AIM: To establish a RP-HPLC method for simultaneous determination of the dl-tetrahydropalmatine and imperatorin in Yuanhu Zhitong Prescription (Rhizoma Corydalis, Radix Angelicae Dahuricae). METHODS: dl- tetrahydropalmatine and imperatorin were extracted with ether and determined by HPLC using a BDS C 18 column(5?m,4.6?250mm),phosphate buffer(pH6.6)-methanol(39∶61) as a mobile phase. The mobile rate was at 1mL?min -1 and detection wavelength was at 280nm. RESULTS: The relationship between the concentration and the peak area of dl-tetrahydropamaltine and imperatorin were good linear relation, respectively. Either of correlation coefficient approached 0.999. CONCLUSION: This method can be used to determine the concentration of dl-tetrahydropalmatine and imperatorin in the preparation of Yuanhu Zhitong Prescription.

The Lazarus phenomenon is defined as delayed ROSC,or ROSC after failure of CPR and cessation of all the emergency medical care,including the cessation of chest compression,mechanical ventilation,and venous fluid resuscitation.It was first reported in 1982 and 53 cases of Lazarus phenomenon have been reported in the medical literature so far.Even though Lazarus phenomenon is rare and the pathophysiological mechanisms are poorly understood,several possible mechanisms are still proposed,which could be rational to explain this phenomenon,such as auto-PEEP,hyperkalemia,alkalosis,delayed action of drugs,etc.In most cases,it was reported that ROSC occurred within 10 minutes after cessation of medical effort.Therefore,before the announcement of death of patient,it is mandatory to monitor those patients for at least 10 minutes after the cessation of CPR.However,more explicit studies seem to be necessary to gain a better understanding of this phenomenon.

As one of the cornerstones of modern cardiopulmonary resuscitation (CPR), ventilation received controversy and challenges in the past two decades. From 2000 to 2015, the changes in CPR guidelines of American Heart Association (AHA) showed that the position of ventilation declined gradually as compared to chest compressions. Chest compressions only CPR has been strongly advocated in recent years, especially in witnessed cardiogenic cardiac arrest (CA). Passive oxygenation and cardiocerebral resuscitation (CCR) also showed good effect in the early stage of cardiogenic CA. However, clinical validation in a larger context is still needed. An impedance threshold device (ITD) transiently blocks air from entering the lungs during recoil, decreases the intrathoracic pressure, facilitates venous return to the chest and increases coronary blood flow. However, the relevant research findings are not consistent, and the guidelines do not recommend routine use of ITD. Positive-pressure ventilation, which can increases intrathoracic pressure, affects the coronary perfusion pressure (CPP) and cerebral perfusion, is thought to be not only useless, but also has adverse effects within the first few minutes of CPR. This view is accepted by many scholars, however, ventilation is essential in late-start CPR, prolonged CPR and non-cardiogenic CA. Mechanical ventilation, especially special ventilation modes for CPR showed some prospects. Positive-pressure ventilation remains the gold standard in CPR in clinical practice at present. It was shown by existing research that hyperventilation significantly reduce the success rate of resuscitation, thus a consensus had been reached about avoiding hyperventilation. Currently, the number of studies on ventilation during CPR is very limited, and many of the conclusions are not consistent among studies. Therefore, more high-quality studies are needed in future to further clarify the application of ventilation during CPR.

Mortality is a key index for assessing technical level and treatment quality of hospital. We filtered and analyzed the literatures about the influence of nurse factors on patient mortality out of China in recent years to guide the study within China. We found the nurse factors impacting mortality included workload, configuration of nursing staff, education status and working environment. Those findings point out the direction of the research on relationship between nurse factors and patient mortality in China, which has great significance.

Objective To discuss the recent clinical efficacy of percataneous pedicle screw internal fixation for thoracolumbar fractures without neurological deficit in the new field comprehensive operation rescue shelter at the war or disaster treatment place.Methods Retrospectively analyzed the clinical data of 29 patients with thoracolumbar fractures who were rescued by our hospital.Those patients included 18 males and 11 females,with the average age of (31.54±2.86) years old.All these patients underwent percutaneous pedicle screw internal fixation in the new field comprehensive operation rescue shelter.Clinical and surgical evaluation including surgery time,blood loses,exercise time after operation and complications.Functional outcomes of pre-operation and post-operation were evaluated by visual analog scale (VAS) and Oswestry disability index (ODI).Cobb's angle and fracture vertebral body front height were compared before and after operation as well.Results All these patients were all successfully completed operation in the field comprehensive operation rescue shelter,and the general post-operation condition was well.The operation time was (86.55±16.15)min,the blood loss was (42.35±6.55)mL,the exercise time after operation was (1.20±0.61) days.There was no complications after operation, and pain of thoracolumbar after operation was obviously alleviated.There was statistical differences in terms of Cobb's angle,fracture vertebral body front height,VAS score and ODI score between pre-operation and post-operation (P<0.05).Conclusion The percataneous pedicle screw internal fixation in the new field comprehensive operation rescue shelter is a quite effective method for thoracolumbar fractures without neurological deficit, and this method is worthy of promoting at the scene when war or disaster urgency treatment.

