Analysis on Legal Relationship Based on a Typical Case of Medical Device Clinical Trial / 中国医学伦理学

Guaranteeing the rights and safety of subjects is an important responsibility of all participants in the medical devices clinical trial, including medical institutions, sponsors and researchers. The legal disputes caused by serious adverse events in the clinical trial of medical devices are characterized by complex legal relationships, great difficulty in handling, and many points of dispute. Based on a typical case of medical device clinical trials, this paper discussed the litigation subject qualification, the treatment of contract breach and tort in medical device clinical trial, analyzed the responsibility of different subjects, and provided constructive suggestions on the risk management of medical device clinical trial.

Analysis for trends in disease burden of congenital birth defects among children under 5 years old in China / 中南大学学报(医学版)

OBJECTIVES@#Congenital birth defects are the main source of disease burden among children under 5 years old in China. This study aims to compare the trends in disease burden of different congenital birth defects among Chinese children under 5 years old from 1990 to 2019, and to provide a scientific basis for strengthening the comprehensive prevention and control of birth defects.@*METHODS@#Based on data from the Global Burden Disease (GBD) in 2019, the incidence mortality rate, and disability-adjusted life years (DALYs) rate of congenital birth defects among Chinese children under 5 years old from 1990 to 2019 were selected as evaluation indicators. The Joinpoint regression model was used to analyze the trends in disease burden of different types with congenital birth defects over three decades. The study also compared the differences in disease burden of congenital birth defects among children under 5 years old by gender.@*RESULTS@#Compared to 1990, the DALYs rates of congenital heart anomalies (1 931.91/100 000), digestive congenital anomalies (364.63/100 000), neural tube defects (277.20/100 000), congenital musculoskeletal and limb anomalies (133.33/100 000), and Down syndrome (128.22/100 000) in children under 5 years old in China in 2019 were decreased 70.78%, 71.61%, 86.21%, 36.84% and 73.65%, respectively. From 1990 to 2019, the mortality rates and DALYs rates of different congenital birth defects showed an overall downward trend, but the incidence of digestive congenital anomalies and Down syndrome showed an upward trend after 2005 and 2001, respectively. Except for congenital musculoskeletal and limb anomalies, incidence of the remaining categories of birth defects were higher in boys than that in girls.@*CONCLUSIONS@#The disease burden of congenital birth defects in children under 5 years old in China is decreased substantially from 1990 to 2019, but the burden of congenital heart anomalies is still serious and the incidence of some birth defect diseases is on the rise, and it is still crucial to strengthen the prevention and treatment for birth defects in children and propose targeted measures according to their gender characteristics.

Epidemiological and clinical characteristics of pediatric lower extremity amputation and functional rehabilitation / 中国康复理论与实践

ObjectiveTo analyze the epidemiological and clinical characteristics of children's lower extremity amputation and amputation rehabilitation, and to explain the causes of children's amputation and the complications after amputation. MethodsFrom January, 2016 to March, 2021, 51 amputation related children were retrospectively analyzed. The correlation between the cause of amputation and complications post amputation were analyzed. ResultsTraumatic amputations accounted for 58.82%, and the main cause was traffic accidents (70%). Amputations caused by diseases accounted for 41.18%, and the main cause was congenital limb deformities (80.95%). Traumatic amputation was more likely to have stump complications than expected (P < 0.05). The possibility of stump complications after disease-specific amputation was lower than expected (P < 0.05). ConclusionTraffic trauma is the main cause of amputation in children and is characterized clinically by a high incidence of unsatisfactory stumps, mainly due to soft tissue abnormalities, and most cases require stump revision to improve the poor residuals for prosthetic restoration of ambulation. Congenital pseudarthrosis of the tibia is the main cause of disease-specific amputation, and the outcome of amputation often cannot be definitely avoided even after long-term limb preservation treatment.

