Effects of endovascular and surface cooling on resuscitation in patients with cardiac arrest and a comparison of effectiveness, stability, and safety: a systematic review and meta-analysis.

OBJECTIVES: This study conducted a meta-analysis to assess the effectiveness, stability, and safety of mild therapeutic hypothermia (TH) induced by endovascular cooling (EC) and surface cooling (SC) and its effect on ICU, survival rate, and neurological function integrity in adult CA patients. METHODS: We developed inclusion criteria, intervention protocols, results, and data collection. The results included outcomes during target temperature management as well as ICU stay, survival rate, and neurological functional integrity. The characteristics of the included population and each study were analyzed. RESULTS: Four thousand nine hundred thirteen participants met the inclusion criteria. Those receiving EC had a better cooling efficiency (cooling rates MD = 0.31[0.13, 0.50], p < 0.01; induced cooling times MD = - 90.45[- 167.57, - 13.33], p = 0.02; patients achieving the target temperature RR = 1.60[1.19, 2.15], p < 0.01) and thermal stability during the maintenance phase (maintenance time MD = 2.35[1.22, 3.48], p < 0.01; temperature fluctuation MD = - 0.68[- 1.03, - 0.33], p < 0.01; overcooling RR = 0.33[0.23, 0.49], p < 0.01). There were no differences in ICU survival rate (RR = 1.22[0.98, 1.52], p = 0.07, I2 = 0%) and hospital survival rate (RR = 1.02 [0.96, 1.09], p = 0.46, I2 = 0%), but EC reduced the length of stay in ICU (MD = - 1.83[- 3.45, - 0.21], p = 0.03, I2 = 49%) and improved outcome of favorable neurological function at discharge (RR = 1.15[1.04, 1.28], p < 0.01, I2 = 0%). EC may delay the hypothermia initiation time, and there was no significant difference between the two cooling methods in the time from the start of patients' cardiac arrest to achieve the target temperature (MD = - 46.64[- 175.86, 82.58]). EC was superior to non-ArcticSun in terms of cooling efficiency. Although there was no statistical difference in ICU survival rate, ICU length of stay, and hospitalization survival rate, in comparison to non-ArcticSun, EC improved rates of neurologically intact survival (RR = 1.16 [1.01, 1.35], p = 0.04, I2 = 0%). CONCLUSIONS: Among adult patients receiving cardiopulmonary resuscitation, although there is no significant difference between the two cooling methods in the time from the start of cardiac arrest to achieve the target temperature, the faster cooling rate and more stable cooling process in EC shorten patients' ICU hospitalization time and help more patients obtain good neurological prognosis compared with patients receiving SC. Meanwhile, although EC has no significant difference in patient outcomes compared with ArcticSun, EC has improved rates of neurologically intact survival.

Efficacy of Low Molecular Weight Heparin in Preventing Perinatal Venous Thrombosis: A Meta-Analysis.

Background: There have been controversies about the preventive effect of low molecular weight heparin (LMWH) on venous thrombosis (VT) in the perinatal period. This study is aimed at exploring the effectiveness of LMWH in preventing perinatal VT through meta-analysis. Methods: Databases such as CNKI, China Biology Medicine disc (CBMdisc), Wanfang, PubMed, MEDLINE, Embase, and Central were searched. Inclusion criteria were as follows: (1) subjects: women at high risk of perinatal VT; (2) experimental group and control group; (3) intervention measures: the experimental group was given LMWH, while the control group was given placebo or standard heparin or physical therapy; (4) outcomes: perinatal VT events or bleeding events; and (5) randomized controlled trials (RCTs). Jadad scale was used to evaluate the literature quality. The Mantel-Haenszel method was used to calculate the odds ratio (OR) and 95% confidence interval (CI). The chi-square test was used to analyze the heterogeneity of the included literature. Subgroup analysis was used to explore the source of heterogeneity. Publication bias was evaluated via funnel plot and Egger test. Results: The incidence of perinatal VT in the LMWH group was lower than that in the control group (OR = 0.16, 95% CI (0.08, 0.32), P < 0.00001). There was no heterogeneity among literatures (P = 0.77, I 2 = 0%) and no publication bias. The incidence of postpartum VT in the LMWH group was lower than that in the control group (OR = 0.14, 95% CI (0.07, 0.30), P < 0.00001). There was no heterogeneity among literatures (P = 0.69, I 2 = 0%) and no publication bias. The incidence of perinatal bleeding in the LMWH group was higher than in the control group (OR = 1.72, 95% CI (1.06, 2.77), P = 0.03). There was no heterogeneity among literatures (P = 0.25, I 2 = 26%) and no publication bias. Conclusion: LMWH can reduce the incidence of perinatal VT in high-risk women but increase the risk of bleeding. The use of LMWH to prevent perinatal VT should be closely monitored.

