A meta-analysis research was executed to appraise the wound cosmesis problems and other postoperative problems of laparoscopic compared to open paediatric inguinal hernia (IH) repair. Inclusive literature research until March 2023 was done and 869 interconnected researches were revised. The 11 picked researches enclosed 3718 paediatric inguinal hernia were in the utilised researches' starting point, 1948 of them were utilising laparoscopic IH repairs, and 1770 were utilising open IH repairs. Odds ratios (ORs) in addition to 95% confidence intervals (CIs) were utilised to appraise the wound cosmesis problems and other postoperative problems of laparoscopic compared to open paediatric IH repairs by dichotomous approaches and a fixed or random model. Laparoscopic IH repairs had significantly lower wound cosmesis problems (OR, 0.29; 95% CI, 0.16-0.52, P < .001), metachronous contralateral inguinal hernia (MCIH) (OR, 0.11; 95% CI, 0.03-0.49, P = .003), recurrence (OR, 0.34; 95% CI, 0.34-0.99, P = .04) and postoperative problems (OR, 0.35; 95% CI, 0.17-0.73, P = .005), and higher wound score (OR, 12.80; 95% CI, 10.09-15.51, P < .001) compared to open paediatric IH. Laparoscopic IH repairs had significantly lower wound cosmesis problems, MCIH, recurrence, and postoperative problems, and a higher wound score compared to open paediatric IH. However, when interacting with its values, caution must be taken since much of the research had low sample sizes.

Background and Aim Cystic fibrosis (CF) is a genetic disease that is difficult to treat and caused by dysfunction of the cystic fibrosis transmembrane conductance regulator (CFTR) protein. Small molecules have been used to treat the symptom caused by CFTR mutations by restoring CFTR protein function. However, the data on children with CF are scarce. This meta-analysis aimed to evaluate the effectiveness and safety of this therapy in children diagnosed with CF. Materials and Methods Relevant studies were identified through searching medical databases before April 1, 2022. The primary outcomes of ppFEV1, lung clearance index2.5 (LCI2.5), sweat chloride concentration (SwCI), and Cystic Fibrosis Questionnaire-Revised (CFQ-R) score were pooled and analyzed. The secondary outcomes were nutritional status (weight, BMI, stature, and their z-score) and adverse events under therapy. Results A total of twelve studies were included. Compared with the placebo group, the pooled outcome of the ppFEV1, LCI2.5, SwCI, and CFQ-R score were improved by 7.91 {[95% confidence interval (CI), 3.71–12.12], –1.00 (95% CI, –1.38 to –0.63), –35.22 (95% CI, –55.51 to –14.92), and 4.45 (95% CI, 2.31–6.59), respectively}. Compared with the placebo group, the pooled result of the change in weight was improved by 1.53 (95% CI, 0.42–2.63). All the aforementioned results were also improved in single-arm studies. No clear differences in adverse events were found between CFTR modulator therapy and the placebo group. Conclusion CFTR modulators could improve multiaspect function in children with CF and result in comparable adverse events.

