Pediatrics belongs to highly professional important disciplines clinically. Because of abstract content of pediatrics, knowledge at odds and the lack of clinical practice, they pediatric pose serious challenges to the...Pediatrics belongs to highly professional important disciplines clinically. Because of abstract content of pediatrics, knowledge at odds and the lack of clinical practice, they pediatric pose serious challenges to the traditional teaching model. With the development of multimedia and network technology and the popularization of hardware facilities in higher vocational colleges, profound change took place in clinical pediatric teaching mode. Multimedia technology has become an important part of modern teaching methods. Through multimedia technology applications in pediatric vocational clinical teaching practice, the pediatric clinical teaching is optimized and classroom teaching improved, but also problems found in the application process of multimedia technology.展开更多
Objective:Hospital-and population-based studies demonstrate an increasing incidence of Clostridium difficile infection(CDI)in adults and children;although pediatric CDI outcomes are incompletely understood.We analysed...Objective:Hospital-and population-based studies demonstrate an increasing incidence of Clostridium difficile infection(CDI)in adults and children;although pediatric CDI outcomes are incompletely understood.We analysed United States National Hospital Discharge Survey(NHDS)data to study CDI in hospitalized children.Methods:NHDS data for 2005–2009(demographics,diagnoses and discharge status)were obtained;cases and comorbidities were identified using ICD-9 codes.Weighted univariate and multivariate analyses were performed to ascertain incidence of CDI;associations between CDI and outcomes[length of stay(LOS),colectomy,all-cause in-hospital mortality and discharge to a care facility(DTCF)].Results:Of an estimated 13.8 million pediatric inpatients;46176 had CDI;median age was 3 years;overall incidence was 33.5/10000 hospitalizations.The annual frequency of CDI did not vary from 2005 to 2009(0.24–0.43%;P=0.64).On univariate analyses,children with CDI had a longer median LOS(6 vs 2 days),higher rates of colectomy[odds ratio(OR)2.0;95%confidence interval(CI)1.7–2.4],mortality(OR 2.5;95% CI 2.3–2.7),and DTCF(OR 1.6;95% CI 1.6–1.7)(all P<0.0001).After adjusting for age,sex and comorbidities,CDI was an independent and the strongest predictor of increased LOS(adjusted mean difference,6.4 days;95% CI 5.4–7.4),higher rates of colectomy(OR 2.1;95% CI 1.8–2.5),mortality(OR 2.3;95% CI 2.2–2.5),and DTCF(OR 1.7;95% CI 1.6–1.8)(all P<0.0001).On excluding infants from the analysis,children with CDI had higher rates of mortality,DTCF and longer LOS than children without CDI.Conclusions:Despite increased awareness and advancements in management,CDI remains a significant problem and is associated with increased LOS,colectomy,in-hospital mortality and DTCF in hospitalized children.展开更多
文摘Pediatrics belongs to highly professional important disciplines clinically. Because of abstract content of pediatrics, knowledge at odds and the lack of clinical practice, they pediatric pose serious challenges to the traditional teaching model. With the development of multimedia and network technology and the popularization of hardware facilities in higher vocational colleges, profound change took place in clinical pediatric teaching mode. Multimedia technology has become an important part of modern teaching methods. Through multimedia technology applications in pediatric vocational clinical teaching practice, the pediatric clinical teaching is optimized and classroom teaching improved, but also problems found in the application process of multimedia technology.
文摘Objective:Hospital-and population-based studies demonstrate an increasing incidence of Clostridium difficile infection(CDI)in adults and children;although pediatric CDI outcomes are incompletely understood.We analysed United States National Hospital Discharge Survey(NHDS)data to study CDI in hospitalized children.Methods:NHDS data for 2005–2009(demographics,diagnoses and discharge status)were obtained;cases and comorbidities were identified using ICD-9 codes.Weighted univariate and multivariate analyses were performed to ascertain incidence of CDI;associations between CDI and outcomes[length of stay(LOS),colectomy,all-cause in-hospital mortality and discharge to a care facility(DTCF)].Results:Of an estimated 13.8 million pediatric inpatients;46176 had CDI;median age was 3 years;overall incidence was 33.5/10000 hospitalizations.The annual frequency of CDI did not vary from 2005 to 2009(0.24–0.43%;P=0.64).On univariate analyses,children with CDI had a longer median LOS(6 vs 2 days),higher rates of colectomy[odds ratio(OR)2.0;95%confidence interval(CI)1.7–2.4],mortality(OR 2.5;95% CI 2.3–2.7),and DTCF(OR 1.6;95% CI 1.6–1.7)(all P<0.0001).After adjusting for age,sex and comorbidities,CDI was an independent and the strongest predictor of increased LOS(adjusted mean difference,6.4 days;95% CI 5.4–7.4),higher rates of colectomy(OR 2.1;95% CI 1.8–2.5),mortality(OR 2.3;95% CI 2.2–2.5),and DTCF(OR 1.7;95% CI 1.6–1.8)(all P<0.0001).On excluding infants from the analysis,children with CDI had higher rates of mortality,DTCF and longer LOS than children without CDI.Conclusions:Despite increased awareness and advancements in management,CDI remains a significant problem and is associated with increased LOS,colectomy,in-hospital mortality and DTCF in hospitalized children.