Human Umbilical Cord Mesenchymal Stem Cells Improve the Necrosis and Osteocyte Apoptosis in Glucocorticoid-Induced Osteonecrosis of the Femoral Head Model through Reducing the Macrophage Polarization

Background and Objectives@#Apoptosis is an outstanding determinant of glucocorticoid (GC)-induced osteonecrosis of the femoral head (ONFH). Human umbilical cord mesenchymal stem cells (hUC-MSCs) have been demonstrated to be associated with apoptosis in diseases models. However, the role of hUC-MSCs in GC-induced ONFH via regulating apoptosis still needs further study. @*Methods@#and Results: In the present study, a GC-induced ONFH model was built in vivo through a consecutive injection with lipopolysaccharide (LPS) and methylprednisolone. The necrosis and apoptosis of the femoral head was evaluated by histological and Terminal-deoxynucleoitidyl Transferase Mediated Nick End Labeling (TUNEL) assay. The level of collagen and TRAP positive cells were determined by Masson and TRAP staining, respectively. M1 macrophage polarization was assessed using immunofluorescence assay. The level of proinflammatory cytokines including tumor necrosis factor (TNF)‐α, Interleukin (IL)‐1β and IL-6 of femoral head was determined by enzyme-linked immunosorbent assay (ELISA) kits. The protein expression of AKT, mTOR, p-AKT and p-mTOR was detected using western blot assay. The results showed that hUC-MSCs treatment prominently promoted the GC-induced the decrease of the collagen level and the increase of TRAP positive cells. Besides, hUC-MSCs treatment decreased necrosis and apoptosis, macrophage polarization, the level of TNF‐α, IL‐1β and IL-6, the protein expression of p-AKT and p-mTOR, and the radio of p-AKT to AKT and p-mTOR to mTOR of femoral head in vivo. @*Conclusions@#Therefore, the present study revealed that hUC-MSCs improved the necrosis and osteocyte apoptosis in GC-induced ONFH model through reducing the macrophage polarization, which was associated with the inhibition of AKT/mTOR signaling pathway.

The mechanism of action of Pudilan Xiaoyan oral liquid against LPS-induced acute respiratory infection in mice based on biological network analysis and metabolomics / 药学学报

This study integrates metabolomics and network pharmacology techniques to systematically analyze the possible mechanism of Pudilan Xiaoyan oral liquid (PDL) in the treatment of acute respiratory infections. GC-MS metabolomics analysis found 8 endogenous metabolites, 3-phosphoglycerate, α-aminoadipate, D-ribulose-5-phosphate, β-mannosylglyceric acid, D-fructose, urea, D-maltose and ornithine in the serum of mice with acute respiratory infection induced by LPS; these substances can be used as biomarkers for PDL use in the treatment of acute respiratory infections. Biological network studies revealed 10 potential targets for intervention by PDL in the glycolysis and pentose phosphate pathways, including GPI, G6PD, H6PD, PFKM, TALDO1, TKT, GAPDH, HK1, PKLR and TPI1. All animal experiments were carried out with approval of the Animal Ethics Committee of Nanjing University of Chinese Medicine. Our findings indicate that the strategy of combining metabolomics and network analysis can provide information on the possible mechanism of PDL in acute respiratory infections, and reveal that PDL may ameliorate the pathological process of acute respiratory infections by regulating disordered metabolic pathways.

Gastrointestinal involvement of COVID-19 and potential faecal transmission of SARS-CoV-2 / 浙江大学学报（英文版）（B辑：生物医学和生物技术）

Coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), was found initially in Wuhan, China in early December 2019. The pandemic has spread to 216 countries and regions, infecting more than 23310 000 people and causing over 800 000 deaths globally by Aug. 24, 2020, according to World Health Organization (https://www.who.int/emergencies/diseases/ novel-coronavirus-2019). Fever, cough, and dyspnea are the three common symptoms of the condition, whereas the conventional transmission route for SARS-CoV-2 is through droplets entering the respiratory tract. To date, infection control measures for COVID-19 have been focusing on the involvement of the respiratory system. However, ignoring potential faecal transmission and the gastrointestinal involvement of SARS-CoV-2 may result in mistakes in attempts to control the pandemic.

