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Out-of-hospital cardiac arrest (OHCA) with high mortality and disable rate is a public health problem of common concern all over the world. In order to improve the survival rate of OHCA, developed countries such as Europe and the United States have established regional and even national OHCA registration database for continuous monitoring and quality improvement of OHCA, identifying the weaknesses in each link of the survival chain, and evaluating effective measures to enhance the survival rate. At present, China still lacks of registration database that can comprehensively collect the information of OHCA and effectively reflect the treatment status and research direction of OHCA. In order to shorten the huge gap of OHCA survival rate between China and developed countries such as Europe and the United States, we should learn from the experience of foreign registration databases and establish OHCA registration database suitable for China's national conditions, so as to promote the improvement of OHCA survival rate in China. This paper presents several major OHCA registry databases of the internationally recognized, such as cardiac arrest registry to enhance survival (CARES), resuscitation outcomes consortium (ROC), European registry of cardiac arrest (EuReCa), Pan-Asian resuscitation outcomes registry (PAROS), and Australian resuscitation outcome consortium (Aus-ROC), aims to provide a reference for promoting the construction of the cardiac arrest registration database in China.
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Objective@#To explore the application and effect of the cancer case management led by cancer case managers in the whole processing management of nasopharyngeal carcinoma (NPC) patients.@*Methods@#A randomized controlled study was designed. 510 patients with nasopharyngeal carcinoma were randomly divided into two groups: the observation group (255 cases) and the control group (255 cases). The observation group adopted the case management led by cancer case managers, and the control group adopted the cancer case management. To evaluate the rate of seeing a doctor, the implementation rate of the treatment plan and the rate of the first follow-up visit between the two groups. M.D. Anderson symptom Inventory-head-neck (MDASI-H&N) was used to evaluate the symptom disturbance (the day of hospitalization, the period of radiotherapy and chemotherapy, 1 months after discharge and 6 months after discharge).@*Results@#The treatment rate was 90.2% (230/255) in the observation group, 78.04% (199/255) in the control group, The rate of implementation of established treatment plans 99.57% (229/230) in the observation group and 90.95% (181/199) in the control group. The first follow-up rate was 98.70% (227/230) in the observation group and 84.42% (168/199) in the control group. The difference was statistically significant (Z=19.768, 15.207, 7.042, P < 0.01). In the observation group, the average value of symptom disturbance, the average severity of symptom distress and the average degree of symptom disturbance in 3 times (the period of radiotherapy and chemotherapy, 1 months after discharge and 6 months after discharge) were (3.00±0.95) , (2.43±0.16) , (2.03±0.34) , (2.95±0.97) , (2.46±0.12) , (2.11±0.16) , (2.89±0.46) , (2.41±0.33) , (1.99±0.16) ; Significantly lower than the control group (3.69±1.51) , (2.82±0.23) , (2.42±0.13) , (3.88±1.39) , (2.87±0.34) , (2.54±0.22) , (3.61±0.75) , (2.72±0.42) , (2.38±0.17) , the difference has the statistical significance (t=-21.152—10.372, P < 0.01).@*Conclusion@#The case management led by cancer case manager can effectively improve the rate of seeing a doctor, the rate of completion of the plan and the rate of the first visit, and ensure the patients to receive effective, standard and full treatment in time. In addition, the case management can effectively improve the symptoms of patients and promote their early return to the community.
