ObjectiveTo investigate the relevant factors influencing the incidence and mortality of post cardiac arrest syndrome (PCAS), and to provide the basis of improvement of resuscitation rate.Methods A single center retrospective study of cardiopulmonary resuscitation (CPR) according to Utstein model was conducted. A clinical case report form was designed to collect clinical data. The clinical data of patients whose spontaneous circulation was restored (ROSC)> 24 hours in intensive care unit (ICU) of the First Hospital of Jilin University from January 2008 to June 2014 were collected and analyzed. The relevant risk factors of the incidence and mortality rate of PCAS were screened and analyzed by multivariate logistic regression analysis.Results① Successful CPR was achieved in 93 patients, of whom 83 patients were shown to have systemic inflammatory response syndrome (SIRS), and 75 patients suffered from PCAS (80.65%). Among them 49 died, and 18 patients who did not suffer from PCAS survived.② The age, gender, history of previous chronic disease, site of occurrence of cardiac arrest, type of rhythm when cardiac arrest occurred, and dosage of adrenaline showed no significant influence on the incidence of PCAS. The incidence of PCAS was elevated when defibrillation was done more than 3 times (χ2= 10.806,P= 0.001), SIRS occurred after ROSC (χ2= 46.687,P< 0.001), interval between collapse and first defibrillation over 5 minutes (χ2 = 6.429,P = 0.011), interval between collapse and CPR longer than 5 minutes (χ2 = 4.638,P = 0.031), interval between collapse and administration of first resuscitation medication> 5 minutes (χ2 = 4.190,P = 0.041), and ROSC time was longer than 10 minutes (χ2 = 20.042,P< 0.001). Bivariate correlation showed that interval between collapse and CPR, interval between collapse and administration of first resuscitation medications, and ROSC time were all correlated (r1 = 0.677,r2 = 0.481,r3 = 0.617, allP< 0.001).③ There were no significant relations between the prognosis of PCAS patients and times of defibrillation, the amount of adrenaline used, and interval between collapse and first defibrillation. The mortality rate of PCAS was relatively elevated when interval between collapse and CRP was longer than 5 minutes (χ2 = 10.792,P = 0.001), interval between collapse and administration of first resuscitation medications was longer than 5 minutes (χ2 = 13.841,P< 0.001), ROSC time> 10 minutes (χ2 = 36.451,P< 0.001), the number of dysfunction organ≥ 4 (χ2 = 28.287,P< 0.001), arterial blood lactate levels> 2 mmol/L (χ2 = 28.926, P< 0.001), and acute physiology and chronic health evaluationⅡ (APACHEⅡ) score> 15 (χ2 = 33.558,P< 0.001). Multivariate logistic regression analysis showed that the risk factors affecting the prognosis were ROSC time [odds ratio (OR) after adjustment = 36.643, 95% confidence interval (95%CI) = 2.382-563.767,P = 0.010], the number of organs with dysfunction (OR = 9.010, 95%CI = 1.140-71.199,P = 0.037), and APACHEⅡ score (OR = 10.001, 95%CI =1.336-74.893,P = 0.025).Conclusions ROSC time, the number of organs with dysfunction, and APACHEⅡ score were independent predictors of PCAS prognosis. Efforts should be given to shorten the rescue time, to shorten the time for restoring the spontaneous circulation, to prevent and treat SIRS after ROSC, and to protect the function of organs, in order to improve the prognosis of patients with PCAS.

Objective To investigate the clinical characteristics of diffuse alveolar hemorrhage. Methods 12 patients with diffuse alveolar hemorrhage hospitalized in Guangzhou NO.1 Hospital were included in the research, whose clinical characteristics were analyzed. Results 7 cases of the 12 diffuse alveolar hemorrhage cases were male and 5 cases were female. 8 cases were caused by ANCA associated vasculitis , 1 cases by connective tissue disease, 1 cases by poisoning, and 2 cases of unknown etiology (medication could be considered). The clinical manifestations were fever (91.67%), hemoptysis (100%), anemia (100%), and dyspnea (3.33%). Conclusion Diffuse alveolar hemorrhage is a life-threatening clinical syndrome. It can be caused by many causes. It should be considered if there is the presence of hemoptysis, dyspnea, anemia, etc. Timely examination and early intervention can effectively improve the prognosis of the disease.

