At present,nutrition therapy plays a very important role in critically ill children,which can impact on the development and outcome of the disease by the process of metabolism and immunity.Immune-modulating nutrients,such as glutamine,which is a current hot topic,but now there is a little research in it in critically ill children,and this paper summarizes the approach,the dose and the efficacy of glutamine in critically ill children,aiming to offer reference in clinics.

Objective To explore the effect of c-Jun NH2-terminal kinase(JNK)signal transduction pathway on hyperoxia-induced lung injury in rats.Methods Twenty-four Wistar rats aged 3 weeks were randomly divided into 3 groups(n=8):room-air control group,7 d hyperoxia exposure group,and 7 d hyperoxia exposure with inhibitor of JNK intervention group.The rats in hyperoxia exposure group were exposed to high concentration of oxygen [fractional concentration of inspired oxygen(FiO2)≥950 mL?L-1] at normal pressure.The rats in room-air control group were placed in room air(FiO2=210 mL?L-1)at normal pressure.The rats in JNK inhibitor intervention group were intraperitoneally injected 30 mg?kg-1 SP600125 and exposed to hyperoxia 2 h later.The histopathological changes of lung tissues were observed by means of light microscope,therefore the changes of lung W/D weight ratio,total protein in bronchoalveolar lavage fluid(BALF)and lung permeation index were detected.The extent of lung cells apoptosis was analyzed by terminal deoxynucleotidyltrans-ferase-mediated dUTP nick end labeling assay.The protein level of p-JNK was measured by Western blotting analysis.Results Compared with room-air control group,conspicuous hyperaemia,edema,hemorrhage and extensive inflammation cells infiltration in the lung tissues were significantly observed in 7 d hyperoxia exposure group.The lung W/D weight ratio,total protein in BALF,lung permeation index,cell apoptotic index and the p-JNK protein levels of lung tissues all significantly increased in 7 d hyperoxia exposure group compared with those in room-air control group(Pa

Objective To explore nursing needs and interventions after caesarean section of patients with acute pancreatitis in pregnancy(APIP).Method The care needs scales designed by the researchers was used to investigate 21 patients with APIP and they had caesarean section.Result The main care needs of the patients are uterine instauration,pain relief,sleep aid,anxiety relief, complication prevention,incision healing,suppression of lactation and knowledge of self-care after hospital discharge.Conclusion Nursing staff can provide nursing interventions based on the patients care needs,which can improve nursing quality and promote the rehabilitation of patients.

OBJECTIVE:To observe the short-term efficacy and toxicity reaction of 2 regimens of taxotere combined with epi-rubicin in the neoadjuvant chemotherapy of breast cancer. METHODS:78 patients with locally advanced breast cancer were random-ly divided into TEC group(45 cases)and TE group(33 cases). TEC group was treated with taxotere 75 mg/m2 by intravenous in-jection,d1+epirubicin 60 mg/m2 by intravenous injection,d1+cyclophosphamide 500 mg/m2 by intravenous injection d1. TE group was treated with taxotere 75 mg/m2 by intravenous injection,d1+epirubicin 60 mg/m2 by intravenous injection,d1. 21 days were a treatment course for 2 groups,and there were totally 4-6 courses. In the 2 groups,efficacy and toxicity reaction were evaluated af-ter 4 weeks at least,and survival rate of 6 months was followed-up. RESULTS:The differences were not statistically significant in the short-term efficacy and toxicity reaction and survival rate between 2 groups (P>0.05). CONCLUSIONS:TEC and TC have similar short-term efficacy and safety in the treatment of locally advanced breast cancer. Both of them can be used as adjuvant medi-cines for neoadjuvant chemotherapy.

Object To investigate the pathological changes,physiological condition,neurobehavior and motor development of the 3-day-old rats with ischemic brain injury.Methods Ninety six 3-day-old male Sprague-Dawley rats were randomly assigned to experimental and control groups.Occlusion of both carotid arteries was performed in the experimental group,while the rats in the control group only received skin incisions without carotid ligation.Physical examinations and neurobehavioral development of the rats were recorded daily from the first day after operation until 3 weeks after birth,including weight,eye opening, incisor eruption,ear unfolding,righting reflex,negative geotaxis,limb placing and grasping reflex. Specimens of the brain tissue were obtained in 24 hours after operation and 3 weeks after birth for the hematoxylin-eosin staining and immunohistochemistry staining to investigate the pathological changes.All the reaults were compared between the 2 groups.Results Compared with the control group,rats in the experimental group were found growth retardation,suppression of primitive reflexes and impaired motor abilities (P < 0.05 ).The brain tissue obtained from the rats after operation showed white matter rarefaction,liquefaction and microglia hyperplasia with Hematoxylin-eosin staining and myelin formation disorder with immunohistochemistry staining.Conclusions Ischemic brain injury of the 3-day-old rats could result the mental retardation,neurobehavioral and motor development disorder because of the white matter injury.

