A meta-analysis of the success rates of heartbeat restoration within the platinum 10min among outpatients suffering from sudden cardiac arrest in China

Background:The optimal time to save a person who has had a sudden cardiac arrest is within the first few minutes of the incident.Early compression and early defibrillation should be performed at this time.Timeliness is the key to successful CPR; as such,Prof.He proposed the 'platinum 10 min' system to study early CPR issues.This paper systematically evaluates the success rates of heartbeat restoration within the 'platinum 10min' among patients suffering from sudden cardiac arrest.Methods:The clinical data of outpatients suffering from a cardiac arrest were retrieved from the China Knowledge Network(January 1975-January 2015),the Chongqing VIP database(January 1989-January 2015),and the Wanfang database(January 1990-January 2015).The success of the cardiopulmonary resuscitation(CPR) performed at different times after the patients had cardiac arrests was analyzed.Two researchers screened the literature and extracted the data independently.A meta-analysis was conducted using Stata 12.0.A total of 57 papers met the inclusion criteria,including 29,269 patients.Of these patients,1,776 had their heartbeats successfully restored.The results showed high heterogeneity(χ~2=3428.85,P<0.01,I2=98.4%).The meta-analysis was conducted using a random-effects model.The combined effect size was 0.171(0.144-0.199).Results:1) The success rate of heartbeat restoration did not differ among the four emergency treatment methods that patients received:the methods described in the 2000 Guidelines for CPR and Emergency Cardiovascular Care,that described in the 2005 version,2010 version,and another CPR method.2) The patients were divided into five groups based on the time when CPR was performed:the ?1min group,the 1-5min group,the 5-10 min group,the 10-15 min group and the >15min group.The CPR success rates of these five groups were 0.247(0.15-0.344),0.353(0.250-0.456),0.136(0.109-0.163),0.058(0.041-0.075),and 0.011(0.004-0.019),respectively.The CPR success rates did not differ between the patients in the ?1min group and the 1-5min group.This success rate was higher for the patients in the 1-5min group than those in the 10-15 min group,those in the 10-15 min group,and those in the >15min group.The CPR success rate was higher for the patients in the 5-10 min group than those in the 10-15 min group and those in the >15min group.The CPR success rate was higher for the patients in the 10-15 min group than those in the >15min group.In addition,the patients were divided into two groups based on whether CPR was performed within the first 10 min after the cardiac arrest occurred:the ?10min group and the >10min group.The CPR success rate was higher for the patients in the ?10min group [0.189(0.161-0.218)] than those in the >10min group [0.044(0.032-0.056)].3) Differences were not found between the CPR success rates among the patients in the telephone guidance group [0.167(0.016-0.351)] and those in the ?1min,1-5min,5-10 min,10-15 min,and >15min groups.4) The CPR success rates did not differ among in the patients in the witness + public group [0.329(0.221-0.436)],those in the ?1min group,and those in the 1-5min group.However,this success rate was higher in the patients in the witness + public group than those in the 5-10 min,10-15 min,and >15min groups.Conclusion:The success rate of heartbeat restoration did not differ among patients receiving CPR based on different guidelines.The success rate of CPR lies in its timeliness.The participation of the general population is the cornerstone of improving CPR.Providing complete emergency treatment equipment and perfecting comprehensive measures can improve the success rate of CPR among patients within the platinum 10 min.CPR research in China must be improved.

Pathophysiology of sepsis-induced myocardial dysfunction

Sepsis-induced myocardial dysfunction is a common complication in septic patients and is associated with increased mortality.In the clinical setting,it was once believed that myocardial dysfunction was not a major pathological process in the septic patients,at least in part,due to the unavailability of suitable clinical markers to assess intrinsic myocardial function during sepsis.Although sepsis-induced myocardial dysfunction has been studied in clinical and basic research for more than 30 years,its pathophysiology is not completely understood,and no specific therapies for this disorder exist.The purpose of this review is to summarize our current knowledge of sepsis-induced myocardial dysfunction with a special focus on pathogenesis and clinical characteristics.

Programmed cell death and its role in inflammation

Cell death plays an important role in the regulation of inflammation and may be the result of inflammation. The maintenance of tissue homeostasis necessitates both the recognition and removal of invading microbial pathogens as well as the clearance of dying cells. In the past few decades, emerging knowledge on cell death and inflammation has enriched our molecular understanding of the signaling pathways that mediate various programs of cell death and multiple types of inflammatory responses. This review provides an overview of the major types of cell death related to inflammation. Modification of cell death pathways is likely to be a logical therapeutic target for inflammatory diseases.

