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简介：AbstractMaternal urogenital human papillomavirus (HPV) infection may place neonates at risk of HPV acquisition and subsequently lower respiratory infections as HPV can influence development of immunity. The respiratory HPV prevalence is not known in remote-dwelling Aboriginal infants, who are at high risk of respiratory infection and where the population prevalence of urogenital HPV in women is high. These data are necessary to inform HPV vaccination regimens. A retrospective analysis using PCR specific for HPV was performed on 64 stored nasopharyngeal swabs from remote-dwelling Aboriginal infants < 6 months of age, with and without hospitalised pneumonia. HPV DNA was not detected in any specimen. Despite the negative result, we cannot exclude a role for HPV in respiratory infections affecting infants in this population; however, our data do not support HPV as an important contributor to acute respiratory infection in remote-dwelling Aboriginal children.

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简介：AbstractImportance:Congenital tuberculosis (TB) is a rare, potentially fatal disease. There is currently a lack of detailed clinical information available regarding this disease.Objective:This retrospective study investigated the clinical manifestations, treatment, and long-term prognosis of congenital TB.Methods:Patients were treated in Beijing Children’s Hospital, Capital Medical University (Beijing, China) between 2009 and 2018. Their demographic data, maternal and family histories, symptoms and signs, treatment information, and follow-up data were retrospectively collected using the hospital’s electronic information system.Results:Ten infants with congenital TB were enrolled. The mean gestational age was 36.6 ± 2.2 weeks and mean birth weight was 2517 ± 487 g. All 10 patients exhibited fever, nine patients (90%) had anemia, and six patients (60%) had extrauterine growth retardation. On chest computed tomography scans, all 10 patients presented multiple pulmonary nodules and four patients (40%) had mediastinal adenopathy. Nine out of ten (90%) completed the T-spot test, and eight of them (8/9, 89%) were positive. Anti-TB treatment was initiated upon diagnostic confirmation. All patients (100%) received combined treatment with isoniazid (INH) and rifampicin (RIF). Eight of 10 patients (80%) received combined treatment with INH, RIF, and pyrazinamide. The survival rate was 100%. One patient was lost to follow-up and four patients are currently continuing treatment. Three of nine patients (33%) achieved normal developmental milestones at 6 months of age.Interpretation:Early diagnosis based on maternal history, typical imaging results, and timely treatment can improve outcomes in infants with congenital TB.

简介：AbstractBackground:Delivery room resuscitation assists preterm infants, especially extremely preterm infants (EPI) and extremely low birth weight infants (ELBWI), in breathing support, while it potentially exerts a negative impact on the lungs and outcomes of preterm infants. This study aimed to assess delivery room resuscitation and discharge outcomes of EPI and ELBWI in China.Methods:The clinical data of EPI (gestational age [GA] <28 weeks) and ELBWI (birth weight [BW] <1000 g), admitted within 72 h of birth in 33 neonatal intensive care units from five provinces and cities in North China between 2017 and 2018, were analyzed. The primary outcomes were delivery room resuscitation and risk factors for delivery room intubation (DRI). The secondary outcomes were survival rates, incidence of bronchopulmonary dysplasia (BPD), and risk factors for BPD.Results:A cohort of 952 preterm infants were enrolled. The incidence of DRI, chest compressions, and administration of epinephrine was 55.9% (532/952), 12.5% (119/952), and 7.0% (67/952), respectively. Multivariate analysis revealed that the risk factors for DRI were GA <28 weeks (odds ratio [OR], 3.147; 95% confidence interval [CI], 2.082-4.755), BW <1000 g (OR, 2.240; 95% CI, 1.606-3.125), and antepartum infection (OR, 1.429; 95% CI, 1.044-1.956). The survival rate was 65.9% (627/952) and was dependent on GA. The rate of BPD was 29.3% (181/627). Multivariate analysis showed that the risk factors for BPD were male (OR, 1.603; 95% CI, 1.061-2.424), DRI (OR, 2.094; 95% CI, 1.328-3.303), respiratory distress syndrome exposed to ≥2 doses of pulmonary surfactants (PS; OR, 2.700; 95% CI, 1.679-4.343), and mechanical ventilation ≥7 days (OR, 4.358; 95% CI, 2.777-6.837). However, a larger BW (OR, 0.998; 95% CI, 0.996-0.999), antenatal steroid (OR, 0.577; 95% CI, 0.379-0.880), and PS use in the delivery room (OR, 0.273; 95% CI, 0.160-0.467) were preventive factors for BPD (all P < 0.05).Conclusion:Improving delivery room resuscitation and management of respiratory complications are imperative during early management of the health of EPI and ELBWI.

