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 assess global systolic function of left ventricle (LV) using speckle tracking echocardiography in patients who are left volumetric overload and to establish the correlativity between strain and left ventricle end-diastolic volume index (LVEDVI). Methods Seventy-seven patients who were left volumetric overload and 30 normal volunteers were enrolled in this study. Respective 3 high frame rate (＞ 100 frames/s) 2D images were recorded from the left ventricular short axis views: the levels of mitral valve annulus, papillary muscle and apex. Three global peak systolic radical strain and strain rate were measured using 2D strain imagirg. LVEDV was obtained by two-plane Simpson method and LVEDVI was obtained by normalized LVEDV with surface body area. Patients were divided into 6 groups: transitionalgroup,group A (LVEDVI:90- 120 ml/m2),group B (LVEDVI: 121 - 150 ml/m2 ),group C (LVEDVI:151 -180 ml/m2),group D (LVEDVI: 181 - 210 ml/m2),and group E (LVEDVI＞210 ml/m2). Patients were divided into two groups by left ventricular ejection fraction (LVEF): group Ⅰ (LVEF≥ 50 % ), group Ⅱ (LVEF＜50％). Results①Compared with normal control group,GRS,GRSr in transitional group showed no change at three short axis levels (P ＞0.05). The above parameters in group A, B and C were significantly higher than those in normal control group( P ＜0. 01 ). In transitional group,group A,B and C,GRS, GRSr of three short axis gradually increased with LVEDVI augmentation. Compared with group A, B,C,D and normal control group,the above parameters of 3 short aixs in group E were decreased( P ＜0. 01 ),which gradually decreased in group C, D, E with LVEDVI augmentation. ②GRS,GRSr of 3 short axis views in group Ⅰ were more significantly high than those in group Ⅱ and normal control group. The parameters above were significantly low in group Ⅱ ( P ＜0.01). ③In group A,B,C,GRS of papillary muscle and apex levels were correlated positively to LVEDVI ( rpapillary muscle = 0.55,0.64,0.76 and rspex = 0. 74, 0. 79,0.71,P ＜0.05) ; In group D, there was no correlativity between GRS of papillary muscle and LVEDVI( r =- 0.35, P ＞ 0.05) while negative correlativity was established in apex level( r = - 0.73, P ＜ 0. 05). In group E,the negative correlativity was found between GRS of papillary muscle and LVEDVI( r = -0. 70,P ＜0.05) while no correlativity was established in apex level( r = - 0.39, P ＞0. 05). GRS of mitral valve annulus was correlated positively to LVEDVI in group A, B( r = 0.79, 0.77, P ＜ 0.05) and had no correlativity in group C,D. The negative correlativity between them was found in group E( r = - 0. 54, P ＜0.05). At LVEDVI: 180- 190 ml/m2 ,GRS of papillary muscle and apex level reach the peak point about 93% and 62% ;GRS of mitral valve annulus level reach the peak about 63% at LVEDVI 150 - 160 ml/m2.Conclusions Radial strain,strain rate change periodically with LV volume overload. Wall motion of left ventricle can be evaluated accurately by speckle tracking echocardiography, which provide useful modality for evaluation cardiac systolic function.

Objective To evaluate the clinical efficacy of neo-adjuvant chemotherapy in the treatment of cervical cancer. Methods A total of 32 patients,of which 12 cases of Ⅰ b2,8 cases of Ⅱ a,5 case of Ⅱ b and 7 cases of Ⅲ, were all treated with 2 - 3 cycles of PF chemotherapy before treatment with cisplatin 100 mg/m2, d 1;5-fluorouracil 1000 mg/m2 ,d1-5. The chemotherapy was performed for 3 weeks followed by three weeks rest as one cycle. Results Short-term effect was 81.3% (26/32), with 3 cases of Ⅰ b2 and 1 cases of Ⅱ a had been completely relieved after 2 - 3 cycles of chemotherapies. Simultaneously, chemotherapy improved the removal rate of surgery. Among these 32 patients, there were 4 cases achieved complete response (CR) ,22 cases achieved partial response (PR) ,5 case of stable disease ( SD), 1 cases of progressive disease(PD). The overall response rate( CR +PR) was 81.3% (26/32) ,and the control rate ( CR + PR + SD) was 96. 9% (31/32). The main adverse events included myelosuppression and gastrointestinal response, which were all tolerable. Conclusions The neo-adjuvant chemotherapy reduced the size of cancer,which can improve removal rate of surgery and the quality of life.

