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关键词： 混合式教学模式   医学教育   儿科学   教学改革  

摘要： "互联网+"时代促进了教育教学发展,以强大的在线教学平台为支撑,与线下教学相结合的方式,产生了"线上线下"混合式教学模式。线上线下混合式教学模式通过两种教学方式的结合,发挥各自的优势,有利于提升教学效果和教学质量。将信息技术与医学教育课程建设融合,促进教育信息化是医学院校教学方式改革中面临的新问题。我们在儿科学教学中实行"线上线下"混合式教学,取得了较好的教学效果。总结混合式教学模式在儿科学教学中的运用经验,为医学院校教学方式改革提供参考和借鉴。

关键词： COVID-19   SARS-CoV-2   Gastrointestinal diseases   Children   Dysbiosis   Faecal-oral transmission  

摘要： The coronavirus disease 2019(COVID-19)pandemic is a threat worldwide for individuals of all ages,including *** manifestations could be the initial presenting manifestation in many patients,especially in *** symptoms are more common in patients with severe disease than in patients with non-severe *** 48.1%of patients had a stool sample that was positive for severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)viral *** typically form 1%-8%of all laboratoryconfirmed cases of *** manifestations of COVID-19 in children are not rare,with a prevalence between 0 and 88%,and a wide variety of presentations,including diarrhoea,vomiting,and abdominal pain,can develop before,with or after the development of respiratory *** manifestations such as appendicitis or liver injury could also appear,especially in the presence of multisystem inflammatory *** this review,we discussed the epidemiology of COVID-19 gastrointestinal diseases in children as well as their implications on the diagnosis,misdiagnosis,prognosis,and faecal-oral transmission route of COVID-19 and the impact of gastrointestinal diseases on the gut microbiome,child nutrition,and disease management.

关键词： 思政教育   儿科学   情境教学  

摘要： 儿学科医生不但要有很高的职业能力,还需要具备高尚的医德,因此,院校在培养人才的时候必须在实践与理论两个方面着手进行,而思想政治的教育必将在其中发挥重要的作用。情境教学法是提升教学质量和实际效果最佳的方式之一,在儿科学思政课堂得到应用,将会产生事半功倍的教学效果。本文基于儿科学的实践,对思政教育融入儿科的情境教学进行了分析和探究。希望能为广大同仁提供一些借鉴和参考。

关键词： 微格教学方法   临床见习   儿科学   留学生   在线教学  

摘要： 目的:探讨微格教学方法在临床医学专业留学生儿科学在线见习教学中的应用效果。方法:2020年5月,选择在哈尔滨医科大学附属第一医院儿科见习的2017级临床医学专业58名留学生作为研究对象,按照随机抽签方式分为试验组和对照组,每组29名留学生。试验组采用在线微格教学方法,通过角色扮演加深学生对临床知识的理解;对照组采用在线病例探讨传统教学方法,教师引导学生共同分析病例,掌握相应的操作技能。见习结束后,对两组学生进行基础理论和实践技能考核,并对师生进行问卷调查。结果:试验组和对照组学生的见习考试成绩分别为(82.80±1.64)分、(64.60±1.62)分,试验组和对照组学生对各自教学方法的综合满意度评分分别为(4.31±0.65)分、(2.97±0.54)分,其差异均具有统计学意义(均P<0.01)。结论:将微格教学方法应用于临床医学专业留学生儿科学在线见习教学中,有助于提高留学生的儿科学见习考试成绩,有助于留学生和教师教学相长,有助于学生发现问题并建立正确的临床诊治思维。

关键词： Photopic stimulator   Xenon   LED   Electroretinogram  

摘要： In the original article, Table 1 was published incorrectly in which GR2 scotopic 6th column value should be 580 instead of 880. The correct version of Table 1 is provided in this correction.

关键词： Vagus nerve stimulator (VNS)   Cardiac-based seizure detection (CBSD)   Automatic stimulation (AutoStim)   Paediatric   Intractable epilepsy  

摘要： Purpose The recent VNS models (AspireSR (R) Model 106, SenTiva (TM) Model 1000 (VNS Therapy (R), LivaNova)) include a new function of cardiac-based seizure detection (CBSD) automatic stimulation, known as 'AutoStim'. This algorithm uses tachycardia as a proxy to a seizure, and the battery delivers a closed-loop electrical current in addition to its programmed stimulation. This function leads to further seizure reduction in adults, but this advantage has not been reported in the paediatric population. This study aims to investigate whether battery change with AutoStim leads to further seizure reduction in children. Methods This observational study included the first 10 cases of VNS battery change from non-AutoStim to AutoStim function. During the battery change operation, the new VNS was switched on, with the same normal and magnet mode settings as the previous VNS. The AutoStim mode was activated at the same time. Data on seizure burden were collected at 3 time points: (1) before the first VNS insertion, (2) before battery replacement (post-1st VNS) and (3) 12 months post-battery change (post-AutoStim). The net effect of AutoStim, the only changed parameter, was evaluated by comparing the seizure burden prior to and 12 months following battery change in each child. Results The seizure reduction improved significantly from 60 to 83% following battery change with AutoStim. Categorising the outcome according the McHugh classification, children achieving class I and II outcome (>= 50% seizure reduction) improved from 70 to 90%. Conclusion This is the first study to demonstrate the additional efficacy of AutoStim in children treated with VNS.

