Objective To assess the effectiveness of continuous aspiration of subglottic secretions (CASS)in preventing ventilator-associated pneumonia.Methods The relevant randomized controlled trials were searched in the Cochrane Library,Pubmed,CNKI,VIP and Wanfang databases.The experimental group received CASS and the control group did not(NASS group).Two reviewers selected studies according to the inclusion and exclusion criteria,the quality of studies was critically appraised and data were extracted by two reviewers independently.Meta-analysis was conducted by using RevMan 5.2.Results Sixteen randomized controlled trials met the inclusion criteria and enrolled 2 576 patients.According to the meta analysis,compared with NASS,CASS reduced the incidence of ventilator-associated pneumonia,shortened the length of stay in the intensive care unit and the duration of mechanical ventilation.There was no effect on hospital mortality.Conclusions Continuous aspiration of subglottic secretions appears effective in preventing ventilator-associated pneumonia,decreasing the duration of intensive care unit length of stay and mechanical ventilation among critically ill patients with mechanical ventilation.

Objective To explore the association between maternal methylene tetrahydrofolate reductase (MTHFR) C677T polymorphism and neural tube defects (NTDs). Methods CBM, VIP, CNKI, Wanfang, PubMed and Web of Science databases from set up to March, 2014 were electronically searched to identify case-control studies on the relationship between maternal MTHFR C677T polymorphism and NTDs. The data were quantitatively analyzed by RevMan 5.0 software. Results A total of 25 studies were selected including 2 282 cases and 3 420 controls. Overall, the pooled OR (with 95%CI) under co-dominant model and allele contrast were 2.28(1.60-3.24), 1.25(1.02-1.53) and 1.42(1.21-1.67). Subgroup analysis showed significant association between maternal MTHFR C677T polymorphism and NTDs susceptibility in Asian populations. Conclusion The present meta-analysis suggests that MTHFR C677T polymorphism is significantly associated with maternal risk for NTDs, especially in Asian populations.

Objective To evaluate ‘Cool-tip nee dl e’ radiofrequency ablation (RFA) for the treatment of solid tumors. MethodsIn this study, 102 patients w ith 157 tumors underwent RFA. Tumor size varied from 1.0cm to 20.0cm in d iameter. Result The comple te ablation(CA) rate was 83.5%(91/109)in tumors less than 5cm in diameter , and 35.4%(17/48)when tumors were larger than 5cm. RFA significantl y ameliorates symptoms in most lung cancer patients, and in 40%(4/10)patient s of pancreatic tumors. In the group receiving percutaneous RFA , no patients we re shifted to celiotomy, nor skin burn, or pneumothorax occurred. RFA for hepa tic tumors was complicated with abdominal pain in 13.4%(11/82), nausea in 6 .1%(5/82), jaundice in 9.7%(8/82), fever in 23.2%(19/82), and biliary leak age in 1.2%(1/82). Post RFA complications for pulmonary tumors included pain in 14.3%(1/7)and hypodermal gas accumulation in 14.3%(1/7). For pancrea tic tumors, pancreatic leakage in developed 20%(2/10), elevated blood amylas e in 70%(7/10), GI bleeding in 20%(2/10). Con clusions Treating solid tumors with ‘Cool-tip needle ’ RFA is efficient, reliable and safe, but great care should be taken in case o f pancreatic tumors.

Objective To investigate the effects of cold exposure with different time courses on cardiovascular function and skeletal muscle contraction in Sprague-Dawley (SD) rats.Methods The male SD rats were randomly divided into control,12-h cold,24-h cold,and 48-h cold groups.The rats in all cold group were maintained in 4 ℃ environment for indicated time and allowed free access to standard rat chow and water ad libitum.After the animal model was established,the heart,thoracic aorta,soleus,and extensor digitorum longus (EDL) were rapidly isolated from rats under anesthesia and then fixed into the respective organ perfusion system that was connected to physiological recorders and data acquisition system.Lanendorff heart persusion was used to detect some parameters of cardiac function,such as coronary flow (CF),mean left ventricular systolic pressure (mLVSP),mean left ventricular diastolic pressure (mLVDP) and maximum ascending and declining rate of left ventricular pressure (± dp/dt max) ; and then the heart was suffered from 30 min ischemia followed by 60 min reperfusion,the changes of above cardiac function indexes were recorded again.Organ bath method was employed to detect contraction response to potassium chloride (KCl) or phenylephrine (PE) and endothelium-dependent relation responses to acetylcholine (ACh) of aortic rings.The twitch tension,titanic tension,and fatigue test of soleus and EDL were examined by electrical stimulation to reflect contractive function of skeletal muscle.Results The coronary flow (CF) were significantly reduced in 24-h and 48-h cold groups compared to control group [(9.0 ± 1.7) ml/g and (9.8 ± 1.3) ml/g vs (11.6 ± 1.2) ml/g,P ＜ 0.05] ; 48-h cold exposure also showed significantly increased mLVSP (P ＜0.01) and mLVP (P ＜ 0.05) of rats.After ischemia-reperfusion,the heart re-beat time was shorter in all cold exposure groups (all P ＜ 0.01),mLVP and mLVDP were higher in 24-h and 48-h cold group than control group (all P ＜ 0.01).The contraction of aortic rings responses to 60 mmol/L KCl [(0.63 ±0.13) g and (0.79 ±0.11)g vs (1.28±0.17)g,P ＜0.01] and 1 μmol/L PE [(0.62 ±0.18)g and (0.68 ±0.13)g vs (1.25 ± 0.18)g,P ＜ 0.01] were decreased while the endothelium-dependent relaxation responses to low concentration ACh (3 × 10-8 ～ 3 × 10-7) were increased in 24-h and 48-h cold groups relative to control group (all P ＜ 0.05).The 48-h cold also reduced titanic tension of SOL and EDL in comparison with control [(4.14 ± 0.62) N/cm2 vs (5.50 ± 0.75) N/cm2,P ＜ 0.05 and (3.00 ± 0.57) N/ cm2 vs (4.70 ± 0.85) N/cm2,P ＜ 0.01].Conclusions 24 ～ 48 h cold exposure could reduce CF but enhance the tolerance of heart from rats to ischemia reperfusion injury and also decrease the contraction of aortic rings response to KCl or PE but increase the sensitive responses to ACh of aortic rings from rats.The 48-h cold could decrease the contraction of skeletal muscle elicited by electrical stimulation.

