Atherosclerosis ; complications ; Fatty Liver ; complications ; Humans ; Non-alcoholic Fatty Liver Disease

Coronary Disease ; Humans ; Smoking

Personnel resource is very important for the development of emergency department and emergency medicine.In recent years a series of researches for the standardized training of emergency residents have been progressed in the Emergency Depart- ment of West China Hospital.It goes through three phases.The idea of the training changes from“general physician”to“emer- gency specialist”.And the training is designed,practised and assessed with standardization.

Objective To investigate the relationship between sarcoplasmic reticulum Ca2+modulation proteins and postresuscitation myocardial dysfunction. Methods Thirty-eight SPF male Sprague-Dawley (SD) rats were randomly divided into control group(n=12)and cardiac arrest(CA)group(n=26). CA was induced by intravenous bolus of potassium chloride(40μg/g),and cardiopulmonary resuscitation(CPR)was conducted 8 minutes later. No CA was induced in control group except catheter placement for monitoring cardiopulmonary parameters after anesthesia. Invasive hemodynamic parameters were monitored for 1 hour after CPR. Echocardiogram was performed to evaluate cardiac function. Myocardial samples were harvested 5 minutes and 1 hour after restoration of spontaneous circulation (ROSC),and sarcoplasmic reticulum Ca2+ ATPase (SERCA2a),phosphorylated phospholamban (p-PLB) and rynodine receptor(RyR)were determined by Western Blot. Results ROSC rate of CA group was 92.3%(24/26),and mean recovery time was (68 ±39)seconds. Cardiac function was significantly impaired in CA group at 1 hour after resuscitation, and ejection fraction, fraction shortening (FS), the maximal rate of left ventricular pressure increase/decline (±dp/dt max)were significantly decreased compared with those in control group 〔ejection fraction:0.548±0.060 vs. 0.809±0.043,F=71.692,P=0.000;FS:(34.4±4.4)%vs. (46.0±3.5)%,F=55.443,P=0.000;+dp/dt max(mmHg/s):4 718±743 vs. 7 098±394,P<0.01;-dp/dt max(mmHg/s):-3 824±612 vs.-6 187±473,P<0.01〕. Compared with control group,the expression levels of p-PLB (gray value)was significantly decreased at 5 minutes and 60 minutes(5 minutes:0.64±0.15 vs. 1.29±0.13,P<0.01;60 minutes:0.95±0.08 vs. 1.30±0.09,P<0.05)after resuscitation in CA group,while the level of sarcoplasmic SERCA2a(gray value)and RyR (gray value)showed no significant differences(SERCA2a 5 minutes:1.01±0.18 vs. 1.24±0.07,60 minutes:1.03± 0.14 vs. 1.25 ±0.06;RyR 5 minutes:0.96 ±0.13 vs. 0.97 ±0.13,60 minutes:0.88 ±0.14 vs. 0.99 ±0.11,all P>0.05). Conclusions The impairment of the p-PLB is closely related to postresuscitation myocardial dysfunction.

