Objective To investigate the clinical charactors and treatment of IgM nephropathy with nephrotic syndrome(NS) in children.Methods Thirty-six IgM nephropathy patients hospitalized in Hunan Children's Hospital as research group(group A),from June 2005 to June 2012.One hundred and six patients with minimal change disease (MCD) as control group (group B),followed up for 1 ～ 8 years.Results (1) Hematuria at presentation of the two groups respectly 3.8％ vs 30.6％ (x2 =20.403,P ＜ 0.05).(2) Renal pathology revealed that there were 26 (72.2％)patients with minimal change disease,9 cases (72.2 ％)with moderate membranoproliferative glomerulonephritis,1 cases with focal segmental glomerulosclerosis.(3) According to renal pathology,group A patients were divided into two sub groups:mild group and moderate group.To compared with group B,the steroid-resistant incidence of the 3 group were respectly 12.3％,19.2％,77.8％ (x2 =24.369,P ＜ 0.05).There was no significant difference between control group and mild group.(4)The remission rate of proteinuria in steroid-resistant patients who combined to use mycophenolate mofetil (MMF) with the two groups were respectively 50％ and 85.7 ％ (x2 =3.60,P ＞ 0.05).Conclusion Incidence of hematuria is higher in IgM nephropathy patients and patients with renal pathology for moderate lesions have a high steroid-resistant,and need use immunosuppressive early.MMF may be a good immunosuppressive for theses patients.

Objectives To analysis clinical pathology of organ speciifc IgA vasculitis (IgA nephropathy) and systemic IgA vasculitis (allergic purpura) of purpura nephritis in children. Methods Clinical and pathological data of hospitalized pediatric patients of IgA nephropathy and purpura nephritis were retrospectively analyzed from June 1993 to November 2014. Results There were 405 patients of IgA nephropathy (256 males and 149 females). The ratio of male to female was 1.7:1. The average age was 10.2±2.8 years. The nephrotic syndrome (31.6%) was the most common clinical type, followed by hematuria and proteinuria (27.9%). There were 548 patients of purpura nephritis, 329 males and 219 females. The ratio of male to female was 1.5:1. The average age was 10.2±3.1 years. The hematuria and proteinuria (61.6%) was the most common clinical type, followed by nephrotic syndrome (21.4%). None of the IgA nephropathy progressed to systemic vasculitis (allergic purpura). Conclusions The causes, onset ages and clinical manifestations of IgA nephropathy and allergic purpura may be consistent or overlap, but none of IgA nephropathy (organ speciifcity IgA vasculitis) progressed to allergic purpura (systemic IgA vasculi-tis). IgA nephropathy might have more renal immune disorder mechanisms involved in its pathogenesis.

Objective: To understand the epidemiology characteristics of child injury aged 6-17. Data was from the National Injury Surveillance System (NISS) and the results of the study would provide corresponding intervention strategies and decision-making for child injury prevention. Methods: Descriptive analysis was applied to depict the general information, injury event and clinical characteristics of child injury aged 6-17 from 2015 to 2018. Results: A total of 331 663 child injury cases aged 6-17 were reported, with the male and female ratio appeared as 2.19∶1. 15:00-18:59 was the peak time of injury cases from 2015 to 2018. The majority of the injuries occurred unintentional(94.85%). The top three causes of injury cases were falling(51.38%), blunt injury (12.50%)and road traffic injury(11.27%). The injuries occurred mainly at home(28.23%), in schools/public places (27.70%) and on the road/street(20.35%). The main activities were leisure activities (46.67%) and sports activities(14.36%). 49.06% cases were bruise. 31.18% of the injury involved with head, but 83.32% of injuries were minor, while 90.05% left hospital after the treatment. Conclusion Falls, blunt injury and road traffic injury are the key causes of children aged 6-17 to go to the outpatient /emergency department for treatment. Prevention and control should be carried out according to the epidemic characteristics of injuries among children of different genders and ages.

