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.

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.

Abstract: Although respiratory tract viral infections in children mainly cause respiratory diseases, severe respiratory viral infections are closely associated with infections, inflammation, or dysfunction of the nervous system. Common respiratory viruses such as human respiratory syncytial virus, influenza virus, coronaviruses, and human metapneumovirus can lead to severe neurological complications including encephalitis, acute disseminated encephalomyelitis, cerebellitis, Guillain-Barré syndrome, acute flaccid myelitis, and necrotizing encephalopathy, posing a threat to life. The outbreak of the SARS-CoV-2 epidemic has continuously increased the incidence and mortality of neurological complications in critically ill children. Therefore, this article will discuss the neuroinvasive mechanisms and neurological manifestations of respiratory viral infections in children, aiming to enhance early recognition of neurological complications related to respiratory viral infections in children by healthcare professionals and to minimize the harm of complications to children's health.

Objective To compare the image guided effect between CT and Ultrasound for percutaneous catheter drainage and sclerotherapy in the treatment of hepatic cysts.Methods 26 patients with hepatic cysts underwent percutaneous catheter drainage and sclerotherapy by CT guided.87 cases underwent percutaneous catheter drainage and sclerotherapy by Ultrasound guided.Results 53 cysts underwent percutaneous puncture with 132 times by CT guided,and 5 cysts underwent sclerotherapy were failed(10.1％).231 cysts underwent percutaneous puncture with 267 times by Ultrasound guided,and 5 cysts underwent sclerotherapy were failed(2.1％).The failed rate of the two groups had statistifically significant difference(x2 =39.6875,P ＜ 0.05).Conclusion In the image guided technique for percutaneous catheter drainage and sclerotherapy in the treatment of hepatic cysts,Ultrasound had more advantages,high accuracy,real time visual,high success rate,less damage,economy and convenience than CT.

Objective To study the mechanism of steroid induced necrosis of femoral head. Methods The cell experiment of effect of dexamethasone on the osteoblast in vitro and animal experiment of steroid induced necrosis of femoral head. Results The cell experiment showed that dexamethasone played two roles to bone marrow' mononucleate cells in vitro. The first was that it can prevent the cells from differentiating into the osteoblasts and the second was that it can cause fatty degeneration. The animal experiment showed the number of vacant bony lacunae in femoral head, the average diameter of fat cells in marrow cavity were increased and the number of blood vessles in subchondral areas was decreased with large doses of dexamethasone. Conclusions The mechanism of steroid induced necrosis of femoral head was that dexamethasone can inhibit the grouth of the osteoblasts directely, and cause fatty proliferation of bone marrow resulting in disorder of micro circulation and osteonecrosis in the femoral head.

Background and purpose:Several reports demonstrated that the expression of STAT3 has been found to be an oncogene in solid tumors such as head and neck squamous cell carcinoma,esophageal carcinoma and prostate carcinoma.This study was done to explore the effects of X-ray irradiation combined with RNAi against STAT3 on proliferation and apoptosis of human esophageal carcinoma cell line Eca-109.Methods:Three pairs of DNA template coding siRNA were synthesized against STAT3 to reconstruct pRNAT-U6.1-siRNA-STAT3,which was transfected into Eca-109 cells,the positive cell clones were screened with G418.Inhibitory effect of STAT3 mRNA and protein in Eca-109 cells was detected by RT-PCR and Western blot,respectively.The transfected cells were exposed to 0,2,4,6 and 8 Gy X-ray respectively;the survival fraction of Eca-109 cells was analyzed by clone formation assay,and flow cytometry was applied to analyze cell apoptosis at the dose of 4 Gy.Results:pRNAT-U6.1-siRNA-STAT3 was reconstructed and identifi ed as correct by sequencing.RT-PCR and Western blot analyses demonstrated that STAT3-siRNA could obviously reduce the expression of STAT3 mRNA and protein in Eca-109 cells.Clone formation assay and flow cytometry results showed that irradiation at different doses combined with STAT3-siRNA could inhibit the proliferation of Eca-109 cells,irradiation with 4 Gy X-ray could induce apoptosis.Conclusion:X-ray irradiation combined with RNAi against STAT3 could inhibit the proliferation of Eca-109 cells and induce apoptosis.

Objective To explore the investigative studies of experimental value on the children suffered from a parotitis with pancreatitis.Methods 108 children patients were divided into 3 sub-groups:parotitis,parotitis with minigitis,parotitis with pancreatitis.45 cases were pantitis,24 were parotitis with pancreatitis and 39 were parotitis with minigititis.All the patients had serum amylase,serum lipase and abdominal B-ultrasound detected.All the results were statistically analyzed.Results The patients who had parotitis with pancreatitis were higher at abnonmal serum lipase and B-ultrasound(?~2=58.68,P

0.05), so they were called the non-Dampness-Stagnation type. After adjusting age, sex, blood pressure, blood fat and blood glucose, Logistic regression analysis demonstrated that insulin sensitivity was closely correlated with SDT (P