NK cell exhaustion and NK-based checkpoint blockade immunotherapy / 中国免疫学杂志

As the first line of defense of the host immune system, natural killer cells play important roles in anti-tumor immunity, either by direct anti-tumor effects, or by assisting T cell immune responses. However, NK cells are usually functionally exhausted in tumor microenvironment, accompanied with dysregulated expression of an array of surface receptors, restricting the effector potentials of NK cells. NK-based checkpoint immunotherapy aims to trigger anti-tumor efficacy by blocking NK cell surface inhibitory receptors, unleashing NK cells from inhibitory signals of the tumor microenvironment, and reversing NK cell exhaustion, representing a novel strategy in cancer therapy. With more in-depth research to reveal the mechanisms of action, indications, and biomarkers for specific NK cell checkpoint molecules, we shall fully exploit the potentials of NK-based checkpoint blockade immunotherapy.

Application on imidazolium ionic liquid in extraction of flavonoids from natural products / 中草药

Flavonoids have many physiological and pharmacological activities. Ionic liquids are increasingly used in the extraction of flavonoids from natural products due to their unique properties. In this paper, various extraction methods of natural flavonoids were reviewed and summarized. The effects of anion and cation type, length of carbon chain, and bond cooperation on the extraction of natural flavonoids in ionic liquids, especially imidazole type ionic liquids, were also reviewed. Suggestions on selection of extractant for ionic liquid extraction of flavonoids were given. The advice of the green recovery of ionic liquids and the development of edible ionic liquids for the future direction of development were suggested. This study will lay the foundation for the basic research and industrial application of ionic liquids in the extraction of natural flavonoids.

Qualitative evaluation of Forsythia suspensa by HPLC-PDA fingerprint combined with UFLC-Q-TOF-MS qualitative identification / 中国中药杂志

The analysis of Forsythia suspensa was performed on Waters Symmetry C18 column( 4. 6 mm×250 mm,5 μm) and mobile phase was methanol( A)-0. 1% formic acid aqueous solution( B) with the elution gradient. Column temperature was maintained at 30℃,and the flow rate was 1. 0 m L·min-1 with detection wavelength 265 nm. The HPLC-PDA fingerprint of F. suspensa was optimized.Chemical constituents in F. suspensa were analyzed by UFLC-Q-TOF-MS in positive and negative ion mode. The quality of 48 batches of F. suspensa from different habitats,processing methods and specifications was evaluated by similarity evaluation and cluster analysis.The 18 common peaks were confirmed. The similarity of F. suspensa from different habitats was more than 0. 98,and 56 chemical constituents were identified. Different processing methods had great influence on the quality of F. suspensa. Compared with boiled and direct drying,the quality of F. suspensa processed by sun-drying was obviously decreased. The similarity was about 0. 58. Different specifications of F. suspensa also had obvious distinction,and the similarity was about 0. 78. The effective components of grown F. suspensa,such as forsythoside A and phillyrin,were significantly reduced. The results of cluster analysis were basically consistent with the results of similarity evaluation. The establishment of fingerprint and the recognition of chemical pattern of F. suspensa can provide a more comprehensive reference for the quality control of herbs.

Pb2+-Induced Allosteric PS2.M as A Label-Free Colorimetric Sensor for Detection of Cumulative Radon Radiation / 分析化学

A new sensitive method for detection of cumulative radon radiation based on the lead was established. PS2.M which stabilized by K+with hemin as a co-factor exhibits superior peroxidase-like activity, and can effectively catalyze the H2O2-mediated oxidation of TMB. In the presence of Pb2+, K+-stabilized PS2.M DNAzymes are induced to undergo a conformational change,because Pb2+has a higher efficiency with regard to stabilizing G-quadruplexes than K+, accompanied by a decrease of catalytic activity and a sharp decrease of readout signal. In the work, a novel"turn-off"model of colorimetry-Pb2+biosensor based on superior peroxidase-like activity of G-quadruplex for Pb2+analysis was developed. The fading degree of reaction system (△A value) was linearly related to Pb2+concentration in the range of 5. 0×10-9-1. 8× 10-7mol/L. The linear regression equation was △A=0.36+0.13C (10-8mol/L), with R=0.9987. The detection limits of lead and radon were 3.76 nmol/L(S/N=3) and 1.96×103Bq·h/m3(S/N=3), respectively. The method exhibited good selectivity, high sensitivity and convenient operation, and could avoid the radioactive hazard in determination of the radon in environment.

