01.1overviewofpediatrics(1)
儿科(英文版)课件
primary syndrome /calcification
11
In immune aspect
IgM: molecules—too large to pass through placenta
deficiency in newborn → infected by G-bacteria
sIgA: deficiency → infection of respiratory system
◆ Age
Children seldom pretend to be sick !
3-4
14
For example:
at birth 3~4m.
Convulsion
asphyxia, birth trauma later deficiency of Vit K
﹤6m
rachitic tetany,
gastrointestinal
IgG: 0~5mon—get from mother
≧6mon—deficiency
3-4
12
In clinical aspect
Spectrum of diseases — 3“more” : Congenital diseases Inherited diseases Acute infectious diseases
meningitis
~3y
fever convulsion
>3y
epilepsy
3-4
15
In treatment aspect
Focus on:
1. Nursing care 2. Supporting treatment 3. Medicine — dosage / method
(儿科学课件)01.1overviewofpediatrics
Outline
• Characteristics of pediatrics • Stage of children by age • Scope of pediatrics • Challenge to pediatricians
14
15
Stages of children by age
Perinatal period （28GA~7days）
20
1
Toddler
From 1 to 3 years old
22
Preschool Period
From 3 years old until 6~7 years old
23
School Period
From 6~7 years old until adolescence
Adult
lobar pneumonia
Young Child
bronchopneumonia 10
Clinical difference
eg： Type of disease: congenital, infectious Manifestation: changeable, atypical Diagnosis: Treatment: Prognosis: less sequela occurrence Prevention
11
Children are not little adults!
12
Association between pediatrics & adult medicine
Eg:
• DOHaD
(Developmental Origins of Health & Disease)
Literacy for the 21st Century- An Overview & Orientation Guide to Media Literacy Education_version2
LITERACY for the 21st Century An Overview & Orientation Guide To Media Literacy Education Part I: Theory CML MediaLit Kit™A Framework for Learning and Teaching in a Media Age Developed and written by Elizabeth Thoman Founder Tessa Jolls President / CEO Revised and expanded by Tessa Jolls President / CEO Center for Media Literacy © 2008Edition 2Edition 2Edition 1CMLEn Espanol!Edition 1 is available in Spanish under the title:Conjunto de Herramientas Para Alfabetismo en MediosISBN: 978-1-879419-18-6/medialitkit.htmlLiteracy for the 21st Century:An Overview & Orientation Guide ToMedia Literacy EducationEdition 2Featuring CML’s Five Key Questions for both Construction and Deconstruction Questions/ Tips (Q/TIPS)ISBN: 978-1-879419-00-1© 2008/pdf/mlk/ola_mlkorientation_ rev2.pdfQuestions/TIPS (Q/TIPS)ISBN: 978-1-879419-01-8© 2008Edition 1Featuring CML’s Five Key Questions for Deconstruction onlyISBN: 978-1-879419-17-9© 2002Table of ContentsI. Literacy for the 21st Century II. The CML MediaLit Kit TM A Framework for Learning and Teaching in a Media Age III. Pedagogy in Plain Language:The Basic Framework Explained Literacy for the 21st Century / New Ways of Learning What a Difference a Century Makes!Why Media Literacy is Important Questioning the MediaMedia Literacy: Theory to Practice to Implementation How this Book is Organized Media Literacy: Charts and HandoutsThe ‘Inquiry’ Process: Deconstruction / Construction Media Literacy: A Definition Five Core Concepts / Five Key Questions: Key Words and Explanations Five Core Concepts / Five Key Questions for Consumers and Producers Media Literacy Process Skills (Access / Analyze / Evaluate / Create / Participate)How to Conduct a ‘Close Analysis’ of a Media ‘Text’• The Empowerment Spiral (Awareness / Analysis / Reflection / Action)Organizing Media Literacy Learning• 071638081112141720223942444860626567Table of ContentsIV. Alternate Questions for Different Ages and Abilities V. Getting Started: Strategies and Tools Adapting the Questions for Different Ages and Abilities Questions to Guide Young Children Expanded Questions for More Sophisticated Inquiry: Deconstruction 10 Benefits of Media Literacy Education Introducing Media Literacy in your School or District A Word about Copyright How CML Can Help CML Educational Philosophy: • Empowerment through Education Words of Wisdom: About Teaching CML‘s • Five Key Questions6876777881838586697375“Educators are often called upon to ‘teach critical thinking’ to their students, butthe big question is, ‘How?’CML’s Five Key Questions, based on the Five Core Concepts of media literacy, provide a path to follow, featuring a basic framework with a specific methodology that is engaging for students and teachers alike.”Tessa Jolls“The convergence of media and technology in a global culture is changing the way we learn about the world and challenging the very foun-dations of education. No longer is it enoughto be able to read the printed word; children, youth, and adults, too, need the ability to both critically interpret the powerful images of a multimedia culture and express themselves in multiple media forms.Media literacy education provides a framework and a pedagogy for the new literacy neededfor living, working and citizenship in the 21st century. Moreover it paves the way to master-ing the skills required for lifelong learning in a constantly changing world.”Elizabeth Thoman and Tessa JollsMedia Literacy: A National Priority for a Changing World“The illiterate of the 21st century will not be those who cannot read and write, but those who cannot learn, unlearn, and relearn.” Alvin TofflerLiteracy for the 21st Century“We must prepare young people for living in aworld of powerful images, words and sounds.”UNESCO, 1982Since the beginning of recorded history, the concept of “literacy” meant having the skill to interpret “squiggles” on a piece of paper as letters which, when put together, formed words that conveyed meaning. Teaching the young to put the words togetherto understand (and, in