Objective To study the predictive value of acute gastrointestinal injury (AGI) grading system introduced into Sequential Organ Failure Assessment (SOFA) score in patients with severe acute pancreatitis (SAP) in order to provide a reliable clinical tool for the evaluation of prognosis of SAP.Methods Patients with acute pancreatitis admitted to ICU from July 2012 to July 2014 were enrolled for study.The criteria of exclusion were the age below 18 years old,pregnancy,or patients without consent to the treatment.A total of 63 patients with 37 males and 26 females aged (47 ± 15.3) years were included.The data of their acute physiology and chronic health evaluation (APACHE) Ⅱ score,the highest SOFA score and AGI grade within the first week,and the 28-day mortality rate were collected.Patients without AGI were defined as zero point,and AGI grade Ⅰ-Ⅳ were defined as 1-4 points.The receiver operating characteristic curve (ROC) was used to evaluate the value of APACHE Ⅱ score,SOFA score,and SOFA + AGI score in predicting the prognosis of SAP.The areas under ROC curve (AUC) of the APACHE Ⅱ score,SOFA score,and SOFA + AGI score were compared with MedCalc software,and P value less than 0.01 was considered to be statistical significance.Results (1) The 28-day mortality of the 63 patients with SAP was 20.6％ (13/63),in which 50 patients in the survival group,13 patients in the death group.The APACHEⅡ scores of two groups were (15.62 ± 4.33 vs.12.10 ± 3.74,P=0.0048),the SOFA scores were (14.77 ± 3.09 vs.9.24 ± 2.88,P ＜0.01),and the SOFA + AGI scores were (18.77 ±3.09 vs.10.74 ± 3.17,P＜0.01).(2) The AUC of APACHEⅡ score was0.748 ± 0.084 (95％ CI:0.622-0.849),the AUC of SOFA score was 0.902 ± 0.059 (95％ CI:0.801-0.962),and the AUC of SOFA +AGI score was 0.963 ± 0.037 (95％ CI,0.882-0.994);There was no significant difference in AUC between APACHE Ⅱ score and SOFA score (P =0.10),and there was statistical significance between the AUC of APACHE Ⅱ score and that of SOFA + AGI score (P =0.013),and the difference in AUC between SOFA score and SOFA + AGI score was statistically significant (P =0.008).The Youden index and the positive likelihood ratio of SOFA + AGI score system were the greatest to be 0.863 and 15.38,respectively.Conclusions SOFA scoring system has better predictive value in patients with SAP when AGI grading system was introduced into it.

Objective To investigate the localization and distribution of the five endocrine cells in the digestive tract mucosa of ricefield eel(Monopterus albus). Methods Using immunocytochemical technique of strept avidin-biotin-peroxidase complex(SABC) were used. Results At least 5 kinds of immunoreactive endocrine cells distributed in the digestive tract mucosa of M.albus. They were gastrin(Gas),somatostatin(Som),5-hydroxytryptamine(5-HT),insulin(Ins),and neurofilament (NF) immunoreactive endocrine(IRE) cells.Gas and Som-IRE cells distributed between stratified squamous epithelium and goblet cell in esophagus. A large number of Gas-IRE cells were found between gastric fundus epithelium and gastric glands, and only a few in the carcia. Ins, 5-HT and NF-IRE cells distributed in the epithelium pylorus and pyloric glandular tube respectively. No any immunoreactive positive reaction was found in the gut of M.albus.In addition, immunoreactive positive reaction of glucagons was not found in whole digestive tract.All immunoreactive endocrine cells were dark brown in color.Their morphology was irregular, cytoplasmic process was shorter and thicker, their nucleus showed an empty bubble.They distributed between esophageal epithelium and gastric epithelium or glandular epithelium, and cytoplasmic process extended to the gastric lumen and glandular cavity.Conclusion There is a complex endocrine function of the digestive system in ricefield eel (M.albus) at the lowest vertebrate.

