ABSTRACT
Objective:To analyze the clinical characteristics, diagnosis, treatment and prognosis of three children with hemophagocytic syndrome (HPS) and provide diagnosis and treatment clues for reasonable treatment and prevention of serious complications and reduction of misdiagnosis and mistreatment.Methods:The clinical data of three children with HPS who received treatment in Taiyuan Maternal and Child Health Care Hospital from March 2018 to March 2020 were retrospectively analyzed. Related literature was retrieved. The clinical data of the three children were summarized to analyze the outcomes.Results:Fever (≥ 39 ℃) was the first symptom in all three cases. In the end, red blood cell line, white blood cell line, and platelet line were reduced to different degrees in all three cases. Hepatosplenomegaly was found in two cases. Transaminase highly increased in two cases, and slightly increased in one case. Ferritin greatly increased, fibrinogen decreased, and hypertriglyceridemia did not occur in all three cases. Two cases had skin rash during fever. Skin rash appeared late in one of them.All three cases had different degrees of lymphadenopathy. Bone puncture examination showed reticulocyte phagocytosis in bone marrow in one case and leishmania in bone marrow smear in another case. These two cases were cured and discharged. One case died of multiple organ failure due to rapid disease progression, and adrenal masses were found at autopsy.Conclusion:HPS has diverse clinical manifestations, complex etiology and different clinical prognoses. HPS should be considered in case of unexplained fever with hemocytopenia. The medical history and living history should be inquired in detail and relevant auxiliary examinations should be improved as soon as possible.
ABSTRACT
Objective To explore the effects of problem-based bedside nursing teaching in clinical teaching. Methods Totally 247 college nursing students were recruited in the study from July 2016 to June 2017. The 118 students were in the experimental group which implemented problem-based bedside nursing teaching,while 129 students were in the control group which implemented traditional teaching.The teaching effects of two groups at the end of practice was compared with mini-CEX. Results The clinical nursing comprehensive ability of the experimental group was 6.42±1.45,the control group was 5.25±1.35,the difference was statistically significant(t=15.73,P=0.000).The clinical teaching effect of the experimental group was better than that of control group,41.53%(49/118)and 51.69%(61/118)met the requirements and reached excellence, and 62.79%(81/129)and 19.38%(25/129)in the control group.The difference was statistically significant (Z=-5.35, P=0.000). Conclusions The model of bedside teaching based on problem can significantly improve nursing students'clinical nursing comprehensive ability and improve clinical teaching effect.