Objective To investigate the effect of curosurf in treatment of children with hyaline membrane disease and the nursing. Methods 56 cases of children patients with hyaline membrane disease from June 2008 to June 2010 admitted to neonatal wards were selected. The control group (26 cases)treated with mechanical ventilation alone and corresponding conventional care, on this basis, the treatment group (30 cases) was treated with curosurf and give systemic nursing intervention. Symptomatic relief time, mechanical ventilation time, length of stay, complication incidence rate, death rate, PaO2 and PaCO2 before and after treatment were observed in two groups. Results Symptomatic relief time, mechanical ventilation time, length of stay, complication incidence rate in the treatment group was significantly lower than that in the control group; PaO2 and PaCO2 amelioration in the treatment group was better than the control group. Conclusions Children with hyaline membrane disease should be treated with curosurf and given systemic nursing intervention as early as possible, it can rapidly improve the symptoms of hypoxia, reduce complications, decrease mortality, accelerate the recovery of disease.

Objective To observe the effect of local mild hypothermia and Naloxone in the treatment of acute intracerebral hemorrhage. Methods Forty-five patients with acute intracerebral hemorrhage were randomly divided into 4 groups:a control group(12 patients),a hypothermia group(11 patients),a Naloxone group(11 patients)and a hypothemrmia plus Naloxone group(11 patients).The patients in the control group were managed with conventional interventions including the administration of 6-aminocaproic acid within 24 hours and dehydrant when intracranial pressure was high.Those in the hypothermia and Naloxone groups were treated with local hypothermia at 33～34 ℃ for 3 days or intravenous transfusion of Naloxone at 4 mg/d in addition to the conventional intervention.Those in the combination group were treated with local hypothermia and intravenous Naloxone in addition to the conventional intervention.Immediately after admission and 2 weeks after treatment,head CT scans were conducted to observe the volume of cerebral hematoma and edema.The patients' neurological function was scored according to the European Stroke Standards(ESS)before and after treatment. Results There was no significant difference among the 4 groups in terms of the volume of hematoma and edema or in their ESS scores before treatment.After treatment,any differences among the 4 groups with regard to hematoma volume were not significant.The volume of edema in the hypothermia group was similar to that in the combination group and significantly lower than that in the Naloxone andcontrol groups.Hematoma volume in the Naloxone group was significantly lower than that in the control group.After treatment,the ESS scores were significantly higher in the combination group than that in hypothermia group,and scores in the hypothermia group were significantly higher than in the Naloxone group.ESS scores in the Naloxone group were significantly higher that in the control group. Conclusion Local mild hypothermia and Naloxone treatment can inhibit cerebral edema and enhance recovery of neurological function in patients with intracerebral hemorrhage.Local mild hypothermia has advantages over Naloxone in inhibiting the development of cerebral edema and in promoting recovery of neurological function.Local mild hypothermia in combination with Naloxone further inhibits edema,and it can enhance neurological function to a greater extent.

Objective: To evaluate the differences of serum total light chain(sTLC), urine total light chain(uTLC) and serum free light chain(sFLC) in different stages of chronic kidney disease(CKD) and their correlation with renal function indexes. To investigate the predictive value of light chain indexes in CKD staging. Methods: 292 patients with CKD were analyzed retrospectively, and plasma cell diseases, acute kidney injury and tumor diseases were excluded. According to the estimated glomerular filtration rate(eGFR), CKD patients were divided into five groups from CKD 1 stage to CKD 5 stage. The levels of sTLC, uTLC, sFLC and corresponding biochemical indexes of CKD patients were detected, and the differences and correlations among the indexes of each group were compared. The receiver operating curve(ROC curve) was used to analyze the predictive value of each light chain index in CKD stage, with CKD1-2 stage combined as control group and CKD3-5 stage combined as case group. Results: There was no significant difference in sTLC κ, sTLC λ, sTLC κ/λ and sFLC κ/λ among CKD1-5 stage(P>0.05). There were significant differences between sFLC κ, sFLC λ and uTLC κ, uTLC λ among CKD1-5 stage(P<0.05), which increased with the increase of CKD staging. The correlation between sFLC κ, sFLC λ and serum creatinine(Scr), blood urea nitrogen(BUN), eGFR were better than uTLC κ, uTLC λ(P<0.001). The sTLC κ, sTLC λ, sTLC κ/λ and sFLC κ/λ had no correlation with renal function indexes(P>0.05). The best critical points of sFLC κ and sFLC λ for predicting CKD3-5 stage were 35.4 mg/L and 52.8 mg/L, and AUC was 0.916(0.883-0.949) and 0.915(0.881-0.949), which were higher than uTLC κ and uTLC λ,AUC was 0.811(0.754-0.869) and 0.787(0.728-0.846), respectively. Conclusion With the increase of CKD staging, the levels of sFLC and uTLC gradually increase. The sFLC and uTLC can effectively predict patients with CKD3 and above, which has an important reference value in stratified management of patients with CKD.