Hypertension is a global problem,affecting both developed and developing nations. The mor-bidity of hypertension in children and adolescents has increased year by year in recent years. Hypertension in children can cause target organ damages(mainly renal,cardiovascular,central neurological,or optic fundal). In clinical practice,we need to find simple and easy methods for early recognition of target organ damages,thus se-rious consequences in adult hypertension may be prevented.

Humans ; Mediastinal Emphysema ; complications ; Paraquat ; poisoning ; Poisoning ; complications ; Pulmonary Fibrosis ; complications ; Subcutaneous Emphysema ; complications

The archives of a hospital are a kind of intangible assets of the hospital and archive administration in a hospital constitutes an important part of the hospital's management. It can be seen from the forming process and contents of the archives in a hospital that strengthening archive administration is beneficial to the modernized and scientific management of the hospital, the improvement of medical quality and service level, the spread and application of medical science and technology, and the safeguarding of the interests of both the hospital and patients. To give full play to the function of the archives in the construction of the hospital, it is imperative to attach importance to the fundamental work concerning archives, set up the concept of archive development and application, and improve the quality of the contingents of archive administrators. Only in this way can we meet the needs of the era of knowledge economy.

Objective To explore the clinical characteristics of multiple organs dysfunction syndrome (MODS) complicated with injury of pancreas.Methods A prospective study was carried out.From January 2011 to December 2012,a total of 69 patients with MODS in Department of Medical Intensie Care Unit,Fujian Provincial Hospital,Fujian Medical University were divided into 2 groups at admission.Patients of group A were suffered from MODS complicated with pancreas injury while patients of group B had MODS without complicatios.They were compared and evaluated by acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score,6-hour clearance rate of lactic acid,incidence of shock,fluid resuscitation in the first 24 and 48 hours,bladder pressure and 28-day accumulative mortality.Results APACHE Ⅱ score in group A was significantly higher than that in group B (P ＜ 0.01).Compared with group B,the 6-hour clearance rate of lactic acid was lower,the incidence of shock increased obviously,and larger volume of fluid resuscitation was needed in the first 24 and 48 hours in the group A (P ＜ 0.05).Bladder pressure,incidence of feeble bowel sounds and the mortality in the group A were higher than those in group B,but the difference had no statistical significance (P＞0.05).Conclusions MODS complicated with pancreas injury is more severe than MODS without complications thereby resulting in higher incidence of shock and the poorer response to fluid resuscitation.

OBJECTIVE:To investigate the utilization of vancomycin in a hospital,and provide reference for the rational use of vancomycin. METHODS:Retrospective survey was conducted for the medical records of 180 inpatients using vancomycin from Jan. to Jun.,2015 in the hospital. The general information,usage and dosage and pathogenic examination were summarized,do-mestic vancomycin rational use evaluation criteria was conducted to evaluate the medication rationality,summarize and analyze cor-responding inappropriate questions. RESULTS:The vancomycin drug utilization index(DUI)of 180 cases was 0.88(mainly elder-ly patients);the microbial test sample submission rate was 84.44%(152 cases);there were 74 cases (41.11%) about the drug combination;32 cases(17.87%)about unauthorized use;37 cases(20.56%)about inappropriate use,in which inappropriate sol-vent(12 cases,32.43%)and inappropriate drug combination(11 cases,29.73%)were the main types. CONCLUSIONS:The clin-ical application of vancomycin is good with no abusing phenomenon,and the microbial inspection rate is qualified in the hospital. But there still exists some problems or shortcomings when using vancomycin,it is necessary to further standardize the medication monitoring of vancomycin to ensure patients’safety.

Objective To observe of therapeutic effect of bamboo shoots extract compound on the treatment of hemorrhagic anemia.Method The glucose,total protein,amino acids,trace and macro elements in bamboo shoots extract were determined.Through the performance of angular vein bloodletting,a hemorrhagic anemia rat model was set up.Two therapy groups received the intragastric administration of compound Ⅰ(0.15% iron porphyrin and 10% honey) and compound Ⅱ(70% bamboo shoots extract,0.15% iron porphyrin and 10% honey),respectively.And the control group only received the de-ionized water of the same dose.The blood samples,collected via tail vein in 0,18,42,67 and 90h after the administration,were detected for hemoglobin,red blood cell and hematocrit.And the acute toxicity test was also conducted.Result Compound Ⅱ,which contained the Bamboo shoots extract that was rich in glucose,amino acids,amino,and trace and macro elements,had a better efficacy in treating hemorrhagic anemia of rats than the Compound Ⅰ.And the result of acute toxicity was normal. Conclusion Bamboo shoots extract compound could promote the recovery of hemorrhagic anemia.

