Serious infection,antibiotic resistance and uncompleted development of organ function are critical problems for pediatrician.The hitting hard and de-escalation are important strategies of antibiotics ap-plication for anti-infection therapy.The emphasis of early applying of broad spectrum antibiotics saved a lot pediatric critically ill patients.Meanwhile,problems gradually appeared such as the overuse of antibiotics,the start time of de-escalation therapy and the impact on the clinical prognosis of patients.Considering that pedi-atric related results of cliniac l research were absent,an anti-infce tion therapy which is guided by microbiolo-gical test and clinical pharmacy is actually needed in the treatment of critically ill patients.Appropriate antibi-otics are chosen based on pathogenic bacetri um detectni g,which avoied sth e overuse of broad spectrum antibi-otics and side effects following overuse of antibiotics.Pathological and physiological changes of critical child should also be considered completely.The pharmacokni etics/pharmacodynamics principle of antibiotics should be followed basing on blood medicinal concentration assay for rational usage of antibiotics.Finally, more randomized controlled trials and real world research trials would be needed for pediatric anti-infection therapy in the future.

Mammary epithelial stem cells, a kind of adult stem cells, possess the potential of multiple differentiation and self-renewal. Studies on mammary epithelial stem cells provide theoretical foundation for mammary gland reconstruction and for preventing and treating breast cancer. Generally, differentiation and renewal of mammary epithelial stem cells are strictly regulated by signal transduction pathway and hormone. Once this mechanism is destroyed or abnormally regulated, cells can abnormally differentiate, unconditionally grow, proliferate, and resulting in mammary epithelial stem cells and tumor. Signal transduction pathway of mammary epithelial stem cell proliferation and differentiation including Wnt, Wnt/?-catenin, Notch and Hedgehog is associated with the onset of breast cancer. To understand the signal transduction pathway, regulatory mechanism and key molecule of self-renewal of mammary epithelial stem cells are crucial for designing an effective method of eradicating tumor initiator cells and mammary epithelial stem cells.

Objective To investigate the pathogens, their drug sensitivities and molecular typing in patients suffering from acute irritant and suffocating gas poisoning under mechanical ventilation. Methods Samples from lower respiratory tracts and breathing circuits of 15 gas poisoning patients and those from hand swabs and fiberoptic bronchoscopies were collected. Pathogens were isolated and drug sensitivity tests and pulsed field gel electrophoresis (PFGE) analysis were performed for those with high isolation rates. Results There were average 3. 86 kinds of isolates in the lower respiratory tracts per patient. Stenotrophomonas maltophilia ranked first, and followed by Enterococcus faecalis, Acinetobacter baumannii, Staphylococcus epidermidis and Candida albicans. Stenotrophomonas maltophilia was resistant to most antibiotics with the resistant rates above 60%. PFGE analysis showed that the isolates from patients and those from hand swabs and fiberoptic bronchoscopies were of the same type. Conclusions It suggests that multi-pathogen infections exit in the lower respiratory tracts of patients who suffered from acute irritant and suffocating gas poisoning with mechanical ventilation. The pathogens are resistant to most antibiotics and their clones may be transmitted among the patients.

Objective To explore the implementation of service concept of "wholly human con-cern" on perioperative nursing. Methods Satisfaction degree investigation was carried out in 150 postoperative patients from January to May, 2008, the existing problems were found out. The service concept of "wholly human concern" was applied in postoperative nursing from June to November, 2008, and satisfaction degree investigation was carried out in 160 postoperative patients, the relevant data was analyzed. Results The satisfaction degree before the implementation was (90.0±1.6), and (97.8±1.2) after the implementation. 20 items in the satisfaction degree questionnaire underwent analysis and 7 of them evidently increased, zero complaint was accomplished. Conclusions Application of service concept of "wholly human concern" in perioperative patients can facilitate them to survive operation period, im-prove the relationship between nurses and patients and increase the satisfaction degree of patients.

