Objective To investigate the resuscitation outcome after a short period of mild hypothermia in porcine model of prolonged ventricular fibrillation (VF).Methods Fourteen male healthy domestic swine weighting 34 to 36 kg were used.VF was induced electrically and maintained untreated for 11 mins,followed by manual cardiopulmonary resuscitation (CPR) procedure.Two investigators initiated chest compression and bag-valve mask ventilation in pattern of 2 min rotation.A biphasic wave of 120 J electric defibrillation (ED) was attempted 6 mins after CPR.If there was no return of spontaneous circulation (ROSC),CPR was restored and ED was delivered when necessarily.Resuscitation was considered unsuccessful if absence of ROSC for 12 mins.However,if ROSC occurred,animals were randomly (random number) diveded into normothermia (NT) group and hypothermia treatment (CH) group.Animals in CH group were immediately cooled by using intravenous infusion of ice-cold saline and surface cooling.Core temperature was reduced to 32-34 degrees centigrade within 120 mins and maintained at this level for 2 h.Active rewarming was completed within 2 h until baseline body temperature was reached.Data of hemodynamic variables,blood-gas analysis and blood lactate before VF of two groups were recorded.Meawhile,cardiac output (CO),heart rate and Tc after ROSC were recorded.Neurological defect scores (NDS) were evaluated every 24 h until 96 h after ROSC.Variables were compared using either Fisher test or repeated measures analysis of variance,followed by Bonferroni for multiple comparisons.A two-sided P value ＜0.05 was regarded statistically significant.Results There was no significant difference in body weight,mean arterial pressure,CO,pH,pressure of end-tidal carbon dioxide (ETCO2) and lactate between groups before VF.In the period of CPR,there were also no significant difference in total resuscitation time,first shock success rate,ROSC rate,shock ROSC rate,total number of shock and doses of epinephrine.However,animals in CH group survived longer time than that in NT groups [(96.00 ± 0.00) hvs.(49.71 ±43.65) h,P=0.031].Meanwhile,the survival rate of 96 h was significantly higher in CH than that in NT (P ＜ 0.05).For neurological function,there was a obviously better NDS in CH group than that in NT group within ROSC 96 h (P ＜ 0.05).Conclusion Even a short duration of 2 hour mild hypothermia could improve resuscitation outcome in porcine model of 11 minute VF.

Objective To study the effects of mild hypothermia on cardiomyocyte contractility improvement after ischemia-repeffusion injury and on the preservation of well-functioning mitochondrial respiratory capability.Methods A total of 50 newborn SD rats 1 ～ 2 days after delivery were sacrificed and their hearts taken to preserved in 4 ℃ cold D-hanks buffer solution with 0.12％ pancreatic proteinase and collagenase and then processed with 37 ℃ water bath to collect the cardiomyocytes cultured in DMEM medium with 10％ FBS for 5 days.The cardiomyocytes of rats were subjected to ischemia/reperfusion,in vitro,by oxygen and glucose deprivation(OGD)/oxygen and glucose restoration(OGR).The cardiomyocytes of rats after ischemia/reperfusion were divided into three groups:control group,hypothemia group and normothermia group.Contractile frequency and velosity were determined before OGD and 0 h,0.5h,1 h,1.5 h and 2 h after OGR.Ultrastructure changes of cardiomyocytes and mitochondrion were observed under transmission electron microscope(TEM)0 h and 2 h after OGR as well as assessment ot respiratory rate and respiratory control rate(RCR)with Clark oxygen electrode in each group.All data were analyzed with statistical software of SPSS 13.0.Results Contractile function of cardiomyocytes in hypothermia group and normothermia group declined to nadir at 0 h after OGR(P =0.000)and the contractile function of cardiomyocytes in hypothermia group was improved one hour later,compared with the normothermia group(P =0.000).Obvious swelling of mitochondrion was observed under TEM in normothermia group with little alteration after OGR.The RCR assessments indicated respiratory function in normothermia group was impaired after OGR(P =0.000)and this may be responsible for contractility dysfunction.Conclusions Mild hypothemia used after ischaemia can optimize the contractility of cardiomyocytes after a normothermia OGR,and the well-functioning respiratory capability of mitochondrion may be preserved in this process.

