Early recognition and treatment of pediatric septic shock is key strategy to improve prognosis and reduce the mortality,yet controversy still surrounds the current fluid therapy approach.Recently,the results of the Fluid Expansion as Supportive Therapy (FEAST) trial in African children with severe febrile and hypoperfusion illnesses challenge many established principles about pediatric fluid resuscitation,and lead to intense discussion.This review is to describe the current fluid supportive therapy and possible potential mechanisms of increased death associated with bolus resuscitation.

Objective: To propose the hypothesis of "endogenous collateral wind" based on the pathomechanism of thrombogenesis complicated by ruptured plaque on acute coronary syndrome(ACS) and the theory of traditional Chinese medicine.Methods: Patients of coronary artery disease with successful coronary angiography(CAG) and intravascular ultrasound(IVUS) was made the differential diagnosis such as blood stasis,blood stasis due to phlegm obstruction and endogenous collateral wind.The levels of plasma inflammatory marker were measured to study the charactristic of "endogenous collateral wind".The prescription principle of Luoheng dripping pills was promoting blood circulation to expel wind-evil and remove wetness under guidence of "endogenous collateral wind" hypothesis.Patients with unstable angina were randomly divided into 3 groups based on therapeutic methods:conventional therapy group,luoheng dripping pills group and Tongxinluo capsule group.Results: There were characteristic changes of severity of coronary artery stenosis,the types of ACC/AHA lesion and Levin lesion,remodeling index,positive or negative remodeling percentage measured by IVUS,the plasma levels of plasma inflammatory marker measured by ELLSA in patients with endogenous collateral wind syndrome.The total effective rate of improved angina in luoheng dripping pills group was significantly higher than those in other two groups.The levels of plasma inflammatory marker were significantly lower in luoheng dripping pills group.Conclusion: There were some pathological found of the hypothesis of "endogenous collateral wind" on acute coronary syndrome.It provides the evidences that patients with coronary artery disease were treated with expelling wind-evil and removing wetness.

AIM: To observe the effect of monoclonal antibody of epidermal growth factor receptor (EGFR) on human colon carcinoma cell lines. METHODS:Cell counting, growth curve measurement and MTT method were applied in this study to examine the proliferation of cultured cells in vitro when different dosage of EGFR McAb is used to treat LST174 colon carcinoma cell lines. RESULT: The proliferation of cultured human colon carcinoma cells could be significantly inhibited in a dose dependent manner by EGFR antibody Compared with the control group, the cell number was decreased by 61 3% and 33 8% respectively when treated with 0 625 mL/L or 2 5 mL/L of EGFR McAb CONCLUSION: EGFR McAb can inhibit cell growth of human colon carcinoma LST174.

Objective To study the expression levels of interlukin-18(IL-18) in the CA1 region of the hippocampus and habenular of the rats with chronic stress. Methods Male Wistar rats (n = 30) weighting about 185～255g were divided into test group (T, n = 15) and control group (C, n = 15) randomly. The rats in group T were exposed to various types of stresses every day for consecutive 21 days. The rats in group C did not receive any stress during 21 days. Weighting and open-field tests were carried out on each rat before the test and on the 22nd day. On the 22nd day, brains were removed and cut coronally. Immunohistochemistry method was used to measure the expression levels of IL-18. Results After 21 -day stress, the body weight, erection time, rearing times, horizontal crossing numbers,modifying times and defecation in group T((297.33 ±25.83)g,(5.14 ±2.02)s,(19.00 ± 9.01), (9.47 ±3.64),(3. 93 ± 1. 87)and(4. 93 ± 1. 94)) were significantly different from those of group C((322.00 ±30.34)g,(1.97 ±0.93)s,(39.80 ±18.58),(14.80 ±5.88),(7.27 ±2.87)and(1.93 ±1.16)) (P < 0.01, P < 0.05). The average optical density values of IL-18 positive cells in CA1 region and habenular in group T ((0.3923 ±0.0084 and 0.4577 ±0.0234)) were higher than that in group C ((0. 3165 ±0.0063 and 0. 3400 ±0.0097)) (P<0.01). Conclusion The expression levels of IL-18 of the hippocampus glial cells and of the habenular neurons in the rats is increase after the chronic stress.

