Turning to critical illness is a common stage of various diseases and injuries before death. Patients usually have complex health conditions, while the treatment process involves a wide range of content, along with high requirements for doctor′s professionalism and multi-specialty teamwork, as well as a great demand for time-sensitive treatments. However, this is not matched with critical care professionals and the current state of medical care in China. Telemedicine, which shortens the distance of medical professionals and the gap of disease diagnosis and treatments in various regions through electronic information, can effectively solve the current problem. Therefore, there is an urgent need to develop a standardized, high-quality visualization telemedicine round system .Therefore, experts have been organized to search domestic and foreign literature on telemedicine round for critically ill patients and to form this consensus based on clinical experiences so as to further improve the level of critical care treatments in regions.

Turning to critical illness is a common stage of various diseases and injuries before death. Patients usually have complex health conditions, while the treatment process involves a wide range of content, along with high requirements for doctor′s professionalism and multi-specialty teamwork, as well as a great demand for time-sensitive treatments. However, this is not matched with critical care professionals and the current state of medical care in China. Telemedicine, which shortens the distance of medical professionals and the gap of disease diagnosis and treatments in various regions through electronic information, can effectively solve the current problem. Therefore, there is an urgent need to develop a standardized, high-quality visualization telemedicine round system .Therefore, experts have been organized to search domestic and foreign literature on telemedicine round for critically ill patients and to form this consensus based on clinical experiences so as to further improve the level of critical care treatments in regions.

Objective To investigate the distribution and antimicrobial resistance of major pathogens causing bloodstream infection in a tertiary hospital,so as to guide the clinical rational use of antimicrobial agents.Methods Blood specimens from patients with suspected bloodstream infection in this hospital between January 2012 and January 2015 were cultured,identified and performed antimicrobial susceptibility testing,the major pathogens and antimi-crobial susceptibility testing results were analyzed statistically.Results A total of 1 658 strains of pathogens were isolated from 19 326 blood culture specimens,isolation rate was 8.58%,in which gram-negative bacilli,gram-posi-tive cocci,and fungi accounted for 58.57% (n=971 ),39.38% (n=653),and 2.05% (n=34)respectively,the major gram-negative bacillus,gram-positive coccus,and fungus were Escherichia coli ,coagulase-negative staphylo-cocci (CNS),and Candida albicans respectively.The isolated pathogens mainly distributed in departments of hema-tology,gastroenterology,and cardiovascular surgery.Detection rates of extended-spectrumβ-lactamases (ESBLs)-producing Escherichia coli and Klebsiella pneumoniae were 56.35% and 36.14% respectively,but were highly sen-sitive to cefoperazone/sulbactam and carbapenems (resistance rates <3%).The percentage of methicillin-resistant coagulase-negative staphylococcus (MRCNS ) and methicillin-resistant Staphylococcus aureus (MRSA ) were 78.60% and 32.28%respectively,but were highly sensitive to vancomycin and linezolid(resistance rates < 1 %). Conclusion Escherichia coli and CNS are predominant pathogens causing bloodstream infection in this hospital,antimicro-bial resistance rates are high;regular analysis on distribution and antimicrobial resistance of pathogens causing bloodstream infection is helpful for the prevention and control of infection caused by multidrug-resistant organisms.

Objective To probe into the cognitive function among elders in Xinzhongjie community and provide the evidence for corresponding nursing interventions. Methods Convenient sampling was used to recruit 193 elders who were equal to or older than 60 for the investigation by Montreal cognitive assessment ( MoCA) . Results There were 37 elders (19. 17%) who were abnormal on cognitive function. Cognitive function was related to age, educational level, and whether had brain disease. Elders, who were in older, with lower educational level, and had brain disease, were more frequently to have abnormal cognitive function (χ2 =9. 54, 20. 58,21. 92;P<0. 01). By Logistic regression analysis, older age and brain disease were risk factors for cognitive function declines, while high educational level was a protective factor for the cognitive function. Conclusions Community nurses should pay increasing attention on the changes of cognitive function among elders who are in older age, with lower educational level, and have brain disease. Non-pharmacological nursing intervention can be provided to elders according to their specific cognitive function decline.

Objective To summarize the nursing experience of treatment of percutaneous and transhepatic portal venous autologous bone marrow stem cell transplantation for chronic hepatic failure.Methods 19 patients who were definitely diagnosed as chronic liver failure received pertinent nursing in different perioperative period of transhepatic portal venous autologous bone marrow stem cell transplantation.Results All of the 19 patients went through perioperative period safely without any adverse reactions or complications.Conclusions In the process of treatment of autologous bone marrow stem cell transplantation for chronic hepatic failure,sufficient preoperative preparation,good communication and close cooperation among doctors,nurses and patients during operation,careful nursing and rehabilitation instruction after operation,are important assurances for autologous bone marrow stem cell transplantation to run smoothly.

Objective Collagenous gastritis is a rare entity, characterized by the deposition of a subepithelial collagen band with an inflammatory infiltrate in the mucosa.This report describes the first case of collagenous gastritis occurring in a young Chinese woman and reviews the literatures.Methods The patient underwent the gastroscopy screening, and the biopsy specimens were treated with HE staining, Masson staining, Congo red staining and Warthin-Starry staining.Patients' clinical data was discussed and followed up.Results A twenty-year-old girl had intermittent epigastric pain for 4 years, abdominal distention, hiccup and weight loss for two months.The gastric endoscopy revealed diffuse white nodular appearance of the mucosa in angular incisure and antrum.Pathologic examination of the gastric biopsies from the antrum and angular showed a subepithelial collagen deposition with moderate infiltrates of lymphoplasma cells and eosinophils of the lamina propria.The collagen band measured up to 120.3 μm (mean 43.8 μm).Prednisone 20 mg/d for 4 weeks led to clinical remission and weight gain.Conclusion There are about 40 cases in literatures to date, and the cause and pathogenesis of collagenous gastritis remain unknown.According to the clinical and pathological characteristics, the patient in this article is the subtype of collagenous gastritis that occurring in children and young adults.Specific therapy has not been established, the gluten-free diet and glucocorticosteroid may be helpful to relieve symptoms in collagenous gastritis patients.