Objective To investigate the expression of nuclear factor-κB in alveolar macrophages of paraquat-induced rats and the effect of diallyl sulfide on it.Methods Forty five male wistar rats were randomly divided into three groups,namely control group,model group,and DAS treatment group (n =15 in each).The model of paraquat poisoning was reproduced by single does of 70 mg/kg given by intra-gastric administration,while the equal volume of normal saline (NS) was given to the rats in control group instead.The dose of 100 mg/kg of DAS was given to rats by intra-peritoneal injection in DAS treatment group.The equal volume of NS was given to the rats by intra-peritoneal injection in model group and control group instead.The rats of model group and DSA treatment group were exposed to paraquat once a day for 14 days.Five rats in each group were sacrificed at 3,7,14 days.Alveolar maerophages were harvested by bronchalveolar lavage (BAL).The protein content of BAL fluid were examined.The exprossion of NF-κB was measured with immunocytochemistry technique.Results Alveolar macrophage cultures were carried out by using differential adherence of isolated and purified alveolar macrophages,and after 30 minutes culture,more adherent macrophages can be seen.Compared with model group,the protein content of BAL fluid at dfferent intervals in the control group were obviously lower,especially on the 3 rd day (261.6 ± 17.16) μg/mL vs.(673.4 ± 151.9) μg/mL;7 d (265.6 ± 18.37) μg/mL vs.(581.3 ± 134.58) μg/mL;14 d (253.8 ± 11.43) μg/mL vs.(589.07 ± 33.85) μg/mL,P ＜ 0.05.Comparisons of protein content in BLA fluid between PQ group and DAS treatment group were on the 3 rd day (673.4 ± 151.9) μg/mL vs.(342.9 ±39.03) μg/mL;on the 7 th day (581.3 ± 134.58) μg/mL vs.(383.7 ±7.37) μg/mL,P＜0.05;on the 14 th day (589.07±33.85) μg/mL vs.(282.9±15.59) μg/mL,P＜0.05.The immunocytochemistry analysis revealed minimal NF-κBp65 expression in the cell cytoplasm in the control group,while high NF-κBp65 expression was found in nuclear in the model group.Minimal NF-κBp65 expression was found in the cell cytoplasm in the DAS treatment group,and integral A value was significantly lower in the DAS treatment groups than that in the model group (P ＜ 0.05).Conclusions Treatment with an intra-peritoneal injection of DAS is capable of attenuating the extent of PQ-induced ALI in rats by lowering BLA fluid protein content,inhibiting the expression of NF-κB in alveolar maerophages.

The morbidity and mortality of cardiovascular diseases(CVD)are still high in our country,they severely threaten peopleS health and quality of life.A dysregulated or reduced autophagy is associated with ischemic heart disease,cardiac hypertrophy,heart failure and arrhythmia.Autophagy is a key regulator in CVD development,and is essential for maintenance of heart function and improvement of prognosis.Thus,modulating autophagy represents an attractive future therapeutic target for treating cardiovascular disease.This article reviewed the research progression about effects of autophagy on ischemic heart disease,cardiac hypertrophy,heart failure and arrhythmia.

ObjectiveTo evaluate the effects of selective cyclooxygenase-2 inhibitor nimesulide lone and combined with cisplatin on tumor growth,and Ki67 and Caspase-3 expression in lung cancer xenografts in nude mice. Methods The mice were randomly divided into 4 groups:the control group,the nimesulide group,the cisplatin group and the nimesulide combined with cisplatin group. A549 cells were injected into BALB/c nude mice subcutaneously.On the 21st day after treatment tumor tissues were collected,and the xenografts growth were observed. The expression of Ki67 and Caspase-3 were detected by immunohistochemical method.ResultsNimesulide combined with cisplatin could significantly inhibited the xenografts growth compared with nimesulide or cisplatin.The tumor inhibition rate was 44.33％ in the nimesulide group,53.61％ in the cisplatin group and 80.41％ in the nimesulide combined with cisplatin group (P ＜ 0.05).Immunohistochemical analysis showed that the expression rates of Caspase-3 was significantly increased in the nimesulide combined with cisplatin group (67.43 ± 23.57 ) ％,the cisplatin group (48.40 ± 20.37 ) ％,and the nimesulide group (38.65 ± 15.37)％,compared with the control group (27.63 ± 13.03)％ (P ＜ 0.05).The expression rate of Caspase-3 was significantly increased in the nimesulide combined with cisplatin group compared with the nimesulide group or the cisplatin group (P ＜ 0.05 ).The expression rate of Ki67 was significantly decreased in the nimesulide group combined with cisplatin group (24.34 ± 15.90)％,the cisplatin group (40.85 ± 22.47)％ and the nimesulide group (53.33 ± 19.67)％ compared with the control group ( 80.43 ± 16.88 ) ％ ( P ＜ 0.05 ).The expression of Ki67 was significantly decreased in the nimesulide combined with cisplatin group compared with the nimesulide group or the cisplatin group ( P ＜ 0.05 ).Conclusion Nimesulide can inhibit human lung cancer A549 cells xenografts in nude mice growth,Nimesulide enhanced the inhibitory effects of cisplatin.The mechanism may be related to inhibition of tumor cell Ki-67 expression,increased expression of Caspase-3,inhibition of tumor cell proliferation,and inducing tumor cell apoptosis.

