1 病例资料 例 1:男,10 岁 10 月,因"咳嗽伴咯血 2d"入院. 患儿2d内无明显诱因下出现单声咳嗽伴咯血5 次,咯血量累计约1000 mL. 最多单次咯血量约 500 mL,为鲜红色伴血凝块,当地医院予垂体后叶素治疗后略好转,遂至浙江大学医学院附属儿童医院(我院)就诊. 患儿的既往史及家族史无特殊. 入院体格检查:神志清楚,口唇苍白,咽充血,呼吸略促,未见明显三凹征,两肺呼吸音粗,右肺闻及少许粗湿啰音.

Kawasaki disease is an acute, systemic vasculitis that easily injures coronary arteries and is the leading cause of acquired heart disease in children.Although the cause of Kawasaki disease remains unknown, it is widely believed that the pathogenesis of Kawasaki disease is an inflammatory cascade caused by a combination of infection and genetic predisposition.Regulatory T cells, which express Foxp3 + , CD4 + and CD25 + , are a T-cell subpopulation specialized in immune suppression.There are some correlations between regulatory T cells and Kawasaki disease in pathophysiology, treatment and prognosis.The dysfunction of regulatory T cells may be involved with the pathogenesis of Kawasaki disease, but there are few researches on it.This article reviews the progress of regulatory T cells in Kawasaki disease in recent years and summarizes the mechanism of regulatory T cells in the occurrence and repair of Kawasaki disease, prospecting the research future of targeted regulatory T cells therapy in the prevention of coronary artery lesions in Kawasaki disease.

Coronary artery damage left by Kawasaki disease persist for a long time, and long-term monitoring is necessary. With the help of hospital information system, an outpatient clinical pathway management system for Kawasaki disease was designed. The system has the functions of path setting, doctor workstation path, scientific research statistical analysis, patient appointment reminding, etc., which can meet the needs of clinical treatment and scientific research of Kawasaki disease. However, the utilization rate of the system and the refinement level of the system operation need to be further improved, which can be continuously improved from two aspects of system support and clinical management.

川崎病是一种急性、自限性发热性疾病，病因不明，在急性发热期主要影响中型动脉、多个脏器和组织。最新研究发现白细胞介素（IL）-1信号通路是川崎病的致病关键环节之一。IL-1受体拮抗剂（IL-1Ra）阿那白滞素通过阻断IL-1信号通路，对于川崎病的治疗有一定的作用，但其应用的临床证据较少，本文就阿那白滞素治疗川崎病的作用机制、疗效及安全性进行综述，旨在为该药治疗川崎病提供依据。

目的:探讨同伴互助教学(Peer-Assisted Learning,PAL)在儿科见习临床技能中的效果.方法:选择浙江大学医学院2015级本科见习生146名作为研究对象,实验组(n=73)采用PAL法,对照组(n=73)采用传统教学法,比较两组的教学效果.结果:临床技能操作成绩两组间无差异(P>0.05),但实验组教师授课时间明显减少;问卷调查显示学生普遍认可PAL法.结论:在儿科见习临床技能中实施PAL,即能保证学习效果又能减轻临床教师的工作负担,值得推广应用.

目的:探讨对非临床医学本科生进行线上教学的效果.方法:选择浙江大学医学院2016级56名学生为对照组,2017级78名学生为实验组,比较两组教学效果.结果:学生普遍支持线上教学方式.两组考试分数无显著差异,而实验组总体考核优秀学生更多.结论:线上教学作为非临床医学本科生教学具有良好效果.

目的:探讨TBL+ PAL在儿科见习应用.方法:选择本校2016级临床医学214名学生为研究对象,对照组107名采用原有模式教学,实验组107名采用TBL+ PAL教学,比较两组教学效果.结果:实验组理论、体格测量、操作得分高于对照组(P＜0.05),临床思维无显著差异(P＞0.05),问卷显示多数学生认可TBL+ PAL教学法.结论:TBL+ PAL教学法可改善儿科见习学习效果.

目的 :探讨在疫情下依托网络工具进行儿科见习的教学效果.方法 :选择浙江大学医学院2016级本科生74名作为研究对象.实验组38名,依托网络工具进行儿科云见习.对照组36名,采用原有见习模式,比较两组的教学效果.结果 :实验组临床思维成绩与对照组无明显差异(P>0.05),但临床技能成绩低于对照组(P<0.01);问卷调查显示学生普遍认可疫情下的临床见习.结论 :疫情下利用网络工具进行教学可以作为儿科临床见习的补充.