10.3969/j.issn.1007-3969.2013.05.004

Objective To effectually record cardiopulmonary resuscitation (CPR) procedure, analyze and compare the CPR performance of all medical and nursing staffs to find out the existed information for the improvement of the quality of CPR and its survival rate. Methods The medical data were collected according to the Utstein Criteria and CPR event was automatically recorded by a digital video-recording system, by which hands-off times within 10 minutes of CPR and times for installation of chest compression machine, establishment of endotracheal intubation and establishment of the venous channel were analyzed. Multiple regression analysis was conducted to analyze the factors affecting CPR effect. Results ① During the period from December 2009 to December 2015, a total of 376 patients with cardiac arrest (CA) was registered, including 248 males and 128 females, with a median age of 68 (53, 78) years. Estimated median time interval from CA to CPR initiation was 5.0 (0.1, 20.0) minutes and there were 189 cases less than or equal to 5 minutes. The acute myocardial infarction (AMI) with 145 cases (38.6%) was the main etiology of CA. Initial shockable rhythm was found in 16 patients (7.0%) out of 230 out-of-hospital cardiac arrest (OHCA) patients, of whom 13 underwent ventricular fibrillation (5.7%), 3 underwent ventricular tachycardia (1.3%). Initial shockable rhythm was found in 47 patients (32.2%) out of 146 in-hospital cardiac arrest (IHCA) patients, of whom 40 underwent ventricular fibrillation (27.4%), and 7 underwent ventricular tachycardia (4.8%). CPR by a mechanical device (Thumper) was performed in 219 patients (58.2%). In 376 patients, 186 patients had return of spontaneous circulation (ROSC, 49.5%), a successful CPR (ROSC ≥ 24 hours) was found in 110 patients (29.3%), 99 patients was hospitalized alive (26.3%) and 40 patients were discharged alive (10.6%). In 146 cases of IHCA, 89 patients had ROSC (61.0%), a successful CPR was found in 63 patients (43.2%), 56 patients were hospitalized alive (38.4%), and 29 patients were discharged alive (19.9%). In 230 patients of OHCA, 89 patients had ROSC (38.7%), 65 patients received pre-hospital CPR (28.3%), a successful CPR was found in 47 patients (20.4%), 43 patients were hospitalized alive (18.7%), and 11 patients were discharged alive (4.8%). There were 37 patients had a successful CPR (69.8%), and 25 patients were discharged alive (47.2%) in 53 patients with ventricular fibrillation. ② There were 77 patients with valid video information for analysis of CPR performance, with 48 patients of OHCA, and 29 patients of IHCA. Delay median time from the patients presence in the resuscitation room to be placed in rescue bed was 22 (0, 33) seconds. Hands-off median times during 10 minutes of CPR was 41 (18, 90) seconds. Thumper installment median times was 43 (31, 69) seconds. Median time for endotracheal intubation was 59 (35, 109) seconds. Median time of venous catheter placement was 112 (70, 165) seconds. It was shown by multivariate regression analysis that there was a significant correlation between estimated time interval from CA to CPR performed, hands-off time and success rate of CPR (t1 = -3.452, t2 = -2.729), rate of discharge alive (t1 = -2.328, t2 = -2.736, all P < 0.05). In 48 OHCA patients, success rate of CPR was significantly correlated with estimated time interval from collapse to CPR performed (t = -2.409, P = 0.021). In 29 IHCA patients, success rate of CPR and rate of discharge alive was significantly correlated with hands-off times (t1 = -3.412, t2 = -2.536, both P < 0.05). Conclusions Survival to hospital discharge following CA is significantly correlated with the time interval from collapse to CPR performed and hands-off times in CPR. Installment and usage of Thumper should be postponed in order to reduce hands-off times during CPR in IHCA.