From the third day after Wenchuan Earthquake,the Chinese government and army dispatched 90 helicopters per day to transport the wounded to Chengdu City (about 100 km away from earthquake-hit area). From 14 May to 21 May 2008, West China Hospital of Sichuan University received totally 760 wounded mainly from Wenchuan, Yingxiu, Maoxian, Beichuan, Lixian, Mianzu. Transfering patients by helicopter is characterized by rapid,flexible and non-restriction from terrain conditions.Compared with transfer on the land,injury induced during the transfer is reduced. However, the height of helicopter cabin is low,so it's difficult for doctors to carry out related treatment works. The instability during the flight also brought a lot of difficulties for the medical care.The rapid change of speed during take-off and landing caused a series of physiological changes on patients, such as thoracic pressure. Wenchuan is located in the mountains,and this also brought difficulties for the flight. The potentially savable victims,whose lives wouldn't be threatened with bad wound and wouldn't die in a short time,should be given the priority of transfer by helicopter. During the trip of transfer,the life-threatening occurrences, such as asphyxia, persistent convulsion and shock, were well prevented. At the same time, airway management, monitoring of vital signs and necessary consolation were important. After arrival at airport, the medical staff waiting at airport should watch and evaluate the patency of airway and vital signs carefully. If the airway obstruction, vital signs unstable and some other critical events are identified, the first aid at airport is essential. When patients are stable,they can be transported to the nearest hospital where the emergency treatment is available. Besides observation of patients' condition, registration of the name, age, address and the phone number of casualties should be done in the ambulance. Stick a label of the general information and the preliminary diagnosis of the patient on bare intact skin. The selection of casualties before transfer and the first aid at the airport are very important for successful short distance trip by helicopter.

Objective To study the role of bacterial collagenase in wound healing with observing capillary neovascularization, epidermis regeneration and collagen fiber reparation in vivo. Method A total of 28 New Zealand rabbits were made into models of superficial soft tissue trauma and divided into two groups. In the experimental group, the right limbs of rabbits were traumatized intentionally in the same length and depth, and their wounds were treated with bacterial collagenase liquor 133 MIU/mL, and the wounds were sutured. Similarly, in the control group, the left limbs of the rabbits were modeled in the same way and their wounds were managed with physiological saline instead and closed. Their wounds were observed continually 1, 2, 3, 5, 7, 10 and 14 days after traumatized. Data were analyzed statistically by using One-way ANOVA, LSD-test, and Wilcoxon rank test. Results There were no significant differences in capillary neovascularization and epidermis regeneration between two groups ( F = 0.12, P = 0.740 and F = 0.95, P = 0.33, respectively), but significant difference in collagen fiber reparation was found between two groups (F = 6.63, P = 0.01). Conclusions In the progress of wound healing, bacterial collagenase can improve the collagen fiber reparation without effects on the new capillary vasculogenesis and epidermis regeneration. The bacterial collagenase does not play a positive role in wound healing.

With the development of laboratory medicine,more and more biomarkers have been discovered and applied in the diagnosis and treatment of acute myocardial infarction.For patients with suspected myocardial infarction,early diagnosis and timely treatment can save endangered myocardium and reduce fatality rate to a great extent.The proper use of biomarkers is of important value in preventing cardiovascular events and improving prognosis.This paper reviews the recent literature on new biomarkers in diagnosis of acute myocardial infarction,introduces the characteristics of these markers and their clinical diagnostic value.