Objective To observe the effect of lung protective ventilation on children with acute respiratory distress syndrome primarily from pulmonary diseases(ARDSp)and acute respiratory distress syndrome primarily from extra-pulmonary diseases(ARDSexp).Methods Between January 2003 and December 2014,354 children with ARDS admitted in PICU of Shengjing Hospital of China Medical University were enrolled and devided into ARDSp protective-ventilation group(n =154) ,ARDSp conventional-ventilation group(n =96) ,ARDSexp protective-ventilation group(n =72) and ARDSexp conventional-ventilation group (n =32).The patients in ARDSp protective-ventilation group and ARDSexp protective-ventilation group received lower tidal volume(6-8 ml/kg)and high levels of positive end-expiratory pressure(PEEP), and optimal oxygenation was achieved by adjusting FiO2 and PEEP.The patients in ARDSp conventional-ventilation group and ARDSexp conventional-ventilation group received relatively higher tidal volume(10-12 ml/kg), and optimal oxygenation was achieved by adjusting FiO2 and PEEP.The mortality,ventilator days and PICU stay days were compared among the four groups.Results The mortality, ventilation days,and PICU stay days were lower in ARDSp protective-ventilation group than those of ARDSp conventional-ventilation group[35.29％ vs.45.62％ ,12(2-44)d vs.16(3-26)d,16(2-67)d vs.22 (3-56)d] ,but there were no significant differences(P ＞0.05).The mortality ,ventilation days,and PICU stay days were also lower in ARDSexp protective-ventilation group than those of conventional-ventilation group[22.22％ vs.46.87％ ,9(1-19)d vs.16(1-21)d,14(1-66) d vs.25(1-47) d] ,which showed significant differences(P ＜0.05).Conclusion Lung protective ventilation may improve the outcome for pediatric patients with ARDSexp,however,larger trials are required before a definite conclusion can be reached.

Objective To study the therapeutic efficacy of Rex shunt in treating pediatric patients with prehepatic portal hypertension (PHPH).Methods Five children with PHPH who were admitted from October 2014 to May 2015 were reviewed.There were three boys and two girls,with age ranging from 50 to 95.5 months [(75.8 ± 1.9) months].They all suffered from recurrent upper gastrointestinal (GI) bleeding.Their red blood cell (RBC),white blood cell (WBC) and platelet (PLT) counts were decreased,but laboratory findings revealed no liver dysfunction.Ultrasound and CT scan diagnosed cavernous transformation of portal vein (CTPV) and splenomegaly.The mean splenic length was (42.8 ± 8.2) cm.Indirect portal venography revealed patent left portal vein.All patients underwent Rex shunt and were followed up for 3 ～ 7 months.Results The mean duration of operation was (566.0 ± 39.7) min.Intraoperative bleeding varied from 10 to 50 ml.The portal pressure significantly decreased after surgery from [(25.6 ± 1.5) mmHg,1 mmHg =0.133 kPa] preoperatively to (19.2 ± 3.3) mmHg postoperatively (P ＜ 0.05).Portal venography indicated patent left portal vein after the Rex shunt.The postoperative course was uneventful in the five patients with a mean hospital stay of (26 ± 9.3) days.There was no further GI bleeding.The RBC,WBC and PLT counts increased.Ultrasound indicated patent anastomotic stomas and decreased splenic size.Conclusion A Rex shunt in treating patients with PHPH is safe,feasible and efficacious.

Noonan syndrome(NS) is a congenital genetic disease characterized by distinctive facial features,short stature,chest deformity,congenital heart disease,and other comorbidities.This article reviewed the research history of NS,the clinical manifestations and their relationship with genotype,the diagnosis and treatment.

OBJECTIVE:To study anti-arrhythmic effects of Lianshen lyuping dripping pills in rats,mice,guinea pigs. METH-ODS:48 SD rats were randomized into a normal control (isometric normal saline) group,a model (isometric normal saline) group,a propafenone (positive control,270 mg/kg) group and Lianshen lyuping dripping pills high-dose,medium-dose and low-dose(210,140,70 mg/kg)groups. The rats’tails were given the drugs iv at a time,10 min later,aconitine(10 mg/L,3 μg/min) iv. The doses of aconitine were recorded when ventricular premature beat(VP),ventricular tachycardia(VT)and ventricular fibril-lation(VF)developed in ECG. 48 guinea pigs were grouped and given drugs as above and 10 min later,were given uabain iv(1 mg/L,1 μg/min). The doses of uabain were recorded when VP,VT and VF developed in ECG. 120 KM mice were grouped and given drugs ip at a dose as above at a time,30 min later,were placed in the beaker containing 4 ml chloroform. When respiratory arrest occurred,ventricular fibrillation rate of mice were calculate.120 Wistar rats were grouped and given drugs at a dose as above,following typical arrhythmia reaction,given 0.8% BaCl2 (0.25 ml/kg) iv and sublingually at a time;48 Wistar rats were grouped and given drugs at a dose as above and,following typical arrhythmia reaction, given 5%CaCl2(0.28 ml/kg)iv and sublin-gually at a time. Recovery of sinus arrhythmia rate of rats were determined.48 SD rats were grouped and given drugs at a dose as above,after the administration ig once daily for 7 consecutive days,the rat models of myocardial ischemia reperfusion were estab-lished,and then VT,VF incidence rate and death were recorded. RESULTS:Compared to the normal control group,those in the model group were all abnormal in all indexes. Compared to the model group,those in Lianshen lyuping dripping pills high-dose, medium-dose and low-dose groups used more aconitine and uabain at the time of the occurrence of VP,VT and VF,had a lower occurrence rate of VF in mice and higher recovery of sinus arrhythmia rate in rats . The rats in Lianshen lyuping dripping pills high-dose and medium-dose groups which had myocardial ischemia reperfusion demonstrated a lower of VT,VF incidence rate and death rate. There were statistically significances (P<0.01 or P<0.05).CONCLUSIONS:Lianshen lyuping dripping pills have an anti-arrhythmic effects in animals to some degree.