Anti-fatigue effects of salidroside in mice

目的将在老鼠学习 salidroside 的反疲劳效果。完全， 120 个正常男 Kunming 鼠标基于身体重量被使随机化进 5 个组(4 个 salidroside 干预组和控制组) 的方法。控制组被给提取的水和组们被给 salidroside 的各种各样的剂量的 4 干预(60， 180， 360， 720 mg/kg ) 为 15 连续的天分别地。层次喂奶，浆液脲氮，肌肉和肝肝糖，最长的游泳时间和血红素在游泳前后被决定测试。结果 salidroside 的不同剂量显著地变长游泳时间并且当减少的时，增加了血红素和肌肉和肝肝糖的内容与控制组相比显著地在血喂奶，特别在 180 mg/kg salidroside 组。结论 Salidroside 在老鼠上有显著反疲劳效果。这些效果是剂量依赖者，并且大多数 biomarkers 上的最强壮的效果与中间的剂量被看见。

Expert consensus on standardized diagnosis and treatment for heat stroke(draft)

Overview Heats stroke(HS)is severe sunstroke caused by a rapid increase in one’s core temperature in excess of 40°C from exposure to a hot and humid environment.HS is accompanied by serious clinical syndromes that damage multiple organ systems.h ese syndromes include burning skin and impaired awareness,such as delir ium,conv ul sions,and loss of consciousness.Exertional heat stroke(EHS)is caused by a rapid increase in one’s core temperature in excess of 40°C from high

Bacterial vaginosis:a synthesis of the literature on etiology,prevalence,risk factors,and relationship with chlamydia and gonorrhea infections

Bacterial vaginosis(BV) is a common vaginal disorder in women of reproductive age. Since the initial work of Leopoldo in 1953 and Gardner and Dukes in 1955, researchers have not been able to identify the causative etiologic agent of BV. There is increasing evidence, however, that BV occurs when Lactobacillus spp., the predominant species in healthy vaginal flora, are replaced by anaerobic bacteria, such as Gardenella vaginalis, Mobiluncus curtisii, M. mulieris, other anaerobic bacteria and/or Mycoplasma hominis. Worldwide, it estimated that 20%–30% of women of reproductive age attending sexually transmitted infection(STI) clinics suffer from BV, and that its prevalence can be as high as 50%–60% in high-risk populations(e.g., those who practice commercial sex work(CSW). Epidemiological data show that women are more likely to report BV if they: 1) have had a higher number of lifetime sexual partners; 2) are unmarried; 3) have engaged in their first intercourse at a younger age; 4) have engaged in CSW, and 5) practice regular douching. In the past decade, several studies have provided evidence on the contribution of sexual activity to BV. However, it is difficult to state that BV is a STI without being able to identify the etiologic agent. BV has also emerged as a public health problem due to its association with other STIs, including: human immunodeficiency virus(HIV), herpes simplex virus type 2(HSV-2), Chlamydia trachomatis(CT) and Neisseria gonorrhoeae(NG). The most recent evidence on the association between BV and CT/NG infection comes from two secondary analyses of cohort data conducted among women attending STI clinics. Based on these studies, women with BV had a 1.8 and 1.9-fold increased risk for NG and CT infection, respectively. Taken together, BV is likely a risk factor or at least an important contributor to subsequent NG or CT infection in high-risk women. Additional research is required to determine whether this association is also present in other low-risk sexually active populations, such as among women in the US military. It is essential to conduct large scale cross-sectional or population-based case-control studies to investigate the role of BV as a risk factor for CT/NG infections. These studies could lead to the development of interventions aimed at reducing the burden associated with bacterial STIs worldwide.

Basic roles of key molecules connected with NMDAR signaling pathway on regulating learning and memory and synaptic plasticity

With key roles in essential brain functions ranging from the long-term potentiation(LTP) to synaptic plasticity,the N-methyl-D-aspartic acid receptor(NMDAR) can be considered as one of the fundamental glutamate receptors in the central nervous system.The role of NMDA R was first identified in synaptic plasticity and has been extensively studied.Some molecules,such as Ca^(2+),postsynaptic density 95(PSD-95),calcium/calmodulin-dependent protein kinase II(Ca MK II),protein kinase A(PKA),mitogen-activated protein kinase(MAPK) and cyclic adenosine monophosphate(c AMP) responsive element binding protein(CREB),are of special importance in learning and memory.This review mainly focused on the new research of key molecules connected with learning and memory,which played important roles in the NMDAR signaling pathway.

