The progress and development of extracorporeal life support (ECLS) is suprising and on-going,especially extracorporeal membrane oxygenation (ECMO) has become an accepted therapeutic modality for patients who have failed conventional therapy with respiratory and/or cardiac support.Blood purification developed from hemodialysis is designed to remove substances from the circulation and now includes hemodialysis,hemofiltration,immunoadsorption,continous blood purification and peritoneal dialysis.Plasma exchange and hemoperfusion play an important role in critically system diseases,i.e.,some kidney diseases,neurologic diseases,liver failure,metabolic diseases,connective tissue disease,infection diseases,intoxication and so on.

Objective To discuss the effect of the PDCA cycle in enhancing the case care ability of nurses in order for nurses to adapt to the assessment model of cases tracking.Methods The training was carried out for enhancing nurses' ability of case care according to the PDCA cycle.Results The scores of the case care,the quality of care in wards and the patient satisfaction degree increased significantly after applying the PDCA cycle compared with those before.The aims of ensuring medical safety,improving the work quality,and increasing patient satisfaction were achieved.Conclusions Training nurses' ability of case care following the PDCA cycle can effectively improve the nurses' ability of case care,make them adapt to the case tracking assessment model,which is worthy of promotion.

Pediatric Critical Care Medicine have developed rapidly and played a big role in the clinical treatment in China in recent years.But we axe now still in lack of unified documents as a guidline because of our late development and difference between regions.We should pay more efforts to formulate and perfect the standardization constructions of pediatric intensive care unit,with the help of The Construction and Management of Critical Care Medicine.In this article,we stated the present situation of development,operational mode,personnel and equipment configuration,monitoring and treatment technology,process specification and quality index in pediatric intensive care unit.And we also offerd some proposal about that.

Objective To approach the problems existed in the obsevation of illness process by low seniority nurses and their solving method. Methods The obversation ability for illness of 42 registered nurses who has worked within 3 years were evaluated.The contents included:Whether the observation was comprehensive,whether the physical checkup was correct,whether the nursing care was complete,whether the recognition of existing and potential nursing problems was in time and the mastering of important points of special medication. Results There existed common problems in the contents of illness observation,special nursing checkup,application and evaluaiton of nursing care and mastering of important points of special medication. Conclusion The illness observation ability of low seniority nurses needed improvement.Study of specialized knowledge is a premise and strengthened training is a pivotal tache.

Objective To analyze the genetic diversity of higher artemisinin-yielding Artemisia annua. Methods With the chemical investigation of artemisinin contents, RAPD analyses of selected plants from ten various habitats in China were carried out using arbitrary primers. Results The RAPD data clearly indicated the genetic diversity level in A. annua was relatively high with 53.6% polymorphic sites. UPGMA Analyses of RAPD and phytochemical trait data showed that the wide phytochemical diversity was included within the genetic diversity being present in at least four geographical regions. ConclusionArtemisinin has obvious inherited differentiation that further support the prospects for selection and breeding of superior artemisinin containing lines.

Objective To investigate the CT and MRI findings of solid-cystic papillary epithelial neoplasm of pancreas, and to improve the diagnosis ability of the disease. Methods CT was performed in all 3 patients with solid-cystic papillary epithelial neoplasm of pancreas proved surgically and pathologically. Of all 3 patients, plain and dynamic enhanced MRI was performed in 1 patient. Both clinical characteristics and CT and MRI findings were analyzed retrospectively. Results All 3 patients were young female without jaundice and were found to have giant solid-cystic mass in the head of pancreas. In 1 of 3 patients, calcification was found in the mass on CT scan. One patient was found to have mild pancreatic duct dilation. No intrahepatic and extrahepatic bile duct dilation was showed in 3 patients. MRI findings in one patient demonstrated mixed signal intensity on T 1WI and T 2WI. On enhanced CT and MRI, the wall of cyst and solid portions of the mass showed obvious enhancement. Conclusion CT and MRI findings of solid-cystic papillary epithelial neoplasm of pancreas are characteristic, and the disease can be preoperatively diagnosed combined with the clinical feature.

