OBJECTIVE: To compare the effects of different chest compression rates (60-140 times/min) on hemodynamic parameters, return of spontaneous circulation (ROSC), resuscitation success, and survival in a porcine model of cardiac arrest (CA) followed by cardiopulmonary resuscitation (CPR). METHODS: Forty healthy male domestic pigs were randomly divided into five groups based on chest compression rate: 60, 80, 100, 120, and 140 times/min (n = 8). All animals underwent standard anesthesia and tracheal intubation. A catheter was inserted via the left femoral artery into the thoracic aorta to monitor aortic pressure (AOP), and another via the right external jugular vein into the right atrium to monitor right atrial pressure (RAP). In each group, animals were implanted with a stimulating electrode via the right external jugular vein to the endocardium, and ventricular fibrillation (VF) was induced by delivering alternating current stimulation, resulting in CA. After a 1-minute, manual chest compressions were performed at the assigned rate with a compression depth of 5 cm. The first defibrillation was delivered after 2 minutes of CPR. No epinephrine or other pharmacologic agents were administered during the entire resuscitation process. From 1 minute before VF induction to 10 minutes after ROSC, dynamic monitoring of AOP, coronary perfusion pressure (CPP), and partial pressure of end-tidal carbon dioxide (P_ETCO₂). Cortical ultrastructure was examined 24 hours post-ROSC using transmission electron microscopy. RESULTS: With increasing compression rates, both the total number of defibrillations and cumulative defibrillation energy significantly decreased, reaching their lowest levels in the 120 times/min group. The number of defibrillations decreased from (4.88±0.83) times in the 60 times/min group to (2.25±0.71) times in the 120 compressions/min group, and energy from (975.00±166.90)J to (450.00±141.42)J. However, both parameters increased again in the 140 times/min group [(4.75±1.04)times, (950.00±207.02)J], the differences among the groups were statistically significant (both P < 0.01). As compression frequency increased, P_ETCO₂, pre-defibrillation AOP and CPP significantly improved, peaking in the 120 times/min group [compared with the 60 times/min group, P_ETCO₂ (mmHg, 1 mmHg≈0.133 kPa): 18.69±1.98 vs. 8.67±1.30, AOP (mmHg): 95.13±7.06 vs. 71.00±6.41, CPP (mmHg): 14.88±6.92 vs. 8.57±3.42]. However, in the 140 times/min group, these values declined significantly again [P_ETCO₂, AOP, and CPP were (10.59±1.40), (72.38±11.49), and (10.36±4.57) mmHg, respectively], the differences among the groups were statistically significant (all P < 0.01). The number of animals achieving ROSC, successful resuscitation, and 24-hour survival increased with higher compression rates, reaching a peak in the 120 times/min group (compared with the 60 times/min group, ROSC: 7 vs. 2, successful resuscitation: 7 vs. 2, 24-hour survival: 7 vs.1), then decreased again in the 140 times/min group (the animals that ROSC, successfully recovered and survived for 24 hours were 3, 3, and 2, respectively). Transmission electron microscopy revealed that in the 60, 80, and 140 times/min groups, nuclear membranes in cerebral tissue were irregular and incomplete, nucleoli were indistinct, and mitochondria were swollen with reduced cristae and abnormal morphology. In contrast, the 100 times/min and 120 times/min groups exhibited significantly attenuated ultrastructural damage. CONCLUSIONS Among the tested chest compression rates of 60-140 times/min, a chest compressions frequency of 120 times/min is the most favorable hemodynamic profile and outcomes during CPR in a porcine CA model. However, due to the wide spacing between groups, further investigation is needed to determine the optimal compression rate range more precisely.
Animals ; Cardiopulmonary Resuscitation/methods* ; Swine ; Male ; Heart Arrest/therapy* ; Heart Massage/methods* ; Hemodynamics

