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关键词： 科学探究活动   幼儿   设计与指导  

摘要： 科学的教学方法是强调让学生亲自参与与动手操作,让学生本身和周围的环境相互融合,从而在实际活动中得到真理和经验。所以在教学过程中,教师可以利用学生感兴趣的内容,设计科学的、有意义的探究活动,以此来有效的增加学生的认知水平。通过不同形式的探究活动,培养幼儿的好奇心,激发幼儿主动探究兴趣,从而帮助幼儿在探索中获得知识,本文就幼儿科学探究活动的设计和指导进行分析和探究。

关键词： 儿科学   考试平台   病例   题库  

摘要： 目的探讨儿科学新型网络考试平台及题库的应用效果。方法以病例为基础建立儿科学新型题库并整合到网络考试平台上。选择中国医科大学2014级五年制临床医学专业8个班的学生作为研究对象。随机分为2组,实验组4个班(n=115人),对照组4个班(n=120人)。两组学生实习课均采用以问题为导向的教学方法(problem-based learning,PBL)联合以病例为基础的教学方法(case-based learning,CBL)进行授课。实验组学生应用考试平台的练习题部分进行辅助教学,对照组学生无练习题辅助教学。对照组参加传统考试,实验组使用新型考试平台考试,再分别进行问诊考核。对实验组学生进行问卷调查。结果实验组学生理论成绩、总成绩均优于对照组(P<0.05),实验组学生问诊成绩优于对照组(P<0.01)。问卷调查结果显示,大部分学生认为应用新型题库及考试平台能增加对儿科学的学习兴趣,增强临床思维及临床能力等,学生普遍希望继续应用新型题库和考试平台(98.26%)。结论儿科学新型题库及新型考试平台适合于新时代儿科学的发展需求,应用前景广阔。

关键词： Crohn's disease   paediatrics   phenotype   biologics   evolution  

摘要： Introduction: Paediatric Crohn's disease (PCD) often presents with extensive and a frequent pan-enteric phenotype at onset. However, its long term evolution into adulthood, especially since the widespread use of biological agents, is not well characterised. We conducted a single centre cohort study of all PCD patients transitioned to adult care to assess the long term disease evolution in the era of biologic therapy. Methods: We conducted a retrospective observational, study of all PCD patients who were subsequently transferred to the care of an adult gastroenterology unit and had a minimum follow up of 2 years. We examined the case notes for evolution of disease location and behaviour. Disease location and behaviour was characterised using Paris classification at diagnosis and Montreal classification at last follow-up. In addition, we examined variables associated with complicated disease behaviour and the need for CD related intestinal resection. Results: In total, 132 patients were included with a median age at diagnosis of 13 (IQR 11-14) and a median follow up of 11 years (range 4-14). At diagnosis, 23 (17.4%), 39 (29.6%) and 70 (53%) patients had ileal, colonic and ileocolonic disease respectively. In addition, 31 (23.5%) patients had L4a or L4b disease at diagnosis (proximal or distal to the ligament of treitz respectively) and 13 patients (9.8%) had both whilst 27 (20.4%) patients had perianal disease. At diagnosis, 27 (20.4%) patients had complicated disease behaviour but 83 (62.9)% of patients had an extensive 'pan-enteric' phenotype. Of these patients only 55 (66.3%) retained the pan-enteric phenotype at last follow-up (p = .0002). Disease extension was noted in 25 (18.9%) of patients and regression was noted in 47 (35.6%) of patients, whereas upper GI disease was noted in significantly fewer patients at last follow-up (21, 15.9%) (p = .0001). More patients had complicated disease behaviour (46 patients, 34.9%, p = .0018) at last follow-up. There was a hig

关键词： 中医儿科学   中华中医药学会   医案医话   针灸推拿   儿童用药   专业杂志   食疗药膳   养生保健  

摘要： 《中医儿科杂志》是由甘肃中医药大学和中华中医药学会主办、甘肃省教育厅主管、国内外公开发行的全国唯一一种中医儿科专业杂志,是中华中医药学会系列杂志。办刊宗旨是弘扬中医传统医学特色、探讨中医儿科学前沿理论、加强中医儿科学学术交流、提高中医儿科学科研水平,全心全意为我国中医儿科临床、科研、教学服务。本刊为双月刊,逢单月25日出版。1主要栏目《中医儿科杂志》设有标准与规范、名医名家、专家诊疗经验、专题笔谈、论著、理论研究、学术探讨、实验研究、临床研究与报道、针灸推拿、名院名科风采、典籍研究、儿童养生保健、食疗药膳、医案医话、儿童用药、教学研究、护理园地、文献综述等栏目。

