Malnutrition is common in critically ill children.Nutrition prescription is hampered by various factors,and the nutritional status of these children often deteriorates during hospitalization.Nutrition therapy for critically ill children must be based on proper nutrition screening and nutritional assessment.Adopting dynamic nutritional assessment is an effective method to monitor patients under nutrition therapy and inform the prescription and administration of nutrition therapy.This article reviews the recent advances in nutrition screening and nutritional assessment in critically ill children.

Acute pancreatitis with high decomposition and metabolic state, is one of the common acute abdominal pain in children. The patients are vulnerable to malnutrition during the illness. Reasonable nutrition therapy has an important role in pancreatitis management. Compared with parenteral nutrition,enteral nutrition,especially early enteral nutrition within 48 hours,can maintain the gut barrier function,reduce the incidence of enterogenic infection and multiple organ function failure,shorten length of hospital stay and re-duce the hospitalization expenses. Enteral nutrition should be initiated first,if feasible. Enteral nutrition,either by nasojejunal tube or via nasogastric tube,is believed to be safe and effective.

Clinically, patients with IgA nephropathy often have symptoms of sore throat or discomfort in the pharynx, which needs to be paid attention to. Traditional Chinese Medicine has certain effect in the treatment of IgA nephropathy, starting from the pharynx.There are many commonly used herbal medicines that could relieve wind, clear heat, detoxify the body and relieve sore-thoat, such as platycodon grandiflorum, dandelion, burdock and other herbs, and pecking treatment could be added to increase the curative effect.

Under the background of international medical market surging in the demand for caregivers and aging of the population in Finland,in order to solve the problem of nursing personnel missing,Finland has attached importance to nursing education.By means of approving creation of international courses,increasing practical courses,raising the degree of convergence settings with the international labor market structure,adopting the Credit Transfer System to facilitate students broad flow,implementing encouraging and innovative curriculum evaluation,training academic awareness,and so on,to broaden students'career horizons and help them to achieve the career orientation as soon as possible.In this regard,our nursing education should actively learn to take reform measures to improve education quality assurance mechanisms; pay attention to the guiding role of the evaluation; enrich extensive practical course content;focus on academic awareness.

Objective-To-study-the-clinical-characteristics-of-laparoscopic-oviduct-anastomosis-for-the-treatment-of-fallopian-tube-sterilization-or-tubal-infertility-.-Methods-A-total-of-48-cases-of-fallopian-tube-sterilization-or-tubal-infertility-patients-underwent-oviduct-anastomosis-between-January-2006-and-August-2013-in-our-hospital-.The-patients-were-divided-equally-into-laparoscopic-surgery-group-(laparoscopic-group,-24-cases)-or-open-surgery-group-(open-group,-24-cases)-in-chronological-order.The-ratio-of-infertility-patient-was-equal-in-both-laparoscopic-surgery-group-and-open-surgery-group-.Repatency-rate-and-pregnancy-rate-of-different-surgical-procedures-were-analyzed-,-respectively-.-Results-All-the-operations-were-successfully-completed-.Bilateral-tubal-repatency-rate-was-100%in-all-the-patients-during-the-operation-.The-pregnancy-rate-of-laparoscopic-surgery-group-(87.5%,21/24)-was-higher-than-that-in-the-open-surgery-group-(62.5%,15/24)-within-24-months-after-surgery,-with-significant-difference-(χ2-=4.000,-P=0.046).-Conclusions-The-success-rate-of-laparoscopic-oviduct-anastomosis-is-comparable-to-open-surgery-.However-,-the-pregnancy-rate-after-laparoscopic-oviduct-anastomosis-is-higher-than-open-surgery-.Laparoscopic-oviduct-anastomosis-has-a-broad-prospect-of-application-.

Small cell lung cancer (SCLC) is a lethal malignancy characterized by rapid growth, early metastatic spread, and unfavorable survival outcomes. Optimizing treatment for patients with SCLC has been the focus for investigators. The emergence of precision medi-cine and personalized treatment brought significant breakthroughs into SCLC treatment and changed the therapeutic model. The de-velopment of molecular bioinformatics increased our understanding of complex molecular mechanisms of SCLC, and novel targets for personalized treatment have been developed. Clinical trials testing these targets are ongoing, which show the potential of personal-ized treatment for SCLC.

Objective Probing into the primary healthcare capabilities of healthcare clinics in the four provinces in China's west,in order to recommend the government in making relevant policies.Results It is found that among those village doctOrs under 45 years of age,76.0%have senior high school diploma/secondary technical school education,89.6%have rural doctor certificates;those above 45 years old,59.5%have middle school education,96.9%have rural doctor certificates,and 1.6%have licensed assistant doctor certificates.x2check is statistically significant,as the village doctors born in different eras have different composition of education and different percentage of qualification certificates.44.44% of the village clinics have less than three rooms,and 41.11%occupy less than 40 square meters.Only 19.44%of the clinics receive funding for their medieal facilities from higher authorities.Conclusion It is imperative to enhance resources input tO the staff and facilities of village clinics in the west,to cater to the primary healthcare needs of the local people.

