Objective To observe the efficacy and safety of polysaccharide sulfate in treating patients with cold erythema multiforme.Methods Using polysaccharide sulfate,cetirizine and compound vitamin E ointment to treat 20 patients with cold erythema multiforme as the treatment group compared with the control group in which 20 patients with cold erythema multiforme were given cetirizine and compound vitamin E ointment.The course of treatment in 2 groups was 14 d.Results Forty patients were eligible for efficacy analysis(20 in each group).The total significant recovery rate was 95% for treatment group and 70% for control group,respectively;the therapeutic effects of the treatment group were better than those of the control group(P

The progress of globalization and frequent international exchanges in the medical com-munity demand doctors' improved English speaking competence, particularly in the clinical aspect. On the basis of the First Principles of Instruction, the research has proposed a module-based teaching model, which integrates 7 modules, including history taking, questions about frequency and pains, analysis of the possible causes, initial check-up, giving prescription, further investigation and conditional advice. The model is cen-tered on linguistic functions and aimed at helping students become proficient in speaking medically through the phrases of demonstration, application, reflection and activation. The model, after two years suc-cessive teaching practice among the elite class undergraduates, received a favorable feedback in triggering interests, classroom arrangement, material selection, and its compliance with FLA (foreign language acquisition), and was proved to be an effective way to improve medical students' English speaking ability in handling clinical dialogues.

The abdomen is an indispensable site of cardiopulmonary resuscitation,and combination with the chest for sustaining artificial circulation is the future research direction for precision medicine.This paper elaborates on the importance of abdomen in cardiopulmonary resuscitation,and analyzes the resuscitation mechanism of the chest,abdomen and thoracic abdominal combination for heart and lung recovery.The respective advantages and complementary points of chest and abdomen compression for cardiopulmonary resuscitation were also discussed.

Objective To explore the clinical value of preparatory treatment using estradiol valerate and mifepristone before the curettage of the late small missed abortion.Methods One hundred and twenty patients with late small missed abortion were randomly divided into two groups:pretreated group(n =660) and control group(n =60).Women in the pretreated group were given 5 mg of Estradiol Valerate 3 times/day and 25 mg of Mifepristone twice/day for 3 days each before conducted curettage on the fourth day.While for the control group,curettage was done directly.The condition of operation and the occurrence of short-and long-term complications were compared between the two groups.Results Compared with the control group,the pretreated group had a significant shorter operation duration[(8.6±2.7) rnin vs.(10.5±3.4) min,t =3.390,P =0.001]and less blood lose during operation[(47.5±18.3) ml vs.(61.8±20.5) ml,t =4.031,P ＜ 0.001].In terms of complications,the rates of incomplete curettage[(0 vs 13.3％,x2 =6.563,P =0.010],artificial abortion syndrome(3.3 ％ vs 15.0％,x2 =4.904,P =0.027),the cervical canal adhesion/Asherman' s syndrome(0 vs 11.7％,x2 =5.461,P =0.019),and the vaginal bleeding duration[(7.5±2.7) days vs(8.7±3.4) days,t =2.141,P =0.034]in the pretreated group were significantly lower than those in the control group.The average recovery time of menstruation after operation in the pretreated patients was significantly shorter than that in the control group[(30.5±9.3) days vs.(35.5±7.4) days,t =3.259,P =0.002].Contusion Estradiol valerate and Mifepristone as a preparatory treatment before the operation can help reduce the occurrence of complications and side effects in the late small missed abortion curettage and is helpful for the patients' recovery,thus worth wide clinical application.

OBJECTIVE: To observe therapeutic effect and adverse reaction of the combination of Concha merelricis Seu cyclinae powder with 0. 02% furacilin solution in treating dermatitis vulvae and eczema. METHODS: Thirty outpatients (9 men and 21 women with the average age of 47. 1 years old) were treated with Concha meretricis Seu cyclinae powder and 0. 02% furacilin solution by wet dressing or external use twice daily for three weeks. RESULTS: 21 cases were cured (70%); 6 cases were significant recovery (20%); 2 cases were effective (6. 66%) and 1 cases was ineffective (3. 33%), The total effective rate was 90. 0% and no adverse reaction was found. CONCLUSIONS: Concha meretricis Seu cyclinae powder combined with 0. 02% furacilin solution is one of the effective therapy in the treatment of dermatitis vulvae and eczema.

