Objective To study the clinical significance of end-tidal carbon dioxide partial pressure (PetCO2 ) during cardiopulmonary resuscitation (CPR) and seek the fixed value according which to decide if we should and when to give up.Methods This was a prospective,observational study.A total of 124 patients with cardiac arrest in or out-of-hospital from may 2003 to March 2009 in emergency department of our hospital were selected.All of them had definite etiological factors.Changes of PetCO2 in 124 cardiac arrest patients during CPR were tracked.Results The gender,age,rescue time in seventy-one patients with the return of spontaneous circulation (ROSC) after endotracheal intubation have a significant difference with that in fifty-three patients without ROSC (P ＜0.01 ).The PetCO2 of the survival were higher than that of patients without ROSC or with ROSC,but finally died (P ＜0.01 ).A fixed point 14.4 mmHg of PetCO2 after 20 minutes' CPR can be used as a reference value to guide CPR or predict prognosis.Conclusions Monitoring PetCO2 during CPR has a predictive value on the success of resuscitation.

0.05).The off-pump group had a shorter respiratory support time [(4.8?1.9)h vs(8.9?2.1)h,t=17.453,P=0.000],less drainage volume[(390?152)ml vs(660?111)ml,t=17.173,P=0.000],and required less blood transfusion [(270?77)ml vs(510?144)ml,t=17.861,P=0.000] than the on-pump group.In the off-pump group,3(2.0%)of the 150 patients developed renal function injury that is significantly more than that in the on-pump group [11/140(7.9%),?2=5.407,P=0.020].Conclusions Off-pump CABG is as effective as the on-pump surgery;moreover,it is a better choice for patients with high-risk coronary disease since this technique is superior in reducing respiratory support time,volumes of chest drainage and blood transfusion,and renal function injury.

BACKGROUND: Hereditary susceptibility is an important role in episode and development of diabetic nephropathy (DN). Aggregation of monocyte in kidney tissue, differentiation to histocyte and reinforcement of signal are possibly closed to episode and development of DN in type 2 diabetes mellitus (DM). Regulated upon activation normal T-cell expressed and secreted (RANTES) is a chemokine of C-C subtribe. It can mediate infiltration and activation of inflammatory cells and cause injuries of renal corpuscle and renal mesenchymal. This may be a key mechanism of episode and development of DM. Thus, RANTES gene may be one of the susceptible gene of DN. OBJECTIVE :To investigate correlation between RANTES gene promoter -28C/G polymorphism and DN in type 2 DM in Chinese. DESIGN: Case-contrast study. SETTING: Department of Endocrine, Affiliated Hospital of Guiyang Medical College; Center of Diabetes Mellitus of Guizhou Province. PARTICIPANTS: A total of 143 patients with type 2 DM were recruited from the Department of Endocrine, Affiliated Hospital of Guiyang Medical College and Department of Endocrine,Guizhou People's Hospital from September 2003 to September 2005. Among them, 53 cases had normoalbuminuria, 54 microalbuminuria and 36 macroalbuminuria. Another 55 healthy subjects who were selected from Center of Health Examination, Affiliated Hospital of Guiyang Medical College were regarded as control group. METHODS: 3-5 mL peripheral venous blood was collected from all subjects. RANTES gene promoter -28C/G genotype was detected with polymerase chain reaction restriction fragment length polymorphism technique. MAIN OUTCOME MEASURES: ① Allele frequency and genotypic frequency of RANTES gene promoter -28C/G; ② risk factor of DN was analyzed with Logistic regression analysis. RESULTS: All 198 subjects were involved in the final analysis. ① Comparison of CG genotypic frequency of -28C/G: There was no significant difference between normal control group and DM group (P＞ 0.05); however, that in microalbuminuria group and macroalbuminuria group was higher than that in normoalbuminuria group (24.1％, 47.2％, 9.4％, P ＜ 0.05), and that in macroalbuminuria group was also higher than that in microalbuminuria group (P ＜ 0.05). ② Frequency of G allele of -28C/G: There was no significant difference between normal control group and DM group (P ＞ 0.05); however, that in micro albuminuria group and macrealbuminuria group was higher than that in microalbuminuria group (12.0％, 23.6％, 4.7％, P ＜ 0.05), and that in macroalbuminuria group was also higher than that in microalbuminuria group (P＜ 0.05). ③ Logistic regression analysis showed that positive genotype of -28G was related to DN (95％ Cl:1.402-15.032, P =0.012). CONCLUSION: Positive genotype of RANTES gene promoter-28G may be related to DN.