Association between the use of antibiotics during pregnancy and obesity in 5-year-old children.

BACKGROUND: Obesity is an epidemic that must arouse our attention. The purpose of this research is to investigate the relationship between antibiotic use during pregnancy and childhood obesity in 5-year-old Chinese children. METHODS: A total of 132 5-year-old children born in our hospital from January 2014 to January 2016 were included. The children's genders, nationalities, chronic diseases, and other factors were collected as adjusted covariates. We also collected the pre-pregnancy body mass indexes (BMIs) of pregnant women, diagnosis of diabetes mellitus or gestational diabetes mellitus (GDM), maternal smoking, mode of delivery (cesarean section and vaginal delivery), and weight gain during pregnancy, which may affect childhood obesity. A linear mixed effect regression model was used to test the correlation between antibiotic use during pregnancy and the BMI of 5-year-old children, and a logistic mixed effect regression model was used to evaluate the correlation between antibiotic use during pregnancy and obesity outcome. RESULTS: When adjusted for the child's gender, birth weight, cesarean section, chronic diseases, maternal smoking during pregnancy, pre-pregnancy BMI, diagnosis of diabetes or GDM, mode of delivery (cesarean section and vaginal delivery), and weight gain during pregnancy (Model 3), antibiotic use during pregnancy was positively correlated with the BMI of 5-year-old children (ß=0.01, 95% CI: 0.01-0.03, P=0.04). Antibiotic use during pregnancy increased the risk of obesity by 4% in 5-year-old children (OR =1.04, 95% CI: 1.01-1.16, P=0.02). CONCLUSIONS: The use of antibiotics during pregnancy is positively correlated with the risk of obesity in 5-year-old children. KEYWORDS: Antibiotics; pregnancy; obesity; children.

Identification of key odorants responsible for cooked corn-like aroma of green teas made by tea cultivar 'Zhonghuang 1'.

Fangping green tea (FPGT) produced by Zhonghuang 1 (C. sinensis var. sinensis cv. Zhonghuang 1), a new tea variety, has a classical cooked corn-like aroma, which is completely different from the green tea aroma. In order to illustrate the aroma characteristics of the green tea, the volatiles of FPGT was analyzed with gas chromatography-mass spectrometry (GC-MS) and gas chromatography-olfactometry (GC-O). The results showed that odor activity value (OAV) of dimethyl sulfide (DMS) was 1195.21 and the odor intensity about DMS was 6.2 in FPGT. Aroma recombination experiment also confirmed the important contribution of DMS to cooked corn-like aroma. Aroma character impact (ACI) values of DMS in tea processed by Zhonghuang 1 and Fudingdabai were 72.01% and 37.86%, respectively. This indicated that the high proportion of DMS was the dominant character of green tea with cooked corn-like aroma. In addition, the S-methylmethionine (SMM) content in fresh leaves of Zhonghuang 1 (0.21 mg/g) was significantly higher than that of Fudingdabai (0.16 mg/g), which was an important reason for high DMS content.

MYB43 in Oilseed Rape (Brassica napus) Positively Regulates Vascular Lignification, Plant Morphology and Yield Potential but Negatively Affects Resistance to Sclerotinia sclerotiorum.

