The clinical teaching of ICU is a new challenge.According to the problem encountered in the practice we should improve and better the teaching methods such as asking students to pay more attention to the combination of substructural subjects and critical medicine and having a clinical macrocosm thinking,good responsibility,and the "intensive" concept during their work so that student can learn more initiatively and get more as well.

Objective: To observe the changes of blood coagulation factors and inflammatory factors and the regulatin effect of Omegaven.Methods: Thirty ICU patients were randomly allocated into two groups: Omegaven group and control group.Serum concentrations of NF-κB、PGF1α、Eselectin、sICAM-1、TAT、D-dimer、TMD、PF1+2 were measured before and after parenteral nutrition.Results: Patients in control group had significantly higher NF-κB、Eselectin、sICAM-1、TAT、D-dimer、TMD、PF1+2 concentration,lower PGF1α concentration.Patients treated with Omegaven had significantly lower NF-κB、Eselectin、sICAM-1、TAT、D-dimer、TMD、PF1+2 concentration,higher PGF1α concentration.Conclusion: Omegaven can suppress inflammatory reaction and improve coagulopathy.

0.05).Conclusion: Enteral nutrition may improve the nutrition status.The naso-jejunum tube feeding has no advantage to nasogastric tube feeding in our patients.The route of enteral nutrition should be selected according to the individual condition and local nosocomial experience.

Objective To investigate the clinical significance and levels of plasma renin activity (PRA), Angiotensin (Ang) Ⅱ in ALI / ARDS patients. Methods The levels of PRA and AngⅡ, APACHE Ⅱ score, lung injury score(LIS), and mortality were analyzed in ALI/ARDS patients and non-ALI/ARDS group. After the patients were grouped accord-ing to prognosis, correlation analysis and ROC curve to evaluate diagnostic efficacy of PRA and AngⅡ were performed. Results Compared with non- ALI/ARDS group, the levels of PRA and AngⅡ were significantly increased in ALI/ARDS (P<0.05). In the death group, the levels of PRA and AngⅡwere higher than that of the survival group (P<0.05). It was significant positive correlation between APACHEⅡ score,LIS,lactic acid (LAC) and PRA, so as AngⅡ. In pre-dicting ALI/ARDS, PRA was significant (AUC=0.705, P=0.001), so as AngⅡ(AUC=0.672, P =0.007). In predict-ing ALI/ARDS, there was no significant difference between PRA and LIS (P=0.923), and also between AngⅡ and LIS (P = 0.713). Conclusion In ALI/ARDS patients, the levels of PRA and AngⅡwere significantly increased, and both could be used to predict ALI/ARDS and determine its prognosis, but AngⅡhad higher specificity in predicting ALI/ARDS.