OBJECTIVE To investigate the cause and preventive measurement for respiratory tract nosocomial(infection) in pediatric ICU(PICU).METHODS Prospective studies were conducted on the basis of clinic data with the positive result in(sputum) culture and X-ray report sheet from Jan to Dec 2005.RESULTS Eight sputum(specimens) of lower(respiratory) tract were positive.Eleven X-ray report sheets showed infection in lungs.(CONCLUSIONS) To explore the cause of infection in lower respiratory tract with mechanical ventilation,to strengthen training,strictly obey the rules of preventing nosocomial infection,and strengthen the surveillance etc are the main measurements to prevent(nosocomial) infection in PICU.

Objectlve To explore the strategies and results of transportation between hospitals for neonates under mechanical ventilation. Methods From January 2006 to December 2007,medical records of 213 newborn infants under meghanical ventilation transported to Guangzhou Women and Children's Medical Center,Guangzhou Children's Hospiml from other hospitals were reviewed.Emergent events,complications and relative managements and prognosis during the transportation were analyzed. Results No patients died during the transportation,giving a rate of Success of 100%.Before transportation,11 babies received sedatives and 157 were transported with indwelling gastric tube.During transportation,three cases required temporary parking for some emergency,and relieved after proper management.One case was due to dislocation of the tracheal tube,one due to cardiac arrest and one due to the tracheal tube block.After transportation,195 patients(91.6%) were fully recovered,11(5.2%) failed to receive any treatment,7(3.3%) died. Conclusiom Skilled doctors and nurses,full preparation before transportation and close monitoring and prompt and proper management during the transportation are essential for successful transportation of newborns under mechanical ventilation.

Objective To explore the current state-trait anxiety among nurses in children's hospital and supply some scientific references for the decision-making to healthy guidance and occupation behavior for the practioners. Methods Investigations were carried out in 410 female nurses in Guangzhou children's hospital by usage of the state-trate anxiety inventory(STAI).The results were analyzed statistically. Results The STAI of nurses in the children's hospital was higher than that of the norreal control (P ＜ 0.01 ).But no difference existed in the aspect of special anxiety (P ＞ 0.05) between them.The special anxiety of female cadre and technical staff was higher than the nurses in the children's hospital (P ＜ 0.01). Conclusion The high level of state-trait anxiety hinted us that we should pay attention to the anxiety status of nurses in the children's hospitals.

Objective To translate Parents' Perception of Uncertainty Scale (PPUS) into Chinese,analyze and selected items,and then test the reliability and validity of the Chinese version of PPUS initially.Methods 210 parents of hospitalized children were recruited for the investigation.Frequency analysis,dispersion degree analysis,correlation analysis and so on were applied to analyze and select items.Internal consistency test,Pearson correlation analysis and exploratory factor analysis etc.were applied to test reliability and validity of the scale.Results The final Chinese version of PPUS contained 28 items.The Cronbach α and parity split-half reliability coefficients were 0.844 and 0.835; The Cronbach α coefficient of 4 dimensions ranged from 0.537 to 0.770.The item-total scale correlation coefficient ranged from 0.300 to 0.737.Item-dimension correlation coefficients ranged from 0.376 to 0.762.Item-other dimension correlation coefficients ranged from 0.028 to 0.514.Dimension-total scale correlation coefficients ranged from 0.480 to 0.863 and those between dimensions ranged from 0.226 to 0.536.In the content validity assessed by experts,I-CVI ranged from 0.75 to 1.00,S-CVI/Ave was 0.928.Four-factor model was performed in the principal component analysis and they explained for 41.401％ variances.The maximum factor loading of all items were higher than 0.3,and most of items had adequate loadings in related dimensions.Conclusions Chinese version of PPUS had appropriate reliability and validity as an assessment tool for parental uncertainty in illness of hospitalized children' parents.

Objective To investigate the level of illness uncertainty and coping styles of parents of children with diabetes mellitus and their relationship, and provide theoretical basis of clinical intervention. Methods Totally 155 patients of children with diabetes mellitus were investigated with General Information Questionnaire, Parents′ Perception of Uncertainty Scale (PPUS) and Coping Health Inventory for Parents (CHIP) to analyze the correlation between illness uncertainty of parents and its influencing factors and coping styles. Results The total score of illness uncertainty was 80.15±10.38 in parents of children with diabetes mellitus. There was significant difference in total uncertainty score in parents with different number of children, parent′s age, education degree, profession, economic conditions and locations (P < 0.05). Coping style, education and Parent′s age entered into the multiple linear regression equation of illness uncertainty, predicting 23.2% of total variation in illness uncertainty. The level of illness uncertainty was negatively associated with coping styles (P < 0.01). Conclusions The illness uncertainty was at higher levels in parents of children with diabetes mellitus. Clinical nurses should measure illness uncertainty of parents of children with diabetes mellitus and improve their coping capacity to reduce illness uncertainty, so as to provide better services of family and promote the quality of life for children .

