Patient safety education among chinese medical undergraduates: An empirical study / 华中科技大学学报（医学）（英德文版）

Patient safety education is conducive to medical students' cognition on patient safety and to improvement of medical quality and safety. Developing patient safety education for medical students is more and more widely recognized by World Health Organization and countries all over the world. However, in China, patient safety courses aiming at medical students are relatively few, and there are few reports about the effect of patient safety courses. This paper explored the influence of patient safety curriculum on medical students' attitude to and knowledge of patient safety. The patient safety curriculum was carried out for 2011-grade undergraduates of Tongji Medical College, Huazhong University of Science and Technology. The students participated in the class according to free choice. After the curriculum, the information of gender, major, attended course, attitude toward patient safety, and knowledge of laws and regulations of the 2011-grade undergraduates were collected. After rejecting invalid questionnaires, the number of undergraduates that participated in the survey was 112 (61 students did not take part in the curriculum; 51 took part in). Chi-square test was applied to analyze patient safety education's influence on medical students' attitude to patient safety and their knowledge mastery situation. The influence of patient safety education on the attitude of medical students to patient safety was not significant, but that on their knowledge of patient safety was remarkable. No matter male or female, as compared with medical students who had not accepted patient safety education, they both had a better acquisition of knowledge after having this education (for male students: 95% CI, 4.556-106.238, P<0.001; for female students: 95% CI, 3.183-33.238, P<0.001). Students majoring in Western Medicine had a relatively better mastery of knowledge of patient safety after receiving patient safety education (95% CI, 6.267-76.271, P<0.001). Short-term patient safety education cannot change medical students' stereotyped cognition on matters related to patient safety, but it can effectively enhance their knowledge of laws and regulations of patient safety.

Post-Operative Treatment and Intensive Care of Infants with Congenital Heart Disease / 实用儿科临床杂志

Objective To explore post-operative treatment and intensive care of infants with congenital heart disease(CHD).Methods Clinical data of post-operative treatment and intensive care in 264 infants with CHD were analyzed retrospectively from May.1998 to Apr.2006.Among them,256 cases underwent radical operation,and 8 cases with palliative operation.Results Sixteen cases died early.Among them,after operation,there were 8 cases with Fallot′s syndrome,2 cases with complete atrioventricular canal anomalous,3 cases with ventricular septal defect(VSD)and pulmonary hypoplasia(PH),1 case with tricuspid atresia,1 case with single ventricle,and 1 case with persistent truncus arteriosus.Causes of death include low cardiac output,acute renal failure,degree of Ⅲ atrioventricular block(AVB),lung infection,respiratory failure and arrhythmia.One case with complete pulmonary vein ectopia was discharged due to post-opertative refractory hypercapnia;1 case with atrial septal defect(ASD)and patent ductus arteriosus(PDA) died of refractory heart failure due to high pulmonary arterial pressure 1 year after operation;1 case with tetralogy of Fallot died of lung hemorrhage after radical correct operation followed by palliative outflow tract deo-ppilant operation.Of them 245 cases alive,there were 233 cases with heart function grade Ⅰ,12 cases with grade Ⅱ.Conclusion Correct management of respiratory system,systemic electrocardial care,handling with arrhthymia on time,low cardiac output and nutritional support are the important measures in improving survival rate of infants with CHD.

Clinical and pathological characterization of antineutrophil cytoplasmic antibody associated small vasculitis in children / 中华儿科杂志

<p><b>OBJECTIVE</b>Antineutrophil cytoplasmic antibody (ANCA) associated small vasculitides (ASV) are rare in children and often complicated in clinical manifestations and have very poor prognosis. In order to deepen our understanding of ANCA-associated small vasculitis (ASV) in children, the present study aimed to characterize their clinical manifestations, serum ANCA and renal histopathological findings and outcomes in Chinese children.</p><p><b>METHODS</b>Serum ANCA was qualitatively tested with indirect immunofluorescence microscopy and anti-proteinase 3 (PR(3)) and anti-myeloperoxidase (MPO) activity were quantitated by enzyme-linked immunosorbent assays (ELISA), and renal biopsies were done to investigate the pathological changes. The clinical manifestation, serum ANCA and renal histopathological findings and outcome were characterized in 5 children with ANCA associated small vasculitis.</p><p><b>RESULTS</b>(1) Five children with ANCA associated small vasculitis only accounted for 1.20% of children in whom renal biopsy was performed and 0.25% of hospitalized children with renal diseases during the same period. The age of onset of the 5 children with ASV was between 8 to 12 years with mean age 10.5 years. All ASV children were female. (2) All ASV children were negative for C-ANCA and showed normal anti-proteinase 3 activities, but positive for P-ANCA with high anti-myeloperoxidase activities between 98 to 242 kEU/L. The mean value of MPO-ANCA was 154.5 kEU/L (normal range < 12.7 kEU/L). (3) All ASV in the children was microscopic polyarteritis with wide-spread glomerular crescents formation and capillary tuft fibrinoid necrosis. Variety of complement C3 deposits and weak immunoglobulin deposits were noted in all ASV but one child who showed relatively strong deposits of IgA and IgM. The electronic dense deposits were mainly located in subendothelial space but were also found in the glomerular basement membrane in one child. (4) Three children with ASV died within one year after diagnosis, and two got remission and restored renal function after combined pulse therapy with methylprednisolone and cyclophosphamide (CTX), but remained to have hematuria and small amount of proteinuria after 1 and 5 year follow-up, respectively.</p><p><b>CONCLUSION</b>Childhood ASV was female and P-ANCA predominant, more vulnerable to progress to renal failure and poorer in prognosis than adult cases. Qualitative and quantitative ANCA measurement and renal biopsy were key to the diagnosis of ASV in children.</p>