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01 November 2013, Volume 33 Issue 11 Previous Issue    Next Issue

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Acute respiratory distress syndrome：the past，current status and prospect. YANG Yi，QIU Hai-Bo. 2013, 33(11): 833-837.  Abstract ( )   PDF (925KB) ( )   Abstract：Acute respiratory distress syndrome (ARDS) is the most commonly-seen clinical acute respiratory failure.After half a century of clinical exploration and practice，great progress has been made in the diagnosis and treatment of ARDS.Despite this intense research progress，there are very few effective therapies for ARDS other than the use of lung protection strategies.With the development of medical technology，new modes of mechanical ventilation and gene therapy for ARDS have been widely concerned.

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Diagnostic criteria of acute respiratory distress syndrome. TANG Zhao-xia，GUAN Xiang-dong. 2013, 33(11): 838-839.  Abstract ( )   PDF (885KB) ( )   Abstract：The definition and diagnostic criteria of acute respiratory distress syndrome (ARDS) have long been controversial.ARDS has high mortality，early and accurate diagnosis becomes the premise of an effective treatment.ARDS diagnostic criteria have been innovated.The latest diagnostic criteria was Berlin criteria promulgated in 2012.

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The effect of biomarkers in acute respiratory distress syndrome diagnosis and prognostic evaluation. YAN Jing,RAO Qun. 2013, 33(11): 840-843.  Abstract ( )   PDF (912KB) ( )   Abstract：Especially in the ICU acute respiratory distress syndrome is a common syndrome with high morbidity and mortality，Early diagnosis is important ,the early biomarkers be favorred gradually，CRP，PCT has been widely used in clinical,some new and original biomarkers still continues to be the focus of the study.

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Role of genetic factors in the development of acute respiratory distress syndrome. LIU Chang，LI Jian-guo. 2013, 33(11): 844-847.  Abstract ( )   PDF (912KB) ( )   Abstract：Acute respiratory distress syndrome (ARDS) is not a genetic disease，but the gene polymorphism influences the susceptibility，severity and prognosis of ARDS.It has been reported that the polymorphism of genes，such as ACE gene，SOD3 gene et al，relates to ARDS.ARDS research related gene polymorphism is currently in the preclinical stage，but it develops fast.In the future，ARDS related gene polymorphism may play an important role in identifying susceptibility risk，assessing prognosis，revealing new etiology and pathophysiological mechanisms，and optimizing diagnosis and treatment.

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Relationship between lung compliance and tidal volume selection in acute respiratory distress syndrome. MU En，MA Xiao-chun. 2013, 33(11): 848-850.  Abstract ( )   PDF (893KB) ( )   Abstract：Ventilation with low tidal volume (Vt)normalized to ideal body weight (IBW) has become a doctrine for the ventilation of patients with ARDS since the end of last century and mortality of ARDS has decreased to some extent.However，it is still highly debatable about how to choose a suitable tidal volume.Recently，with better insights into ARDS’ pathophysiological changes and its respiratory mechanics，especially with the more popular use of EIT，critical ultra sound and lung stress and strain，it is feasible to choose tidal volume individually according to the lung compliance of ARDS patients.

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Assessment of lung recruitment potential in acute respiratory distress syndrome. LONG Yun,LIU Da-wei,DING Xin. 2013, 33(11): 851-854.  Abstract ( )   PDF (903KB) ( )   Abstract：Recruitment maneuver (RM) plays a key role in the treatment of acute respiratory distress syndrome.Assessment of lung recruitability may reach a good compromise between improvement of oxygenation and reduction of ventilation-induced lung injury.Lung imaging and functional assessment are two main methods to evaluate alveolar recruitment.CT remains the gold standard in the assessment of lung recruitablity.Although P-V curve and lung ultrasound can provide evidences of alveolar recruitment at bedside，the two methods can’t provide information of lung hyperinflation.Electrical impedace tomography allows bedside assessment of tidal recruitment in dependent and nondependent regions.In addition to assessment of lung recruitablity，PET/CT can also evaluate the lung inflammation during RM.Further research is required for bedside assessment of lung hyperinflation combining alveolar recruitment.

