Early weaning from mechanical ventilation in children will lead to an extubation failure,however,prolonging mechanical ventilation will increase the risk of ventilator associated complication and the economical burden of disease.Nowadays there is no unified and objective ventilator weaning indexes in pediatrics,so it is significant to searching for appropriate and feasible ventilator weaning indexes.This article detailed the current progress on the condition and predictors of ventilator weaning in children,and comparing the predictability and accuracy of ventilator weaning indexes in children,also looking forward to the possibility of higher accuracy or scheme in ventilator weaning that used for clinical purposes.

Objective Study on the best drug compatibility for the double-lumen endobronchial intubation anesthesia. Methods Eighty ASA Ⅰ - Ⅱ patients undergoing selective thoracis surgery requiring intubation with double-lumen tubes were randomly divided into A and B group, with 40 cases in each group.The systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR), were recorded before induction (T0) , after drug injection (T1), during intubation (T2), and at 1 min (T3), 3 min (T4)and 5 min (T5) after intubation. Results There was no significant difference in SBP, DBP and HR between the two groups at T0[(124. 9 ± 16. 0) mmHg vs (125.8 ±6. 4) mmHg, (73. 1 ±9. 9)mmHg vs (74. 3± 10. 4) mmHg, (81.8 ± 6. 6) times/min vs (82. 4 ± 8. 1) times/min] (P ＞ 0. 05). Compared with parameter at T0, SBP, DBP and HR, parameters in two groups in T1 were all significantly decreased after anesthesia [(94. 8 ± 10. 03) mmHg vs (96. 9 ± 10. 1) mmHg, (57. 3 ± 7. 66) mmHg vs (55.4 ± 7. 03) mmHg,(69. 6 ± 7. 43) times/min vs (66. 3 ± 7. 03) times/min] (P ＜ 0. 05). The cardiovascular parameters at T0,T2, T3, T4 were all comparable with those in group B [SBP: (130 ± 11.6) mmHg, (125.6 ± 10. 43) mmHg,(120. 1 ± 12. 3)mmHg,(116. 8± 11.4)mmHg;DBP:(75.6 ±9. 12)mmHg,(76. 2 ±9. 8)mmHg,(73. 1 ±9. 2) mmHg, (71.6 ± 8.46) mmHg; HR: (88 ± 9. 12) times/min, (82. 9 ± 7.5) times/min, (81.9 ± 8.2)times/min, (79. 9 ± 7. 8) times/min] (P ＞ 0. 05) , which were significantly higher than those in group A [SBP: (146. 3 ± 14. 2) mmHg, (141.2 ± 10. 63) mmHg, (137. 2 ± 13.23) mmHg, (122. 9 ± 11.6) mmHg;DBP: (94. 9 ± 10. 6) mmHg, (84 ± 9.63) mmHg, (79. 9 ± 9) mmHg, (75.8 ± 8. 3) mmHg; HR: (102 ±10. 63) times/min, (97.6 ± 9. 23) times/min, (87. 7 ± 8. 2) times/min, (82. 1 ± 7.32) times/min] (P ＜0. 05). The parameters at T2, T3, T4 in group A were obviously higher than those group B (P ＜ 0. 05).Conclusions Cardiovascular response with double-lumen endobronchial intubation by sufentanil-induced was stronger than fentaty, sufentanil had more stable hemodynamic parameters and it worth to be usd in clinic.

Objective To investigate the effect of nursing ward rounds with doctors on cognition disease of primary caretakers of asthmatic children . Methods According to the admission sequence, 82 asthmatic patients and their primary caretakers were set as the control group, 76 asthmatic patients and their primary caretakers were set as the observation group. The control group adopted the traditional method of separating ward rounds between doctors and nurses. The observation group used the method of nursing ward rounds with doctors. Then their differences were compared in terms of cognition of disease and medical compliance of these two groups′primary caretakers. Result The observation group was significantly better than the control group in terms of the cognition of disease and medical compliance (P<0.01). Conclusions The method of nursing ward rounds with doctors can improve the cognition of disease and medical compliance of the asthmatic patients′ primary caretakers. It can effectively monitor and manage the asthmatic patients and control the disease recurrence. As effective ward rounds, it is worth in clinical application.

Objective: To explore the working methods of clinical pharmacists for improving the rationality of drug use through participating in individualized treatment practice for the patients with tumor.Methods: Clinical pharmacists participated in the individualized treatment of the patients with tumor, found out adverse drug interactions, adjusted dosage for the renal insufficiency patients, treated infection or pain and corrected inappropriate drug combination, etc.Results: Clinical pharmacists provided integrated pharmaceutical care and offered medical advice in accordance with the individualized information of patients, which improved the treatment effect and avoided potential adverse drug reactions or adverse events.Conclusion: Clinical pharmacists provide pharmaceutical care and participate in the performance of individualized treatment for cancer patients, which can effectively improve the level of drug treatment.