Objective To evaluate left ventricular torsion and untwisting in patients with coronary artery disease by speckle tracking imaging. Methods Study population consisted of 48 patients, who were diagnosed coronary artery disease initially and received one of coronary arteriography, coronary artery spiral computerized tomography, radionuclide imaging, interventional therapy and bypass surgery. High frame rate (≥60 frame/s) two-dimensional dynamic images of the left ventricular apical long-axis views and parasternal short-axis views at basal and apical levels were recorded. Rotation was measured in the left ventricular short-axis views using 2D strain software. Left ventricular torsion was defined as relative rotation degree between the apical level and basal level. Patients were divided into three groups according to clinic final diagnosis [myocardial infarction ( MIN) group, n = 19; myocardial ischemia ( MIS) group, n =19; normal coronary artery (Contrast) group, n - 10]. Results In MIS group,peak rotation value and rotation value at aortic valve closure in basal level were smaller than those in apical level. Untwisting rate reduced in MIN group. There was linear correlation between left ventricular peak torsion and end-diastolic diameter. There was aslo linear correlation between left ventricular peak torsion and eject fraction. Left ventricular peak rotation at basal level was correlative to eject fraction. Left ventricular untwisting rate had linear correlation to eject fraction, and also had correlation to peak torsion. Conclusions In patients with myocardial ischemia, left ventricular rotation value at apical level is larger than that at basal level. Left ventricular diastolic function is injured severely in patients with myocardial infarction. Untwisting rate is a quantitative index to evaluate myocardial diastolic function.

BACKGROUND: In spite of some good successes of nickel-titanium alloy have been achieved in orthopaedic surgery, there are still serious limitations in clinical application, such as potential leakage of elements and ions, which could be toxic to cells, tissues and organs. OBJECTIVE: To review the research progress and the exiting problems of nickel-titanium shape memory alloy in orthopaedics and to provide theoretical supports for safe use of the alloy in clinical practice.METHODS: A computer-based online search of Springerlink and CNKI was performed for articles published between 2003 and 2010 both in Chinese and English. The search was conducted respectively with the key words of "nickel-titanium shape memory alloy (NiTi-SMA), biocompatibility, modifications, orthopaedics". Researches regarding nickel-titanium shape memory alloy and its properties, clinical applications, corrosion performance, biocompatibility, corrosion resistance by surface/structure modifications and the long-term challenges were included. Irrelevant or repetitive articles were excluded. RESULTS AND CONCLUSION: Nickel-titanium shape memory alloy has special value in medical field due to favorable shape-memory and superelasticity. However, due to the nickel toxicity, it is of great importance to elevate corrosion resistance of nickel-titanium alloy. The modifications of the alloy are the main focus and direction for further research.

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.

The cases of cardiac arrest are increasing because of the increased incidence of cardiovascular diseases. Cardiopulmonary resuscitation (CPR) is the necessary measure to rescue these patients. But the success rate of recovery is still low. Acid-base disturbance is one of the important factors affecting the recovery effect. Overseas and domestic studies in recent years focused on the acid-base changes and mechanism in CPR have founded that it exits extraordinary hypercapnia and CO2 spike, which have important guidance to the clinical work. The research for the arterial blood gas analysis during CPR, changes in the exact time, and treatment of hypercapnia and acid-basic change in different etiology and different populations were very few, therefore the a lot of clinical data is needed to accumulate for further study.

Bronchopulmonary dysplasia (BPD) is a chronic pulmonary disease which seriously affects the survival and long term quality of life in premature infants. Its pathogenesis is not yet clear. In recent years, the role of pulmonary vascular dysplasia in BPD has received increasing attention and evolved into a“vascular hypothesis”of the pathogenesis of BPD. Angiogenesis therapy based on this hypothesis has also made some progress in the treatment of BPD. This paper brielfy reviews the current research situation in this ifeld.

Aim Curcumol and Zedoary Turmeric Oil (ZTO) were prepared to liposome, which were used to study the anti-hepatoma effect, and its mechanism that was expected to provide theoretical support for the clinic anticarcinomal use of Zedoray Rhizome Abstracts.Methods Curcumol and ZTO were prepared to liposome by mechanical diffusion and ultrasonic techniques.Proliferation of HepG2 cell in vitro was observed with curcumol and ZTO by MTT assay. Apoptosis of cells was observed by staining with Hoechst 33258/PI and laser confocal scanning microscopy (LCSM). Expression of COX-2 mRNA and VEGF mRNA of HepG2 cell was investigated by RT-PCR.Results Envelopment ratios of curcumol liposome and ZTO liposome were 86.2% and 74.5%,respectively.Curcumol and ZTO inhibited proliferation of HepG2 cell by MTT assay.Compared with control group, Curcumol and ZTO increased the apoptosis rate of HepG2 cell significantly (P