The American Heart Association published a new guideline for cardiopulmonary resuscitation in Oct 2010.One of the most important recommendations is the sequence change of cardiopulmonary resuscitation from ABC to CAB.As pediatrician,we should understand the background of these changes,and give the most reasonable treatment to improve the success rate of resuscitation according to the different locations,different circumstances and different obiects.

It is a brief introduction of necessity of uniform guidelines for pediatric emergency and critical care.Uniform guidelines are very important for development of discipline,safety of patients,protection of medical staff and administration.Uniform guidelines should be enacted according to our national condition with a scientific attitude of rigorous and gravity.

Objective:To design Disinfection device of Infant incubator to address the existing infant incubator terminally sterilized in the presence of ultraviolet light disinfectant wipe and disinfection effect is not complete. Methods:Using vaporized hydrogen peroxide to kill spores of principle, to design a PLC and touch screen technologies such as infant incubator terminal disinfection device, mainly by vaporized hydrogen peroxide generator to accommodate infant incubator stainless steel tanks, gas communication piping, etc., through clean and dry after the infant incubator, pushed into stainless steel tanks, a key parameter set to start after the end of the introduction of the incubator to disinfection, disinfection by chemical and biological indicator discoloration indicator kill situation to judge. Results:The disinfection device for gas distribution, no disinfection dead, low-temperature sterilization effect is good and easy to verify, infant incubator for material compatibility, safe, reliable, easy to operate, chemical indicator from green to yellow, biological indicator Bacillus stearothermophilus cultured for 7 days, sterile growth. Conclusion:The device is easy to verify the sterilization effect, material compatibility, safety and reliability, reduce labor intensity in clinical neonatology and critical sections infant incubator terminal disinfection areas have higher promotion and application value.

AIM　To study the effect of glucocorticoid acetic acid cortisone on expression of CaM mRNA in hypothalamus-pituitary-adrenal axis (HPAA). METHODS　Using reverse transcription polymerase chain reaction (RT-PCR),the expression of CaM mRNA was measured in HPAA of rats which were injected with acetic acid cortisone. RESULTS　Acetic acid cortisone induced the expression of CaM mRNA in hypothalamus and adrenal respectively, but it had no effect significantly in pituitary. CONCLUSION　These data suggest that CaM mRNA plays important role in the modulation of GC in HPAA.

Medical Imaging faculty has made the teaching reform which is design-oriented and integrative with intent to cultivate students' innovation consciousness and practice ability in the teaching system,teaching method and writing new textbooks.From the teaching practice,we have obtained satisfactory teaching results and can provide one kind of clear train of thought for the college curriculum adapting to the demand of this society.

Job burnout of clinical teachers at affiliated hospital of medical college has be-come a problem that cannot be ignored today.The current situation and the causes of job burnout are discussed to provide directions for carrying out some intervention measures in the future.

The clinical teaching of medical colleges and universities is an important stage of medical education,the clinical teacher is the clinical teaching concrete undertaker,and the teaching quality is closely related to clinical teacher's work,therefore,in order to improve the quality of teaching,we must strengthen the clinical teachers'education and the continuing education through a variety of ways.

AIM To study the effect of glucocorticoid acetic acid cortisone on expression of CaM mRNA in hypothalamus pituitary adrenal axis (HPAA). METHODS Using reverse transcription polymerase chain reaction (RT PCR),the expression of CaM mRNA was measured in HPAA of rats which were injected with acetic acid cortisone. RESULTS Acetic acid cortisone induced the expression of CaM mRNA in hypothalamus and adrenal respectively, but it had no effect significantly in pituitary. CONCLUSION These data suggest that CaM mRNA plays important role in the modulation of GC in HPAA.

Objective To evaluate the relationship between lactate,lactate clearance rate and prognosis of children with septic shock.Methods A total of 42 children with septic shock admitted in the PICU from Oct 2009 to Jun 2011 were enrolled in the study.All the children were given goal-directed therapy early according to the treatment routine of septic shock.The blood lactate levels before resuscitation and at 1h,2h,6 h after resuscitation were detected,the lactate clearance rates at 1 h,2 h,6 h after resuscitation were calculated.All the patients were divided into the survival group ( n =20 ) and the non-survival group ( n =22 ) by prognosis.The relationship between the early lactate level,lactate clearance rate and prognosis of the children with septic shock was evaluated.Results ( 1 ) The lactate levels before resuscitation and at 1 h,2 h,6 h after resuscitation in the survival group were significantly lower than those in the non-survival group [ (3.92 ± 2.58) mmol/L vs (6.91 ± 4.16) mmol/L,( 2.79 ± 1.89 ) mmol/L vs ( 7.93 ± 4.39 ) mmol/L,( 2.20 ±1.83) mmol/L vs (9.20 ±4.97) mmol/L,( 1.32 ±0.51 ) mmol/L vs (9.94 ±5.02) mmol/L,P ＜0.05].(2) The lactate clearance rates at 1 h,2 h,6 h after resuscitation in the survival group were significantly higher than those in the non-survival group [ (26.31 ± 20.82) ％ vs ( - 24.28 ± 53.39 ) ％,(43.46 ± 17.85 ) ％ vs (-34.31±58.98)％,(61.04±16.71)％ vs ( -45.33 ±83.51)％,P＜0.05].(3) The area under curve of the lactate and the lactate clearance rate at 6 h after resuscitation were 99.4％ and 96.7％ according to the receiver operating characteristic curve.The children had high mortality if the lactate value ＞ 2.20 mmol/L and lactate clearance rate ＜ 18.65％ at 6 h after resuscitation.Conclusion It is important to dynamicly monitor the lactate of the children with septic shock,the lactate and the lactate clearance rate at 6 h after resuscitation can be used to evaluate the prognosis.

OBJECTIVE:To observe the efficacy and economy of omeprazole and esomeprazole in the treatment of brain trauma and cerebral hemorrhage complicated with upper gastrointestinal hemorrhage. METHODS:The data of 110 patients with trauma cere-bral hemorrhage complicated with upper gastrointestinal hemorrhage were retrospectively analyzed and divided into omeprazole group (56 cases)and esomeprazole group(54 cases). All patients were given conventional treatment. On this basis,omeprazole group was treated with Omeprazole for injection 40 mg by intravenous infusion;esomeprazole group was treated with Esomeprazole injection 40 mg by intravenous infusion,twice a day. The treatment course for 2 groups was 5 d. The efficacy and economy of patients were com-pared. RESULTS:The total effective rates in esomeprazole group were significantly higher than omeprazole group higher,the cost-ef-fectiveness in esomeprazde group(1 397.71)were significantly lower than omeprazole group(1 512.09)(P<0.05),andΔC/ΔE=91.52. CONCLUSIONS:Esomeprazole has good efficacy,safety and economy in the treatment of brain trauma cerebral hemorrhage compli-cated with upper gastrointestinal hemorrhage.