Negative pressure pulmonary edema is a common pediatric disease,but also often to be ignored,which occurs from the upper airway obstruction caused by the change in the absolute value of negative intrathoracic pressure increase,resulting in a corresponding respiratory physiology,hemodynamic changes,common causes include laryngitis,whooping cough,foreign body,such as obstructive sleep apnea.Therefore,it is important to know the common causes of negative pressure pulmonary edema and to treat the patients in time.

Respiratory virus remains to be an important pathogen of respiratory disease in children.The disease can occur in all age groups, especially in young children.Most viral infections have a good prognosis, but special viruses still cause great harm to the health of children.Respiratory viral therapy includes symptomatic therapy, broad-spectrum antiviral drugs, drugs that directly target the viral replication cycle, drugs that attenuate the inflammatory response, and anti-viral nanodrugs.New antiviral drugs are urgently needed to develop.The repurposing of the existing therapeutic agents previously designed for other virus infections is also an effective way.The treatment of respiratory virus infection has become an important topic in clinical research.

Surfactant protein C(SP-C)is found to be expressed only in the alveolar type Ⅱ cells(AECⅡ),surfactant protein C gene mutations are found to be associated with Children interstitial lung disease.This review discusses the mechanism,diagnosis and therapy of the interstitial lung disease induced by the surfactant protein C gene mutations.

Objective Intranasal drops of dexmedetomidine can induce conscious sedation in children .This study was to com-pare the sedative effects of different doses of intranasal dexmedetomidine in different age groups of children patients . Methods We e-qually randomized 90 hernia children waiting for elective unilateral inguinal surgery ( ASAⅠ-Ⅱ) to groupsⅠ,ⅡandⅢ.At 35 minutes be-fore surgery, we obtained the heart rate (HR), mean artery pressure (MAP) of all the patients.The children in groupsⅠandⅡreceived nasal instillation of dexmedetomidine at 1 and 2μg/kg respectively, while those in groupⅢ0.4 mL of normal saline, followed by sevoflu-rane induction, intravenous injection of sufentanil (0.2μg/kg), and laryngeal mask airway anesthesia with sevoflurane .We recorded HR, MAP before medication, at 10 min, 20 min and 30 min before mediation, right after surgery, and at the recovery to consciousness . We also recorded the sedation onset time and post-surgery recovery time and assessed sedation satisfaction using the Ramsay score . Results The rates of satisfactory preoperative sedation were 50 and 63% in groupsⅠandⅡ, significantly higher than 10%in groupⅢ(P<0.05). In the 1-4-year group, the sedation satisfaction rate , sedation onset
time and post-surgery recovery time showed no significant differences between groupsⅠandⅡ(P>0.05).In the 5-8-year group, seda-tion satisfaction rate was markedly higher in groupⅡthan in groupsⅢ(77%vs 22%, P<0.05) andⅠ(77%vs 45%) . Conclusion At 1 and 2μg/kg, intranasal drops of dexmedetomidine produces similar rates of satisfactory sedation in children aged 1-4 years, and at 2μg/kg can achieve an even higher rate of satisfactory sedation without adverse hemodynamic effects in those aged 5-8 years.

Chronic inflammation has been demonstrated closely related to the tumor progression.Tumorassociated macrophage,as the most abundant immune cells in the tumor microenvironment,is a key element that links inflammation and cancer.Recently,studies found that the phenomenon and function of tumor-associated macrophage almost tend to M2 type macrophage.As an important indicator,tumor-associated macrophage usually predicts the poor progress with the cancer development.In China,Most of patients with hepatocellular carcinoma are associated with chronic viral infection.A large number of macrophages in the liver infiltrated in chronic inflammation,which are differentiated by variety of mechanisms under the chronic inflammatory stimulation,promote the development of liver cancer.In this paper,we will review the tumor-associated macrophages and the development of liver cancer.

Objective: To determine the content ursodesoxycholic acid of Compound Capsule of Bear Gall thylic. Methods: TLCS method was used. Results: Owing to improving the method on the base of original Criterion, the determination result is more similar to the true value.

Objective To compare the effect and safety of propofol with intranasal dexmedetomidine in analgesic enteroscopy for children.Methods Ninety children undergoing analgesic enteroscopy were ran-domly assigned to 3 groups.Intranasal dexmedetomidine followed by propofol was administered in the observ-ing group;sufentanil and followed by propofol was intravenously given to the control group A;propofol was given to the control group B.The scale of anesthetic effect,HR,RR,MAP and SpO2 30 min after intranasal administration were monitored.The intranasal sedation satisfaction rate,the dose of propofol,wake-up time, hospitalization,hemodynamics,adverse reaction and complication after anesthesia were recorded.Results Intranasal sedation satisfaction rate of the observing group was 83.3%(25 /30).The anesthetic effect in ob-serving group(excellent/good /bad:24 /6 /0)showed no significant difference from that in the control group A (excellent/good /bad:25 /5 /0),but better than that in the control group B(excellent/good /bad:12 /14 /4) (P <0.05).The amount of propofol in the observing group(96.2 ±5.3)mg showed no significant difference from that of group A(93.7 ±4.6)mg,but less than group B[(121.1 ±4.9)mg,P <0.05].The time of re-covery of infants in the control group A[(14.2 ±5.5)min]and the control group B[(13.7 ±3.9)min] were longer than that in observing group[(7.9 ±4.1)min,P <0.05].The hospitalization time of observing group[(14.3 ±5.4)min]was shorter than those of group A[(27.5 ±3.7)min,P <0.05]and group B [(26.3 ±6.6)min,P <0.05].The incidences of breath suppression,glossoptosis,nausea and dizziness were the lowest in the observing group,compared with the two others (all P <0.05).Conclusion In-tranasal dexmedetomidine combined with propofol,increasing children compliance,decreasing the adverse reaction,is satisfactory and safe for children anesthesia.

