Objective To evaluate the relative safety of different ventilation methods regarding mortality and rates of complication,on neonatal respiratory distress syndrome (NRDS).Methods Network Meta-analysis was used to collect data on randomized controlled trials of pulmonary ventilation strategies in preterm infants with a mean gestational age of less than 32 weeks.Diagnostic criteria on NRDS were published in the PubMed,Cochrane,Web of Science,EBSCO,and Springer Link databases from January 1986 to June 2018.Revman 5.3 software was used to evaluate the quality of studies,based on the Cochrane quality assessment tool.Data were analyzed by Bayesian and frequency methods,using both Win BUGS 1.4.3 and STATA 13.0 software.Safety of different ventilation strategies for NRDS mortality and complications would include intraventficular hemorrhage (IVH),patent ductus arteriosus (PDA) and retinopathy of prematurity (ROP) and were evaluated.Counted data was displayed by OR and 95％CI.Results A total of 31 RCTs were included in this paper,including 5 827 preterm infants and 11 ventilation strategies.There were no statistically significant differences appearing in 11 ventilation strategies on mortality,PDA or ROE IVH results were reported in 28 studies.Compared with nasal intermittent positive pressure ventilation (NIPPV),both high-frequency oscillation ventilation (HFOV) (OR=3.33,95％ CI:1.08-16.67,P＜0.05) and synchronized intermittent mechanical ventilation (SIMV) (OR=8.22,95％CI:1.25-29.44,P＜0.05) schemes seemed to have increased the risk of IVH in preterm infants with NRDS.NIPPV appeared the optimal ventilation strategy in the rankings of cumulative probability.Results on clustering showed that NIPPV was probably the best ventilation strategy for children with NRDS after considering the orders of IVH,PDA and ROP on mortality,respectively.However,HFOV,IMV,and SIMV did not seem to be the ideal ventilated strategies.Conclusions Most of the clinical decision makers might prefer using NIPPV in the treatment of children with NRDS through mechanical ventilation systems to reduce both the incidence and death caused by IVH,PDA and ROP.It was not recommended to use HFOV,SIMV and IMV in treating NRDS with gestational less than 32 weeks.We suggested that larger numbers of multi-center RCTs ba carried out to make the above conclusions more convincing.

This article summarized the clinical experience of MEI Guoqiang in treating lung cancer of phlegm-heat obstructed in the lung syndrome with modified Xiaoxianxiong Decoction （小陷胸汤）. It is believed that the key pathogenesis of lung cancer with phlegm-heat obstructed in the lung syndrome is the phlegm-heat toxin accumulation. According to the different pathogenic effects of qi stagnation， blood stasis， pathogenic toxin， phlegm-damp， qi deficiency， yin deficiency in the occurrence and development of the disease， it is advocated to clear heat and resolve phlegm， and additionally the methods of diffusing the lung and relieving cough， resolving toxins and dissipating masses， rectifying qi and activating blood， dispelling dampness， supplementing and boosting qi and yin are used if necessary. Multiple methods are used together and flexibly matched. In clinical practice， Xiaoxian-xiong Decoction with the function of clearing heat and relieving phlegm is recommended as the basic formula for further modification. For patients with mild lung symptoms， modified Xiaoxianxiong Decoction is commonly used， while for those with obvious symptoms， self-made Maxing Xianxiong Decoction（麻杏陷胸汤） in modifications is suggested. For patients with Shaoyang （少阳） diseases， modified Chaihu Xianxiong Decoction （柴胡陷胸汤） is often used.