Objective To explore psychological resilience, anxiety, depression, coping styles and social supports status among parents of preterm infants of ophthalmic clinic, and analyze their relationship. Methods A total of 217 parents of preterm infants at ophthalmic clinic of hospital were selected by convenience sampling method and investigated by self- designed general information questionnaire, Connor-Davidson Resilience Scale, Self-rating Anxiety Scale, Self-rating Depression Scale, Social Support Rating Scale, and Simplified Coping Style Questionnaire. Results The total score of psychological resilience was (67.48 ± 14.20) points. The average score of positive coping styles dimension was (1.98±0.50) points, and negative coping style dimension score was (1.19±0.55) points. The social support score was moderate with a total score of (42.75 ± 6.17) points, the anxiety and depression got a total score of (36.77 ± 8.17) points and (39.67 ± 9.02) points respectively. Psychological resilience was negatively correlated with anxiety and depression (r=-0.363--0.242, P<0.01), and was positively correlated with coping styles and the social support (r=0.141-0.312, P<0.05 or 0.01). Multi-factor linear regression analysis showed that depression and social support were the influence factors of psychological resilience(t=-4.376, 2.516, P<0.01 or 0.05). Conclusions The parents of preterm infants are at the poor psychological states. Coping styles and depression are the important factors which affect psychological resilience among parents of preterm infants. Nurses should assess the psychological status of the parents, provide targeted interventions to relieve stress, guide the parents use social support effectively, and improve their psychological state.

Objective To investigate the alterations of dopamine,norepinephrine,cortisol,C-reactive protein (CRP),heart rate (HR),respiratory rate (RR) and mean artery pressure (MAP) before and after the laser photoeoagulation for retinopathy of prematurity (ROP) with topical anesthesia and to provide the guideline for improving its routine management and interventions.Methods Thirty children with ROP who received ROP laser photocoagulation in Guang zhou Women and Children's Medical Center from May to Dec.2012 were selected.The blood of the 30 cases of infants were collected at 4 time points:before laser therapy,the end of laser therapy,1 hour and 24 hours after laser therapy.The concentrations of dopamine,norepinephrine,cortisol and CRP in plasma were measured at each time point with radio immunoassay,and the values of HR,RR and MAP of infants were recorded as well.Results The levels of dopamine,norepinephrine and cortisol at the end and 1 hour after therapy were higher than those in the quiet state before therapy,and the differences were statistically significant (t =6.39,2.55 ; t =7.74,2.91 ; t =8.87,2.15 ; all P ＜ 0.05) ; the levels of CRP at the end of therapy,1 hour and 24 hours after therapy had no statistical difference in comparison with those in quiet state before therapy (t =0.06,0.89,1.16; all P ＞ 0.05) ; the levels of HR and RR at the end of therapy,1 hour and 24 hours after therapy had statistical difference in comparison with those in the quiet state before therapy (t =4.33,3.84,3.38 ; t =6.81,4.42,2.96 ; all P ＜ 0.05).The level of MAP at the end of therapy had statisti cal difference in comparison with that in the quiet state before therapy (t =6.10,P ＜ 0.001).Conclusions Infantswho experieneed ROP laser photocoagulation had stress response.Clinicians should pay more attention to monitoring HR and RR of preterm infants receiving retinal laser photocoagulation under topical anesthesia and take active intrvventions in order to relieve the stress response.

OBJECTIVETo document morphological changes in hepatic microcirculation in liver tissue with hepatitis B and the pathogenesis of hepatic microcirculatory disturbances.

METHODSLiver tissue samples were obtained from patients with hepatitis B by liver biopsy. These samples were examined with a light microscope and transmission electron microscope.

RESULTSHepatic microcirculatory disturbances existed in patients with hepatitis B, including those with normal liver function, manifested by red blood cell aggregation in sinusoids seen under light microscope and sinusoidal capillarization seen under electron microscope. Weibel-Palade bodies in sinusoidal endothelial cells were seen in 26 out of 53 cases. Intimate contacts were found between lymphocyte/Kupffer cells and sinusoidal endothelial cells.

CONCLUSIONSHepatic microcirculatory disturbances exist in patients with hepatitis B. The appearance of Weibel-Palade bodies in sinusoidal endothelial cells may be a key step in the development of hepatic microcirculatory disturbances.

Adolescent ; Adult ; Aged ; Female ; Hepatitis B, Chronic ; pathology ; physiopathology ; Humans ; Liver ; blood supply ; pathology ; ultrastructure ; Liver Circulation ; Male ; Microcirculation ; pathology ; ultrastructure ; Microscopy, Electron ; Middle Aged