Objective To meet the demand of ECG signal processing in high sampling rate,a simple and narrowband power-line interference notch filter is designed.Methods Based on the band elimination filter which was combined with counteraction of zeros and poles and the interpolation theory,we designed a simple,integral coefficient filter with adjustable filter bandwidth.To eliminate the Gibbs phenomena,we adopted the average filter in linear segments which was designed by the former.Results With our designed filter,50 Hz power-line interference in high sampling rate was efficiently removed,and the filter coefficients were simple,integral,and convenient.Conclusion The new design can produce a narrowband notch filter in high sampling rate,remove the 50 Hz power-line interference effectively,and retain the significant signal as much as possible to meet the needs of ECG analysis.

Myelin oligodendrocyte glycoprotein(MOG)is expressed in oligodendrocytes of the mammalian central nervous system, which is located on the surface and an important component of the myelin sheath.MOG antibody related inflammatory demyelinating disease is a hot topic in the field of neurology in recent years, and its clinical phenotype spectrum varies.Currently, cell-based assay(CBA)is recommended to detect MOG antibodies in peripheral blood.Due to the complexity and diversity of the clinical manifestations, and different manifestations in different age groups, it is difficult to make the clinical diagnosis.The exact pathogenesis is still unclear, and the therapeutic options and long-term prognosis remain controversial.In this article, the pathogenesis, clinical manifestations, treatment options and clinical prognosis of MOG antibody related inflammatory demyelinating diseases will be reviewed.

Objective To evaluate the influence of extraocular counterpulsation on ocular fundus blood vessels using high-frequency color Doppler ultrasonography. Methods Twenty-one patients with ischemic optic neuropathy were treated with extraocular counterpulsation. During treatment, the Doppler spectra were detected with high-frequency color Doppler ultrasonography. The peak systolic velocity (PSV), end diastolic velocity (EDV) and resistance retinal index (RI) of central retinal artery and posterior ciliary artery were measured instantly before treatment and 1 min,5 min and 15 min after treatment. Results The instant PSV and EDV of central retinal artery and posterior ciliary artery were significantly increased (P＜0.05) after treatment, then decreased gradually. Fifteen min after treatment ,they returned to the level before treatment. Conclusions We can observe the changes of ocular fundus blood vessels noninvasively on high-frequency color Doppler ultrasonography. The method may be regarded as one of the basis for evaluating the effect of extraocular counterpulsation.

Objective To evaluate the factors in relation to prognosis of severe diarrhea associated with hypernatremia in children.Methods The medical records of severe diarrhea and hypernatremia admitted to pediatric intensive care unit(PICU) from January 2000 to December 2004 reviewed retrospectively.The relationship between prognosis and serum sodium peak level,severity of diseases,treatment strategies were analyzed in 63 children with severe diarrhea associated with hypernatremia.Results There were 169 severe diarrhea and 85 hypernatremia cases during the study period.In the 169 severe diarrhea children,63 were associated with hypernatremia(37.28%) and accounted for 74.12% of all 85 hypernatremia cases admitted to our PICU.The mean pediatric critical illness score(PCIS) was(75.50?6.83) score in survival group and(60.75?5.34) score in mortality group,with significant statistical difference((t=)5.86 P0.05).All the children were cured when the reduction rate of serum sodium concentration was between 0.5-1.0 mmol/(L?h).Signs of cerebral edema developed in 8 children and 5 of 8 died when the reduction rate of serum sodium concentration was between 1.2-2.4 mmol/(L?h).Conclusions Severe diarrhea associated with hypernatremia is common in children and is the major cause of hypernatremia in critically ill child.The key to determine the prognosis of severe diarrhea with hypernatremia in children is the severity of disease and the strategies of treatment.

Adult ; Aged ; Bronchoalveolar Lavage ; methods ; Critical Pathways ; Humans ; Male ; Middle Aged ; Pneumoconiosis ; therapy