Objective Puerarin can remove inflammatory mediators, but the underlying mechanisms are not yet clear.The purpose of this study is to observe the synthesis of IL-6 in co-cultured bronchial epithelial (Beas-2B) and neutrophil cells, and to investigate the inhibitory effect of puerarin on IL-6.Methods Beas-2B and neutrophil cells were extracted and divided into six groups: neutrophil cells cultured alone (NC), Beas-2B cells cultured alone (BC), Beas-2B and neutrophil cells co-cultured (BC+NC), and Beas-2B and neutrophil cells co-cultured with puerarin at 50 μg/mL (BC+NC+P50), 100 μg/mL (BC+NC+P100) and 200 μg/mL (BC+NC+P200).The concentrations of IL-6 in different groups were quantitatively measured by ELISA and the expression of the IL-6 gene detected by real-time PCR.Results After 18 hours of culturing, the concentration of IL-6 was significantly increased in the BC+NC group ([280.409±21.340] pg/mL) as compared with those in BC ([240.002±23.727] pg/mL), NC ([22.771±1.146] pg/mL), BC+NC+P50 ([244.205±9.335] pg/mL), BC+NC+P100 ([218.168±18.635] pg/mL), and BC+NC+P200 ([179.539±7.340] pg/mL) (P<0.05), but lower in the BC+NC+P200 than in the BC+NC+P50 and BC+NC+P100 groups (P<0.05).The expression of the IL-6 gene was markedly up-regulated in the BC+NC group (1.515±0.013) in comparison with those in BC (1.000±0.215), BC+NC+P50 (0.398±0.024), BC+NC+P100 (0.332±0.016), and BC+NC+P200 (0.306±0.015) (P<0.05), but lower in the BC+NC+P200 than in the BC and BC+NC+P50 groups (P<0.05).Conclusion Direct-contact co-culture of Beas-2B and neutrophil cells significantly enhances the synthesis and release of the inflammatory mediator IL-6, which can be inhibited by puerarin.

Objective To analyze the correlation between the polymorphism of PTPN22 gene (R620W and R263Q sites)and pulmonary tuberculosis(TB)in Chinese Han population and to investigate the environmental factors associated with pulmonary TB. Methods A case-control study was conducted on 235 patients with pulmonary TB and 251 healthy subjects. The single nucleotide polymorphisms(SNP)of PTPN22 gene at R620W and R263Q sites were detected by the assay of polymerase chain reaction and re-striction fragment length polymorphism(PCR-RFLP). A questionnaire was designed to gather information about tuberculosis-associated environmental factors. Univariate and multivariate logistic analysis were con-ducted. Results Genotype frequencies of PTPN22 R620W(C1858T)SNP were 233(99. 15% ,CC),2 (0. 85% ,CT),0(0% ,TT)in patients with pulmonary TB and 240(95. 62% ,CC),11(4. 38% ,CT), 0(0% ,TT)in healthy subjects. There was a difference with the distribution of PTPN22 C1858T allele be-tween patients with pulmonary TB and healthy subjects[0. 43% vs 2. 19% ,P = 0. 01,odds ratio(OR)=0. 19,95% confidence interval(CI)= 0. 07-0. 35]. Genotype frequencies of PTPN22 R263Q(G788A) were 218(92. 77% ,GG),17(7. 31% ,GA),0(0% ,AA)in patients with pulmonary TB and 248 (98. 71% ,GG),3(1. 29% ,GA),0(0% ,AA)in healthy subjects. The frequencies of G788A allele in patients with pulmonary TB were higher than those in healthy subjects(3. 62% vs 0. 60% ,P﹤0. 01,OR=6. 03,95% CI=2. 12-18. 38). Conclusion The results of this study suggested that the R263Q GG geno-type of PTPN22 gene was associated with the susceptibility to TB in Chinese Han population.

Column chromatography on silica gel was used to study the chemical constituents of traditional Chinese medicine Siegesbeckia pubescens. The chemical structures of the separated compounds were elucidated by spectroscopic data analyses. As a result, eighteen compounds were obtained and identified as 3, 4'-dimethoxy quercetin(1), 3, 3', 4'-trimethoxy quercetin(2), 3, 3'-dimethoxy quercetin(3), 7, 3', 4'-trimethoxy luteolin(4), ursolic acid(5), 2β,19α-dihydroxyursolic acid(6), 2β-hydroxyursolic acid (7), stigmasterol-7-one(8), 5α, 8α-epidioxy-24(R)-methyl-cholesta-6, 22-diene-3β-ol(9), β-sitosterol(10), 2, 6-di(3-hydroxy-4-methoxyphenyl)-3, 7-dioxacyclo [3. 3. 0] octane (11), aurantiamide acetate (12), 3-(m-hydroxyl-p-methoxy)-N-(2'-p-hydroxyl-phenethyl)-2E-acrylamide(13), p-hydroxy benzaldehyde (14), m-hydroxy-p-methoxy benzaldehyde (15), 3, 4, 5-trimethoxybenzoic acid(16), monoethyl malonate(17), and p-hydroxylcinnamic acid(18). Among them, compounds 1-9, 11-18 were isolated from this plant for the first time.
Asteraceae ; chemistry ; Drugs, Chinese Herbal ; chemistry ; isolation & purification ; Luteolin ; chemistry ; isolation & purification ; Medicine, Chinese Traditional ; Plants, Medicinal ; Quercetin ; chemistry ; isolation & purification ; Sitosterols ; chemistry ; isolation & purification ; Triterpenes ; chemistry ; isolation & purification

