In order to explain the contribution of increase of endogenous catecholamines and exogenous administration of catecholamines to cardiac dysfunction in patients suffering from septic shock,we discussed the effects of application of catecholamines and heart,cardiac toxicity induced by catecholamines,septic shock sympathetic-adrenergic activation state and exogenous administration of catecholamines on the myocardium in sepsis.

Objective To summarize the clinical characteristics of necrotizing pneumococcal pneu-monia in childhood,so as to estimate the prognosis and guide the therapy. Methods We retrospectively col-lected and analyzed the data of 15 necrotizing pneumococcal pneumonia cases hospitalized in the pediatric de-partment of Shengjing Hospital from January 2008 to April 2011. The clinical features and treatment outcomes were analyzed,which included sex, age, maximum body temperature, hospital stay, duration of fever, white blood cell count and C-reactive protein level. Fifteen strains of the clinical isolated streptococcus were ana-lyzed antimicrobial susceptibility test with the disk diffusion procedure,and eleven strains of them were ana-lyzed by with minimal inhibitory concentrations. Results All of 15 cases had fever and pleural effusion,1 case with extrapulmonary manifestations. In chest X-ray and CT scanning,the lesion location were on the left in 7 cases,on the right in 7 cases,bilateral in 1 case. All patients had increased white blood cell count and C-reactive protein. Fifteen strains of streptococcus pneumoniae were collected from clinic samples,which had high sensitivity to vancomycin,linezolid,rifampicin,levofloxacin,no resistant strains appeared. We observed that the resistant rates of streptococcus pneumoniae to penicillin was 7/15,and to erythromycin and clindamy-cin were 11/11 and 10/11. The average length of stay in hospital was 39 d and no death occurred during the hospitalization. Conclusion The treatment of necrotizing pneumococcal pneumonia in childhood usually takes a longer time,and patients always have obvious symptoms. The drug-resisting of streptococcus pneu-moniae are serious,and children with necrotizing pneumococcal pneumonia are easily complicated by pleural effusion. But through active treatment,the prognosis is good.

Probiotics have been defined as living microorganisms exert beneficial effects on the health of the host,which can be effective in the treatment of gastrointestinal tract,respiratory tract infections and allergic diseases.Although it is currently mainly used for the treatment of bacterial and viral infections,there are also studies have shown that probiotics have inhibitory effects on parasites infection.Therefore,probiotics will provide a new way for the prevention and treatment of parasites.

Objective To investigate the efficacy of endovenous laser combined with high ligation and traditional operation in treatment of great saphenous vein varicose.Methods One hundred and fifty-six cases of great saphenous vein varicose were divided into endovenous laser combined with high ligation(observation group,78 cases)and traditional operation(control group,78 cases)by table of random digits.The incidence of postoperative recovery and complications between two groups were compared.Result The operation time,amount of bleeding in operation,incidence of affected limb hematoma in observation group were significantly lower than those in control group[(42±5)min vs.(64±8)min,(30±8)ml vs.(50±5)ml,5.13％(4/78)vs.11.54％(9/78),P＜0.05].There was no significant difference between two groups of the postoperative recovery incidence and saphenous nerve injury incidence(P＞0.05).There was no affected limb deep venous thrombosis and great saphenous vein recanalization 1 year after operation.Conclusion Compared with the traditional operation,endovenous laser combined with high ligation has the same clinical efficacy,but less operation time,less amount of bleeding in operation,and less complication.

Pediatric acute liver failure is a severe and sudden onset of hepatocyte dysfunction,leading to synthetic and detoxification failure,which could progress to multi-organ failure and death.Mortality is predominantly high due to the raised intracranial pressure,infections and multi-organ failure.The mainstay of management is supportive care in an intensive care unit.The intensive care managements include immediate measures,etiology,management of complications and liver assist device,liver transplantation.Liver transplantation is an important life saving procedure for children with acute liver failure.

Acute kidney injury(AKI)is a syndrome with many different causes and can occur at different stages throughout critical illness.Renal Doppler ultrasonography is the most appropriate imaging test in the evaluation of AKI and has the highest level of recommendation: (1)assessment of intrinsic causes of AKI, (2)distinguishing acute from chronic kidney diseases, (3)detection of the causes of obstruction.The resistive index in patients with AKI will be reviewed with attention to its use for predicting the development and prognosis of AKI.Meanwhile, combined application of cardiopulmonary ultrasound and evaluation of hemodynamics are helpful to evaluate the etiology, supervision and guiding treatment of AKI.