Objective:To explore the clinical characteristics and genetic etiology of a child with Spondyloocular syndrome (SOS) in order to enhance the awareness and understanding of this disease.Methods:A 3.5-year-old boy with SOS who had presented at the Department of Medical Genetics of Hunan Children′s Hospital on August 10, 2023 due to the repeated fractures for over 2 years and after binocular cataract surgery was selected as the study subject. Clinical data of his pedigree were collected, and peripheral venous blood samples were collected for the extraction of genomic DNA and subjected to trio-whole exome sequencing. Candidate variants were verified by Sanger sequencing and analyzed with bioinformatic software. This study was approved by the Medical Ethics Committee of Hunan Children′s Hospital (No. KYSQ2022-263).Results:The child had manifested repeated fractures, bilateral bowed femur, osteoporosis, cataract, atrial septal defect, and developmental delay. Ultrasonography has revealed fetal edema, peritoneal effusion, pleural effusion and polyhydramnios. Trio-whole exome sequencing and Sanger sequencing revealed that he has harbored compound heterozygous variants of the XYLT2 gene, namely c. 1103_1104delAG (p.Gln368Argfs*8) and c. 1238_1253delinsA (p.Val413_Pro418delinsGlu), which were inherited from his phenotypically normal father and mother, respectively. Neither variant was reported previously. Based on the guidelines from the American College of Medical Genetics and Genomics (ACMG) and recommendations from the Clinical Genome Resource (ClinGen), the c. 1103_1104delAG was predicted as a pathogenic variant (PVS1+ PM2_Supporting+ PP4), whilst the c.1238_1253delinsA was predicted as a likely pathogenic variant (PM4+ PM3+ PM2_Supporting+ PP4). Conclusion:The c. 1103_1104delAG and c. 1238_1253delinsA compound heterozygous variants of the XYLT2 gene probably underlay the pathogenesis in this child. Above finding has enriched the phenotypic and mutational spectrum of SOS, and provided a basis for the clinical diagnosis, treatment, prognosis assessment and genetic counseling for this pedigree.

Objective:To explore the effect of preoperative rehabilitation management based on enhanced recovery after surgery (ERAS) in patients with gynecological tumor surgery.Methods:Using the convenience sampling method, 80 patients with gynecological tumor surgery who were admitted to the First Affiliated Hospital of Wenzhou Medical University from January to May 2020 were selected as the control group, and 82 patients who underwent gynecological tumor surgery from January to May 2021 were selected as the observation group. The control group was treated with conventional ERAS program, and the observation group received preoperative rehabilitation management on the basis of the control group. The postoperative rehabilitation indicators (time of getting out of bed, time of exhausting and defecation, occurrence of complications) , depression and satisfaction with medical treatment were compared between the two groups.Results:The time of first getting out of bed, the time of exhausting, the time of defecation and the total complication occurrence of the observation group were lower than those of the control group, and the differences were statistically significant ( P<0.05) . The postoperative depression of the observation group was lighter than that of the control group, and the difference was statistically significant ( P<0.05) . There was no significant difference in patient satisfaction between the two groups ( P>0.05) . Conclusions:The implementation of ERAS-based preoperative rehabilitation management for gynecological tumor surgery patients is conducive to promoting postoperative recovery and reducing depression in patients.