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Non-conventional mechanical ventilation in acute respiratory distress syndrome. QI Zhi-dong，YU Kai-jiang. 2013, 33(11): 855-858.  Abstract ( )   PDF (906KB) ( )   Abstract：Mechanical ventilation is still one of the main treatment measures of acute respiratory distress syndrome (ARDS).From the traditional high tidal volume ventilation (10 ~ 15 mL/kg) to the current use of lung protective ventilation strategies：low tidal volume ventilation (VT)，positive end-expiratory pressure (PEEP)，airway pressure release ventilation (APRV)，bilevel positive airway pressure(BIPAP)，considerable progress has been made.In addition to the well-known conventional mechanical ventilation modes and methods，there are many non-standard mechanical ventilation modes and methods，such as prone position ventilation，neurally adjusted ventilatory assist (NAVA)，extracorporeal membrane oxygenation (ECMO)，high-frequency ventilation and etc.All these measures produce unique effects on the treatment of ARDS.

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Role of lung stress and strain in treatment of acute respiratory distress syndrome. HUANG Ying-zi，YANG Yi. 2013, 33(11): 859-862.  Abstract ( )   PDF (1763KB) ( )   Abstract：Acute respiratory distress syndrome (ARDS) is a common clinical acute respiratory failure，mechanical ventilation is the primary means of treatment of ARDS.Although mechanical ventilation in the continuing improvement，ARDS mortality remains high.Lung stress and strain is objective response ARDS lung mechanics mechanism indicators.In the future，monitoring of lung stress and strain，stress and strain guidance with lung protective ventilation in ARDS is very important.

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Inter pretation of 2013 European Federation of Neurological Societies recommendations for the diagnosis of Parkinson’s disease. LI Fang-fei,FENG Tao. 2013, 33(11): 862-865.  Abstract ( )   PDF (904KB) ( )   Abstract：The European Federation of Neurological Societies (EFNS) recommendations for the diagnosis of Parkinson’s disease published in 2013 provide guidelines in the Clinical diagnostic criteria,Genetic testing,Autonomic function tests,Olfactory tests,Drug challenge tests,Neurophysiological tests,Neuropsychological tests and Neuroimaging.The diagnosis of PD is still largely based on the correct identification of its clinical features.Selected investigations (genetic,olfactory,and neuroimaging studies) have an ancillary role in confirming the diagnosis，and some of them could be possibly used in the near future to identify subjects in a pre-symptomatic phase of the disease.

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Interpretation of 2013 surviving sepsis campaign guidelines for management of severe sepsis and septic shock. HUANG Wei,WAN Xian-yao. 2013, 33(11): 866-868.  Abstract ( )   PDF (897KB) ( )   Abstract：The core concept of “early goal directed therapy” was persistently intensified and the bundle strategy was revised in 2013 Surviving Sepsis Campaign (SSC) guidelines for management of severe sepsis and septic shock.Meanwhile，in the new guideline the items regarding antibiotics selection，fluid resuscitation，ARDS，as well as intestinal nutritional therapy were also modified.Nevertheless，recommendations in 2013 SSC guideline，on the whole，need further improvement.Besides，new promising therapies treatments were barely adequate.To summarize，principles can be followed according to specific circumstances and applied based on differentiation.New measures and new insights should be formed to the greatest extent.

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2012 American Society of Hematology report：advances in aplastic anemia. HE Guang-sheng. 2013, 33(11): 869-871.  Abstract ( )   PDF (897KB) ( )   Abstract：HLA-B61 is highly expressed in some pediatric patients with aplastic anemia.Mutations of STAT3，GATA-2 and SLIT1，found in some pediatric patients，may involve the immune pathogenesis of aplastic anemia.Animal model showed that the pathway about peroxisome proliferator-activated receptor-gamma might be related to activation of T cells and to adipogenesis of bone marrow in aplastic anemia.Due to the high toxicity of cyclophosphamide(120 mg/kg)，without likelihood of benefit from decreased relapse and clonal evolution，the cyclophosphamide failed in treatment for severe aplastic anemia in NIH.The front-line IS is an excellent therapy for children with acute aplasticanemia，and that in case of failure of this treatment HCST is a very good salvage option.Fludarabine，cyclophosphamide plus antithymoglobin was an optimal conditioning regimen for severe aplastic anemia patients treated by unrelated donor HSCT.