Objective:To explore the application of typical case combined with practice teaching in the pediatric clinical teaching.Methods:A total of 80 clinical interns majoring in pediatrics who practiced in the Affiliated Hospital of Jining Medical University between September 2019 and January 2020 were selected as the research subjects, and they were randomly divided into observation group ( n=41) and control group ( n=39). The control group adopted conventional teaching while the observation group were given typical case combined with practice teaching model. After 16 weeks of training, the theoretical knowledge, practical operation [direct observation of procedural skill (DOPS) evaluation, and mini-clinical evaluation exercise (Mini-CEX)] and overall performance were analyzed in the two groups of students. SPSS 19.0 was used for t test, chi-square test and rank sum test. Results:After the internship, the theoretical scores of common pediatric diseases, clinical disease characteristics, etiopathogenesis, treatment regimen and complications were enhanced in the two groups, and the above scores in observation group were higher than those in control group ( P<0.05). Besides, the DOPS scores and Mini-CEX scores of the two groups were increased, and the scores were higher in observation group than in control group ( P<0.05). Furthermore, the overall excellent rate of the observation group was 87.80% (36/41), which was higher than 69.23% in control group (27/39). Survey found that the number of interns who believed that the teaching regimen could deepen the knowledge mastery degree, increase the internship interest and improve the comprehensive ability, internship efficiency and clinical thinking ability was more in observation group than in control group. Conclusion:Typical case combined with practice teaching can effectively deepen the interns' understanding of theoretical knowledge of clinical pediatrics, improve the practical operation ability and arouse the interest in learning.

Objective:To analyze the risk factors of hearing loss caused by neonatal cytomegalovirus (CMV) infection, to construct a nomogram prediction model, and to evaluate its discrimination and consistency.Methods:Data of a total of 250 neonates with congenital and perinatal CMV infection who were treated in our hospital from June 2018 to March 2021 were collected, and grouped into hearing-impaired group of 50 cases and hearing-unimpaired group of 200 cases according to whether the hearing was impaired or not. Logistic regression analysis was performed to analyze the risk factors affecting hearing loss caused by CMV infection in neonates. R software was applied to construct a nomogram model for predicting the risk of hearing loss caused by CMV infection in neonates, and the ROC curve and calibration curve were analyzed to verify the discrimination and consistency of the nomogram model.Results:Among 250 CMV-infected neonates in the modeling group, the incidence of hearing impairment was 20.00%. The proportion of primary maternal infection before 14 weeks of gestation, the proportion of urine CMV viral load >5×10 4 copies/ml, the proportion of symptomatic CMV infection and the proportion of abnormal head MRI in the hearing-impaired group were significantly higher than those in the hearing-unimpaired group ( χ2=12.545, 11.812, 11.801, and 9.025, P=0.000, 0.001, 0.001, and 0.003). That urine CMV viral load>5×10 4 copies/ml, symptomatic CMV infection and abnormal head MRI were the risk factors affecting hearing loss caused by CMV infection in neonates ( OR=2.388, 6.765, and 4.993, P=0.022, 0.000, and 0.001), the prediction model of the line graph was constructed using Bootstrap internal verification, Hosmer-Lemeshow goodness of fit test =6.055, P=0.301, area under ROC curve was 0.817, 95% CI=0.754~0.880, and external verification result showed that the predicted probability of the calibration curve was close to the actual probability and has a good agreement, with an AUC of 0.791 (95% CI=0.716~0.866). Conclusions:The nomogram model constructed in this study to predict the risk of hearing loss caused by CMV infection in neonates can be used for the prediction of hearing loss in neonates after CMV infection.

Objective:To describe the epidemiological characteristics of respiratory syncytial virus (RSV) infection in preschool children and explore the risk factors for severe pneumonia.Methods:Epidemiological data of 279 preschool children with RSV infection were investigated. The children were screened for severe pneumonia and separated into ordinary and severe types. General data and laboratory test data from both groups were compared, and binary logistic regression model analysis was applied to determine the risk factors for severe pneumonia.Results:Preschool children with RSV infection were mostly male (63.08%), <6 months old (65.95%) and had poor living environment (53.05%), with main symptoms of cough (91.04%) and wheezing (69.18%), the lung auscultation was mainly characterized by wheezing (86.74%), and imaging findings were mainly patchy shadows (76.34%), the onset season was concentrated in autumn (31.18%) and winter (43.37%). The detection rate of severe pneumonia in 279 pediatric patients was 20.27% (56/279). The proportions of onset season being autumn or winter, low birth weight infants, history of respiratory infections within 3 months, delayed treatment, neutrophils count <10×10 9/L, C-reactive protein≥10 mg/L, procalcitonin≥1.5 ng/mL, albumin<30 g/L, CD4 + /CD8 + <1.2 in the severe types were higher than those in the normal types ( P<0.05). Logistic regression analysis showed that the onset season was autumn or winter ( OR=2.316, 95% CI: 1.235-4.345), low birth weight infants ( OR=2.679, 95% CI: 1.442-4.977), history of respiratory infections within 3 months ( OR=2.815, 95% CI: 1.539-5.148), delayed treatment ( OR=2.869, 95% CI: 1.581-5.206), low albumin<30 g/L ( OR=2.756, 95% CI: 1.495-5.080), and low CD4 + /CD8 + <1.2 ( OR=3.016, 95% CI: 1.695-5.366) were risk factors for severe RSV pneumonia in preschool children ( P<0.05). Conclusions:Autumn and winter, low birth weight infants, history of respiratory infections within 3 months, delayed treatment, low albumin, and low CD4 + /CD8 + are related to the occurrence of severe RSV pneumonia in preschool children. Therefore, it is necessary to strengthen the attention to the condition of preschool RSV infected children with the above risk factors, and actively intervene in controllable factors to reduce the risk of severe pneumonia.

