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关键词： 马克思主义理论   儿科学专业   医学生  

摘要： 随着我国儿科医学的不断发展及人民群众对儿科医疗服务要求的不断提高,儿科学专业医学生培养显得越来越重要。马克思主义理论可在医学专业教育和人文教育中发挥重要作用,儿科学专业医学生培养过程中坚持与马克思主义理论相结合,是提高人才培养质量的重要途径。

关键词： 课程思政建设   中医儿科学   教学改革  

摘要： 目的 探讨基于课程思政建设的中医儿科学教学改革。方法 以广州中医药大学本科生、长年制本科阶段学生为研究对象,采用基于课程思政建设的中医儿科学教学模式,进行学生自评、学习成绩、作品展示、教师评价、形成性评价、调查问卷等观察,并跟踪学生临床实习情况。结果 基于课程思政建设的中医儿科学教学模式能更好地培养学生人文素养、医德医风、沟通技能、文化自信,与传统教学模式相比,差异有统计学意义(P<0.05);基于课程思政建设的中医儿科学教学模式能提高学生成绩、临床实习能力,与传统教学模式相比,差异有统计学意义(P<0.05);相比传统教学模式,学生更认可、更推荐基于课程思政建设的中医儿科学教学模式,差异有统计学意义(P<0.05)。结论 基于课程思政建设的中医儿科学教学模式,可以培养学生人文素养、医德医风、沟通技能、文化自信,提高学生成绩、临床实习能力,更受学生认可、推荐,值得在教学中推广。

关键词： 林巧稚   儿科学   冠名   编撰者   作者名字   声名显赫   医学家   妇科肿瘤学  

摘要： 在中外医学史上,许多教科书是以作者名字来命名的,如《西塞尔内科学》《格雷氏解剖学》《黄家驷外科学》《诸福棠儿科学》……这些被称为“冠名教科书”的作者通常都是中外医学史上声名显赫的医学大家。一直以来,“冠名教科书”每一版的编撰者都像是火炬手,将医学的新知识、新技术一棒一棒传递下去。旧知识、旧技术虽然被新理论、新技术所代替,但留载史册的医学家不该被历史遗忘,“冠名教科书”刚好发挥了这样的作用。因此,本刊“人文”栏目刊登“冠名教科书”系列文章,旨在介绍历史、展现医学家事迹、彰显教科书的内容与价值,达到传承医学历史、牢记医家贡献的目的。

关键词： dental anxiety   dexmedetomidine   sedation  

摘要： Background Many children experience dental anxiety during dental treatment. Conscious sedation is used to alleviate anxiety and enhance a child's cooperation. Aim This study aimed to compare the efficacy of intranasal versus sublingual dexmedetomidine. Design Forty-two healthy, uncooperative children participated in the study. They were divided randomly into two groups: In the first visit, Group I received intranasal dexmedetomidine and group II received sublingual dexmedetomidine, whereas at the second visit, the alternate route was implemented in a crossover design. The child's acceptance of drug administration method was assessed using a 4-point rating scale. Time until optimum sedation was measured. Anxiety during local anesthesia administration was scored using Venham's rating scale. Postoperative response was recorded through Vernon et al's questionnaire. Results The Modified Vernon et al questionnaire that was answered by the parents 24 hours after the dental visit through the phone showed that there was no negative effect on postoperative behavior of children. Conclusions Both routes prevented the increase in anxiety scores equally during local anesthesia and do not have negative effect on postoperative behavior of children. However, the sublingual route showed better acceptance with longer onset time of action than the intranasal route.

关键词： asthma   atopic dermatitis   COVID-19  

关键词： children   COVID-19   diabetic ketoacidosis   Kuwait   type 1 diabetes  

摘要： Introduction The COVID-19 pandemic might have a multifaceted effect on children with type 1 diabetes (T1D), either directly through infection itself or indirectly due to measures implemented by health authorities to control the pandemic. Objective To compare data on children newly diagnosed with T1D in Kuwait during the COVID-19 pandemic to the pre-pandemic period. Research Design and Methods We analysed data on children aged 12 years or less registered in the Childhood-Onset Diabetes electronic Registry (CODeR) in Kuwait. Data were incidence rate (IR), diabetic ketoacidosis (DKA), and its severity and admission to the paediatric intensive care unit (PICU). Results The IR of T1D was 40.2 per 100,000 (95% CI;36.0-44.8) during the COVID-19 pandemic period and was not statistically different from pre-pandemic. A higher proportion of incident T1D cases presented with DKA and were admitted to the PICU during the pandemic (52.2% vs. 37.8%: p < 0.001, 19.8% vs. 10.9%;p = 0.002, respectively). The COVID-19 pandemic was positively associated with presentation of DKA and admission to PICU (AOR = 1.73;95% CI, 1.13-2.65;p = 0.012, AOR = 2.04;95% CI, 1.13-3.67;p = 0.018, respectively). Children of families with a positive history for diabetes were less likely to present with DKA and get admitted to the PICU during the COVID-19 pandemic (AOR = 0.38;95% CI, 0.20-0.74;p = 0.004, AOR = 0.22;95% CI, 0.08-0.61;p = 0.004, respectively). Conclusion High rates of DKA at presentation and admission to PICU in incident T1D cases during the COVID-19 pandemic warrant further studies and effective mitigation efforts through increasing awareness, early detection, and timely intervention.

