Comparison between two rat models of cardiac arrest: asphyxiation and ventricular fibrillation / 上海交通大学学报（医学版）

Objective·To compare the differences in cardiac function and neurological function between asphyxia and ventricular fibrillation (VF)induced cardiac arrest rat model.Methods·Twenty healthy adult male SD rats were randomly divided into VF group (n=8),asphyxial group (n=8)and sham group (n=4).Cardiac arrest models were established in VF group and asphyxial group by VF and asphyxia respectively.All animals were observed for 24 h and advanced life support was offered for the first 1 h after resuscitation.During the 24 h,ejection fraction (EF) and cardiac output (CO) were measured with the help of cardiac ultrasonography at 1,3,5 and 6 h post resuscitation.Electrocardiographic changes,24 h survival analysis and neurological deficit score (NDS) were also recorded and analyzed at 6,12,18 and 24 h post resuscitation.Results·Both EF and CO decreased dramatically after resuscitation compared with sham group at the same time point (P=0.000).At 1 h post resuscitation,the CO decreased from (98.84±4.86)mL/min to (59.17±22.99) mL/min in VF group and from (99.86±10.34) mL/min to (46,02±22.32) mL/min in asphyxial group,but there was no difference between the two groups (P=0.792).At 3,5 and 6 h post resuscitation,the CO in VF group was higher than that in asphyxial group (P=0.041,P=0.007,P=0.020).At 1 h post resuscitation,the EF decreased from (82.67±6.21)％ to (70.23±13.24)％ in VF group and from (83.24±3.01)％ to (65.46±13.11)％in asphyxial group,but no difference was observed between the two groups (P=0.877).Then a recovery tendency was observed in both groups,but more obvious in VF group at 3 and 5 h post resuscitation (P=0.031,P=0.024).No difference was found between the two groups in survival rate during 24 h and the NDS after resuscitation,although the neurological function was greatly impaired.Conclusion·VF and asphyxia are most commonly used methods to induce cardiac arrest,but these models may differ in cardiac function post resuscitation.Researchers need to choose appropriate models according to their study objectives.

Acute hyperlipidemic pancreatitis in a pregnant woman / 世界急诊医学杂志（英文）

@#BACKGROUND: Acute pancreatitis is a serious complication during pregnancy, however the incidence of hyperlipidemia induced by pancreatitis is lower. METHODS: We treated a pregnant woman with hypertriglyceridemia-associated acute gestational pancreatitis who simultaneously developed hypoxemic acute respiratory failure (ARF). RESULTS: The woman was successfully treated through noninvasive positive pressure ventilation (NPPV), emergent caesarean delivery, drainage of chylous ascites, and peritoneal lavage. CONCLUSION: The signs and symptoms of ARF were greatly improved in this patient after NPPV and conventional therapies. Early NPPV may be related to good prognosis of the disease.

Early tracheotomy for acute severe asthma / 世界急诊医学杂志（英文）

@#BACKGROUND: Few studies have reported the effects of early tracheotomy in acute severe asthmatic patients. We report two patients with acute severe asthma who were successfully treated with early tracheotomy. METHODS: The two patients with acute severe asthma were retrospectively reviewed. They had been treated at the Department of Emergency and Critical Care, Renji Hospital, Shanghai Jiaotong University School of Medicine. RESULTS: They developed progressively hypercapnia and severe acidosis, and were not improved after conventional therapies. Early tracheotomy after mechanical ventilation decreased airway resistance and work of breathing, and corrected hypercapnia and acidosis. Adequate gas exchange was maintained after tracheotomy. The two patients were subsequently weaned from mechanical ventilation and discharged. CONCLUSION: Early tracheotomy could be a valuable approach in certain patients with severe asthma.

Clinical Investigation of the Treatment of Acute Stroke with Atrial Fibrillation: Gap Between Guidelines and Practice / 上海第二医科大学学报

Objective To evaluate the current status of treatment and prophylaxis of ischemic stroke associated with atrial fibrillation(AF),and to assess the opportunities for improvement. Methods Ninty-seven consecutive patients with acute ischemic stroke and AF were evaluated and compared with 173 acute ischemic stroke patients without AF.Medical records were reviewed using a pre-defined questionnaire developed from the guidelines.Functional outcome was measured according to modified Rankin scale. Results The patients with stroke and AF was older than the control group(years vs years,P