Objective:To study the efficacy and influence on serum interleukin 4 (IL-4) and interferon-γ(IFN-γ) levels of Xiy-anping injection in acute bronchitis children .Methods:Totally 74 cases of acute bronchitis children were divided into the experimental group and the control group with 37 cases in each .The control group was treated with the conventional treatment , while the experimen-tal group was given Xiyanping injection additionally .Before the treatment and in 7 days after the treatment , the level changes of IL-4 and IFN-γ, improvement time of clinical symptoms , clinical curative effect and adverse reactions of the two groups were compared .Re-sults:After 7 d treatment , two groups of children with the level of serum IL-4 levels were lower than the previous treatment , the IFN-γlevels were higher than previous treatment (P<0.05); And experimental groups with serum IL-4, IFN-γlevels were significantly better than control group (P<0.05).Experimental group’s lung sound, cough and expectoration, antifebrile time significantly were shorter than the control group(P<0.05), the clinical total effective rate was significantly higher than the control group (P<0.05). The incidence of adverse drug reactions in two groups had no statistical significance (P)0.05).Conclusion:Xiyanping injection com-bined with the conventional treatment can obviously increase serum levels of IL -4 and IFN-γin acute bronchitis children , improve the clinical symptoms of patients , and shorten the disease course with few adverse reactions and promising clinical curative effect .

The application of information management for ethical review work help improve the quality of audit work quality and efficiency in our country , further standardize the ethical review work , also helps to protect the pri-vacy of the subjects in medical research , and establish the medical research ethics review information system in our country has certain feasibility .Therefore , can be based on the experience of the informatization construction of drug clinical trials , through the establishment of ethical review information and tracking system , to set up the electronic signature of information rights management system , building the continuing education training , establish a commu-nication platform with the principal investigator , to build and perfect the medical research ethics review information system.

[Objective] To analyze the cases performed by unicompartmental knee arthroplasty in order to assess the early outcome,and to discuss the indications and the key points of surgical technique.[Methods]Under the principle of "slight undercorrection",15 patients were performed by unicompartmental knee arthoplasty with the technique of limited medial release if necessary.The HSS score,the fomeral tibial angle and the maxima degree of flexion and extension measured preoperatively and in the latest follow-up were analyzed by SPSS 13.0 with the method of paired t test.Meanwhile the angle of the posterior slope of the tibial implants was measured.[Results]Postoperatively the HSS score,the fomeral tibial angle and the maxima degree of flexion and extension were improved significantly in the latest follow-up,and the average angle of the posterior slope of the tibial implants was 4.2 degrees.[Conclusion]Unicompartmental knee arthroplasty has a satisfing early outcome.And it is very important to carry out the indications strictly.With the surgical technique of limited medial release,the flexional contracture could also be improved significantly.

Objective: To reveal if the use of antimicrobi als is rational in the authors hospital.　Methods: 1 025 cases were investigated retrospectively by systematic sampling from all the inp atients of the year 1997.　Results: 77.8% of the subjects were treated with antimicrobials, of whom, 55.2% treated with 2 or more antimicr obials. Yet only 39 cases had microbiological test before the administration of antimicrobials.　Conclusion: Inappropriate use of antimicr obials exists in the hospital. The management of the use of antimicrobials and c ontinuing education of medical doctors should be enhanced so as to make the use of antimicrobials more rational.

With water immersion, the water exerts a pressure on the body surface. Thus there is a blood volume shift from the periphery to the central circulation, resulting in marked volume loading of the thorax and heart. This article illustrated hemodynamic and hurohumoral responses of hydrotherapy, and dicussed whether patients with left ventricular dysfunction (LVD) or chronic heart failure (CHF) can immerse, take balneotherapy, exercise in the water and swimming. A positive effect of therapeutic warm-water tub bathing has been observed in patients with LVD and CHF, which was assumed to be from afterload reduction due to peripheral vasodilatation caused by the warm water. Optimal swimming as used for cardiovascular training programs may be allowed exclusively for NYHA class Ⅱ patients with myocardial infarction older than 6 weeks, myocarditis suffered more than 6 months ago, and cardiomyopathy. Patients with previous severe myocardial infarctions and/or CHF may bathe in a half sitting position, but immersed no deeper than the xiphoid process, because immersion up to the neck could produce abnormal increase in mean pulmonary pressure and pulmonary capillary wedge pressure temporarily. In coronary artery disease (CAD) patients with reduced LV function the heart is working more efficiently with mild cycling in water than cycling outside of water. Decompensated heart failure is the absolute contraindication to hydrotherapy.

The pulse wave velocity(PWV)known as one of important monitoring methods in crowd more can precisely reveal the occurrence of cardiovascular events.The brachia-ankle PWV(baPWV)is referred to cosmically epidemiological study in crowd.PWV is known as a vicarious mark of arteriosclerotic burden and an independent risk factor.Moreover,used for decision the therapeutic effect.Our study initially showed that PWV was only a mark of cardiovascular events and was not a predict end point.