Objective Analyzing risk factors for gastrointestinal bleeding(GIB) after coronary artery bypass grafting(CABG). Methods 582 cases undergoing CABG from August 2001 to May 2005 were divided into two groups (GIB group ,n=6 ;control group,n=576) . Preoperative , operative and postoperative clinic data were com-pared. Results The ratio of over-aging(age greater than 70), hypertension, cerebrovascular disease, myocardial in-fraction,heart function (NYHA) over Ⅲ and postoperative low output syndrome (LOS) in GIB group were signifi-cantly higher than that in control group;age, blood transfusion and hospitalized time were significantly higher and left ventricular ejective fraction was significantly lower in GIB group than that in control group. Age over 70,history of myocardial infraction and heart function (NYHA) over Ⅲ were selected as risk factors of GIB after CABG by step-wise logistic regression analysis. Conclusions It is very useful for precaution, early diagnosis and early therapy of GIB after CABG to evaluate if patients have the risk factors of GIB after CABG before operations.

The new cardiopulmonary resuscitation (CPR) guideline emphasize the importance of chest compression, which was considered as the first step to CPR. The duration for CPR is usually limited to 30 minutes. With the development of new technology and evidence-based medicine, the success of extra longtime CPR has become possible, which is of great significance to some patients with cardiac arrest (CA), but the time limit has not been determined. On February 23rd in 2016, a 76-year-old female patient with respiratory and cardiac arrest who was on the third day after transurethral resection of bladder tumor (TUR-BT) was admitted to the intensive care unit of the General Hospital of Fushun Mining Bureau. On the basis of the comprehensive treatment measures such as ventilator support ventilation, physical cooling with ice cap, 1 mg adrenaline for intravenous injection, low molecular heparin of 5000 U for subcutaneous injection, and the continuous chest compression were carried out in a timely and effective manner for 125 minutes, which make the patient recover to sinus rhythm and her brain function recovered well without any sequelae, and follow-up of the patient in 1 year showed well. The key to success or failure of CPR depend on the patient's condition. If the patients in healthy, single cause, a good response to the resuscitation, the pulsation of the large artery can be seen now and then during the rescue, and the recovery of the spontaneous breathing, CPR should be kept on. In the process of CPR, individualized assessment of the disease progression without the 30-minute time limit, may benefit the patients in maximum. In the future clinical practice, we should actively explore more favorable evidence, so that CA patients can be rescued more.

Objective To analyze the relationships of expressions of serum microRNA(miR)-20a-5p and miR-128-3p with cranial nerve development in the premature infants with hypoxic-ischemic en-cephalopathy(HIE).Methods A total of 95 HIE premature infants were selected as HIE group,and according to the severity of HIE,they were divided into mild group(n=27),moderate group(n=46)and severe group(n=22);another 95 premature infants without HIE in the same period were se-lected as control group.Apgar score and the Neonatal Behavioral Neurological Assessment(NBNA)score were performed in both groups;the expression levels of miR-20a-5p and miR-128-3p in serum were detected by real-time fluorescence quantitative polymerase chain reaction(qRT-PCR);Spearman method was used to analyze the correlations of serum miR-20a-5p and miR-128-3p levels with Apgar score and NBNA score;the values of serum miR-20a-5p and miR-128-3p levels in diagnosing HIE in premature infants were analyzed by receiver operating characteristic(ROC)curve.Results Compared with the control group,the levels of serum miR-20a-5p and miR-128-3p in the HIE group increased sig-nificantly,while the Apgar score and NBNA score decreased significantly(P＜0.05).In the mild,moderate,and severe groups,the levels of serum miR-20a-5p and miR-128-3p increased gradually,while the Apgar score and NBNA score decreased gradually,with the significant between-group differences(P＜0.05).Spearman analysis results showed that the level of serum miR-20a-5p was negatively correlated with the Apgar score and NBNA score(r=-0.659,-0.548,P＜0.001),and the level of serum miR-128-3p was negatively correlated with the Apgar score and NBNA score(r=-0.582,-0.499,P＜0.001).The combined prediction of serum miR-20a-5p and miR-128-3p for HIE in premature infants had an area under the curve(AUC)of 0.920,with a sensitivity of 78.95％and a specificity of 97.89％.The predictive efficacy of the combined model was superior to that of miR-20a-5p and miR-128-3p alone(P＜0.05).Conclusion The serum levels of miR-20a-5p and miR-128-3p increase in the premature infants with HIE,and are closely related to the severity of the disease and the development of brain nerves.The combined detection of miR-20a-5p and miR-128-3p has good predictive value for the occurrence of HIE in premature infants.

Objective To analyze the relationships of expressions of serum microRNA(miR)-20a-5p and miR-128-3p with cranial nerve development in the premature infants with hypoxic-ischemic en-cephalopathy(HIE).Methods A total of 95 HIE premature infants were selected as HIE group,and according to the severity of HIE,they were divided into mild group(n=27),moderate group(n=46)and severe group(n=22);another 95 premature infants without HIE in the same period were se-lected as control group.Apgar score and the Neonatal Behavioral Neurological Assessment(NBNA)score were performed in both groups;the expression levels of miR-20a-5p and miR-128-3p in serum were detected by real-time fluorescence quantitative polymerase chain reaction(qRT-PCR);Spearman method was used to analyze the correlations of serum miR-20a-5p and miR-128-3p levels with Apgar score and NBNA score;the values of serum miR-20a-5p and miR-128-3p levels in diagnosing HIE in premature infants were analyzed by receiver operating characteristic(ROC)curve.Results Compared with the control group,the levels of serum miR-20a-5p and miR-128-3p in the HIE group increased sig-nificantly,while the Apgar score and NBNA score decreased significantly(P＜0.05).In the mild,moderate,and severe groups,the levels of serum miR-20a-5p and miR-128-3p increased gradually,while the Apgar score and NBNA score decreased gradually,with the significant between-group differences(P＜0.05).Spearman analysis results showed that the level of serum miR-20a-5p was negatively correlated with the Apgar score and NBNA score(r=-0.659,-0.548,P＜0.001),and the level of serum miR-128-3p was negatively correlated with the Apgar score and NBNA score(r=-0.582,-0.499,P＜0.001).The combined prediction of serum miR-20a-5p and miR-128-3p for HIE in premature infants had an area under the curve(AUC)of 0.920,with a sensitivity of 78.95％and a specificity of 97.89％.The predictive efficacy of the combined model was superior to that of miR-20a-5p and miR-128-3p alone(P＜0.05).Conclusion The serum levels of miR-20a-5p and miR-128-3p increase in the premature infants with HIE,and are closely related to the severity of the disease and the development of brain nerves.The combined detection of miR-20a-5p and miR-128-3p has good predictive value for the occurrence of HIE in premature infants.