Arabidopsis thaliana MYB43 (AtMYB43) is suggested to be involved in cell wall lignification. PtrMYB152, the Populus orthologue of AtMYB43, is a transcriptional activator of lignin biosynthesis and vessel wall deposition. In this research, MYB43 genes from Brassica napus (rapeseed) and its parental species B. rapa and B. oleracea were molecularly characterized, which were dominantly expressed in stem and other vascular organs and showed responsiveness to Sclerotinia sclerotiorum infection. The BnMYB43 family was silenced by RNAi, and the transgenic rapeseed lines showed retardation in growth and development with smaller organs, reduced lodging resistance, fewer silique number and lower yield potential. The thickness of the xylem layer decreased by 28%; the numbers of sclerenchymatous cells, vessels, interfascicular fibers, sieve tubes and pith cells in the whole cross section of the stem decreased by 28%, 59%, 48%, 34% and 21% in these lines, respectively. The contents of cellulose and lignin decreased by 17.49% and 16.21% respectively, while the pectin content increased by 71.92% in stems of RNAi lines. When inoculated with S. sclerotiorum, the lesion length was drastically decreased by 52.10% in the stems of transgenic plants compared with WT, implying great increase in disease resistance. Correspondingly, changes in the gene expression patterns of lignin biosynthesis, cellulose biosynthesis, pectin biosynthesis, cell cycle, SA- and JA-signals, and defensive pathways were in accordance with above phenotypic modifications. These results show that BnMYB43, being a growth-defense trade-off participant, positively regulates vascular lignification, plant morphology and yield potential, but negatively affects resistance to S. sclerotiorum. Moreover, this lignification activator influences cell biogenesis of both lignified and non-lignified tissues of the whole vascular organ.

Effects of withering on the main physical properties of withered tea leaves and the sensory quality of congou black tea.

To explore the relationship between the moisture content of withered tea leaves and their physical properties (i.e., elasticity, plasticity, flexibility, and texture) during withering, texture analyzer was employed to test the elasticity and flexibility of withered tea leaves with different moisture contents. The texture was evaluated by computer vision technology. The withered tea leaves with different moisture contents were used to process congou black tea, which was then subjected to sensory evaluation. Results showed that good elasticity, optimal flexibility, and plasticity were achieved when the moisture content of the withered tea leaves of Fudingdabai comprising two leaves and one bud varied arranging from 65.51 to 61.48%. The sensory evaluation of congou black tea revealed that moderate withering was better than long-term withering and that both moderate and long-term withering were better than no withering during processing. The moisture content was significantly correlated with the flexibility and plasticity of the withered tea leaves. Fresh tea leaves undergoing moderate withering with moisture content of 65.51-61.48% to process congou black tea, good tea shape and liquor color were achieved. This study provided new evidence that the moisture content of withered tea leaves significantly affected the quality of black tea.

Metformin Activates the Protective Effects of the AMPK Pathway in Acute Lung Injury Caused by Paraquat Poisoning.

OBJECTIVE: To observe whether metformin (MET) plays a protective role in acute lung injury (ALI) induced by paraquat (PQ) poisoning in rats by activating the AMPK/NF-κB signaling pathway. METHODS: PQ exposure was used to construct a rat model of ALI and a model of acute type II alveolar epithelial cell (RLE-6TN) injury, and MET intervention was performed. Rat lung tissue samples were collected to evaluate pathological changes in rat lung tissue, the oxidation index, and inflammatory factors; cell viability was detected by CCK-8 assays, and the protein expression levels of phospho-AMPK and phospho-NF-κBp65 in rat lung tissue and RLE-6TN cells were observed by Western blotting. RESULTS: Compared with the PQ group, the MET treatment group showed significantly (1) reduced lung wet/dry ratio (W/D: 4.67 ± 0.31 vs. 5.45 ± 0.40, P < 0.001), (2) reduced pathological changes in lung tissue, (3) decreased MDA levels (nmol/mg prot: 2.70 ± 0.19 vs. 3.08 ± 0.15, P < 0.001) and increased SOD and GSH-Px activities (U/mg prot: 76.17 ± 5.22 vs. 45.23 ± 6.58, 30.40 ± 2.84 vs. 21.00 ± 3.20; all P < 0.001) in lung tissue homogenate, (4) reduced levels of IL-1ß, IL-6, and TNF-α in lung tissue homogenates (pg/mL: 47.87 ± 5.06 vs. 66.77 ± 6.55; 93.03 ± 7.41 vs. 107.39 ± 9.81; 75.73 ± 6.08 vs. 89.12 ± 8.94; all P < 0.001), (5) increased activity of RLE-6TN cells (%: 0.69 ± 0.09, 0.76 ± 0.06, and 0.58 ± 0.03 vs. 0.50 ± 0.05; all P < 0.05), (6) decreased protein levels of phospho-NF-κBp65 in lung homogenates and RLE-6TN cells (p-NF-κB/NF-κB: 0.47 ± 0.09 vs. 0.81 ± 0.13; 0.26 ± 0.07 vs. 0.79 ± 0.13; all P < 0.01), and (7) upregulated protein expression of phospho-AMPK in lung homogenates and RLE-6TN cells (p-AMPK/AMPK: 0.88 ± 0.05 vs. 0.36 ± 0.12; 0.93 ± 0.03 vs. 0.56 ± 0.15; all P < 0.01). After the addition of the AMPK inhibitor Compound C (Com C), the protein expression levels of phospho-AMPK and phospho-NF-κBp65 returned to baseline. CONCLUSION: MET can effectively alleviate ALI induced by paraquat poisoning and increase the viability of cells exposed to paraquat. The mechanism may be related to the activation of the AMPK/NF-κB pathway, downregulation of inflammatory mediators such as IL-6 and TNF-α, and upregulation of the SOD and GSH-Px oxidation index, and these effects can be inhibited by the AMPK inhibitor Com C.

