The mi nimizign time on mechanical ventilait on is one of the great importna t issues in crit-ical ill patienst ,only limited guidance on weaing and extubation is available from the pediatric literature.T he clinical application ofni dicta ions for weaning are even less clear,and the protocol-based wae ningw ith sponta-neous breaht ing trail is a feasible way in pediatric intensive care unit.

OBJECTIVE:To cultivate qualified prescription-checking pharmacists and to ensure patients'rational drug use. METHODS:The status quo of prescription-checking pharmacists in China was analyzed and some concrete suggestions on how to cultivate qualified prescription-checking pharmacists were made.RESULTS:The phenomena of low educational level and low professional title,lack of professional knowledge and medical knowledge,lack of staff members were widespread in today's Chinese prescription-checking pharmacist professionals.CONCLUSION:The rational drug use can only be realized through being fully aware of the importance of prescription-checking pharmacists,enhancing whose admittance qualifications,working out professional standards for whom,clearly defining their responsibilities,strengthening their cultivation and increasing their numbers.

Objective To explore the common complications and methods of treatment in the malignant obstruction of upper alimentary tract with stent insertion. Methods With interventional procedure under fluoroscopic guidance fourteen self expanding stents were implanted in twelve patients, including nine with strictures or obstructions of esophagus, three with obstructions of gastroduodenum. Of the fourteen, nine were coated stents and five were uncoated stents. Results All stents were implanted successfully, but complications after the procedure occurred sometimes. There complications included: 1. Food bolus obstructed in three patients. 2. Chest pain occurred in four patients. 3. Tumour overgrowth or hyperplasia of granulation tissue in three patients caused restenosis of gastrointestinal tract. 4. Stent replacement in three patients. 5. Hemorrhage occurred in two patients (over 300 ml) causing threat to life. Conclusions The implantation of self expanding stent is a simple and effective method offering good palliation for upper alimentary tract obstructions. The complications shoud be treated correctly.

The incidence of severe viral pneumonia increased year on year,cardiac dysfunction is one of the commonest complications in severe pneumonia.But it is still controversial whether or not the severe pneumonia is associated with heart failure.This article focuses on the mechanisms and the treatment of severe pneumonia complicated with cardiac dysfunction.

Abstract: Although respiratory tract viral infections in children mainly cause respiratory diseases, severe respiratory viral infections are closely associated with infections, inflammation, or dysfunction of the nervous system. Common respiratory viruses such as human respiratory syncytial virus, influenza virus, coronaviruses, and human metapneumovirus can lead to severe neurological complications including encephalitis, acute disseminated encephalomyelitis, cerebellitis, Guillain-Barré syndrome, acute flaccid myelitis, and necrotizing encephalopathy, posing a threat to life. The outbreak of the SARS-CoV-2 epidemic has continuously increased the incidence and mortality of neurological complications in critically ill children. Therefore, this article will discuss the neuroinvasive mechanisms and neurological manifestations of respiratory viral infections in children, aiming to enhance early recognition of neurological complications related to respiratory viral infections in children by healthcare professionals and to minimize the harm of complications to children's health.

Objective To discuss the value of ultrasonic miniature probe (UMP) in the preoperative staging of colorectal cancer.Methods Sixty-one colorectal cancer patients were examined before operation using the UMP (Olympus UM-2R,12 MHz).According to the intestinal wall structural layers and the close organic infiltration,the tumor encroaching depth was judged and the diagnosis of the T stage was made.All cases got the pathological verification,which was compared with the stage of UMP.Results The general diagnostic accurate rate of tubal wall encroaching depth (T stage) by the UMP was 86.9% (53/61) in the colorectal cancer and the diagnostic accurate rate was 100.0% (3/3) in the early stage cancer.UMP stage and TNM stage showed a better consistency (Kappa=0.790).Conclusions UMP has high accurate rate in the judgment of the colorectal cancer encroaching depth.There is some value in the T stage diagnosis before operation,which could help patients with colorectal cancer select suitable therapies.

Objective: To study the cell proliferation, cell cycle and apoptosis of esophageal carcinoma Eca-109 cells treated with RNA interference technique to silence signal transducers and activators of transcription 3 (STAT3) gene. Methods: Three pairs of DNA template coding siRNA specific for human STAT3 gene mRNA were designed and synthesized. The annealed oligonucleotide fragments were subcloned into pRNAT-U6.1/neo plasmid to construct STAT3-siRNA expression vector which was then transfected into Eca-109 cells. The expression of STAT3 mRNA and protein in cancer cells was detected by RT-PCR and Western blot, respectively. The cell proliferation, cell cycle distribution and apoptosis were examined by MTT and flow cytometry. Results: STAT3-siRNA expression vector was successfully constructed and identified by sequencing. The results of RT-PCR and Western blot demonstrated that STAT3 expression in Eca-109 cells transfected with STAT3-siRNA expression vector was significantly higher than that in the control group (P＜ 0.01). MTT showed that after transfection of the siRNA vector into Eca-109 cells, cell proliferation was obviously reduced and the cell growth inhibition ratio in the siRNA3 group was 35.68%, significantly higher than that in the control group (P＜0.01). Flow cytometry results suggested that cell cycle arrest and more apoptosis were observed in the siRNA3 group. Cell cycle was arrested at G_0/G_1 phase, and the rate of apoptosis was 13.26%, much higher than that in the control group (P＜0.01). Conclusion: Silencing STAT3 gene by RNA interference technique can effectively inhibit STAT3 expression, suppress the proliferation of Eca-109 cells, induce cell cycle arrest at G_0/G_1 phase, and promote apoptosis.

Through introducing the current situation of systemic pediatric emergency protocol,including five-level triage system,pediatric critical rescue protocol,pediatric trauma life support,emergency observation and guidelines for the pediatric intrahospital transport,we reviewed the issues of pediatric emergency to put forward recommendations.

Objective To study the mechanism of steroid induced necrosis of femoral head. Methods The cell experiment of effect of dexamethasone on the osteoblast in vitro and animal experiment of steroid induced necrosis of femoral head. Results The cell experiment showed that dexamethasone played two roles to bone marrow' mononucleate cells in vitro. The first was that it can prevent the cells from differentiating into the osteoblasts and the second was that it can cause fatty degeneration. The animal experiment showed the number of vacant bony lacunae in femoral head, the average diameter of fat cells in marrow cavity were increased and the number of blood vessles in subchondral areas was decreased with large doses of dexamethasone. Conclusions The mechanism of steroid induced necrosis of femoral head was that dexamethasone can inhibit the grouth of the osteoblasts directely, and cause fatty proliferation of bone marrow resulting in disorder of micro circulation and osteonecrosis in the femoral head.

Objective To explore the investigative studies of experimental value on the children suffered from a parotitis with pancreatitis.Methods 108 children patients were divided into 3 sub-groups:parotitis,parotitis with minigitis,parotitis with pancreatitis.45 cases were pantitis,24 were parotitis with pancreatitis and 39 were parotitis with minigititis.All the patients had serum amylase,serum lipase and abdominal B-ultrasound detected.All the results were statistically analyzed.Results The patients who had parotitis with pancreatitis were higher at abnonmal serum lipase and B-ultrasound(?~2=58.68,P