In view of the increased incidences of cardiac arrest outside hospital year by year and younger tendency of the patients,foreign medical education practice showed that school-age children accepting cardiopulmonary resuscitation (CPR) skill training will benefit most from this survival skill in the future.This article elaborated on the meaning and methods of promoting CPR training in primary and middle school based on the present situation of CPR in order to promote its further development.

Objective Diabetic macular edema( DME) is a common complication of diabetic patients.Laser photocoagula-tion therapy is effective in the treatment of DME despite of some patients with unsatisfactory curative effect or recurrence.This study was to explore efficacy and safety of aescin combined with laser photocoagulation in DME treatment. Methods A total of 102 pa-tients with diabetic macular edema in our hospital were randomly divided into control group(51 cases of 67 eyes) and combined treat-ment group (51 cases of 69 eyes).Aescin combined with laser photocoagulation were applied in observation group, and laser photoco-agulation was applied in control group.Observation was made on the changes of intraocular pressure, best corrected visual acuity( BV-CA), central macular thickness(CMT) and the leakage in macular area between the two groups before and after he treatment, along with detection on adverse reactions during the treatment. Results Com-pared with pre-treatment, there were no significant differences be-
tween the two groups in intraocular pressure at 1, 2, 3, 6 months after therapy(P>0.05), and compared with control group in the same time point, the intraocular pressure showed no change significantly in combined treatment group(P>0.05).Compared with con-trol group after therapy, the average value of BVCA in observation group showed significantly decreased at 2, 3, 6 months(Z=2.130, 1.932, 2.283;P=0.037, 0.028, 0.005) while the average value of CMT showed significant increase( Z=1.979, 2.315, 3.08;P=0.045, 0.031, 0.000).Compared with control group at the same time point, the number of patients who suffered from the leakage in macular area significantly decreased in combined treatment group at 2, 3, 6 months(χ2 =4.213, 5.074, 6.625; P=0.040, 0.024, 0.010) .7 patients(13.7%) in combined treatment group suffered from stomach and nausea during the treatment, without any observation of serious adverse reaction. Conclusion Conclusion Aescin combined with laser photocoagulation is effective for the rehabilitation of patients and chconsolidate effect with high safety, which is of great clinical application.

[Objective]To detect the effect of constant magnetic field on metal ion Co2+,Cr3+ induced TNF-? secreted by human mononuclear cells,and to search a method for prevention and treatment of aseptic loosening. [Methods]CoCl2 powder and CrCl3 powder were dissolved in the asepsis injecting water. Mononuclear cells from human peripheral blood,were taken and cultured with Co2+,Cr3+ ions in different magnetic field of 10Gs,100 Gs,1000Gs for 12,24 and 48 hs. There were nine groups:control group,Co2+ group,Cr3+ group,Co2+andCr3+ with various intensities of constant magnetic field,respectively.ELISA method was applied to detect tumor necrosis factor (TNF-?) in serum via the absorbance (A).[Results]Co2+ and Cr3+ ions stimulated human mononuclear cell to secrete TNF-? (P

Objective To investigate the effects of ulinastatin on serum concentrations of advanced oxidation protein products and C-reactive protein in patients with multiple organ dysfunction syndrome(MODS).Methods Seventy-two patients with MODS were randomly divided into ulinastatin group(n=36) and control group(n=36).The serum concentrations of advanced oxidation protein products and C-reactive protein in two groups were determined before therapy and after 3d,5d and 7d of therapy.Acute physiology and chronic health evaluation Ⅲ (APACHE Ⅲ)for patients were recorded before therapy and after 3d,5d,7d of therapy.Mortality within 28d was also compared between the two groups.The serum concentrations of advanced oxidation protein products and C-reactive protein in 36 healthy volunteers were detected as normal control.Results The concentrations of AOPP and CRP in patients with MODS before therapy were significantly higher than those obtained from healthy volunteers(P<0.05), whereas no obvions difference was found between the two groups.However,the levels of AOPP and CRP in patients with MODS were significantly decreased after 3d,5d,7d of therapy.Compared with control group,AOPP concentrations and CRP levels were markedly attenuated and APACHE Ⅲ scores decreased significantly in ulinastatin group(P<0.05).The mortality in ulinastatin group was also improved more significantly than that in control group(P<0.05).Conclusion Ulinastatin can decrease the concentrations of serum AOPP and CRP in patients with MODS,so as to alleviate the damage resulting from oxidative stress and inflammation,contributing to improve the outcome in patients with MODS.