Objective: To analyze and compare the disease burden of falls in Chinese population aged 0-19, in 1990 and 2017. Methods: Indicators including number of deaths, mortality rates, years of life lost due to premature mortality (YLL), years lived with disability (YLD) and disability-adjusted of life years (DALY), on falls, were gathered from the Global Burden of Disease (GBD) 2017 and used to describe the disease burden and corresponding parameters on falls, between 1990 and 2017, in China. Results: In 2017, number of death, YLLs, YLDs, DALYs caused by falls were 5 321, 0.43 million person years, 0.14 million person years and 0.57 million person years respectively, among aged 0-19 group. Rates on standardized mortality, YLLs, YLDs and DALYs on falls were 1.76/100 000, 141.49/100 000, 46.99/100 000, and 188.48/100 000, respectively. The burden of falls decreased with the increase of age. Compared with 1990, disease burden of falls decreased in all age groups, both in male and female, with more seen in the lower age groups. Compared with 1990, the number of deaths, rates on YLLs, YLDs and DALYs caused by falls decreased by 65.08%, 46.63%, 47.38% and 36.33% respectively, in 2017. However, the YLDs rate increased by 73.31% between 1990 and 2017. The ratio of YLLs to DALYs decreased from 90.84% in 1990 to 75.07% in 2017, with a proportion as 17.36%. Conclusion Compared with 1990, although the disease burden of falls among aged 0-19 group showed a decreasing trend, falls still caused serious disease burden for the aged 0-19 group. Research that targeting prevention on falls, should be continued.

Objective: To understand the current situation of road traffic injuries among primary and secondary school students in Mengzi city. Methods: Using the cluster random sampling method, more than 9 000 primary and secondary school students from 20 primary and secondary schools in Mengzi city, were randomly sampled. A questionnaire survey was conducted on the occurrence of road traffic injuries in school students. Results: A total of 9 197 students were surveyed, including 150 from road traffic injuries. The incidence rates of road traffic injuries was 1.63% among students in Mengzi city and 2.85% among junior high school students, with the high incidence in May. The leading places of injuries were village roads (38.00%), city roads (33.33%) and district roads (12.67%), respectively. 26.67% of the traffic injuries occurred on the way to or from schools, with riding on electric bicycle (52.00%) as the major cause and contusion/abrasion (75.33%) appeared as the major signs. Both lower and upper limbs plus multiple parts were accounting for 45.51%, 22.16% and 16.17%, respectively of all the injuries. 70.67% of all the cases with road traffic injuries in children, recovered after treatment. Children with road traffic injuries would stay in the hospital for up to 90 days but spent less than 30 000 Yuan. Conclusion The incidence of road traffic injuries among students in Mengzi city seemed relatively high, with junior high school students reached the highest. Riding electric bicycle appeared as the leading cause for traffic injuries in children in Mengzi city of Yunnan province.

OBJECTIVETo understand the epidemiological characteristics of head injuries in children.

METHODSData was derived from the Chinese National Injury Surveillance System (NISS) in 2014. Method on descriptive analysis was applied to depict general information, injuries events and clinical characteristics of head injuries among children under 18 years of age.

RESULTSA total number of 47 690 cases with child head injuries in 2014 were collected, including 32 542 males and 15 148 females. 43.47% of them were under 1-4 years of age. In October, 06:00 PM appeared the peak time for the injuries to happen. The three leading causes responsible for child head injuries were falls (69.57%), hit by blunt force (14.23%) or road traffic (11.01%). Main locations responsible for the head injuries to happen were:at home (44.98%), at public places (19.65%) or on roads/streets (15.81%). Recreation activates (77.88%), driving (7.32%), sports (5.72%) were the three major activities causing the injuries to take place. Majority of the cases happened unintentionally (95.35%), with bruise (71.69%) or mild injuries (85.27%) and went back home after treatment (90.25%).

CONCLUSIONSIn 2014, child head injuries were seen more in males than in females and mostly occured at home. The leading causes for head injuries would include falls, hit by blunt stuff or road traffic .

Accidental Falls ; statistics & numerical data ; Accidents, Traffic ; statistics & numerical data ; Asian Continental Ancestry Group ; statistics & numerical data ; Automobile Driving ; Child ; China ; epidemiology ; Craniocerebral Trauma ; epidemiology ; Environment ; Female ; Humans ; Male ; Population Surveillance ; Recreation ; Sports ; Transportation ; Wounds and Injuries ; epidemiology

Objective:To analyze and discuss the application value and teaching effect of simulate patients (SP)-assisted problem-based learning (PBL) combined with team-based learning (TBL) mode in pediatric first aid teaching, in order to provide a new reference for the reform of standardized residency training and teaching mode of pediatrics in the new era in China.Methods:A total of 103 residents who participated in the standardized training in the Department of Pediatrics of Hunan Children's Hospital from January 2018 to December 2020 were selected as the research objects, and they were divided into the control group (50 cases) and the experimental group (53 cases). The control group adopted the previous teaching mode of residents, while the experimental group adopted the SP-assisted PBL combined with TBL mode. In this study, SPSS 22.0 software was used for t test and chi-square test. Results:The examination scores of the experimental group in the theoretical knowledge of pediatric first aid, clinical thinking and skills, and application of pediatric first aid skills were higher than those in the control group [(86.98±3.42), (85.69±5.13), (89.62±4.75)] vs. [(77.23±4.16), (81.16±3.96), (76.54±5.78)], with statistically significant differences between the two groups ( P<0.05). The questionnaire survey showed that the clinical thinking and pediatric emergency skills, doctor-patient communication ability, teamwork ability and other aspects of the experimental group were significantly better than those of the control group ( P<0.05). Conclusion:The SP-assisted PBL combined with TBL mode can produce positive effects in the standardized residency training of pediatrics, which will help residents better master pediatric first aid skills, improve their clinical comprehensive capabilities, and be more conducive to improving the quality of pediatric residency training, which is worth promoting in the new era.