关键词： clinical trials   immunosuppression   modelling and simulation   pharmacokinetic-pharmacodynamic   population analysis  

摘要： Aims To optimise the dosing regimen of oseltamivir for immunocompromised (IC) paediatric patients (<18 years) with influenza, we used an extrapolation approach alongside clinical data. Methods Efficacy was extrapolated from adult IC patients to paediatric IC patients by leveraging existing efficacy, safety, pharmacokinetic (PK)/pharmacodynamic (PD), and disease-progression models of oseltamivir and oseltamivir carboxylate (OC). Data of IC paediatric patients from two studies (NV25719 and NV20234) were included in the population PK (n = 30), PK/PD analysis (n = 22) and disease modelling approach (n = 36). Simulations were performed to identify the optimal dosing regimen. Results Clearance of oseltamivir (CL) and OC (CLM) were similar in IC and otherwise-healthy (OwH) patients <10 years, but decreased by 44.4% (95% CI: 26.8-62.0) and 49.1% (95% CI: 34.5-63.8), respectively, in IC patients aged 10-17 years versus OwH patients. There were no notable exposure-response relationships for any of the virologic PD analyses. Thus, no additional benefit was seen with oseltamivir carboxylate exposures higher than achieved with the conventional dose (75 mg twice daily, age- and weight-adjusted for children <13 years). The disease model illustrated that doses above the conventional oseltamivir dose had limited impact on viral kinetics in IC paediatric patients and a prolonged treatment duration of 10 days was favoured to limit potential viral rebound. Conclusion An oseltamivir dosage recommendation (conventional dose, twice daily for 10 days) was established in IC paediatric patients with influenza, based on extrapolation of efficacy from IC adults, leveraging population PK, PK/PD, and disease modelling, whilst taking resistance and safety data into account.

关键词： ixekizumab   paediatric   pharmacokinetics   pharmacokinetics-pharmacodynamics   population pharmacokinetics   psoriasis  

摘要： Aims Ixekizumab is a high-affinity monoclonal antibody that selectively targets interleukin-17A used in the treatment of adult and paediatric patients with moderate-to-severe psoriasis. This analysis evaluated the pharmacokinetics (PK) of ixekizumab and the exposure-efficacy relationship in paediatric patients aged 6 to Population PK and exposure-efficacy models were developed. The models used data from paediatric patients with psoriasis participating in the Phase 3 IXORA-PEDS trial in which patients were dosed according to weight categories. The exposure-efficacy model is a Psoriasis Area and Severity Index (PASI) time course model using data up to Week 12, a co-primary efficacy endpoint. Results A 2-compartment population PK model describes the PK of ixekizumab in paediatric patients with the effect of body weight incorporated on clearance and volume terms using an allometric relationship. The weight category-based dosing ensured that ixekizumab mean trough serum concentrations in paediatric patients with psoriasis (3.20-3.33 mu g/mL) were within the range of concentrations observed in adult patients with psoriasis (mean [standard deviation]: 3.48 [2.16] mu g/mL) administered an efficacious dosing regimen. The observed PASI response rates at Week 12 in paediatric patients (91.9/81.8/52.5% for PASI75/90/100) are well predicted by the final exposure-efficacy model and response rates are similar or higher than those achieved in adults (86.2/66.6/35.0% for PASI75/90/100). Conclusion This analysis is the first to describe the PK and exposure-efficacy relationship of ixekizumab in paediatric patients with psoriasis. The analyses support the selection of the weight category-based ixekizumab dosing regimens approved for use in paediatric patients with psoriasis.

关键词： Paediatric   gastrointestinal disorders   coeliac disease   inflammatory bowel disease  

摘要： Gastrointestinal biopsies represent an increasing proportion of the paediatric pathologist's workload, an increase fundamentally due to an expansion of the understanding of the basic clinical, molecular, genetic, and histopathological features of paediatric gastrointestinal disorders. The histological interpretation of endoscopically retrieved gastrointestinal biopsies in children requires a unique set of diagnostic expertise and detailed knowledge of various gastrointestinal disorders that have a predilection for the paediatric population. This article's major role is to highlight the unique problems inherent to paediatric gastrointestinal disorders that require immediate communication with the paediatric surgeon or the gastroenterologist. For this, we tried to cover the most important diseases that a paediatric pathologist might encounter in daily practice. Some of these diseases are relatively rare, such as microvillous inclusion disease and tufting enteropathy, but some are more common such as eosinophilic disorders and inflammatory bowel disease. Awareness of the histopathological features of these diseases, particularly those that are relatively uncommon, is crucial to spare the patient a lengthy and costly evaluation. We made a particular effort to abundantly reference this article should the reader wish to expand on the content of any section.