BACKGROUND:No international reports had shown that statins were effective for the treatment of vascular cognitive impairment. However, Chinese studies concerning effects of statins on vascular dementia had a smal sample size, so no definite conclusion was obtained.
OBJECTIVE:To perform a meta-analysis on effects of statins on vascular cognitive impairment, the methods recommended by the Cochrane Col aboration were used.
METHODS:The databases such as China National Knowledge Internet, Wanfang, VIP, Chinese Biological and Medical Database and PubMed Medline were searched by computer and manual y for randomized control ed trials about the effect of statins on vascular cognitive impairment. Retrieval time was from foundation to January 2013. The studies were screened according to the inclusion and exclusion criteria and then the data were extracted. The methodological quality of included studies was assessed and meta-analysis was performed by Revman 5 software.
RESULTS AND CONCLUSION:This study final y included 15 randomized control ed trials, a total of 1 203 patients, including 616 in statins group and 587 in control group. The fixed and random effect models were used to analyze mini-mental state examination and activity of daily living scales including 14 scoring method and the Barthel index score. Compared with the control group, mini-mental state examination scores in the patients of statins group (14 randomized control trials, 1 112 patients) were, mean difference (MD)=3.02, 95%confidence interval (CI):2.26 to 3.77, P<0.000 1;activity of daily living scores (14 scoring method, 7 randomized control ed trials, 513 patients) were, MD=-4.14, 95%CI:-6.11 to-2.18, P<0.000 1;the Barthel index scores (2 randomized control ed trials, 171 patients) were, MD=11.62, 95%CI:9.78 to 13.46, P<0.001. Our study mentioned a total of 14 cases of adverse reactions. One case was in control group, and the other 13 cases were in statins group which were al caused by atorvastatin. There were no serious adverse reactions in statins group and the rate of adverse reactions was 2.1%. The current evidence suggested that statins can improve cognitive function in patients with vascular cognitive impairment, with good safety. However, further conclusion stil requests higher quality of randomized control ed trials.

Objective To observe the results of 45 cases with acquired immunodeficiency syndrome(AIDS) genotypic viral resistance test(GT) assay.Method The technitues provided by AB Applied Biosystem was used to check the mutations in the reverse transcriptase associated with significant viral resistance.Results Fourteen cases out of 40(35%)cases which failed from first line regimen showed resistance to both zedovudine(ZDV) and lamivudine(LMV),and 26 cases out of 40(65%) cases showed resistance to ZDV or lamivudine used in the first line.For no-nucleoside reverse transcriptase in habitor(NNRTIs),11 cases out of 40(27%) cases had resistance to nevirapine(NVP),29 cases out of 40(63%) cases showed resistance to both NVP and efairavir(EFV).Two cases out of 5 which failed from second line regimen showed that one drug from both first and second line had no resistance,so it still could be used in the new regimen.Conclusion GT assay is very useful for choosing a best and personalized regimen for AIDS patients.

Objective To study the correlation between laryngopharyngeal reflux (LPR) and voice disorders . Methods One hundred and three patients with reflux -related symptoms were recruited .The patients were evalu-ated with reflux symptom index (RSI) ,reflux finding score (RFS) evaluation and 24-hour dural-probe pH moni-toring .Eighty -nine cases with voice disorders were divided into 5 groups :vocal process granuloma (n=18) chron-ic pharyngolaryngitis (n=19) ,vocal polyps (n=15) ,vocal fold leukoplakia (n=21) and Reinke's edema (n=16) . The other 14 patients without voice disorders were the control subjects .Results According 24-hour dural -probe pH monitoring assessments ,48 .3% of the patients with voice disorders showed LPR positive .The positive rate in the vocal fold leukoplakia group (71 .4% ) and Reinke's edema group (75 .0% ) were significantly higher than the control group (35 .7% ) .RSI and RFS of the patients with Reinke's edema were both significantly higher than the control group(P=0 .020 ,P=0 .009) .RSI of the patients with chronic pharyngolaryngitis were significantly higher than the control group (P=0 .019) .The acid reflux episodes ,acid reflux time which except in the supine position of the vocal fold leukoplakia group were significantly higher than the control group .The acid reflux episodes ,acid ex-posure and acid reflux time which all except in the supine position of the Reinke's edema group were significantly higher than the control group .Conclusion The correlations between Reinke's edema ,vocal fold leukoplakia and LPR were stronger .In these two groups ,the acid reflux episodes were higher and acid reflux times were longer .