To promote the technical training and scientific popularization of cardiopulmonary resuscitation (CPR) in China, the Cardiopulmonary Resuscitation Specialized Committee of Chinese Research Hospital Association combined with the Science Popularization Branch of the Chinese Medical Association wrote "2018 National consensus on cardiopulmonary resuscitation training in China". The formation was based on the general outline about "2016 National consensus on cardiopulmonary resuscitation in China", and to implement the important strategies included the "three pre" policy, prevention, precognition, and pre-warning, before the cardiac arrest (CA); the "three modernization" methods, standardized, diversified and individualized, during the CA; and the "three life" strategies, the rebirth, the extra and the extended, after the CA; and also combined with the concrete National conditions and clinical practice of China area. The document summarized the evidence of published science about CPR training till now, and recommend the establishment of "the CPR Training Triangle" according to the Chinese National conditions. The bases of the triangle were system, training and person, the core of which was CPR science. The main contents were: (1) The "three training" policy for CPR training: the cultivation of a sound system, which included professional credibility, extensive mobilization and continuous driving force, and the participation of the whole people and continuous improvement; the cultivation of scientific guidelines, which included scientific content, methods and thinking; and the cultivation of a healthy culture, which included the enhancement of civic quality, education of rescue scientifically, and advocate of healthy life. (2) The "three training" program of CPR training: training professional skills, which included standard, multiple, and individual skills; training multidimensional, which included time, space, and human; and training flexible, including problem, time, and innovation oriented. (3) The "three party" direction of CPR training, the application for achievement translation, which included scientific translations, skill propagators, and cultural advocates; the precision disseminators, which included accurate communication sources, channels, and dissemination of the audience; and theoretical innovation guides, which included scientific, popular science and communication theory. That integrated the wisdom of scholars, melt the thought of genius, and created the act of envoy for Chinese and foreign CPR training. The training program should be suitable for different trainee, no matter who is trainer or trainee. The release of the expert consensus on the 2018 CPR training will make the National CPR education into the new training era with definite direction, clear target and fully standard of China.
Cardiopulmonary Resuscitation ; China ; Consensus ; Heart Arrest ; Humans

Objective: To explore the advantage of RR-Lorenz plot (RR-LP) in analyzing the patients of sinus rhythm with long RR interval.
Methods: A total of 308 RR-LP patients with long RR interval were retrospectively studied. The patients were divided into 7 groups according to the type of long RR intervals. ① Sinus bradycardia with arrhythmia group, n=63,②Repeated transient sinus arrest group, n=16, ③Ⅱ° sino-atrial block group, n=14, ④Ⅱ° atrial ventricular block (Ⅱ° AVB) group, n=47, ⑤ Un-passed atrial premature beats (APB) group, n=28, ⑥ Atrial premature beats group, n=72 and ⑦ Premature ventricular beats group, n=68. We analyzed the patients of RR interval greater than 1500 ms with ambulatory electrocardiogram record.
Results: ①RR-LP of sinus bradycardia with arrhythmia group showed a single distributing area with 1500 ms for the origin of transverse and longitudinal axis with B line slope at 1, tilt angle of 45°.②RR-LP of repeated transient sinus arrest,Ⅱ° sino-atrial block,Ⅱ° AVB and APB groups showed special four distributing areas with B line slope at (0.51 ± 0.01), tilt angle of (23.04 ± 0.50) °, B line slope at 0.6, tilt angle of (27°), B line slope at (0.57 ± 0.21), tilt angle of (25.69 ± 9.59)° and B line slope at (0.50 ± 0.01), tilt angle of (22.59 ± 0.54) ° respectively.③RR-LP of premature beats groups showed special four regional distributing areas, B line slope for atrial premature beats was at (0.38 ± 0.12), tilt angle of (17.06 ± 5.22) ° and B line slope for ventricular premature beats was at (0.07 ± 0.05), tilt angle of (3.02 ± 2.39) °.
Conclusion: RR-LP in patients of sinus rhythm with long RR interval had speciifc morphology and distribution features, the local abnormality could be found in a plane via all RR intervals which provided a differential diagnosis for repeated occurrence of short RR interval.