Simultaneous determination of 9 components in Xiao'er Chiqiao Qingre granules by UPLC / 中国中药杂志

To establish a method for the simultaneous determination of 9 components, namely gardenoside, paeoniflorin, forsythoside A, baicalin, forsythin, glycyrrhizic acid, rhein, honokiol, and magnolol in Xiao'er Chiqiao Qingre granules（XECQ Gra）. Ultra performance liquid chromatography (UPLC) was used on an Acquity UPLC HSS T3 C₁₈ column (2.1 mm×100 mm, 1.8 μm) with 0.1% phosphoric acid acetonitrile (A)-0.1% phosphoric acid solution (B) as mobile phase for gradient elution. The flow rate was 0.3 mL·min⁻¹ ; the column temperature was set at 30 °C, and the determination wavelength was set at 220 nm. All the 9 compounds were well separated, and showed good linear relationship within their concentrations (r>=0.999). The average recoveries were between 95.84%-101.4% and the RSD values were all less than 3.0%. The method is simple, reliable, and accurate, and could be used for the quality control of XECQ Gra.

Cucurbitane-type triterpenoids from the tubers of Hemsleya dolichocarpa / 药学学报

Seven cucurbitane-type triterpenoids were isolated from the ethanol extract of the tubers of Hemsleya dolichocarpa, with a combination of various chromatographic approaches, including silica gel, Sephadex LH-20, Semi-HPLC and so on. On the basis of spectroscopic data analysis, they were identified as 3β,11α,26,27-tetrahydroxycucurbita-5,24(E)-diene-3,26-glucosides (1), scandenogenin D (2), jinfushanencin F (3), scandenoside R3 (4), scandenoside R1 (5), scandenogenin A (6), scandenoside R2 (7). Among them, compound 1 is a new triterpenoid, compound 2 showed remarkable activity against human cancer cell line HeLa with IC50 value of 6.78 μmol·L-1.

Reassessment of Echocardiography for Diagnosing Infectious Endocarditis / 中国循环杂志

Objective:To explore the value of echocardiography for diagnosing infectious endocarditis (IE).Methods:A total of 487 patients with cardiovascular implantable electronic devices (CIED) infection treated in our hospital from 2013-01 to 2015-06 were enrolled.Based on symptoms,blood culture and echocardiography,9 patients with suspected IE were further examined by 18F-FDG PET-CT to confirm their diagnosis and classification.Definitive therapy was conducted and the patients were followed-up for 1 year to confirm the diagnostic accuracy of echocardiography on CIED induced IE.Results:3 patients were preliminarily diagnosed for bacteremia since no vegetation was found by echocardiography,while IE was finally diagnosed by PET-CT.2 patients were preliminarily diagnosed for IE by echocardiography presented valvular vegetation,while PET-CT showed no evidence of vegetation;then one of them was diagnosed as bacteremia by positive blood culture and another was diagnosed as non-infection.4 patients were preliminarily diagnosed for IE by echocardiography indicated existing vegetation after CIED lead extraction,while PET-CT demonstrated no infection sign in heart chamber and the finally diagnosed was as "non-infectious fibrous residual tissue".According to final diagnosis,definitive therapies were performed to specific patients with at least 1 year follow-up study,no one had new and recurrent infection.Conclusion:Echocardiography had deficiency for diagnosing vegetation in heart chamber especially in suspicious IE patients after CIED lead extraction.It is necessary to make accurate diagnosis with other method for guiding appropriate therapy.