OBJECTIVE To investigate the bacterial distribution and the extent of drug resistance in ICU patients,and offer the first-hand information to the clinical preventive and therapeutic countermeasures. METHODS The antimicrobial susceptibility tests to 28 commonly used antibiotics were performed using the ATB Expression of Bio-Merieux with K-B method.The ESBLs were detected by the disk diffusion tests and the confirmatory tests,and the MRSA,MRCNS,and VRE were also tested at the sametime. RESULTS Totally 264 strains were isolated from the 201 positive samples,among them 192 strains were Gram-negative bacteria,43 strains were Gram-positive ones,and 29 strains were fungi.The percentage of these three groups were 72.7%,16.3% and 11.0%,respectively.The main strains of the Gram-negative bacteria were PAE,ABA,KPN,ECO and SMA,and of the Gram-positive bacteria were EC,SAU and CNS.The major strain of fungi was C.albicans.The pathogens tested showed high drug resistance.The Gram-negative bacteria showed tendency of sensitivity to IPM,AZT,CAZ,FEP,SFC,AMK and CIP,and the Gram-positive bacteria to VAN,SXT,RIF and NIF.For KPN and ECO,the percentage of strains producing ESBLs were 64.7% and 64.3%.And the percentage of MRSA,MRCNS,VRE were 80%,66.7% and 22.2%,respectively. CONCLUSIONS It was showed that the major pathogens infected the ICU patients are Gram-negative bacteria,and the pathogens show the high drug resistance.Doctors should pay more attention to analyze the bacterial resistance profile in order to decrease the incidence of drug resistance and use the antibiotics properly.

OBJECTIVE:To study the chemical compositions of n-butabol extract from Solanum lyratum. METHODS:Glucan LH-20 column chromatography,silica gel column chromatography and TLC were adopted to separate and purity the chemical com-positions,physicochemical property and spectral evidence to identify their structures. RESULTS:Totally 10 chemical compositions were separated from n-butabol extract,namely apigenin-7-O-β-D-apiofuanosyl(1→2)-β-D-glucose (1),apigenin-7-O-β-D-glucose (2),adenosine(3),3-methoxy-4-hydroxy-5-[(8′S)-3′-methoxy-4′-hydroxyl-phenyl-alcohol]-E-cinnamic-phenylpropyl alcohol-4-O-β-D-glucoside (4),N-(4-amino-butyl)-3-(3-hydroxy-4-methoxy-phenyl)-E-acrylamide (5),N-(4-amino-butyl)-3-(3-hydroxy-4-me-thoxy-phenyl)-Z-acrylamide (6),resveratrol (7),naringenin (8),quercetin (9) and dioscin (10). CONCLUSIONS:Compound 1-8 are first separated from S. lyratum,the study can lay a foundation for quality evaluation of S. Lyratum.

Objective To analyze the timing and frequency of spontaneous gasping during cardiopulmonary resuscitation in a rat model,and evaluate its value bearing some relation to duration of cardiac arrest (CA ) in predicting the severity of post-resuscitation myocardial dysfunction.Methods Twenty-seven healthy Sprague-Dawley rats were randomly (random number)divided into 3 groups according to different durations of CA:CA 4 min (n=9),CA 6 min (n=9)and CA 8 min (n=9).CA of rats was electrically induced and untreated for 4,6 or 8 min respectively in the corresponding groups,and then cardiopulmonary resuscitation (CPR)was initiated and continued for 8 min in all animals.The emergence timing and frequency of spontaneous gasping during cardiopulmonary resuscitation and resuscitation outcomes were documented.Myocardial function such as cardiac output,ejection fraction and Tei index was measured by echocardiography prior to CA and at 1 h,2 h and 4 h post-resuscitation.Results The earliest appearance of gasping with highest frequency was observed in the CA 4 min group during CPR.Gasping appeared later with decreased frequency observed following longer duration of CA.There were statistically significant differences in the timing and frequency of gasping among the 3 groups.In the CA 4 min group with frequent gasping,all animals were successfully resuscitated with 8-min CPR with the least number of defibrillation,which was significantly better than that in the CA 8 min group.During the evaluation of post-resuscitation myocardial function,cardiac output,ejection fraction and myocardial work index (Tei index) were better in the CA 4 min group with frequent gasping,worse in the CA 6 min group and worst in the CA 8 min group, showing statistically significant differences in cardiac function among the 3 groups. Conclusions The spontaneous gasping appeared sooner with higher frequency during cardiopulmonary resuscitation indicated shorter duration of CA,and predicted better success of resuscitation and post-resuscitation myocardial function.

BACKGROUND:Longitudinal study of changes in obesity is an important method to explore the etiology, which can provide scientific basis for preventing and control ing obesity.
OBJECTIVE:To investigate the effect of age, observation period and birth cohort on the obesity prevalence of adults in Jiangsu province through the age-period-cohort analysis.
METHODS:20-69-year-old adults in Jiangsu province were col ected as the research objects. The stratified cluster sampling method was used to col ect the obese data in 2000-2010, and analyzed with SAS software. RESULTS AND CONCLUSION:Obesity prevalence of 1946-1950 birth cohort to 1976-1980 birth cohort was gradual y increased (P<0.05) from 2000 to 2010. Obesity prevalence from 1931-1935 birth cohort to 1941-1945 birth cohort was not significantly increased (P>0.05). With the increasing age in each age group of over 25 years old, the risk of obesity was increased gradual y. There were significant differences in the odds ratios between the baseline groups of 20-25 years old and the age groups of over 25 years (P<0.05). Compared with the 1995-1999 birth cohort, the other periods had a slight influence on the obesity prevalence (P>0.05). Compared with 1976-1980 birth cohort, there were no significant differences in the risks of obesity of the birth cohorts after 1951-1955 (P>0.05). But the risk of obesity from 1946-1950 birth cohort to 1931-1935 birth cohort was gradual y significant since the 2000;obesity risks of those born in the different times were different;rural area wil be the key area than 45 years old.

