Child ; Consensus ; Disease Management ; Humans ; Pediatrics ; Shock, Septic ; therapy

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.

This paper is a literature review of impact of comorbidity on the executive function(EF) of patients with attention deficit hyperactivity disorder(ADHD).Over 80% of children and adolescents and 65%-89% of adults with ADHD suffer from one or more additional psychiatric disorders.EF deficits in ADHD of all ages can be demonstrated to be independent of psychiatric comorbidity.The presence of comorbid learning disorder(LD) and mood disorder(MD) appears to increase the EF deficits in ADHD which seems to be decreased by the the presence of comorbid anxiety disorder and oppositional defiant disorder and conduct disorder(ODD/CD).However,the comorbidity of LD,MD,ODD/CD and Tourette syndrome may have no impact on the EF deficits in ADHD.

Objective:To test the reliability and validity of the behavior rating scale of executive function(BRIEF) parent form for school age children in China.Methods:A total of 216 patients [attention deficit hyperactivity disorder(ADHD) or schizophrenia or autism] and 311 normal controls were involved in this research.Parents of the subjects completed the BRIEF,ADHD rating scale-Ⅳ,Conners,and Rutter rating scales.And performance-based tests of executive function were carried out among some of the controls and ADHD subjects.These tests included Rey-Osterrieth complex figure(ROCF),trail-making test,digit span test,Tower of Hanoi(TOH), and Stroop test.Results:Test-retest reliability was 0.68—0.89 and Cronbach a coefficient was 0.74—0.96 except for the initial subscale(0.61).Subscales of BRIEF were moderately correlated(r=0.41—0.64) with subscales of other criteria scales such as ADHD rating scale-Ⅳ,etc.And there were correlations(r=0.32—0.41) between subscales of BRIEF and some indexes of the performance-based tests of executive function in the control group while the correlations in the diagnostic group were negative.For example,the inhibition subscale correlated with detailed score of ROCF delayed recall test and Stroop word-color interference time(r=-0.32,0.38).The working memory subscale correlated with time for trial B of the trail-making test,numbers of backwards digit test and Stroop word-color interference time(r=0.30,-0.39,0.41).Lisrel Confirmatory factor analysis showed that the 8-subscale model of BRIEF was reasonable.Compared with the control group,the diagnostic groups(ADHD-C,ADHD-I,schizophrenia and autism) got significant higher scores almost on all subscales of BRIEF(Z=-3.17—-4.17,P

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.

Objective:To study the stability of thiamine nitrate ( VB1 ) and pyridoxine hydrochloride ( VB6 ) in total parenteral nu-trition ( TPN) solution containing multi-trace elements injection (Ⅱ) . Methods:HPLC was used to determine the contents of VB1 and VB6 in different prescriptions in 0, 2, 4, 6, 8 and 24 h. Meanwhile, the pH value was determined and the appearance of the solution was observed. Results:The contents of VB1 and VB6 in 5% glucose solution containing multi-trace elements injection (Ⅱ) were changed mithin the range of 10%. In the TPN solution, containing multi-trace elements injection (Ⅱ) , the content of VB1 decreased by 12% in 8 h, and the content of VB6 was changed within the range of 10%. The solutions containing multi-trace elements injection (Ⅱ) were all light yellow, while the solutions without multi-trace elements injection (Ⅱ) were colorless and transparent. The pH val-ue showed no significant change in each group. Conclusion: The TPN solution containing multi-trace elements injection (Ⅱ) and compound trivitamin B for injection (Ⅱ) is recommended to be used in 8 hours.

Objective:To study the stability of total parenteral nutrition ( TPN) solution used in our hospital .Methods:The ap-pearance and pH of the compatibility solution were observed and the content of vitamin C was determined in 8 h after the compatibility . Results:The content of vitamin C in compound amino acid solution was decreased with the time , and the solution turned yellow in 4 h and the content of vitamin C was decreased by 10%, while no notable change in pH value was shown .The solution without compound amino acid was stable in 6 h.Conclusion:Vitamin C injection mixed with TNP solution containing compound amino acid is not recom-mended, and vitamin C should be used alone .

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.

1.78 mmol/L,intact parothyroid(iPTH)2.37 mmol/L,calcium dose was 1 000 mg/d;if serum Ca~ 2+ was0.05].After low-calcium dialysis(1.25 mmol/L Ca~ 2+ dialysate)for 6 months:the serum Ca~ 2+ level had no change[(2.37?0.26)mmol/L to (2.41?0.24)mmol/L];the serum P level had decreased significantly from[(2.60?0.47)mmol/L to (2.29?0.58)mmol/L];the iPTH had increased significantly from[(130.7?84.6)pg?mL~ -1 to (169.2?105.8)pg?mL~ -1 ,P

Objective To investigate the value of CT perfusion imaging in quantitative monitoring on microcirculation hemodynamics,differences between tumor and normal tissues,differences between mass center and edge,and on tumour microvascular responses to anti-angiogenesis therapy. Methods Fifteen male New Zealand white rabbits were established to VX2 tumor-bearing model. The animals were divided into 2 groups,anti-angiogenesis therapy (n=11,TNP-470,20 to 30 mg/kg),and control (n=4). DEC-CT scanning (80 kV,120 mA,20 cm VOF) was performed at 1 week after tumor implantation,1 week after anti-angiogenesis therapy,and 2 week after anti-angiogenesis therapy. Perfusion parameters,including blood flow (BF),blood volume (BV),mean transit time (MTT),and permeability surface (PS) were calculated for tumor mass,tumor edge,tumor center and normal tissue. Results Significant differences of the average values were observed in BF,PS and MTT between tumor and normal tissue [149.32?30.99 vs 32.18?4.10 ml/(100 g?min),28.24?5.15 vs 11.88?0.71 ml/(100 g?min),2.79?0.66 vs 6.57?0.90 s,P