Based on the performance status quo of the deficiency of medical informing duty,this paper analyzed the causes,from the respects of system,management,medical side,patient side,legal,cultural and ethical factors.

Objective To develop and evaluate the reliability and validity of evaluation criterion for continuing health education in very low birth weight premature infants.Methods The literature review,theoretical analysis,qualitative research and Delphi technique were conducted to identify the evaluation criterion for continuing health education.The reliability and validity of evaluation criterion was tested in 112 parents of very low birth weight premature infants.Results The evaluation criterion which was based on the frame of KABP Model and Nursing Outcomes Classification as well as Nursing Interventions Classification consisted of 3 projects with 29 specific items.The content validity index for the scale was 0.950.Three common factors were extracted by the principal components extraction analysis and the cumulative contribution rate was 49.70％,73.25％ and 46.90％ respectively.The Cronbach' s alpha coefficient was 0.934,the retest reliability was 0.865 and the ICC was 0.940 for the total scale.Conclusion The evaluation criterion for continuing health education in very low birth weight premnature infants has good reliability and validity and can be used as a measurement tool for health education effect of continuing health education.The design of the scale provides basis for making transitional care model as well.

OBJECTIVESepsis remains a serious clinical problem because of high morbidity and mortality. The importance of Toll-like receptors (TLRs) for the induction of immune responses against sepsis was demonstrated in humans. The present study aimed to probe the gene polymorphisms of TLR4 (Asp299Gly and Thr399Ile) and TLR2 (Arg753Gln) in patients with sepsis among Chinese Han children in Wenzhou, and investigate the correlation with sepsis.

METHODThis study was conducted as a case-control study. Using polymerase chain reaction and DNA sequencing, gene polymorphisms of TLR4 (Asp299Gly and Thr399Ile) and TLR2 (Arg753Gln) in 59 children with sepsis, 38 children with severe sepsis (including 20 septic shock) and 57 healthy controls were analyzed. Hardy-Weinberg method of statistics was used to compare the frequency of genotypes alleles among three groups.

RESULTThe mutant genotypes of TLR4 gene (Asp299Gly and Thr399Ile) were not found among sepsis, septic shock and control groups. In severe sepsis group, the Arg753Gln TLR2 polymorphism occurred in 2 out of 38 severe sepsis patients and both of the subjects with the TLR2 Arg753Gln polymorphism had fatal staphylococcal infections.

CONCLUSIONTLR4 gene (Asp299Gly and Thr399Ile) polymorphisms may not be correlated with susceptibility to sepsis among Chinese Han children in Wenzhou. The fact that only 2 out of 38 severe sepsis patients had Arg753Gln TLR2 polymorphism suggests that a larger sample size is needed because of the rarity of the TLR2 allele among Chinese Han children in Wenzhou.

Asian Continental Ancestry Group ; genetics ; Case-Control Studies ; Child ; Child, Preschool ; China ; Female ; Genetic Predisposition to Disease ; Humans ; Male ; Polymorphism, Single Nucleotide ; Sepsis ; ethnology ; genetics ; Toll-Like Receptor 2 ; genetics ; Toll-Like Receptor 4 ; genetics

Bacterial Infections ; diagnosis ; C-Reactive Protein ; analysis ; Calcitonin ; blood ; Child ; Child, Preschool ; Female ; Humans ; Male ; Protein Precursors ; blood ; Scrub Typhus ; diagnosis

OBJECTIVETo study the changes of serum albumin contents after operation and investigate whether post-operational serum albumin contents are correlated with the disease severity in children with acute intussusception.

METHODSSerum albumin contents were measured using the automatic biochemistry analyzer in 32 children with mild acute intussusception and 21 children with severe acute intussusception 1 day after surgical operation. After 5 days combined treatment, serum albumin contents were re-examined. Thirty healthy children severed as the control group. The correlation between post-operational serum albumin contents and critical illness scores was evaluated.

RESULTSSerum albumin contents in the mild (34.2+/-6.5 g/L; P<0.05) and the severe intussusception groups (25.8+/-7.5 g/L; P<0.01) 1 day after operation were significantly lower than those in the control group (37.1+/-4.1 g/L). There were significant differences in serum albumin contents between the mild and the severe intussusception groups (P<0.05). Five days after operation, serum albumin contents in the mild intussusception group significantly increased (37.1+/-11.4 g/L; P<0.05), while serum albumin contents in the severe intussusception group did not differ from those 1 day after operation. There was a positive correlation between serum albumin contents on the 1st day after operation and the critical illness scores (r=0.879, P<0.01).

CONCLUSIONSSerum albumin contents decreased on the 1st day after operation and were correlated with the disease severity in children with acute intussusception. Hypoalbuminemia lasted for a longer period in severe cases. The post-operational measurement of serum albumin contents may be useful in the evaluation of the severity for children with acute intussusception.