Objective To investigate the effect of electroacupuncture on expression of growth associated protein-43 (GAP-43) and Nogo-A in brain after focal cerebral ischemia/reperfusion in rats. Methods 48 male Sprague-Dawley rats were randomly divided into sham group, model group and electroacupuncture group, and the latter two were modeled as middle cerebral artery occlusion and reperfusion with nylon monofilament suture. Electroacupuncture was performed 90 min after modeling in the electroacupucture group at acupoints of Neiguan (PC06), Shuigou (DU26), Sanyinjiao (SP06), Baihui (DU20), for 30 min, once a day. The sham group and the model group were conventionally fed in cages without any intervention. 8 rats of each group were assessed with Longa's score, and the expressions of GAP-43 and Nogo-A were detected with immunohistochemistry 7 d and 14 d after modeling respectively. Results The sham group presented no neurological symptoms. There was not different in Longa's score between the model group and the electroacupuncture group 7 d after modeling (P>0.05), but was different 14 d after modeling (P<0.05). GAP-43 positive cells was not found in the sham group, but could be found around cerebral ischemia 7 d after modeling, which decreased 14 d after modeling in the model group. GAP-43 positive cells increased significantly in the electroacupuncture group compared with the model group at each time (P<0.01). Nogo-A positive cells was few found in the sham group, and was more in the model group (P<0.01). The expression of Nogo-A decreased significantly in the electroacupuncture group compared with the model group at each time (P<0.01). Conclusion Electroacupuncture can improve neurological function of focal cerebral ischemia/reperfusion rats, which may be associated with the increase of GAP-43 and descrease of Nogo-A in peri-infarct regions

Objective To compare the efficacy of combination therapy of intravenous immunoglobulin (IVIG) and corticosteroids versus corticosteroids alone in the treatment of toxic epidermal necrolysis (TEN) and Stevens-Johnson syndrome (SJS). Methods A retrospective study was conducted. Totally, 65 consecutive patients diagnosed as either TEN or SJS from January 1993 to October 2007 were included in this study. For 45 patients collected from 1993 to 2000, including 35 cases of TEN and 10 cases of SJS, methylprednisolone of 1 - i.5 mg per kilogram bodyweight per day or equivalent hydrocortisone or dexamethasone was given; for the remaining 20 patients collected from 2001 to 2007, including 12 cases of based on SCORTEN, a severity-of-illness-score system for TEN/SJS prognosis. Results Among the 45 patients treated with corticosteroids alone, 8.63 patients were expected to die based on SCORTEN system, while 10 deaths were observed. Standardized mortality ratio (SMR) analysis revealed that the patients treated with corticosteroids alone were 16% more likely to die than those treated with routine therapy (SMR = 1.16; 95% confidence interval, 0.56 - 2.13). In the remaining 20 patients who received combination therapy, 3 deaths occurred, while 3.51 deaths were expected based on the SCORTEN system. SMR analysis showed that the combination therapy had a trend to reduce the mortality rate of TEN/SJS (SMR = 0.85; 95% confidence interval, 0.18 - 2.50). No significant difference was noted in the mortality rate of TEN/SJS between the combination therapy and corticosteroid monotherapy (16.7% vs 22.8% in TEN, 12.5% vs 20% in SJS, respectively, both P > 0.05). In patients with TEN, the combination therapy significantly reduced the time to arrest disease progression (4.30 ± 2.36 days vs 7.15 ± 3.35 days, t = 2.46, P < 0.05) and total hospitalized time (23.40 ± 5.10 days vs 34.30 ± 16.00 days, t = 3.14, P < 0.05), but had no significant effect on the time to taper corticosteroid dose (12.30 ± 3.10 days vs 12.20 ± 5.13 days, t = -0.045, P > 0.05) compared with the corticosteroid monotherapy did; so was the case for SJS. Conelusious Compared withsolo administration of corticosteroids, the combination therapy with corticosteroid and IVIG seems to reducethe mortality rate of TEN/SJS. Also, the combination therapy could arrest the progression of TEN/SJS earlier accompanied by a decrease in hospitalization time. However, the time period of corticosteroid tapering is not shortened by the combination therapy.

ObjectiveTo explore the clinical effect of oral administration and external application of traditional Chinese medicine on early stage of osteofascial compartment syndrome. Methods56 early osteofascial compartment syndrome patients had assigned in two groups randomly, each group had 28 patients. The treatment group used topo-application Xiaoyu tincture,after aseptic gauze sodden by physic liquor,affected limb would coverd by the aseptic gauze and change of dressing every two hours,oral administration of Xingqihuayu decoction. The control group used 250ml of 20％ mannitol with dehydration therapy,two times everyday;654-2 bullet 10ml to intramuscular injection,three times every day. ResultsAfter the treatment,the results showed that the treatment group was much better than the control group at the time of ache abatement,swelling regression and disappear of all levels injury, arteriae dorsalis pedis changing. The difference had statistical significance( P ＜ 0.05). ConclusionTopo-application chinese drugs pharmaceutics of Xiaoyu tincture and oral administration of Xingqihuayu decoction was a available nonspecific treatment to early osteofascial compartment syndrome.