Objective To explore the effect of decoction of four-drug juice plus glutamine on nutritional support in the elderly critically ill patients. Methods One hundred and twenty-four elderly critical ill patients in The First Hospital of Jilin University from May 2010 to May 2012 were randomly divided into treatment group(n = 62)and control group(n = 62). Patients in both two groups were given enteral nutrition(EN)plus parenteral nutrition(PN)after the hemodynamics became stable. In addition,patients in control group were given routine EN + PN,while in treatment group was given decoction o four-drug juice + EN plus glutamine + PN. Prealbumin (PA),serum total protein( TP),transferrin( TF)and serum albumin( ALB)were detected before and after treatment of nutritional support. The informations including recovery of bowel sounds,the occurrence of complications,antibiotic use time and the duration of ICU stay were recorded. Results There were no significant differences between two groups in terms of nutrition indices before treatment(P > 0. 05). After treatment,the contents of pre albumin,transferrin,total serum protein,serum albumin in treatment group were( 145. 24 ± 6. 72)g/ L,(1. 93 ± 0. 98)g/ L,(79. 86 ± 10. 38)g/ L,(54. 91 ± 2. 91)g/ L respectively,better than those in control groups((139. 24 ± 38. 76),(1. 68 ± 0. 33),(74. 73 ± 7. 31),(49. 87 ± 2. 61)g/ L),and the differences were statistically significant( t = 3. 610,2. 929,4. 360,6. 767;P < 0. 05). The incidence of stress ulcer and double infection in treatment group were 42%(26 / 62),37%(23 / 62),significantly lower than the control group(59%(37 / 62),53%(33 / 62)),and the differences were statistically significant( χ2 = 5. 186, 5. 271,P < 0. 05). Antibiotic use time and the duration of ICU stay in treatment group were(8. 82 ± 0. 71)d and(16. 14 ± 3. 01)d,and reaching full eternal nutrition time was(6. 90 ± 1. 01)d,decreased less than that in control group((10. 21 ± 1. 30),(20. 67 ± 2. 29),(13. 91 ± 1. 51)d)and the differences were statistically significant(t = 8. 892,7. 786,3. 609,P < 0. 05). The average recovery time of bowel sounds and first anal exhaust time average in treatment group were(26. 8 ± 3. 6)h,(25. 4 ± 3. 2)h,lower than that in control group ((38. 4 ± 4. 8)h,(37. 6 ± 4. 9)h)and the differences were statistically significant( t = 3. 551,2. 516,P< 0. 05). Conclusion The application of decoction of four-drug juice plus glutamine on nutritional support of the elderly critically ill patients can reduce complications,shorten the duration of ICU,recover the intestinal function as soon as possible. Meanwhile,patients can transit to full eternal nutrition as soon as possible,then the cost of therapy is reduced and rehabilitation is quickly.

Objective To improve the stability and practicability of field liquid transfusion control system.Methods SPCE062A 's high accurate AD was used to acquire the dropping speed,and a new method for weight sensor 's self proofread was applied.Results The infrared photoelectric sensor was removed,so the monitoring part could work with any appropriate sensor.Conclusion The system cost is decreased and its stability and availability are enhanced.[Chinese Medical Equipment Journal,2008,29(2):66-67]

BACKGROUND: Permanent or transient implantation of biomaterials can result in biomaterials-centered infections (BCI) in lung cancer patients.OBJECTIVE: To investigate the relationship between BCI and peripheral blood transforming growth factor β1 (TGF-β1) in patients with lung cancer.METHODS: A total of 248 lung cancer patients undergoing in vivo intravascular catheter indwelling > 7 days were included.Quantitative method was used for intubation, bacteriological culture and paired blood culture, and API Staph strips were adopted for positive patients. While enzyme-linked immunosorbent assay was used to detect TGF-β1 levels in the peripheral blood of patients with lung cancer and 75 healthy volunteers as normal controls.RESULTS AND CONCLUSION: Among the 248 patients, there were 82 BCI-positive cases, and 166 BCI-negative cases.Thirteen patients were confirmed to have catheter-related bloodstream infection. There were 48 Gram-positive bacteria, 24Gram-negative bacilli, and 10 fungal. The levels of TGF-β1 were higher in BCI-positive patients than BCI-negative patients (P < 0.05); the levels of TGF-β1 in the BCI-negative group were higher than those in the normal control group (P < 0.05). For lung cancer patients with nosocomial infection induced BCI, there are various species of pathogenic bacteria, and Gram-positive bacteria are more common. To detect TGF-β1 levels in patients with lung cancer is of significance for early prevention of BCI.