turn, express) ever more complex ideas became the goal of education as it evolved over the centuries.Today information about the world around us comes to us not only by words on a piece of paper but more and more through the powerful images and sounds of our multi-media culture. Although mediated messages appear to be self-evident, in truth, they use a complex audio/visual “language” which has its own rules (grammar) and which can be used to express many-layered concepts and ideas about the world. Not everything may be obvious at first; and images go by so fast! If our children are to be able to navigate their lives through this multi-media culture, they need to be fluent in “reading” and “writing” the language of images and sounds just as we have always taught them to “read” and “write” the language of printed communications. Furthermore, they need the skills to interact, to share their ideas and to collaborate constructively, making it possible to participate in today’s media-driven culture.In the last 40 years, the field of media literacy education has emerged to organize and promote the importance of teaching this expanded notion of “literacy.” At its core are the basic higher-order critical and creative thinking skills—e.g. knowing how to identify key concepts, how to make connections between multiple ideas, how to ask pertinent questions, formulate a response, identify fallacies—that form the very foundation of both intellectual freedom and the exercising of full citizenship in a democratic society. Indeed in a time when candidates are elected through websites and 30-second com-mercials, and wars are fought real-time on the internet and television, a unique role of media literacy is to prepare citizens to engage in and contribute to the public debate.It also expands the concept of “text” to include not just written texts but any message form—verbal, aural or visual (or all three together!)—that is used to create and then pass ideas back and forth between human beings.New ways of learningThis explosion in information has presented a major challenge to the world of formal education. For centuries, schooling has been designed to make sure students learned facts about the world—which they proved they knew by correctly answering questions on tests. But such a system is no longer relevant when the most up-to-date facts are available at the touch of a button. What students need today is to learn how to find what they need to know when they need to know it, from the best sources available—and to have the higher order thinking skills to analyze and evaluate whether the infor-mation they find is useful for what they want to know.How will schools do this? First, schools and classrooms must be transformed from being storehouses of knowledge to being more like portable tents providing a shelter and a gathering place for students as they go out to explore, to question, to experiment, to discover!Secondly, to use a phrase from the great Brazilian educator, Paulo Freire, teaching must be distinguished from “banking.” No longer is it necessary for teachers to deposit in-formation in students’ heads. Rethinking the principles of democratic pedagogy dating back to Socrates, wise teachers realize they do not have to be a “sage on the stage.” Instead their role is to be a “guide on the side:” encouraging…guiding…mentoring…supporting the learning process. Creative classrooms today are ones where everyone is learning, from each other as well as the teacher!Thirdly, curriculum, classes and activities must be designed that will engage students in active problem solving and discovery. And today’s multi-media culture, which includes print but is not limited to it, provides a nearly limitless resource for real world learning—from how to identify “point of view” by exploring how camera angles influence our perception of the subject being photographed to how to conduct a social marketing campaign through multiple communications and technology platforms.The transformation of our culture from an Industrial Age to an Information Age is why a new kind of literacy, coupled with a new way of learning, is critical in the 21st century.“Most of what we have called formal education has been intended to imprint on the human mind all of the information that we might need for a lifetime.Education is geared toward information storage. Today that is neither possible nor necessary. Rather, humankind needs to be taughthow to process information that is stored through technology.Education needs to be geared toward the handling of data rather than the accumulation of data.”David Berlo Communication and Behavior, 1975What a Difference a Century Makes!The following chart provides a quick comparison of how traditional education has been organized in the past and how it needs to change in order to prepare students for living all their lives in a 21st century media culture. Media literacy education, with inquiry as its core, provides the engaging bridge over which students can pass to learn the critical process skills they’ll need to not just survive but to thrive as adults in the 21st century.Why Media Literacy is Important1. The influence of media in our central democratic processes.In a global media culture, people need three skills in order to be engaged citizens ofa democracy: c ritical thinking, self-expression and participation. Media literacy instills these core skills, enabling future citizens to sort through political packaging, understand and contribute to public discourse, and, ultimately, make informed decisions in the voting booth.2. The high rate of media consumption and the saturation of society by media. When one considers cell phones, social networking, video games, television, pop music, radio, newspapers, magazines, billboards, the internet—even T-shirts!