简介：摘要目的分析超声造影(CEUS)肝脏影像报告和数据系统(LI-RADS)2017版和增强CT(CECT)/MRI LI-RADS 2018版对长径≤2 cm肝微小病灶分类的一致性及差异性。方法回顾性收集2018年1月至2019年6月在天津市第三中心医院同时接受CEUS和CECT或钆塞酸二钠增强磁共振成像(EOB-MRI)检查且具有肝细胞癌(hepatocellular carcinoma，HCC)高危风险的145例患者共145个病灶，按照CEUS LI-RADS 2017版和CECT/MRI LI-RADS 2018版分类标准对病灶进行LI-RADS分类。通过Kappa检验评估两种影像学LI-RADS分类的一致性。并对CEUS和CECT/MRI LI-RADS分类不一致的病灶行进一步分析。结果145个病灶长径为(1.65±0.33)cm。CEUS及CECT/MRI分类为LR-3、4、5、M病灶数分别为16、23、90、16个和25、31、87、2个。CEUS分类为LR-5、M共106个(73.1%)，CECT/MRI分类为LR-5、M共89个(61.4%)，差异有统计学意义(P＝0.033)。CEUS及CECT/MRI分类为LR-3、4、5类中HCC的阳性预测值分别为37.5%、52.2%、97.8%和56.0%、64.5%、96.6%。56个病灶CEUS与CECT/MRI LI-RADS分类不一致。CECT/MRI分类LR-3、4类中28个被CEUS上调为LR-4、5类，HCC所占比例为82.1%。CEUS分类LR-3、4类中14个被CECT/MRI分类上调，HCC所占比例为85.7%。结论CECT/MRI及CEUS中LR-5类对HCC均具有较高的阳性预测值，但二者对LI-RADS分类的一致性较差。CEUS分类为LR-5、M病灶数较CECT/MRI显著增多。CECT/MRI分类LR-3、4类中HCC比例高于CEUS。

简介：摘要目的探讨基于钆塞酸二钠（Gd-EOB-DTPA）增强MRI的2018版肝脏影像报告和数据系统（LI-RADS v2018）和2017版LI-RADS（LI-RADS v2017）对高危人群肝细胞癌（HCC）诊断效能的差异。方法回顾性收集2016年6月至2019年12月天津市第三中心医院行Gd-EOB-DTPA增强MRI并于1个月内取得术后或穿刺病理结果的237例HCC高危人群的临床及影像资料，共纳入282枚病灶。由2名放射科医师进行独立盲法阅片，分别根据LI-RADS v2018和v2017将病灶分类，采用Kappa值评价2名医师分类结果的一致性。以病理结果为金标准，分别计算LI-RADS v2018和v2017以LR-5和LR-4+5为标准对HCC的诊断效能，包括灵敏度、特异度、准确度和约登指数，并采用配对样本McNemar检验比较两者差异。结果2名医师对病灶分类的一致性较好，Kappa值在0.536~0.793之间。以LR-5为标准诊断HCC，LI-RADS v2018的约登指数（0.687）高于v2017（0.612），灵敏度［80.6%（166/206）］、准确度［82.6%（233/282）］均高于LI-RADS v2017［70.4%（145/206）、75.9%（214/282）］（χ²=19.048、14.087，P均<0.001），特异度分别为88.2%（67/76）、90.8%（69/76），差异无统计学意义（χ²=0.500，P=0.500）。以LR-4+5为标准诊断HCC，2个版本的诊断效能相同，其灵敏度［91.3%（188/206）］、准确度［87.6%（247/282）］高于、特异度［77.6%（59/76）］低于LI-RADS v2018的LR-5标准，差异均有统计学意义（χ²=20.045，P<0.001；χ²=5.633，P=0.018；χ²=16.056，P<0.001），其约登指数（0.689）亦高于LI-RADS v2018的LR-5标准。结论基于Gd-EOB-DTPA增强图像的LI-RADS v2018诊断HCC较v2017拥有更高的灵敏度和准确度，合理应用可以为临床提供更加客观的诊断依据。

简介：摘要：本文选用稀土元素钕作为掺杂元素，采用共沉淀法制备了钕掺杂的Li4Ti5O12分级介孔微米球，讨论了钕的掺杂量对电化学性能的影响。发现共沉淀法制备了Nd3+掺杂Li4Ti5O12的分级介孔微米球。其中，样品Li3.88Ti5Nd0.04O12表现出了非常优异的电化学性能。样品在5 C的电流密度下，首次放电容量高达168.2 mA h g-1，经过500次循环，其放电容量仍为157.3 mA h g-1。在10 C的电流密度下，首次放电容量高达157.4 mA h g-1，经过500次循环后，其放电容量仍为146.2 mA h g-1。

简介：摘要：立足当前的教育工作背景，我们小学英语教师结合我县小学生的英语实际，充分利用好线上教学平台，通过家长的积极配合，实践和探索新的英语教学理念。从小学生的心理特征、英语基础出发，科学组织，精心设计，创设英语学习环境、搭建英语交流平台、循序渐进地提高学生英语水平、培养学生良好的英语学习习惯、让孩子们享受英语学科阅读学习的快乐。