BACKGROUND: As a reliable marker of inflammation, intercellular adhesion molecule-1 (ICAM-1) plays an important role in atherogenesis. Recently, it is assumed in researches of recent years that chronic inflammation mediated by ICAM-1 is involved in hypertensive left ventricular hypertrophy probably, but there are still some objections reported. Tanshinone ⅡA is a kind of liposoluble extract from danshen(Radix Salviae Mitiorrhizae) . It is verified in animal experiment that it can inhibit hypertensive left ventricular hypertrophy.OBJECTIVE: To investigate the relationship between ICAM-1 and hypertensive left ventricular hypertrophy and the effect of tanshinone ⅡA on expression of ICAM-1.DESIGN:A randomized controlled observation was designed.SETTING: Tongji Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology.MATERIALS: The experiment was performed in the Laboratory of Emergency Department of Tongji Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology from October 2002 to January 2004. Ten male WKY rats(10 WKY rats) of 12-week-old and 20 rats with spontaneous hypertension(20 SHR rats) were employed and divided into the control group(10 WKY rats), hypertension group(10 SHR rats) and tanshinone ⅡA group(10 SHR rats).injected from caudal vein for treatment and distilled water at the same dose was injected in the other two groups. Twelve weeks later, the rats were sacrificed and myocardium was collected for specimen preparation. Haematoxylin and eosin(HE) staining, VG staining, immunocytochemical staining and myocardial ED1 labeling were applied to determine myocardial macrophage infiltration degree. The reverse transcription-polymerase chain reaction (RT-PCR) and enzyme-linked immunosorbent assay(ELISA) were used to determine the expressions of ICAM-1 mRNA and protein.MAIN OUTCOME MEASURES: Degree of macrophages infiltration and the expressions of ICAM-1 mRNA and protein in myocardium in each group.RESULTS: Twelve SHR and 10 WKY rats were employed in the experiment pared with the control group, ICAM-1 mRNA and protein expressions in hypertrophic myocardium were increased significantly in hypertension group (0.176±0.087,0.537±0.195;0.104±0.011,0.173±0.027, P ＜0.01or P ＜ 0.05) . Infiltration of macrophage was significant(0. 62 ±0.07,non Ⅱ A group, the expressions of ICAM-1 mRNA and protein were decreased significantly(0. 537 ±0. 195, 0.291 ±0. 106; 0. 173 ±0.027, 0. 125± 0. 014, P ＜ 0.01 or P ＜ 0. 05); the amount of macrophages infiltration was decreased(1.85 ±0. 23, 1.16 ±0. 17, P ＜ 0.05) and the degree of cardiomyocytic hypertrophy and interstitial fibrosis was remarkably relieved.CONCLUSION: Excessive expression of myocardial ICAM-1 and its mediated inflammatory cellular infiltration plays an important role in hypertensive left ventricular hypertrophy. The inhibition of tanshinone ⅡA on left ventricular hypertrophy may be contributed to decreased expression of ICAM-1 and alleviated inflammatory cellular infiltration in myocardium.

Purpose　The aim is to develop a synthesis method of the silver carboxymethyl chitosan and to study its bacteriostasis to Staphlococcus aureus(S.aureus),Pseudomonas aeruginusa(P.aeruginusa),Escherichia Coli(E.coli),Klebsiella pneumoniae(K.pneumoniae) and Proteus vulgaris(P.vulgaris).Methods　Chitosan was modified by way of chemistry.The structure analysis of its derivate was analysed by infra-red absorption spectroscopy,using methods of dilution and concavering to study the bacteriostasis to some ordinary bacteria which cause infection in burn.Results　The infra-red spectragram of the derivate showed the chitosan had been modified by chloroacetic acid.When the concentrationl of silver carboxymethyl chitosan was 1.028 mg/ml and the concentration of the five bacteria were 104CFU/ml，the rate of bacteriostasis was 88%、80.2%、75.3% to S.aureus、P.aeruginusa and E.coli respectively.The MIC of silver carboxymethyl chitosan was similar to that of AgNO3 when they act on S.aureus and P.aeruginusa,but the former was lower than later when acting on E.coli.Conclusion　Silver carboxymethyl chitosan could inhibit some bacteria which caused infection in burn.It was a novel pharmaceutical in preventing and curing burn infection.