—we are exposed to more mediated messages in one day than our great-grandparents were exposed to in a year. Media literacy teaches the skills we need to navigate safely through this sea of images and messages—for all our lives.3. The media’s influence on shaping perceptions, beliefs and attitudes.While research disagrees on the extent and type of influence, it is unquestionable that media experiences exert a significant impact on the way we understand, interpret and act on our world. By helping us understand those influences, media education can help us separate from our dependencies on them.4. The increasing importance of visual communication and information.While schools continue to be dominated by print, our lives are increasingly influenced by visual images—from corporate logos to huge billboards to cell phones to Internet websites. Learning how to “read” the multiple layers of image-based communication isa necessary adjunct to traditional print literacy. We live in a multi-media world.5. The importance of information in society and the need for lifelong learning. Information processing and information services are at the core of our nation’s produc-tivity but the growth of global media industries is also challenging independent voices and diverse views. Media education can help both teachers and students understand where information comes from, whose interests may be being served and how to find alternative views.—With thanks to Len Masterman, Teaching the Media“From the clock radio that wakes us up in the morning until we fall asleep watching the late night talk show, we are exposed to hundreds—even thousands—of images and ideas not only from television but now also from newspaper headlines, magazine covers, movies, websites, video games and billboards.Media no longer just shape our culture…they ARE our culture.”Media&Values #57Questioning the Media“At the heart of media literacy is the principleof inquiry.”Elizabeth Thoman, Founder / Center for Media LiteracyTo be a functioning adult in a mediated society, one needs to be able to distinguish between different media forms and know how to ask basic questions about everything we see, read or hear.Although most adults learned through literature classes to distinguish a poem from an essay, it’s amazing how many people do not understand the difference between a daily newspaper and a supermarket tabloid, what makes one website legitimate and another one a hoax, or how advertisers package products to entice us to buy.Simple questions about the media can start even at the toddler stage, planting im-portant seeds for cultivating a lifetime of interrogating the world around us. Parents, grandparents, even babysitters can make a game of “spot the commercial” to help children learn to distinguish between entertainment programs and the commercial messages that support them. Even children’s picture books can help little ones grasp the storytelling power of images—”And what do you think will happen next?”As children grow and are able to distinguish the world of fantasy from the real world they live in, they can explore how media are put together by turning the sound off during a cartoon and noting the difference it makes, or even create their own super-hero story using videocams or cell phones and easy to use editing software. When students begin to use the internet to research school projects, they can compare different websites and contrast different versions of the same information in order to detect bias or political “spin.”Usually the questioning process is applied to a specific media “text”—that is, an identifiable production or publication, or a part of one: an episode of anime, an ad for Pepsi, an issue of People magazine, a billboard for Budweiser beer, photos and articles about a bank robbery on the front page of a newspaper, the SuperBowl telecast, a hot new video game.Sometimes a media “text” can involve multiple formats. A new animated Disney film, for example, involves not only a blockbuster movie released in thousands of theatres but also a whole campaign of advertising and merchandising—character dolls and toys, clothes, lunchboxes, etc.—as well as a website, storybooks, games and perhaps eventually, a ride at one of the Disney theme parks.Uncovering the many levels of meaning in a media message and the multiple answers to even basic questions is what makes media education so engaging for kids and so enlightening for adults.Essential Questions for Teachers1.Am I trying to tell the students what the message is? Or am I giving students the skills to determine what they think the message(s) might be?2.Have I let students know that I am open to accepting their interpretation, as long as it is well substantiated, or have I conveyed the message that my interpretation is the only correct view?3.At the end of the lesson, are students likely to be more analytical? Or more cynical?—with thanks to Faith Rogow, Ph.D.