Based on clinical features of refractory diseases and clinical practice experience for many years,the author expounded the therapeutic strategies from establishing individualized system of differentiation treatment,treatment strategies of refractory diseases,and the key for medication,and emphasized individual concerned therapy,separating primary and secondary treatment and grasping the physiological state to treat pathological changes.Thus complicated and changeable diseases can be treated clinically.

Brain Injuries ; surgery ; Female ; Humans ; Hypoxia-Ischemia, Brain ; surgery ; Infant, Newborn ; Male ; Neural Stem Cells ; cytology ; transplantation

Anti-Bacterial Agents ; therapeutic use ; Emergencies ; Enterocolitis, Necrotizing ; diagnosis ; epidemiology ; etiology ; prevention & control ; Humans ; Infant, Newborn ; Infant, Premature ; Infant, Premature, Diseases ; diagnosis ; epidemiology ; etiology ; prevention & control ; Infant, Very Low Birth Weight ; Infection Control ; Intensive Care Units, Neonatal ; Premature Birth ; prevention & control ; Risk Factors

Microorganisms can affect the development of body immune system.Intestinal flora regulate immune function by promoting the intestinal immune system development,inducing T cell differentiation to avoid or reduce the incidence of immune-related diseases.Allergic diseases are related with the body's immune system hypoplasia and imperfect immune regulation mechanism.The immune system can be affected by intestinal flora,and the distribution of flora in the body between children with allergies and healthy children are significantly different,indicating that the occurrence of allergic diseases are associated with intestinal microflora.Studies have reported probiotic are helpful to the prevention and treatment of allergic disease,providing a new way for the prevention and treatment of allergic diseases.

1he increased peripheral benzodiazepine receptors are more significant than normal ones after cerebral ischemia. Its main reactions are the multiple pathological changes,including microglial activation, participating in neuroinflammation response, and regulation of mitochondrial function. Using radionuclide-laheled specific ligands of the peripheral benzodiaz-epine receptor (such as PK11195) for in vivo imaging contribute to the location and quantitative detection for brain injury and the study of the pathophysiological changes after cerebral ischemi-a. In addition, this receptor is promising to become a new target of neuroprotective treatment.This article reviews the recent progress in research on peripheral benzodiazepine receptors and cerebral ischemia.

Objective To study the relationship between operative procedures and complication of colorectal carcinoma with acute colonic obstruction in the elderly patients. Methods 65 elderly patients undergoing emergency operation for acute colonic obstruction were analyzed retrospectively. One stage tumor resection and anastomosis was performed in 25 cases with right-side colonic lesion and in 26 cases with left-side colonic lesion, Hartmann operation in 8 cases, Dixon operation in 4 cases and proximal colostomy in 2 cases. Results In 65 cases, 13 cases of postopera-tive complications,the rate was 20.0% (13/65) ,which infected with toxic shock two cases,four cases of pulmonary infection,anastomotic leakage two cases, wound infection, split 2 cases, death three cases, the mortality rate was 4.6%. The rates of postoperative complications in right-side colonic lesion, left-side colonic lesion, Hartmann opera-tion and Dixon operation were 69.2% ,0,30.7% and 0 respectively(P < 0.05 ～ 0.01). Conclusion Acute obstruc-tion of colon cancer,the right-side colonic lesion were safe,feasible and few complications in colorectal carcinoma with acute colonic obstruction.

Anemia of prematurity is very common in preterm infant.Phlebotomy losses and inadequate production of erythropoietin are the main reasons.Treatment of anemia of prematurity includes delayed umbilical cord clamping at delivery,decreasing phlebotomy losses,use of red cell growth factors such as erythropoietin properly,red blood cell transfusions,which are based on indications and guidelines.In this article we review recent studies in preventing and treating anemia in preterm infants.

Patent ductus arteriosus (PDA)is a common disease among premature neonates and the management of which has always been a challenge to the neonatologists. Early treatment has been advocated as the first-line approach, and drug induced closure is yet the most effective, inexpensive, and convenient method. During the last two decades,indomethacin was often given as conservative treatment, and its closure rate in PDA was approximately 46% ～ 89%. However,indomethacin may increase the number of undesirable or harmful effects including renal damage, intraventricular hemorrhage, necrotizing enterocolitis, and enterobrosis,etc. Recently,ibuprofen is rapidly emerging as a new promising drug for treatment of PDA in preterm infants with closure rate of 73.0% ～95.5%. It is used as standard therapy to close PDA,and it has less influence on the hemodynamics of kidneys, brain and gastrointestinal tract. The surgery is needed in patients with drug treatment failure and cardio-pulmonary function damage.

A magnitude of 8.0 earthquake struck on Wenchuan on May 12, 2008. Until July 1, 1393 injured persons had been admitted to Deyang People's Hospital. Of all injured persons, 32 were diagnosed with abdominal injury, including 18 men and 14 women. All the abdominal injuries were closed injury, and multiple abdominal viscera were involved in the abdominal injuries after the earthquake. Careful examination is crucial in preventing missed diagnosis. The incidences of the liver and spleen injuries were significantly higher than that of the intestine, and the reason may be that the liver and spleen are the parenchymal viscera. Diagnostic abdominocentesis can timely diagnose the parenchymal viscera with severe blood loss. Diagnostic peritoneal lavage combined with selective CT scan can timely diagnose the abdominal injuries with comparatively low cost.

Objective To evaluate the effect of chronic alcohol intake on the sedative potency of propofol through investigating the effect of chronic alcohol intake on the half-effective target effect-site concentration ( EC50 )of propofol required for loss of consciousness in patients. Methods Fifty male ASA Ⅰ or Ⅱ patients, aged 25-60 yr, weighing 50-80 kg, scheduled for elective surgery, were divided into 2 groups according to the history of chronic alcoholic intake ( n = 25 each): control group (alcoholic intake per day ＜ 25 g) and chronic alcoholic group (alcoholic intake per day＞45 g, lasting for 2 yr or more). The EC50 and 95% confidence interval (CI)were determined by up-and-down sequential method. The initial target effect-site concentration was 2 μg/nl in chronic alcoholic group and 1.5μg/ml in control group, and the ratio between the two successive concentrations was 1.05. Loss of consciousness was defined as loss of response to verbal command and eyelash stimulation. Results The EC50 of propofol that produced loss of consciousness was 3.92 (95 % CI 3.56-4.63 ) μg/ml in chronic alcoholic group and 2.73 (95%CI 2.26-3.31)μg/ml in control group. The EC50 of propofol was significantly higher in chronic alcoholic group than in control group ( P ＜ 0.05). Conclusion Chronic alcohol intake can increase the EC50 of propofol required to induce loss of consciousness and reduce sedative potency in patients.