Objective To analyze the burden and changes caused by burns among Chinese population,from 1990 to 2013.Methods Using the G20 data and the China national and subnational data from GBD2013,this study deemed to comprehensively show the burden caused by burns and the change from 1990 to 2013,using the indicators of death and DALY.Results In 2013,the standardized mortality of burns in Chinese was 0.88/100 000,with the standardized DALY rate of burn as 30.58/100 000.The ratio of DALY between males and females was 1.85 ∶ 1.Among the G20 countries,China ranked 16 for the standardized DALY rate,according to the top down order.The highest death rate was seen in the age group of 70 and over,followed by age group of 5,which had the highest DALY rate and followed by the 70 or older age group.In different provinces,Guizhou presented the highest DALY rate (50.24/100 000),with Aomen area the lowest (6.16/100 000).From 1990 to 2013,the burden of burn reduced generally.Both the standardized rates on death and DALY reduced by 68.10％ and 76.95％ respectively,more in females than in males.Standardized rates on death and DALY reduced among all the age groups,with the rates of reduction increasing by age.From 1990 to 2013,the DALY rate decreased in all the provinces.Conclusions The burden of burn decreased in Chinese population during 1990-2013.However,the burden of burn among children,elderly and males were still relatively high that called for closer attention.

Objective To explore the disease burden of road injuries in China.Methods The results of Global Burden of Disease 2013 including death rate,disability-adjusted of life years (DALY),years of life lost due to premature mortality (YLL),years lived with disability (YLD),were used to describe the burden caused by road injuries in 2013 and the trends from 1990 to 2013,in China.Results In 2013,there were 313 676 deaths caused by traffic accidents in China.Death rate,rates on DALY,YLL and YLD were 22.52 per 100 000,1 076.54 per 100 000,971.21 per 100 000 and 105.34 per 100 000,respectively.Rates on deaths,YLL and YLD appeared higher in males,pedestrians than in females and other types of road travelers.Burden of injuries caused by traffic accidents was seen higher in those aged 15 to 49-year-old.From 1990 to 2013,the overall death rate on road injuries increased by 0.54 per 100 000 in China,with an increase of 2.34 per 100 000 and 0.81 per 100 000,respectively in males and pedestrians.The rates on DALY,YLL and YLD decreased by 164.21 per 100 000,115.06 per 100 000 and 49.06 per 100 000,respectively.Conclusions During the past 20 years,achievements had been made on road injury prevention and control,with the decrease of disease burden caused by road accidents.Males,young adults and pedestrians should be called for more attention to prevent road injuries.

Objective To analyze the disease burden of falls in Chinese population aged 70 and over,in 1990 and 2013 and to provide evidence for the development of prevention strategies on falls in the elderly.Methods Indicators including mortality rate,years of life lost due to premature mortality (YLL),years lived with disability (YLD) and disability-adjusted of life years (DALY) on falls,were gathered from the results of Global Burden of Disease 2013 and used to describe the disease burden of falls in China by calculating the changing rates on corresponding parameters in 1990 and 2013.Results In 2013,the number of deaths,YLLs,YLDs,DALYs caused by falls among Chinese population aged 70 and over were 48 800,0.44 million person years,0.30 millions person years,and 0.74 million person years,respectively.The standardized mortality rate,rates on YLLs,YLDs and DALYs of falls were 561.71 per 100 000,55.87 per 100 000,373.98 per 100 000 and 929.85 per 100 000,respectively.The burden of falls increased along with the increase of age.Compared with 1990,the number of deaths,YLLs,YLDs and DALYs caused by falls increased by 308.80％,161.01％,54.67％ and 104.47％,respectively,in 2013,more seen in males than in females.The standardized mortality rate,YLLs and DALYs caused by falls increased by 63.67％,38.54％ and 73.08％,respectively,during 1990 and 2013.However,the standardized YLDs rate fell by 17.90％ during the same period.Conclusion Falls caused heavy disease burden which increased in 1990 and 2013 among the Chinese population aged 70 and over.