Pyruvate substituting lactate dialysis solution peritoneal resuscitation on the effects of hemorrhagic shock rabbit liver function / 实用医学杂志

Objective To observe the influence of direct peritoneal resuscitation on liver function in hemorrhagic shock rabbits with pyruvate peritoneal dialysis solution instead of lactate peritoneal dialysis solution. Methods 48 hemorrhagic shock rabbits were randomly divided into conventional intravenous resuscitation group (group A),intravenous resuscitation plus intraperitoneal injection of lactate peritoneal dialysis solution group (group B),intravenous resuscitation plus intraperitoneal injection of pyruvate peritoneal dialysis group(group C), intravenous pyruvate peritoneal dialysis resuscitation plus intraperitoneal injection of pyruvate peritoneal dialysis group(group D). The hemodynamic changes were observed and the AST and ALT were measured respectively before and 60 min after shock ,60 min and 180 min after resuscitation. The dry/wet weight ratio ,MDA and SOD of liver tissue were measured,and the liver morphological changes were observed. Results After the completion of shock resuscitation,MAP of all groups were almost restored to the basal level. 180 min after resuscitation,the MAP of animals in group A was lowered than that in group B,C and D(P<0.05). After shock,ALT and AST were signifi-cantly higher than those before shock ,but no significant difference was found between groups (P > 0.05). After resuscitation,ALT and AST continued to decline in all groups,but the decline range increased with the order of A, B,C,D group(P < 0.05). The water content and MDA in liver tissue decreased with the order of A,B,C,D group,while the SOD increased and the differences between groups were significant(P<0.05). And the degree of liver tissue morphological injury also relieved correspondingly. Conclusion Pyruvate substituting lactate peritoneal dialysis solution peritoneal resuscitation can be more effective in reducing liver damage of hemorrhagic shock rabbits.

Reassessment of Echocardiography for Diagnosing Infectious Endocarditis / 中国循环杂志

Objective:To explore the value of echocardiography for diagnosing infectious endocarditis (IE).Methods:A total of 487 patients with cardiovascular implantable electronic devices (CIED) infection treated in our hospital from 2013-01 to 2015-06 were enrolled.Based on symptoms,blood culture and echocardiography,9 patients with suspected IE were further examined by 18F-FDG PET-CT to confirm their diagnosis and classification.Definitive therapy was conducted and the patients were followed-up for 1 year to confirm the diagnostic accuracy of echocardiography on CIED induced IE.Results:3 patients were preliminarily diagnosed for bacteremia since no vegetation was found by echocardiography,while IE was finally diagnosed by PET-CT.2 patients were preliminarily diagnosed for IE by echocardiography presented valvular vegetation,while PET-CT showed no evidence of vegetation;then one of them was diagnosed as bacteremia by positive blood culture and another was diagnosed as non-infection.4 patients were preliminarily diagnosed for IE by echocardiography indicated existing vegetation after CIED lead extraction,while PET-CT demonstrated no infection sign in heart chamber and the finally diagnosed was as "non-infectious fibrous residual tissue".According to final diagnosis,definitive therapies were performed to specific patients with at least 1 year follow-up study,no one had new and recurrent infection.Conclusion:Echocardiography had deficiency for diagnosing vegetation in heart chamber especially in suspicious IE patients after CIED lead extraction.It is necessary to make accurate diagnosis with other method for guiding appropriate therapy.

Pyruvate substituting lactate dialysis solution peritoneal resuscitation on the effects of hemorrhagic shock rabbit liver function / 实用医学杂志

