Acute respiratory distress syndrome is a serious disease and has a high mortality rate.Protective ventilation strategy and conservative fluid management is the mainstay of treatment and there is no effective pharmacological treatment yet.Recent studies found that beta-2 adrenergic receptor agonists in the treatment of acute respiratory distress syndrome could inhibit the inflammatory response,protect the functions of alveolar capillary barrier,improve pulmonary edema fluid removal,promote the secretion of surfactant and enhance the impaired lung repair,and so on.This review aimed for the pathogenesis,mechanism of action and treatment mechanism of the recent studies.

Prevalence rates of paediatric allergic diseases have been gradually increasing worldwide,which cannot be ignored.The theory of atopic march of paediatric allergic diseases has been verified as early in 1985.The atopic march refers to that allergic symptoms in infancy or early childhood often predate development of other allergic diseases later in life.A number of longitudinal epidemiological studies support this theory,mainly from Europe and North America.However,there are some challenges to this theory.Allergic disease in children is influenced by various factors such as early wheezing,gender and a parental history of allergic diseases.This article reviews the latest progress on the atopic march of paediatric allergic diseases,which may provide clues to the early recognition and management of children at high risk of these diseases.

ObjectiveTo observe the effect ofTong Guan Li Qiao(opening orifices) needling method on the swallowing function in patients with post-stroke deglutition disorders.MethodNinety-one patients were randomized into an acupuncture group of 46 cases and a control group of 45 cases. The acupuncture group was intervened byTong Guan Li Qiaoneedling method, while the control group was by rehabilitation training. The Standard Swallowing Assessment (SSA), Modified Barthel Index (MBI), Swallowing-related Quality of Life (SWAL-QOL) and Hamilton Depression Scale (HAMD) were adopted for evaluation before and after intervention.ResultAfter intervention, the SSA, MBI, SWAL-QOL, and HAMD scores were significantly improved in the two groups (P<0.05); there were significant differences in comparing the scores between the two groups after intervention (P<0.05), and the improvements in the acupuncture group were more significant than that in the control group (P<0.05).Conclusion Tong Guan Li Qiaoneedling method can produce a more significant efficacy than conventional rehabilitation, by more effectively improving the swallowing function, activities of daily life, quality of life, and depression state in patients with post-stroke deglutition disorders.

Objective To explore the relationships of traumatic brain injury ( TBI ) and recognition and empathy.Methods 120 cases with moderate to-severe TBI and 120 healthy controls with age and gender-matched were chose.Participants were evaluated for facial and vocal affect recognition;and affective and cognitive empathy (empathic concern and perspective-taking,respectively) were detected.Results Participants with TBI had signifi-cantly poorer facial and vocal affect recognition.Facial and vocal affect recognition variances (14.28 ±3.87) points and DANVA2-Voice (14.12 ±3.14) points were significantly lower than those of the control group ( t=-3.927, 4.183,all P<0.05);the empathic concern score (19.58 ±4.87) points and perspective taking(14.46 ±5.34) points were significantly lower than those of the control group too (t=-3.015,-3.935,all P<0.05).Conclusion TBI patients have a tendency to avoid thinking about emotions and more likely to have problems recognizing others′emotions and assuming others′points of view.

Objective To study the diagnostic value of 3T three-dimensional contrast-enhanced MR angiography (3D CE-MRA) of arteriosclerosis occlusive disease of lower extremities using a low dose of gadolinium.Methods 26 patients with arteriosclerosis occlusive disease of lower extremities were prospectively enrolled.DSA and 3D CE-MRA with a low dose of gadolinium were per-formed and directly compared by radiologists.Sensitivity,specificity,accuracy,positive and negative predictive values,Kappa val-ue of 3D CE-MRA were determined for significant stenoses and vessel occlusions (5 1%-100%).Results The diagnosis coincidence rate of 3D CE-MRA was 87.21%,over-and underestimation rates were 8.91% and 3.88%,respectively.Sensitivity,specificity, accuracy,positive and negative predictive values,Kappa value of 3D CE-MRA in the characterization of significant stenoses and oc-clusions were 91.67%,94.29%,93.22%,91.67%,94.29%,0.860,respectively,in aortoiliac arteries,and 90.63%,94.23%, 92.86%,90.63%,94.23%,0.849,respectively,in femoropopliteal arteries and 93.67%,75%,87.83%,89.1 6%,84.38%, 0.718,respectively,in infrapopliteal arteies.The overall sensitivity,specificity,accuracy,positive and negative predictive values, Kappa value in the lower extremity were 92.59%,88.62%,90.70%,89.93%,84.50% and 0.813.Conclusion 3T 3D CE-MRA with a low dose of gadolinium is an accurate method used to depict significant stenoses and occlusions comparable with that of DSA in lower extremity artery disease.