Acute lung injury (ALI) is a kind of clinical syndrome which is characterized by the rising on capillary permeability.Acute respiratory distress syndrome(ARDS) is a serious kind of manifestation of ALI and also a usual kind of critical illness in children.Alveolar macrophage is the first defense line against pathogenic microorganisms and lung injury.More and more evidences show that it plays an important role during the period of occurrence, development and prognosis in ALI.In the last few years, there is an extensive focus on the effect of alveolar macrophage in ALI.This summarization makes a general review on the recent research progress of the effect of alveolar macrophages in ALI.

Good clinical results were shown in nasopharyngeal carcinoma (NPC) patients received radiotherapy. The patients with long term life partially had radiation induced injuries that severely affect the quality of life (QOL). The study on QOL of those patients is important. Our article reviewed the effects of NPC QOL by treatment options, health education, rehabilitation therapy, traditional chinese medicine and qigong. The current measurement scale of NPC QOL in China was also discussed.

Hypoxic pulmonary hypertension(HPH) is a common disease featured by acute hypoxic pulmonary vasoconstriction(HPV) and chronic hypoxic pulmonary vascular remolding(HPVR) leading to the sustained increasing of pulmonary artery pressure.There are many mediators involved in the HPH but none can illustrate it successfully.Primary work has found 15-lipoxygenase(15-LO) and its catalyzed production 15-hydroxyeicosatetraenoic acid(15-HETE)(from arachidonic acid) are up-regulated in pulmonary vascular when exprosed to hypoxia.And it has been found 15-LO/15-HETE involved in many processes of both the HPV and HPVR,indicating 15-LO/15-HETE may be an important mediator of HPH.Advances research on 15-LO/15-HETE may illustrate the mechanism of HPH,and will give some message in looking for a potential clinical target of HPH.

Objective To discuss the perioperative nursing method for patients receiving colorec-tal tumor surgery under peritoneoscope. Methods Using the nursing procedure, through appraisal of patients' health situation→listing the nursing diagnosis or the nursing questions→formulation of nursing plan→ implementation of nursing plan→appraisal of the expected effect, combination of the surgical nursing's characteristic, to practice the idea of "the perfect person health and concern", cooperation with medical and nursing team, we provided a complete treatment and nursing plan for 38 patients receiving colorectal tumor surgery under peritoneoscope. Results 38 patients made satisfactory results with no surgery complications. The average in-hospital time was 9 days. Conclusions This technology has slight wound,light hemorrhage,slight draw-off, less pain, short exposure time of intestine, fast recovery of intestine function and early food intake. Systematic and intact perioperative nursing can improve the nursing quality and the success rate and reduce the complications so that the patients can live through the surgery safely.

Sepsis is still a leading cause of death in infants and children.It is the result of multiple organ dysfunction syndrome caused by infection.For sepsis,early diagnosis is very important.Biomarkers (procalcitonin,C-reactive protein,pro-inflammatory cytokines,white blood cell count,neutrophil count,left shift and CD64) during the response to infection can be used for early diagnosis.In addition,continuously monitoring these biomarkers can be used for evaluating severity of illness,monitoring of treatment responses and predicting outcome.

OBJECTIVE:To investigate the role of clinical pharmacists in pediatric severe infection treatment,and to provide reference for rational drug use in clinic. METHODS:Based on related typical cases,the breakthrough points of clinical pharmacists providing pharmaceutical care in pediatric severe infection treatment plan were introduced. RESULTS:Clinical pharmacists formu-lated multi-drug resistance pathogenic antibacterial plan according to the results of pathogenic microbiological examination,use pharmacokinetics/pharmacodynamics,excluded interference to pediatric anti-infection treatment from ADR,and guideline and eco-nomical factors of patients. CONCLUSIONS:Clinical pharmacists adopt professional knowledge of pharmacy to provide pharmaceu-tical care in pediatric severe infection treatment and play professional assisted role so as to guarantee safe,effective and economical treatment.