Nearly every patient admitted into PICU is administered sedation and analgesia therapy.The precise control of the depth of sedation and the intensity of pain are often not well managed.Inappropriate treatment will cause more adverse effects.Self-assessment is considered the gold standard in pain rating,other complementary methods being the behavioural measures and the biological measures,that reflect the body's answer to pain.There is a growing need for reliable and valid sedation and pain instruments that can easily be incorporated into daily care.There are many methods for assessing pain and sedation in critical children,but none is completely accepted as an objective measure or suitable for all ages of children.The clinicians should choose appropriate assessment tools and even combine different tools according to the environment,condition and the characteristics of patients.

Acute liver failure (ALF) is rare in children but carries high mortality.It can progress to multi-organ failure and death.The etiology,clinical manifestations,diagnosis and prognosis of pediatric acute liver failure (PALF) are different from that of adults,and vary with age.The classic adult symptoms are often absent in children and the clinical encephalopathy may not be present.Children correctly diagnosed with well-characterized causes of PALF may benefit from the early implementation of directed medical therapies.Early recognition,diagnosis,and identification of prognostic factors will help in optimizing treatment and selecting patients for liver transplantation or artificial support,and improved their survival chances.

There are much more multidrug-resistant organisms (MDRO) in the intensive care unit than ever.If the doctors could distinguish the colonization from infection of MDRO,they can make right decision on the rational clinical use of antibiotics to reduce resistant organisms and nosocomial infection.However,it's a confused problem for clinicians to distinguish between colonization and infection.Bacterial culture combined with clinical symptoms and signs maybe helpful,but it is limited.There should be more objective indicators.This article was aimed to state the definition and relationship between colonization and infection,and how to determine the colonization and infection of MDRO.

Child ; Continuous Positive Airway Pressure ; Humans ; Pediatrics

normal morphology + cervicitis).

0 05). It is suggested that: ①When foot brace fixed the femur at inward rotation of 0?, 15?and then 15? after moving body position, and ROI was near the neck, BMDs of the neck and the trochanter were not affected in either of the three positions, with femoral neck with highest BMD; ②When BMD value of the femoral Ward′s triangle is taken as the index, it is better to take the mean of 3～5 scannings at one position.

Objective To assess the effect of scene simulation-based teaching on pediatric advanced life support(PALS)skills in medical students.Methods The students of two grades of Department of Pedi-atrics in Capital Medical University participated in the PALS training.All of them had the examination of the-ory and skills of critical illness management and cardiopulmonary resuscitation in children before and after the scene simulation-based teaching on PALS.The questionnaire was filled out and the data was analyzed after the training.Results Fifty-one students completed the training.The average score after the training was sig-nificantly higher than that before the training(86.51 ±7.16 vs.53.85 ±14.24,P ﹤0.05).After the training, the error rate of ECG recognition,etiological identification and treatment of the disease,and the dosage as well as usage of medicine was significantly decreased (64.7% vs.15.7%,71.0% vs.10.5%,73.2%vs.25.9%).All of the students could use the defibrillator correctly and the students'satisfaction rate was more than 94%.Conclusion Scene simulation-based teaching on PALS skills can improve the theory and skills of critical illness management and cardiopulmonary resuscitation of children in medical students.

Animals ; Cardiomyopathy, Dilated ; metabolism ; Connexin 43 ; metabolism ; Disease Models, Animal ; Hypericum ; Male ; Plant Extracts ; pharmacology ; Rats ; Rats, Wistar

Adult ; Animals ; Female ; Foodborne Diseases ; epidemiology ; therapy ; Humans ; Male ; Middle Aged ; Seafood ; poisoning ; Snails ; Young Adult

Objective To observe the effect of Jiaotai Pills ( JP) on hypothalamic neurotransmitters of Orexin A and gamma-aminobutyric acid ( GABA) in rapid eye movement ( REM) sleep deprivation rats. Methods Rat model of REM-sleep deprivation was established by water small platform method. The rats were randomized into 6 groups, namely normal control group, model group, Diazepam group (3 mg/kg), and high-, medium-and low-dose JP groups ( JP in the dosage of 18.6, 9.3 and 4.6 g/kg respectively) . Enzyme-labeled instrument was used to detect the absorbance ratio of rat hypothalamic Orexin A content, and high performance liquid phase electrochemical detection method was adopted for the detection of hypothalamic GABA content. Results Compared with the normal control group, all of the rats in the model group suffered from insomnia, and the Orexin A content was increased ( P<0.05) . Compared with the model group, insomnia in rats of high-, medium- and low-dose JP groups was markedly relieved, and Orexin A was decreased (P<0.05) . The difference of GABA was insignificant between model group and JP groups (P>0.05) . Conclusion The sedative and hypnic mechanism of JP is probably related with the inhibition of hypothalamic Orexin A.