Extracorporeal membrane oxygenation(ECMO)is a salvage treatment for severe respiratory or circulatory failure, which is refractory to conventional management.Critical care ultrasound can be used in each phase of pediatric ECMO treatment, such as ECMO initiation, cannulation, complications management, weaning and so on, which may provide valuable information for pediatricians.

As a kind of effective treatment,continuous blood purification (CBP),still left some risk factors in critically ill children.The risk factors include catheter-related complications such as bleeding and mispractice at the acute phase,long-term complications such as catheter infections,tube jam;complications occurred in the process of CBP such as low blood pressure,hypothermia and abnormal coagulation;metabolic complications such as lost syndrome and imbalance syndrome.CBP should be implemented safely and effectively in pediatric field by mastering the skill proficiently,continuously monitoring vital signs,tackling complications and accidental episodes.

In order to continuously improve the level of English abstracts for medical postgraduates , this paper introduces the definition, purpose, types, contents and writing strategies of English abstracts .It also introduces the writing difference and evolution of the word abstractand the writing tips of all kinds of abstracts , especially the structured abstract .In reference to international and do-mestic writing criteria , it points out the problems which should be paid attention to in writing English abstracts and tried to develop the students′consciousness in improving their level of writing English abstracts so that their thesis will be better recognized and cited by in -ternational experts , thus promoting the international academic exchanges as well as the development of China ′s medical undertakings .

Sepsis is a complex systemic inflammatory response syndrome caused by invasion of a varie-ty of pathogenic bacteria. The disease spectrum includes sepsis, severe sepsis, septic shock and multiple organ failure. Mitochondria are referred to as “power plants”, providing energy for viscera to maintain normal func-tion. Immune disorders,the activation and release of a series of inflammatory factors,anomalies of intracellular signal transmission and oxidative stress in sepsis can induce mitochondrial dysfunction. Recent research suggests that mitochondrial autophagy also plays a certain role in mitochondrial dysfunction. This article reviews the mechanism of mitochondrial functional damage during the pathogenesis of sepsis.

Objective To explore the value of the diagnosis of middle cerebral artery (MCA) stenosis with transcranial Doppler ultrasound (TCD). Methods The clinical data in patients with ischemic cerebrovascular disease examined with digital subtract angiography (DSA)and TCD were analyzed retrospectively. DSA was used as a gold standard to analyze the sensitivity and specificity of the diagnosis of MCA stenosis with TCD. The normal and TCD blood flow velocity with different degrees of stenosis were compared. The best cut-off point of the TCD blood flow velocity of MCA at different degree of stenosis was calculated. Results DSA confirmed that 103 patients had MCA stenosis or occlusion, in which 12 were mild stenosis, 22 were moderate stenosis, 40 were severe stenosis, and 39 were occlusion. Compared to DSA, the sensitivity of TCD in detection of moderate and severe MCA stenosis or occlusion was 78. 8%, the specificity was 96. 0%, and the accuracy was 93. 0%, the missed diagnosis rate was 21. 2%, and the misdiagnosis rate was 4. 0%. As to the blood flow velocity, there was no significant difference between the mild stenosis and normal groups; while there was significant difference between the moderate stenosis and normal groups (P ＜0. 001). In addition, there was no significant difference in blood flow velocity between the moderate stenosis and severe stenosis groups. Determining the cut-off value of the best peak systolic velocity of the moderate stenosis was 163. 5 cm/s, while the best cut-off value of the mean velocity was 108. 5 cm/s. Conclusions TCD has certain advantages in the diagnosis of the MCA stenosis or occlusion, and it can be used as a safe and inexpensive screening means before DSA examination.

Objective To investigate the effect of Amp activated protein kinase(AMPK)activity in radiosensitivity of human na-sopharyngeal carcinoma cells .Methods Human nasopharyngeal carcinoma cells ,CNE-2 ,were treated with AMPK inhibitor ,Com-pound C(CC) ,for 1 h .Then cells were explored in X-ray .The expression of total AMPK (t-AMPK) ,phosphorylation AMPK (p-AMPK) ,and MAPlLC3 were detected by Western blot .The number of autophagosomes were observed and calculated by transmis-sion electron microscope(TEM) .Cells processed with CC were explored in X-ray .MTT assay was used to detect the difference of two groups in cell proliferation .Cell apoptosis were assayed by flow cytometry .Results The expression of p-AMPK in CC group cells were significantly downregulated compared to the negative control group cells (P< 0 .01) ,while no significant change of t-AMPK expression were found(P>0 .05) .The expression of MAPlLC3 and the number of autophagosomes in CC group cells were significantly decreased compared to the control group cells (P<0 .05) .Correspondingly ,the cell proliferation rate in CC group was lower than in control group ,and the percent of apoptosis cells was higher in CC group than in control group (P<0 .05) .Conclusion Suppression of AM PK activity could inhibited autophagy induced by decreasing the degree of p-AM PK ,then enhanced the effect of proliferation inhibition and apoptosis promotion in CNE-2 cells .The AMPK inhibitor ,CC ,can serve as an effective assistant treatment of radiotherapy for nasopharyngeal carcinoma .