“…A marvelous piece of work—clear, concise, the distillation of the most available research and practice…As a framework for taking teachers through all of the necessary stages, components, ideas and assumptions about media literacy, it could scarcely be bettered.I hope it reaches every school and college in the land.”Len Masterman Author:Teaching the MediaMedia Literacy: Theory to Practice to Implementation Like a map for a journey, the CMLMediaLit Kit™ provides both a vision and an evolving guide for navigating today’s global media culture.As a vision of media literacy, the MediaLit Kit title is simply a metaphor for a collection of core ideas and tools that are fundamental to media literacy’s inquiry-based pedagogy. As an evolving guide, the CML MediaLit Kit™ expands our educational philosophy of Em-powerment through Education through a series of documents and resources articulating the theory, practice and implementation of media literacy in the US educational system.Resting on a foundation of CML’s 30 years of experience in the field plus the thinking of leading practitioners around the world, the MediaLit Kit™ was created to help establish a common ground upon which to build curriculum programs, teaching materials and training services for teaching in an increasingly mediated world.We believe that the CML MediaLit Kit™ provides, for the first time, an accessible, integrated Basic Framework of the established foundational concepts and implemen-tation models needed to organize and structure teaching activities using a media literacy lens. This Basic Framework for media literacy features the Five Core Concepts and Five Key Questions of media literacy, with help on how to apply them to decon-struct, construct and participate with media.How this project came to beThe Center for Media Literacy has built a reputation for clear and concise interpretation and articulation of the theory and issues in media education—first through Media&Values magazine (1977–1993) and later in a series of Media Literacy Workshop Kits, the first generation of teaching tools for US-based media literacy.In 1994, CML founder Elizabeth Thoman made her foundational article “Skills and Strat-egies for Media Education” copyright free. Reprinted widely for workshops and training, it helped to create a common language and understanding for media literacy nationally. In 2001, CML President and CEO Tessa Jolls, after managing school-based media literacy programs, saw that for teachers and students to more easily grasp media literacy con-cepts, “packaging” and labeling the concepts and related questions would enable teach-ers to directly engage students through a process of exploration and discovery. Connect-ing the Five Core Concepts to Five Key Questions for deconstruction represented the genesis of the CML MediaLit Kit.This new articulation reflects evolutionary developments in both education and society, including the impact of the Internet and new multi-media technology on learning—and on life. The CML MediaLit Kit™ includes the theory / practice / implementation docu-ments and resources listed below.As articulated in this Overview and Orientation Guide, the CML’s Basic Framework now serves as the basis for all CML’s work in curriculum development and training. We invite others, whether individual teachers, staff development trainers, researchers or publishers to adopt it as well.Terms of UseBooks and other elements of the CML MediaLit Kit are available for purchase through CML’s website, . Schools and districts, publishers, curriculum devel-opers, training agencies and others who incorporate elements of the MediaLit Kit™framework for profit or for wide dissemination should license it from CML. Much as soft-ware is developed by users, CML encourages additional adaptations and specialized applications as well as research relating media literacy pedagogy to learning objectives across the curriculum.A Framework for Learning and Teaching in a Media Age Part I: TheoryLiteracy for the 21st Century: An Overview and Orientation Guide to Media Literacy EducationA plain language introduction to the basic elements of media literacy education. An invaluable reference for teachers, media librarians, curriculum developers, researchers and all who want to understand what media literacy is all about. Contains CML’s Basic Framework,charts, handouts and explanation for each of the elements in the frame-work plus tips and recommendations for how to introduce media literacy in your school, district or state.Part II: PracticeFive Key Questions That Can Change the World: Classroom Activities forMedia LiteracyA collection of 25 cornerstone lesson plans to help you introduce students to the Five Key Questions of Media Literacy for deconstruction and master them through practice. Activities emphasize not just analysis but also creative production. Useful for all grade levels and across the curriculum: language arts, social studies, health, math, and the arts.MediaLit MomentsA collection of ideas and activities illustrating the Five Key Questions for deconstruction, construction and participation. Features topical and stimulating views that illicit the “Aha!” moment that often comes with asking one of the Five Key Question s.Part III: ImplementationMedia Literacy Works!Case studies illustrate program implementation in detailed and useful ways, sharing experience of those who have gone before in providing media literacy programs. These cases include Project SMARTArt: A Case Study in Elementary Media Literacy and Arts Education, featuring an inside look at a federally-funded demonstration project at Leo Politi Elementary School in Los Angeles. During Project SMARTArt, teachers developed innovative strategies to link media literacy to state standards for the arts as well as for language arts and English language development. The case also includes lesson plans, student animation and findings on how the Five Key Questions make media literacy possible to