Fetoscopic endoluminal tracheal occlusion (FETO) is considered to increase survival among fetuses with congenital diaphragmatic hernia (CDH). Data from high-quality trials had been lacking until the largest randomized controlled trials (the TOTAL trials) were completed. This study aimed to elucidate the efficacy and safety of FETO for increasing the survival of fetuses with moderate or severe CDH. Relevant studies published before August 1st, 2021 were identified by searching PubMed, Cochrane Library and Web of Science. Only randomized controlled trials (RCTs) reporting patients who underwent FETO versus patients who received standard perinatal care were included in the analysis. The primary outcome was survival in the FETO and control groups. The secondary aim was to evaluate complications during pregnancy, such as premature rupture of membranes (PROM) and preterm delivery, and neonatal complications, including the need for supplemental oxygen at birth and discharge and pulmonary hypertension in the FETO and control groups. The Mantel–Haenszel random effects model was applied, and risk ratios (RRs) or odds ratios (ORs) were calculated. Four RCTs were eligible for inclusion. The quality of these studies was high. The pooled estimate of survival for fetuses with moderate or severe CDH was higher in the FETO group than in the control group [odds ratio (OR), 3.43; 95% confidence interval (CI), 1.12–10.48; P = 0.03] with relatively strong evidence of between-study heterogeneity (I2 = 66%). Subgroup analysis revealed that in the severe CDH group, the pooled estimates of neonatal survival were significantly higher in the FETO group than in the control group (OR, 6.57; 95% CI, 1.39–31.06; P = 0.02). However, in the moderate CDH group, the pooled results of neonatal survival were only slightly higher in the FETO group than in the control group (OR, 1.65; 95% CI, 0.93–2.91; P = 0.08) and the difference was not significant. The risks of PROM and preterm delivery were both higher in the FETO group. No significant difference was found for the need for supplemental oxygen at birth and discharge or in pulmonary hypertension between the FETO group and matched controls. A limitation is that we were unable to calculate the effect of the second intervention on prematurity, which would have been meaningful for evaluating the risk of FETO for PROM or preterm delivery. FETO increases the survival rate in fetuses with moderate and severe CDH, especially in fetuses with severe CDH. However, FETO is associated with a higher risk of PROM and preterm delivery, and the optimal time of FETO should be carefully chosen.

Background. This study performed a meta-analysis to explore the clinical efficacy of creatine phosphate sodium (CPS) and/or vitamin C for viral myocarditis (VMC) in children, to provide guidance for its clinical treatment. Methods. A literature search was performed on PubMed, Web of Science, Embase, China National Knowledge Infrastructure, and Wanfang databases to obtain published clinical randomized controlled trials (RCTs) on CPS and/or vitamin C for VMC in children, with a time span from 2013 to 2022. Relevant data was extracted and meta-analysis was performed using the statistical software Stata 16.0. Results. A total of 723 studies were retrieved and 19 studies were finally included for meta-analysis, with a total of 1,957 patients. The meta-analysis results showed that the observation group (conventional treatment + CPS and/or vitamin C) was superior to the control group (conventional treatment alone) in treatment effective rate (OR = 3.60, 95% CI (2.55, 5.07), and P < 0.001). Additionally, the observation group had lower levels of cardiac troponin-I (SMD = − 2.63, 95% CI (− 3.51, − 1.76), and P < 0.001), creatine kinase isoenzyme (SMD = −2.78, 95% CI (− 3.53, − 2.03), and P < 0.001), lactate dehydrogenase (SMD = −1.95, 95% CI (− 2.49, − 1.42), and P < 0.001), aspartate aminotransferase (SMD = −0.87, 95% CI (− 1.84, 0.09), and P = 0.076), tumor necrosis factor- α (SMD = −3.90, 95% CI (− 4.47, − 3.06), and P < 0.001), and higher superoxide dismutase levels (SMD = 2.48, 95% CI (1.64, 3.33), and P < 0.001). Except aspartate aminotransferase, there were significant differences between the two groups in the other parameters. Conclusion. CPS and/or vitamin C treatment could greatly improve the treatment, protect myocardial function, and relieve inflammatory response in children with VMC.

Objective To explore the effect of improving the process of intravenous therapy using six Sigma methodology among hospitalized patients. Methods Select patients of a certain ward in our hospital as the objects. Used the steps of standard six Sigma methodology as define, measure, analyze, improve, and control. Analyze the relevant causes and formulate improvement measures after identifying and defining the adverse events. Quality control team ensured the implementation of the improvement measures, and finally compared the incidences of adverse events before and after the implementation of the measures. Results Before implementation of the improvement measures, intravenous therapy was performed within 1056 persons in a month. There were 132 adverse events, and the percentage was 12.5％. After the implementation of improvement measures, 1102 patients were performed intravenous therapy. There were 81 adverse events, and the percentage was 7.4％. The incidence of adverse events was significantly reduced (χ2=16.08, P<0.01). Conclusion The application of six Sigma management method can effectively improve the effect of intravenous treatment of inpatients with reducing the incidence of adverse events.