[Effects between chest-compression-only cardiopulmonary resuscitation and standard cardiopulmonary resuscitation for patients with out-of-hospital cardiac arrest: a Meta-analysis].

OBJECTIVE: To comprehensively evaluate and compare the resuscitation efficacy of chest-compression-only cardiopulmonary resuscitation (CCPR) and standard cardiopulmonary resuscitation (SCPR) for patients with out-of-hospital cardiac arrest (OHCA). METHODS: Databases such as PubMed, Embase, Ovid, Cochrane Library, Wanfang, CNKI, VIP, CBM were searched from the date of their foundation to March 2nd 2018, and the studies on the difference of effects between CCPR and SCPR for patients with OHCA were retrieved. The outcomes included the return of spontaneous circulation (ROSC) rate, survival to hospital discharge, neurological function completion rate. Two reviewers independently screened the literature meeting the inclusion criteria, independently collected information and evaluated the literature quality. Meta-analysis was conducted using RevMan 5.3 software, and sensitivity analysis was conducted by selecting model analysis method and removing single research method. Funnel plot was used to evaluate publication bias. RESULTS: A total of 10 cohort studies were included, including 174 163 patients with OHCA, of which 95 157 undergone CCPR and 79 006 undergone SCPR. The scores of the Newcastle-Ottawa scale (NOS) were 8-9, indicating that the quality of the literatures included was high. It was shown by the Meta-analysis that CCPR had the higher rate of survival to hospital discharge [relative risk (RR) = 1.04, 95% confidence interval (95%CI) = 1.00-1.08, P = 0.04] and neurological function completion (RR = 1.11, 95%CI = 1.06-1.17, P < 0.000 1) than SCPR, but there was no significant difference in ROSC rate between the two groups (RR = 1.01, 95%CI = 0.98-1.04, P = 0.52). In the subgroup, there was no statistical significance between CCPR and SCPR in the rate of survival to hospital discharge in cardiac OHCA patients (RR = 1.13, 95%CI = 0.82-1.57, P = 0.45). However, in non-cardiac OHCA group, SCPR showed more benefits than CCPR in improving the rate of survival to hospital discharge (RR = 0.88, 95%CI = 0.80-0.96, P = 0.004). The above analysis results were consistent in the fixed effect model and random effect model, indicating that the results were reliable and stable. It was shown by the funnel plot that most of the studies were left-right inverted funnel type, indicating a low publication bias. However, the bias could not be completely excluded due to the small number of included literatures. CONCLUSIONS: For patients without OHCA etiological classification, CCPR was not less than SCPR in improving ROSC rate, discharge survival rate and good neurological function, and CCPR was more advantageous in learning and the willingness of bystanders to implement. However, when non-cardiogenic OHCA could be identified, SCPR should be recommended when conditions permit.