implement across the curriculum and what it takes for a media literacy pro-gram to be replicated in a school or district and sustained over time.Part IV: ResourcesCML provides a collection of curricula and supplemental materials related to CML’s Basic Framework for media literacy.All resources available online at: How this Book is OrganizedThe first section of this Overview & Orientation Guide provided a rationale for media literacy as literacy for a 21st century media culture. Now we will explore in depth each of the core elements in the MediaLit Kit’s Basic Framework, providing rationale, context, and relevant background.The Basic Framework consists of the elements outlined below. Gain a quick under-standing of these elements in the charts on the following three pages. The page refer-ence below each chart will take you to the page in later sections where the element is explained more fully.The cornerstone of the MediaLit Kit™ pedagogy is the Five Core Concepts of Media Literacy, with related Five Key Questions that provide an innovative recasting of the Five Core Concepts which the early media literacy field adapted from the traditional rhetorical analysis of primarily print literature.Through CML’s program implementations, we realized that concepts are difficult to teach but questions are powerful. Learning to ask a series of Key Questions about today’s media culture provides an internal checklist against which to analyze and evaluate any media message from any source. This provides a consistent methodology for critical thinking during deconstruction or construction of messages—a shortcut for gaining infor-mation process skills. That’s empowerment! You will see these concepts and questions in a variety of formats in the pages that follow.Basic Framework:1.The ‘Inquiry’ Process: “Activate Your Mind / Express Your View / Participate inYour World”2.A Media Literacy Definition3.Questions/TIPS (Q/TIPS)4.Five Core Concepts5.Key Words6.Five Key Questions for Consumers: Deconstruction7.Five Key Questions for Producers: Construction8.Media Literacy Process Skills: Access / Analyze / Evaluate / Create / Participate•How to Conduct a ‘Close Analysis’ of a Media ‘Text’The Empowerment Spiral: Awareness / Analysis / Reflection / Action9.•Participation in a Media World: How to Organize for Learning and ActionAlternate Questions for Different Ages and Abilities1.Key Questions to Guide Young Children: Deconstruction (Consumers)2.Key Questions to Guide Young Children: Construction (Producers)3.Expanded Questions / for more sophisticated inquiryA few ideas for exploring the concepts in the classroom are included but for a com-prehensive collection of lesson plans we refer you to Part II of the MediaLit Kit™: Five Key Questions That Can Change the World. And for implementation models, see the Media Literacy Works! case studies on the CML website.AcknowledgementsWe acknowledge the generous contribution of leaders and colleagues in the field who have graciously allowed us to incorporate their reflections, experience and wisdom in order to share them with you.Charts and Handouts. For more detail on each idea, go to the page indicated.3942Charts and Handouts. For more detail on each idea, go to the page indicated.4444Charts and Handouts. For more detail on each idea, go to the page indicated.4848Charts and Handouts. For more detail on each idea, go to the page indicated.60 65Alternate Questions for Different Ages and Abilities6969Alternate Questions for Different Ages and Abilities7575Alternate Questions for Different Ages and Abilities7575CML’s Five Key Questions: Deconstruction (Consumers)4848CML’s Five Key Questions: Deconstruction (Consumers)5051CML’s Five Key Questions: Deconstruction (Consumers)5253CML’s Five Key Questions: Deconstruction (Consumers)54CML’s Five Key Questions: Construction (Producers)4848CML’s Five Key Questions: Construction (Producers)5556CML’s Five Key Questions: Construction (Producers)5758CML’s Five Key Questions: Construction (Producers)59CML’s FIVE CORE CONCEPTS AND KEY QUESTIONS FOR CONSUMERS AND PRODUCERSMedia Deconstruction/Construction Framework“The MediaLit Kit™ is an outstanding map for anyone embarking on the critical and rewarding journey that is teaching media literacy…An incredibly valuable piece of work that will, no doubt, contribute significantly to the develop-ment and form of media literacy education in the U.S. and beyond.”Faith Rogow, Ph.D. Founding National President / Alliance for a Media Literate America (AMLA)1. The ‘Inquiry’ ProcessThe teaching approach that best suits the media literacy classroom is called the “inquiry process” and includes both analytical (deconstruction) skills as well as cre-ative communications (construction / production) skills. When analysis is combined with creative production, theory unites with application, thereby allowing students to discover and express their learning in an interconnected and natural process. Each enriches the other, and allows for interaction that furthers knowledge and encourages participation. These intermixing of skills are particularly important in using today’s communication technologies, since very quick processing is required between consuming and producing messages that are unique to the individual.Since media messages are transmitted through so many different mental processes, the combination of analysis with production also incorporates multiple intelligences in the learning process (linguistic/verbal, logical/mathematical, musical/rhythmic, visual/ spatial, body/kinesthetic, intrapersonal and interpersonal). While