Pediatric Critical Care Medicine have developed rapidly and played a big role in the clinical treatment in China in recent years.But we axe now still in lack of unified documents as a guidline because of our late development and difference between regions.We should pay more efforts to formulate and perfect the standardization constructions of pediatric intensive care unit,with the help of The Construction and Management of Critical Care Medicine.In this article,we stated the present situation of development,operational mode,personnel and equipment configuration,monitoring and treatment technology,process specification and quality index in pediatric intensive care unit.And we also offerd some proposal about that.

The progress and development of extracorporeal life support (ECLS) is suprising and on-going,especially extracorporeal membrane oxygenation (ECMO) has become an accepted therapeutic modality for patients who have failed conventional therapy with respiratory and/or cardiac support.Blood purification developed from hemodialysis is designed to remove substances from the circulation and now includes hemodialysis,hemofiltration,immunoadsorption,continous blood purification and peritoneal dialysis.Plasma exchange and hemoperfusion play an important role in critically system diseases,i.e.,some kidney diseases,neurologic diseases,liver failure,metabolic diseases,connective tissue disease,infection diseases,intoxication and so on.

Objective To approach the problems existed in the obsevation of illness process by low seniority nurses and their solving method. Methods The obversation ability for illness of 42 registered nurses who has worked within 3 years were evaluated.The contents included:Whether the observation was comprehensive,whether the physical checkup was correct,whether the nursing care was complete,whether the recognition of existing and potential nursing problems was in time and the mastering of important points of special medication. Results There existed common problems in the contents of illness observation,special nursing checkup,application and evaluaiton of nursing care and mastering of important points of special medication. Conclusion The illness observation ability of low seniority nurses needed improvement.Study of specialized knowledge is a premise and strengthened training is a pivotal tache.

Objective To discuss the effect of the PDCA cycle in enhancing the case care ability of nurses in order for nurses to adapt to the assessment model of cases tracking.Methods The training was carried out for enhancing nurses' ability of case care according to the PDCA cycle.Results The scores of the case care,the quality of care in wards and the patient satisfaction degree increased significantly after applying the PDCA cycle compared with those before.The aims of ensuring medical safety,improving the work quality,and increasing patient satisfaction were achieved.Conclusions Training nurses' ability of case care following the PDCA cycle can effectively improve the nurses' ability of case care,make them adapt to the case tracking assessment model,which is worthy of promotion.

ObjectiveTo summarize the early postoperation complications and treatments in children with total anomalous pulmonary venous connection (TAPVC).MethodsThirty TAPVC children who were treated with corrective operation and transferred into PICU were collected.Patients were monitored routinely for electrocardiogram,blood pressure and SpO2.The routine treatment measures included mechanical ventilation,sedation,hemostasis,positive inotropic agents,diuresis,vasodilator,antibiotics and symptomatic treatment.Adrenaline or isoproterenol was used when low cardiac output syndrome appeared and temporary pacemaker was employed in the case of bradycardia.Alprostadil and sildenafil were added instantly after corrective operation when severe preoperative pulmonary hypertension or reactive postoperative pulmonary hypertension was present.ResultsThe early postoperation complication was found in 30 cases of TAPVC,which included 13 cases of pneumonia (43.3％ ),8 of arrhythmia (26.7％ ),7 of low cardiac output syndrome (23.3％),6 of respiratory failure (20.0％ ),4 of pulmonary hypertension ( 13.3％ ),3 of pulmonary edema or atelectasis( 10.0％ ) and 1 of pneumorrhagia ( 3.3％ ).Two cases died postoperatively.The interval of stay in PICU was 1 ～ 21 d and the mean time was (5.95 ± 4.94) d.ConclusionOccurrence of respiratory complications is high among early postoperative complications of TAPVC.Therefore,preventing pulmonary infection and maintaining pulmonary function should be viewed as the key points in early postoperative monitoring and managing.In addition,more attention should also be paid on correction of arrhythmia,prophylaxis and treatment of low cardiac output syndrome and pulmonary hypertension crisis,which may improve the postoperative survival rate and care quality of TAPVC.