Objective To observe the influence of direct peritoneal resuscitation on liver function in hemorrhagic shock rabbits with pyruvate peritoneal dialysis solution instead of lactate peritoneal dialysis solution. Methods 48 hemorrhagic shock rabbits were randomly divided into conventional intravenous resuscitation group (group A),intravenous resuscitation plus intraperitoneal injection of lactate peritoneal dialysis solution group (group B),intravenous resuscitation plus intraperitoneal injection of pyruvate peritoneal dialysis group(group C), intravenous pyruvate peritoneal dialysis resuscitation plus intraperitoneal injection of pyruvate peritoneal dialysis group(group D). The hemodynamic changes were observed and the AST and ALT were measured respectively before and 60 min after shock ,60 min and 180 min after resuscitation. The dry/wet weight ratio ,MDA and SOD of liver tissue were measured,and the liver morphological changes were observed. Results After the completion of shock resuscitation,MAP of all groups were almost restored to the basal level. 180 min after resuscitation,the MAP of animals in group A was lowered than that in group B,C and D(P<0.05). After shock,ALT and AST were signifi-cantly higher than those before shock ,but no significant difference was found between groups (P > 0.05). After resuscitation,ALT and AST continued to decline in all groups,but the decline range increased with the order of A, B,C,D group(P < 0.05). The water content and MDA in liver tissue decreased with the order of A,B,C,D group,while the SOD increased and the differences between groups were significant(P<0.05). And the degree of liver tissue morphological injury also relieved correspondingly. Conclusion Pyruvate substituting lactate peritoneal dialysis solution peritoneal resuscitation can be more effective in reducing liver damage of hemorrhagic shock rabbits.

Effect of pyruvate replacing lactate dialysis solution peritoneal resuscitation on intestinal mucosal barrier of rabbit with hemorrhagic shock / 重庆医学

Objective To observe the effects of peritoneal resuscitation by pyruvate replacing lactate peritoneal dialysis solution on the intestinal mucosal barrier in rabbits with hemorrhagic shock.Methods The hemorrhagic shock model was prepared in 48 healthy male rabbits by adopting the improved Wiggers method.Then the rabbits were randomly divided into the conventional intravenous resuscitation group (group A),conventional intravenous resuscitation plus intraperitoneal injection of lactate peritoneal dialysis solution group (group B),conventional intravenous resuscitation plus intraperitoneal injection of pyruvate peritoneal dialysis solution group (group C) and intravenous pyruvate peritoneal dialysis solution resuscitation plus intraperitoneal injection of pyruvate peritoneal dialysis solution group (group D).The levels of diamine oxidase (DAO) and lipopolysaccharide (LPS) were measured before shock,at 60 min after shock,at 60,180 min after resuscitation.At the end of observation,the ileum tissues were taken from the 5 cm away from the ileocecal region for measuring the dry/wet ratio,malondialdehyde (MDA) level and superoxide dismutase (SOD) activity and their morphological changes was observed.Results There was no statistical difference in the plasma levels of DAO and LPS before shock among the four groups (P＞0.05);which at 50 min after shock were increased,but the comparison among the groups had no statistical difference (P＞0.05);the plasmas levels of DAO and LPS at 60,180 min after resuscitation in the group A,B,C and D were decreased in turn (P＜0.05).The MDA levels of ileum tissues after 180 min of resuscitation in the group A,B,C and D were decreased in turn (P＜0.05),but the SOD activties and tissue dry/wet mass ratios were increased in turn (P＜005),moreover the tissue injury degrees were also relieved in turn.Conclusion The peritoneal resuscitation by pyruvate replacing lactate peritoneal dialysis solution can more effectively protect the intestinal tissue cells and reduce intestinal mucosal damage in hemorrhagic shock rabbits.

Application of Problem-based Learning and Case-based Learning in Course of Outcome Measures in Prosthetics and Orthotics / 中国康复理论与实践

Objective To apply problem-based learing(PBL)and case-based learning(CBL)in course of Outcome Measures in Prosthet-ics and Orthotics.Methods The undergraduate students in Grade 2012 of Prosthetics and Orthotics Engineering in Capital Medical Universi-ty (group A, n=27) were taught in traditional teaching, and those in Grade 2014 (group B, n=25) were taunght with PBL and CBL. Both groups received an immediate test after class,and group B also fulfilled an anonymous questionnaire.Results The score of immediate test was better in group B than in group A(t=-4.972,P<0.001).Most students in group B recognised that the new strategy of learning could im-prove their ability of independent solving clinical problems,literature retrieval,communication and expression.Conclusion Application of PBL and CBL in teaching of Outcome Measures in Prosthetics and Orthotics can promote students'activity in learning and improve teaching quality.

