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Objective:To evaluate the effect of teacher simulate standardized patient (TSSP) consultation training in pediatric practical teaching.Methods:A total of 120 interns from the five-year clinical medicine major of Batch 2015 were randomly divided into experimental group and control group. In the experimental group, 60 interns were trained by TSSP for consultation after admission. After the training, the clinical parents of the children were consulted and the children were physically examined under the guidance of teachers. In the control group, 60 interns were trained according to the same requirements, but TSSP consultation training was not included. At the end of the practice, the performance, operation skills and medical record writing ability of the interns were compared, and the satisfaction of the experimental group was investigated. SPSS 25.0 software was used for t test and chi-square test. Results:The medical record writing results of the experimental group were (96.15±3.00) points, significantly higher than that of the control group [(81.02±3.29) points], and the differences were statistically significant ( t = 26.38; P < 0.001). In the mini-clinical evaluation exercise (Mini-CEX), the scores of medical history collection, communication skills, humanistic care and physical examination were significantly higher than those of the control group ( t= 15.41, 17.67, 15.39 respectively; all P < 0.001). The experimental group had high satisfaction with the teaching method of TSSP consultation training. Conclusion:TSSP consultation training improves the intern medical record writing ability, doctor-patient communication ability, clinical operation ability, stimulates the learning interest of interns, trains the trainee doctors humanistic consciousness, integrates into the ideological and political education, effectively ensures the quality of practical teaching of pediatrics, and obtains recognition from intern, which is worth promoting.
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Objective:In order to explore the impact of corona virus disease 2019(COVID-19)on the hospitalization of children with bronchiolitis and to improve clinicians′ understanding of the characteristics of bronchiolitis during the COVID-19 epidemic.Methods:This was a multicenter clinical study, and the data have been collected from 23 children′s medical centers in China.All the clinical data were retrospectively collected from children with bronchiolitis who were hospitalized at each study center from January 1, 2019 to December 31, 2021.The results included gender, age at hospitalization, length of stay, respiratory syncytial virus(RSV) test results, severity rating, ICU treatment, and the total number of children hospitalized with respiratory tract infection during the same period.The clinical data of children with bronchiolitis in 2019 before COVID-19 epidemic and in 2020、2021 during COVID-19 epidemic were statistically analyzed and compared.Results:According to a summary of data provided by 23 children′s medical centers, there were 4 909 cases of bronchiolitis in 2019, 2 654 cases in 2020, and 3 500 cases in 2021.Compared with 2019, the number of bronchiolitis cases decreased by 45.94% in 2020 and 28.70% in 2021.In 2019, 2020 and 2021, there were no significant differences in gender ratio, age, and duration of hospitalization.Compared with 2019, the ratio of bronchiolitis to the total number of hospitalizations for respiratory tract infection decreased significantly in 2020 and 2021( χ2=12.762, P<0.05; χ2=84.845, P<0.05).The proportion of moderate to severe bronchiolitis cases in both 2020 and 2021 was lower than that in 2019, and the difference was statistically significant ( χ2=4.054, P<0.05; χ2=8.109, P<0.05).There was no statistically significant difference in the proportion of bronchiolitis cases requiring ICU treatment between 2019, 2020, and 2021 ( χ2=1.914, P>0.05).In 2019, a total of 52.60%(2 582/4 909) of children with bronchiolitis underwent RSV pathogen testing, and among them, there were 708 cases with RSV positive, accounting for 28.00%.In 2020, 54.14%(1 437/2 654) of children with bronchiolitis underwent RSV pathogen testing, and there were 403 cases with RSV positive, accounting for 28.04%.In 2021, 66.80%(2 238/3 500) of children with bronchiolitis underwent RSV pathogen testing, and there were 935 cases with RSV positive, accounting for 41.78%.Compared with 2019 and 2020, the RSV positive rate in 2021 showed a significant increase( χ2=99.673, P<0.05; χ2=71.292, P<0.05). Conclusion:During the COVID-19 epidemic, the implementation of epidemic prevention and control measures reduced the hospitalization rate and severity of bronchiolitis, but did not reduce the positive rate of RSV detection.
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BACKGROUND:Fractures of shafts of the tibia and fibula are the most common diaphyseal fractures among al long bones. The clinical significance of fibula fixation in treatment of distal third shaft fractures is controversial, and the studies are also different. OBJECTIVE:To explore the clinical significance of fibular fixation in treatment of distal third tibia shaft fractures. METHODS:A retrospective review has been performed on the clinical data of sixty-four cases with distal third tibia shaft fracture in Department of Orthopedics, China National Offshore Oil Corporation General Hospital from January 2006 to March 2010. Al cases were divided into two groups based on whether the fibula was fixed or not: fibula fixation group (n=36) and fibula non-fixation group (n=28). Union rate of fracture, bone union time and tibial valgus angle were compared between the two groups. According to Merchant-Dietz criteria, the ankle range of motion and ankle evaluation score were evaluated and compared between the two groups. RESULTS AND CONCLUSION: No significant difference in union rate of fracture, bone union time and ankle range of motion was detected between two groups. Tibial valgus angle was smaler in the fibula fixation group (5.42±1.16)° than in the fibula non-fixation group (7.54±1.90)°(P=0.006). Ankle function score was higher in the fibula fixation group (93.58±0.97) than in the fibula non-fixation group (90.57±3.92) (P=0.000). Three cases in the fibula fixation group suffered from superficial wound infection, and achieved good healing after treatment of anti-infection and changing dresses. Above results verify that fibular fixation can reduce tibial valgus angle and improve ankle joint function in treatment of distal third tibia fractures.
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BACKGROUND:Extreme lateral lumbar disc herniation is a rare type of lumbar disc herniation, there are a variety of treatment methods, but the therapeutic efficacy and recurrence rate are controversial. OBJECTIVE:To investigate the availability of lumbar pedicle screw fixation combined with interbody fusion cage for treating extreme lateral lumbar disc herniation. METHODWe retrospectively analyzed 19 patients with extreme lateral lumbar disc herniation after treatment with lumbar pedicle screw fixation combining with interbody fusion cage from March 2006 to January 2009. The outcomes were evaluated depending on VAS scoring standard and Macnab scoring standard, lumbar stability were observed postoperatively. We analyzed the spinal stability in recurrent lumbar disc herniation patients after lumbar pedicle screw fixation combined with interbody fusion cage depending on literature search. RESULTS AND CONCLUSION:Al the 19 patients were fol owed up for 13 months to 3 years, the leg and lumbar pain of al the patients were relieved to varying degrees. Preoperative VAS score was 7.3±1.28 points and postoperative VAS score was 2.1±0.8 points, showing significant difference between two groups (P<0.05). The excellent and good rate was up to 95%with 15 excellent results, 3 good results and 1 acceptable result depending on Macnab evaluation standard. There was no pedicle screw loosening, broken, non-fusion phenomenon. Al the lumbar interbody fusions were good. No one occurred secondary lumbar spinal stenosis. Experimental findings indicate that, lumbar pedicle screw fixation combined with interbody fusion cage for extremely lateral lumbar disc herniation, is characterized as fast symptom relief, strong fixation and good lumbar stability.