Pharmacogenomics is a discipline studying the influence of genetic differences on drug effectiveness .It promises to op-timize the effect of medicine and reduce side effects .It is one of the most effective ways to predict the drug reaction in human body by using pharmacogenomics , which can achieve the goal of precision medicine .With the rapid development of the genetical test technolo-gies, the in vitro individual genome testing projects with the properties of high throughput , and measurable and low cost are better to be applied in medical practice and guiding for making individualized medicine plan .The study elucidated the progress in single nucleotide polymorphism and its clinical application , and focused on the strategic effects of pharmacogenomics on individualized treatment and gene diversity for guiding medicine .

Objective To study the probability safety assessment to analyze and evaluate radiation error risk in the external beam radiotherapy,so as to establish and strengthen the control and management of the radiotherapy process,continuous improvement of quality control and quality management.Methods To build the whole of radiotherapy flow chart and process tree,using the decision tree model to determine critical control points in the whole process,making risk assessment chart and analyzing 4 patients with potential safety hazards error.Results The whole process is divided into 22 missions in 3 functional areas,the entire cover 15 branches and 59 key and 11 key control point.The enumeration of error as risks and critical control points has certain correlation.Conclusions Probabilistic safety assessment method have strengthened manage,analyze and control to risk,and all these provide the basis for developing and improving radiotherapy process control management.Radiotherapy quality management for future multidisciplinary and high-level management personnel who take up provides a prospective study.

The purpose of this paper is to investigate the reversal effect of small interfering RNA (siRNA) targeting MDR1 and MDR3 genes on the resistance of MCF-7/ADR cells to adriamycin. siRNA plasmid vector targeting MDR1 and MDR3 genes was transfected into MCF-7/ADR cells, and then was stained with Annexin-V FITC (fluorescein isothiocyanate conjugated) to detect the early stage cell apoptosis by flow cytometry (FCM). 50% inhibition concentration (IC50) of adriamycin for MCF-7/ADR cells was determined by MTT method. MDR1 and MDR3 mRNA was assessed by RT-PCR. Treatment of MCF-7/ADR cells with the two kinds of siRNAs resulted in a reversal of adriamycin resistance of MDR to different extents. 1) The apoptosis efficiency of MDR1 and MDR3 siRNA vector after transfection was (18.21+/-1.65) % and (9.07+/-2.16) % respectively (P<0.05), and there was significant differences in the apoptosis efficiency between pSuppressor Neo vector and the MDR1siRNA or MDR3 siRNA vector (P<0.01); 2) The reversal effect of MDR1 siRNA is higher than that of MDR3 siRNA (P<0.05); 3) The expression of MDRI and MDR3 mRNA can be restrained by pSuppressor Neo MDR1 and MDR3 siRNA respectively, and the reduction in the mRNA level was in a time-dependent manner (P<0.01). MDR1 and MDR3 gene silencing can enhance intracellular adriamycin accumulation in MCF-7/ADR cells, improve sensitivity of MCF-7/ADR cells to adriamycin, and induce cell apoptosis. The reversal effect of adriamycin resistance by siRNA of MDR1 was more effective than that of MDR3.

Objective To investigate the inhibitory effects of Argatroban on the instant bloodmediated inflammatory reaction(IBMIR)after islet transplantation.Methods Rat islets were isolated and purified rat islets,and were divided into blank control group,control group and experimental group.In the control group,the blood and the islets were directly mixed,and in the experimental group the Argatroban was added to the mixture based on the control group.while the blank control group was added with blood alone without the islets.Each group was reacted at 37℃for 60min,and then the content was filtered through trap valve of 70 μm.The residual thrombus and tissues were filtered by the trap valve in both the experimental and control groups,detected by the thinprep cytologic test(TCT),and the filtrate received blood routine test,and the function of islet was determined using insulin releasing test.Results The number of blood platelets,white blood cells,mononuclear cells,and lymphocytes percentage in the experimental group were significantly higher than in the control group after 60 min(P＜0.05).Under the environment of the high and low concentrations of glucose,the insulin release in experimental group was significantly increased as compared with the control group,and the insulin release index of former was 2.25±0.18,significantly higher than that of the latter 3.36±0.18(P＜0.05).The residual thrombus and tissues had few islet cells in the control group,the structure was damaged seriously,the capsule was not intact,and there were a large mumber of micro-thrombosis around the islets formed by red blood cells.But there were a large number of islet cells in the experimental group.the structure was intact in a mass,and no obvious micro-thrombosis around the islets was found.Conclusion Argatroban can effectively inhibit IBMIR in vitro,and alleviate the damage to the islet cells.