The incidence of severe viral pneumonia increased year on year,cardiac dysfunction is one of the commonest complications in severe pneumonia.But it is still controversial whether or not the severe pneumonia is associated with heart failure.This article focuses on the mechanisms and the treatment of severe pneumonia complicated with cardiac dysfunction.

OBJECTIVE:To cultivate qualified prescription-checking pharmacists and to ensure patients'rational drug use. METHODS:The status quo of prescription-checking pharmacists in China was analyzed and some concrete suggestions on how to cultivate qualified prescription-checking pharmacists were made.RESULTS:The phenomena of low educational level and low professional title,lack of professional knowledge and medical knowledge,lack of staff members were widespread in today's Chinese prescription-checking pharmacist professionals.CONCLUSION:The rational drug use can only be realized through being fully aware of the importance of prescription-checking pharmacists,enhancing whose admittance qualifications,working out professional standards for whom,clearly defining their responsibilities,strengthening their cultivation and increasing their numbers.

The mi nimizign time on mechanical ventilait on is one of the great importna t issues in crit-ical ill patienst ,only limited guidance on weaing and extubation is available from the pediatric literature.T he clinical application ofni dicta ions for weaning are even less clear,and the protocol-based wae ningw ith sponta-neous breaht ing trail is a feasible way in pediatric intensive care unit.

Objective To explore the common complications and methods of treatment in the malignant obstruction of upper alimentary tract with stent insertion. Methods With interventional procedure under fluoroscopic guidance fourteen self expanding stents were implanted in twelve patients, including nine with strictures or obstructions of esophagus, three with obstructions of gastroduodenum. Of the fourteen, nine were coated stents and five were uncoated stents. Results All stents were implanted successfully, but complications after the procedure occurred sometimes. There complications included: 1. Food bolus obstructed in three patients. 2. Chest pain occurred in four patients. 3. Tumour overgrowth or hyperplasia of granulation tissue in three patients caused restenosis of gastrointestinal tract. 4. Stent replacement in three patients. 5. Hemorrhage occurred in two patients (over 300 ml) causing threat to life. Conclusions The implantation of self expanding stent is a simple and effective method offering good palliation for upper alimentary tract obstructions. The complications shoud be treated correctly.

Objective To study the feasibility and safety of laparoscopically assisted hepatectomy without choledochotomy and T-tube drainage for the treatment of hepatolithiasis.Methods The study included 11 patients with hepatolithiasis in the left intrahepatic duct.Of the 11 patients,8 patients were complicated with choledocholith and 5 patients with cholecystolithiasis.After laparoscopically assisted left hepatectomy,extrahepatic bile duct stone removal and right hepatic duct exploration were carried out under video-assisted choledochoscopy through the left hepatic duct,without choledochotomy and T-tube drainage.Results The operation was successfully accomplished in all the 11 patients.Liver procedures included laparoscopically assisted left lateral lobectomy in 5 patients and left hemihepatectomy in 6 patients.The mean operation time was 128 min(range,110~150 min),and the mean blood loss was 95 ml(range,50~150 ml).No serious postoperative complications occurred.The mean postoperative hospital stay was 7 d(range,5~10 d).The 11 patients were followed for a mean of 7.6 months(range,2~16 months).The curative effects were classified as excellent in 10 patients and good in 1.No residual or recurrent stones were noted.Conclusions Laparoscopically asisted hepatectomy without T-tube drainage for the treatment of hepatolithiasis is feasible and safe for selected patients.This procedure offers advantages of simplicity of performance,short operation time,and fewer complications,being a worthwhile minimally invasive alternative.

Objective]Not only to promote the rational allocation of resources between government, society and universities,but also to provide theoretical basis and practical path for connotational development of newly-built undergraduate college.[Methods]Focusing on“ the development situation and the demand for the connotational development of the newly-built undergraduate college”and“ the aid possibility”,five representatives of newly-built undergraduate colleges and seven aid-donors were interviewed and inquired by Likert scale .[Results]The average index of newly-built undergraduate colleges on“ the development situation” and “ the demand for the connotational development” are respectively 2.93 and 4.03,showing a good situation and strong demand for external assistance.Meanwhile, the aid-donors also show a high will on the aid possibility” ,the average index is 4.06.[Conclusion]Based on analysis of“ the development situation and the demand for the connotational development of the newly-built undergraduate college, andthe aid possibility”,our research puts forward aid model and mechanism in connotational development of newly-built undergraduate college in order to make full use of external assistance, including government,society and universities.