Objective To investigate the effects of fasting with different time courses on the contraction of skeletal muscle and cardiovascular function in Sprague-Dawley (SD) rats.Methods The healthy and male SD rats were randomly divided into (1) control,(2) 12 h fasting,(3) 24 h fasting,and (4) 48 h fasting groups.After animal models of fasting with different time courses were established,the heart,thoracic aorta,soleus,and extensor digitorum longus (EDL) were rapidly isolated from rats under anesthesia and then fixed into the respective organ perfusion system that was connected to physiological recorders and data acquisition system.Langendorff heart perfusion was used to detect some parameters of cardiac function,including left ventricular systolic pressure (LVSP),left ventricular end-diastolic pressure (LVEDP),and maximum ascending and declining rate of left ventricular pressure (± dP/dt max).Then,the heart was suffered from 30 min ischemia followed by 60 min reperfusion,the changes in above cardiac function parameters were recorded again.The contraction response to potassium chloride or phenylephrine and endothelium-dependent relation responses to acetylcholine (ACh) of aortic rings were measured with organ bath.The changes of twitch tension and titanic tension of soleus and EDL were examined to reflect contractive function of skeletal muscle.Results The + dP/dt max was significantly reduced in 24 h and 48 h fasting groups compared to the control (P ＜ 0.01).After ischemia-reperfusion,the heart re-beat time was significantly longer [(24.3 ± 7.0)min vs (14.0 ± 2.9)min,P ＜0.05],both mLVDP and mLVP were significantly higher in 48 h and 24 h fasting groups than control group (P ＜ 0.05),and those changes did not normalized until re-perfusion 60 min.The 48 h fasting increased significantly endothelium-dependent relaxation of aortic rings response to low concentration acetylcholine (P ＜ 0.05),but did not affect the maximum relaxation of aortic rings response to high concentration acetylcholine and contraction of aortic rings responses to potassium chloride and phenylephrine.The 48 h fasting also enhanced significantly titanic tension of soleus compared to the control [(7.01 ± 1.22) N/cm2 vs (5.5 ± 0.75) N/cm2 for48 h-Fasting vs Control,P ＜0.05].Conclusions The 24 ～48 h fasting may induce inhibition of cardiac function,while fasting 48 h can increase the sensitivity of aortic rings responses to ACh and contraction function of soleus in healthy and male rats.

Objective: To observe the effect of coxsackie virus B3 on airway tract and lung morphology, and to study the relation between CVB infection and asthma. Methods: We established CVB3 infective model: 5 d neonatal rats inhaled CVB3 by ultrasonic brume. CVB3-IgM was examined 10 d after inoculating of CVB3, and LW/BW, airway tract and lung pathological change 10 d and 30 d after inoculation of CVB3 were observed. Results: Rats from the virus group had higher D of CVB3-IgM than control's (+2s ) and had higher LW/BW 10 d after inoculation of CVB3 than control (P<0.01). Neonatal rats had acute inflammatory changes 10 d after inoculation of CVB3 and persistent changes in morphology and cytology. Conclusion: Neonatal rats virus model is established. Respiratory infection by CVB3 in neonatal rats has persistent changes in airway tract inflammatory and morphology.