Objective To investigate the effect of defecation modes on constipation and anxiety in patients with acute intracerebral hemorrhage.Methods Sixty three conscious patients with acute hintracerebral hemorrhage were recruited in this study.Twenty five patients chose bedside closestool for defecation according their own intention and 38 chose in bed defecation.The incidence of constipation was documented and the severity of anxiety was evaluated with Zung self-rating anxiety scale (SAS) at day 7,14,21 and 28 after admission in two groups.Results Patients using bedside closestool for defecation had significantly lower rate of constipation between day 14-28 after admission (x2 =63.0,P ＜ 0.01) and lower SAS scores at day14,21 and 28 after admission (t =6.7,7.7 and 9.8,all P ＜0.01) than those with in bed defecation.Conclusions The bedside mode of defecation may improve constipation and anxiety in patients with acute intracerebral hemorrhage.

Objective To discuss the risk factors of the chronic obstructive nephropathy progression.Methods A retrospective analysis of the patients with chronic obstroctive nephropathy was performed.Multivariate logistic regression was used to identify correlate risk factors of the chronic obstructive nephrupathy progression.All calculation were compu- ted with the aid of SPSS 10.0 software package.Results In the analysis of risk factors of the chronic obstructive ne- phropathy progression,gender(OR=1.963,P=0.018),hypertention(OR=2.228,P=0.039),hyperuricemia (OR=4.204,P=0.000),hypocalcemia(OR=2.612,P=0.031),proteinuric(OR=1.639,P=0.049),hy- poabumia(OR=5.505,P=0.000),SIRS(OR=6.113,P=0.000),anemia(OR=5.257,P=0.000),renal atophy(OR=5.964,P=0.009),contrast medium(OR=6.113,P

Objective To observe the change of serum ischemia modified albumin (IMA) in continuous ambulatory peritoneal dialysis (CAPD) patients.Methods Seventy-four end stage renal disease patients undergoing CAPD more than 3 months (CAPD group) were divided into 2 groups according to clinical symptoms of cardiovascular diseases:CAPD symptoms group (29 cases) and CAPD asymptomatic group (45 cases).Seventy healthy subjects were selected as control group.The serum IMA level and abnormal rate of electrocardiogram and heart color ultrasonic were examined and compared.Results The serum IMA level in CAPD group was significantly higher than that in control group [(92.33 ± 17.17) kU/L vs.(69.63 ± 9.24)kU/L,P＜ 0.01].The serum IMA level in CAPD symptoms group was significantly higher than that in CAPD asymptomatic group [(109.37 ± 21.34) kU/L vs.(85.31 ± 8.58) kU/L,P ＜ 0.05].The elevatory rate of serum IMA level and abnormal rate of electrocardiogram and heart color ultrasonic in CAPD symptoms group were significantly higher than those in C APD asymptomatic group [37.9％ (11/29) vs.15.6％(7/45),62.1％ (18/29) vs.22.2％ (10/45),P ＜0.05].Conclusions The serum IMA level in CAPD patients is elevatory.Serum IMA level is significantly higher in CAPD patients with cardiovascular disease clinical symptoms,it can be used for diagnosis of myocardial damage in CAPD patients.

Objective:To observe the effect of supplementing qi,nourishing yin and promoting blood flow Chinese herbs on serum lipoprotein lipase (LPL) in type 2 diabetes mellitus (T2DM) patients.Methods:To determine the serum LPL of 38 cases before and after being treated with supplementing qi,nourishing yin and promoting blood flow Chinese herbal compound Danzhi Jiangtang Capsules.Results:Danzhi Jiangtang Capsules not only can improve T2DM patients in blood sugar,blood lipids and insulin sensitivity index,but also increase the level of serum LPL (P

Objective:To explore the participation ways of clinical pharmacists in clinical drug treatment to improve the rationality of drug use through the involvement in the drug treatment of patients with liver injury induced by hepatitis B virus reactivation caused by chemotherapy .Methods:Clinical pharmacists provided advice on drug use in accordance with evidence -based medicine , developed in-dividualized treatment program with clinicians and promoted clinical rational drug use .Results:Clinical pharmacist gave advice to cli-nicians based on the causes of liver function damage , hepatoprotective and anti HBV drug selection and evidence-based medicine , and the liver function of the patient was recovered rapidly .Conclusion:Clinical pharmacists can provide pharmaceutical service , partici-pate in individualized treatment of cancer patients , avoid delay of effective drug treatment , and effectively improve drug treatment level and medical quality .

OBJECTIVE:To explore the role of clinical pharmacists in tumor pain management for patients receiving tumor pain palliative radiotherapy. METHODS:In prospective randomized controlled study, 60 patients with tumor pain who received palliative radiotherapy in radiotherapy department of our hospital from June 1,2013 to May 31,2014,according with the selection criteria,were randomized into observation group(30 cases)and control group(30 cases). Clinical pharmacists participated in the treatment of observation group;provided pharmaceutical care for doctors;and recorded drug treatment,pain evaluation,medica-tion compliance,Karnofsky Performance Status(KPS)and quality of life(QOL)of 2 groups. RESULTS:On the 5th day,the pain remission rate of observation group reached 63.3%,and was significantly higher than that(36.7%)of control group(P<0.05). 1 month treatment later,pain remission rate of 2 groups reached 70% and 80%,respectively (P>0.05). At the same time,KPS, QOL and medication adherence were all improved significantly,compared with before treatment(P<0.01 or P<0.05),and medi-cation adherence of observation group was obviously better than that of control group(P<0.01). CONCLUSIONS:The participa-tion of clinical pharmacists in the pain management can obviously improve medication compliance,relieve pain more effectively, and promote rational drug use.