ABSTRACT
Objective To assess the effect of isosorbide dinitrate on the improvement of cardiac function after cardiopulmonary resuscitation (CPR) by regulating myocardial cells apoptosis..Methods Total of 30 domestic pigs were divided into three groups randomly (random mumber) after anesthetization:the sham group (n=6),the control group (n=12),and the isosorbide dinitrate group (n=12).Cardiac arrest of ventricular fibrillation was induced by programed electrical stimulation in the control and isosorbide dinitrate groups.Isosorbide dinitrate was infused at the rate of 2 μg/(kg·min) in the isosorbide dinitrate group.Coronary perfusion pressure (CPP) and cardiac output (CO) were recorded at baseline,2,6,12 and 24 h after restoration of spontaneous circulation (ROSC).Myocardial enzyme and heart fatty acid binding protein (H-FABP) was tested at the same time points.At 24 h after ROSC,the animals were sacrificed to obtain the myocardium for pathological section and Western blot.The expression of Bcl-2,Bax and activated Caspase-3 were tested and apoptosis was tested by TUNEL and apoptosis index was calculated.Results Right atrial pressure (RAP) increased after ROSC and decreased in the isosorbide dinitrate group compared with the control group (P＜0.05).CPP at 12,24 h after ROSC and CO at 24 h after ROSC in the isosorbide dinitrate group increased significantly compared with the control group (both P＜0.05).HE staining revealed that the injury of myocardial cells was ameliorated in the isosorbide dinitrate group.Apoptosis index of the isosorbide dinitrate group significantly decreased than the control group [(37.8±15.5)％ vs (13.1±0.5)％,P＜0.05].The expression of Bax and activated Caspase-3 decreased while Bcl-2 and Bcl-2/Bax increased after ROSC in the isosorbide dinitrate group compared with the control group (all P＜0.05).Conclusions Isosorbide dinitrate could improve the isehemia/reperfusion injury and cardiac function after ROSC by inhibiting apoptosis regulated with Caspase-3 pathway.
ABSTRACT
Objective To investigate a new mode of training for emergency residents by WeChat,case-based learning (CBL) and team-based learning (TBL).Methods From January to December of 2017,a total of 160 emergency residents with bachelor degree in Beijing Chao-Yang Hospital,whose training time were more than 4 months,were involved in this investigation.Residents in treatment group (n=80) received the training with WeChat,CBL and TBL.In the control group (n=80),the residents received the traditional training protocols.At the end of training,the final examination and satisfactory inquire were done to evaluate the outcomes of treatment.Results The final examination scores of the control and treatment group was 66.4±6.0 and 71.7±4.4 respectively,significant difference was found between the two groups (t=4.012,P=0.012).The satisfactory inquire evaluation of the control and treatment group was 72.5±7.1 and 80.2±3.7,significant difference was found between the two groups too (t=4.764,P=0.001).Conclusions The new training method of WeChat with CBL and TBL can improve the teaching and the satisfactory degree of the emergency residents significantly.