الملخص
Objective:To analyze and discuss the application value and teaching effect of simulate patients (SP)-assisted problem-based learning (PBL) combined with team-based learning (TBL) mode in pediatric first aid teaching, in order to provide a new reference for the reform of standardized residency training and teaching mode of pediatrics in the new era in China.Methods:A total of 103 residents who participated in the standardized training in the Department of Pediatrics of Hunan Children's Hospital from January 2018 to December 2020 were selected as the research objects, and they were divided into the control group (50 cases) and the experimental group (53 cases). The control group adopted the previous teaching mode of residents, while the experimental group adopted the SP-assisted PBL combined with TBL mode. In this study, SPSS 22.0 software was used for t test and chi-square test. Results:The examination scores of the experimental group in the theoretical knowledge of pediatric first aid, clinical thinking and skills, and application of pediatric first aid skills were higher than those in the control group [(86.98±3.42), (85.69±5.13), (89.62±4.75)] vs. [(77.23±4.16), (81.16±3.96), (76.54±5.78)], with statistically significant differences between the two groups ( P<0.05). The questionnaire survey showed that the clinical thinking and pediatric emergency skills, doctor-patient communication ability, teamwork ability and other aspects of the experimental group were significantly better than those of the control group ( P<0.05). Conclusion:The SP-assisted PBL combined with TBL mode can produce positive effects in the standardized residency training of pediatrics, which will help residents better master pediatric first aid skills, improve their clinical comprehensive capabilities, and be more conducive to improving the quality of pediatric residency training, which is worth promoting in the new era.
الملخص
Objective@#To understand the epidemiology characteristics of child injury aged 6-17. Data was from the National Injury Surveillance System (NISS) and the results of the study would provide corresponding intervention strategies and decision-making for child injury prevention.@*Methods@#Descriptive analysis was applied to depict the general information, injury event and clinical characteristics of child injury aged 6-17 from 2015 to 2018.@*Results@#A total of 331 663 child injury cases aged 6-17 were reported, with the male and female ratio appeared as 2.19∶1. 15:00-18:59 was the peak time of injury cases from 2015 to 2018. The majority of the injuries occurred unintentional(94.85%). The top three causes of injury cases were falling(51.38%), blunt injury (12.50%)and road traffic injury(11.27%). The injuries occurred mainly at home(28.23%), in schools/public places (27.70%) and on the road/street(20.35%). The main activities were leisure activities (46.67%) and sports activities(14.36%). 49.06% cases were bruise. 31.18% of the injury involved with head, but 83.32% of injuries were minor, while 90.05% left hospital after the treatment.@*Conclusion@#Falls, blunt injury and road traffic injury are the key causes of children aged 6-17 to go to the outpatient /emergency department for treatment. Prevention and control should be carried out according to the epidemic characteristics of injuries among children of different genders and ages.
الملخص
Objective To investigate the clinical charactors and treatment of IgM nephropathy with nephrotic syndrome(NS) in children.Methods Thirty-six IgM nephropathy patients hospitalized in Hunan Children's Hospital as research group(group A),from June 2005 to June 2012.One hundred and six patients with minimal change disease (MCD) as control group (group B),followed up for 1 ~ 8 years.Results (1) Hematuria at presentation of the two groups respectly 3.8% vs 30.6% (x2 =20.403,P < 0.05).(2) Renal pathology revealed that there were 26 (72.2%)patients with minimal change disease,9 cases (72.2 %)with moderate membranoproliferative glomerulonephritis,1 cases with focal segmental glomerulosclerosis.(3) According to renal pathology,group A patients were divided into two sub groups:mild group and moderate group.To compared with group B,the steroid-resistant incidence of the 3 group were respectly 12.3%,19.2%,77.8% (x2 =24.369,P < 0.05).There was no significant difference between control group and mild group.(4)The remission rate of proteinuria in steroid-resistant patients who combined to use mycophenolate mofetil (MMF) with the two groups were respectively 50% and 85.7 % (x2 =3.60,P > 0.05).Conclusion Incidence of hematuria is higher in IgM nephropathy patients and patients with renal pathology for moderate lesions have a high steroid-resistant,and need use immunosuppressive early.MMF may be a good immunosuppressive for theses patients.
الملخص
Objectives To analysis clinical pathology of organ speciifc IgA vasculitis (IgA nephropathy) and systemic IgA vasculitis (allergic purpura) of purpura nephritis in children. Methods Clinical and pathological data of hospitalized pediatric patients of IgA nephropathy and purpura nephritis were retrospectively analyzed from June 1993 to November 2014. Results There were 405 patients of IgA nephropathy (256 males and 149 females). The ratio of male to female was 1.7:1. The average age was 10.2±2.8 years. The nephrotic syndrome (31.6%) was the most common clinical type, followed by hematuria and proteinuria (27.9%). There were 548 patients of purpura nephritis, 329 males and 219 females. The ratio of male to female was 1.5:1. The average age was 10.2±3.1 years. The hematuria and proteinuria (61.6%) was the most common clinical type, followed by nephrotic syndrome (21.4%). None of the IgA nephropathy progressed to systemic vasculitis (allergic purpura). Conclusions The causes, onset ages and clinical manifestations of IgA nephropathy and allergic purpura may be consistent or overlap, but none of IgA nephropathy (organ speciifcity IgA vasculitis) progressed to allergic purpura (systemic IgA vasculi-tis). IgA nephropathy might have more renal immune disorder mechanisms involved in its pathogenesis.