese medicine personnel accounted for 7.40 percent of the total medical workers in the country.The number of staff with education below undergraduate degree in TCM hospital accounted for 35.6% of the total.Conclusions Education level of TCM hospital staff is expected to elevate, and their education needs to respect the law of growth for such human resources and professional development.Continuing education calls for greater attention for elevation of the human resources in general.