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 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 investigate the efficacy of low dose thalidomide combined with chemotherapy in treatment of multiple myeloma(MM)and the clinical curative effect of the treatment method.Methods From June 2010 to June 2012,80 patients were diagnosed with multiple myeloma as the research object in Traditional Chinese Medicine Hospital of Haining,randomly divided into control group and observation group,with 40 cases in each group.The control group adopted conventional chemotherapy,the observation group were given low dose thalidomide combined with conventional chemotherapy.The clinical effect and adverse drug reactions were compared. Results The total effective rate of observation group (87.5%)was significantly higher than that of control group(65.0%)(P<0.05).The adverse reactions were 87.5%(35/40)in observation group and 100.0%(40/40)in control group,there was no significant difference between the two groups.The mean progression-free survival(PFS)and overall survival(OS)in observation group(5.5 ±1.2 months;1 1.5 ±2.4 months)were higher than those in control group(3.7 ±0.8 months;8.5 ±1.3 months)(P<0.05 ). Conclusion Low dose thalidomide combined with conventional chemotherapy in the treatment of multiple myeloma can improve clinical effect and decrease recurrence rate,with high safety and less adverse reactions.

Objective:To investigate the effects of Chinese medicine prescriptions Gancaofuzi-tang and Tongbi-fang on adjusting the dynamic expression of related cytokines and further ameliorating the histopathology of synovitis in rats with Ⅱ collagen induced arthritis(CIA).Methods:The experimental Wistar rat model of CIA was set up successfully.The rats divided into five groups in random: normal(N),Gancaofuzi-tang treatment(GF),Tongbi-fang treatment(TB),Puwei western medicine treatment(PW) and model control(C).The different medicine was affused into stomach 1.5 ml/rat,once daily.The rats were sacrificed after 6 weeks of medicine administration.Foot swelling degrees of the rats were measured every other day,and then calculate swelling rates.Getting blood after 3 weeks of treatment from rat's innercanthus to detect the level of serum Sialic Acid(SA) and the level of serum IL-2 and TNF-? by ELISA.The synovial histopathology was observed with HE staining under optical microscope.Results:Gancaofuzi-tang and Tongbi-fang significantly decreased swelling rate of joints in CIA rats.The pathology of synovisl tissues was markedly ameliorated.After administration for 3 weeks,the levels of serum SA,IL-2 and TNF-? of the rats in GF and TB groups were significantly decreased compared with the control.Continuous administration for 6 weeks,the levels of the targets in GF and TB rats reached to near the normal level.Conclusion:All the results demonstrate that Gancaofuzi-tang and Tongbi-fang play anti-inflammatory and immunoregulatory roles in CIA rats through inhibiting activation of some inflammatory mediators,adjusting related cytokines expression,then eliminating the joint swelling and improving synovitis pathology,which might be looked as immune suppression effects similar to NSAID medicine.

As one of important sorts of pesticides,organophosphorus pesticides(OPPs) are used widely in the world.They can cause serious environmental problems and have some adverse effects on the health of people and animals.They can induce acute neurotoxicity and delayed neurotoxicity,and result in the damages of organs.The objective of this paper is to provide a brief review of the mechanisms involved in the OPPs-induced hyperglycemia.OPPs can influence body glucose homeostasis by several mechanisms including oxidative stress,nitrosative stress,inhibition of cholinesterase,inhibition of paraoxonase,disturbance in metabolism of liver tryptophan and so on.

AIM: To evaluate the effect of Shenfu injection on hemodynamics of hypovolemic shock patients and oxygen delivery by transesophageal Doppler echocardiography (Hemosonic 100 TM). METHODS: The transesophageal probe was placed in 32 patients with hypovolemic shock. 50 mL Shenfu injection were intravenously administered within 5 min. The parameters, including ABF, SVa, Acc, LVETi and TSVRa, were recorded at interval of 5, 10, 20, 30, 60 and 120 min. Meanwhile, MAP was measured at the same interval. Arterial and venous blood gases were taken at the beginning and 30, 60 and 120 min of the trial. DO2, VO2 and ERO2 were calculated. RESULTS: Acc, SVa, ABF increased while TSVRa decreased at 10 min after administration of Shenfu injection ( P