Keeping the right time in space: importance of circadian clock and sleep for physiology and performance of astronauts

The circadian clock and sleep are essential for human physiology and behavior; deregulation of circadian rhythms impairs health and performance. Circadian clocks and sleep evolved to adapt to Earth's environment, which is characterized by a 24-hour light–dark cycle. Changes in gravity load, lighting and work schedules during spaceflight missions can impact circadian clocks and disrupt sleep, in turn jeopardizing the mood, cognition and performance of orbiting astronauts. In this review, we summarize our understanding of both the influence of the space environment on the circadian timing system and sleep and the impact of these changes on astronaut physiology and performance.

Septic encephalopathy: When cytokines interact with acetylcholine in the brain

Sepsis-associated encephalopathy(SAE) is a brain dysfunction that occurs secondary to infection in the bo characterized by alteration of consciousness, ranging from delirium to coma, seizure or focal neurological signs. S involves a number of mechanisms, including neuroinflammation, in which the interaction between cytokines a acetylcholine results in neuronal loss and alterations in cholinergic signaling. Moreover, the interaction also occurs the periphery, accelerating a type of immunosuppressive state. Although its diagnosis is not specific in biochemis and imaging tests, it could potentiate severe outcomes, including increased mortality, cognitive decline, progress immunosuppression, cholinergic anti-inflammatory deficiency, and even metabolic and hydroelectrolyte imbalan Therefore, the bilateral communication between SAE and the multiple peripheral organs and especially the immu system should be emphasized in sepsis management.

Autologous transplantation of bone marrow mesenchymal stem cells on diabetic patients with lower limb ischemia

学习骨头髓的自体同源的移植的功效和安全的目的有更低的手足局部缺血的糖尿病的病人上的间充质的干细胞。有更低的手足局部缺血的五十种类型 2 糖尿病的病人被注册并且使随机化到也的方法移植了组或控制组。病人在两个都，组接受了一样的常规治疗。同时，从每个移植病人的 20 ml 骨头髓被收集，并且间充质的干细胞被密度坡度 centrifugation 分开并且在有自体同源的浆液的媒介有教养。在在 vitro 的三星期的支持者文化以后， 7.32 ????????????????? 金 ???????????? ㈠ ?????? ┷？

Progress of safflower (Carthamus tinctorius L.) regeneration through tissue culture

Background: Safflower regeneration through tissue culture has long been limited to low frequency and lack of an efficient protocol that suitable for most safflower cultivars. In past decades, researches had been carried out to investigate safflower regeneration through tissue culture and great progress had been made. Objective: To investigate factors that affect safflower regeneration through tissue culture principally. Methods: This article summarized available literatures about advancements in safflower regeneration, especially discussed factors affecting safflower tissue culture in detail. Results: Safflower regeneration was fairly hard than other congeneric plants, such as chrysanthemum. The genotype, seedling age, type of explants, medium components, plant growth regulators and other additives all had specific influences on safflower tissue culture. More deepgoing researches need to be undertaken to establish an effective safflower regeneration system.

Clinical significance of three dimensional finite element analysis on humerus fracture

Abstract Objective:To treat humerus fracture with three dimensional pattern andfinite element analysis,providing mechanical basis for treating humerus fracture.Methods:Humerus pattern was established based on the CT images,and calculation was done by ANSYS5.6 software.Three dimensional ten-node tetrahe-dron unit was selected and were divided into 2729 nodes,49041 units.Distribution and amount of axial com-pression of humerus were analyzed when clip angle was 30°,45°,90°between facture face and axial line with fixed X,Y,Z directions.Results:The distribution of stress was greatly different between fracture face and non fracture face.Stress in fracture part was fairly concentrated with incomplete symmetric distribution around the center of fracture face;Greater stress distributed in the regions 10 mm from fracture face, which was 2-3 times that of other stress regions.Conclusion:Required load must be estimated under various condi-tions as to select the suitable internal fixation implants during the treatment of humerus fracture,which can provide helpful stress environment for fracture healing.