Objective:To explore the effect of emotional imagery desensitization therapy on posttraumatic stress disorder among school- age children with fracture, to alleviate the adverse psychological state of the children.Methods:By a randomized controlled trials, a total of 78 school- age children with fracture at the Affiliated Hospital of Jining Medical University from July 2021 to July 2023 were divided into experimental group and control group according to the admission time, with 39 cases in each group. Both groups carried out routine care, the control group was given routine psychological intervention, the experimental group implemented emotional imagery desensitization therapy. Before and after 3 months of intervention, the effects was assessed by Post-Traumatic Stress Disorder Self-rating Scale (PTSD-SS) and Medical Coping Modes Questionnaire (MCMQ), respectively.Results:During the research process, there were 2 cases of dropout in the control group due to disconnection, and 4 cases in the experimental group due to disconnection and voluntary withdrawal. 37 children in the control group [20 males and 17 females, age (9.27 ± 1.62) years], and 35 children in the experimental group [21 males and 14 females, age (9.57 ± 1.63) years] completed the intervention. Before intervention, the difference of PTSD-SS and MCMQ scores between two groups was no statistically significant (all P>0.05). After intervention, the subjective assessment, re-experiencing, avoidance symptoms, hypervigilance, functional impairment factor scores and total PTSD-SS scores were (1.51 ± 1.06), (10.74 ± 3.30), (10.86 ± 2.93), (11.94 ± 3.18), (2.31 ± 1.30), (37.37 ± 6.37) in the experimental group, lower than in the control group (2.08 ± 0.80), (12.92 ± 3.63), (12.73 ± 2.99), (14.65 ± 4.23), (2.97 ± 0.87), (45.35 ± 5.86), the differences were statistically significant ( t=2.53-5.54, all P<0.05). After intervention, the confrontation subscale scores were (23.49 ± 2.48), higher than in the control group (21.89 ± 2.38), the avoidance, acceptance- resignation subscale were (10.31 ± 1.89) and (6.83 ± 1.98), lower than in the control group (11.57 ± 1.79) and (7.86 ± 2.12), the differences were statistically significant ( t=2.79, 2.89, 2.14, all P<0.05). Conclusions:Emotional imagery desensitization therapy can effectively alleviate post- traumatic stress disorder and promote positive coping mode in school-age children with fracture.

Objective:To explore the effects of family-centered conductive education on the muscle strength in children with cerebral palsy and the stress of caregivers.Methods:Totally 92 children with cerebral palsy and 92 their main caregivers admitted into the Affiliated Hospital of Jining Medical University from October 2018 to December 2019 were selected and divided into a control group and a conductive education group according to the random number table, with 46 children with cerebral palsy and their 46 main caregivers in each group. Patients in the control group received routine care, while patients in the conductive education group underwent family-centered conductive education on the basis of routine care. The Chinese version of the Modified Ashworth Scale (MAS) , Caregiver Strain Index (CSI) , and the Chinese version of Family Management Measure (FaMM) were used to evaluate the muscle strength, caregiver pressure, and disease management ability of the two groups before and after intervention. Therefore, there were actually 43 cases in the control group and 42 cases in the conductive education group.Results:After intervention, the MAS scores of the two groups were lower than those at admission, and the score was lower in the conductive education group than in the control group, with statistically significant differences ( P<0.05) ; the CSI score of caregivers in the conductive education group was lower than that in the control group, and the difference was statistically significant ( P< 0.05) , while the FaMM score was higher than that in the control group, with statistically significant difference ( P<0.05) . Conclusions:Family-centered conductive education can effectively reduce the muscle strength of children with cerebral palsy, alleviate the pressure of their caregivers, and improve the caregivers' disease management ability.