2012年 · 第50卷第09期

The 10th International Symposium on Kawasaki Disease, co-sponsored by the American Heart Association, the World Heart Federation, the Kawasaki Disease Society of Japan and the Japanese Pediatric Society, was held in Kyoto, Japan, from February 7 to 10, 2012. The topic of this conference is: Synergistic research and management of Kawasaki disease from genetics to the clinic.

Continuous blood purification (CBP) has been used in pediatrics to treat severe sepsis in children for nearly 10 years. In order to promote the popularization, standardization and development of continuous blood purification treatment for severe sepsis in children, from November 18 to 19, 2011, 18 well-known experts from all over the country in the field of severe and continuous blood purification in children gathered in Beijing to discuss the progress of continuous blood purification treatment for severe sepsis in children, exchange their respective experiences and experiences, and draft the "Expert Consensus on Continuous Blood Purification Treatment for Severe Sepsis in Children". Now, the relevant issues in the writing of "consensus" are interpreted as follows.

The proband male, 11 months old, was admitted to the hospital due to unstable head-up and inability to sit alone. The child was the second birth, the second birth, and was born naturally at 41 weeks. He denied asphyxia, birth injury and rescue history. When he was 3 months old, his eyes could not chase light and objects, and he was diagnosed as "congenital cataract and congenital glaucoma" in an outside hospital, and was treated with surgery. Still won't roll over at 8 months old. Now my head is unsteady and I can't sit alone.

Children's response to pain stimuli is similar or even stronger than that of adults. Stimuli such as anxiety, fear and pain can also lead to their excessive stress response, which directly affects the prognosis of critically ill children. Therefore, sedation and analgesia treatment is an important part of comprehensive treatment of critically ill children. Because most children cannot express or cannot express exactly, it is more difficult for clinicians to grasp the appropriate degree of sedation and analgesia. At present, there are differences in the treatment guidelines of sedation and analgesia in different countries and regions. How to apply different regional or national guidelines to individualized clinical practice, and whether relevant fields around the world can come together to formulate standard guidelines or recommendations for sedation and analgesia to obtain safer treatment measures, so that critically ill children can receive treatment in a relatively comfortable and painless state, has always been one of the challenges faced by pediatric medical staff^[1]。 To develop and standardize the sedation and analgesia treatment of children with severe illness, especially the problems that domestic pediatric colleagues need to pay attention to.

Sepsis refers to systemic inflammatory response syndrome (SIRS) caused by infection (confirmed or suspected). It is one of the main causes of death in ICU children, and it is also a difficult problem faced by critical care medicine today. The 2002 International Pediatric Sepsis Conference defined SIRS, sepsis, severe sepsis, septic shock and organ dysfunction in children, laying the foundation for large-scale, multi-center clinical research. Although the international campaign to save sepsis has provided guidelines for the diagnosis and treatment of severe sepsis, the mortality rate of severe sepsis remains high. Continuous Blood Purification (CBP), also known as continuous renal replacement therapy (CRRT), is a general term for all treatments that continuously and slowly remove water and solutes through extracorporeal bypass and filter. CBP can remove inflammatory mediators in the blood, reduce the level of inflammatory mediators in tissues, and improve vital organ functions through filtration, dialysis and adsorption, which may be helpful in the treatment of severe sepsis.

In 2009, the Gastroenterology Group and the Infectiology Group of the Pediatrics Branch of the Chinese Medical Association published the "Expert Consensus on Diagnosis and Treatment Principles of Children's Diarrheal Diseases"^[1]It emphasizes early oral rehydration, continued feeding, zinc supplementation treatment and early identification of dehydration signs, advocates breastfeeding, and recommends the application of new oral rehydration salt (ORS) formula. This consensus has important guiding significance for pediatric clinicians and children's health care workers to treat children's diarrhea. In the clinical treatment of infantile diarrhea, besides fluid rehydration and corresponding drug treatment measures, nutritional intervention in diarrhea and diarrhea recovery period is also very important. In order to strengthen and refine the specific content of nutritional intervention, on the basis of expert consensus, the Gastroenterology Group of Pediatrics Branch of Chinese Medical Association and the Pediatrics Group of Parenteral and Enteral Nutrition Branch of Chinese Medical Association specially discussed and formulated this nutritional intervention path.

The training and growth process of pediatricians need to go through the so-called "three-stage" education, that is, systematic undergraduate education, rigorous standardized training of residents and continuing education for life^[1]。 The first two parts of the three-stage education model (undergraduate education and standardized training for residents) teach medical students how to meet the basic requirements of pediatricians, including basic clinical skills, basic knowledge, professional ethics and conduct of physicians, medical ethics and humanistic care, etc. Without meeting the requirements of these elements, it is impossible to complete the work of a pediatrician. Continuing education is a high-level, knowledge renewal and lifelong education carried out by pediatricians on the basis of completing the above basic training. The purpose and motivation of continuing education stems from the clinical problems encountered and attempts to address them. There are many ways of continuing education, such as further study, participation in classes and academic conferences, etc. The main way of which is self-study; The highest level of self-learning method is based on the summary of experience and scientific research of clinical problems^[2]。

On the occasion of the 10th anniversary of the establishment of the Sleep Collaborative Group of the Respiratory Group of the Pediatrics Branch of Chinese Medical Association, the 4th Sleep Academic Conference and Children's Sleep Medicine Study Class were successfully held in Beijing on March 17-20, 2012. More than 160 experts and related representatives from more than 70 medical and health care institutions in 21 provinces (cities) across the country engaged in sleep medicine research attended the meeting.

neurally mediated syncope (NMS) is a syncope caused by the imbalance of autonomic function regulation, including vasovagal syncope (VVS), postural orthostatic tachycardia syndrome (POTS), orthostatic hypotension, situational syncope, etc., and its incidence rate accounts for about 80% of syncope in children.

The "Instructions for Clinical Use of Pharmacopoeia of the People's Republic of China" (2010 edition) (hereinafter referred to as "Instructions for Clinical Use") organized and compiled by the National Pharmacopoeia Commission has been published by China Medical Science and Technology Press in April 2011.