both activities can happen independently there is much to gain by meshing the two into one cohesive activity of analysis and production—that is: Activate Your Mind! Express Your View! Participate in Your World!2. Media Literacy: A DefinitionThe definition most often cited in the US is a succinct sentence hammered out by participants at the 1992 Aspen Media Literacy Leadership Institute:…the ability to access, analyze, evaluate and create media in a variety of forms. Definitions, however, evolve over time and a more robust definition is now needed to situate media literacy in the context of its importance for the education of students in a 21st century global media culture. CML’s MediaLit Kit™ uses this expanded definition:Media Literacy is a 21st century approach to education.It provides a framework to access, analyze, evaluate, create and participate using messages in a variety of forms—from print to video to the internet. Media literacy builds an understanding of the role of media in society as well as essential skillsof inquiry and self-expression necessary for citizens of a democracy.What is important to understand is that media literacy is not about “protecting” kids from unwanted messages. Although some groups urge families to just turn the cell phone or TV off, the fact is, media are so ingrained in our cultural milieu that even if you turn off the technology, you still cannot escape today’s media culture. Media no longer just influence our culture. They are our culture.Media literacy, therefore, is about helping students become competent, critical and literate in all media forms so that they control the interpretation of what they see, hear or interact with rather than letting the interpretation control them. To become media literate is not to memorize facts or statistics about the media, but rather to learn to raise the right questions about what you are watching, reading, listening or contributing to. Len Masterman, the acclaimed author of Teaching the Media, calls it “critical autono-my” or the ability to think for oneself.Without this fundamental ability, an individual cannot have full dignity as a human person or exercise citizenship in a democratic society, where to be a citizen is to both understand and contribute to the debates of the time.。
电子显微镜检查在呼吸道感染病原学诊断中的意义
•6 •国际儿科学杂志2021年1月第48卷第1期Int J Pediatr.Jan 2021，Vol.48，No. 1•综述.电子显微镜检查在呼吸道感染病原学诊断中的意义汪亚南（综述）曹玲（审校）首都儿科研究所附属儿童医院呼吸内科，北京100020通信作者：曹玲，Email:caoling9919@ 163. com【摘要】电子显微镜技术在医学领域发挥着越来越重要的作用，常用于各系统的超微结构观察、机制研究和疾病的临床诊断等，其中在呼吸道病原学诊断中的作用不容忽视，但其相关的综述较少。
利用电子显微镜可以准确观察呼吸道病原体的形态学特征，并对新发呼吸道感染病原体进行初步的分类筛选。
但由于设备昂贵、技术难度大、操作复杂等因素，电子显微镜技术很少应用于常规的病原学诊断，而更多的用于实验室基础研究。
该文综述了电子显微镜检査在呼吸道病原学诊断方面的优缺点及意义。
【关键词】电子显微镜；诊断；呼吸道病原基金项目：北京市医院管理中心儿科学科协同发展中心专项经费资助项目（XTCX201821)DOI ：10.3760/cma.j.issn.1673-4408. 2021.01.002The significance of electron microscopy in the etiological diagnosis of respiratory tract infectionWang Yanan, Cao LingDepartment of Respiratory Medicine, Children's Hospital Affiliated to the Capital Institute o f Pediatrics, Beijing100020, ChinaCorresponding author：Cao Ling，Email：caoling9919@ 163. com【A bstract】At present，electron microscopy has played a more and more important role in the field ofmedicine. It is often used in the ultrastructure observation of various systems, mechanism research and clinicaldiagnosis of diseases. The role of electron microscopy in the etiological diagnosis of respiratory tract infectioncannot be ignored, but its related review is less. By using electron microscopy, the moqDhological characteristics of respiratory tract pathogens can be accurately observed and the new respiratory tract infection pathogenscan be classified and screened. In addition, through the combination of samples with patients' serum and observation of immuno-electron microscopy, the host response to pathogens can also be understood. However, dueto the high equipment requirements, technical difficulties，complex operation and other factors, electron microscopy is rarely used in conventional etiological diagnosis, and more used in laboratory basic research. In thispaper, the advantages, disadvantages and significance of electron microscopy in the etiological diagnosis of respiratory tract are reviewed.【Key words 】Electron microscopy; Diagnosis ；Respiratory tract pathogenFund program ：Special Fund Support Project of Pediatrics Collaborative Development Center of BeijingHospital Management Center (XTCX201821)DOI ：10. 3760/cma. j. issn. 1673-4408. 2021.01.002呼吸道感染是一种常见的感染性疾病，在人群中 广泛存在。
儿童及成人头发皮质醇检测方法的建立及应用
DOI：10.13822/ki.hxsj,2021007926化学试剂，2021,43(4),494〜498儿童及成人头发皮质醇检测方法的建立及应用张琦宗V,卢晓琳2,王硕文2,常韶燕2,刘蓿'，张霆2,张敏'，赵丽娇'，王理"(1.北京工业大学生命科学与生物工程学院，北京100022；2.首都儿科研究所遗传科，北京100020；3.中国发展研究基金会，北京100011)摘要：目前检测皮质醇主要的方法是通过检测血液、唾液以及尿液中的皮质醇浓度，但这只能反映人体的应激压力，而头发皮质醇含量则可以反映人体慢性压力。
建立了一种定量检测头发皮质醇含量的方法，比较了一步法与四步法测定头发皮质醇含量的差异.探讨了磷酸盐缓冲液(PBS)体积、样品放置时间等因素对测定结果的影响：结果表明，四步法比一步法更加有利于充分提取出头发中的皮质醇；溶解5mg头发皮质醇的最佳PBS体积为170|iL；皮质醇溶液放置7<1后，会随时间的延长而降解，对最终检测结果造成影响。
使用该方法对20例头发样本中的皮质醇含虽:进行了测定，结果表明儿童中女生头发皮质醇含量比男生高，成人中男性头发皮质醇含量比女性高。
