“Expert consensus for the diagnosis and management of septic shock( infectious shock) in children (2015)” has been published based on the “Recommended protocol for diagnosis and treatment of septic shock in children” which was published in 2006.The definition, diagnosis and early management pro-t ocol of pediatric septic shock was revised partly in the latest expert consensus.The goal of the expert consen-sus was to guide the clinical physicians on early identification and early intervention of pediatric septic shock, and reduce mortality and improve prognosis of septic shock in children.

ObjectiveTo obtain data related to various periods of acupuncture treatment for rat focal ischemia and reperfusion and infer the optimal time point of acupuncture treatment by examining cerebral ROCK expression on the ischemic side in different periods of acupuncture for rats with focal ischemia and reperfusion.MethodOne hundred andeighty male adult Wistar rats were enrolled and randomly allocated to blank, sham operation, model and acupuncture groups. The model and acupuncture groups were separately divided into 5 subgroups: the 6 h, 24 h, 48 h, 72 h and 2 w subgroups. There were atotal of 12 groups, 15 rats each. An animal model of focal cerebral ischemia was made using a thread occlusion method for obstructing rat right middle cerebral artery. The carotid artery was only separated in the sham operation. Materials were taken in the blank and sham operation groups on day 2 after model making. Materials were taken for examination in every subgroup of the model group at 6, 24, 48 and 72 hours and 2 weeks after model making. Materials were taken for examination after acupuncture at Baihui(GV20), Dazhui(GV14)and Zusanli (ST36)in every subgroup of the acupuncture group at 6, 24, 48 and 72 hours and 2 weeks after model making.ResultAcupuncture markedly improved neurological deficits in rats with cerebral ischemia and reperfusion. Areduction in the neurological deficit score was largest in the 6 h acupuncture group and there was a statistically significant difference compared with the other acupuncture groups (24 h, 48 h and 72 h) (P<0.05). There was no statistically significant difference in ROCK expression between the sham operation and blank groups (P>0.05). There was a statistically significant difference in ROCK expression between the model (ischemia-reperfusion 6 h, 24 h, 48 h and 72 h) and blank groups (P<0.05). ROCK expressionreached the peak value at 6 hours after ischemia and reperfusion. There was a statistically significant point-to-point difference in ROCK expression between the acupuncture (ischemia-reperfusion 6 h, 24 h, 48 h and 72 h) and model (ischemia-reperfusion 6h, 24 h, 48 h and 72 h) groups (P<0.05). ROCK expression was down-regulated most markedly in the ischemia-reperfusion 6 h acupuncture group.Conclusion Acupuncture has an inhibitory effect on Rho/Rock in a rat model of cerebral ischemia and reperfusion. Six hours after ischemia and reperfusion is the optimal time point of acupuncture treatment. Acupuncture at that time can protect and improve post-ischemic injured brain tissue to the largest extent.

Objective An initial study on the cognition of the relationship between clinical and management staff for the purpose of improvements. Methods Questionnaires were issued to 38 clinical medical staff and 26 hospital management staff, regarding this relationship. Results Consensus is found between the two groups regarding clinical involvement in management, teamwork and exchange, and cognition on the competence and capability of the other party, P>0.05. On the other hand, however,cognitive differences are found regarding mutual penetration, power balance and implementation of policies and systems. Conclusions In-depth cooperation and understanding between the two groups and the mutual conversion of their behaviors and concepts are the cornerstones of an ideal relationship between clinical staff and management staff.

Bronchiolitis is a common respiratory infective disease in children, which is caused by viruses mostly. A view that bronchiolitis is a special pattern of manifestation of asthma is accepted widely. In the past few years, many agents appeared as a inducement from bronchiolitis to asthma, such as family histoty and atopy. At the same time, the life style of infants( feeding patterns,infective frequency ,environment exposure)plays a role in this process. Studying these factors will help doctors to detect people with high risk, and supply treatment earlier.

OBJECTIVE:To discuss about the spot break for promoting technical skipping in pharmaceutical industry of China.METHODS:Based on imbalance of technical development,matrix of technical change skipping and cluster of innovation,the necessity and possibility of the spot break for promoting technical skipping in pharmaceutical industry of China were discussed.RESULTS & CONCLUSIONS:Because the spot or part break is the normal model for promoting technical skipping in history of technical change and innovation,so if pharmaceutical industry of China wants to get technical skipping,we have to promote the spot break.In the end of this paper,the suggestions how to get spot breaks in the skipping of pharmaceutical technical change and innovation in China are put forward.

