Objective To investigate the expression and clinical significance of platelet glycoprotein CD62p,CD63 and neutrophil surface CD64 in sepsis.Methods Fifty-six children with sepsis from March 2010 to March 2013 in Communicable Disease Department of our hospital were divided into severe sepsis group(n =16) and general sepsis group (n =40),normal control group included 34 subjects from health check.CD62p,CD63 and CD64 were detected by flow cytometry in children with sepsis,and compared with normal control group.Results The levels of CD62p,CD63 and CD64 in severe sepsis group were higher than those of general sepsis group (P ＜ 0.01).The levels of CD62p,CD63 and CD64 in general sepsis group were higher than those of normal control group (P ＜ 0.01).Correlation analysis indicated that CD62p and CD63 were in positive correlation with CD64 in children with sepsis(r =0.817,0.796,P ＜0.001).The positive correlations of CD62p,CD63 and CD64 with pediatric critical illness score were also found(CD62p:r =0.883,P ＜0.001;CD63:r=0.862,P ＜0.001;CD64:r=0.805,P ＜0.001).Conclusion CD62p,CD63 and CD64 are closely related to the severity of infection and diseases,and may be used as immune parameters for the estimation of the clinical severity and the prognosis of acute and severe diseases.

Almost all children in PICU need analgesia and/or sedation.A therapeutic plan for analgesia and sedation should be established for each patient and regularly reviewed.The most often used sedation agents in PICU patients are Morphine or Fentanyl alone or in combination with Midazolam.There are several agents that have been used to provide sedation and analgesia in the PICU patient including benzodiazepines,opioids,ketamine,propofol,chloral hydrate,barbiturates,NSAIDs and paracetamol and α-adrenoreceptor agonists.This review described the various agents for sedation and discussed their advantages and disadvantages as they pertain to the PICU.Consequences of and treatment strategies for adverse effects with sedation and analgesia including respiratory depression,hypotension,withdrawal syndrome and propofol infusion syndrome were reviewed.

Objective To investigate the distribution and antibiotic resistance of pathogenic bacteria in PICU and to provide evidence for use of antibiotics rationally.Methods All the basic clinical features and pathogenic bacteria isolated from patients in PICU of our hospital from October 2009 to September 2012 were analyzed retrospectively.Results A total of 672 pathogenic bacterial strains were isolated (positive rate 16.7％ 672/4 020),75.1％ and 24.9％ were gram negative bacteria and gram positive bacteria,respectively.Pseudomonas aeruginosa was the most common bacteria isolated in gram negative bacteria,followed by Klebsiella pneumonia and Escherichia coli in this order.And Staphylococcus was the main strain in gram positive bacteria.Positive specimens were mainly from lower respiratory tract and bloodstream infection.Most Staphylococcus were resistant to penicillin,oxacillin and erythromycin but susceptible to vancomycin,teicoplanin and linezolid.Gram negative bacteria were resistant to ampicillin,ampicillin-sulbactam,piperacillin and cephalosporin,but susceptible to imipenem,cefoperazone-sulbactam,piperacillin-tazobactam,ciprofloxacin and amikacin.Conclusion Gram negative bacteria is the prevalent strains in PICU of our hospital,Pseudomonas aeruginosa,Klebsiella pneumonia and Escherichia coli are common bacterium isolated.Most isolates are highly drug-resistant.Analysis of pathogenic bacteria and drug-resistance surveillance are of vital importance to guide treatments for critically ill children and reduce drug-resistant bacterial strains.

Objective To identify iron nutritional status in very low birth weight infants (VLBWI) and its influence factors.Methods A total of 115 babies admitted from January to December 2014 were included in the study.Serum ferritin of new born infants was analyzed.The clinical data of gestational age,birth weight,hemoglobin,iatrogenic blood loss,cumulative volume of blood transfusion and pregnancy maternal diseases(diabetes,hypertension and anemia) were analyzed.Results The serum ferritin of 115 VLBWI were 100.8 to 210.3 μg/L,the average were(140.32 ± 13.21) μg/L;the minimum serum ferritin of babies born ＜ 32 weeks gestational age were(124.5 ± 31.3) μg/L.Smaller the VLBWI gestational age,the lower the basic baby serum ferritin(F =14.367,P =0.000).More severe the maternal anemia,the lower the basic baby serum ferritin levels [no anemia:(230.9 ± 68.7) μg/L,mild anemia:(189.5 ± 75.3) μg/L,moderate anemia:(133.5 ± 88.1) μg/L,severe anemia:(122.2 ± 56.8) μg/L;P ＜ 0.05].Lower the level of hemoglobin,the lower the basic level of serum ferritin(P ＜ 0.05).Volume of blood transfusion had a huge impact on the last serum ferritin levels (P ＜ 0.05).Conclusion Improvement of the basic baby serum ferritin level in the early stage is useful to ensure the VLBWI iron reserves.It is necessary to regularly monitor serum ferritin during hospitalization and even after discharge.