关键词：头发皮质醇；定量分析；四步法；一步法；检测中图分类号:Q819文献标识码：A文章编号:0258-3283(2021)04-0494-05Establishment and Application of Hair Cortisol Determination Method for Children and Adults ZHANG Qi-zong'2,LLJ Xi-ao-lin,WANG Shuo-wen\CHANG Shao-yan2,LIU Bei',ZHANG Ting1.ZHANG Min,ZHAO Li-jiao',WANG Li*2(1.College of Life Science and Bioengineering,Beijing University of Technology,Beijing100022,China；2.Genetic Department, Capital Institute*of Pediatrics,Beijing100020,China；3.China Development Research Foundation,Beijing100011,China),Huaxue Shiji,2021, 43(4),494~498Abstract:At present,the main cortisol detection method is to detect the concentration of cortisol in blood,saliva and urine,but this can only reflect the stress pressure of the human body,and the cortisol content of the hair can reflect the chronic pressure of the human body.Therefore,A method to quantitatively detect the cortisol content of hair was established.The difference between the one-and four-step methods for detecting the cortisol content of hair was compared,and the influence of the volume of phosphate buffered saline(PBS)and time of sample placement on the determined results were discussed.The four-step method is more conducive to fully extract cortisol from hair than the one-step method；the optimal PBS volume for dissolving5mg of cortisol in hair is170jjl L;the cortisol solution will degrade over time after being placed for7days,which finally influences the results. This method was used to determine the cortisol content in20hair samples,and the results showed that the cortisol content in the hair of girls was higher than that of boys in children,and the cortisol content in the hair of men was higher than that of women in adults.Key words:hair cortisol；quantitative analysis；four-step method；one-step method；detection皮质醇亦称氢化可的松，是从肾上腺皮质中提取出的对糖类代谢具有很强作用的肾上腺皮质激素，属于糖皮质激素的一种。
鼻洗液中
论著Federico R. Laham, MD a , Amanda A. Trott, MD b , Berkeley L. Bennett, MD, MS c , Claudia A.Kozinetz, PhD, MPH d , Alan M. Jewell, BS e , Roberto P. Garofalo, MD b , Pedro A. Piedra, MD a,e鼻洗液中LDH 浓度可作为细支气管炎严重度的生化预测指标aDepartment of Pediatrics, Section of Infectious Diseases; d Epidemiology Center, and; e Department of Molecular Virology andMicrobiology, Baylor College of Medicine, Houston, Texas; b Department of Pediatrics, University of Texas Medical Branch,Galveston, Texas; and; c Division of Emergency Medicine, Department of Pediatrics, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio摘要目的由于细支气管炎婴儿住院的决定往往依据的是主观标准，缺乏细支气管炎严重度的客观指标，因此我们检验了受损细胞释放的乳酸脱氢酶(LDH)是一个有用的细支气管炎严重度生化标志的假设。
患者与方法我们回顾性分析了一项有关＜24月龄因罹患细支气管炎而在急诊科(ED)就诊儿童的研究。
获得人口统计学信息、临床信息、鼻洗液(NW)和血清标本。
对NW 样本进行了呼吸道病毒、Caspase 3/7活性和一组细胞因子以及趋化因子的分析。
Pediatric词汇
儿科常用英语词汇儿科学Pediatrics儿童保健Child care疾病防治Disease prevention营养基础Basal nutrition婴儿喂养Infants’feeding营养不良Malnutrition小儿肥胖Obesity in childhood解剖Anatomy生理生化Physiology and biochemistry营养代谢Nutrition and Metabolism免疫Immunity病理Pathology疾病的种类Variety of Disease临床表现Clinical Situation诊断Diagnosis治疗Treatment预后Prognosis预防Prevention胎儿期Fetal Stage胚胎期Embryo Stage新生儿期Neonatal Period足月儿Term Infant早产儿Premature过期产儿Post term Infant围产期Perinatal stage婴儿期Infancy幼儿期Toddler Period学龄期School age青春期Adolescence遗传inheritance性别sex内分泌endocrine营养nutrition。
生活环境living environment急性感染acute infection慢性疾病chronic disease消化道疾病disease of digestive tract 内分泌疾病endocrine disease先天性疾病congenital disease体格生长Physique growth摄入不足insufficiency of intake胎粪排出excretion of meconium水分丢失loss of moist生长高峰summit of growth站立位erect position头顶vertex耻骨联合上缘superior margin of pubic symphysis 耻骨联合上缘superior margin of pubic symphysis 足底sole脐nave头围Head Circumference胸围Chest Circumference颅骨Cranium颅缝cranial sutures前囟anterior fontanel后囟posterior脊柱Rachis ——生理弯曲的形成长骨Long Bone干骺端Metaphysis软骨骨化Cartilaginous ossification骨膜下成骨Subperiosteum ossification乳牙deciduous teeth恒牙permanent teeth(乳牙)萌出eruption神经系统nervous system脊髓spinal cord运动发育Motor development发音器官organs of voicing听觉sense of hearing大脑语言中枢cerebral language center 语言交流communication护理Nursing计划免疫Planned Immunity心理卫生Mental Health生活习惯living habit社会适应能力social adaptation亲情parent-child relationship健康查体Physical Examination随访follow-up户外活动open field activity身体抚触stroking massage窒息apnea中毒intoxication外伤trauma预防接种Vaccination主动免疫Active immunity被动免疫passive immunity预防接种vaccination小儿传染病infectious disease卡介苗Bacillus Calmette-Guerin vaccine, BCG vaccine脊髓灰质炎疫苗Polimyelitis Vaccine麻疹疫苗Measles Vaccine百白破三联疫苗Pertussis-Diphtheria-T etanus triple vaccine 乙肝疫苗Hepatitis B vaccine初种primary vaccination复种revaccination不良反应reaction热量的需要Caloric Requirement基础代谢Basal Metabolism排泄Excretion蛋白质Protein碳水化合物Carbohydrate脂肪Fat维生素Vitamins水溶性维生素Water-soluble Vitamin脂溶性维生素Fat-soluble Vitamin矿物质Mineral膳食纤维Dietary Fiber母乳喂养Breast Feeding母乳的成分Component of Mother’s Milk 免疫物质immune material免疫球蛋白Immune Gloulin补体Complement乳铁蛋白Lactoferrin溶菌酶Lysozyme双歧因子Bifidus Factor细胞成分Components of Cells慢性消耗性疾病Chronic consumptions 精神障碍Mental disorders急性传染病Acute infectious diseases 断奶Weaning人工喂养Bottle-Feeding稀释Dilution加糖Add Sugar煮沸Boiling定时定量Time and rationed Feeding个体差异Individual Difference混合喂养Mixed Feeding大小便Defecation代授法Breast-bottle-feeding补授法Supplemental Feeding辅食添加The Introduction of solid food营养不良Malnutrition代谢异常Developmental and Metabolic Disorder临床分型Clinical typing消瘦型Marasmus Malnutrition浮肿型Edema Malnutrition消瘦－浮肿型Marasmus—Edema Malnutrition病因Etiological Factor摄入不足Deficiency of Intake辅食添加不及时Introduction of Solid Food饮食结构不合理Incorrect Components of Diet不良饮食习惯Bad Eating Habit消化吸收障碍Disorder of Digestion and Absorption消化道先天畸形Congenital Anomaly of Digestive Tract先天性代谢障碍Congenital Dysbolism消化功能紊乱Disorder of Digestive Function需求增多Requirement Increases生长发育迅速的时期The period when children grow rapidly 疾病恢复期Recovery Phase of diseases双胎或多胎Twins or Multiplets早产Premature消耗性疾病Consumptions病理生理Pathophysiology代谢异常Dysbolism体温调节Thermoregulation机体各系统功能低下Incapacity of Body Systems 消化系统Digestive System循环系统Circulatory System泌尿系统Urinary System神经系统Nervous System免疫系统Immune System临床表现Clinical Situation皮下脂肪Subcutaneous Fat腹Abdomen躯干Trunk臀Breech四肢Extremities面颊Cheeks皮肤Skin干燥Dehydration苍白Pale；肌肉Muscles松弛Laxity萎缩Atrophy；精神状态Mental Status萎靡Dispirited反应差Low Response；全身症状General Symptoms并发症Complication营养性贫血Nutritional