Objective:To investigate the effect of play therapy-based group counseling on behavior disorders and mental coping of school-age nephrotic syndrome children.Methods:A total of 140 school-age nephrotic syndrome children were randomly divided into experiment group ( n=70) and control group ( n=70). Children in the control group recieved routine care, while experiment group carried out play therapy-based group counseling based on the routine care. With the Conners Parent Symptom Questionnaire (PSQ) and Coping with a Disease (CODI), the overall curative effect was assessed before and after intervention by their scores. Results:After intervention, the incidence rate of behavior disorder of nephrotic syndrome children in the experiment group was 18.0% (11/63), lower than in the control group 33.8% (23/68), the difference was statistically significant ( χ2 value was 4.131, P=0.042). The conduct, psychosomatic disorder and hyperactivity index scores in the experiment group were (1.12±0.23), (0.24±0.08), (1.22±0.32) pionts, lower than (1.25±0.31), (0.29±0.09), (1.39±0.37) pionts in the control group, the difference was statistically significant ( t values were 2.625, 2.950, 2.825, P<0.05); the scores of acception, escape, negative feelings and total CODI scores were (12.87±3.19), (22.51±5.24), (25.83±4.51), (101.23±11.48) pionts, higher than (11.27±3.77), (20.41±4.00), (24.13±4.38), (95.38±8.33) pionts in the control group, the difference was statistically significant ( t values were 2.191-3.361, P<0.05). Conclusion:Play therapy-based group counseling can effectively alleviate behavior disorders and improve mental coping of school-age nephrotic syndrome children.

Objective To study the risk factors for ventilator associated pneumonia (VAP) in ICU and pathogens antimicrobial resistance.Methods 220 patients were selected and divided into observation group (88 patients) and control group(132 patients) depending on whetherhe has VAP or not.The clinical data were reviewed to explore the risk factors.And the secretions of respiratory tract were investigated by the routine bacterial culture and drag-resistance methods to analysis the distribution of pathogens.Results The risk factors associated with VAP were COPD,mechanical ventilation,the extensive use of antibiotics,age ＞ 60 years,APACHEII score ＞ 30(P ＜ 0.01).157 bacterial were cultured,68.9％ of pathogens was Gram-negative bacteria in which Pseudomonas aeruginosa was rated as the top one,and 26.1％ of pathogens was Gram-positive bacteria in which MRSA was the majority.The results of the antibiotic resistance monitoring indicated that all Gram-positive and Gram-negative bacteria showed high drugresistance to common antibiotics.Conclusion We should control these risk factors which are closely related to VAP,and select suitable antibiotics on the basis of etiological analysis and drug-resistance.

Objective To investigate the expression of RhoA and Rho kinase in junctional zone (JZ) of adenomyosis and normal myometrium and explore its relationship with severity of dysmenorrheal.Methods From Mar.to Dec.2012,32 cases with adenomyosis undergoing hysterectomy were enrolled as adenomyosis group including 18 cases with proliferative endometrium and 14 cases with secretory endometrium matched with 29 cases with hysterectomy due to cervical disease and ovarian tumor as control group including 12 cases with proliferative endometrium and 17 cases with secretory endometrium in Beijing Obstetrics and Gynecology Hospital Affiliated to Capital Medical University.JZ smooth muscle cells were isolated and cultured immediately after the operation.The expression of mRNA and protein of RhoA and ROCK Ⅰ in JZ in two groups were measured by real-time fluorescence quantitative RT-PCR and western blot.Results (1) The mRNA expression of RhoA and ROCK Ⅰ in JZ of adenomyosis group did not show cyclic change.In proliferative phase,the expression of RhoA and ROCK Ⅰ (1.41 ±0.16,1.05 ±0.15) was not significantly higher than that in secretory phase (1.17 ± 0.25,0.98 ± 0.10) (P ＞ 0.05).While JZ in control group,it showed obviously cyclic change.The expression level of them in proliferative phase(0.93 ±0.10,1.00 ± 0.18) was significantly higher than that in secretory phase (0.48 ± 0.03,0.55 ± 0.05) (P ＜0.05) ; It also showed that expressions of RhoA and ROCK Ⅰ in adenomysis group were significant higher than those in the control (P ＜ 0.05).(2) The mRNA and protein expression of RhoA and ROCK Ⅰ was positively correlated in each of two groups (r =0.48,P ＜ 0.01 ; r =0.67,P ＜ 0.01).(3) The expression of RhoA and ROCK Ⅰ were 1.66 ±0.19,1.32 ±0.11 in severe dysmenorrheal,1.28 ±0.12,1.09 ±0.08 in moderate dysmenorrheal and 0.93 ± 0.09,0.81 ± 0.06 in mild dysmenorrheal,it all reached statistical difference when compared the other group.(All P ＜ 0.05).Conclusions The expressions of RhoA and ROCK Ⅰ in JZ in adenomyosis group were higher than those in control group,and positively correlated with the severity of dysmenorrheal in adenomysis group,but it does not change with the menstrual cycle.High expression of RhoA and ROCK Ⅰ might be involved in abnormal contraction of uterine myometrium and correlated with the dysmenorrheal in adenomysis.