Objective: To observe the effect of coxsackie virus B 3 on airway tract and lung morphology, and to study the relation between CVB infection and asthma. Methods: We established CVB 3 infective model: 5 d neonatal rats inhaled CVB 3 by ultrasonic brume. CVB 3 IgM was examined 10 d after inoculating of CVB 3, and LW/BW, airway tract and lung pathological change 10 d and 30 d after inoculation of CVB 3 were observed. Results: Rats from the virus group had higher D of CVB 3 IgM than control's ( +2s ) and had higher LW/BW 10 d after inoculation of CVB 3 than control ( P

Aim This study was aimed to explore the influence and mechanism of the long-term exercise on skeletal muscle contraction and mitochondrial biosyn-thesis in different muscle fibers.Methods Soleus (SOL)and extensor digitorum longus (EDL)were i-solated from SD male rats with platform running train-ing for eight weeks.The changes of contractility under different electrical stimulation were observed, mito-chondrial biosynthesis,including ATP content,mito-chondrial DNA,the gene expression of PGC-1αand NRF were also detected.Results Long-term endur-ance exercise can improve twitch tension and titanic tension of SOL and EDL ,but only enhanced the fa-tigue resistance in SOL.ATP contents were significant-ly increased in the two types of muscles,but mtDNA content,PGC-1αexpression and NRF translation were only obviously enhanced in SOL,in accompanied with an increase in p-AMPK/AMPK protein ratio.Conclu-sion Long-term endurance exercise increased skeletal muscle contractility and improved the anti-fatigue abili-ty in SOL,which may be associated with increase in mitochondrial biosynthesis via activated AMPK-PGC-1αaxis.

Objective To investigate the effects of calorie restriction (CR) for 4 weeks on twitch tension,titanic tension,and fatigue contraction induced by electrical stimulation in different kind skeletal muscles from rats and explore the possible mechanisms.Methods The rat model of CR was established by a limitation of 40％ calorie intake of control rats for 4 weeks,and then oral glucose tolerance test (OGTT) was performed.The soleus (SOL) and extensor digitorum longus (EDL) were isolated under anesthetization to detect twitch tension,titanic tension,and fatigue contraction induced by electrical stimulation.Adenosine triphosphate (ATP) content was measured by fluorescent enzymatic methods to reflect mitochondrial function.The ratio of mitochondrial gene COX Ⅰ and nuclear gene β-actin copy number was analyzed to evaluate mitochondrial biogenesis.Furthermore,the transcriptions of peroxisome proliferatoractivated receptor γ coactivator-1 (PGC-1α) and nuclear respiratory factor 1 (NRF1) genes,expressions of phosphorylated adenosine 5'-monophosphate-activated protein kinase (AMPK) and nitric oxide synthase (NOS) proteins,and nitric oxide (NO) content were determined in skeletal muscle.Results The blood glucose level at 30 min and area under the curve of blood glucose levels at various time points during OGTT were significantly decreased in the CR group compared to the control group.The twitch tension [(2.5 ± 0.15)N/cm2 vs (1.24±0.12)N/cm2,(2.66 ±0.21)N/cm2 vs (1.69 ±0.17)N/cm2,P ＜ 0.05],titanic tension [(10.43 ± 0.36) N/cm2 vs (8.06 ± 0.19) N/cm2,(11.35 ± 1.02) N/cm2 vs (8.12 ± 0.23) N/cm2,P ＜ 0.05],and fatigue contraction force in SOL and EDL from CR rats were significantly increased in association with increases of ATP content [(34.82 ±4.31)) mnol/mg protein vs (15.32 ± 1.94) nmol/mg protein,(30.82 ± 2.15) nmol/mg protein vs (12.32 ± 0.97) nmol/mg protein,P ＜ 0.05] and mitochondrial biogenesis (2.75 ± 0.20 vs 1.52 ± 0.06,1.32 ± 0.10 vs 0.84 ± 0.11,P ＜ 0.05) compared to control rats.CR for 4 weeks upregulated the transcriptions of PGC-1α and NRF genes as well as the phosphorylation of AMPK protein in SOL but not in EDL.Furthermore,CR also enhanced NOS expression and NO content in both skeletal muscles.Conclusions CR for 4 weeks can strengthen the contractile function of SOL and DL from rats,and the underlying mechanisms might be related to the upregulation of PGC-1α transcription and AMPK activation,resulting in the enhances of mitochondrial biogenesis and mitochondrial function in skeletal muscles.

Objective To explore the management strategy for liver trauma combined with juxla-hepatic venous injury and discuss relating factors leading to postoperative deaths. Methods The clini-cal data of 11 patients with juxtahepatic venous injury were retrospectively analyzed in aspects of prefer-ence of irregular hepatectomy and vein repair.There were 8 males and 3 females,at age range of 22-65 years(mean 33.7 years).Injury causes included traffic injury in 7 patients,fall-from-height injury in 3 and crush injury in 1.Of all,9 patients were combined with other abdominal organ injury and 7 with over one part fractures.All patients showed symptom of shock on admission. Results No patient died dur-ing operation but 3 died after operation.The complications included bleeding in 6 patients,severe infec-tion in 2.liver function failure in 3, acute renaI function failure in 2.bile-1eakage in 4,abdominal ab-scess in 4 and incision infection in 6. Conclusion Low blood pressure in the operation is the main cause for death.It is safe and effective to treat liver trauma combined with juxtahepatic venous injury with irregular hepatectomy and vein repair.