Objective:To study the nephrotoxicity induced by triptolide ( TP) on MDCK cell model and investigate its effect on oxidative stress. Methods:Aristolochic acid was chosen as the positive control. After the MDCK cells were incubated with 0. 5, 5, 50 and 500 nmol·L-1 TP for 24h, MTT method was used to observe the cell inhibiting rate and lactate dehydrogenase (LDH) release test was used to detect the cell membrane damage caused by TP. The cell morphology was observed under an inverted microscope. After the MDCK cells were incubated with 500 nmol·L-1 TP respectively for 30min, 1h, 2h, 4h and 6h, the level of reactive oxygen species ( ROS) was detected using 2′,7′-dichlorodihydro-fluorescein diacetate ( DCFH-DA) as the fluorescent probe. Results:Compared with those of the negative control group, the cell inhibiting rates and the relative LDH release rates in TP-treated group were increased sig-nificantly(P<0. 01). The cells in TP-treated group were creased, turned into the round shape and began to shed off. After the MDCK cells were incubated with TP for 30min, the level of ROS reached the highest value, and then began to decrease (P<0. 01). Conclu-sion:TP can induce the toxic effects on MDCK cells and the mechanism may be related to oxidative stress.

Objective To find a method to improve the range accuracy of moving target such as peripheral lung tumors, since a single CT snapshot may not be accurate during the treatment process.Methods A simple harmonic motion phantom, embedded with a cube and a circular ball, was used to simulate the tumor motion. Individualized moving targets were scanned 24 times with different amplitudes and frequencies. Then the images were fused from every 1, 2 or 3 sets of CT scans. The GTV volume variation of circular target and the length variation of the cube target along the z axis were contoured and analyzed. Results As motion amplitude increased, the maximum of both circular target volume and cube target length was increased, while the minimum of the factors was decreased. Motion frequency affected the target volume less than amplitude. For a cube target with the length of 3.3 cm at stationary phase, when motion frequencies was 20 and motion amplitude was 2 cm, the maximal length was 2. 4 times of the minimal length (5. 1 cm vs. 2. 1 cm). When it came to the cube target groups fused from every 1,2 and 3 sets of CT scans, the average length and standard deviation were (3.77 ± 1.20) cm, (4.18 ±0. 91)cm and (4.52 ±0. 59) cm, respectively. With the increase of fused scan number, targets became bigger, the standard deviation decreased, and the change of center positions was decreased. Conclusions The motion amplitude, frequency and the number of CT scans are the main factors affecting target definition, though, the optimized scanning phase is not certained. When 4DCT and respiration gating technique are not available,the efficient and practical method to solve this problem is to scan the target three or more times and fuse them in planning system, which will generate a larger, more reproducible GTV volume for moving targets.

Objective To establish a swine model of 10 min prolonged cardiac arrest (CA) induced by electrically triggered ventricular fibrillation,and then evaluate the quality of the model and the value in the establishment of post-cardiac arrest syndrome.Methods Fourteen domestic healthy swine weighing 38 ±3 kg were selected for study.Ventricular fibrillation was induced for 10 min,and then cardiopulmonary resuscitation (CPR) was initiated and continued for 5 min.The resuscitated animals were observed for 72 h after resuscitation.The resuscitation outcomes and survival rate were recorded.The functions of heart,lung and brain,and systemic inflammatory response and tissue perfusion were regularly evaluated for 72 h post-resuscitation.Results Eleven of the fourteen swine obtained restoration of spontaneous circulation (ROSC),and the rate of successful resuscitation and 72 h survival were both 78.6％.Significantly worse post-resuscitation myocardial function was found in all animals compared to the value prior to CA and the myocardial function was evaluated by decreased stroke volume and global ejection fraction,and increased levels of serum cardiac troponin-Ⅰ and n-terminal pro brain natriuretic peptide.Postresuscitation extra-vascular lung water index and pulmonary vascular permeability index were significantly increased accompanied with significantly decreased oxygenation index compared with the values before CA,indicating the occurrence of acute lung injury.In addition,post-resuscitation systemic inflammatory response and tissue low perfusion evidenced by significantly higher levels of serum tumor necrosis factor-α and interleukin-6 and arterial blood lactate were observed.Consequently,severe neurological deficit with significantly higher levels of serum neuron-specific enolase and S-100B was observed following 72 h postresuscitation.Conclusions This swine model of prolonged cardiac arrest induced by electrically triggered ventricular fibrillation was a well established model with high success rate of resuscitation,significant vital organ injury and relatively long duration of survival;it is an excellent model for the study of post-cardiac arrest syndrome.