Objective:To observe the therapeutic efficacy of somatostatin combined with compound salvia miltiorrhiza injection(复方丹参注射液)on patients with acute pancreatitis(AP).Methods:By using randomized controlled trail,62 patients with AP were divided into control group(31 cases) and observation group(31 cases) in a period from June,2002 to December,2006.In the control group,routine measures,such as forbidding food,decompressing stomach and intestines,were taken,and in addition,intravenous injection of somatostatin 250 ?g with subsequent intravenous drip 3 000 ?g in normal saline 500 ml at a rate of 250 ?g/h once everyday was used for 7-14 days.On the above treatment of the control group,compound salvia miltiorrhiza injection 20 ml in normal saline 250 ml,intravenous drip every day for 7-14 days,was added in the observation group.The disappearance of symptoms and abdominal signs,amylase of urine and blood,the time of recovery of hepatic function,change of calcium concentration,incidences of multiple organ dysfunction syndrome(MODS) and case fatality were observed and compared.Results:Amylase of blood after treatment in observation group was lower than that in the control group,while serum calcium concentration was higher,especially on 3 and 5 days after treatment(all P

AIM: To investigate the protective effect of ulinastatin on rats with hemorrhagic shock. METHODS: A prospective, controlled animal study was designed. The model of hemorrhagic shock in rats was produced by Chaudry method. After 60 min, rats were resuscitated by transfusion of shed blood and normal saline, but a half of them were treated with ulinastatin. At different time points after reperfusion, the levels of tumor necrosis factor-alpha (TNF-?), interleukin-6 (IL-6), malondialdehyde (MDA) and superoxide dismutase (SOD) in serum were detected. RESULTS: The levels of TNF-?, IL-6 and MDA significantly increased and the activity of SOD decreased. In the ulinastatin-treated groups, the blood pressure and heart rate were obviously improved; the levels of TNF-?, IL-6 and MDA significantly decreased and the activity of SOD had little change after hemorrhagic shock and reperfusion. CONCLUSION: Ulinastatin has a protection effect on rats with hemorrhagic shock by suppressing the production of inflammatory factors and reducing oxidative damage.

Objective To evaluate the effect of prophylactic intra-aortic balloon pump (IABP) on reduction of the incidence of major adverse cardiovascular events (MACE) occurred during perioperativeperiod.Methods A total of 246 high-risk patients with AMI admitted from October 2013 through October 2016 were divided into two groups:prophylactic IABP group (n =144) and remedial IABP group (n =102).The likely complications associated with IABP were observed such as dissecting aneurysm,thrombocytopenia,lower extremity thrombosis,anemia,hematoma at puncture site.The comparison of postoperative heart failure,cardiogenic shock and refractory arrhythmia,and nosocomial death between two groups was carried out.The difference in length of time for treatment with IABP between two groups was compared.Statistical analysis of measurement data expressed in (x) ± s using independent sample t test.Countdata expressed in percentage were compared with chi-square test.Non-normal distribution data were checked with median ± interquartile range.P ＜ 0.05 for the difference was concerned statistically significant.Results Gensini score was higher in prophylactic IABP group (t =2.311,P ＜ 0.05).In remedial IABP group,the operative time was longer (t =2.626,P ＜ 0.05),the higher rate of using therapeutic medicine was significant (x2 =60.105,P ＜0.01),the no reflow rate was higher (x2 =19.920,P ＜0.01),the amount of contrast agent used was greater (t =2.437,P ＜ 0.05),the in-hospital incidence of heart failure was higher (x2 =31.638,P ＜ 0.01),the rate of nosocomial postoperative cardiogenic shock was higher (x2 =7.793,P ＜0.01),and the number of in-hospital death increased (x2 =4.827,P ＜ 0.05).Compared with prophylactic IABP group,higher BNP (t =7.44 7,P ＜ 0.05),and lower LVEF (t =3.557,P ＜ 0.05)were found in remedial IABP group.Conculsion Prophylactic employment of IABP for the treatment of high-risk AMI patients effectively improved the survival rate and reduced peri-opearative MACE.