Objective:To observe the therapeutic effect of echinacoside (ECH) on liver injury and glucose metabolism disorder in sepsis rats induced by cecal ligation and puncture (CLP), and to explore its possible mechanism.Methods:Forty eight male Sprague Dawley (SD) rats were randomly divided into four groups: sham group (sham), model group (CLP), treatment group (CLP+ ECH) and inhibitor group (CLP+ ECH+ EX527). The sham group only received laparotomy, and the model group underwent CLP. The treatment group was intragastric administration of echinacea (30 mg/kg) every day after CLP modeling. The inhibitor group was injected with silence information regulator 1 (SIRT1) inhibitor EX527 (5 mg/kg) one hour before CLP, and then treated the same as the treatment group. Fasting blood glucose, insulin and serum biochemical indexes were detected in virous groups. The serum levels of interleukin (IL)-1 β, IL-6 and tumor necrosis factor-α(TNF-α) were detected by enzyme-linked immunosorbent assay (ELISA). 2′, 7′- dichlorofluorescein diacetate (DCFH-DA) staining was used to observe the production of reactive oxygen species (ROS) in liver tissue of rats in each group; hematoxylin-eosin (HE) staining was used to observe the pathological changes of liver tissue in each group; The expressions of SIRT1, glucose-6-phosphatase (G6Pase), phosphoenolpyruvate carboxykinase (PEPCK), phosphorylated signal transducers and activators of transcription 3 (p-STAT3) and phosphorylated protein ki-nase B(p-AKT) were detected by Western blot.Results:Compared with sham group, the levels of serum glucose, serum insulin, alanine aminotransferase (ALT), aspartate aminotransferase (AST), ROS, IL-1β, IL-6 and TNF-α in model group increased, while the liver glycogen and survival rate decreased (all P<0.05). After echinacoside treatment, the serum glucose, serum insulin, ALT, AST, ROS , IL-1β, IL-6 and TNF-α levels decreased, and the liver glycogen and survival rate increased (all P<0.05); After SIRT1 inhibitor intervention, the levels of serum insulin, ALT, AST, IL-6 and ROS in the inhibitor group increased ( P<0.05). HE staining showed that there were infiltration and necrosis of inflammatory cells in the liver tissue of model group, and echinacoside could significantly reduce the focal and massive necrosis; Western blot showed that compared with the sham group, the expression levels of SIRT1, p-STAT3 and p-AKT protein in the model group decreased, while the expression levels of G6Pase and PEPCK protein increased ( P<0.05); After echinacoside treatment, the expression levels of SIRT1, p-STAT3 and p-AKT increased, while the expression levels of G6Pase and PEPCK decreased ( P<0.05). After SIRT1 inhibitor intervention, the expression of SIRT1, p-STAT3 and p-AKT protein decreased, and the expression of G6Pase and PEPCK protein increased in the inhibitor group ( P<0.05). Conclusions:Echinacoside is a potential therapeutic agent for sepsis associated liver injury and glucose metabolism disorders, which may play a role by targeting SIRT1 to activate STAT3 and AKT in the liver.

Objective:To explore the effect of evidence-based quality control circle activities in improving the implementation rate of enhanced recovery after surgery in gynecological tumor surgery.Methods:Gynecological tumor surgery patients admitted to the First Affiliated Hospital of Wenzhou Medical University were selected as the research object from January to March 2018 and September to December 2018, respectively. A total of 80 patients before the quality control circle activities from January to March 2018 were used as the control group, and the conventional enhanced recovery program was adopted. A total of 78 patients after the quality control circle activities from September to December 2018 were taken as the observation group, and the enhanced recovery program was implemented based on the evidence-based quality control circle. The implementation rate of enhanced recovery after surgery, postoperative rehabilitation indicators, and hospitalization satisfaction of the two groups of patients were compared.Results:The total implementation rate of the 8 enhanced recovery after surgery in observation group was 86.9% (542/624) , which was higher than 62.2% (398/640) of control group. The total incidence of complications in observation group was 6.4% (5/78) , which was lower than 22.5% (18/80) in control group. The early ambulation time, exhaust time, and hospitalization time of observation group were shorter than those of control group, and the hospitalization satisfaction of observation group was higher than that of control group. The above differences were statistically significant ( P<0.05) . Conclusions:Evidence-based quality control circle activities can standardize the practice standards for enhanced recovery, facilitate the development of enhanced recovery after surgery for gynecological tumor surgery, and promote postoperative recovery of patients.

