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Atypical teratoid/rhabdoid tumor (AT/RT) is a rare malignancy located primarily in infratentorial or subcortical areas with a poor prognosis, and rarely in the lateral ventricle with a very poor prognosis. So far, only 6 cases of AT/RT in lateral ventricle have been reported in China. This article reports the diagnosis and treatment of four children with AT/RT in the lateral ventricle, and discusses the clinical manifestations, differentiation and diagnosis, treatment and prognosis of the disease through literature review, in order to improve clinicians' understanding of the disease and reduce missed diagnosis and misdiagnosis.

The digital and programmable metasurfaces, as opposed to conventional metasurfaces, offer a more sophisticated method of collaborating information and physics, showcasing several real-time controls to electromagnetic (EM) ways in succinct ways. In this work, we propose a multi-frequency amplitude-programmable (MFAP) metasurface with multiple frequency channels to enhance the presentation and manipulation of EM data. With this metasurface, the reflected amplitudes can be simultaneously and independently encoded between high (digit “1”) and low (digit “0”) levels. The amplitude code is unique, which exhibits both reflection coefficients and radiation patterns to allow for flexible multi-functional EM operations with frequency. For instance, the MFAP metasurface can be used to design innovative communication systems by transmitting various EM signals individually across the channels in time domain. It is also possible to carry out multi-bit transmissions by mixing these frequency channels. By introducing complex coding patterns in space domain, it is possible to manipulate EM powers with greater precision. A square-split ring meta-atom that can achieve stable single-frequency amplitude control and multi-frequency 1 bit amplitude-programmable features is described as a proof-of-concept. Varactors loaded on metallic structures of various sizes are switched between operating states to modify the amplitude codes at each frequency channel. The suggested MFAP metasurface’s validity is confirmed by simulations and measurements from a dual-channel MFAP metasurface prototype.

Objective To analyze the clinical characteristics of neonatal necrotizing enterocolitis (NEC) and food protein-induced proctocolitis (FPIPC) in neonates with bloody stool as the initial manifestation. Methods We retrospectively analyzed the clinical data of 207 neonates with NEC (n=57; 27.5%) and FPIPC (n=150; 72.5%), who presented with bloody stool as the initial symptom and were treated in the outpatient clinic of our hospital between January 2018 and December 2018. The clinical symptoms and signs, laboratory test results, imaging findings, treatment and prognosis were compared between the two groups. Results The neonates with FPIPC were more likely to have such clinical manifestations as diarrhea, fat globules in the feces and elevated peripheral blood eosinophil count than those with NEC (P < 0.05). The neonates with NEC often had disease onset at a younger age and were more likely to have abdominal distension, vomiting, fever, elevated C-reactive protein, white blood cells in the feces, pneumatosis intestinalis, and portal venous gas than those with FPIPC group (P < 0.05). Conclusion In neonates admitted for bloody stool as the initial symptom, NEC often occurs at a younger age than FPIPC and is associated with a higher incidence of sepsis. The neonates with FPIPC often have more obvious elevation of eosinophil count, which can be accompanied by pneumatosis intestinalis or portal gas accumulation.

