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.

AIM:The homologous recombination takes place in E.coli BJ5183 between shuttle vector and adenoviral backbone vector.Recombinants are selected for kanamycin resistance,and the linearized recombinant plasmid is transfected into 293 cells.In this study,AdEasy system was used to generate recombinant adenovirus vector carrying rat interleukin-10(IL-10) gene.METHODS:The experiment was conducted in Department of Microbiology,Qingdao University Medical College from August 2006 to May 2007.①The materials included five clean-grade SD rat,a shuttle vector pAdTrack-CMV,an adenoviral backbone plasmid pAdEasy-1,E.coli.BJ5183 and DH10B,and human embryo kidney 293 cells,which were given as a present by professor Luo.All animal treatment was accorded with the ethical standards.②Total RNA was extracted from spleen cells of rat stimulating by lipopolysaccharide.IL-10 cDNA was amplified by using RT-PCR.The gene of interest was firstly cloned into a shuttle vector pAdTrack-CMV.The resultant plasmid was linearized by digesting with restriction endonuclease Pme Ⅰ,and subsequently transformed into E.coli.BJ5183 cells with an adenoviral backbone plasmid pAdEasy-1.Finally,the linearized recombinant plasmid was transfected into adenovirus packaging cell lines 293 cells.Recombinant adenovirus vAd-IL-10 was obtained.The expression of green fluorescent protein(GFP) was observed under fluorescent microscope.293 cells were cultured in 96-well culture plate with 1 ?104 cells per well.Condensed virus stock solution was added into the plate at different ratios.Recombinant adenoviruses titer was determined.Three days later,total RNA was extracted from 293 cells by TRIzol one-step method,and contaminant DNA was digested by DNaseⅠ.Electrophoresis detected the expression of IL-10 mRNA.RESULTS:①GFP expression was observed 16 hours after packing of the linearized recombinant adenoviruses in 293 cells.The amplification product of replicationdeficient Ad-IL-10 virus was transfected into adenovirus packaging cell lines 293 cells.When the fourth and fifth generations were seeded in virus for 24-48 hours,fluorescence was found in almost cells,and 5.5?108 pfu/mL titer of Ad-IL-10 was obtained.Titer of vAd-GFP was 9.0?108 pfu/mL.②Total RNA was extracted from transfected 293 cells.Electrophoresis showed that 580bp amplification product was expressed obviously and recombinant adenovirus was duplicated in 293 cells.CONCLUSION:The recombinant adenoviral vector carrying IL-10 gene is successfully constructed using AdEasy system.Moreover,vAd-IL-10 recombinant adenovirus with high titer is prepared and transcribed in 293 cells.

Objective In order to meet the needs of Medicare patients, hospitals use existing network equipment to implement the connection with Data Center of Medicare without changing the present frame. Methods Network Address Translation function (NAT) was used to translate equipment IP address that hospital needs to connect with data center of Medicare into legal IP address in data center of medicare. Results The author used existing NAT function of equipment to reduce the repeating purchase for network equipment and successfully realized the connection between hospital and Data Center of Medicare. Conclusion Using NAT devices not only does not need to change the local IP address but effectively overcomes the lack of legal IP addresses, and what's more, network security is further strengthened.

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.

Objective To investigate different scoring systems in predicting the severity of acute pancreatitis(AP).Methods The clinical data of 1 56 patients with AP were retrospectively reviewed.Ser-um c-reactive protein(CRP)levels were measuredat admission.According to the Chinese guidelines for the management of acute pancreatitis(2007),all the patients were categorizedas either mild acute pancre-atitis(MAP)or severe acute pancreatitis(SAP).Ranson,acute physiology and chronic health evaluation (APACHE)-Ⅱ,bedside index for severity in acute pancreatitis(BISAP),and computed tomography se-verity index(CTSI)scoring systemswere calculated according to the corresponding grading standardsin all patients.Patients were divided into MAP group(APACHEⅡ <8,Ranson <3,BISAP <2,CTSI <3 and CRP <21 .4)and SAP group (APACHEⅡ≥8,Ranson≥3,BISAP≥2,CTSI≥3 and CRP≥21 .4)ac-cording to the scoring results.ROC curve was used to compare the difference among the systems.Results Among the 1 56 patients,21 (1 3.5%)were classified as SAP and 1 35 as (86.5%)MAP.AUCs for Ranson,BISAP,APACHEⅡ,CTSI,and CRP in predicting SAP were 0.69 (95%CI:0.62-0.76),0.74 (95%CI:0.66-0.80),0.78 (95%CI:0.70-0.84),0.69 (95%CI:0.61 -0.76),and 0.68 (95%CI:0.57-0.78),respectively.There were no significant differences among these scoring systems.Conclusion There were no significant differencesin predicting the severity of AP among these scoring systems. Therefore,the early prediction of SAP should consider multiple scoring systems,and the referential signifi-cance of accessing and applying a simpler laboratory indicator deserves further studies.

Objective To analysis the causes and characteristic of cracked teeth with pulpitis and explore clinical diagnosis and treatment methods.Methods A total of 78 tooth that was identified as a cracked tooth with pulpitis was recorded and analyzed in terms of the age,the position in the mouth,and the location of crack-line.After reducing the cusp height,root canal therapy and crown restoration,the patients were followed up for one year and the treatment effectiveness was reviewed.Results The most prevalent age was 39-49 years.The most of cracked teeth were found in the maxillary molars.There were 65 cases (83.33%)that were treated successfully,the function of 1 1 cases (14.10%)were improved,and the rate of failure were 2.56% (2 cases).Conclu-sion Reasonable clinical diagnosis and treatment can contribute to the retention of the cracked teeth.Coronal restoration after root canal therapy might be a very effective way to treat cracked teeth with pulpitis.

Objective:To summarize the application of hospital electronic medical record system and implementation experience, for the scientific and reasonable construction of digital hospital provides design scheme. Methods: The electronic medical record to the patient as the center including the establishment of hospital medical records, doctor's orders, all kinds of inspection, inspection reports and other information. Results: The uniform ultimate implementation of electronic health record standard, electronic data from medical records and medical information barrier-free exchange, realize the integration and sharing of electronic medical records information inside the hospital. Conclusion: The electronic medical record system to improve the clinical efficiency in hospital application, provide auxiliary functions for clinical decision making.