Acute respiratory distress syndrome(ARDS) is a common critical disease in pediatric patients,and mechanical ventilation is one of the most important methods for respiratory support.High frequency oscillation ventilation,which has these characteristics of low tidal volume,low airway pressure,and low alveolar injury,is a safe and effective treatment of ARDS.This article will elaborate about current status and recognition of high frequency ventilation in ARDS.

Tracheal gas insufflation is a non conventional respiratory support technology. It might avoid severe CO2 retention in lung protective ventilation strategy, reduce ventilator-associated lung injury, which was recommented recently. In this article,we made a brief introduction of the principle,classification and clinical applications of tracheal gas insufflation technique.

Respiratory tract infection is a commo n disease in hc ildren.The pathoeg ns of respiratory trract infection are very complex, includingvi ruses, bactre ia, mycoplasma pneumoniae, and fugn al, etc.The research of respiratro y pathogens is imp ortant for clinical diagnosis na d treatmento f respiratory tract infec-tions in children.In this article,we make a brife introduction to the ca qiu sition and interpretation of respirato-ry pathogens in cih ldren.

Fulminant myocarditis is a myocarditis of acute hemodynamic disorder as the main per-formance,with acute onset,rapid progression and high mortality.It will lead to serious arrhythmia and cardic shock,which may be delay to the diagnosis.There is no specific medicine for this disease currently,which is treated with symptomatic and supportive therapy in general.The application of extracorporeal membrane oxy-genation is an effective measures for the treatment of acute fulminant myocarditis in recent years.In this arti-cle,we made a review on the application of extracorporeal membrane oxygenation in fulminant myocarditis at present.

Objective To evaluate the effect of edaravone on apoptosis in hippocampal cells in a rat model of endotoxic shock.Methods Thirty-six male Sprague-Dawley rats, weighing 200-250 g, aged 6 weeks, were randomly divided into 3 groups (n=12 each) using a random number table: control group (group C), endotoxic shock group (group ES), and edaravone group (group E).Lipopolysaccharide 10 mg/kg was injected via the femoral vein to establish the model of endotoxic shock in ES and E groups, while the equal volume of normal saline was given in group C.In group E, edaravone 3 mg/kg was intravenously injected immediately after establishment of the model once every 2 h until the animals were sacrificed.The equal volume of normal saline was given instead of edaravone in C and ES groups.At 6 and 12 h after administration of edaravone, 6 rats in each group were sacrificed, and the hippocampi were isolated for determination of malondialdehyde (MDA) content (using thiobarbituric acid method) , tumor necrosis factor-alpha (TNF-α) and interleukin-6 (IL-6) contents (using enzyme-linked immunosorbent assay), and cell apoptosis in hippocampal CA1 region (by TUNEL assay).The apoptotic index was calculated.Results Compared with group C, the MDA, TNF-α and IL-6 contents were significantly increased at 6 and 12 h after administration of edaravone, and the apoptotic index was increased at 12 h after administration of edaravone in ES and E groups.Compared with group ES, the MDA, TNF-α and IL-6 contents were significantly decreased at 6 and 12 h after administration of edaravone, and the apoptotic index was decreased at 12 h after administration of edaravone in group E.Conclusion Edaravone can reduce apoptosis in hippocampal cells, and the mechanism is associated with the reduced oxidative stress and inflammatory responses in a rat model of endotoxic shock.

Fulminant myocarditis is a myocarditis of acute hemodynamic disorder as the main per-formance,with rapid progression and high mortality. There is no specific medicine for this disease currently, which is treated with symptomatic and supportive therapy in general. The application of mechanical support is an effective measure for the treatment of acute fulminant myocarditis in recent years. In this article,we made a review on the application of extracorporeal membrane oxygenation and left ventricular assist device in ful-minant myocarditis at present.

Objective To evaluate the effects of edaravone on the permeability of blood-brain barrier in septic rats.Methods Ninety male Sprague-Dawley rats,weighing 200-250 g,were randomly divided into 3 groups (n=30 each):control group (group C),sepsis group (group lipopolysaccharide (LPS)) and edaravone group (group E).Sepsis was induced by injection of LPS 10 mg/kg via the femoral vein in LPS and E groups.After LPS injection,edaravone 3.0 mg/kg was injected intravenously every 2h for 7 times in group E.The equal volume of normal saline was administered instead of edaravone in C and LPS groups.At 2,6 and 12h after LPS injection,5 rats were chosen and Evan's blue (EB) was injected via the femoral vein,and then the rats were sacrificed and brain tissues were removed for determination of EB and water contents.Another 5 rats were chosen and blood samples were taken from the femoral artery for measurement of serum MDA concentration,and then the rats were sacrificed and the brain tissue was harvested for microscopic examination.Results Compared with group C,brain water and EB contents were significantly increased at 6 and 12h after LPS injection,and the serum MDA concentration was increased at 2,6 and 12h after LPS injection in LPS and E groups (P ＜ 0.05).Compared with group LPS,brain water and EB contents were significantly decreased at 6 and 12h after LPS injection,and serum MDA concentrations were decreased at 2,6 and 12h after LPS injection in group E (P ＜ 0.05).Sepsis-induced pathological changes were significantly attenuated in group E.Conclusion Edaravone can decrease the permeability of blood-brain barrier,attenuate brain edema and brain injury in septic rats,and reduction of oxygen free radical production may be involved in the mechanism.

Acute kidney injury(AKI) is a clinical syndrome characterized as acute renal dysfunction with difficult treatment and high mortality,and is one of the most common complications in critically ill patients.Till now,the blood creatinine and urine volume were widely used to diagnose AKI in clinic,but both of them could not represent the change of renal function timely and accurately.Some new biomarkers provide new probable criteria for early diagnosis and treatment of AKI.In this paper,we make a review on new biological markers focused on AKI research at present.

Nicotinic acetylcholine receptors concentrate on the postsynaptic membrane in the neuromuscular junction and participate in the neuromuscular transmission,which is of great importance to normal muscle function. The nicotinic acetylcholine receptor is a kind of pentamer.There are 2 types of nicotinic acetylcholine receptor due to the different subunit:fetal type ?-AChR (? 2???) and adult type ?-AChR(? 2???). This article reviews the difference of 2 types of nAChR in expression period,distribution,regulation mechanism and physiological significance.

Objective To screen and identify the recombinants from the cDNA library of the adult Paragonimus west-ermani (PwA) for immunodiagnosis and immunoprophylaxis. Methods PwA cDNA library was screened with the PwA antigen immunized rabbit sera(IRS) pre-absorbed by the extract of E. coli XLl-Blue. The recombinants from positive clones were amplified by PCR, sequenced and cut off by KpnI/BarnHI and, then sub-cloned into pRESETB vector. The fusion protein was expressed,analysed by SDS-PAGE and identified by Western blotting with immune rabbit serum against worm antigen of Paragonimus westerrnani. Results The inserted cDNA fragment from the positive clone Pw-2 was about 800 bp, which contained an open reading frame(ORF) encoding Pw pre-procathepsin L belonging to cysteinase family. Expression product of Pw-2 was a fusion protein of 32 kDa, which can be recognized by immune rabbit serum against worm antigen of Paragonimus 晈esterrnani. Conclusion A recombinant plasmid Pw-2 encodes Pw pre-procathepsin L is constructed.