ObjectiveTo summarize the early postoperation complications and treatments in children with total anomalous pulmonary venous connection (TAPVC).MethodsThirty TAPVC children who were treated with corrective operation and transferred into PICU were collected.Patients were monitored routinely for electrocardiogram,blood pressure and SpO2.The routine treatment measures included mechanical ventilation,sedation,hemostasis,positive inotropic agents,diuresis,vasodilator,antibiotics and symptomatic treatment.Adrenaline or isoproterenol was used when low cardiac output syndrome appeared and temporary pacemaker was employed in the case of bradycardia.Alprostadil and sildenafil were added instantly after corrective operation when severe preoperative pulmonary hypertension or reactive postoperative pulmonary hypertension was present.ResultsThe early postoperation complication was found in 30 cases of TAPVC,which included 13 cases of pneumonia (43.3％ ),8 of arrhythmia (26.7％ ),7 of low cardiac output syndrome (23.3％),6 of respiratory failure (20.0％ ),4 of pulmonary hypertension ( 13.3％ ),3 of pulmonary edema or atelectasis( 10.0％ ) and 1 of pneumorrhagia ( 3.3％ ).Two cases died postoperatively.The interval of stay in PICU was 1 ～ 21 d and the mean time was (5.95 ± 4.94) d.ConclusionOccurrence of respiratory complications is high among early postoperative complications of TAPVC.Therefore,preventing pulmonary infection and maintaining pulmonary function should be viewed as the key points in early postoperative monitoring and managing.In addition,more attention should also be paid on correction of arrhythmia,prophylaxis and treatment of low cardiac output syndrome and pulmonary hypertension crisis,which may improve the postoperative survival rate and care quality of TAPVC.

[ Objective ] To investigate the mechanism of Zhenchan Ning (ZN) for Parkinson's Disease ( PD). [Methods] Rat models of PD were established by striatal infusion of 6-hydroxy dopamine (6-OHDA) . Effect of ZN on rat rotating behavior was observed, and the contents of dopamine ( DA), homovanillic acid (HVA), superoxide dismutase (SOD), malondialdehyde (MDA), glutathione (GSH) and glutathione peroxidase (GSH-PX) in blood and corpus striatum were also detected. [Results] As compared with those before treatment, high-dose ZN could improve the rotating behavior and decrease the rotating frequency ( P 0.05), but could decrease serum MDA content (P

OBJECTIVE By analyzing the high risk factors for pulmonary fungus infection in intensive care units of neurosurgery,this paper may be regarded as a good reference for early diagnosis and treatment. METHODS According to the domestic diagnostic standard on pulmonary fungus infection,we analyzed the clinical data of 58 patients with pulmonary fungus infection in department of neursurgery. RESULTS Totally 117 strains of fungi were isolated from the 58 cases.Candidiasis was the most frequent type,accounting for 92.3%.Some factors,such as the severity of underlying diseases,long-time coma,long-term use of broad-spectrum antibiotic,abuse of glucocorticoid,the open airway and some traumatic intubations might be regarded as the high risk factors for pulmonary fungus infection.Fluconazole showed good clinical effects on the treatment of fungus infection. CONCLUSIONS It is important to eliminate the high risk factors for pulmonary fungus infection,to provide early diagnosis and to use prophylactic antifungal agent,which can reduce the incidence rate of pulmonary fungus infection.

Objective To analyze the clinical diagnosis and treatment of drug hypersensitivity syndrome (DIHS) in children. Method The allergenic drugs, clinical manifestations, laboratory examinations, treatment effects, complications and prognosis in 22 children with DIHS were analyzed retrospectively. Results All 22 patients had a medication history and fever. Among them, 90.9% patients had erythema morbilliforme, 90.9% had liver damage, 18.2% had renal damage, 54.5% had superficial lymph node enlargement and 36.4% had granulocytosis. Five patients had serious complications. One patient was complicated by autoimmune hemolytic anemia, 3 patients had transaminase elevated greater than 10 times and 1 patient died due to hepatic failure, hepatic encephalopathy and multiple organ failure. The treatment mainly included the use of glucocorticoid and gamma globulin, and, if necessary, plasma exchange. Conclusion The incubation period of children with DIHS is long, and the skin lesions are mainly erythema morbilliforme. Most of the affected organs are mainly liver, and some of patients can be combined with eosinophilia. Glucocorticoid therapy is effective.