Comparison of the effect of two different ways of cardiopulmonary resuscitation during cardiac arrest / 中国基层医药

Objective To compare the effect of two different types of cardiopulmonary resuscitation (CPR)in cardiac arrest.Methods 150 patients with cardiac arrest were selected.The patients were divided into two groups according to the random number table method,each group in 75cases.The patients in the control group were treated with CPR.The patients in the observation group were treated with CPR machine.The body temperature,hemoglobin concentration,hematocrit,arterial blood gas analysis and resuscitation were compared between the two groups after 10min and 30min.Results There were no statistically significant differences in body temperature,hemoglobin and hematocrit between the control group and the observation group at 10min and 30min after CPR (t10min =1.44,2.01,1.23,t30min =1.69,1.81,1.02,all P ＞ 0.05).There were no statistically significant differences in PaCO2 between the two groups at 10 min and 30 min after resuscitation (t =1.54,1.02,all P ＞ 0.05).The arterial blood pH[(7.02 ±0.14)],PaO2 [(16.29 ± 4.38) kPa],HCO3 [(5.66 ± 1.73) kPa] and SaO2 [(0.84 ± 0.05) ％] of the control group recovered 30 min were significantly lower than recovered 10 min (t =7.14,6.55,6.20,7.03,all P ＜ 0.05).The arterial blood pH[(7.11 ± 0.1)],PaO2 [(18.36 ± 4.55) kPa],HCO3 [(6.34 ± 2.15) kPa],SaO2 [(0.86 ±0.04) ％] of the observation group recovered 30 min were significantly lower than recovered 10 min (t =6.75,6.21,6.01,6.60,all P ＜0.05).The arterial blood pH,PaO2,HCO3 and SaO2 of the observation group were significantly higher than those in the control group at 10 min and 30 min,the differences were statistically significant (t10min =6.03,7.34,7.88,6.10,t30min =6.21,8.20,7.10,6.11,all P ＜ 0.05).The effective rate of CPR in the observation group was 69.33％,which was significantly higher than 46.67％ in the control group,the difference was statistically significant (x2 =9.34,P ＜ 0.05).Conclusion Compared with artificial heart and lung resuscitation,CPR machine is more effective for patients with heartbeat respiratory arrest.It is more effective in cycling support and can improve the efficacy of CPR and is worthy of clinical application.

Diagnostic of serum tumor markers for colon cancer assessed with logistic regression analysis and PLS-DA model / 重庆医学

Objective To investigate the diagnostic value of serum tumors M2 pyruvate kinase (TuM2-PK),carcino-embryonic antigen (CEA),CA199,CA724,CA125 and CA242 in colon cancer.Methods Serum levels of TuM2-PK,CEA,CA199,CA724,CA125 and CA242 in 231 patients with colon cancer,105 patients with colon benign lesion diseases and 166 normal controls were measured by the ELISA and electrochemiluminescence assays.The operation working characteristic curve (ROC) and the logistic regression-ROC were used to evaluate the diagnostic value of tumor markers for colon cancer individually and in combination.The models of logistic regression analysis and partial least-squares discriminant analysis (PLS-DA) were established to diagnose patients with colon cancer based on the optimal panel of serum tumor markers.Resalts Concentrations of serum TuM2-PK,CEA,CA199,CA125 and CA724 in the colon cancer group are higher than those in the colon benign diseases group and the normal controls (P＜0.05).The area under the operation working characteristic curve (AUC) of CA199 is the highest 0.79 [95％ confidence interval (95％CI),0.75-0.83] at the cutoff value of 69.5 U/L with 64.1％ of sensitivity and 89.7％ of specificity.The AUC of combined serum tumor markers based on logistic regression analysis is higher than those in individuals,of which serum (CEA+ CA199+TuM2-PK) is the optimal [AUC=0.89,95％ confidence interval(95％CI),0.86-0.92].The diagnostic accuracy of logistic analysis and PLS-DA model for colon cancer is 82.7％ and 77.5％,and for colon cancer is 93.7％ and 95.6％,respectively.Conclusion The combination of serum tumor markers CEA,CA199 and TuM2-PK is more suitable as a diagnostic model for the screening of colon cancer.