Objective:To explore the application of the flipped classroom teaching method in pediatric internship, evaluate the feedback from both students and faculty, and provide evidence for optimizing clinical medical education strategies.Methods:Fourth-year students ( n=174) enrolled in 2019 in the eight-year clinical medicine program at Peking University Health Science Center and instructors ( n=42) participated in this study. Questionnaire survey and exit examination scores were used to assess the effectiveness of the flipped classroom method. A statistical analysis was performed using SPSS 26.0. Kruskal-Wallis test and Dunn's multiple comparisons were used to evaluate the differences in satisfaction across teaching components. Chi-square test and Fisher's exact test were applied to compare satisfaction between high-score (top 30%) and low-score (bottom 30%) student groups. Results:①Overall student satisfaction with the flipped classroom reached 91.33% ("very satisfied" + "satisfied"). High satisfaction was reported for pre-class self-learning videos (80.35%), recommended clinical guidelines (82.80%), and English literature (71.10%), while satisfaction with the flipped classroom lectures was comparatively low (52.60%), with significant differences compared to other components ( P<0.05). ②High-score students exhibited significantly lower satisfaction than low-score students across all components (overall evaluation, 84.61% vs. 98.08%, Fisher's exact test, P=0.031; pre-class videos, 53.85% vs. 76.92%, χ2=6.12, P=0.013; preparatory assignments, 61.54% vs. 80.77%, χ2=4.68, P=0.030; English literature, 53.85% vs. 75.00%, χ2=5.80, P=0.016; and flipped class lectures, 36.54% vs. 59.62%, χ2=5.55, P=0.019). ③Enhanced competency in ≥2 core areas was reported in 71.68% of students, including theoretical knowledge acquisition (49.71%), self-directed learning (35.84%), clinical thinking (31.21%), research capabilities (25.43%), and communication skills (22.54%). ④Faculty feedback indicated that 83.33% of instructors perceived the flipped classroom as equivalent or superior to traditional teaching, particularly in cultivating clinical thinking (90.48%), self-directed learning (85.71%), theoretical knowledge acquisition (76.19%), and communication skills (76.19%). ⑤Student participation willingness was primarily influenced by pre-class time investment (46.51% reported excessive effort in preparing discussion materials), while faculty engagement depended on implementation effectiveness (42.86%) and curriculum design (35.71%). Conclusions:The flipped classroom method demonstrated promising initial outcomes in pediatric internship, with high satisfaction among both students and faculty. However, further exploration and practice are required in optimizing teaching components, implementing differentiated instructional strategies, and managing time investment.

Objective:To explore the application of the flipped classroom teaching method in pediatric internship, evaluate the feedback from both students and faculty, and provide evidence for optimizing clinical medical education strategies.Methods:Fourth-year students ( n=174) enrolled in 2019 in the eight-year clinical medicine program at Peking University Health Science Center and instructors ( n=42) participated in this study. Questionnaire survey and exit examination scores were used to assess the effectiveness of the flipped classroom method. A statistical analysis was performed using SPSS 26.0. Kruskal-Wallis test and Dunn's multiple comparisons were used to evaluate the differences in satisfaction across teaching components. Chi-square test and Fisher's exact test were applied to compare satisfaction between high-score (top 30%) and low-score (bottom 30%) student groups. Results:①Overall student satisfaction with the flipped classroom reached 91.33% ("very satisfied" + "satisfied"). High satisfaction was reported for pre-class self-learning videos (80.35%), recommended clinical guidelines (82.80%), and English literature (71.10%), while satisfaction with the flipped classroom lectures was comparatively low (52.60%), with significant differences compared to other components ( P<0.05). ②High-score students exhibited significantly lower satisfaction than low-score students across all components (overall evaluation, 84.61% vs. 98.08%, Fisher's exact test, P=0.031; pre-class videos, 53.85% vs. 76.92%, χ2=6.12, P=0.013; preparatory assignments, 61.54% vs. 80.77%, χ2=4.68, P=0.030; English literature, 53.85% vs. 75.00%, χ2=5.80, P=0.016; and flipped class lectures, 36.54% vs. 59.62%, χ2=5.55, P=0.019). ③Enhanced competency in ≥2 core areas was reported in 71.68% of students, including theoretical knowledge acquisition (49.71%), self-directed learning (35.84%), clinical thinking (31.21%), research capabilities (25.43%), and communication skills (22.54%). ④Faculty feedback indicated that 83.33% of instructors perceived the flipped classroom as equivalent or superior to traditional teaching, particularly in cultivating clinical thinking (90.48%), self-directed learning (85.71%), theoretical knowledge acquisition (76.19%), and communication skills (76.19%). ⑤Student participation willingness was primarily influenced by pre-class time investment (46.51% reported excessive effort in preparing discussion materials), while faculty engagement depended on implementation effectiveness (42.86%) and curriculum design (35.71%). Conclusions:The flipped classroom method demonstrated promising initial outcomes in pediatric internship, with high satisfaction among both students and faculty. However, further exploration and practice are required in optimizing teaching components, implementing differentiated instructional strategies, and managing time investment.

