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 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 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 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.

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.

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 discuss the correlation between the consumption of antibacterials and the antibiotic resistance of Pseudomonas aeruginosa(PA) in our hospital.METHODS: The total antibacterial consumption expressed as defined daily doses(DDDs/day/100 persons) as well as the synchronous antibiotic resistance rate of PA were computed and the correlation beween the them was analyzed.RESULTS: The resistance rates of PA to cefepime,gentamycin and ciprofloxacin were positively correlated with the consumption of ciprofloxacin.A significant positive correlation was noted between the resistance rates of PA to gentamycin and imipenem cilastatin and the consumption of imipenem.The resistance rates of PA to ceftazidime and ceftriaxone were positively correlated with the consumption of piperacillin/tazobactam.The resistance rates of PA to amikacin and gentamycin were positively correlated with the consumption of amikacin and gentamycin respectively.CONCLUSION: A positive correlation was noted between antimicrobial consumption and antibiotic resistance of PA.

Through introducing the current situation of systemic pediatric emergency protocol,including five-level triage system,pediatric critical rescue protocol,pediatric trauma life support,emergency observation and guidelines for the pediatric intrahospital transport,we reviewed the issues of pediatric emergency to put forward recommendations.

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 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.