Alemtuzumab ; Antibodies, Monoclonal ; therapeutic use ; Antibodies, Monoclonal, Humanized ; Antibodies, Neoplasm ; therapeutic use ; Antigens, CD ; metabolism ; Antigens, CD7 ; metabolism ; Antigens, Neoplasm ; metabolism ; Antineoplastic Agents ; therapeutic use ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; CD3 Complex ; metabolism ; CD5 Antigens ; metabolism ; CD52 Antigen ; Chromosome Aberrations ; Chromosome Deletion ; Cyclophosphamide ; therapeutic use ; Diagnosis, Differential ; Doxorubicin ; therapeutic use ; Glycoproteins ; metabolism ; Hodgkin Disease ; metabolism ; pathology ; Humans ; Lymphoma, Large-Cell, Anaplastic ; metabolism ; pathology ; Lymphoma, T-Cell, Peripheral ; drug therapy ; genetics ; metabolism ; pathology ; Neoplasm Recurrence, Local ; Prednisone ; therapeutic use ; Receptors, CXCR3 ; metabolism ; Survival Rate ; Vincristine ; therapeutic use

Objective To observe the therapeutic effect of rhubarb combined with Probiotics for treatment of patients with severe acute pancreatitis (SAP) accompanied by acute lung injury (ALI). Methods A prospective randomized controlled trial was conducted. Sixty patients with SAP and ALI were randomly divided into a rhubarb group and a combination of rhubarb and Probiotics group (combined group), 30 cases in each group. Both groups were treated with conventional therapy. On that therapeutic base, the patients in rhubarb group were treated with rhubarb 3 g·kg-1·d-1 (Raw rhubarb in boiling water 200 mL was cooked for 30 minutes, then the decoction was divided into two parts to be infused through nasal jejunal tube, retaining for 1 hour);while in the combined group, beside the above rhubarb therapy, the patients were additionally given Probiotics [Clostridium butyric acid:Chang Lekang capsule, once 1 grain (0.42 g), twice a day] through nasal jejunal tube. The therapeutic course was 14 days in the two groups. The plasma endotoxin levels, oxygenation index, and acute physiology and chronic health evaluationⅡ(APACHEⅡ) score were observed before and after treatment for 7 days and 14 days, respectively. After treatment for 30 days, the time of intestine functional recovery and mechanical ventilation, number of damaged organs, number of infectious sites, number of pancreatic pseudocysts, length of intensive care unit (ICU) stay and 30-day fatality rate were observed in the two groups. Results With the prolongation of treatment, the plasma level of endotoxin and APACHEⅡscore in the two groups were gradually reduced, and the oxygenation index was gradually increased after treatment for 7 days and 14 days in the two groups compared with those before treatment, and there were statistically significant differences in above indexes on the 14th day after treatment between combined group and rhubarb group [endotoxin (μg/L): 19.16±1.90 vs. 21.20±1.05, oxygenation index (mmHg, 1 mmHg = 0.133 kPa): 369.50±5.45 vs. 341.50±7.36, APACHE Ⅱscore:11.84±0.60 vs. 13.00±0.86, P<0.05 or P<0.01]. The length of intestine functional recovery in the combined group was longer than that in the rhubarb group (days: 5.63±1.75 vs. 5.02±1.54), the number of damaged organs (2.08±0.74 vs. 2.70±1.11), the number of infectious sites (1.93±0.64 vs. 2.23±0.83), the number of pancreatic pseudocysts (1.22±0.34 vs. 1.63±0.11) and the mortality rate [10.0%(3/30) vs. 13.3%(4/30)] in the combined group were lower than those of the rhubarb group, but there were no statistically significant differences between two groups (all P > 0.05). The times of mechanical ventilation (days: 13.40±1.76 vs. 15.60±1.28) and the length of ICU stay (days:16.13±1.25 vs. 17.63±1.30) were significantly shorter in combined group than those in rhubarb group (both P<0.05). Conclusion Rhubarb combined with Probiotics for treatment of patients with SAP and ALI can promote their recovery of lung function and shorten their length of ICU stay.