Medical rescue of naval combat: challenge and future

There has been no large-scale naval combat in the last 30 years. With the rapid development of battleships, weapons manufacturing and electronic technology, naval combat will present some new characteristics. Additionally, naval combat is facing unprecedented challenges. In this paper, we discuss the topic of medical rescue at sea: what challenges we face and what we could do. The contents discussed in this paper contain battlefield self-aid buddy care, clinical skills, organized health services, medical training and future medical research programs. We also discuss the characteristics of modern naval combat, medical rescue challenges, medical treatment highlights and future developments of medical rescue at sea.

Altered expression of mitochondrial related genes in the native Tibetan placents by mitochondrial cDNA array analysis

Objective: To explore the mechanism of native Tibetan fetuses adaptation to hypoxia, we tried to find the different expression genes about mitochondrial function in the native Tibetan placents. Methods: In this study, the placents of native Tibetan and the high-altitude Han (ha-Han) were collected. After the total RNA extraction, the finally synthesized cDNAs were hybridized to mitochondrial array to find the altered expression genes between them. Then, the cytochrome c oxidase 17 (Cox17), dynactin 2 (DCTN2, also known as p50), and vascular endothelial growth factor receptor (VEGFR, also known as KDR) were chosen from the altered expression genes to further verify the array results using the SYBR Green real-time PCR. Because the altered expression genes (such as Cybb and Cox17) in the array results related to the activities of COXI and COXIV, the placental mitochondria activities of COXI and COXIV were measured to find their changes in the hypoxia. Results: By a standard of ≥1.5 or ≤0.67, there were 24 different expressed genes between the native Tibetan and the ha-Han placents, including 3 up-regulated genes and 21 down-regulated genes. These genes were related to energy metabolism, signal transduction, cell proliferation, electron transport, cell adhesion, nucleotide-excision repair. The array results of Cox17, DCTN2 and KDR were further verified by the real-time RT-PCR. Through the mitochondria respiration measurements, the activity of COXI in the native Tibetan placents were higher than that of ha-Han, there was no difference in COXIV activity between them. Conclusion: The altered mitochondrial related genes in the native Tibetan placents may have a role in the high altitude adaptation for fetuses through changing the activity of mitochondrial COX.

Antifungal susceptibility analysis of berberine,baicalin,eugenol and curcumin on Candida albicans

Objective:To analyze the antifungal effects of Chinese herb monomers,i.e.berberine,baicalin,eugenol and curcumin,on Candida albicans.Methods:After Candida albicans strain Y01-09 was incubated for 48 h in YEPD broth which contained different concentrations of Chinese herb components,the cell cycle,fluorescent intensity and the size of cell volume were detected by flow cytometry.Results:The 4 Chinese herb monomers could affect the cell cycle of Candida albicans in different ranges.The ratio of cells in S-G2-M period decreased as the agents concentration increased,indicating that the cell division was inhibited.The fluorescent intensity of Candida albicans cells became weaker after being incubated,which reflected the loss of DNA fragments.The higher the concentration was,the weaker the fluorescent intensity became.The cell size,cell diopter and particle size changed much as the agents concentration increased.Conclusion:Chinese herb monomers play the antifungal role in inhibiting cell division.FCM could be used to determine the susceptibility of antifungal agents.

Relationship between acute stress and sleep disorder in grass-root military personnel:Mediating effect of social support

Background: To explore the relationship between acute stress, social support and sleep disorder in grass-root military personnel, and construct the relational model through structural equation modeling. Methods: A total of 2,411 grass-root military personnel were randomly selected by cluster sampling, and administered the Chinese Military Personnel Sleep Disorder Scale, Military Acute Stress Scale and Social Support Rating Scale.Results: The total score of acute stress scale was positively correlated with the total score and factor scores of sleep disorder scale(r=0.209~0.465, P<0.01); The total score of social support scale was positively correlated with the total score of acute stress scale and the total score and factor scores of sleep disorder scale(r=0.356~0.537, P<0.01). The analysis of mediating effects showed that lack of social support partially mediated between acute stress and the factors of sleep disorder. The analysis of structural equation model showed that acute stress not only had a direct effect on sleep disorder(the path coefficient was 0.29, P=0.000), but also on lack of social support(the path coefficient was 0.39, P=0.000); lack of social support had a direct effect on sleep disorder(the path coefficient was 0.48, P=0.000).Conclusions: Acute stress and lack of social support are two significant factors of sleep disorder in grass-root military personnel. Well-established social support could alleviate sleep disorder induced by acute stress. Lack of social support was a partial mediator between acute stress and sleep disorder.