Objective To explore the surgical method and the efficacy of posterolateral approach combined with locking plate for treatment of posterior Pilon fracture with lateral malleolus fracture. Methods We retrospectively analyzed the clinical data of 59 patients with posterior Pilon fracture complicated by lateral malleolus fracture treated in our hospital from January, 2014 to January, 2018, including 33 male and 26 female patients aged 21-69 years (mean 46.8 years). Among these cases, the fractures resulted from sprains in 29 cases, falling in 21 cases and traffic accidents in 9 cases; the fractures occurred on the left side in 31 cases and on the right in 28 cases. According to YU Guangrong's classification, 19 patients had type Ⅰ, 24 had type Ⅱ and 16 had type Ⅲ fractures. All the patients underwent distal tibia posterior locking plate internal fixation through a combined posterolateral approach, and the postoperative complications, bone healing time and fracture reduction were recorded; the ankle function was assessed based on the American Orthopaedic Foot and Ankle Society (AOFAS) score. Results The patients were followed up for 12 to 30 months (mean 18 months) after the operation. According to the Burwell-Charnley's criteria, anatomical reduction was achieved in 46 cases and good reduction in 9 cases, with an excellent and good reduction rate of 93.2%. The mean healing time of the fracture was 11 weeks (9-15.5 weeks). The mean VAS scores at rest, in motion and in weight bearing were 0.54, 0.77 and 1.31, respectively. The ankle function, as evaluated according to AOFAS scores, was excellent in 45 cases, good in 11 cases, and acceptable in 3 cases, with an excellent and good function rate of 94.9%. No such complications as infection, failure of internal fixation, nonunion or malunion occurred during the follow-up. Conclusion The posterolateral approach combined with the locking plate, which has a clear surgical approach to allow flexible operation and reliable fixation, can achieve satisfactory clinical effect for treatment of posterior Pilon fracture with lateral malleolus fracture and promotes early functional recovery.

Objective To investigate the clinical characteristics of neonatal acute respiratory distress syndrome (ARDS), and the factors influencing its prognosis. Methods Clinical data of 1 018 cases suffering from respiratory failure admitted to the neonatal intensive care unit (NICU) of our hospital during the year of 2017 were collected and retrospectively analyzed. Among them, 204 cases were diagnosed as neonatal ARDS according to the Montreux definition. The clinical data of these 204 neonatal ARDS patients were retrospectively analyzed. Results ① There were 12 preterm infants (5.9%) with gestational age of 24 weeks to 27 weeks + 6 d, 49 preterm infants (24.0%) with gestational age of 28 weeks to 31 weeks + 6 d, 70 preterm infants (34.3%) with gestational age of 32 weeks to 36 weeks + 6 d, and 73 full-term infants (35.8%). The infants had an average birth weight of 2 260±898 g, with the male ratio of 62.3% (127 cases). Among them, 42 cases (20.7%) got 5 min Apgar score≤7 points. There were 94 cases (46.1%) suffering from sepsis, including 85 cases with early-onset sepsis. According to oxygen index, the 204 ARDS infants were assigned into mild (n=137, 67.2%), moderate (n=49, 24.0%) and severe (n=18, 8.8%) groups, and significant differences were seen in the ratio of non-invasive ventilation, time of assisted ventilation and length of hospital stay among the groups (P < 0.05). ② Among the 204 cases, 163 cases (79.9%) got improved or cured, and 41 cases (20.1%) were abandoned or dead. For different prognosis groups, univariate analysis found that gestational age, birth weight, and 5 min Apgar score were related to prognosis (P < 0.05). Multivariate logistic regression analysis showed that gestational age was an independent influencing factor for neonatal ARDS prognosis. Conclusion Gestational age, birth weight and 5 min Apgar score are pivotal factors for the prognosis of neonatal ARDS.

Background: Emergence delirium (ED) occurs immediately after emergence from general anesthesia, which may have adverse consequences. This cross-sectional survey assessed Chinese physicians’ and nurses’ knowledge of, attitudes towards, and practice regarding ED in adults. Methods: Electronic questionnaires were sent to 93 major academic hospitals across mainland China and both attending anesthesiologists and anesthesia nurses were recommended to complete them. Results: A total of 243 anesthesiologists and 213 anesthesia nurses participated in the survey. Most of the participants considered it a very important issue; however, less than one-third of them routinely assessed ED. In terms of screening tools, anesthesiologists preferred the Confusion Assessment Method, while anesthesia nurses reported using multiple screening tools. Divergence also appeared with regard to the necessity of monitoring the depth of anesthesia. Anesthesiologists considered it only necessary in high-risk patients, while the nurses considered that it should be carried out routinely. No unified treatment strategy nor medication was reported for ED treatment during the recovery period. Conclusions: This study illustrated that there are high awareness levels among both Chinese anesthesiologists and anesthesia nurses regarding the importance of ED. However, a specific practice in terms of routine delirium assessment, anesthesia depth monitoring, and a standardized treatment algorithm needs to be implemented to improve ED management.