Objective To investigate the fluoride content in drinking water as well as the current status of endemic fluorosis in 5 counties of Shandong Province,in order to provide a scientific basis for making prevention and control strategies.Methods According to the survey data of fluoride content in drinking water in Shandong Province between 2005 to 2007,an epidemiological investigation was carried out in Mudan,Jiaxiang,Wucheng,Pingdu and Boxing Counties from September to November 2013.The fluoride content in drinking water and urine and dental fluorosis of children aged 8 to 12 were investigated in 3-4 major survey villages selected in the five counties.The fluoride content in drinking water was detected by fluoride ion selective electrode method,and dental fluorosis was diagnosed by Deans method.Results Fifty-eight drinking water samples were investigated in 16 villages of the five counties.Water fluorine content in Wucheng,Mudan,Pingdu,Boxing and Jiaxiang counties was 4.14,3.84,1.83,1.33 and 0.43 mg/L,respectively.There were 4 counties' fluorine content exceeding the national standard (1.20 mg/L) except Jiaxiang County.The exceeding rate was 100％ in Wucheng and Mudan counties.Urine fluorine content of 320 children aged 8 to 12 in Wucheng,Mudan,Boxing,Pingdu and Jiaxiang counties was 4.51,4.62,1.82,1.30,1.01 mg/L respectively;the total detection rate of dental fluorosis of 574 children was 61.85％ (355/574),the rate of dental damage was 12.89％ (74/574),and dental fluorosis index was 1.27;the detection rate of dental fluorosis in Wucheng,Mudan,Boxing,Pingdu and Jiaxiang Counties was 90.18％ (101/112),97.73％ (86/88),62.22％ (84/135),54.90％ (28/51) and 29.79％ (56/188),respectively.Conclusions The exceeding rate of water fluorine content is very high in 5 counties of severe endenic fluorosis areas in Shandong Province.The urinary fluorine level of the population is still high and the prevalence of dental fluorosis of children is high.Endemic fluorosis in Shandong Province has not yet been effectively controlled,control situation is still grim.

Objective To detect miR-181d expression levels in colon cancer cell lines,and to study the functions of miR-181d on colon cancer cell proliferation and apoptosis.Methods RT qPCR was employed to study miR-181d cxpression levels in colon cancer cell line HCT116,HT29,LoVo,SW480 and SW620 cells,as well as in colon normal epithelial cell line HIEC.miR-181d mimic and control were transfected into LoVo cells while miR-181d inhibitor and control were transfected into SW620 cells.qRT-PCR was performed to validate the transfection efficiency.MTT assay was performed to measure cell proliferation while flow cytometry was performed to detect cell cycle and apoptosis rate.Results miR-181d was universally downregulated in all colon cancer cell lines compared to the colon normal epithelial cell line HIEC (F=29.34,P＜0.01).Overexpression of miR-181d in LoVo cells significantly decreased in vitro cell proliferation rate (F=5.403,P＜0.01).Flow cytometry indicated that cells at S phase were greatly decreased (t=4.71,P＜0.05) and apoptotic cells were gready increased compared to the control cells (t=3.47,P＜0.05).On the contrary,inhibition of miR-181d in SW620 cells significantly promoted cell proliferation (F=20.82,P＜0.01).Cell cycle was accelerated with significant increase in S phase compared to the control cells (t=2.92,P＜0.05),whereas apoptosis rano was significantly decreased (t=4.14,P＜0.05).Conclusion miR-181d was universally downregulated in colon cancer cell lines compared to the normal epithelial cell line.miR-181d inhibits cell proliferation and induces apoptosis,thus functions as an tumor suppressive miRNA.

Objective Radiological grade of splenic injury was seldomly used in China trauma center now,though it had been established in 1994 by American Association for Surgery of Trauma (AAST) and widely used.The present study is aimed to analyze the imaging grade and clinical characteristics of traumatic splenic rupture in children,discuss the feasibility of conservative treatment,and the role of radiographic grading during clinical treatment.Methods Information (including age,gender,severity based on radiological findings,treatment strategies,and clinical outcome) regarding 59 hospitalized splenic injury patients whose injuries occurred between 2008 and 2014 was retrospectively analyzed.Results Between 2008 and 2014,59 pediatric patients with splenic injury were treated in our institution.Median age was 9.5 years (range,3 months to 16 years).Of all patients,41 (69.5%) were male.The injuries were primarily caused by traffic crash (45.7%),stumbling/falling from a height (38.9%).According to AAST,5 cases were grade Ⅰ,26 patients grade Ⅱ (44.1%),and 21 cases grade Ⅲ (35.6%),6 over grade Ⅳ,and only one was unclear.Of all patients,25 cases were with the other organs complications.All patients underwent fasting,bed rest,and antibiotics.Only 1 case was transferred to operation during the conservative treatment.Forty-nine patients underwent with CT scan over 2 times.Conclusion Imaging classification helps guide clinical treatment.Conservative treatment is feasible for traumatic splenic injury in children.Early imaging classification of splenic injury may be helpful in clinical judgment,and reduce children radiation exposure.

Objective To investigate the effect of autophagy in radiosensitivity of nasopharyngeal carcinoma CNE-2 cells.Methods The expression of ATG5 in CNE-2 cells was inhibited by lentiviral mediated RNA interference.The cells were divided into three groups:control group,NC group and ATG5 group.Cell proliferation,apoptosis and radiosensitivity were detected by CCK-8 method,flow cytometry and colony-forming assay,respectively.Results Compared with the NC group and control group,the survival of ATG5-interfected cells was reduced (F =3.755,46.086,8.609,44.160,P ＜ 0.05).After 6 Gy X-ray irradiation,the apoptosis index of the ATG5 group significantly higher than that of NC group and control group (F =394.876,P ＜ 0.05).In addition,the radiosensitivity of ATG5 group was also higher than that of control cells.Conclusions Suppression of autophagy activity enhances the radiosensitivity of human nasopharyngeal carcinoma cells.