Objective To compare the application value of contrast enhanced ultrasound (CEUS) and contrast enhanced magnetic resonance angiography ( CEMRA ) in the diagnosis of carotid plaque characteristics . Methods Fourty-six patients ( 48 carotid plaques) were performed with carotid CEUS and CEMRA examination prior to carotid endarterectomy . The following characteristics of plaque including the surface of the plaque ,the presence of calcification ,the internal composition and the diameter stenosis were observed and measured ,which were compared with pathologic and digital subtraction angiography ( DSA ) results . Results There were 42 vulnerable plaques and 6 stable plaques in the 48 plaques . Fourty-seven carotid plaques had been correctly diagnosed by CEUS and CEMRA ,and one plaque had been misdiagnosed . The sensitivity ,specificity and accuracy between CEUS and CEMRA had no obvious differences in terms of the overall evaluation of plaque vulnerability ( P > 0 .05) ;CEUS and CEMRA in the diagnosion of the plaque surface situation had no statistical difference in terms of sensitivity ,specificity and accuracy compared with pathological results( P > 0 .05) ;There was no significant difference in diagnostic accuracy rate between two modalities ( P < 0 .05) ;In the diagnosis of plaque internal composition ,they had statistically differences in terms of specificity and accuracy ( P < 0 .05) ,while sensitivity had no obvious difference ( P > 0 .05) . With DSA examination results as the gold standard ,the accuracy of CEUS in the diagnosis of the diameter stenosis was 97 .92% (47/48) ,CEMRA was 100% (48/48) ,they had no significant difference between two groups ( P > 0 .05 ) . Conclusions CEUS and CEMRA in carotid plaques characteristic evaluation have respective advantages ,are highly complementary ,and combining two methods can systematically evaluate for plaque characteristics .

Objective To study the correlation between maternal serum 25‐OH‐VitD concentration and early‐onset severe pre‐eclampsia(EOSPE) .Methods 5 000 early singleton pregnancy women with gestational age 8-12+6 weeks and without any compli‐cations in the outpatient department of the hospital from January 2013 to January 2015 were enrolled in the study .The levels of ser‐um 25‐OH‐VitD were measured by using chemiluminescence method .Only 2 988 women with Vitamin D deficiency went through regular prenatal care and delivery .The 2 988 women were divided into two groups intervention group and non intervention group whose age ,BMI and gestation age were matched .Intervention group(n=1 490) received vitamin D supplementation ,the non inter‐vention group did not received the supplementation .Those patients who developed EOSPE were counted .Finally ,Patients diagnosed with EOSPE and were Vitamin D deficient(n=118) were divided into two groups late intervention group and non late intervention group .The late intervention group were treated with vitamin D supplementation ,The non late intervention group were only treated routinely .Results Patients with Vitamin D deficiency accounted for 63% ,insufficiency 32% ,normal 5% .The levels of serum 25‐OH‐VitD and VEGF in patients with EOSPE were significantly lower than those in normal control group(P<0 .05) .The occur‐rence rate of EOSPE in 2 988 women was 4 .1% (123 women) .The occurrence rate of EOSPE in intervention group and no interven‐tion group were 2% (30/1 490) and 6% (93/1 498) respectively ,which were statistically different(P<0 .05) .The outcome of ma‐ternal and perinatal infant in late intervention group were not significantly different from those in non late intervention group .Con‐clusion Vitamin D deficiency or insufficiency is a common problem in early pregnant women .The risk of EOSPE increases in early pregnant women with Vitamin D deficiency .Vitamin D supplementation in the first trimester in women with Vitamin D deficiency could significantly decrease the occurrence rate of EOSPE .Vitamin D supplementation in women diagnosed with EOSPE could not change the outcome of maternal and perinatal complications .

Objective To study if 5-Aza-2’-deoxycytidine along or together with 4-phenylbutyric acid could affect miR-196b expression levels in chronic myeloid leukemia cells .Methods K562 cells were treated with DNA methylation inhibitor 5-Aza-2’-deoxycytidine, histone deacetylase inhibitors 4-phenylbutyric acid separately and the combined treatment with both of them, then expression levels of miR-196b were detected using Real-time PCR.Results The half inhibition concentration of 4-phenylbutyric acid was 1.58mmol/L.Comparing with the expression level of miR-196b in normal human bone marrow cells, the expression levels of miR-196b were significantly lower in Aza group , PBA group and negative control cells and nearly consistent among three groups , and as high as normal cells in combined treatment group . Conclusion The expression level of miR-196b in K562 cells could not return to normal treated with 5-Aza-2 ’-deoxycytidine or 4-phenylbutyric acid separately , while could restore normal when treated with both agents , indicating that miR-196b expression level in K562 cells is related with both DNA methylation and histone acetylation .

