Objective:To investigate the relationship between blood lead and blood microelements levels and attention-deficit/ hyperactivity disorder.Methods:To compare the children of ADHD and control groups,levels of blood lead were analysised by anodic stripping voltammetry,and blood microelement Levels were detected by atomic absorption spectrophotometry.Results: Blood lead levels were significantly higher in ADHD than that in control group (P

Nursing simulation teaching is one of the important measures in nursing teaching reform. As an advanced medical teaching model, SimMan synthetic simulation has been recognized by medical educators both at home and abroad for its advantages of high simulation, repeatability, case diversity and process controllability. Our country has relied on the SimMan synthesis simulation person to carry on the nursing simulation teaching for many years, usually as a teaching strategy into the course of teaching. Its advantages and innovation are affirmed by nursing educators and learners, but still face challenges in the design of simulation teaching, the development of functions and the improvement of equipment utilization. It is worthy discussing deeply by nursing educators.

Objective Enterovirus 71(EV71) is one of the important etiologic agent for young children,which can cause various kind of diseases.EV71 can cause HFMD outbreak in a large scale and encephalmeningitis to death.This review introduced the research method and status of EV71 molecular epidemiology,examined and analyzed the evolution of EV71,summerized all genotype/subgenotype for EV71.the geographic and time distribution.

Objective To investigate the effect of small dose of doxepin combined with psychological behav-ior intervention in the treatment of insomnia.Methods 21 patients with insomnia were selected as the study sub-jects,took doxepin 25mg before going to bed at every night,to the research object and psychological behavior interven-tion by hand,continuous treatment for 8 weeks.Used the method of questionnaire survey before and after two periods of time,assessed by using pittsburgh Sleep Quality mder(PSQI)scale,analysed the correlation between sleep quality and sleep beliefs attitudes.Results After treatment with 8 weeks,subjected sleep quality,sleep difficulties,sleep time,sleep efficiency,sleep disturbance,hypnotic drug use,and daytime functional scores were lower than before treat-ment (t =17.34,16.65,10.54,13.37,11.65,7.66,11.57,all P <0.05 ),the difference of the score of PSQI between after treatment[(5.80 ±0.97)points]and before treatment[(13.34 ±2.28)points]was significant(t =21.27,P <0.01).Conclusion Small dose of doxipin combined with psychological behavior intervention in treating insomnia can improve the sleep quality of patients.

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 observe the application effect of Clampcath trocar in immune adsorption.Methods A tatol of 40 patients underwent immune adsorption in our hospital were divided into the observation group and the control group according to the random number table method,with 20 cases in each group.In the observation group,20 cases were treated with Clampcath trocar as temporary vascular access for immune adsorption,and in the control group,20 cases were treated with 16 G indwelling needle as temporary vascular access for immune adsorption.The blood flow,tube plugging rate,discount rate,indwelling time of immune adsorption of patients in each group were compared.Results The tube blocking rate and discount rate of the observation group were significantly lower than that of the control group (P＜0.05),the difference wasstatistically significant;in the observation group,the blood flow was significantly higher than that in the control group (P＜ 0.01),the indwelling time of the observation group was longer than that of the control group (P＜0.05),the difference was statistically significant.Conclusion Clampcath trocar could be used as temporary vascular access for immune adsorption,of which the operation is simple,and is cheap and affordable.Meanwhile,it has advantages include low tube plugging rate and discount rate,long indwelling time and sufficient blood flow,thus it could alleviate the suffering of patients and reduce the waste of resources,and it's worthy of clinical promotion.

Primary central nervous system lymphoma (PCNSL) is a rare type of malignant lymphoma which originates in the central nervous system without spreading to other systems. It is more predisposable to immunodeficient individuals. However, an increase in the incidence of PCNSL has been also observed in the healthy population in recent years. PCNSL has short phase of clincal release, and easy to relapse with poor prognosis. Some studies have shown that relative prognostic factors were associated with age, performance status, the radiotherapy and chemotherapy modalities, the response to early adminstration of the glucocorticoid,tissue pathologic type and the molecular biologic marks.

Mesenchymal stem cells (MSCs) play a neuroproteetive effect via a variety of mechanisms.They provide a new idea for the treatment of cerebral ischemia.However,the inadequate sources have significantly limited the possible clinical applications.Carbon nanotubes (CNTs),a new nanomaterials,can not only promote the adhesion,proliferation and differentiation of MSCs in vitro,but also as the cell carriers they can provide good microenvironmental guarantee for the survival of MSCs through the regulation of secretion of cytokines and neurotrophic factors,as well as regulation of biological characteristics of neurons,glial cells,and macrophages after their cell transplantation,provide a good microenvironment guarantee for the survival of MSCs,and promote the effect of MSCs on the therapeutic effect of cerebral ischemia.

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.

Objective To explore the clinical value of N-terminal prosoma of B-type natriuretic peptide (NT-ProBNP) in assessing the heart function of the patients with chronic heart failure.Methods 94 inpatients diagnosed as chronic heart failure were divided into 4 groups (Ⅰ,Ⅱ,Ⅲ,Ⅳ) according to the cardiac function of NYHA Functional Class(NYHA-FC),and 5 inpatients with normal cardic function were also selected as control group.The plasma NT-ProBNP was detected.The results of heart color ultrasound was collected.Results In patients with heart failure,left ventricular end-diastolic dimension(LV) increased following the increase of plasma NT-ProBNP level.Among NYHA-FC groups,NT-ProBNP levels were different,which increased as the NYHA-FC upgrades.Spearman correlation analysis showed that NT-ProBNP had good correlation with both LV and NYHA-FC(r =0.453,P ＜0.01 ;r =0.538,P ＜ 0.01).There was also good correlation between LV and NYHA-FC(r =0.322,P ＜ 0.01) ;but the correlation was slightly lower than the previous.Conclusion NT-ProBNP can reflect the level of ventricular remodeling and the severity of the cardiac decompensation in chronic heart failure patients.