Objective To analyze the genetic diversity of higher artemisinin-yielding Artemisia annua. Methods With the chemical investigation of artemisinin contents, RAPD analyses of selected plants from ten various habitats in China were carried out using arbitrary primers. Results The RAPD data clearly indicated the genetic diversity level in A. annua was relatively high with 53.6% polymorphic sites. UPGMA Analyses of RAPD and phytochemical trait data showed that the wide phytochemical diversity was included within the genetic diversity being present in at least four geographical regions. ConclusionArtemisinin has obvious inherited differentiation that further support the prospects for selection and breeding of superior artemisinin containing lines.

Objective To investigate the CT and MRI findings of solid-cystic papillary epithelial neoplasm of pancreas, and to improve the diagnosis ability of the disease. Methods CT was performed in all 3 patients with solid-cystic papillary epithelial neoplasm of pancreas proved surgically and pathologically. Of all 3 patients, plain and dynamic enhanced MRI was performed in 1 patient. Both clinical characteristics and CT and MRI findings were analyzed retrospectively. Results All 3 patients were young female without jaundice and were found to have giant solid-cystic mass in the head of pancreas. In 1 of 3 patients, calcification was found in the mass on CT scan. One patient was found to have mild pancreatic duct dilation. No intrahepatic and extrahepatic bile duct dilation was showed in 3 patients. MRI findings in one patient demonstrated mixed signal intensity on T 1WI and T 2WI. On enhanced CT and MRI, the wall of cyst and solid portions of the mass showed obvious enhancement. Conclusion CT and MRI findings of solid-cystic papillary epithelial neoplasm of pancreas are characteristic, and the disease can be preoperatively diagnosed combined with the clinical feature.

Asian Continental Ancestry Group ; Hepatitis B virus ; Hepatitis B, Chronic ; immunology ; Humans ; Killer Cells, Natural ; immunology

Objective The study aimed to investigate the influence of head nurse's transformational leadership style on emotional labor and psychological empowerment of nurses.Methods Totally 851 staff nurses from four 3A hospitals were investigated with the Transformational Leadership Style Sub Scale of Multifactor Leadership Questionnaire,Psychological Empowerment Scale and Emotional Labor Scale.Results The head nurse's transformational leadership style scored (2.41±0.81).The psychological empowerment of nurses scored (3.27±0.47),its autonomy dimension scored (3.81±0.50),staying at medium level.The emotional labor of nurses scored (3.68±0.61),its deep acting dimension scored (4.67±0.76),which was above medium level.The indirect correlation coefficient between head nurse's transformational leadership style and emotional labor (r=-0.13) was far higher than direct correlation coefficient (r=-0.04).The psychological empowerment was the full mediation variable by which head nurse's transformational leadership style influence emotional labor of nurses.Conclusions Head nurse's transformational leadership style can enhance nurse's selfefficacy,cognition of work significance and work autonomy,so that nurse's deep acting and positive perception of emotional display can be increased,and nurse's emotional exhaustion and job burnout can be decreased to retain nurses.

OBJECTIVE By analyzing the high risk factors for pulmonary fungus infection in intensive care units of neurosurgery,this paper may be regarded as a good reference for early diagnosis and treatment. METHODS According to the domestic diagnostic standard on pulmonary fungus infection,we analyzed the clinical data of 58 patients with pulmonary fungus infection in department of neursurgery. RESULTS Totally 117 strains of fungi were isolated from the 58 cases.Candidiasis was the most frequent type,accounting for 92.3%.Some factors,such as the severity of underlying diseases,long-time coma,long-term use of broad-spectrum antibiotic,abuse of glucocorticoid,the open airway and some traumatic intubations might be regarded as the high risk factors for pulmonary fungus infection.Fluconazole showed good clinical effects on the treatment of fungus infection. CONCLUSIONS It is important to eliminate the high risk factors for pulmonary fungus infection,to provide early diagnosis and to use prophylactic antifungal agent,which can reduce the incidence rate of pulmonary fungus infection.