Acute Disease ; Child, Preschool ; Female ; Humans ; Infant ; Intussusception ; blood ; complications ; surgery ; Male ; Serum Albumin ; analysis

Objective:To explore the effect of applying scaffolding teaching to infectious disease teaching.Methods:The study selected 259 undergraduate nursing students of Batch 2017 as the research objects, and they were randomly divided into an experimental group (126 students) and a control group (133 students) according to the odd and even numbers of their student numbers. The experimental group carried out scaffolding teaching, and the control group adopted traditional teaching. After the teaching, the two groups of students were assessed on the theory of infectious diseases and scenario simulation excercises. The teaching satisfaction of the two groups was assessed through questionnaire surveys. SPSS was used for t test and chi-square test. Results:The experimental group's theoretical assessment and scenario simulation excercises scores were both higher than those of the control group, and the difference was statistically significant ( P<0.05). The results of the questionnaire survey showed that the experimental group students were more satisfied with the scaffolding teaching model [80.2% (101/126)], which was higher than that of the control group [54.1% (72/133)], with statistically significant differences ( P<0.001). Conclusion:Scaffolding teaching is helpful to improve teaching quality and satisfaction in infectious disease teaching, and it is worthy of further promotion and application in educational practice.

OBJECTIVETo identify the risk factors for death in children with septic shock.

METHODSClinical data of 53 children with septic shock admitted to the Yuying Children's Hospital between January 2006 and July 2008 were retrospectively studied. Risk factors for death were assessed using univariate analysis and logistic regression analysis.

RESULTSNineteen cases died out of 53 children with septic shock. Univariate analysis and logistic regression analysis showed that arterial blood pH value<7.0 (OR=89.66), hypotension (OR=84.00), the pediatric critical illness score<70 (OR=60.00), the number of organ dysfunction>or=3 (OR=38.98), incompletion of volume resuscitation within 6 hrs after shock (OR=26.41), and no administration of effective antibiotics within 1 hr after shock (OR=11.43) and of vasoactive drugs (OR=75.68) were risk factors for death in children with septic shock.

CONCLUSIONSA low arterial blood pH value (<7.0), hypotension, a pediatric critical illness score (<70) and the number of organ dysfunction>or=3 are related to a high mortality in children with septic shock. If the volume resuscitation can be completed within 6 hrs after shock, effective antibiotics can be administered within 1 hr after shock, and vasoactive drugs can be used properly, the outcome of children with septic shock may be improved.

Child ; Child, Preschool ; Female ; Humans ; Hydrogen-Ion Concentration ; Infant ; Logistic Models ; Male ; Risk Factors ; Shock, Septic ; metabolism ; mortality

Objective: To explore the heterogeneity and correlation of clinical phenotypes and genotypes in children with disorders of sex development (DSD). Methods: A retrospective study of 1 235 patients with clinically proposed DSD in 36 pediatric medical institutions across the country from January 2017 to May 2021. After capturing 277 DSD-related candidate genes, second-generation sequencing was performed to analyzed the heterogeneity and correlation combined with clinical phenotypes. Results: Among 1 235 children with clinically proposed DSD, 980 were males and 255 were females of social gender at the time of initial diagnosis with the age ranged from 1 day of age to 17.92 years. A total of 443 children with pathogenic variants were detected through molecular genetic studies, with a positive detection rate of 35.9%. The most common clinical phenotypes were micropenis (455 cases), hypospadias (321 cases), and cryptorchidism (172 cases) and common mutations detected were in SRD5A2 gene (80 cases), AR gene (53 cases) and CYP21A2 gene (44 cases). Among them, the SRD5A2 mutation is the most common in children with simple micropenis and simple hypospadias, while the AMH mutation is the most common in children with simple cryptorchidism. Conclusions: The SRD5A2 mutation is the most common genetic variant in Chinese children with DSD, and micropenis, cryptorchidism, and hypospadias are the most common clinical phenotypes. Molecular diagnosis can provide clues about the biological basis of DSD, and can also guide clinicians to perform specific clinical examinations. Target sequence capture probes and next-generation sequencing technology can provide effective and economical genetic diagnosis for children with DSD.
3-Oxo-5-alpha-Steroid 4-Dehydrogenase/genetics* ; Child ; China/epidemiology* ; Cryptorchidism/genetics* ; Disorders of Sex Development/genetics* ; Female ; Genital Diseases, Male ; Genotype ; Humans ; Hypospadias/genetics* ; Male ; Membrane Proteins/genetics* ; Penis/abnormalities* ; Phenotype ; Retrospective Studies ; Steroid 21-Hydroxylase/genetics*