Post-cardiac arrest syndrome (PCAS) is one of the most common medical emergencies in children.The fatality rate and disability rate are extremely high.Pathogenesis of PCAS remains incompletely clear,and clinical manifestation is complicated.The treatment is mainly limited to supportive care.In recent years,the phases of PCAS are defined according to the pathophysiological changes and clinical prognosis.Investigators also made some advances in the fields of pathophysiological changes and clinical treatment of brain damage and myocardial damage.For the treatment of PCAS,early therapeutic hypothermia,glucose control and seizure control,and reasonable cardiopulmonary support are promoted.In this article,we reviewed the advances in the above fields and the latest advance on the management of PCAS in foreign countries.

Objective To analyze the change of disease spectrum and the direct cause of death in Xi'an Children's Hospital emergency patients in the past 2 years.Methods The cases of death in 130 emergency cases from 2009 to 2010 were retrospectively analyzed.Results The main causes of death in 2009 were pneumonia,congenital heart disease,asphyxia,neonatal pulmonary hemorrhage and intracranial hemorrhage.Meanwhile,The main cause of death in 2010 were pneumonia,asphyxia,viral encephalitis,congenital heart disease and neonatal pulmonary hemorrhage,which significantly changed compared with 2009.Major direct causes of death were found:respiratory failure in 25 cases (27.5％),heart failure in 17 patients ( 18.7％ ),shock in 17patients ( 18.7％ ),asphyxia in 16 cases ( 17.5％ ),and hernia in 16 cases ( 17.5％ ),Conclusion In order to reduce the mortality rate of emergency patients,we should strengthen health care,actively manage pulmonary infection,systemic infection,and shock,control heart failure,and prevent aspiration.

Objective To investigate the association of single nucleotide polymorphism (SNP) rs13333226 in uromodulin (UMOD) gene with diabetic kidney diseases (DKD) in Han population in Tianjin,China.Methods A total of 210 type 2 diabetes (T2DM),90 normal controls (NC) and 280 DKD patients were recruited.According to the level of estimated glomerular filtration rate (eGFR),the DKD subjects were further subdivided into three groups:GFR≥90 ml/min group (n=105),60 ml/mim≤GFR ＜ 90 ml/min group (n=84) and GFR ＜ 60 ml/min group (n=91).Polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) was used for UMOD rs13333226C genotyping.Results The frequencies of AA,GA,GG genotype were 27.8％,58.9％,13.3％ in NC group and 41.0％,48.6％,10.5％ in T2DM group and 54.3％,36.1％,9.6％ in DKD group.The frequency of G allele was 42.8％ in NC group,34.8％ in T2DM group and 27.7％ in DKD group.The genotype distribution of UMOD was statistically significant between NC group and DKD group,and between T2DM group and DKD group (P ＜ 0.05).G allele of UMOD was an independent protective gene polymorphism of DKD in Logistic regression (B=-0.248,Wald=8.012,P=0.021,OR=0.780,95％ CI 0.612-0.968).Conclusion The G allele of UMOD gene may be an independent protective factor of DKD in Han population in Tianjin,China.

Objective To investigate the factors impact on the mortality of severe acute pancreati- tis(SAP)and the related treatment methods.Methods The data from 24 patients died of SAP from Jan- uary 1993 to June 2006 were retrospectively analyzed.The factor that impact motality and treatment measures were also analyzed.Results The mortality of patients with SAP was 6.65%(24/361).Multi- ple organ dysfunction sydrome(MODS)was the main cause of death in early stage of SAP.The infection was an important cause in later stage.The mortality was higher in SAP patients with other complications than those without.Conclusions MODS is the main cause of death in early stage.Close monitoring and supportive treatments in early stage can reduce mortality.Individualized treatments,including nonsurgi- cal,surgical and interventional therapy should be adopted in later stage,with emphases on reducing com- plications.

Objective: To understand the psychological status of the rescue troops one month after rescue action for the devastating earthquake and to explore the effect of some important events on the psychological status of soldiers. Methods: The subjects were randomly selected from the 3 major rescue forces, a Cannon troop from PLA Chengdu Military Area Command, a Cannon troop from PLA Jinan Military Area Command and Armed Police Forces of Sichuan Province, 32-42 days after the disaster rescue. A total of 170 subjects were tested with Symptom Checklist-90(SCL-90), and the results were compared with the norms of normal Chinese and Chinese serviceman. Student's t test was used to determine the significance of the differences. Results: A total of 78 valid questionnaires were analyzed. The total score of SCL-90 was 130. 25 ± 33. 07 for the rescuers, the positive items was 27.59 ± 15.75, and the mean factorial score was 1.28-1.64. The somatization score was higher (P<0.05) and the interpersonal sensitivity score was lower (P<0.01) than the norms of the Chinese. The factorial scores of obsession, interpersonal sensitivity, depression, anxiety, paranoid and psychotic were lower than the norm of Chinese servicemen (all P< 0.01). Soldiers with experience of searching dead bodies had lower scores in sleep and food consumption, and higher score of positive items (all P<0.01 for each) compared those without the related experience. Conclusion: The psychological status of the earthquake-rescuers is basically normal 32-42 days after the earthquake. Some positive items are associated with the experience such as body treatments. Surveillance of psychological disorders in these troops is helpful for the early diagnosis and intervention of psychological problems.