Anemia各种维生素缺乏症Various Kinds of Avitaminosis 感染Infections低血糖Hypoglycemia诊断标准Standard of Dignosis分型Types分度Degrees实验室检查Laboratory Examination鉴别诊断Differential Diagnosis治疗原则Therapeutic Principle综合治疗Comprehensive Treatment治疗方法Therapeutic Method积极治疗原发病Cure the Primary Disease饮食治疗Diet Therapy药物治疗Drug Treatment支持治疗Supporting Therapy危重症处理Treatment in Crises度营养不良伴腹泻时的治疗Severe Malnutrition companied by Diarrhea营养不良性水肿的治疗Nutritional Edema蛋白质缺乏综合症（恶心营养不良综合症）Kwashiorkor添加辅食Instruction of solid food睡眠充足Sufficient Sleeping防治先天性疾病和小儿急性传染病Prevention and Treatment of Congenital Diseases and Acute Infectious Diseases孕期保健与产前诊断Health Care in Pregnancy and Prenatal Diagnosis新生儿筛查Neonatal Screening治疗先天性疾病Cure Congenital Diseases按时预防接种Vaccination on time定期体格检查Regular Physical Examination营养障碍性疾病Dystrophy病因及病理生理Etiological Factor and Pathophysiology单纯性肥胖Simple Obesity摄入过多Excessive Intake活动过少Lack of Movement家族遗传Inheritance神经、精神因素Nervous and Mental Factors继发性肥胖Secondary Obesity膝外翻Genu Valgum扁平足Fallen arch性发育较早Early Sexual Development 实验室检查Laboratory Examinations 胆固醇Cholesterol甘油三酯Triglycerideβ脂蛋白Beta Lipoprotein胰岛素Insulin生长激素Growth Hormone诊断标准Standard of Diagnosis。
儿科学绪论
Primary Prevention
the measures of health promotion: ex. nutrition, health education, physical activity, Immunization, accident prevention, mental health and well entironment, etc.
childhood
current challenges in pediatrics
Current challenges
• health disparities
•children’s social, cognitive, and emotional lives •congenital and genetic disorders
Clinical pediatrics
To investigate or research the diagnosis and treatment of diseases in pediatrics.
Pediatrics divides into sub-speciality according to diseases relate to organ system
Introduction of Pediatrics
Cheng Qian Dept. of Child Health Children’s Hospital Chongqing Medical University
contents
the scope of pediatrics the characteristic of pediatrics the developmental periods across
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Fetal Period
Embryo: 0-8 ws Middle fetus: 9-28 ws Late fetus: 29-40 ws
Embryonic period Fetal period
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Infancy
1year old
After delivery until
Overview of Pediatrics
Dr. Yan Hu
Care
Dept. of Child Health
Children’s Hospital
UniversityChongqing Medical
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Pediatrics
Pediatrics is the sole discipline concerned with all aspects of the well-being of infants, children, and adolescents, including their health; their physical, mental, and psychologic growth and development; and their opportunity to achieve full potential as adults.
Treatment:
Prognosis: less sequela
occurrence
Preventio精n品课件
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Children are not little adults!
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Association between pediatrics & adult medicine
Eg:
• DOHaD
Neonate （0~28days）
Perinatal period （28GA~7days）
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Toddler
From 1 to 3 years old
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Preschool Period
From 3 years old until 6~7 years old
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American Academy of Pediatircs(1930) • China: Dr. Futang Zhu(1899~1994)
<Practical pediatrics>1943
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Outline
• Characteristics of pediatrics • Stage of children by age • Scope of pediatrics • Challenge to pediatricians
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Stages of children by age
FETUS
INFANCY
ADOLESCENCE SCHOOL CHILDREN PRE-SCHOOL
TODDLER
Children:0~18yr
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Fetal Period
From fertilized ovum formed until to delivery ( about 40 weeks
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Outline
• Characteristics of pediatrics • Stage of children by age • Scope of pediatrics • Challenge to pediatricians
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Is a child miniature of an adult?
*individual difference
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Outline
• Characteristics of pediatrics • Stage of children by age • Scope of pediatrics • Challenge to pediatricians
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(Developmental Origins of Health & Disease)
• Child behavioral problem & adult offence
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Outline
• Characteristics of pediatrics • Stage of children by age • Scope of pediatrics • Challenge to pediatricians
(Nelson’s Textbook of Pediatrics)
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History of Pediatrics
• Hippocrates(c.400 BC) • Germany: Society for Infant
Therapeutics • USA: Dr. Abraham Jacobi(1830~1919)
Adult
Young Child
lobar pneumonia
bronchopneumonia
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Clinical difference
eg：
Type of disease: congenital,
infectious
Manifestation: changeable,
atypical
Diagnosis:
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School Period
From 6~7 years old until adolescence
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Adolescence
From 2nd sexual character appearing until sexual mature and growth stopped
Girl:11-18yr Boy:13-20yr
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ቤተ መጻሕፍቲ ባይዱ
Anatomy
Eg:
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Physiology
Eg1:
At birth 5yr
PR （/min） 140
100
RR （/min） 40
25
15yr adult 70 60~70 20 20
Eg2:
Immature immunity
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Pathology
Eg: Streptococcus infection
Subspecialties
• Preventive Pediatrics • Developmental Pediatrics • Clinical Pediatrics • Community Pediatricians