ABSTRACT
OBJECTIVE: Out-of-hospital cardiac arrest (OHCA) studies are usually conducted at metropolitan medical centres. Because rural studies are rare, our study aimed to assess non-traumatic OHCA prevalence and resuscitation outcomes in rural Taiwan. DESIGN: A retrospective observational study. SETTING: All seven designated community hospital emergency departments (ED) in Nantou County, Taiwan. PARTICIPANTS: All OHCA patients from May 2011 to March 2013. MAIN OUTCOME MEASURES: Any return of spontaneous circulation (ROSC) and survival for ED discharge. RESULTS: In the 23-month period, 850 OHCA cases were reported; 741 (87.2%) were non-traumatic. The overall ROSC achievement rate was 19.7%, with 16.4% case survival for ED discharge. Logistic regression identified that arrest in public (OR: 2.62, 95% CI: 1.19-5.78), witness when collapsed (OR: 2.14, 95% CI: 1.28-3.60), and cardiopulmonary resuscitation (CPR) by bystander (OR: 2.09, 95% CI: 1.02-4.26) might increase the likelihood of any ROSC; arrest in public (OR: 2.68, 95% CI: 1.10-6.50), witnessed collapse (OR: 2.26, 95% CI: 1.24-4.09) and CPR by bystander (OR: 2.79, 95% CI: 1.28-6.05) might also increase the likelihood of survival. For non-traumatic OHCA patients conveyed to EDs via emergency medical service system (EMS), a shorter response time (OR: 1.09, 95% CI: 1.01-1.18) and travelling time (OR: 1.04, 95% CI: 1.00-1.09) might also increase the chance of survival. CONCLUSION: Compared to previous data from metropolitan areas, ROSC achievement rate was lower in rural Taiwan. Witness presence, response and travelling times affect ROSC achievement in non-traumatic OHCA patients in rural Taiwan.
Subject(s)
Cardiopulmonary Resuscitation/statistics & numerical data , Emergency Medical Services/statistics & numerical data , Out-of-Hospital Cardiac Arrest/epidemiology , Rural Health Services/statistics & numerical data , Adult , Aged , Aged, 80 and over , Female , Humans , Logistic Models , Male , Middle Aged , Prevalence , Retrospective Studies , Taiwan/epidemiologyABSTRACT
BACKGROUND: This study provides in vitro and in vivo evaluation of Astragalus membranaceus (AM) on peripheral nerve regeneration. METHODS: In the in vitro study, we analyzed the effects of AM on cell differentiation and neurite outgrowth by using a PC12 cell model. In the in vivo study, silicone rubber chambers filled with the AM water extract were used to bridge a 10-mm sciatic nerve defect in rats. RESULTS: We found that the AM water extract caused a marked enhancement of the nerve growth factor-mediated neurite outgrowth and the expression of growth-associated protein 43 from PC12 cells. Animals from the groups treated with the AM for 8 weeks had a relatively more mature structure with larger mean values of myelinated axon number, endoneurial area, and total nerve area when compared with those in the controls receiving the saline only. CONCLUSION: These results suggest that the silicone rubber tubes present a good framework for the nerve fibers to regenerate across the gap, and the AM extract can be a potential nerve growth-promoting factor, being salutary in aiding the growth of axons in the peripheral nerve.