Peripheral exudative hemorrhagic chorioretinopathy (PEHCR) is a peripheral retinal disease characterized by subretinal hemorrhage and/or subretinal pigment epithelial hemorrhage or exudation. It is often misdiagnosed as age-related macular degeneration, polypoidal chorioretinopathy or choroidal melanoma. With the development of multimodal imaging, PEHCR has different features under different examinations, such as B-scan ultrasound, fluorescein fundus angiography, optical coherence tomography and so on, which contributes to differention from other diseases. Clinical treatments for the disease include intravitreal injection of retinal photocoagulation therapy, anti-vascular endothelial growth factor, pars plana vitrectomyand so on, but there is still no universal consensus. In order to gain a deeper understanding of the clinical features, treatment options and prognosis of PEHCR, minimize missed diagnoses and misdiagnoses, and improve treatment efficiency, further research is required.

BACKGROUND AND OBJECTIVEAdenoid cystic carcinoma is primary bronchopulmonary carcinoma with low malignancy, and 43 patients treated in the past 50 years in our hospital were retrospectively studied. The aim of this study is to discuss the clinical symptoms, pathologic characteristic and therapeutic method of primary tracheal or bronchuotracheal adenoid cystic carcinoma.

METHODSThis study summarized total 43 patients of primary tracheal or bronchus adenoid cystic carcinoma treated in our hospital from Jan. 1958 to Dec. 2007. Among them, 40 patients were treated by surgical resection, and 3 patients were treated by fiberoptic bronchoscope's interventional treatment.

RESULTSThe 1-yr, 3-yr, 5-yr survival rates of the 43 patients above were 100% (41/41), 89.5% (34/38), 87.1% (27/31), respectively.

CONCLUSIONPrimary tracheal or bronchus adenoid cystic carcinoma are rare and low malignancy carcinoma. The clinical symptoms of them are not typical. The best treatment is early detection and taking measures of operation plus radiotherapy. The other palliative treatment is fiberoptic bronchoscope's interventional treatment.

Adult ; Aged ; Bronchial Neoplasms ; diagnosis ; mortality ; surgery ; Carcinoma, Adenoid Cystic ; diagnosis ; mortality ; surgery ; Female ; Humans ; Male ; Middle Aged ; Prognosis ; Tomography, X-Ray Computed ; Tracheal Neoplasms ; diagnosis ; mortality ; surgery

Objective:To analyze the diagnostic value of transvaginal two-dimensional ultrasound and three-dimensional ultrasound volume imaging (3DVI) technology for intrauterine adhesions.Methods:A total of 120 suspected patients with intrauterine adhesions admitted to Beijing Tongzhou District Maternal and Child Health Hospital from July 2022 to June 2023 were selected as the research subjects. All patients underwent transvaginal two-dimensional ultrasound and 3DVI technology examination, and the diagnostic value of vaginal two-dimensional ultrasound and 3DVI technology single examination and combined examination was compared based on the results of hysteroscopy examination as the gold standard; Comparison of ultrasound parameters between the intrauterine adhesions group and the non intrauterine adhesions group, as well as patients with different degrees of intrauterine adhesions [endometrial thickness (ED), endometrial volume (EV), vascular index (VI), blood flow index (FI), vascular comprehensive index (VFI)].Results:Among 120 suspected patients with intrauterine adhesions, 104 cases were positive in hysteroscopy examination, with a positive rate of 86.67%. Among them, 50 cases were mild, 36 cases were moderate, and 18 cases were severe. 76 cases were positive in vaginal two-dimensional ultrasound examination, with a positive rate of 63.33%; 79 cases were positive for 3DVI technology examination, with a positive rate of 65.83%; The combined examination results of vaginal two-dimensional ultrasound and 3DVI technology were positive in 87 cases, with a positive rate of 72.50%. The sensitivity, specificity, positive predictive value, and negative predictive value of vaginal two-dimensional ultrasound examination were 68.27%, 68.75%, 93.42%, and 25.00%, respectively. The 3DVI technique examination was 73.08%, 81.25%, 96.20%, and 31.71%, respectively. The combined examination was 83.65%, 100.00%, 100.00%, and 48.48%, respectively. The sensitivity, specificity, positive predictive value, and negative predictive value of the combined examination were all higher than those of vaginal two-dimensional ultrasound examination (all P<0.05). 104 cases in the intrauterine adhesions group and 16 cases in the non intrauterine adhesions group; The ED, EV, VI, FI, and VFI of the intrauterine adhesions group were lower than those of the non intrauterine adhesions group (all P<0.05). The differences in ED, EV, and VI among patients with different degrees of intrauterine adhesions were statistically significant (all P<0.05); The ED, EV, and VI in the moderate group were lower than those in the mild group (all P<0.05), while the ED, EV, and VI in the severe group were lower than those in the mild and moderate groups (all P<0.05), and the FI was lower than those in the mild group ( P<0.05). Conclusions:Transvaginal two-dimensional ultrasound combined with 3DVI technology has high diagnostic value for intrauterine adhesions and can be used to evaluate the degree of intrauterine adhesions.