BACKGROUND: Recent studies have demonstrated that energy metabolism-related genes play important roles in intervertebral disc (IVD) cell adaptation to negative environmental factors, such as hypoxia and insufficiency of nutrient. But the effects of these genes in pressure-induced intervertebral disc degeneration remain uncertain.OBJECTTVE: To investigate continuous pressure-induced expression of energy metabolism genes: hypoxia-inducible factor 1α(HIF-lo), glucose transporter-1 (GLUT-1) and vascular endothelial growth factor (VEGF) in rabbit annulus fibrosus (AF).DESIGN: A randomized controlled experiment.SETTING: The Central Laboratory and the Laboratory of Department of Orthopaedics, Union Hospital Affiliated to Tongji Medical College, Huazhong University of Science and Technology.MATERIALS: The experiment was carried out in the Central Laboratory and the Laboratory of Department of Orthopaedics, Union Hospital Affiliated to Tongji Medical College, Huazhong University of Science and Technology from May to October 2005. Twenty-five Japanese white rabbits(about 4 months old, weighting 2.5-3.0 kg, provided by the Experimental Animal Center of Tongji Medical College, Huazhong University of Science and Technology) were selected to establish the animal model.METHODS: A controllable pressure-induced rabbit intervertebral disc degeneration model was adopted to impose various pressured on rabbit IVDs in vivo. The survived animals whose IVDs were compressed successfully were divided randomly into 4 groups. The IVDs were treated with no pressure as control (control group), with 15 kg axial load for 24 hours (24hours group), 72 hours (72 hours group), and 24 hours with 48 hours free for self-reparation (reparation group). Reverse transcriptase-polymerase chain reaction was used to detect the expression of HIF-1α and GLUT-1. Western Blot and immunohistochemical test were carried out for the content and distribution of VEGF.MAIN OUTCOME MEASURES: Expression of HIF-1α and GLUT-1, content and distribution of VEGF.RESULTS: Twenty of 25 rabbits entered result analysis. Two rabbits were missed because of vertebral fracture, while death of 3 rabbits within 1-3 days postoperatively caused another loss. ①HIF-1α. A very low expression was detected in the control group, while the expression in the 24 hours group was raised over 20 times than that in the control group (t=25.022, P＜0.01). The expression in the 72 hours group and reparation group decreased as compared with the 24hours group. ②GLUT-1 expressed weakly in the control group. The expression in the 24 hours group rose a lot as compared with the control group (t=18.314, P＜0.01) and the expression in the 72 hours group rose slightly than that in the 24 hours group (t =2.819, P＜0.05). The expression in the reparation group is close to that in the 24 hours group. ③Littie VEGF content was detected in the control group, while the content rose significantly in the other 3 groups. Immunohistochemical staining showed more VEGF positive stained cells in outer AF than in inner AF.CONCLUSION: Continuous pressure can strongly up-regulate the expression of energy metabolism gene: HIF-1α,GLUT-1 and VEGF in vivo. These genes play important roles in AF adaptation and reparation in over load-caused damage.

By reviewing the research on patient reported outcomes (PRO) and the understanding of the theory of traditional Chinese medicine in coronary heart disease, the author found that the evaluation scale of PRO in coronary heart disease in traditional Chinese medicine should be guided by the theory of traditional Chinese medicine, including the theories of ‘heart-oriented, five internal organs correlation, internal injuries by seven emotions, unity of body and mind, correspondence between human and nature’ and other modern theoretical framework of PRO scale.It was believed that the physical, psychological, independence and social sphere constructed a special PRO efficacy scale of traditional Chinese medicine in coronary heart disease. The field of physiology on the scale was guided by ‘heart-based, five internal organs correlation' theory as the main line, and the scale was divided into various aspects in order to reflect all aspects of uncomfortable self-feeling of patients. Finally, 19 sides such as chest pain, chest tightness, heart palpitations, flank pain, insomnia, soreness and weakness of waist and knees, frequent urination at night, anorexia, weakness, spontaneous perspiration, shortness of breath, individual ability, daily life, positive feelings, negative feelings, personal relations and social support needed, level of social services, social intercourse and economy, healthy and medical care formed the theoretical structure model of the scale,which established the theory foundatio for the further development of PRO scale.