关键词： Food insecurity   Paediatric   Screening   Social determinants  

摘要： Objective: The American Academy of Pediatrics recommends screening for food insecurity (FI) at all well-child visits due to well-documented negative effects of experiencing FI in childhood. Before age 3, children have twelve recommended primary care visits at which screening could occur. Little is known regarding the stability of FI status at this frequency of screening. Design: Data derived from electronic health records were used to retrospectively examine the stability of household FI status. Age-stratified (infant v. toddler) analyses accounted for age-based differences in visit frequency. Regression models with time since last screening as the predictor of FI transitions were estimated via generalised estimating equations adjusting for age and race/ethnicity. Setting: A paediatric primary care practice in Philadelphia. Participants: 3451 distinct patients were identified whose health record documented two or more household FI screens between April 1, 2012 and July 31, 2018 and were aged 0-3 years at first screen. Results: Overall, 9 center dot 5 % of patients had a transition in household FI status, with a similar frequency of transitioning from food insecure to secure (5 center dot 0 %) and from food secure to insecure (4 center dot 5 %). Families of toddlers whose last screen was more than a year ago were more likely to experience a transition to FI compared with those screened 0-6 months prior (OR 1 center dot 91 (95 % CI 1 center dot 05, 3 center dot 47)). Conclusions: Screening more than annually may not contribute substantially to the identification of transitions to FI.

关键词： chronic intestinal pseudo‐   obstruction Disease   intestinal motility disorders   PDGFR pathway   plasticity   smooth muscle cells  

摘要： Smooth Muscle Cells (SMC) are unique amongst all muscle cells in their capacity to modulate their phenotype. Indeed, SMCs do not terminally differentiate but instead harbour a remarkable capacity to dedifferentiate, switching between a quiescent contractile state and a highly proliferative and migratory phenotype, a quality often associated to SMC dysfunction. However, phenotypic plasticity remains poorly examined in the field of gastroenterology in particular in pathologies in which gut motor activity is impaired. Here, we assessed SMC status in biopsies of infants with chronic intestinal pseudo-obstruction (CIPO) syndrome, a life-threatening intestinal motility disorder. We showed that CIPO-SMCs harbour a decreased level of contractile markers. This phenotype is accompanied by an increase in Platelet-Derived Growth Factor Receptor-alpha (PDGFRA) expression. We showed that this modulation occurs without origin-related differences in CIPO circular and longitudinal-derived SMCs. As we characterized PDGFRA as a marker of digestive mesenchymal progenitors during embryogenesis, our results suggest a phenotypic switch of the CIPO-SMC towards an undifferentiated stage. The development of CIPO-SMC culture and the characterization of SMC phenotypic switch should enable us to design therapeutic approaches to promote SMC differentiation in CIPO.

关键词： Developing countries   paediatric cancer   radiation oncology   radiotherapy  

摘要： Aims: Childhood cancer survival is suboptimal inmost low- and middle-income countries (LMICs). Radiotherapy plays a significant role in the standard care of many patients. To assess the current status of paediatric radiotherapy, the International Atomic Energy Agency (IAEA) undertook a global survey and a review of practice in eight leading treatment centres in middle-income countries (MICs) under Coordinated Research Project E3.30.31;'Paediatric radiation oncology practice in low and middle income countries: a patterns-of-care study by the International Atomic Energy Agency.' Materials and methods: A survey of paediatric radiotherapy practices was distributed to 189 centres worldwide. Eight leading radiotherapy centres in MICs treating a significant number of children were selected and developed a database of individual patients treated in their centres comprising 46 variables related to radiotherapy technique. Results: Data were received from 134 radiotherapy centres in 42 countries. The percentage of children treated with curative intent fell sequentially from high-income countries (HICs;82%) to low-income countries (53%). Increasing deficiencies were identified in diagnostic imaging, radiation staff numbers, radiotherapy technology and supportive care. More than 92.3% of centres in HICs practice multidisciplinary tumour board decision making, whereas only 65.5% of centres in LMICs use this process. Clinical guidelines were used in most centres. Practice in the eight specialist centres in MICs approximated more closely to that in HICs, but only 52% of patients were treated according to national/international protocols whereas institution-based protocols were used in 41%. Conclusions: Quality levels in paediatric radiotherapy differ among countries but also between centres within countries. In many LMICs, resources are scarce, coordination with paediatric oncology is poor or non-existent and access to supportive care is limited. Multidisciplinary treatment plannin

关键词： Parents   Experiences   Children   Paediatric intensive care   Caring  

摘要： The objective is to identify the available literature on parents' experiences in caring for children in the Paediatric Intensive Care Unit (PICU). Original research on parents experience in caring their child in PICU were identified from five online databases, namely CINAHL, Science Direct, Proquest, Cochrane, and Pubmed (2008-2018) using the terms "parent," "experience," "children", "paediatric intensive care" and "caring.'' We included articles addressing the parent's experiences while their child was admitted to PICU their needs and participation in the care of the child. Twenty-two papers have met the criteria for inclusion. Further review of these articles resulted in summarised topics - PICU parents' experience, parental stressors, and parental needs. Current research demonstrates a diversity of parent's experiences while caring for their child;however, little is known about interventions to improve and support parents who are in a difficult situation when their child being treated in PICU. (C) 2021 Published by Elsevier Espana, S.L.U.