With the development of income per capita,"high personal medical expenditure" shows the wider of disease risk,which is resulted from the increasing medical payment and imperfect risk pooling.The former that is related with the excess delivery of advance medical technology and drug has been a dominating reason since 1980.And the imperfect risk pooling means the imperfect social medical insurance,of which the government should take charge.However,influenced by the reform policies of the economic systems,similar to all the transitional economies reducing the government role in healthcare financing,China has put an increasing emphasis on the payroll tax-based social insurance system and out-pockets payment,moving away from a predominantly general revenue-based financing system under the old command economy.In a conclusion,the Chinese Government should make clear the financing function,and replace fee-for-service(FFS) payment according to the distorted pricing system with aggregated pre-payment for patients covered by social insurance to mitigate the incentive for cost escalation.Meanwhile,the target of the new medical reform that should resolve the problem of high personal medical expenditure is demanding and perfecting the social medical insurance with wider risk pooling.

Objective: To explore the effect of the application of ICQ technology in constructing a harmonious environment for nursing staff.Method: The Internet,support from Tencent network,ICQ technology are employed to conduct on line communication among nursing staff.Result: the Working and interpersonal connection environment is remarkably improved by the application of ICQ technology,thus it is of great significance in constructing a harmonious relation among nursing staff and enhancing medical service quality.

OBJECTIVE: To establish HPLC fingerprint of Compound danshen tablets.METHODS: The separation was performed on Agilent Eclipse XDB-C18(150 mm?4.6 mm,5?m) column with mobile phase consisted of acetonitrile-0.04% phosphate (gradient elution) at flow rate of 1.0 mL?min-1.Detection wavelength was set at 272 nm and column temperature was 30℃.RESULTS: Established HPLC fingerprint was distinct and reproducible.There were 8 characteristic peaks among which No.5 characteristic peaks,No.6,No.7,No.8 came from HPLC fingerprint of Salvia miltiorrhiza and No.1 characteristic peaks,No.2,No.3,No.4 came from HPLC fingerprint of Panax notoginseng.CONCLUSION: The characteristic peaks of effective parts of Compound danshen tablet mainly come from S.miltiorrhiza.The study can be used for tracing and isolation of effective part of Compound danshen tablet and establishes basis for the further development of Chinese patent drugs.

Invasive aspergillosis (IA) is a major cause of morbidity and mortality in immunocompromised children.The purpose of the review was to provide epidemiological,clinical aspects,diagnosis and antifungal treatment options in the pediatric population.Diagnosis of IA remains a challenge as the clinical and imaging manifestations are not specific,and a histological diagnosis is often unfeasible,and blood culture shows low sensitivity rates.In recent years,great progress has been made in the detection of fungal biomarkers,which is mainly described in this paper.

BACKGROUND:There is a close relationship between tumor stem cels and tumor occurrence and recurrence, but there are stil some disputes in the presence of tumor stem cels in al tumors.
OBJECTIVE:To investigate the differentiation and culture of tumor stem cels in human primary gastric cancer cels.
METHODS:Primary gastric cancer cels isolated from fresh gastric cancer tissues were stained with hematoxylin-eosin and identified by immunohistochemical detection of carcinoembryonic antigen. The CD44 expression of the cels was detected using immunofluorescence method. Magnetic activated cel sorting was used to isolate CD44+gastric cancer cels that were then seeded subcutaneously behind the armpit of mice. Growth of implanted tumor cels was observed.
RESULTS AND CONCLUSION:Human primary gastric cancer cels were isolated in serum-free medium. Compared with the routine culture group, the number of CD44+cels(P< 0.05)and the tumor volumewere significantly increased in the spheroid culture group. Furthermore, at 90 days after transplantation, the tumor volume of mice in spheroid culture group was significantly higher than that in the routine culture group. These experimental findings indicate that gastric cancer cels with certain tumorigenicity can be successfuly isolated from gastric cancer cels using serum-free culture method and magnetic activated cel sorting method.