对护理人员参加中美两军救援减灾实兵演练进行总结和探讨.通过总体部署、制订演练方案、直前训练、装备展示、技术交流以及两军混编小组进行废墟搜救、绳索救援等联合实兵演练,通过演练,提升了两军护理人员共同参与国际人道主义救援减灾领域合作的能力,对演练中两军卫勤保障的模式及装备存在差异进行分析,得到了有关军事护理实践的启示.

目的:通过分析在利比里亚埃博拉诊疗中心(Ebola Treatment Center,ETC)的我国首批医疗队员中留观区护理人员在工作中不同程度的发生身体不适的原因,并从实际工作、生活的经验中总结、探讨帮助护理人员减轻不适症状的发生、发展的对策.提升护理人员在工作中的舒适性和参与工作的积极性,以便能够更好的保护护理人员的自身安全,促进护理工作的正常进行.方法:归纳总结在医疗队留观区工作实践中采取使用的减轻不适症状的方式方法.结果:我国首批援利医疗队63名护理人员(均为女性)中有26人在患者基数最大的留观区工作,在67个工作日中虽然都曾不同程度的发生过身体不适的现象,但通过积极改进工作与生活方式能够得到症状的缓解与减轻,并在执行任务期间无一人感染.结论:针对身体不适原因进行自我调整与护理工作的改进可以有效的减轻、减缓不适的再次发生.能够提高护士的自身安全又能提高工作的舒适程度并且有助于提升护理质量.

云计算、物联网、移动互联网等现代信息技术现已融入社会生活各个方面,大数据技术得到迅猛发展,对医疗业态产生着深刻影响.充分运用大数据技术和智慧医疗,创新军队医院为部队服务举措,需要确立新的服务理念,不断创新服务方式,创造优质服务支撑,着力提高全程全方位为部队服务质量效能.

早产儿是指胎龄不满37周的活产婴儿，因其各系统功能发育不成熟，容易发生各种并发症，甚至死亡。我国早产儿的发病率为5%~6.4%。近年来，随着医疗技术水平的不断提高，早产儿的存活率逐年上升。但早产儿与正常的新生儿相比，神经系统解剖和生理发育不成熟，智能发育障碍，生活质量及社会适应能力较差，给家庭和社会带来了沉重的负担。因此，如何提高早产儿的生活质量，保证早产儿的正常发育，国内外的医学工作者进行了广泛的研究。目前国内外对于早期干预早产儿智能发育的理论基础、评价方法等方面进行了探索，现就这方面的研究进展综述如下。

多发性骨髓瘤（multiple myeloma,M M）是浆细胞恶性增殖性疾病，骨髓中克隆性浆细胞异常增生，并分泌单克隆免疫球蛋白或其片段（M 蛋白），并导致相关器官或组织损伤（ROTI）。在西方国家 MM 大约占所有恶性肿瘤的1%，占血液系统恶性肿瘤的10%[1]；在我国，MM 发病率约为1/10万。

目的 探讨风险防范式护理在儿科护理管理中的应用.方法 收集2014年2月——2015年8月期间于我院儿科就诊的患儿100例临床资料,按照入院顺序随机分为两组,各50例.对照组患儿常规护理,观察组在此基础上进行风险防范式护理.对比两组患儿家庭的SAS、SDS评分,及对护理的满意情况.结果 观察组患儿家庭的焦虑评分、抑郁评分均明显低于对照组,差异具有统计学意义(P＜0.05);观察组家庭对护理工作满意率94.0％,显著高于对照组的70.0％ (P ＜0.05).观察组发生不良事件发生率4.0％,并发症发生率2.0％;对照组不良事件发生率18.0％,并发症发生率12.0％.两组患儿不良事件发生率,并发症发生率具有显著性差异(P＜0.05).结论 儿科风险防范式护理模式能够有效预防小儿护理中不良事件的发生,降低并发症发生率,改善家庭的负性情绪,提高对家庭对护理质量的满意度,值得临床推广.