Objective To study the benchmark dose (BMD) of fluoride concentration in saliva,and to evaluate the significance of saliva fluoride on control and prevention of endemic fluorosis.Methods In September 2014,middle school students in endemic fluorosis areas and non-endemic fluorosis areas in North China Petoleum were selected as objects.The contents of fluoride in water,urine and saliva were determined.The correlation of fluoride content in water,urine fluoride and fluoride concentration in saliva was analyzed.According to the levels of the saliva fluoride concentration,the children were divided into 11 groups,＜ 1.00,1.00-,2.00-,3.00-,4.00-,5.00-,6.00-,7.00-,8.00-,9.00-and ≥ 10.00 mg/L.The prevalence of dental fluorosis and defected dental fluorosis were investigated and the saliva fluoride concentration was calculated by Banch-Mark Dose Software.Results Compared with non endemic areas,the fluoride contents in water,urine and saliva [(2.13 ± 0.13),(1.29 ±0.73),(4.01 ± 3.61) mg/L] were higher than that in endemic areas [(0.67 ± 0.13),(0.38 ± 0.08),(0.75 ± 0.12) mg/L,t =158.730,24.780,18.114,all P ＜ 0.01].The fluoride concentration in saliva was positively correlated with the fluoride content in water and urine in endemic areas (r =0.626,0.945,all P ＜ 0.01).The (BMDs and benchmark dose lower bound (BMDLs) were 0.91,0.54,3.72,3.32 mg/L respectively,calculated by Banch-Mark Dose Software.With the increase of fluoride concentration in saliva,the prevalence of dental fluorosis and defect dental fluorosis had increased too,especially when the fluoride content in saliva was more than 4 mg/L.There were significant doseresponse relationships between the urine fluoride and the prevalence of dental fluorosis and defected dental fluorosis.Conclusion The fluoride concentration in saliva could be used as one of the evaluation indexes of fluorosis,and the BMD of saliva fluoride concentration in endemic fluorosis areas is suggested as 0.91 mg/L.

Objective To discuss the short-term effect of Sextant system fixation for thoracolumbar fractures without neurological deficit in the field comprehensive operation rescue shelter.Methods There were 32 patients with thoracolumbar fractures without neurological deficit which rescued by our hospital.Those patients included 18 males and 14 females, with average age of (25.54±2.86) years old.All patients were undergoing internal fixation with Sextant system in the field comprehensive operation rescue shelter.Clinical and surgical evaluation including surgery time,intraoperative blood loss,postoperative ambulation time and wound healing time were observed.Functional outcomes of pre-operation and postoperation 3-days were evaluated by visual analog scale(VAS) and Oswestry disability index(ODI).Cobb angle and front height of fracture vertebral body were compared between pre-operation and postoperation 3-days.Results The operation time was (96.55±14.15)minutes, intraoperative blood loss was (45.25±3.55)mL, postoperative ambulation time was (1.20±0.61)days.There were statistical differences in terms of Cobb angle,front height of fracture vertebral body,VAS and ODI between pre-operation and postoperation 3 days.Conclusion The Sextant system fixation in the field comprehensive operation rescue shelter is a timely,safe and effective method for thoracolumbar fractures without neurological deficit,which is deserved to utilize at the scene when war or disaster urgency treatment.