Objective To clarify the diagnostic value of salivary gland ultrasonography in Sj(o)gren's syndrome (SS),and its correlation with the disease activity index and important organs involvement were analyzed.Methods A total of 116 patients with SS were involved,including 71 cases of primary SS and 45cases of secondary SS.Ultrasonography examination of major salivary glands was conducted for these patients,at the same time the clinical data including inflammatory parameters,the immunological parameter and the involved systems were collected.Ultrasonography examination was conducted in 49 cases as the control group.Use t test,x2test and analysis of variance for statistical analysis.Results The positive rate of salivary gland uhrasonography in SS (56/116,48.3％) was significantly higher than that of the normal control groups (1/49,2.0％),(The chi-square value was 32.57,P＜0.05),the sensitivity of salivary gland ultrasonography in primary SS (62.0％) was obviously higher than secondary SS (27％),(The Chi-square value was 13.75,P＜0.01).The specificity of salivary gland ultrasonography was 98％.The scores of salivary gland ultrasonography had shown positive correlation with the erythrocyte sedimentation rate,the levels of Immunoglobulin (Ig)G,and RF(r=0.234,0.353,0.176;P=0.002,0.000,0.013),and negative correlation with the white blood cell count (r=-0.292,P=0.000).Conclusion Salivary gland ultra-sonography provides additional evidence for the diagnosis of SS,particularly in primary SS groups.The scores of ultrasonography are correlated with inflammatory biomarkers,indicating that salivary gland ultrasonography is related to disease activity.

Objective To assess the efficacy and safety of propofol sedation for gastrointestinal endoscopy,we conducted a Meta-analysis of randomized controlled trials (RCT) comparing propofol with traditional sedative agents.Methods Referring Cochrane Collaboration search strategy to develop retrieval in Medline,Web of Science,Wanfang and CNKI database to retrieve the anesthetic propofol and traditional agents in the literature for randomized controlled trials of gastrointestinal endoscopy,surgery and assess their recovery effect.Results Twenty-one original RCTs investigating a total of 1 765 patients,of whom 894 received propofol only and 871 received traditional sedative agents only,met the inclusion criteria.Research showed that compared with traditional anesthetics,no significant differences existed in anesthetic effects of propofol on gastrointestinal endoscopy surgery time.However,surgery can significantly shorten recovery time and the average discharge time; and higher recovery rates.The result of racial subgroup analysis showed:the anesthetic propofol can significantly shorten the time of gastrointestinal endoscopy surgery for Asian populations,but had little effect on the European population.Contrast method for subgroup analysis showed:anesthetic propofol could significantly shorten the ERCP angiography in gastrointestinal endoscopy surgery time,but has little effect on the UGE and colonscopy angiography.Conclusions Propofol is safe and effective for gastrointestinal endoscopy procedures and is associated with shorter endoscopy recovery and discharge time,higher post-anesthesia recovery scores.Care should be taken when extrapolating our results to specific practice settings and high-risk patient subgroups.

Objective:To improve the sensitivity and the linear range of electrochemical immunosensor to detect Schistosoma japonicum (S.japonicum) antibody.Methods:Carbon inks and silver/silver chloride inks were printed on a polyethylene terephthalate (PET) board to make a two-electrode test strip,where carbon was the working electrode and S.japonicum soluble egg antigen (SEA) was fixed at one end of working electrode by different methods; silver/silver chloride electrode was used as control.We tested the valency of the antibody by cyclic voltammetry (CV) and differential pulse voltammetry (DPV) in an electrochemistry workstation,and conducted comparison with the results of ELISA.Two new immunosensing electrodes have been developed,based on glutaraldehyde cross-linked (GA) or chitosan-glutaraldehyde cross-linked (Chit-GA) transducer fixing S.japonicum antigen.We tested the titer of the antibody by means of CV and DPV.Results:Our experimental S.japonicum antigen (50 μg/L) is the optimal test concentration for the GA sensor,and 10 μg/L for Chit-GA sensors.The immune reaction time of both electrodes is all essentially complete in 1 minute.The linear range for S.japonicura antibody in human positive serum sample detection by the glutaraldehyde cross-linked immunosensor is 1∶1000 to 1∶400,and by the chitosan-glutaraldehyde cross-linked immunosensor is 1∶1000 to 1∶500.As the concentration of dilution ratio of S.japonicum antibody in human positive serum sample increased,the test value of DPV increased proportionally.Conclusion:GA sensor and Chit-GA cross-linked S.japonicum sensors have high sensitivity and broad linear range response,and both exhibited a good linear relationship between the DPV signal and the test antibody titer.