Objective To evaluate the clinical effectiveness of direct coronary stenting without predilatation in acute myocardial infarction (AMI) Methods Intracoronary stent was directly deployed without ballon predilation in 22 patients within 12 hours from onset Single vessel disease was in 12 patients (54 5%),double vessel disease in 4 patients(18 2%) and triple vessel disease in 6 patients(27 3%) Infarct related arteries (IRA) were left anterior descending artery in 12 patients (54 5%), left circumflex in 5 patients (22 7%), right coronary artery in 5 patients (22 7%) Thrombolysis in myocardial infarction TIMI 1 flow in 5 patients (22 7%), TIMI 2 flow in 13 patients (59 1%) TIMI 3 flow in 4 patients (18 2%) Results Twenty two stents were implanted (1 stent/patient) Post stenting residual stenosis decreased to 3 2?2 9%, stent deployment was successful in 100% of the cases, There were no complications, no death, no Q wave or non Q wave myocardial infarction and no repeated recanalizations during the hospitalization Conclusion Direct coronary stenting without predilatation can be performed in AMI with its high successful rate and low complication

Objective To explore the effects of X-ray irradiation combined with RNAi against signal transducer and activator of transcription 3(STAT3)on the radiosensitivity of human esophageal carcinoma cells.Methods Human esophageal carcinoma cells of the line Eca-109 were euhured.Three pairs of DNA template aiming at the base sequences of the coding regions 2037-2055,1243-1261,and 455-473 of the STAT3 mRNA were synthesized(siRNAI,siRNA2,and siRNA3),and a negative sequence was synthesized to be used as control.STAT3-siRNA positive recombinant plasmids(pRNAT-U6.1-siRNAI,pRNAT-U6.1-siRNA2, and pRNAT-U6.1-siRNA3), and a STAT3-siRNA negative recombinant plasmid (pRNAT-U6.1-negative)were thus constructed and then transfected into the cultured Eca-109 cells,which were divided into transfection reagent control group,pRNAT-U6.1-siRNAl-3 transfection groups,and pRNAT-U6.1-negative centrel group.The positive eell clones were screened.RT-PCR and Westem blotting were used to detect the STAT3 mRNA and protein expression.The transfected Eca-109 cells were exposed to 0,2,4,6,and 8 Gy of X-rays,respectively,and the survival fraction of the cells was analyzed by clone formation assay.Flow cytometry was applied to analyze the cycle arrest and cell apoptosis 4 Gy post-irradiation.Results Agarose gel electrophoresis confirmed the successful construction of the plasmid pRNAT-U6.1-siRNA.RT-PCR and Western blotting demonstrated that the mRNA and protein expression levels of STAT3 transfected with sTAT3-siRNA3 were both significanfly lower than those of the control groups.At 2-8 Gy, the survival fractions of the siRNA3 group were aU significantly lowered than those of the control group(t＝-0.228--0.051,P<0.05).Flow cytometry showed that the percentage of the cell cycle G0/G1 phase and the apoptosis rate of the siRNA3 group were both significantly higher than those of the control groups at 4 Gy post-irradiation(t＝-13.137-16.350,P<0.01).Conclusions X-ray irradiation combined with RNAi against sTAT3 could inhibit the proliferation of the human esophageal carcinoma cells,induce cell cycle arrest and apoptosis,improve the radiosensitivity in Eta-109 cells.

Objective To discuss the value of ultrasonic miniature probe (UMP) in the preoperative staging of colorectal cancer.Methods Sixty-one colorectal cancer patients were examined before operation using the UMP (Olympus UM-2R,12 MHz).According to the intestinal wall structural layers and the close organic infiltration,the tumor encroaching depth was judged and the diagnosis of the T stage was made.All cases got the pathological verification,which was compared with the stage of UMP.Results The general diagnostic accurate rate of tubal wall encroaching depth (T stage) by the UMP was 86.9% (53/61) in the colorectal cancer and the diagnostic accurate rate was 100.0% (3/3) in the early stage cancer.UMP stage and TNM stage showed a better consistency (Kappa=0.790).Conclusions UMP has high accurate rate in the judgment of the colorectal cancer encroaching depth.There is some value in the T stage diagnosis before operation,which could help patients with colorectal cancer select suitable therapies.

Objective: To study the cell proliferation, cell cycle and apoptosis of esophageal carcinoma Eca-109 cells treated with RNA interference technique to silence signal transducers and activators of transcription 3 (STAT3) gene. Methods: Three pairs of DNA template coding siRNA specific for human STAT3 gene mRNA were designed and synthesized. The annealed oligonucleotide fragments were subcloned into pRNAT-U6.1/neo plasmid to construct STAT3-siRNA expression vector which was then transfected into Eca-109 cells. The expression of STAT3 mRNA and protein in cancer cells was detected by RT-PCR and Western blot, respectively. The cell proliferation, cell cycle distribution and apoptosis were examined by MTT and flow cytometry. Results: STAT3-siRNA expression vector was successfully constructed and identified by sequencing. The results of RT-PCR and Western blot demonstrated that STAT3 expression in Eca-109 cells transfected with STAT3-siRNA expression vector was significantly higher than that in the control group (P＜ 0.01). MTT showed that after transfection of the siRNA vector into Eca-109 cells, cell proliferation was obviously reduced and the cell growth inhibition ratio in the siRNA3 group was 35.68%, significantly higher than that in the control group (P＜0.01). Flow cytometry results suggested that cell cycle arrest and more apoptosis were observed in the siRNA3 group. Cell cycle was arrested at G_0/G_1 phase, and the rate of apoptosis was 13.26%, much higher than that in the control group (P＜0.01). Conclusion: Silencing STAT3 gene by RNA interference technique can effectively inhibit STAT3 expression, suppress the proliferation of Eca-109 cells, induce cell cycle arrest at G_0/G_1 phase, and promote apoptosis.