There is high incidence of relative adrenal insufficiency (RAI) in critical children. The causes of adrenal insufficiency in patients with severe sepsis and septic shock are the mechanical injury of the hypothalamic-pituitary-adrenal axis, cytokines and other mediators of inflammatory or hormone resistance. There are many symptoms associated with adrenal insufficiency. Diagnosis is often suspected when these patients have hypotension refractory to fluid therapy and to vasoactive drugs. The corticotropin stimulation test is widely used as a method to identify adrenocortical hyporesponsiveness, but controversy exists as to the corticotropin dose to be used. The 250 μg dose is the standard dose. Low doses of corticotropin (1 μg) have recenfly been proposed,suggesting that they may have higher sensitivity and the characteristics of safe and effective.

Gastrointestinal dysfunction is abnormalities of digestion and absorption caused by various reasons, which manifests bacterial colonization of the gastrointestinal tract, bacterial/endotoxin translocation,gastrointestinal mucosal barrier injury and immune disorders. Child and newborn gastrointestinal dysfunction/failure is secondary to the severe syndrome of critical illness, always be a part of multiple organ dysfunction syndrome. Structure and function of the gastrointestinal tract are significantly different between child and adult. The key therapy strategy of gastrointestinal dysfunction are maintenance of intestinal barrier, reconstruction of intestinal continuity, adjust of homeostasis, circulation and oxygen supply, and management of the primary disease on time.

This paper describes the development of Department of Burns of the 159th Hospital of PLA in the past 60 years and shows their spirit of hard working and achievements of several generations.

Objective To observe the effect of Morita therapy on self-esteem level and life satisfaction in schizophrenic patients. Methods 140 schizophrenic patients received Morita therapy, and followed up for 1 year. Self- esteem Scale (SES), Life Satisfaction Index B (LSIB), and Personal and Social Performance scale (PSP) were evaluated. Results The scores of SES and LSIB significantly improved after treatment (P=0.000). 117 cases (83.57%) were in stable condition; 20 cases (14.29%) were in unstable condition with poor medication compliance; only 3 cases (2.14%) needed to be re-hospitalized due to relapse. The 117 cases were followed up for 1 year, and their SES and LSIB scores maintained at the level when discharge, in which 94 cases kept in well social function. Conclusion Morita therapy can improve the self-esteem and life satisfaction of schizophrenic patients, and maintain good social function.

Several comparative studies on anti-implantation and estrogenicities of noret histerone oxime(NETO)and norethisterone(NET) or ethynyl estradiol (EE2)were carried out in order to clarify their relationships. It was observed that NETO was showed much stronger potency than NET, which the anti-implantation, uterotrophic and vaginal cornifi-cation effect were 25, 26, and 21 times, respectively. The ratio of anti-implantation to vaginal cornification of NETO was 14-fold stronger than that of EE2. These results suggest that the increased antiimplantative activity of NETO is related to its stronger estrogenic activity, but other mechanisms contribute to the anti-implantation besides estragenicity.

Objective] To investigate the relationship between pain from malnutrition and MM, looking for a cure for MM.[Methods]To analyze the relationship between pain from malnutrition and MM in clinical TCM based on the study of Neijing and the textual works of famous Chinese physicians. According to the etiology and pathogenesis to find the treatment method, and validation from clinical cases. [Result]We find that the pain from malnutrition caused by deficiency of kidney and spleen is a major cause of MM by summarizing of the ancient physicians. And we tally up the invigorating kidney is an important method for the treatment of MM.[Conclusion]Pain from malnutrition is an important pathogenesis of MM. To a method of treating MM, invigorating kidney and spleen is obvious and this method for the treatment of MM will bring more help.