Objective To explore the effects of adipose tissue-derived stem cells (ADSCs) on the proliferation and invasion of pancreatic cancer cell lines in vitro.Methods ADSCs were isolated and co-cultured with pancreatic cancer cells.The proliferation and invasion of pancreatic cancer cells was tested by CCK-8 test kit.Stromal cell derived factor (SDF-1),vascular endothelial growth factor(VEGF),matrix metalloproteinase(MMP-9)and transforming growth factor-β (TGF-β1)in the culture medium were assayed by ELISA.The expression of cytokines in pancreatic cancer cells and ADSCs were detected by qRT-PCR.CCK-8 test kit was used to measure the AMD3100 regulation for the co-culture of ADSCs and pancreatic cancer cells.Results ADSCs can promote the proliferation and invasion of pancreatic cancer cells (all P ＜0.05); more SDF-1,VEGF,MMP-9 and less TGF-β1 was secreted by ADSCs than by pancreatic cancer cells(SDF-1:1100±100 vs.0 vs.0,F=389.134,P＜0.01;VEGF:140±4 vs.99±5 vs.93 ±4,F=174.102,P ＜0.05;MMP-9:61.8 ±4.2 vs.43.5 ±2.8 vs.54.5 ±3.0,F=76.279,P＜0.05;TGF-β1:20.6 ±3.0 vs.35.6 ±2.6 vs.41.3 ±5.5,F =79.338,P ＜0.05).ADSCs promote the expression of VEGF and MMP-9 in pancreatic cancer cells(VEGF:63.7 ±5.9 vs.50.6 ±4.1,t =7.536,P＜0.05; MMP-9:mRNA(55.8±3.6 vs.42.7 ±3.1,t =8.279,P＜0.05).AMD3100 significantly downregulates these growth-promoting effects of ADSCs on pancreatic cancer cells(SW1990:1.539 ±0.140 vs.1.361±0.066,t=2.835,P＜0.05;PANC-1:1.376±0.100 vs.1.281±0.031,t=2.860,P＜0.05).Conclusions ADSCs promote the proliferation and invasion of pancreatic cancer cells.

Objective To study the protective effects of resveratrol against hepatic stellate cells (HSCs) and liver fibrogensis.Methods HSCs were isolated from liver of SD rats.The reactive oxygen output in HSCs under resveratrol in different concentrations was tested by DCFH-DA kit.The proliferation of HSCs was tested by CCK-8 test kit.Smoothmuscle α-actin (α-SMA) expression of HSCs was evaluated by Western blotting.The activity-related genes were measured by PCR.The models of liver fibrogenes were established.Resveratrol in different concentrations was administrated intraperitoneally.Liver was studied by pathology and SMA staining.Hydroxyproline content of liver and levels of collagen Ⅲ and hyaluronic acid in serum were tested.Results HSCs were isolated from liver and cultured successfully.Resveratrol inhibited the generation of the reactive oxygen.Proliferation and activation of HSCs was inhibited by resveratrol (0.536 ±0.052,0.411 ±0.047,0.327 ±0.063,0.312 ±0.032,F =12.776,P ＜0.05) (103 ±7,90 ±7,63 ± 4,53 ± 3,F =62.179,P ＜ 0.05).Resveratrol inhibited the expression of genes (myogenic determination gene MyoD,collagen 11 and collagen Ⅰ) in HSCs(122 ± 5,96 ± 3,68 ± 3,60 ± 3,F =180.600,P＜0.05) (100±8,82 ±3,53 ±3,51 ±2,F=77.451,P ＜0.05) (170 ±3,147 ±4,92 ±3,90 ±2,F =462.878,P ＜ 0.05).Resveratrol downregulated the level of hydroxyproline,collagen Ⅲ and hyaluronic acid (358.3 ± 20.2,320.5 ± 15.3,290.3 ± 24.5,F =23.929,P ＜ 0.05) (32.8 ± 3.1,28.9 ±1.3,25.3±1.8,F=20.050,P＜0.05)(276.3 ±17.8,225.3 ±28.3,195.4 ±11.2,F=18.585,P＜0.05).Conclusions Resveratrol can inhibit the proliferation and activation of HSCs and downregulate the fibrogensis level of the liver of rats.

Heparin and low molecular weight heparin have been widely used in clinical therapy as anticoagulants in cardiovascular disease and in hemodialysis. Crude heparin is usually prepared from porcine intestinal mucosa. Purified heparin is a mixture of polysaccharides consisting mainly of repeating GlcNS(6S)-IdoA2S disaccharides and other disaccharides with different GlcNAc/GlcNS±3S±6S-GlcA/IdoA±2S residues. Heparin injections are drugs prepared from heparin active pharmaceutical ingredient ( API ) that is prepared from crude heparin. Low molecular weight heparins are dominant heparin-based drugs used clinically, which are prepared by degrading heparin into smaller sizes. As a result, low molecular weight heparins are sharing the same major disaccharides but have different reducing and non-reducing ends. In current study, we focused on the disaccharide compositional analysis of clinically used heparin and heparin-based drugs. HeparinaseⅠ,II, and Ⅲ were used to degrade all heparin and heparin-based drugs including heparin sodium injection, Enoxaparin sodium injection, Nadroparin calcium injection, Dalteparin sodium injection, Fondaparinux sodium into disaccharides. All the degraded products were analyzed by strong anion high perforance liquid chromatography ( SAX-HPLC) coupled with an UV-detector. Commercially available unsaturated disaccharide standards were then used for structral identification. Furthermore, unusual disaccharides present in Nadroparin, Dalteparin, and Fondaparinux were confirmed by reversed-phase ion pair HPLC coupled with mass spectrometry. The developed method produced detailed structural information, which should be useful for quality control of heparin and heparin-based drugs.