OBJECTIVE　A HPLC method was established for the determination of racecadotril and its impurities.METHODS　A ODS column was used and the mixture of acetonitrile-potassium dihydrogen phosphate (KH2PO4) solution (70∶30) was used as the mobile phase.The detection wavelength was 210 nm.RESULTS　The liner range of the racecadotril was 0.08～0.24 mg*mL-1 and the regression equation was Y=15847X+3873(r=0.9997).The liner range of benzylthiorphan disulphide was 2.40～21.56 μg*mL-1 and the regression equation was Y=1826x+46 (r=0.9999).The measurable lowest limit was 1 μg*mL-1.The average recovery was 100.0%.CONCLUSION　The method was convenient,accurate and specific.

15-deoxy-△12,14-prostaglandin J2(15d-PGJ2) is one of the natural ligands of the peroxisome proliferator-activated receptor γ.It plays an important protective role during cerebral ischemia.This article reviews the recent progress in research on the neuroprotective mechanism of 15d-PGJ2.

Objective To study the influence of electroacupuncture on the expression of Nestin in neural stem cells after focal cerebral ischemia in rats and to explore the mechanism of electroacupuncture in treating ischemic brain injury. Methods The model of middle cerebral artery occlusion was made by using opening cranium hot coagulation in 72 rats, who were divided randomly into a model group and an electroacupuncture group. Electroacupuncture was applied on "Dazhui" and "Baihui" points in rats in electroacupuncture group, and immunohistochemistry method was used to observe the number of Nestin expression positive cells on the 3th, 7th, 14th and 21st days after ischemia. Results There were Nestin positive cells in the cortex, hippocampal dentate gyrus (DG) and striatum at different time points after cerebral ischemia, and the number of Nestin positive cells in various brain regions were increased significantly on the 7th day (P

Objective To observe the effect of sling exercise therapy on nonspecific low back pain. Methods 35 cases with nonspecific ow back pain in community were divided into treatment group (n=18) and control group (n=17). All the cases accepted electrotherapy and hose in the treatment group accepted sling exercise in addition for 4 weeks. Before and after treatment, the cases were assessed with Numeric ain Rating Scale (NRS) and Oswestry Low Back Pain Disability Questionnaire. Results The scores of NRS and Oswestry Low Back ain Disability Questionnaire both improved more in the treatment group than in the control group (P<0.05). Conclusion Sling exercise can elieve the pain and disability from nonspecific low back pain in community.

Ischemic cerebrovascular disease is a common and frequently emergency, and leads to disability and death. In recent years,inflammatory reaction is thought as the key to secondary injury after cerebral ischemia/reperfusion. Inflammatory cells, as the target of inflammatoryfactors, infiltrate and gather in the ischemic areas leading to secondary neurological injury and enlarge the infarct size. Acupuncturemay adjust the activity of inflammatory cells.

AIM: To investigate the expression of vascular endothelial growth factor receptor 2 (VEGFR-2, also known as FLK-1) in laser-induced choroidal neovascularization (CNV) in mouse.METHODS: CNV was induced in C57BL/6 mouse eyes by krypton laser photocoagulation. Choroidal fiuorescein angiography and histopathological examination were used to assess the development of experimental CNV. Cryostat sections from lesions on day 10 after laser treatment and normal eyes were prepared for Immunohistochemistry for FLK-1.RESULTS: Laser-induced CNV developed in all lesions on day 10. The expression of FLK-1 was detected in endothelial cells, retinal pigmented epithelium (RPE)-like cells and fibroblast-like cells in neovascular lesions. In normal adult mouse retinas, FLK-1 expression was mainly observed in RPE cells, inner nuclear and ganglion cell layers.CONCLUSION: Our findings demonstrated that expression of FLK-1 may play a role in the formation of laser-induced CNV in mice, which suggest that FLK-L may be a promising potential target for antiangiogenesis therapy for CNV.