Objective To investigate the clinical characteristics and emergency management of severe hand-foot-mouth disease(HFMD)associated with encephalitis and neurogenic pulmonary edema(NPE)caused by en-terovirus 71(EV71)in children.Method Data of critical patients with severe HFMD associated with encephalitis and NPE admitted to pediatric intensive care unit(PICU)Fuyan city Hospitals Anhni Province from May to June 2008 were reviewed.Results Of 30 patients,the mean age was 15.8 months ranged from 4 months to 48 months.The overall morality was 19.4%.Tha average duration of critical symptoms persisted Was 2.1 days ranged from 12 hours to 5 days.There were no rash found in 12 patients(33.3%).The chinical features of nervous system mani-fested the symptoms of brainstem encephalitis in 27 patients(75%),brainstem encephalitis with myelitis in 6 pa-tients(16.7%),and encephalitis in 3 patients(8.3%).The frothy expectoration tinged with pink or bloody,asyrmmetrical pulmonary edema or hemoptysis were the main features of NPE.The main approaches to the treatment were mechanical ventilation,mannitol,methylpredifiselone,intravenous immunoglobulin(IVIG),and vasoactive a-gents.And nine patients(25%)needed fluid volume resuscitation in addition.Conclusions Young children are particularly vulnerable to the Severe EV71 encephalitis with NPE.The majority of involved fatal patients are aged under 3 years.Patients may die of acute onset of NPE and/or hemoptysis with rapid progress towards cardiopul-monary failure.Early diagnosis and evaluation,respiratory support,lowering intracranial pressure and maintaining hemodynamics ale the essential therapeutic approaches.

Objective To understand the status and influencing factors of the early, middle and late pregnant women's dietary behavior in Chengdu, so as to provide a reference for the development of targeted health education.Methods A self-made questionnaire was used to investigate the dietary behaviors of 600 pregnant women in early, middle, late stage of pregnancy from 4 hospitals in Chengdu. Data entry was carried out by EpiData software, and analyzed by Chinese version of statistical software SPSS 17.0. Results The status of dietary behavior of women in different stages of pregnancy was generally good. However, there were still unhealthy eating behaviors, such as partial food, excessive intake of fruit and milk, smoking and drinking alcohol. The knowledge of dietary behaviors was mainly from families, friends, newspapers and magazines. The results of the structural equation modeling showed that the dietary behavior of pregnant women was influenced by behavioral intentions, and the standardization regression coefficientβ was 0.301. Behavioral attitudes and subjective norms affected dietary behavior by influencing behavioral intentions, withβ values of 0.131 and 0.647 respectively. The education degree of pregnant women influenced dietary behavior directly (β=0.226); family per capita income affected eating behavior by influencing behavior attitude (β=0.168); and the mother's education degree affected dietary behavior by influencing subjective norms (β=0.217).Conclusions The dietary behavior of pregnant women is generally good, but there are still some unhealthy eating habit. We should give full play to the role of medical and health personnel, give health education of pregnancy diet, and change the unhealthy dietary behaviors by changing the diet related attitudes of pregnant women and their family members.

Objective Using the evaluation and analysis of nursing risk of the patients with gastric tube after open-heart surgery , to formulate corresponding nursing strategies in order to insure patients'safety. Methods A total of 316 patients with gastric tube after open heart surgery were examined and evaluated by each nursing risks.Results A total of 316 patients with gastric tube had no adverse events , with good nursing outcomes.Conclusions By evaluation and analysis the nursing risk of the patients with gastric tube after open-heart surgery, it is possible to reduce and avoid harmful events and insure patients'safety.