目的探讨低能量氦氖激光血管内照射(intravascular He-Ne laser irradiation,ILIB)治疗氯丙嗪所致锥体外系副反应(extraPyramideal side effects,EPS)的疗效。方法将61例住院精神分裂症患者随机分为ILIB治疗组(31例)和对照组(30例),两组患者均单一服用氯丙嗪。对出现EPS的 ILIB治疗组患者采用ILIB治疗,10次为1个疗程;对出现EPS的对照组患者使用安坦治疗。于治疗前、中、后用EPS副反应量表评定两组患者的疗效。结果对氯丙嗪所致的EPS,ILIB治疗组和对照组疗效无显著性差异(P>0.05),但ILIB治疗组抗胆碱能副作用发生率明显低于对照组(P<0.01)。结论ILIB对氯丙嗪所致EPS疗效确切,同时还有对抗氯丙嗪的抗胆碱能副作用。

Objective To determine the expression of E-cadherin-catenins complex(E-cad,?-cat,?-cat and ?-cat) in early gastric cancer and their relationships with biological characteristics of early gastric cancer by evaluating the invasion and the lymph nodes metastasis of eraly gastric cancer(ECG).Methods 53 cases of EGC,who accepted radical operations from January 1997 to December 2000 in Sir Run Show Hospital were included in this study.According to the invasion depth and lymph nodes metastasis,they were divided into different sub-groups for discussion.Also the normal gastric mucosa of 10 cases with extra-gastric disease were selected as control group.Results All four proteins(E-cad,?-cat,?-cat and ?-cat) were normally expressed in control group.In early gastric cancer,the abnormal expression rates of E-cad,?-cat,?-cat and ?-cat were 64.2%,69.8%,66% and 73.6%,respectively.In the sub-group of mucosal invasion,the abnormal expression rates were 61%(14/23),65.2%(15/23),47.8%(11/23) and 56.5%(13/23),respectively.But in the sub-group of submucosal invasion,the abnormal expression rates were 66.7%(20/30),73.3(22/30)%,80%(24/30) and 86.7%(26/30),respectively.In sub-group of no lymph node metastasis,the abnormal expression rates were 61.4%(27/44),65.9%(29/44),63.6%(28/44) and 70%(31/44) respectively.In sub-group of lymph node metastasis,the abnormal expression rates were 77.8%(7/9),88.9%(8/9),77.8%(7/9) and 88.9%(8/9) respectively.Abnormal expression of ?-cat and ?-cat had significantly difference between the sub-group of mucosal invasion and the submucosal invasion(P

Objective To investigate the role of platelet rich plasma (PRP) on free fat graft's survival in a rat model.Methods Twenty-four rats were used in the experiment.For each rat,three groups of free fat grafts were injected into the subcutaneous layer of dorsum.Group A was the control group with 0.5 ml fat and 0.12 ml normal saline.Group B received 0.5 ml fat and 0.1 ml PRP with 0.02 ml normal saline.Group C was given combination of 0.5 ml fat and 0.1 ml PRP which was activated by 0.02 ml calcium chloride.Eight rats were euthanised using pentobarbital sodium each time,1,2 and 3 months after fat transplantation.Specimens were acquired and stained with haematoxylineeosin,and then the histological changes examined using light microscopy.All the data were statistically analysed using paired t test to determine if there were differences between the study groups.Results Compared the volume of the fat grafts at 1 month,there was no deference between the groups(P＞0.05).However,the diameter of group C was significantly higher than group A (P＜0.05).On histological examination,larger vascular density was observed in group C compared with group A at 1 month (P＜0.05).And reduced inflammatory reaction was also observed in group C at 3 months(P＜0.05).While other histological parameters were not statistically significant (P＞0.05).Conclusions PRP does not enhance the survival of fat graft in the Wistar rat model.

Objective To compare the clinical effectiveness of whole blood derived platelets and apheresis platelets in children with hematological diseases.Methods Children were divided into two groups: apheresis platelet group(463 children) and whole-blood-derived platelet group(155 children).The platelet corrected count increment(CCI),percentage platelet recovery(PPR),the incidence rate of post-transfusion refractoriness to platelets(PTR) and adverse reaction were observed and assayed at 24,48 and 72hours after transfusion.Results In the apheresis platelet group,CCI and PPR at 24,48,and 72 hours after transfusion were significantly higher(P