The relationship between immuno-suppression and poor prognosis of sepsis causes widely concern.Immuno-modulatory therapy is one of the research hotspots in critical medical care.Some studies have shown that to enhance the function of lymphocyte might improve the prognosis of septic patients.This paper will review the immune dysfunction and explore the value of immuno-modulatory therapy in process of sepsis.

Objective To investigate the expression and significance of ERα (estrogen receptorα),ERβ(estrogen receptorβ),PR,and Bcl-2 of endometrial polyps.Methods 50 cases of endometrial polyp patients were studied.And 45 cases of endometrial normal subjects were selected as the control group.The enzyme-linked immunosorbent assay was used to detected the FSH,LH,E2,P,T and PRL six levels of the two groups.And endometrial ERα two groups of patients,ERβ,PR and Bcl-2 expression was studied.Results The FSH,LH,E2,P,T and PRL six levels of the two groups were no significant difference(P ＞0.05).Polyps in patients with proliferative phase of ERα,ERβ expression levels of the normal group had no significant difference (P ＞ 0.05),the expression level of PR(0.47 ± 0.02) point was significantly lower than that of the normal group(0.53 ± 0.02) point (t =10.383,P =0.000),Bcl-2 expression levels(0.53 ± 0.04) point was significantly higher than that of the normal group (0.49 ± 0.02) point (t =4.322,P =0.000).Polyps in patients with secretory phase of ERα,Bcl-2 expression levels (0.46 ± 0.07;0.43 ±0.04)point were significantly higher than that of the normal group (0.37 ± 0.05 ;0.39 ± 0.03) point (t =5.007,P =0.000; t =3.834,P =0.000),the expression level of PR (0.42 ± 0.02) point was significantly lower than that of the normal group (0.46 ± 0.01)point(t =8.486,P =0.000),there was no significant difference in expression levels between the two groups ERβ(P ＞0.05).Between the two groups displayed,ERα,PR proliferative phase of the normal group and the polyp group,the expression levels of Bcl-2 were significantly higher than that of the secretory phase (P ＜ 0.05).Conclusion The increase of the ERα,Bcl-2 expression levels,and the reduction of the level of PR expression in patients with endometrial polyps are closely related.

Objective To investigate the relationship between the ultrasonic sign and expression of HMGB1 ,VEGF in serum of hepatocellular carcinoma patients .Methods Doppler ultrasound was used to inspect the size of the tumor and to analyze the typing and flow classification .The ELISA was used to check the HMGB1 and VEGF in serum .Results The expression level of HMGB1 in nodular and massive group was higher than that in small modelgroup (53 .5 ± 4 .3) ng/mL .The expression level of HMGB1 in massive group(102 .9 ± 9 .7)ng/mL was higher than that in nodular group(76 .0 ± 6 .2) ng/mL(P<0 .05) .The VEGF among three groups had no difference(P>0 .05) .With the increase of flow classification ,the levels of HMGB1 and VEGF also increased(P<0 .05) .Conclusion The HMGB1 in serum has some connection with morphology types .The HMGB1 and VEGF in serum increase with the flow classification .

In accordance with the requirement of comprehensive therapy of plum-blossom magnetic needle, the corresponding acupoints were punctured by plum-blossom needles, in combination with effect-enhancing pad. In 98 cases of the patients, after 1-2 courses of the treatments, the results showed remarkable effect in 50 cases, improvement in 39 cases and failure in 9 cases, in the total effective rate of 92.8%. Comprehensive therapy of plumblossom magnetic needle is an effective therapy for bronchial asthma.

Objective To explore the relationships between antithrombinⅢ(AT-Ⅲ) and D-dimer (DD) level with pediat-ric critical illness score (PCIS) in children with sepsis, and to evaluate the values in assessing the severity of illness. Methods Sixty-one children with sepsis were included in this study. Within 24 hours after admission, blood samples were tested for the ac-tivity of AT-Ⅲ and DD level. The PCIS was calculated. According to PCIS, the patients were divided into extremely critical group (<70), critical group (71-80) and non-critical group (80-100). According to the prognosis, the patients were divided into survival and death groups. The differences of the activity of AT-Ⅲand DD were compared and the relationship with PCIS were analyzed. Results The activity of AT-Ⅲ was lower and DD level was higher in critical group than in non-critical group (P<0.01) and the changes in extremely critical group were more evident than those in critical group. The activity of AT-Ⅲand PCIS were positively correlated (r=0.548, P<0.01).The DD level and PCIS was negatively correlated (r=-0.657, P<0.01). Compared with survival group, the level of DD was significantly higher in death group (P<0.01), and PCIS and the activity of AT-Ⅲwere significantly lower in death group (P<0.05). Conclusions The patients with sepsis have dysfunctions of coagulation. The activity of AT-Ⅲ, DD level are correlated with illness severity, and can be useful for assessing the severity of sepsis.