Research progress of TCM in treating radiation enteritis based on intestinal microecology / 国际中医中药杂志

Patients with radioactive enteritis generally have certain intestinal microecological imbalance. Traditional Chinese Medicine (TCM) has showed good advantage in regulating intestinal microbial flora. In clinical practice, patients are treated based on syndrome differentiation of heat toxin damaging collaterals, cold-heat mixed syndrome, spleen deficiency and dampness stagnation, spleen and kidney yang deficiency, yin deficiency and body fluid deficiency. The Baitouweng Decoction, Wumei Pill, Sijunzi Decoction are the common prescriptions. TCM can promote the balance of intestinal microecology and treat digestive diseases such as radioactive enteritis, by improving the abundance of intestinal flora, inhibiting the level of inflammatory cytokines, and playing the role of probiotics and immune regulation.

Nutritional assessment in a pediatric intensive care unit / 中华急诊医学杂志

Objective To assess nutritional status of critically ill children,and to investigate the correlation of nutritional status with illness severity and clinical outcomes,so as to provide a theoretical basis for rational nutrition support of critically ill children.Methods All patients hospitalized in the pediatric intensive care unit of Beijing Children's Hospital from November,2010 to January 2011 were enrolled and studied prospectively.We collected anthropometric parameters (body length/height,body weight,head circumference,etc) for nutritional assessment,as well as their clinical data such as underlying diseases,pediatric risk of mortality scores (PRISM),length of hospital stay and mechanical ventilation duration.Results tn 196 cases,the prevalence of malnutrition was 21.9％ (43/196).Malnutrition group had greater PRISM scores,higher mechanical ventilation rate and a lower 28-day survival rate than normal nutritional status group (all P ＜ 0.05).Conclusions The prevalence of malnutrition on admission to the PICU was high and poor nutritional status indicated greater illness severity and adverse clinical outcomes

The prevalence of vitamin D deficiency and its relationship with the severity and prognosis in critically ill chil-dren / 中华实用儿科临床杂志

Objective To investigate the prevalence of vitamin D deficiency and to examine its relationship with the severity and prognosis in the critically ill children. Methods A total of 83 critically ill children admitted from November 1,2010 to December 9,2010 to Pediatric Intensive Care Unit in Beijing Children's Hospital,Capital Medical University were enrolled in the study. Serum 1,25 - Dihydroxyvitamin D concentration was measured by using an en-zyme - linked immunosorbent assay(ELISA). Anthropometric parameters such as height/ length and weight of the chil-dren were measured. Data collection also included primary disease,Pediatric Critical Illness Score(PCIS),the Pediatric Risk of Mortality Ⅲ(PRISM Ⅲ)score,multiple organ dysfunction syndrome( MODS)rate,mechanical ventilation rate,time of hospital of stay and the 28 - day survival rate. Results There were 32 cases with vitamin D deficiency on admission,vitamin D deficiency rate on admission was 38. 6% ,and there was no statistically significant difference among different primary disease groups(P = 0. 815). Vitamin D deficiency rate of malnutrition group was lower than that of the normal group[60. 0%(12 / 20 cases)vs 40. 0%(8 / 20 cases),χ2 = 5. 989,P = 0. 014]. PCIS scores of those with a normal vitamin D status was higher than those of the vitamin D deficiency group,showing a significant difference [(80. 47 ± 6. 18)scores vs(77. 16 ± 7. 59)scores,P = 0. 022]. PCIS score was positively correlated with the vitamin D level(r = 0. 267,P = 0. 015). There was no statistically significant difference among the PRISM score,MODS rate, mechanical ventilation rate,hospital stay length and the 28th day survival rate between the normal vitamin D group and the vitamin D deficiency group(all P ﹥ 0. 05). Conclusions A high prevalence of vitamin D deficiency is found in the critically ill children. The prevalence of vitamin D deficiency in children with malnutrition is higher. Vitamin D status may be correlated to the severity of the critically ill children,but the association with the prognosis is not obvious.

The diagnosis and treatment of critical illness-related corticosteroid insufficiency / 中国小儿急救医学

In recent years,relative adrenal insufficiency in critical patients has become a hot issue.With progression of studies,this definition is insufficient in accuracy.Thus a new definition of critical illnessrelated corticosteroid insufficiency(CIRCI)is developed.Now CIRCI have not had consentaneous diagnostic criteria.Moreover,the benefits of this diagnose to corticosteroid treatment in critical patients remains unclear.This article will review on the diagnosis of CIRCI and current situation of corticosteroid treatment.