关键词： 幼儿科学活动   幼师理科教学   专业性   趣味性  

摘要： 幼儿科学领域的活动,作为学前教育五大教学内容之一,其活动内容、方式、过程对幼儿的思维发展有着不可忽视的奠基作用。幼儿教师的科学素养对于幼儿科学活动的质量起着关键性的作用,在活动设计和进行过程中,只有做到一定的专业性和一定的趣味性有机统一,才能达到促进幼儿科学认知成长的效果,否则只是走过场,甚至还可能出现教育失误现象。在追根溯源的意义上,它要求做好上游幼师物理、数学等必修课的课程建设,其中尤其要重视对理科课程的专业性和趣味性相互融合的教学模式探讨。

关键词： 免疫性血小板减少症   紫癜   中医药疗法   儿科学  

摘要： 免疫性血小板减少症(ITP)是小儿常见的出血性疾病,部分患儿迁延难愈,转化为慢性而严重影响其生活质量。张炜教授从中医辨证角度,认为慢性ITP(CITP)病机虚实夹杂,主要病理因素为"风、火、湿、瘀、虚",以辨虚实标本为则,以疏风散热、清热燥湿、益气养阴、补益肾气为法,活血贯穿始终,临床疗效显著。

关键词： 重症肺炎   多巴胺   多巴酚丁胺   血清炎症因子   儿科学   β受体激动作用  

摘要： 目的探讨小剂量多巴胺联合多巴酚丁胺治疗小儿重症肺炎的临床效果。方法本研究选取2017年3月-2019年3月沈阳市某医院收治的100例重症肺炎患儿作为研究对象,采用随机数字表法将患儿分为研究组与对照组,每组50例。对照组患儿接受常规治疗,研究组患儿在对照组患儿治疗基础上接受小剂量多巴胺联合多巴酚丁胺治疗。比较2组患儿治疗前后白细胞介素-6(IL-6)、白细胞介素-8(IL-8)及C反应蛋白(CRP)水平;比较2组患儿治疗前后呼吸峰值流速(PEF)、剩余50%潮气量时呼气流速(TEF50%)、达峰时间比(TPEF/TE);比较2组患儿临床疗效。结果研究组患儿治疗总有效率为94.0%,高于对照组的76.0%,差异有统计学意义(P<0.05)。治疗后,研究组患儿IL-6,IL-8及CRP水平分别为(52.99±7.82)pg/mL,(19.87±3.14)pg/mL及(12.37±2.98)mg/L,低于对照组的(73.87±8.35)pg/mL,(28.72±3.67)pg/mL及(23.02±6.37)mg/L,差异均有统计学意义(P<0.05)。治疗后,研究组患儿PEF及TEF50%分别为(70.38±4.27)mL/s及(69.42±3.35)mL/s,均低于对照组的(78.09±5.42)mL/s及(76.03±3.89)mL/s,差异均有统计学意义(P<0.05)。治疗后,研究组患儿TPEF/TE为26.64±3.87,大于对照组的21.32±3.38,差异有统计学意义(P<0.05)。结论在常规治疗的基础上加用小剂量多巴胺、多巴酚丁胺治疗小儿重症肺炎,能够取得更加理想的临床效果,可有效调节患儿的血清炎症细胞因子水平,促进患儿肺功能的恢复,该方案可作为今后临床治疗小儿重症肺炎的一种推荐用药方案。

关键词： 微课教学   幼儿教育   实际应用  

摘要： 本文从微课教学的主要内容为基础展开分析,对微课教学的教学意义重新定义。在新课改的背景下,科学化、多媒体化的教学方式成为素质教育发展的趋势,微课在幼儿科学活动的教学方式中的作用越来越明显。本文就微课教育方式的实际意义与影响进行探究与分析。

关键词： Coeliac disease   Diagnosis   Recommendation   Serology   Intestinal biopsy   HLA   ESPGHAN  

摘要： Coeliac disease is a systemic immune-mediated disorder triggered by the ingestion of gluten, which is given in genetically predisposed subjects. It manifests with a wide variety of clinical symptoms, specific serological markers, HLA-DQ2/DQ8 haplotype and enteropathy. The criteria followed for this have usually been those established by the European Society for Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) since 1969. These criteria have advanced from the need of several intestinal biopsies to, thanks to the development of serological tests of high sensitivity and specificity, considering the enteropathy as one more element in this diagnosis and makes it possible to perform a diagnosis without the need of an intestinal biopsy in certain circumstances. The updated review of the 2012 criteria in 2019 provides new evidence on some aspects, such as the role of HLA, the diagnosis of asymptomatic patients, and the effectiveness of the serological markers. These aspects are reviewed in detail, with the aim of facilitating the rational application of the new 2020 criteria at all care levels. In this sense, Paediatric Primary Care is fundamental in the search for active cases and to perform a first serological study, being recommended that the diagnosis is always established by a Paediatric Gastroenterologist. (C) 2019 Asociacion Espanola de Pediatria. Published by Elsevier Espana, S.L.U.