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Introduction of Pediatrics

Introduction of Pediatrics. 广　州　市　儿　童　医　院 曾　其　毅. 儿科学绪论. 广　州　市　儿　童　医　院 曾　其　毅. Children are not small adults !! Infants are not small children!!. Objectives & Tasks. Excellent health care Promoting Quality of life. Pediatric Bible. Nelson : The Text book of Pediatrics.

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Introduction of Pediatrics

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  1. Introduction of Pediatrics 广　州　市　儿　童　医　院 曾　其　毅

  2. 儿科学绪论 广　州　市　儿　童　医　院 曾　其　毅

  3. Children are not small adults !! • Infants are not small children!!

  4. Objectives & Tasks • Excellent health care • Promoting Quality of life

  5. Pediatric Bible Nelson : The Text book of Pediatrics

  6. Study on following • Growing & Development Physical growth & its related factors Mental development & its related factors • Pediatric diseases -Etiology -Patho-physiology -Clinical manifestation

  7. -Diagnosis -Management ( treatment, therapy) -Prognosis • Preventive health care -Epidemiology

  8. -Screening - Vaccination • Rehapabilitation -Special education & training -New therapy development & improvement

  9. Features of Pediatrics • Contenuious growing & development • Differences between individuals • Better recovering ability • Immature organ function

  10. Knowledge Needed for Pediatric • Basic - Anatomy - Organ function - Physiology - Endocrinology - Pathology - Immunology - Pathophysiology - Psycollogy

  11. Clinical -Pediatric diseases -Clinical manifesitation -Diagnosis -Therapy -Prognosis -Prevention

  12. Age stages & Its Features • Fetal - Gestational weeks 38~42 w - Earlier gestation <12 w - Full term - Preterm < 34 W

  13. Age stages & Its Features • Newborn infant - age < 28 d -High morbidity & mortality !! Perionatology

  14. Infantile • Features: - age < 1 yr - insufficiency organ function - different mature rate in different organs Age < 6M : Genetic & Congenital diseases > 6 < 1yr: Secondery diseases (infection) Auto-immunol system is not mature

  15. Toddler - age 1~3 yrs - Quicker physical growth & mental development - Early education & protection needed - Trauma, Poisoning & Forign body!!

  16. Preschool - age 3~7 yrs - Learning ability developing - Social adaptation • Teenages - age 10 ~ 20 yrs - thinking - Independent - Second peak of growth & development

  17. Future & Prospective • Infectious diseases----Control • Malnutrition ----- Improvement • Genetic & Metabolic diseases –moduatte genetic therapy - Biochemistry - Genetic engineering - Gene planting - Term cell Transplan

  18. Bio-Social-Medical Science • Vaccination • Community Health Care - Primary Care : Community health care center Village health care center - Public health education

  19. Chapter 2 growth & development 一、features of growth & development： １、continute with 2 peaks First P = 1yr Second P = 13~18 yrs 2、 Ununiforme: Brain Reproduction System

  20. 3、Order of Growth & Development Top foot Distal Doxical Gross Find Basic Advanced 4、 Individual Differences

  21. 二、Influences Factoes １、Genetic --- Internal Metabolic Endocrine abnormalities 2、Environment-- External -Nutrition -Disease -Maternal disease -Living condiction

  22. 三、Physical growth • Parameters for measurement: 1、 Body growth - BW– 体重　　　　ＵＬＣ－上臂围 - BH－身高　　　　ＳＣＦ－皮下脂肪 - SH－头围 - HC－胸围

  23. Uneven Growth Rate ２、Body growth rate • Body weight: - Newborn: Male — 3.3 +- o.4 CM Female – -3.2 +-O.4 CM - 3 Ms 0.6 kg\ M - 9 Ms 6 kg -12 Ms 12kg

  24. Body Height (see table 2-1) --The younger the faster Before 12 yrs UP > LP 12yrs UP = LP After 12yrs UP < LP

  25. Sitting Height : • Finger Tip Distant FTD < BH • HC - Newborn 34 CM -1 yr = 46 cm -2 yrs = 48 cm

  26. HC = 2 SD - Too fast – Hydroencephalopathy - Too slow - Retardation

  27. TC - Newborn TC < HC 1~2 cm - 1 yr HC + age – 1 cm = cross point • UL Growth - 1yr= faster - 1 ~ 5 yrs slow down

  28. Nutrition state: A UL> 13.5 cm B = 12.5 ~ 13.5 cm C < 12 cm

  29. endollecence • Children to adults -Mature M > F -The Second peak in growth …… • Feature of growth: BW BH Hormone Second Sex Sign

  30. Measurement & Envaluationof Growth 一、Data analysis & Expressions Statistic Methods: 1、 -x +- DS ; -X+- 2SD ; =95 % -X+- 3SD ; =99.7 % 2 、Percentile： Normal distribution, Bia distribution

  31. Percentile = X+-SD 3、标准差离差法　Z score (SDS） ４、中位数（ＭＮ） Normal distribution MN = 50% = X Normal arrange = 均数 2DS

  32. Measurement Expressions • Form ---- For refering • Growth Curve ---- Continue observation • Evaluation: 3 Grade 5 Grade 6 Grade

  33. Measurement & Envaluation • Evaluation: BH, BW, HC, TC, SH, ULC, BA. • Evaluation: - Growth • Skull: Closse Funtan --- 1~ 1.5 yrs Sealture – 6 M

  34. 2) Spinal Column • Curve – Neck , Thoracic, Lumber, 3) Bone age: X ray: Knee, Wrist, Knee + Wrist --Factors influences bone age: GH, TH, SH

  35. Teeth Development • Milk teeth – 20 ; start 4~10m 2.5 yrs full development; • Permanent teeth 32 , 6 yrs, 6 ~ 12 yrs 17 ~ 18 yrs • Teeth growth order: L to Up; infront to back

  36. Reproduction System • The function of reproduction Organs : - Organ function & Hormone - Second Sexual Sign

  37. Never System • Spinal core: Newborn : L 2 4 yrs : L 1 < 2 yrs : Kernig’ Sign ( + ) Babibskin’ Sign( + )

  38. Development of Sences • Seeing , • Smelling, • Listening , • Tasting • Feeling

  39. Movement Development • 3M Head lifting • 6M Sitting • 9M Prawning Scraping • 12M Standing & Start walking

  40. Langueage Development • Speaking Single world ------ 1 yr • Speaking 15 ~ 20 worlds – 18 Ms • Telling Story ---- 3 ~ 4 yrs

  41. Mental & Psyciatric Development • From fetal to adult • Factors influenced development -Genetic -Ecolomy -Education -Environment

  42. Health Care Prinsaples • Fetal : Perionatal Care • Newborn: Feeding • Infantile: Prevention • Toddler: Protection • Preschool: Behavir • Endolessence: Education & Mental Guide

  43. Children ‘s Education Learn by sample • Habites Behavir & Moral • Physical & Psycological • Good education

  44. Vaccinations • Under 1 yr : Tuberculosis 3 Combinations Measel Hepatitis A , B

  45. Thank you!! 谢谢！

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