The improvement of oxygenation basis on prone positioning in acute respiratory distress syndrome (ARDS) includes increased end-expiratory lung volume,improved ventilation-perfusion (V/Q) matching,and drainage of secretions.Randomized controlled trials report that prone position ventilation in patients with ARDS tends to reduce mortality rates,especially when used in conjunction with lung protective strategies and greater prone positioning durations.At present,the available data suggest that early prone positioning may provide benefit to ARDS with severe hypoxemia.keeping in mind that a risk of positioning-related complications will have to be taken into account when weighing the risk to benefit for patient with ARDS.There is still limited information available of prone position ventilation application in pediatric ARDS.

Malignant tumor is a serious threat to human health and its pathogenesis is complex , which caused by interaction of a variety of carcinogenic factors in the human body .SALL4 gene is a kind of newly dis-covered gene and it plays an important role in function of embryonic stem cell due to its protein transcription fac -tor with C2H2 zinc finger domain.Studies found that this gene mutation often results in occurrence of malignant tumor.This paper will summarize the molecular mechanism of SALL 4 in the occurrence and development of malig-nant tumor and its diagnosis and treatment on malignant tumor .

Adenovirus,respiratory syncytial virus,influenza virus type A and B,cytomegalovirus and EB virus are the mainly etiology of severe pneumonia in children.New type of virus,such as influenza-H1N1 virus,avian influenza virus(H5N1 or H7N9) can also be epidemic in pediatric population.Ribavirin is effective drugs in the treatment of respiratory syncytial virus and adenovirus pneumonia.Acyclovir or ganciclovir is used for EB virus or immune deficiency and irnmunosuppressive patients with CMV pneumonia.Current opinin strongly recommend treatment with oral oseltamivir as soon as possible in influenza and seasonal influenza.Oseltamivir reduces the severity,duration of the symptoms of influenza,and reduces the frequency of secondary illnesses and exacerbation of underlying conditions.Zanamivir and peramivir may be effective in patients infected with influenza virus,including oseltamivir-resistant virus.Some Chinese medicine such as maxingshigan-yinqiaosan can obtain similar effect of oseltamivir in treatment of influenza virus infection.

Early goal-directed therapy ( EGDT ) emerged as a novel approach for reducing septic shock mortality and the EGDT protocol requires invasive patient monitoring to guide resuscitation with intra-venous fluids.EGDT was incorporated into guidelines published by the international Surviving Sepsis Cam-paign,but remains controversial.Recently,large randomized trials showed that EGDT did not significantly de-crease mortality in patients with septic shock compared with usual care.Fliud resuscitation and monitoring is the most important in septic shock.Therefore the EGDT is still valuable in present stage.Further,development practical methods for accurately assessing optimal fluid administration is needed.

Purpose:To study the clinical features of meningeal metastasis (MM) and investigate its diagnosis and treatments and prognosis. Methods:The clinical materials of 22 patients with MM were retrospectively analyzed. Results:Of all the 22 patients,MM was diagnosed by CT/MRI scan in 20 patients and by cytological analysis of CSF in 6 patients,the patients received therapies including systemic chemotherapy,intrathecal chemotherapy and radiotherapy,and also 1 patient without therapy.Median survival was 3 months (range 1 week-15 months). Conclusions:MM,with a poor prognosis,is one of the most serious complication of cancer. At present,all the therapies are palliative.

Objective To investigate the exposure levels of organic pollutants in child-bearing age women body. Methods The blood and urine specimens were collected simultaneously from each of 8 health women, aged 23-32 years, the organics were extracted with hexane and determined qualitatively by gas chromatography-mass spectrometer (GC-MS) for each specimen. Results In blood, 34 kinds of organic compounds had been detected , at average of (8.63?5.01 )kinds per person. Di-n-butyl phthalate (100%) and 14-bate-H-pregna (75.0%) revealed the highest detectable rates. In urine, 39 kinds of organic compounds had been identified, at average of (10.63?1.30) kinds per person, di-n-butyl phthalate(100%), HANFETT(100%), 14-bate-H-pregna(87.5%), docosane (87.5%), di-isobutyl phthalate(75.0%) were the chemicals noticed more frequently. Some kinds of these identified organics compounds were environmental toxic pollutants. Conclusion This study suggested that toxic organic pollutants had existed in child-bearing age women body, phthalic acid esters were the chemicals checked out more frequently. Their potential adverse health effects on women and offspring should be paid highly attention to.

Medical equipment is playing an important role in medical treatment, teaching and scientific research, especially in how to improve the utilization rate of large and middle medical equipment to ensure the safety and integrity of medical equipment in the clinical operation, and this is a very significant job. Through the operation of large and middle medical equipment to conduct analysis, comparison and statistics, it can be found the issue and adjusts timely to improve the medical equipment management of the technological level and economic benefits.

Objective To explore the re-treatment approach for nonsmall-cell lung cancer(NSCLC)in clinic with therapeutic alliance of cryotherapy and interventional chemotherapy. Methods Sixty two patients with uncontrolled NSCLC after common radiotherapy and(or)chemotherapy were re-treated with therapeutic alliance of cryotherapy and interventional chemotherapy, and their serum tumor markers of NSE, CEA, CY21-1 and the value(I.S%,I.O.D%)of correlative protein in nucleolus region-Ag-NORs were tested before and after the re-treatment. Meanwhile, patients' one year survival and therapeutic effect to NSCLC were recorded during the follow up. Results After the re-treatment, distinguished decline of the serum tumor markers was observed(P

Objective To construct an eukaryotic expression plasmid containing gene coding for the hemagglutinin-neuraminidase(HN)of newcastle disease virus(NDV)oncolytic strain Italien,and then to express the protein in eukaryotic cell.Method The HN cDNA was synthesized from viral RNA by RT-PCR,and the eukaryotic expression vector of HN gene(named pcDNA3.1-HN)was constructed.The vector pcDNA3.1-HN was transfected into CHO-K1 cell by liposome,and G418 was used to select stable clones expressing HN gene.The expression of HN protein was visualized by Western blot and Immunofluorescence microscopy.Results Restriction analysis and DNA sequencing proved that HN gene was correctly cloned into expression vector.Western blot analysis and immunofluorescence showed that the HN was expressed in CHO-K1 cells.Conclusion The HN cDNA of NDV was successfully cloned into eukaryotic vector which showed good expression of HN protein in CHO-K1 cells.

Objective To explore the causes of acute renal failure resulted from tacrolimus in the treatment of nephrotic syndrome. Method The clinical data of acute renal failure caused by tacrolimus in treatment of nephrotic syndrome in 3 children during January 2012 and December 2015 were retrospectively analyzed. Results There were 2 male and 1 female aged 3, 11,and 13 years respectively. Clinical manifestations were consistent with simple type of primary nephrotic syndrome. One child was frequently recurrent and another two were secondary steroid resistant. The renal pathology showed minimal changes. Acute renal failure occurred within 4 weeks after treatment with tacrolimus on the basis of hormone therapy in all patients who had infection within one week. Renal function recovered to normal within 2 weeks after discontinuation or reduction of tacrolimus combined with anti-infection and diuresis treatment. Two children continued with tacrolimus, but the other one was replaced with cyclosporin A. The renal function of all patients remained normal during the follow-up for 10-42 months. Conclusion In the first 4 weeks of tacrolimus therapy in children with nephrotic syndrome, infection may lead to reversible acute renal failure.