Objective:To investigate frequencies of microsatellite instability(MSI)and loss of heterozygosity(LOH)in renal ceil carcinoma(RCC),and to discuss the relationship of clinicopathological characteristics of RCC with MSI and LOH. Methods:Twelve microsatellite markers located at chromosomes 3p,9p and 14q were selected to investigate microsatellite alterations(MSI and LOH)in 31 RCC specimens and their paired metastasis specimens by polymerase chain reaction- polyacrylamide gel elect rophoresis-ethylene dibromide(PCR-PAGE-EB)staining and sequencing.Results:The frequency of MSI could reached 61.3% and that of LOH could reach 54.8%.The highest frequency of MSI was at locus of D9S168(32.3%);the highest frequency of LOH was at locus of D3S1289(21.4%).No correlation was found between MSI or LOH and the patients' age,sex,pathology type and metastastis,except that MSI was correlated with TNM stage of RCC(P

Adenoma ; genetics ; metabolism ; pathology ; surgery ; Adult ; Carcinoma, Papillary ; genetics ; metabolism ; pathology ; Diagnosis, Differential ; Exons ; Female ; Follow-Up Studies ; Humans ; Ki-67 Antigen ; metabolism ; Male ; Mutation ; Nuclear Proteins ; metabolism ; Proto-Oncogene Proteins B-raf ; genetics ; Thyroglobulin ; metabolism ; Thyroid Neoplasms ; genetics ; metabolism ; pathology ; surgery ; Thyroid Nuclear Factor 1 ; Transcription Factors ; metabolism

Objective To investigate the clinical outcomes of minimally invasive percutaneous nephrolithotomy(MPCNL)in the treatment of lower caliceal calculi.Methods We retrospectively re- viewed the clinical outcomes and complications of 33 patients who underwent MPCNL for lower caliceal cal- culi from March 2001 to April 2005.The average diameter of the calculi was 2.8 cm.Single tract nephrosto- my was performed in all 33 cases;among them renal access was obtained through a middle calyx in 10 cases and a lower calyx in 23.Nine cases had F14 renal access;and 24 cases,F16.Results Of 33 cases,28 (85%)achieved stone-free at 1 session.A second-look was needed in 3 cases due to intraoperative bleed- ing;ESWL,in 1 case with residual,calculi;no treatment,in 1 case with residual calculi＜4 ram.The mean operative time was 93 min;mean blood loss was 113 ml;mean hospital stay was 11 d.Blood transfusion was needed in 1 patient who suffered from hepatic cirrhosis preoperatively;another experienced severe bleeding 7 d after operation and was cured with hyperselective spongia gelatinosa embolization of the renal artery.Fol- low-up was available in 19 cases for 2-48 months,and no recurrence of renal calculi was noted.Conclu- sions Minimally invasive percutaneous nepbrolithotomy has advantages of safety,less invasion,and easy re- covery for the treatment of lower caliceal calculi.

Objective To evaluate the effectiveness of low-dose erythromycin for the treatment of feeding intolerance in preterm infants in China.Methods In this study,random clinical trials on the treatment of feeding intolerance in preterm infants with intravenous low-dose erythromycin published were searched at Chinese Journal Full-text Database,Chongqing Weipu Database and Wanfang database by using the methods of Cochrane systematic review.At the same time the information from related journals,professional data and network were hand-searched.The publishing deadline for the literatures reviewed in this study was August 2012.Statistical analysis of clinical data was performed by using RevMan 4.2 software provided by the Cochrane Collaboration.Results A total of 9 studies were included.The results showed that compared with the group of comprehensive therapy,the group of low-dose erythromycin was superior in the following aspects with significant differences(P ＜ 0.05):the average length of hospital stay,time of parenteral nutrition,time to full feeding,the incidence rate of feeding intolerance (Z =3.44,P =0.000 6 ; Z =6.78,P ＜0.000 01 ; Z =3.96,P ＜ 0.000 1 ; Z =2.51,P =0.01).Conclusion Low-dose erythromycin therapy for feeding intolerance in preterm infants is superior to the comprehensive therapy.It provides a prospective therapeutic method for feeding intolerance in preterm infants.However,large scale,multicenter and well-designed clinical trials should be adopted to confirm the conclusions.

Endophytic fungi were isolated from Macleaya cordata growing in Dabie Mountain by agar-block method, and then the endophytic fungi were grouped into different types based on their morphological characteristics, and thin layer chromatography (TLC) and high performance liquid chromatography (HPLC) were employed to determine whether the metabolic substances contained sanguinarine or not, and then preliminarily identified by morphological method. The results showed that the leaves hosted the largest number of endophytes (96 isolates) followed by the stems (57 isolates) and finally the roots (28 isolates), respectively. Based on morphological characteristics the endophytic fungi were grouped into 26 types in our study. TLC and HPLC results showed that there was sanguinarine in the metabolic substances of BLH 51 strain. According to the morphological characteristic, the BLH 51 strain was identified as Fusarium proliferatum. All these indicated that the medicinal plant M. cordata harbors abundant endophytes, which could be a new source for the search of active secondary metabolites.
Benzophenanthridines ; metabolism ; Endophytes ; isolation & purification ; Fungi ; isolation & purification ; Isoquinolines ; metabolism ; Papaveraceae ; metabolism ; microbiology ; Plant Leaves ; microbiology ; Plant Roots ; microbiology ; Plant Stems ; microbiology