The present paper consults the concept of clinical competence, cultivation actuality, examination and assessment system of master of nursing specialist (MNS) at home and aboard based on literature analysis.Currently there is neither unified concept of master nursing specialist clinical competence, nor a unique clinical ability training mode of MNS.This paper mainly expounds the differences of the nursing professional master degree graduate students clinical ability evaluation system at home and abroad in the assessment methods, assessment tools, assessment agencies and assessment index, pointing out that our country should make a unified concept of the clinical competence.We should develop a flexible, diverse clinical competency assessment method, establish specialized evaluation agencies which are independent of the government, and implement 3 level quality monitoring system-graduate school of the university, clinical college graduate school and nursing department of, to ensure the training quality.

Objective To study the clinical features and gene mutation of congenital hyperinsulinism (CHI). Methods Clinical data of one newborn infant with CHI were retrospectively analyzed, and relevant literatures were reviewed. Results The infant was admitted at 24 days after birth due to recurrent hypoglycemia. Genetic examination revealed the single heterozygous mutation on ABCC8, which conifrmed the diagnosis of CHI. Experimental treatment of Diazoxide was effective. The blood glucose was normal in the follow up. Conclusions The improvement of genetic testing at the soonest can not only helps early diagnosis of CHI, but also guides the long-term clinical management of CHI.

OBJECTIVE:To discuss the effect of performance management in medication consultation service in hospital,and to improve the service quality in medication consultation center. METHODS:The performance management mode of medication consultation center was implemented in our hospital through formulating consultation pharmacist performance evaluation content and accounting rules from four dimensions of business skills,cultural literacy,work attitude,workload,conducting daily evaluation and check,developing training,setting development plan,etc. The effects of the mode were evaluated. RESULTS:In performance evaluation,business skills,cultural literacy,work attitude and workload took up 20,15,15 and 50 points,respectively;they were subdivided into 16 specific items and extra point items. After the implementation of above performance management,average weekly clients increased from 104 persons to 247 persons (increasing by 138%);the proportion of patient medication education mainly provided by clinical pharmacists increased from 18.30% to 46.34%(increasing by 153%);the complex and professional problems of medication consultation such as drug interaction rose from 0.96% to 5.28%;the problem of drug usage and dosage in-creased from 6.73% to 23.17%. The performance management mode not only improved the service consciousness and the enthusi-asm of consultation pharmacists,but also improved the level of pharmaceutical care. CONCLUSIONS:Reasonable and effective performance management mode can promote the service quality and ability of medication consultation center,and play more impor-tant role in hospital pharmaceutical care.

Objective To investigate the treatment of symptomatic patent ductus arteriosus (PDA) in very low birth weight preterm infants. Methods From January 1, 2008 to December 31, 2010, 78 very low birth weight preterm infants (birth weight＜1500 g) were diagnosed as symptomatic PDA. Among which, 42 cases administered orally with indomethacin (0.2 mg/kg, every 12 hrs for three times) were taken as treatment group, while five cases in this group who failed to indomethacin treatment were interrupted with video-assisted thoracoscopic surgery. And 36 cases who did not receive treatment for ductus arteriosus were taken as control group. The clinical outcomes, complications and prognosis of these patients were observed. Results There were no significant differences between the gentle percentage, gestational age, diameter of ductus arteriosus, rate of complicated with heart failure, sepsis, neonatal respiratory distress syndrome and intraventricular hemorrhage of two groups (P>0.05, respectively). The ductus arteriosus closed in 33 patients of treatment group (78.6%) and in nine patients of control group (25.0%)(χ2=22.39,P=0.000). There were no significant differences in serum creatinine level and platelet count between before and after the treatment in treatment group(P>0.05). Compared with control group, the treatment group had lower incidence of intraventricular hemorrhage (z=1.167, P=0.030), shorter duration of oxygen therapy [(8.0±5.5) d vs (13.3±9.3) d, t=2.225, P=0.032] and shorter hospital stay [(39.0±7.7) d vs (43.6±10.6) d, t=2.229, P=0.029]; while the incidence of bronchopulmonary dysplasia and necrotizing enterocolitis were similar (P>0.05). The five cases of PDA who received video-assisted thoracoscopic surgery were successfully interrupted with no residual shunt left, while three of them had lung infections and one had pleural effusion, but no pneumothorax and infant death associated with surgery occurred. Conclusions Symptomatic PDA of very low birth weight preterm infants should be treated actively. Oral indomethacin was an effective and safe method to cure the PDA in these infants. Surgical ligation under video-assisted thoracoscopic surgery after failure of indomethacin treatment might be a good option.