Although acute respiratory distress syndrome (ARDS) has been the focus of extensive basic science and clinical research over the past 40 years,its pathogenesis is not clear.The therapies for ARDS have been not consensus.In addition to the lung-protective ventilatory strategies,effective pharmacologic therapy for ARDS remains extremely limited and still continue to explore and study.This paper reviews the cunent pharmacotherapies to treat ARDS,including neuromuscular blockers,corticosteroids,neutrophil elastase inhibitor,antioxidants,granulocyte macrophage-colony stimulating factor,β2 adrenergic receptor agonists,pulmonary vasodilators.

Objective To study the activation of macrophage and upregulation of CD40 in neutropenic and nonneutropenic lipopolysaccharide (LPS)-induced acute lung injury (ALI).Methods Forty mice were randomly divided into four groups (neutropenic septic group,neutropenic control group,non neutropenic septic group and normal control group).The pathologic changes of mice lungs were observed after hematoxylin and eosin staining.CD40 expression was determined by flow cytometry.Cytokine tumor necrosis factor-α levels from bronchoalveolar lavage fluid (BALF) and serum were measured by ELISA.Results The average weight and peripheral blood white cell counts were increased significantly in the neutropenic group as compared to the non neutropenic group before the rats were sacrificed [(181.13 ± 16.94) g vs (168.56 ±5.03) g,(9.54 ± 1.25) × 109/L vs (2.56 ± 1.12) × 109/L,P ＜0.05,respectively].The cell counts in BALF were higher in neutropenic septic and non neutropenic septic groups compared to the normal control group [(3.33 ±0.26) × 106/L,(3.23 ± 0.06) × 106/L,(1.68 ± 0.23) × 106/L,P ＜ 0.05].The concentration of tumor necrosis factor-α from serum were increased significantly in neutropenic septic and non neutropenic septic groups as compared to the normal control group [(2 337.08 ± 1 148.85) pg/ml,(2 274.01 ± 1 569.37) pg/ml,(96.20 ± 93.69) pg/ml,P ＜ 0.05].The CD40 molecular expressions were higher in neutropenic septic and non neutropenic septic groups compared to the normal control group [(42.06 ± 11.90) ％,(46.38 ±7.42) ％,(21.62 ± 4.86) ％,P ＜ 0.01].Conclusion Upregulation of CD40 molecule induces the inflammatory cytokines releasing,then leads to ALI.Therefore both the inflammatory cytokines and CD40 play vital role in the pathogenesis of ALI.

Aorta, Thoracic ; abnormalities ; Humans ; Infant ; Magnetic Resonance Angiography ; Male ; Pulmonary Artery ; abnormalities ; Recurrence ; Respiratory Insufficiency ; etiology ; Respiratory Sounds ; etiology ; Subclavian Artery ; abnormalities ; Vascular Diseases ; complications ; congenital ; diagnosis ; pathology ; physiopathology

Adolescent ; Anesthesia, Intravenous ; Bronchoscopy ; Child ; Child, Preschool ; Female ; Heart Rate ; drug effects ; Humans ; Infant ; Infant, Newborn ; Male ; Oxygen ; blood ; Propofol ; pharmacology

The hypothalamo-pituitary-adrenal (HPA) axis modulates the inflammatory response during sepsis.Macrophage migration inhibitory factor (MIF) is a unique cytokine and critical mediator of host defenses in sepsis and septic shock.MIF counteracts the anti-inflammatory activity of glucocorticoid (GC).The interaction of GC and MIF might cause adrenal insufficiency.MIF could be a valuable clinical marker of adrenal insufficiency in sepsis.

Objective To study expiration time and the origin of bacteria for the sterile packages of strategic reserve between inland region and littoral under natural environment.Methods We prepared operation dressing package,apparatus package as well as dressing and apparatus mixed package with double- cotton and to be deposited in storage boxes of combat readiness warehouse under natural environment after pulsing vacuum steam sterilization.Three packages of every kind were put in a storage boxes and samples were taken from the packages and underwent bacterial culture at different time-points.Meanwhile,the bacteria strains in combat readiness warehouse' air and in the storage boxes were cultured and performed with homology analysis.Results Expiration time of sterile packages of strategic reserve was 40d in inland region whereas 24d in littoral.The major bacteria were G+ bacilli and G+ staphylococus in sterile packages of strategic reserve,combat readiness warehouse' air and storage boxes in two regions.In inland region,the 16～23SrRNA ITS sequences of bacteria strains in sterile packages shared about 97％～100％ homology with which between the air bacteria strains in combat readiness warehouse and the storage boxes whereas it was about 98％～99％ homology in littoral.Conclusions The storage environment is the most influential factor on expiration time of sterile packages of strategic reserve.The bacteria in sterile packages of strategic reserve came from the air of combat readiness warehouse.To ensure the expiration time of sterile package of strategic reserve,corresponding management methods are important guarantee which can provide new methods about management on strategic reserve.

Adolescent ; Child ; Child, Preschool ; Female ; Humans ; Infant ; Male ; Neoplasms ; complications ; Respiratory Distress Syndrome, Adult ; complications ; Risk Factors

Objective To investigate the origin of bacteria in sterile packages for war readiness under natural environment in inland region.Methods Genomic DNAs from the Bacillus cereus,Micrococcus luteus and Staphylococcus cohnii ureal in sterile packages for war readiness and from air bacteria strains in war readiness warehouse were extracted,and then used as templates to amplify the 16S rRNA and 23S rRNA ITS(internal transcribed spacer) sequences by PCR.The PCR products were extracted and sequenced,and the sequences homology analysis was performed with BLAST.Results Amplification products of DNA PCR from Bacillus cereus,Micrococcus luteus and Staphylococcus cohnii ureal were about 800,1 200 and 1 000 bp respectively;The 16S rRNA-23S rRNA ITS sequences of bacterial strains in sterile packages shared 98% to 99% homology with those from the air bacteria strains in war readiness warehouse.Conclusion The bacteria in sterile packages for war readiness come from the air in war readiness warehouse under natural environment in inland region.

After half a century of development,liver transplantation has become an important means to solve the problem of end-stage liver diseases and has greatly improved the prognosis of the patients.This article reviewed and summarized the post-operation intensive care management and treatment of complication in children with liver transplantation.