Objective To explore the changes of gene and protein expressions of nuclear factor-κB(NF-κB) and tumor necrosis factor-α (TNF-α) in immature rats with pilocarpine-induced epilepsy treated with ghrelin. Methods The pllocarpine-induced epilepsy model in immatured rats were built, then the rats were divided into three groups: Ghrelin-treated group, saline-treated group and model group, meanwhile the normal control group was set. The NF-κB and TNF-α levels of gene and protein in the cerebral cortex of immature rats were detected. Results The expression levels of gene and protein of NF-κB and TNF-α were increased in model group,but decreased in the normal control group;NF-κB and TNF-α levels in Ghrelin treated group were obviously lower than those of saline-treated group and model group(P < 0. 05). Conclusion The protective mechanism of Ghrelin for nerve cell is cutting down the expressions of NF-κB and TNF-α in the cerebral cortex of immature rats with epilepsy and lessening inflammatory reaction in neurocytes.

Objective To explore the correlation between wide QRS of transesophageal atrial pacing (TEAP) and implicit ventricular pre-excitation.Methods 77 patients tested by TEAP were divided into two groups according to the ECG results .45 patients in group Ⅰhad normal electrocardiogram .32 patients in group Ⅱhad ven-tricular pre-excitation.In group Ⅰ,TEAP results showed that electric pulse wave (S wave) was followed by intermit-tent or continuous wide QRS complex .At the same time , the results of group Ⅰ were compared with the results of groupⅡ.Results (1)The patients of group Ⅰwere excluded the presence of concealed accessory pathway by intra-cavitary electrocardiographic test,among them 20 patients (group ⅠA) were ventricular pacing,the test results dis-played that S wave was followed by wide QRS complex exhibiting a pattern of right bundle branch block ( RBBB) ,SR interval was 0 s;SR intervals of 25 patients (groupⅠB) were not fixed,SR interval was (0.07 ±0.01)s,S wave had no concern with QRS wave ,the wide QRS complex was premature ventricular contraction ,QRS wave shapes were dif-ferent according to the different sites of pacing origin .(2)In groupⅡ,the test results displayed that S wave was close-ly followed by the atrial depolarization wave P ,and there was a wide QRS complex with pre-excitation wave at the be-ginning after a atrioventricular conduction time shorter than normal ,SR interval was fixed ,SR interval was (0.08 ±0. 03)s,at the same time,different parts of accessory pathway QRS complex had different morphological characteristics . (3) SR interval of ⅠA group compared with groupⅠB and groupⅡ,the differences were statistically significant ( t=2.97,3.02,all P<0.05);SR interval had no statistically significant difference between group ⅠB and groupⅡ(t=2.66,P>0.05).Conclusion When TEAP displaying pacing wide QRS complex ,in order to avoid bringing misdiag-nosis,TEAP results should be analyzed comprehensively rather than blindly believing that the reason was concealed accessory pathway .

Objective To investigate the heterogeneity of immunomodulatory function of exosomes secreted from human umbilical cord-derived mesenchymal stem cells(hUC-MSC).Methods Five different hUC-MSCs lines were isolated and cultured.Exosomes were isolated from the supernatant.The expression of specific surface markers CD9,CD63,CD81 and CD44 was detected by flow cytometry.The protein concentration of hUC-MSCs exosomes(hUC-MSCs-ex)was evaluated by the BCA assay.Concanavalin A and rhIL-2 stimulated umbilical cord blood mononuclear cells (UBMCs) from healthy donor were co-cultured at different concentrations of hUC-MSCs-ex from different cell lines for 72 h.The growth rate of UBMCs was detected by MTT assay.ELISA was used to test the levels of IFN-γ and TNF-α of the supernatants.The UBMCs co-cultured with hUC-MSCs were co-cultured with K562 cells at the ratio of 5∶1.The cytotoxic activity was calculated by MTT assay.Results hUC-MSCs-ex expressed CD9,CD63,CD81and CD44.Different hUC-MSCs lines had different regulating activities on the proliferation,secretion and killing ability of UBMCs.Conclusion hUC-MSCs-ex has heterogeneity of immunomodulatory function on UBMCs.