Objective To summarize the causes,related factors and outcome of extremely premature infants and extremely low birth weight infants.Methods One hundred and three cases of extremely premature infants and extremely low birth weight infants were admired to First Affiliated Hospital of Inner Mongolia Medical University between January 2009 and December 2015.The study was performed to analyze the clinical data of the 103 cases,included history of pregnancy,birth situation,treatment and prognosis.Results In these 103 cases,67 infants survived,36 infants died.The survival rate was 65.0％ (67/103).The extremely premature infants and extremely low birth weight infants were mainly associated with pregnancy-induced hypertension,infection,premature rupture of membranes.Factors that could affect the outcome of these cases included gestational age,sex,birth weight,pulmonary hemorrhage,bronchopulmonary dysplasia and necrotizing enterocolitis(P ＜0.05).The survival infants with long-term hospitalization often complicated with anemia.The top four causes of the death mostly were pulmonary hemorrhage,pneumonia,neonatal respiratory distress syndrome,and necrotizing enterocolitis.Conclusion In order to reduce the incidence of extremely premature infants and extremely low birth weight infants,improve the survival rate and infants quality of life,we should monitor the high-risk pregnant women closely during pregnancy period,prevent and treat all kinds of complications and prevent the occurrence of nosocomial infection.

Objective To determine the serum 25 hydroxy vitamin D3[25(OH)D3]levels in chil-dren with bronchial asthma and its relationship with lung function,fraction of exhaled nitric oxide( FeNO). Methods Totally 112 children with asthma aged 6 years to 14 years old were selected as the study group, meanwhile 78 healthy children aged 6 years to 14 years old were selected as the control group,serum 25 ( OH)D3 was determined using the electrochemical luminescence method. Lung function was measured, which included peak expiratory flow( PEF),forced expiratory volume in one second( FEV1 ),percentage of PEF in predicted value( PEF% pred),percentage of FEV1 in predicted value( FEV1% pred). FeNO of the study group was measured. The relationship between serum 25( OH)D3 and PEF% pred,FEV1% pred,FeNO were all analyzed. Results The proportion of vitamin D deficiency and insufficiency in the study group were higher than those in the control group(χ2 =7. 78,P﹤0. 01). The values of PEF% pred and FEV1% pred were decreased with the decreasing of the 25(OH)D3 levels(F=28. 12,29. 56,P﹤0. 05),FeNO values were in-creased with the decreasing of the 25(OH)D3 levels(F=15. 65,P﹤0. 05). Conclusion Vitamin D defi-ciency or insufficiency is related to asthma in children. It is associated with the decrease of lung function,and can increase the level of airway inflammation in children with asthma.

The incidence of invasive fungal infection in critically ill patients is increasing year by year. Its clinical manifestation lacks specificity which is difficult for early diagnosis. It′s hard to identify inva-sive fungal infection with fungal colonization in clinical practice. We need to find out the way to distinguish them.

Extracorporeal membrane oxygenation (ECMO) is a technology of cardiopulmonary life-support,where blood is drained from the venous vascular to an oxygenator,circulated outside the body by a mechanical pump,and then reinfused into the circulation.Recently,the application of ECMO in China is increasing gradually.Effective prevention and treatment of complications of ECMO is an important factor for the success of this technology.The aim of this paper is to discuss cardiac stun during ECMO support.

Hemodynamic monitoring is an essential part in the care of children with congenital heart disease during perioperative period to guide clinical management.Currently,there are several methods available for hemodynamic monitoring.The invasive methods include the Fick method,thermodilution method,using the Swan-Ganz catheter and the pulse contour method.The noninvasive methods include partial carbon dioxide resorption,impedance method.In this paper,the principle,advantages and disadvantages of these monitoring methods in children undergoing cardiopulmonary bypass surgery were reviewed.

Necrotizing enterocolitis (NEC) is one of the common critical disease in preterm infants,not only the mortality is high,but part of the surviviors suffer from complications,such as intestinal stenosis,intestinal obstruction,malnutrition,parenteral nutrition associated cholestasis,and even short bowel syndrome,intestinal function failure and neurological dysfunction.The etiology of NEC is complex and the pathogenesis has not yet entirely clear.Therefore,early diagnosis of NEC is more difficult.In recent years,premature birth,unreasonable feeding,Toll-like receptors expression,bacterial colonization,hypoxia ischemia and hemodynamic changes are considered to be the risk factors of NEC.However,breast feeding and probiotics can reduce the incidence of NEC in premature infants.