2014年在西非暴发了有史以来最严重的埃博拉疫情,大量儿童被埃博拉病毒感染且病死率极高.儿童埃博拉病毒病(Ebola virus disease,EVD)表现出与成人不同的临床特征,早期临床表现不具有特异性,RT-PCR检测是儿童EVD实验室诊断的金标准,纠正脱水及电解质紊乱、营养支持、预防和控制感染,防治休克及多器官功能衰竭等是当前行之有效的治疗策略.

目的：中国人民解放军首批。利医疗队(以下简称医疗队)在利比里亚首都蒙罗维亚建立了由中国独自运营管理的埃博拉治疗中心(ETC),任务期2个月收治疑似埃博拉患者112例,确诊5例,164名队员做到"零感染"。通过总结烈性传染病隔离病房工作中注意细节预防感染的有效性,对今后的传染病隔离病房护理工作提供参考。方法回顾性总结从出国前准备到在ETC工作实际情况,从培训、制度、流程及PPE的穿脱等细节之处做到医护人员"零感染"的作用。结果解放军。利医疗队从接到任务后,通过严谨、细致的培训,精益求精的要求,科学合理的工作流程,全体人员做到"零感染"。结论在治疗护理EVD隔离病房中工作,注重工作环节中细节操作,对保证医护人员减少或避免感染是有效的。

目的 评价不同剂量酪酸梭菌、婴儿型双歧杆菌二联活菌治疗婴儿湿疹的疗效、复发情况和安全性.方法 将150例婴儿湿疹按随机数字表法分为5组,每组30例,A组为对照组,给予丁苯羟酸乳膏外用,B、C、D、E组在此基础上,分别给予口服酪酸梭菌婴儿型双歧杆菌二联活菌治疗,剂量依次分别为250 mg/次,2次／d;250 mg/次,3次／d；500 mg/次,2次/d；500 mg/次,3次／d治疗,共治疗10 d.比较各组治疗效果及复发率.结果 各组患儿治疗前湿疹面积及严重度指数(EASI)评分比较,其差异无统计学意义(P＞0.05),但各组治疗后EASI评分均低于治疗前(t=3.82 ～4.20,P＜0.01)；治疗后B组与A组差异无统计学意义(P＞0.05)、C、D、E组患者EASI评分均低于A组(t =2.14,P＜0.05;t=2.72,P＜0.01;t'=3.79,P＜0.05)；E组总有效率最高(93.3％),复发率最低(20.0％),无不良反应发生.结论 酪酸梭菌婴儿型双歧杆菌二联活菌治疗婴儿湿疹疗效好,呈剂量依赖性,复发少,无不良反应、安全.

患儿男,10岁.因发热、咳嗽2 d,于2002年6月1日入院.患儿于1年前应用头孢唑林钠出现过血尿,经对症治疗消失.无结核、肾结石等病史,无食物过敏史.

我科1994-1999年成功地抢救了10名极低体重儿伴硬肿症,呼吸衰竭.现将抢救护理体会报告如下.1 临床资料10例患儿,入院体重最低的800g1例,1000g1例;1250g 2例,1450-1800g 4例,1900-2000g 2例,最低肛温28℃4例,34℃ 6例.脉搏60-80次/min,呼吸20-30次/min.硬肿症重度3例,中度7例,重症肺炎7例,皮肤黄染7例,3例缺血、缺氧性脑病,周身出血点,口吐咖啡样分泌物,发绀,跖甲青紫色,抽搐,各种生理反射消失,时有呼吸暂停,合并呼吸衰竭.