Objective: To summarize the clinical features and gene variation characteristics of a child with Okur-Chung syndrome caused by CSNK2A1 gene variation. Methods: The medical records of one patient who was diagnosed with Okur-Chung syndrome in Department of Pediatrics, Xiangya Hospital of Central South University in July 2018 were analyzed. Using "CSNK2A1" gene as the keyword, relevant information about CSNK2A1 gene was searched at CNKI, Wangfang Data, OMIM, PubMed, ClinVar, Decipher (until August 2018). The characteristics of CSNK2A1 gene variation and the clinical phenotype of children with Okur-Chung syndrome were summarized. Results: The boy, 1 year and 8 months old, was sent to hospital at the age of 1 year and 6 months because of delayed growth for more than 1 year. He was susceptible to cough while eating or drinking. He was also suffering from constipation and poor sleep. Physical examination showed that his body weight was 10.2 kg, microcephalus, broad nasal bridge, micrognathia and hypotonia were observed. Whole exome-sequencing test identified a de novo heterozygous variation c.524A>G (p.D175G) in CSNK2A1 gene. This was the first case report of CSNK2A1 gene variation in the mainland of China. So far, a total of 52 cases were reported worldwide (52 single nucleotide variants), including 35 cases in 7 articles, 9 cases in Decipher database and 14 cases in ClinVar database, 6 of which were also reported in PubMed. In previously reported 52 cases, there were 48 missense variants, whereas, splice and frameshift variations were found in 3 cases and 1 case, respectively. Among the variation sites, p.K198R was the most common sites (12 cases), followed by p.R47 (6 cases), p.R80H (4 cases) and p.S51 (4 cases). Among these 52 cases, only 27 cases have been elaborately described in other studies, so the clinical characteristics were summarized in 28 cases eventually (including 27 cases in the articles and this patient), 27 of whom presented severe intellectual disability or global development delay, 1 case with mild language development delay, and 19 had hypotonia; 8 had autism spectrum disorders, 5 had attention deficit hyperactivity disorder, and 9 had sleep problems. 20 had dysmorphic facial features, 10 of them had microcephalus. 16 had failure to thrive or short stature, 12 had gastrointestinal or oromotor problem, 5 had immunological problem, and 4 had skin abnormalities. Conclusions The main clinical feature of patients with CSNK2A1 gene variations is intellectual disability with multiple systems involved, such as microcephalus, abnormal facial shape and hypotonia. The variation of CSNK2A1 gene is the cause of Okur-Chung syndrome. Missense variation is the main cause, and P. K198R is the hotspot variation.

A variety of neurological complications might occur during the course of childhood bacterial meningitis (BM). The incidence rate of neurological sequelae in patients with neurological complications is as high as 30%-50%.Therefore, in order to reduce the mortality and morbidity of childhood BM, it is of great importance to identify the complications as early as possible, standardize the treatment and enhance the understating of prevention and follow-ups.