Objective To observe the effect of the optimized formulas of extracts of Radix Astragali and Radix Angelicae Sinensis on the survival status of the idiopathic pulmonary fibrosis (IPF) mice,and on the expression levels of transforming growth factor-β (TGF-β) and vascular endothelial growth factor(VEGF),so as to optimize the therapeutic regimen and to explore the therapeutic mechanism.Methods One hundred and five SPF ICR male mice were randomly divided into normal group,model group and 5 Chinese medicine treatment groups (group 1,2,3,4,5 of the optimized formula of Radix Astragali and Radix Angelicae Sinensis extracts).The mice in the model group and the 5 treatment groups were intratracheally injected with bleomycin (5 mg/kg) to induce the pulmonary fibrosis model.On day 21,the lung tissues were taken out for the test.Hydroxyproline content was detected by alkaline hydrolysis method,and morphological changes of lung tissues were observed by hematoxylineosin (HE) staining and Mallory's staining methods.The expression levels of TGF-β and VEGF were detected by polymerase chain reaction (PCR).Results The HE staining and Mallory's staining results showed that the pulmonary fibrosis in the 5 treatment groups was relieved as compared with that in the model group,especially in the group 1,and the alveolar structure recovered better.The 21-day overall death rate in the treatment groups were lower than those in the model group,and group 1 and group 5 had the lowest rates,the difference being statistically significant (P＜ 0.05).Compared with the model group,the content of hydroxyproline in the lung tissues of the treatment groups were decreased to some degrees,and there was significant difference (P ＜ 0.05 or P ＜ 0.01).The expression levels of TGF-β and VEGF in model group were higher than those in normal group,but were deceased in the treatment groups to some degrees,except TGF-β expression in group 5,and the difference was significant(P ＜ 0.05 or P ＜ 0.01).Conclusion When the contents of Radix Astragali water-extract and Radix Angelicae Sinensis alcohol-extract were predominated,the extract formula exerts certain effects on decreasing hydroxyproline content in the lung tissues,inhibiting the expression levels of TGF-β and VEGF,and relieving the degree of pulmonary fibrosis in IPF mice.

AIM:To discuss the effect of Shenmai injection on insulin resistance ( IR) in 3T3-L1 cells and its mechanisms.METHODS:3T3-L1 preadipocytes were induced by chemical reagents to differentiate into fully differentiated adipocytes.Oil red O staining was used to detect the differentiation level of the adipocytes .The insulin-resistant 3T3-L1 cell model was demonstrated using insulin , which was confirmed by glucose concentration in cell supernatant .The IR cell model was given 10 μmol/L rosiglitazone , 25 and 50 g/L Shenmai injection and normal saline for comparison .MTT assay was used to assess the cell activity of 3T3-L1 cells which was treated with drugs for 8, 16, 24 and 36 h.Glucose oxidase method was used to detect the glucose concentration in the cell supernatant at 8, 16 and 24 h.The protein levels of glucose transporter-4 (GLUT4), phosphatidylinositol 3-kinase (PI3K), AKT and p-AKT were determined by Western blot .RE-SULTS:3T3-L1 adipocytes were successfully induced as shown by the positive oil red O staining .The IR cell model was demonstrated , and glucose concentration in the cell supernatant after treatment with Shenmai injection showed that Shenmai injection reduced the IR in 3T3-L1 cell model.The protein levels of GLUT4, PI3K and p-AKT increased compared to con-trol group.CONCLUSION:Shenmai injection reduces the IR in 3T3-L1 cell model, which functions by increasing the protein levels of GLUT4, PI3K and p-AKT.

OBJECTIVETo study trace chemical constituents contained in traditional Chinese medicine Trachelospermum jasminoides.

METHODThe chemical constituents were separated and purified by using such column chromatographic methods as ployamide, silica gel, Sephadex LH-20 and ODS, and their structures were identified on the basis of spectral data analysis.

RESULTEleven compounds were separated from T. jasminoides and identified as bergenin (1), chrysoeriol-7-O-beta-D-glucoside (2), arctigenin-4'-O-beta-gentiobioside (3), matairesinol 4'-O-beta-gentiobioside (4), traxillagenin (5), traxillaside (6), 4-demethyltraxillagenin (7), luteolin-7-O-beta-gentiobioside (8), arctiin (9), trachelogenin-4'-O-beta-gentiobioside (10) and luteolin-7-O-beta-D-glucoside (11).

CONCLUSIONCompounds 1 and 2 were separated from Trachelospermum genus for the first time, while compounds 3-7 were separated from this plant for the first time.