Carbon nitride (CNx) films supported on fluorine-doped tin oxide (FTO) glass are prepared by radio frequency magnetron sputtering, in which the film thicknesses are 90â100 nm, and the element components in the CNx films are in the range of x = 0.15â0.25. The as-prepared CNx is for the first time used as counter electrode for dye-sensitized solar cells (DSSCs), and show a preparation-temperature dependent electrochemical performance. X-ray photoelectron spectroscopy (XPS) demonstrates that there is a higher proportion of sp2 Cî…C and sp3 Cî¸N hybridized bonds in CNx-500 (the sample treated at 500 °C) than in CNx-RT (the sample without a heat treatment). It is proposed that the sp2 Cî…C and sp3 CâN hybridized bonds in the CNx films are helpful for improving the electrocatalytic activities in DSSCs. Meanwhile, Raman spectra also prove that CNx-500 has a relatively high graphitization level that means an increasing electrical conductivity. This further explains why the sample after the heat treatment has a higher electrochemical performance in DSSCs. In addition, the as-prepared CNx counter electrodes have a good light transmittance in the visible light region. The results are meaningful for developing low-cost metal-free transparent counter electrodes for DSSCs. Keywords: Solar cells, Counter electrodes, Carbon nitride, Electrocatalysis, Magnetron sputtering

The low frequency electromagnetic field was applied during direct chill (DC) semi-continuous casting of the ZK60 magnesium alloy billets. Effects of low frequency electromagnetic field on surface quality, microstructure and hot-tearing tendency of Φ500 mm ZK60 magnesium alloy billets were investigated. The results showed that with the application of the low frequency electromagnetic field, the surface quality of the ZK60 magnesium alloy billets is markedly improved and the depth of cold fold is decreased. The microstructure of the billets is also significantly refined. Besides, the distribution of the grain size is relatively uniform from the billet surface towards its center, where the average grain size is 42 μm at surface and 50 μm at center. It also shows that the hot-tearing tendency of DC semi-continuous casting ZK60 magnesium alloy billets is significantly reduced under low frequency electromagnetic field.

Development in science, technology, engineering, and mathematics (STEM) is widely emphasized worldwide. In the past decades, China has become the largest rising economy with a strong forward momentum in STEM advancement and education, which has profoundly impacted the global economy. This study investigates the current trends in STEM career aspirations among Chinese adolescents, who will soon become the future workforce. The results indicate a significant increase of students' STEM aspirations in comparison to the 2015 PISA outcomes. Further investigation suggests that the rapid change can be attributed to the recent transitions in world politics which have shifted from collaboration to exclusive competition. Insights gained from this study call for a change of mindset to recognize that in the STEM economy, collaboration is the most powerful form of competition.

The Lawson's Classroom Test of Scientific Reasoning (LCTSR) is a popular instrument that measures the development of students' scientific reasoning skills. The instrument has a two-tier question design, which has led to multiple ways of scoring and interpretation. In this research, a method of pattern analysis was proposed and applied to analyze two-tier item pairs on the subskill of Control-of-Variable (COV) of LCTSR. The data were collected from students in grade 4 through college in both the United States and China. Students' response patterns to two combined item pairs were analyzed and compared against students at different grade levels and reasoning development levels. Six performance levels were established based on students' response patterns, serving as indicators of COV reasoning development levels. With the new method, a relation was obtained between students' level of COV skills and grade level, as well as their level of overall reasoning development. It can provide useful information on the possible developmental levels of students' reasoning skills.