Objective: To explore the application and effect of case teaching method combined with clinical pathway teaching method in clinical teaching of pediatricgastroenterology.Methods A total of 84 interns enrolled in the Department of Gastroenterology, Children''s Hospital Affiliated to Soochow University from January 2019 to June 2021 were randomly divided into experimental group (42) and control group (42).The control group adopted traditional teaching method, and the experimental group adopted case teaching method combined with clinical path teaching method.After the internship, the experimental group and the control group were evaluated for theoretical knowledge and practical operation ability, and the satisfaction evaluation was completed.The results of the two groups were compared.ResultsThe score of theoretical knowledge and practical operation ability of the experimental group were higher than those of the control group (P ＜0.05), and the satisfaction of the experimental group was higher than that of the control group (P ＜0.05), the difference was statistically significant.Conclusion Case teaching method combined with clinical pathway teaching method has achieved satisfactory results in pediatric gastroenterology department, standardized clinical teaching practice, and improved the ability of clinical diagnosis and treatment thinking of interns, which is worthy of further promotion.

Background NGLY1-related congenital disorder of deglycosylation (NGLY1-CDDG) is a multisystemic neurodevelopmental disorder in which affected individuals show developmental delay, epilepsy, intellectual disability, abnormal liver function, and poor growth. This study presents a 10-month-old female infant with elevated liver transaminases, developmental delay, epilepsy (subclinical seizures), and constipation who possesses two compound heterozygous mutations inNGLY1. Case presentation The proband was admitted to the Department of Gastroenterology, Children's Hospital of Soochow University, with elevated liver transaminases. She had a history of intrauterine growth retardation and exhibited elevated transaminases, global developmental delay, seizures and light constipation during early infancy. Whole-exome sequencing (WES) and Sanger sequencing revealed two compound heterozygous mutations inNGLY1that had been inherited in an autosomal recessive manner from her parents. One was a termination mutation, c.1168C > T (p.R390*), and the other was a missense mutation, c.1156G > T (p.D386Y). NGLY1-CDDG is a rare disorder, with a few dozen cases. The two mutations of this proband has not been previously identified. Conclusions This study investigated a Chinese proband with NGLY1-CDDG born from healthy parents who was studied using WES and Sanger sequencing to identify the causative mutations. We identified two novel compound heterozygous mutations inNGLY1, c.1168C > T (p.R390*)/c.1156G > T (p.D386Y), which are probably causative of disease.

儿科临床教学是将儿科理论与实践有效结合的重要阶段,如何做好儿科临床教学工作,使学生能够更好地掌握儿科临床知识是一项艰巨的任务.文章探索翻转课堂融合TBL这种新颖的教学模式应用于儿科临床教学的可行性,从儿科临床教学的特点,翻转课堂融合TBL教学的实施过程,翻转课堂融合TBL教学的优点、存在的问题及解决的建议等方面进行论述,说明翻转课堂融合TBL教学是其他教学模式的补充、完善和优化,值得尝试.

目的:分析奥美拉唑联合磷酸铝凝胶治疗小儿胃食管反流病的临床疗效.方法:选取苏州大学附属儿童医院胃食管反流病患儿80例,随机分为两组,每组各40例.对照组给予奥美拉唑治疗,观察组采用奥美拉唑联合磷酸铝凝胶治疗,比较两组临床疗效.结果:观察组治疗总有效率、各项酸反流指标变化情况均优于对照组,差异有统计学意义(P<0.05).两组患儿不良反应发生情况对比,差异无统计学意义(P>0.05).结论:奥美拉唑联合磷酸铝凝胶治疗小儿胃食管反流病的疗效显著,可有效改善胃食管反流症状,且不良反应无明显增加.

The pulmonary damage induced by nanosized titanium dioxide (nano-TiO2) is of great concern, but the mechanism of how this damage may be incurred has yet to be elucidated. Here, we examined how multiple genes may be affected by nano-TiO2 exposure to contribute to the observed damage. The results suggest that long-term exposure to nano-TiO2 led to significant increases in inflammatory cells, and levels of lactate dehydrogenase, alkaline phosphate, and total protein, and promoted production of reactive oxygen species and peroxidation of lipid, protein and DNA in mouse lung tissue. We also observed nano-TiO2 deposition in lung tissue via light and confocal Raman microscopy, which in turn led to severe pulmonary inflammation and pneumonocytic apoptosis in mice. Specifically, microarray analysis showed significant alterations in the expression of 847 genes in the nano-TiO2-exposed lung tissues. Of 521 genes with known functions, 361 were up-regulated and 160 down-regulated, which were associated with the immune/inflammatory responses, apoptosis, oxidative stress, the cell cycle, stress responses, cell proliferation, the cytoskeleton, signal transduction, and metabolic processes. Therefore, the application of nano-TiO2 should be carried out cautiously, especially in humans.

Exposure to titanium dioxide nanoparticles (TiO(2) NPs) elicits an adverse response such as oxidative damage. The molecular targets of TiO(2) NPs remain largely unidentified. In the present study, the function and signal pathway of nuclear factor erythroid 2 related factor 2 (Nrf2) in protection against TiO(2) NPs-induced oxidative stress in the mouse lung were investigated. Mice were exposed to 10 mg/kg body weight by an intratracheal administration for 15-90 days. With increasing exposed terms, TiO(2) NPs were significantly accumulated and increased the reactive oxygen species (ROS) production in lung, which resulted in severe pulmonary edema, inflammatory response and pneumonocyte apoptosis for 90 days. Furthermore, TiO(2) NPs exposure could greatly induce expression of Nrf2, heme oxygenase 1 (HO-1), and glutamate-cysteine ligase catalytic subunit (GCLC) from 15-day to 75-day exposure, whereas 90-day exposure caused significant decreases of three factors expression levels in lung. Our findings imply that the induction of Nrf2 expression is an adaptive intracellular response to TiO(2) NPs-induced oxidative stress in the mouse lung, and that Nrf2 is protective against TiO(2) NPs-induced pulmonary damages during certain exposure terms.