Measurement of mouse liver glutathione S-transferase activity by the integrated method

Objective: The integrated method was investigated to measure Vm/Km of mouse liver glutathione S-transferase (GST) activity on GSH and 7-Cl-4-nitrobenzofurazozan. Methods: Presetting concentration of one substrate twenty-fold above the others and taking maximum product absorbance Am as parameter while Km as constant, Vm/Km was obtained by nonlinear fitting of GST reaction curve to the integrated Michaelis-Menten equation ln [Am/(Am-Ai)]+Ai/(ε×Km)=(Vm/Km)×ti (1). Results: Vm/Km for GST showed slight dependence on initial substrate concentration and data range, but it was resistant to background absorbance, error in reaction origin and small deviation in presetting Km. Vm/Km was proportional to the amount of GST with upper limit higher than that by initial rate. There was close correlation between Vm/Km and initial rate of the same GST. Consistent results were obtained by this integrated method and classical initial rate method for the measurement of mouse liver GST. Conclusion: With the concentration of one substrate twenty-fold above the others, this integrated method was reliable to measure the activity of enzyme on two substrates, and substrate concentration of the lower one close to its apparent Km was able to be used.

Experimental study on model establishment，mechanism of production，and reverse therapy of gastric mucosal precancerous lesions

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Undergraduate nursing education in the United States

Nursing education in the United States began in the 1870s with hospital training schools modeled after the Nightingale plan. Presently there are three educational paths that students may take to become a registered nurse (RN). These are the baccalaureate degree (BS), the associate degree (AD) and the diploma. Accelerated nursing programs are also available for people who have a baccalaureate degree in another field. Nursing education and nursing practice in the United States is regulated by each of the 50 states. The focus of nursing education is the preparation of nurses who use critical thinking skills to provide comprehensive patient-centered care to a variety of clients. It is expected that nurses will function using evidence-based practice in a culturally competent, safe manner. Nursing schools must be approved by the state in which they exist. In addition to this, most nursing schools are also accredited, a voluntary process that is done by a non-governmental association. All graduates take the same licensing exam, a computer adaptive test that is from 75 to 265 items long. In 2008 almost 120,000 US educated graduates were first time test takers; 85.5% passed the exam. Trends in nursing education include a focus on evidence based practice, an emphasis on safety and quality, patient education and management of chronic conditions, genetics and genomics and the use of simulation in nursing education.

Correlation between blood pressure changes and AMS, sleeping quality and exercise upon high-altitude exposure in young Chinese men

Background: Excessive elevation of arterial blood pressure(BP) at high altitude can be detrimental to our health due to acute mountain sickness(AMS) or some AMS symptoms. This prospective and observational study aimed to elucidate blood pressure changes induced by exposure to high-altitude hypoxia and the relationships of these changes with AMS prevalence, AMS severity, sleep quality and exercise condition in healthy young men.Methods: A prospective observational study was performed in 931 male young adults exposed to high altitude at 3,700 m(Lhasa) from low altitude(LA, 500 m). Blood pressure measurement and AMS symptom questionnaires were performed at LA and on day 1, 3, 5, and 7 of exposure to high altitude. Lake Louise criteria were used to diagnose AMS. Likewise, the Athens Insomnia Scale(AIS) and the Epworth Sleepiness Scale(ESS) were filled out at LA and on day 1, 3, and 7 of exposure to high altitude.Results: After acute exposure to 3,700 m, diastolic blood pressure(DBP) and mean arterial blood pressure(MABP) rose gradually and continually(P<0.05). Analysis showed a relationship with AMS for only MABP(P<0.05) but not for SBP and DBP(P>0.05). Poor sleeping quality was generally associated with higher SBP or DBP at high altitude, although inconsistent results were obtained at different time(P<0.05). SBP and Pulse BP increased noticeably after high-altitude exercise(P<0.05).Conclusions: Our data demonstrate notable blood pressure changes under exposure to different high-altitude conditions: 1) BP increased over time. 2) Higher BP generally accompanied poor sleeping quality and higher incidence of AMS. 3) SBP and Pulse BP were higher after high-altitude exercise. Therefore, we should put more effort into monitoring BP after exposure to high altitude in order to guard against excessive increases in BP.