Objective To prepare the infected Oncomelania hupensis by artificial method for the research on the activity, vaccine, and genetic variation of Schistosoma Japonicum (S. Japonicum).Methods The mature eggs of S. Japonicum were collected by Nylon silk method and the miracidia were incubated under appropriate conditions. Negative snails were infected with miracidia in different proportion by means of individual or collective infection to seek the best method and proportion of infection between miracidia and snails. Infected snails were divided into 12 groups in total. Ⅰ-Ⅵ groups were for individual infection and Ⅶ-Ⅻ groups were for collective infection. There were 200 snails in each group. The infection ratios between snails and miracidia in Group Ⅰ-Ⅵ or screened, numbered, and reared singly. The amount of cercariae was calculated once every 10 days until the infected snails died. Then cercariae shedding quantity, infection quantity, and mortality of infected snails in every group were compared to find the best infection method and the best infection proportion between miracidia and snails. The cercariae were collected from the first generation of infected snails and were used to infect experimental animals. The mature eggs of S. Japonicum were saved from the infected experimental animals and incubated to get miracidia. The snails were artificially infected by miracidium to get the second generation of infected snails. The developmental rates of adult worms, the egg density in fecal and liver were compared between artificially and naturally infected snails. Results In individual infection GroupⅠ-Ⅵ,the average infection value of snails were 0±0,22.7±4.2,31.7±4.5,53.0±5.3,39.3±5.9,32.7±4.7,the average fatality of snails were 21.7±3.1,25.0±3.6,31.3±4.9,44.7±6.5,78.3±9.5,89.7±13.6, and the average value of cercariae shedding from infected snails were 0.0±0.0,308.0±96.6,428.1±146.2,527.0±171.1,571.4±148.9,602.9±356.3, respectively. In collective infection Group Ⅶ-Ⅻ,the average infection value of snails were 0±0,12.3±2.5,18.7±4.7,28.3±4.2,33.3±4.7,29.3±5.5,and the average fatality of snails were 22.7±3.8,23.7±4.5,28.3±5.5,47.0±9.5,75.7±8.5,86.3±12.2, and the average value of cercariae shedding from infected snails were 0±0,244.5±57.3,292.3±74.8,347.1±100.8,477.2±142.1,447.3±161.4, respectively. The second generation of artificially infected snails was obtained successfully. The average infection rate and fatality rate for the second generation of artificially infected snails were 24.65% and 24.50%, both of which were not obviously different from that of the first generation of artificially infected snails (P>0.05). In the animal experiment, the worm growth rate for the naturally infected snails, the first or second generation of artificially infected snails were 68.50%,73.50% or 71.00%. There was no obvious difference among them (P>0.05). The fecal (or liver) eggs per gram for the naturally infected snails, the first or the second generation of artificially infected snails were 1 503±269,1 683±233, or 1 541±117 (or 6 641±1 819,6 272±1 419, or 7 263±1 643). There was no significant difference among the 3 groups (P>0.05). Conclusion Infected snails can be obtained through the artificial method by using S. Japonicum miracidia to infect snails. Individual infection has the advantage over collective infection. The optimal proportion of infection between first and the second generation of artificially infected snails in the average of cercariae shedding, infection, and fatality average of snails. There was no significant difference between artificially and naturally infected snails in the developmental rate of adult worms, fecal and liver eggs per gram.

Objective To study the function of ventrolateral medulla (VLM) in the treatment of rabbit myocardial ischemia by electroacupuncture at Neiguan point. Methods On the basis of the protection of rabbits against acute myocardial ischemia by electroacupuncture at Neiguan point,the action potential of rabbit's ischemic myocardial cell was observed after the VLM was blocked with Naloxone. Results Compared with the sham operation group, acute myocardial ischemia group and sham VLM block group,the ST segment potential remarkably increased and MAPA, MAPD_~50 ,MAPD_~90 significantly decreased in VLM block group. There were statistic significance(P