The children with septic shock could not be presented in hospitals with PICU facilities first.Furthermore,from a pathophysiologic perspective paediatric shock does not resemble adult septic shock.This suggests that every physician that could be faced with these children needs to understand how to recognize paediattic shock and have basic knowledge of the principles of primary management.

The importance of hemodynamic monitoring is reflected in the correct interpretation of the monitoring results and taking simultaneously the appropriate treatment strategy according to the correct interpretation of the results.The essence of the shock is body tissue hypoperfusion,whtich result in tissue hypoxia and organ dysfunction.The essence of the hemodynamic imbalance is the imbalance of oxygen supply and oxygen consumption.Therefore,the end point of the fluid resuscitation for shock is now increasing emphasis on monitoring mixed/central venous oxygen saturation and the concentration of blood lactate,the rate of lactate clearance.

Because bronchoscopy and CT technology development,the number of confirmed cases of children with airway stenosis have increased every year,but clinical management of pediatric airway constriction is a very thorny issue.This article described the application principles,indications and methods of thermal cauterization,cryotherapy,balloon dilatation airway-plasty and airway stent in airway stenosis.

Sepsis,the systemic inflammatory response syndrome(SIRS)induced by infection,is the first cause of death of patients in intensive care unit. Early diagnosis of sepsis with the actions of corresponding treatment can improve the prognosis of sepsis.It is an appropriate way to achieve early diagnosis of sepsis that using proteomics methods to detect unknown proteins during early stage of sepsis,in which we search for new protein biomarkers.

The guide of fluid resuscitation for septic shock is universal instructional.However,different individuals present different pathophysiologic characteristics.The clinicians should pay attention to the specific children when fluid resuscitation was performed.In this article,we discussed the specificity of fluid resuscitation for septic shock.

The application of bronchoscopy intervention is focused on the diagnosis and treatment of pulmonary disease infection,central airway and upper airway stenosis for children.There are few reports on the application of acute respiratory distress syndrome (ARDS),the indications and timing of the application is not common,and lack of randomized controlled study.Despite this,the present limited study suggests that therapeutic prospects have been shown in the treatment of ARDS with bronchoscopy intervention.

Extracorporeal life support system (ELSS) can maintain the heart,lung,liver,kidney function and increased cerebral blood supply and reduce intracranial pressure.In addition,for children with emergency and serious disease combined multiple organ failure (MOF),ECLS has an irreplaceable role in gaining time for the treatment of protopathy,which can ultimately reduce mortality and sequelae for children with emergency and serious disease.This review briefly summarizes the indication,pathophysiology and timing of ECLS in pediatric emergency and serious disease.

Search relative literature according to key words,focus parameters of oxygen metabolism in the diag-nosis and treatment of shock on progress. The importance of hemodynamic monitoring is reflected in the correct interpre-tation of the monitoring results and takes simultaneously the appropriate treatment strategy according to the correct inter-pretation of the results. The essence of the shock is body tissue hypoperfusion,which result in tissue hypoxia and organ dysfunction,the essence of the hemodynamic imbalance is the imbalance of oxygen supply and oxygen consumption. The end point of the fluid resuscitation for shock is now increasing emphasis on monitoring mixed / central venous oxygen saturation and the concentration of blood lactate,the rate of lactate clearance.

Objective To investigate the effect of tea polyphenols and sulforaphane on the expression of protein kinase A anchoring protein 95 and cyclin E2 in lung cancer tissue.Methods 56 cases confirmed by pathology and operation therapy for lung cancer patients,were randomly divided into combined treatment group and control group,each had 28 cases.The content of protein kinase A anchoring protein 95 and cell cycle protein E2 in all patients were determined with ELISA.The expression of protein kinase A anchoring protein 95,cyclin E2 and statistics of microvessel density(MVD) were detected by immunohistochemical SP method.The protein levels of protein kinase A anchoring protein 95 and cell cycle protein E2 protein were detected by Western Blot. Results The contents of protein kinase A anchoring protein 95 and cyclin E2 in control group were higher than that in combination group,the differences were statistically significant(P<0.01 ).Immunohistochemical SP results showed that protein kinase A anchoring protein 95 and cyclin E2 expression all had positive expression,and the MVD in control group was higher than combination group(P<0.01);Western Blot results showed that the expressions of protein kinase A anchoring protein 95 and cyclin E2 protein in control group were higher than combination group(P<0.01).Conclusion Protein kinase A anchoring protein 95 and cyclin E2 expressions are increased in both groups in lung cancer tissues,and they are positively correlated,negatively correlated with drug treatment,which can be used as the indexes of lung cancer evaluation.

In order to analyze and judge the condition of critical patients in PICU,and provide an objective basis for the treatment,invasive monitoring of physiological functions as a technology of understanding organs state is particularly important in clinical practice.Due to organ failure,some children require in vitro device to completely or partly replace organ function for a certain time,which can save and restore organ function.In order to reduce the incidence of iatrogenic damage,risk awareness and active prevention are required during these invasive procedures and organ replacement.