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<p><b>OBJECTIVE</b>To observe the effects of moxibustion on Treg/Th17 imbalance and related signal pathway in mice with rheumatoid arthritis (RA), so as to explore the action mechanism of moxibustion on RA.</p><p><b>METHODS</b>Twenty-four DBA/1J male mice were randomly divided into a normal group, a model group, a sham moxibustion group and a moxibustion group, 6 mice in each one. RA model was induced by subcutaneous injection of typeⅡcollagen and adjuvant at tail in mice other than the normal group. The mice in the moxibustion group were treated with moxibustion at"Zusanli" (ST 36) and "Shenshu" (BL 23), 1 mg per cone, 6 cones per acupoint. The consecutive 6-day treatment was taken as one course, and totally 2 courses were given with an interval of 2 d between courses. The mice in the sham moxibustion group were treated with immobilization as the moxibustion group. The effects of moxibustion on joint swelling was evaluated by RA scale of collagen induced arthritis (CIA); the pathological changes of joint inflammation were observed by HE staining; the cell count of Th17 and Treg in spleen was analyzed by flow cytometry; the content of cytokine IL-1β, IL-6, IL-10, IL-17, IL-23, TGF-β and Galectin-9 were analyzed by ELISA; the mRNA and protein expression of Foxp3, Galectin-9, RORγt, CARMA1, NF-κB were analyzed by Real-time PCR and Western Blotting method.</p><p><b>RESULTS</b>Ten to 12 d after the secondary immune, red and swelling of ankle joint, feet and toe joint were observed, indicating successful establishment of RA model. 15 d into moxibustion treatment, the joint swelling was improved in the moxibustion group and the sham moxibustion group, which was superior in the moxibustion group (<0.05). As for pathological changes, compare with the normal group, the articular surface was rougher and synovial layer thinner in the model group, which was recovered to a certain extent in the sham moxibustion group; the articular surface was smooth and synovial layer was thicker in the moxibustion group, which was similar to the normal group. The results of flow cytometry test indicated the cell count of Treg in the model group was reduced but that of Th17 was increased than the normal group (both<0.01); the moxibustion could increase significantly the cell count of Treg (<0.05), but no effect was observed on Th17 (>0.05). The results of ELISA test indicated the differences of increasing of IL-1β, IL-6, IL-17, IL-23, TGF-βas well as the reducing of IL-10 were not significant between the sham moxibustion group and the moxibustion group (all>0.05); moxibustion treatment could increase the content of Galectin-9 which was reduced in RA mice (<0.05). The results of RT-PCR and Western blotting test indicated the mRNA and protein expression of Foxp3, Galectin-9 were reduced in the model group (all<0.01), which could be up-regulated by moxibustion treatment (<0.05,<0.01); the mRNA and protein expression of RORγt, CARMA1, NF-κB was increased (all<0.01), which could be down-regulated by moxibustion treatment (<0.05,<0.01).</p><p><b>CONCLUSION</b>Moxibustion could improve the swelling of joint and inflammatory reaction of joint synovial in RA mice; the mechanism may be related to the regulation of Treg cells number in spleen and the expression of Foxp3, Galectin-9, RORγt, CARMA1, NF-κB, mRNA and protein expression.</p>
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Objective To observe the therapeutic effects of exercise combined with tiotropium bromide and salmeterol/fluticasone inhaling on stable chronic obstructive pulmonary diseases (COPD).Methods Sixty COPD patients with pulmonary function Ⅲ-Ⅳ grade were randomly allocated into experiment group and control group (30 cases in each group).The patients in experiment group were treated with inhaled tiotropium bromide and salmeterol/fluticasone combined with excise,while the patients in control group were treated only with inhaled tiotropium bromide and salmeterol/ fluticasone.Respiratory training with shrinkage lip respiration and steps training was given to the patients in experiment group for 8 weeks.Main outcome measures included forced expiratory volume in one second (FEV1),FEV1,in the anticipation value (FEV1%),FEV1/forced vital capacity (FVC),Medical Research Council (MRC) score,activities of daily living (ADL) score and 6-minute walking distance (6MWD).Results MRC score in control group and experiment group was both lower than that of pre-treatment (P < 0.01).ADL score,6MWD and pulmonary functional parameters in both groups were improved than those of pre-treatment (P< 0.01).FEV1,FEV1%,FEV1/FVC,MRC score,ADL score and 6MWD were (1.41 ±0.25) L,(53.76 ±11.17)%,(62.12 ±10.78)%,(1.56 ± 1.16) scores,(5.51 ±0.18) scores and (342.7 ± 19.7) m after treatment in experimentgroup,and (1.28 ± 0.23) L,(46.27 ±8.85)%,(55.76 ±8.57)%,(2.29 ±1.13)scores,(4.47 ±0.13)scores and (280.6 ± 17.8)m after treatment in control group.There were significant differences between two groups (P<0.05).Conclusion Tiotropium bromide,salmeterol/ fluticasone inhaling can improve life quality and pulmonary functional parameters in patients with stable COPD,while exercise combined with that can significantly enhance the therapeutic effects.
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Objective To develop a conductance-ion chromatography for simultaneous determination of 5 anions in drinking water. Methods The orthogonal experiment method L9(34) was used to select the optimum working conditions of IC-2000 ion chromatography. Under the founded chromatography condition, 5 anions in water samples were determined simultaneously after filtered with 0.45 ?m filter membrane. Results Both of the precision and accuracy of this method were desirable, all the relative standard deviation was less than 5.0%, the rates of recovery were 90%-106.7%, the correlation coefficient was more than 0.999 except NO2-(0.990 5). Conclusion This method is simple, accurate, quick and suitable for simultaneous determination of 5 anions in drinking water with no need of sample pretreatment.