Objective To observe neurobehavior and pathological changes of spinal cord injury (SCI) model in adult rats.Methods The Basso Beattie Bresnahan (BBB) scoring,histological and immunohistochemical changes after SCI were observed by means of self-designed spinal cord injurying device controlled by electrocircuit.Results From the 3rd day(1.0 ± 0.7),the BBB score of injured group began to increase (increased to 4.2 ± 1.3significantly at 7th day,and at the 28th day was 7.2 ± 1.3),and the hind limb could not support the body weight.Degeneration,necrosis of lots of neurons and glial cells proliferation could be observed obviously in spinal cord injured group.Immunohistochemical experiments showed that the grey level began to decrease 2nd hour after injury,went down the minimum at the 1st day,then 3rd day recovered,and at 28 th day was still lower than that of sham group.The glial fibrillary acidic protein (GFAP) immunostaining positive cells area was gradually increased from 3rd day,reached the apex in the 14 th day,then decreased in the 28 th day.The changes of neuron specific enolase (NSE),neurofilament protein 200 (NF200) and GFAP had a close relationship with BBB score (r =0.856,0.856,0.795 respectively,P＜0.01).Conclusion The changes of NSE,NF200,GFAP after spinal cord injury reflect the characteristic of pathological change,which have a close relationship with functional recovery.

Naphazoline,Diphenoxylate, Over-the-counter (OTC) cough and cold medications, widely used for the symptomatic relief of nasal obstruction, diarrhea or common cold symptoms. But these medicines might cause poisoning even if utilized in recommended doses for treatment. The side effects of these medicines were neglected when they were used much more commonly. The clinical manifestation of these medicine poisoning were delitescence and children' s parents couldn't provide the whole history, so these medicine poisoning were often misdiagnosis, even lead to treatment failure. We explore the toxicities of these medicines ,discuss their mechanisms and clinical manifestation, and suggest why physicians should be more vigilant in specifically inquiring about them when evaluating an ill child.

BACKGROUND:Nuclear transcription factor(NTF) ?B is a transcription factor,which exists universally in eukaryocyte.It has been identified that its overacting is correlated to the ongoing and development of many diseases.Among the pathomechanism of rheumatoid arthritis,the abnormal activation of NTF ?B has a lot to do with the inflammatory hyperplasia of synovium and the erosion of tissue around articulation.OBJECTIVE:To review the recent progress of NTF ?B,pathogenesis and treatment of rheumatoid arthritis.RETRIEVAL STRATEGY:A computer-based online search of PubMed database was undertaken to identify the articles published in English from January 2000 to July 2007,with the Key words of "nuclear transcription factor ?B,rheumatoid arthritis,pathogenesis,treatment".Meanwhile,Wanfang database was searched for the related Chinese articles published between January 2000 and July 2007,with the same key words in Chinese.A total of 72 articles were finally selected for the first trial.Inclusive criteria:the articles focus on the NTF ?B,the pathogenesis and treatment of rheumatoid arthritis.Exclusive criteria:repeated experiments.LITERATURE EVALUATION:Among the 30 inclusive literatures,7 were related to reviews while the others were clinical or basic researches.DATA SYNTHESIS:①NTF ?B is a significant transcription factor,which participates in regulating many genes related to immune function and inflammation reaction.The promoters of many genes have the binding sites of NTF ?B.②It is indicated that the abnormal activation of NTF ?B plays an important role in the pathogenesis of rheumatoid arthritis.In recent years,many researches inhibiting its activation through different components of signaling pathways have been doing,which become very hot in anti-inflammatory and anti-rheumatism treatment.③In recent years,people have been making great progress in the therapy of rheumatoid arthritis aiming at cytokine and its receptor,however,interfering NTF ?B to treat rheumatoid arthritis is still in study stage.CONCLUSION:NTF ?B target therapy provides a new therapeutic strategy for the treatment of rheumatoid arthritis,which is a very exciting prospect indeed.

Extract of Ground Beetle was found to affect rat rheology. when given orally to rats for 10 consecutive days, it resulted in the lowering of packed corpuscular volume, high and low whole blood shear viscosity, RBC aggregation and rigidity indices and sedimentation rate,but the constant of SR equation was raised and without effect on Plasma viscosity and fibrinogen content. These results suggested that the effect of ground beetle extract is by way of its action on RBC