Objective:To translate the Treatment Burden Questionnaire (TBQ) into Chinese, and test its reliability and validity.Methods:The original questionnaire was translated, synthesized and back-translated according to the Brislin model. From March to July 2021, convenience sampling was used to select 240 elderly people from the 6 designated nursing homes for the aged of Qingdao Municipal Medical Insurance Bureau as the research object to conduct a questionnaire survey. The content validity index ( CVI) and construct validity were used to evaluate the validity of the scale, and the construct validity was evaluated by exploratory factor analysis. Cronbach's alpha coefficient and test-retest reliability were used to test the reliability of the scale. Results:A total of 240 questionnaires were distributed in this study, and 220 valid questionnaires were recovered. The Chinese version of TBQ included 15 items. A total of three common factors were extracted by exploratory factor analysis, and the cumulative variance contribution rate was 58.15%. The item-level CVI of the Chinese version of the TBQ was from 0.80 to 1.00, and the scale-level CVI was 0.91. The Cronbach's α of the total scale was 0.71, and the test-retest reliability coefficient was 0.77. Conclusions:The Chinese version of the TBQ has good reliability and validity, and can be used to assess the treatment burden in the elderly under the Chinese cultural background.

Objective To investigate the influence mechanism of Cordyceps sinensis (CS) on β-glycerophosphate-induced vascular smooth muscle cell (VSMC) calcification.Methods The effect of CS on VSMC cell viability was detected by CCK-8.The cellular models of rat VSMC calcification were established by treating with β-glycerophosphate (β-GP,10 mmol/L);then CS (10 mg/L),autophagy inhibitor 3-methyladenine (3-MA,5 mmol/L),and AMPK inhibitor compound C (CC,10 μmol/L) were added to the cell cultures.There were a total of 5 experiment groups:VSMC cultured in normal medium (Control),VSMC treated with β-GP,VSMC treated with β-GP and CS,VSMC treated with 3-MA,β-GP and CS,and VSMC treated with CC,β-GP and CS.The calcium nodules and calcium content were examined with alizarin red S staining and the O-cresolphthaleincomplexone method,respectively.The autophagosomes within the VSMC were observed using transmission electron microscope (TEM).Immunofluorescence showed the accumulation of microtubule-associated protein 1 light chain 3 (LC3) puncta.In addition,levels of osteogenic related proteins,autophagy related proteins,and AMPK/mTOR pathway related proteins were evaluated by Western blotting.Results CS increased the number of autophagosomes and the accumulation of LC3 puncta within VSMC.It also upregulated the protein levels of LC3 Ⅱ/LC3 Ⅰ,beclin1,α-SMA,and p-AMPK;whereas,the protein levels of Runx2 and p-mTOR,as well as calcium nodules and calcium content were reduced (all P ＜ 0.01).When the cells were pretreated with 3-MA before treating with β-GP and CS,the autophagosomes,accumulation of LC3 puncta,and protein levels of LC3 Ⅱ/LC3 Ⅰ,beclinl,and α-SMA were decreased (all P ＜ 0.01);however,the protein level of Runx2,and the calcium nodules and calcium content were increased (all P ＜ 0.01).Nevertheless,when the cells were pretreated with CC before giving β-GP and CS,the autophagosomes,the accumulation of LC3 puncta,and the expression levels of p-AMPK,LC3 Ⅱ/LC3 Ⅰ,beclin1,and α-SMA were significantly down-regulated (all P ＜ 0.01);whereas,the expression levels of Runx2 and p-mTOR,as well as calcium nodules and calcium content were increased (all P ＜ 0.01).Conclusions CS can effectively alleviate β-GP-induced VSMC calcification,which may be due to the activation of autophagy by AMPK/mTOR signaling pathway.