The progress and development of extracorporeal life support (ECLS) is suprising and on-going,especially extracorporeal membrane oxygenation (ECMO) has become an accepted therapeutic modality for patients who have failed conventional therapy with respiratory and/or cardiac support.Blood purification developed from hemodialysis is designed to remove substances from the circulation and now includes hemodialysis,hemofiltration,immunoadsorption,continous blood purification and peritoneal dialysis.Plasma exchange and hemoperfusion play an important role in critically system diseases,i.e.,some kidney diseases,neurologic diseases,liver failure,metabolic diseases,connective tissue disease,infection diseases,intoxication and so on.

The increased level of fibrinogen (Fg) is an independent factor that resulting in the occurrence of ischemic cardio-cerebrovascular diseases. The Fg level is correlated with heredity, age, sex, obesity, lipid, smoke, inflammation and infection, and the pathogenic effect of genetic factor has been increasingly receiving attention. In recent years, more than 10 FgBβ gene polymorphisms have been reported, among them, - 148C/T, - 455G/A, and - 854G/A are considered to be significantly correlated with the increased level of Fg, and may be one of the most key factors in influencing the genetic risk factors of the occurrence of ischemic cerebrovascular disease.

Objective To analyze the clinical features of overlap syndromes(OS),I.e.,chronic obstructive pulmonary disease(COPD)complicated with obstructive sleep apnea hypoventilation syndrome (OSAHS).MethodsFrequency of episodes of acute exacerbation,severity,quality of life,exercise endurance,complications and three-year survival rate were investigated in eight patients with OS and 10 patients with pure COPD.Results Both quality of life and exercise endurance in OS group were lower than those in COPD group(P＜0.05).Annual frequency of acute exacerbation episodes and severity were more and three-year survival rate was lower in OS group than those in COPD group(P＜0.05).Complications of hypertension,diabetes,erythrocythemia,respiratory failure and heart failure were all more frequent in OS group than those in COPD group.Among all the above clinical features,increased frequency of acute exacerbation episodes was the most significant.Conclusions OS is clinically more severe than pure COPD,so more attention should be paid to it.Survival for patients with OS can not extended by nocturnal oxygen therapy alone,which may be beneficial when combined with biphasic positive airway pressure(BiPAP)or continuous positive airway pressure(CPAP)ventilation.

Pediatric Critical Care Medicine have developed rapidly and played a big role in the clinical treatment in China in recent years.But we axe now still in lack of unified documents as a guidline because of our late development and difference between regions.We should pay more efforts to formulate and perfect the standardization constructions of pediatric intensive care unit,with the help of The Construction and Management of Critical Care Medicine.In this article,we stated the present situation of development,operational mode,personnel and equipment configuration,monitoring and treatment technology,process specification and quality index in pediatric intensive care unit.And we also offerd some proposal about that.

The onset of stroke is related to the deficiency of kidney water, internal stirring of liver wind, disorder of brain marrow, and blood. They are in evolutionary relationship. The disorder of kidney-liver-brain axis is the core pathogenesis of stroke. In the aspect of meridian and function, the Du meridian is closely related to the kidney, liver and brain. Acupuncture on the Du meridian to regulate the kidney-liver-brain axis is an effective method in the treatment of stroke. The clinical practice and research have proved that DU20-Baihui and DU14-Dazhu are im-portant acupoints in the treatment of stroke.

Objective To develop a new type of medical ultrasound debridement instrument and the amplitude bar. Methods According to the specific requirements of the debridement instrument, the electronic design techniques were adopted to determine the sound intensity threshold, oscillation amplitude and near-filed distance. Results The amplitude bar could meet all kinds of technical requirements, and the titanium alloy raw materials made it corrosion-resistant and anti-fatigue. Conclusion The amplitude bar adapts well to the debridement instrument, and other medal materials also can be adopted according to different requirements.

Toxoplasma gondii is a globally distributed Apicomplexan Protozoa which can infect all warm-blooded animals and cause serious diseases in immunocompromised host.More attention has been paid to wide distribution and opportunistic pathogenesis of T.gondii.This paper is summarized the history,the lastest hotspots in Toxoplasma and future challenges in toxoplasmosis control.

Objective:To analyze the influences of azithromycinantibiotic combined glucocorticoids on the levels of erythrocyte sedimentation rate (ESR),serum lactate dehydrogenase (LDH) and inflammatory cytokines levels as well as the clinical effect of severe pneumonia mycoplasma.Methods:112 children with severe pneumonia mycoplasma who were treated in our hospital were selected and randomly divided into the control group and the observation group with 56 cases in each group.The patients in the control group were treated with azithromycinantibiotic,while the patients in the observation group were treated with glucocorticoid on the basis of the control group.Then the levels of ESR,LDH,isoenzyme MB (CK-MB),creatine kinase (CK),aspertate aminotransferase (AST),c-reactive protein (CRP),interleukin 6 (IL-6),tumor necrosis factor-o (TNF-α),CD4+ and CD8+,the clinical efficacy and adverse reactions between two groups were observed and compared before and after the treatment.Results:The effective rate in the observation group was higher than that of the control group,and the difference was statistically significant (P＜0.05).After treatment,the levels of ESR,LDH,CK-MB,CK,AST,CRP,IL-6,TNF-α and CD8+ in the two groups decreased,which were lower in the observation group than those of the control group (P＜0.05).After treatment,the levels of CD4+ in both groups increased,which was higher in the observation group than that of the control group (P＜0.05).The disappearance time of fever,cough relief,lung rale of observation group were shorter than those of the control group(P＜0.05).There was no statistically significant difference in the adverse reactions between the two groups (P＞0.05).Conclusion:Azithromycin combined with glucocorticoids was more effective than azithromycin alone in the treatment of severe mycoplasma pneumonia with high safety,which could obviously relieve the myocardial injury and inflammatory response,enhance the immune function.