There is high incidence of relative adrenal insufficiency (RAI) in critical children. The causes of adrenal insufficiency in patients with severe sepsis and septic shock are the mechanical injury of the hypothalamic-pituitary-adrenal axis, cytokines and other mediators of inflammatory or hormone resistance. There are many symptoms associated with adrenal insufficiency. Diagnosis is often suspected when these patients have hypotension refractory to fluid therapy and to vasoactive drugs. The corticotropin stimulation test is widely used as a method to identify adrenocortical hyporesponsiveness, but controversy exists as to the corticotropin dose to be used. The 250 μg dose is the standard dose. Low doses of corticotropin (1 μg) have recenfly been proposed,suggesting that they may have higher sensitivity and the characteristics of safe and effective.

Gastrointestinal dysfunction is abnormalities of digestion and absorption caused by various reasons, which manifests bacterial colonization of the gastrointestinal tract, bacterial/endotoxin translocation,gastrointestinal mucosal barrier injury and immune disorders. Child and newborn gastrointestinal dysfunction/failure is secondary to the severe syndrome of critical illness, always be a part of multiple organ dysfunction syndrome. Structure and function of the gastrointestinal tract are significantly different between child and adult. The key therapy strategy of gastrointestinal dysfunction are maintenance of intestinal barrier, reconstruction of intestinal continuity, adjust of homeostasis, circulation and oxygen supply, and management of the primary disease on time.

This paper describes the development of Department of Burns of the 159th Hospital of PLA in the past 60 years and shows their spirit of hard working and achievements of several generations.

Objective To observe the effect of Morita therapy on self-esteem level and life satisfaction in schizophrenic patients. Methods 140 schizophrenic patients received Morita therapy, and followed up for 1 year. Self- esteem Scale (SES), Life Satisfaction Index B (LSIB), and Personal and Social Performance scale (PSP) were evaluated. Results The scores of SES and LSIB significantly improved after treatment (P=0.000). 117 cases (83.57%) were in stable condition; 20 cases (14.29%) were in unstable condition with poor medication compliance; only 3 cases (2.14%) needed to be re-hospitalized due to relapse. The 117 cases were followed up for 1 year, and their SES and LSIB scores maintained at the level when discharge, in which 94 cases kept in well social function. Conclusion Morita therapy can improve the self-esteem and life satisfaction of schizophrenic patients, and maintain good social function.

Objective] To investigate the relationship between pain from malnutrition and MM, looking for a cure for MM.[Methods]To analyze the relationship between pain from malnutrition and MM in clinical TCM based on the study of Neijing and the textual works of famous Chinese physicians. According to the etiology and pathogenesis to find the treatment method, and validation from clinical cases. [Result]We find that the pain from malnutrition caused by deficiency of kidney and spleen is a major cause of MM by summarizing of the ancient physicians. And we tally up the invigorating kidney is an important method for the treatment of MM.[Conclusion]Pain from malnutrition is an important pathogenesis of MM. To a method of treating MM, invigorating kidney and spleen is obvious and this method for the treatment of MM will bring more help.

Several comparative studies on anti-implantation and estrogenicities of noret histerone oxime(NETO)and norethisterone(NET) or ethynyl estradiol (EE2)were carried out in order to clarify their relationships. It was observed that NETO was showed much stronger potency than NET, which the anti-implantation, uterotrophic and vaginal cornifi-cation effect were 25, 26, and 21 times, respectively. The ratio of anti-implantation to vaginal cornification of NETO was 14-fold stronger than that of EE2. These results suggest that the increased antiimplantative activity of NETO is related to its stronger estrogenic activity, but other mechanisms contribute to the anti-implantation besides estragenicity.

目的探讨低能量氦氖激光血管内照射(intravascular He-Ne laser irradiation,ILIB)治疗氯丙嗪所致锥体外系副反应(extraPyramideal side effects,EPS)的疗效。方法将61例住院精神分裂症患者随机分为ILIB治疗组(31例)和对照组(30例),两组患者均单一服用氯丙嗪。对出现EPS的 ILIB治疗组患者采用ILIB治疗,10次为1个疗程;对出现EPS的对照组患者使用安坦治疗。于治疗前、中、后用EPS副反应量表评定两组患者的疗效。结果对氯丙嗪所致的EPS,ILIB治疗组和对照组疗效无显著性差异(P>0.05),但ILIB治疗组抗胆碱能副作用发生率明显低于对照组(P<0.01)。结论ILIB对氯丙嗪所致EPS疗效确切,同时还有对抗氯丙嗪的抗胆碱能副作用。

ObjectiveExplore the pathogeny of cell immunity of severe aplastic anemia(SAA),also appraise the effect and prognosis value of T cell subset change in the treatment of SAA.MethodTake normal persons as control,combine CD_3,CD_4,CD_8 with human being peripheral blood monocytes,analyse with flow cell method the cells of CD~+_3,CD~+_4,CD~+_8 in monocyte and CD~+_4/CD~+_8.Compare and analyse T cell subset in 3 groups before and after treatment.ResultCompared with control,there’s obvious meaningful difference in T lymphocytesCD~+_3 and CD~+_8,and CD~+_4/CD~+_8(P

It has not been well agreed on transportation of severely burned patients for a long distance during shock stage due to having high risks. After meticulouss preparation and much effort, a group of severely burned patients during shock period were safely transferred by air far away from our hospital in Aug. 2000, and fluid resuscitation and hemodynamical stabilization were maintained on the plane. The process passed smoothly. All the patients survived finally after active and effective treatment in our burn center. The experience shows that transportation by air of burned patients for a long distance during shock stage is possible on condition that all relative measures are properly carried out during the journey.

Objective To assess the possibility of the transportation of patients with critical burns during shock stage. Method Data on 9 groups (63 cases) of critical burn patients, who were transferred to burn unit in 48 hours after injury, were collected and analyzed during recent 5 years. Results All of the 63 patients were transported stably and successfully. Sixty-one of them were cured and 2 were died of multiple system organ failure at the 9th and the 19th day post burn, respectively. Conclusions On principle, anti-shock treatment of the critical burn patients should be initiated immediately on the spot before transportation. For the hospitals with limited medical resources, however, it is necessary to transfer the patients to the specialized burn units with speedy and smooth vehicles after rapid fluid resuscitation, and fluid transfusion must be carried out simultaneously during transportation.