中暑是指在高温热辐射或高强度体力活动情况下，机体体温调节功能障碍，导致核心体温升高，引起潜在致命性机体紊乱［1］。依据致病因素，中暑可分为经典型中暑（高温环境所致）和劳力性中暑（高强度体力活动所致）。按照临床表现，中暑可分为热射病、热痉挛和热衰竭。重症中暑以核心体温升高（＞40℃）伴脑功能障碍为临床特征，表现为意识不清、谵妄、惊厥等［2］。随着温室效应等导致全球气候变暖，加之居民生产、生活条件改善，人类耐热能力逐步减退，中暑发生率呈上升趋势［3］。重症中暑可导致脑、循环、血液及肝、肾等器官功能不全或衰竭，而多器官功能障碍综合征（MODS）是重症中暑患者的主要死因，其病死率高达58%～71%［3］。苏州地区自2013年7月7日至8月18日连续43 d最高气温均在35℃以上，其中8月8日至10日的日最高气温均在40℃以上。在此期间，本院重症加强治疗病房（ICU）共收治9例中暑致MODS患者。反思重症中暑患者诊治中存在的问题，总结成功救治经验，并进行文献复习，具有重要的临床意义，现报告如下。

Acute pancreatitis (AP) remains a common critical disease. Recently, the diagnosis and treatment of AP have made remarkable progress, early diagnosis and standard life support therapy could markedly improve prognosis of patients with AP. Nevertheless, AP is complex and variable;physicians are often required to make correct clinical decisions within a very short period of time. In fact, it is very important to establish a scientific rational decision making of AP, which could efficiently guide the appropriate diagnosis and treatment of patients with AP. Clinical physicians should strive to fully learn and use the dialectical thinking, deeply understand the genesis and pathophysiological mechanisms of AP, and develop the reasonable diagnosis and treatment. We believe that these findings could lead to significant improvement in our therapeutic approach to AP.

Objective To explore the clinical application value of Orem self-care theory in the mental nursing of children with acute leukemia .Methods Fifty-five children with acute leukemia were randomly divided into the control group ( n=27 ) and the experimental group ( n=28 ) according to single and double number .The control group received the routine nursing , and the experimental group received the nursing intervention according to Orem self -care theory on the basis of the routine nursing .The changes of mental status and the nursing satisfaction were evaluated and compared between two groups through the Symptom Checklis-90 ( SCL-90 ) , Hamilton Anxiety Scale ( HAMA ) , and Hamilton Depression Scale ( HAMD ) . Results The anxiety and depression were mainly dominated in children with leukemia .One week after the intervention, the score of HAMA in the experimental group decreased from (18 ±6)to (12 ±5),and was lower than (16 ±3)in the control group; the score of HAMD in the experimental group decreased from (23 ±8) to (17 ±3), and was lower than (20 ±4) in the control group, and the differences were statistically significant (t=3.50, 2.39, 2.68, 1.87, respectively;P<0.05).The nursing satisfaction in the experimental group was 96.4%, and was higher than 85.2%in the control group, and the difference was statistically significant (χ2 =3.47, P<0.05).Conclusions The application of Orem self-care theory in children with acute leukemia can obviously alleviate their anxiety and depression , and improve clinical nursing satisfaction .