Objective To study the application of Cell Counting Kit-8(CCK-8) in detecting the growth inhibiting effect of 5-Aza-2’-deoxycytidine on chronic myeloid leukemia cell .Methods The proliferation of K562 cells was detected by CCK-8 with different concentrations of 5-Aza-2 ’-deoxycytidine and the cell cycle and apoptosis of K 562 cells were detected after K562 treated by 50% inhibitory concentration of 5-Aza-2 ’-deoxycytidine .Results The 50% inhibitory concentration of 5-Aza-2’-deoxycytidine was 15.55nmol/L, after treated with this concentration , K562 cells showed that G2 phase arrest occurred , proliferation inhibited and apoptosis peaks appeared .Conclusion Inhibition of proliferation of K562 cells with different concentrations of 5-Aza-2’-deoxycytidine varied in a dose-dependent relationship , and 5-Aza-2’-deoxycytidine could promote apoptosis of K 562 cells.CCK-8 can be used in detecting the effect of 5-Aza-2’-deoxycytidine on chronic myeloid leukemia cells .

Objective:To observe the effect of xylitol on the cyclooxygenase(COX)-2 expression of renal tubule in diabetic rats.Methods:The Wistar rats were randomly divided into normal control group(group NC),diabetes control group(group DC),5% xylitol-treated group(group 5%),10% xylitol-treated group(group 10%)and 20% xylitol-treated group(group 20%).At the end of 8 weeks,the expression of COX-2 in kidney tissue,the level of serum uric acid,allantoin and creatinine were tested in rat groups.Results:The levels of serum uric acid and allantoin were higher in group 5% and group 10% compared with that of group DC.The differences in levels of serum uric acid and allantoin were statistical significance between group 10% and group DC(P ＜ 0.05),whereas,the lower levels of serum uric acid and allantoin were found in group 20% compared with those of group DC(P ＞ 0.05).The levels of urine uric acid and allantoin were lower in group 5% and group 10% than those of group DC(urine uric acid,P＞ 0.05 and allantoin,P＜ 0.05),whereas,group 20% had higher levels of urine uric acid and allantoin than those of group DC(P＜ 0.05).The fractional excretion of uric acid(FEUA)was lower in group 5% and group 10% compared with that of group DC(P ＜ 0.05).The FEUA was higher in group 20% than that of group DC(P ＜ 0.05).The expression of COX-2 was significantly increased in group 5% and group 10% compared with that of group DC(P ＜ 0.05),but the expression of COX-2 decreased in group 20%(P ＜ 0.05).Conclusion:The lower and mediate doses of dietary xylitol could aggravate the tubular injury through increasing the level of serum uric acid and the expression of COX-2 in renal tubule.The higher doses of xylitol could increase the excretion of uric acid and down-regulate the expression of COX-2 in renal tubule.

Objectives To summarize the clinical characteristics of imported falciparum malaria patients and the treatment so as to provide the evidences for improving the diagnosis and treatment of the disease. Methods A total of 138 imported falci?parum malaria patients who received the treatment in Shandong Institute of Parasitic Diseases from January 2007 to February 2013 were adopted as the observation subjects and their clinical data were collected and analyzed. Results All the 138 pa?tients were back from African countries. The main manifestations were fever headache asthenia and hepatosplenomegaly and most of them were with decreased RBC PLT levels and increased LDH levels and 36.96%of them were misdiagnosed as respiratory diseases nephritis hepatitis and so on. Through antimalarial treatment of artemether or artesunate or dihydroartemis?inin and primaquine or dihydroartemisinin and piperaquine and symptomatic treatment the short?term and long?term cure rates were 98.55%and 94.93%respectively with 1 case unrecovered and 1 died. Conclusions Artemisinins are still the most effective antimalarial drugs for falciparum malaria. However some patients recrudesce as the Plasmodium in their body is resis?tant or insensitive to these drugs. We should pay more attention to the antimalarial and symptomatic treatments in the early stage of severe malaria so as to improve the cure rate.

Objective To study the influence of CTP-OD1-HA and CTP-OD2-HA fusion peptides and combined with imatinib on proliferation of K562 cells.Methods K562 cells were treated with CTP-OD1-HA and CTP-OD2-HA peptides or together with imatinib.The proliferation of cells were detected and compared by MTT and clone formation methods.Results MTT examination demonstrated that CTP-OD1-HA and CTP-OD2-HA peptides could inhibit the proliferation of K562 cells,and the effect was more obvious when acted along with imatinib;Clone formation showed that CTP-OD1-HA and CTP-OD2-HA peptides suppressed the continuous colony forming ability of K562 cells.Conclusion CTP-OD1-HA and CTP-OD2-HA could specially inhibit the proliferation of K562 cells,and increase the sensitivity of imatinib.