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Background Streptococcus pneumoniae (S. pneumoniae) is a major cause of bacterial meningitis, septicemia and pneumonia in children. Inappropriate choice of antibiotic can have important adverse consequences for both the individual and the community. Here, we focused on penicillin/cefotaxime non-susceptibility of S. pneumoniae and evaluated appropriateness of targeted antibiotic therapy for children with IPD (invasive pneumococcal diseases) in China. Methods A multicenter retrospective study was conducted in 14 hospitals from 13 provinces in China. Antibiotics prescription, clinical features and resistance patterns of IPD cases from January 2012 to December 2017 were collected. Appropriateness of targeted antibiotics therapy was assessed. Results 806 IPD cases were collected. The non-susceptibility rates of S. pneumoniae to penicillin and cefotaxime were 40.9% and 20.7% respectively in 492 non-meningitis cases, whereas those were 73.2% and 43.0% respectively in 314 meningitis cases. Carbapenems were used in 21.3% of non-meningitis cases and 42.0% of meningitis cases for targeted therapy. For 390 non-meningitis cases with isolates susceptible to cefotaxime, vancomycin and linezolid were used in 17.9% and 8.7% of cases respectively for targeted therapy. For 179 meningitis cases with isolates susceptible to cefotaxime, vancomycin and linezolid were prescribed in 55.3% and 15.6% of cases respectively. Overall, inappropriate targeted therapies were identified in 361 (44.8%) of 806 IPD cases, including 232 (28.8%) cases with inappropriate use of carbapenems, 169 (21.0%) cases with inappropriate use of vancomycin and 62 (7.7%) cases with inappropriate use of linezolid. Conclusions Antibiotic regimens for IPD definite therapy were often excessive with extensive prescription of carbapenems, vancomycin or linezolid in China. Antimicrobial stewardship programs should be implemented to improve antimicrobial use.

非典型畸胎样/横纹肌样肿瘤是一种好发于小儿的高度恶性中枢神经系统胚胎性肿瘤。其组织形态学表现多样，具有向神经上皮、上皮与间叶组织多向分化的特点，典型表现为出现数量不等的横纹肌样细胞。发生在成人和/或鞍区的病例罕见，对它的临床病理学与生物学行为等特点的认识可能存在不足。因此，本文分析了2例发生于成人的非典型畸胎样/横纹肌样肿瘤，并复习相关文献，以期总结其临床病理特征。.

Simulations of lithium (Li) impurity transport behaviour with a liquid lithium divertor on the EAST tokamak have been performed using the fluid code EMC3-EIRENE and the Monte Carlo code ITCD. The interactions between particles and the wall surface, like the gyration-induced scrape-off effect, sheath acceleration, kinetic self-sputtering and reflection, are typically ignored or simplified in fluid models. In order to uncover the impacts of the scrape-off effect, sheath acceleration, kinetic self-sputtering and reflection on Li distribution, detailed analysis of the density distributions of Li1+ and Li2+ ions at the divertor region have been carried out by ITCD modelling. The newly-upgraded ITCD code can principally reproduce the distribution patterns of Li ions as well as EMC3-EIRENE under identical plasma conditions on EAST. However, due to the scrape-off effect and sheath acceleration, the densities of Li1+ and Li2+ ions simulated by ITCD are evidently reduced compared to the EMC3-EIRENE simulations. The kinetic self-sputtering by redeposited Li particles in ITCD can increase the densities of the Li ions. Moreover, the kinetic reflection database calculated by SRIM code has been employed by ITCD, which leads to an increase in the Li densities compared to the reflection approach used in EMC3-EIRENE. Overall, by adding the aforesaid physical effects in ITCD, the total number of Li ions shows an obvious reduction compared to the EMC3-EIRENE modelling.

Accurate metering and transport of samples and reagents are a critical process in many microfluidic applications, such as biochemical analysis, diagnostics and drug delivery. However, as the liquid volume to be processed is usually rather small, its sensoring and metering remains a challenging problem. Though some studies on this issue have been reported so far, there is still much room for improvement regarding the metering accuracy, system simplicity and control flexibility. In this work, we propose a simple, automatic and cost-effective method for microfluidic metering and transport. To improve the accuracy, the geometric metering approach with hydrophobic valves of minimum dead volumes is adopted. Besides, an on-chip Bernoulli pump is designed to reduce the hardware requirement, and a pulse width modulation (PWM) scheme is used to facilitate the operation. Testing results show that for metering of 20 μL liquid, the averaged error is − 1.3%, the relative standard deviation is 0.42%. The liquid transport can also be well regulated via PWM method.

Solitary fibrous tumor/hemangiopericytomas (SFT/HPCs) are mesenchymal tumors characterized by “staghorn” blood vessels and collagen deposition. Little is known about SFT/HPCs with papillary architecture. We summarized the clinicopathologic features of 12 patients with papillary SFT/HPCs (8 males and 4 females; median age: 59 years), including 8 previously reported cases. Tumors were present in the meninges (75%, 9/12), adrenal gland (8%, 1/12), orbit (8%, 1/12), or spinal canal (8%, 1/12). Six tumors (50%) had a true papillary architecture with fibrovascular cores and 6 tumors (50%) had a pseudopapillary architecture with vascular cores. Nuclear staining for STAT6 was present in all tested tumors (10/10). RT-PCR indicated NAB2 ex6-STAT6 ex17 fusion in 4 tumors (80%, 4/5) and NAB2 ex4-STAT6 ex2 fusion in 1 tumor (20%, 1/5). Five patients (42%, 5/12), all with tumors in the meninges, developed local recurrence at a median of 61 months after surgery (range: 56–165 months; mean: 88.6 months). These results indicated that the papillary architecture is a morphological form of SFT/HPCs. The recognition of this pattern, with appropriate immunohistochemical analysis and assessment of NAB2-STAT6 fusion, should facilitate the distinction of these rare neoplasms from morphologically similar tumors in the meninges, lung, pleura, and soft tissue.

Importance The clinical characteristics of infectious mononucleosis (IM) in Chinese children have not been evaluated in multicenter studies, and the effectiveness of antiviral treatment are controversial. Objective To investigate the clinical characteristics of Chinese children with IM and current status of antiviral therapy for affected patients. Methods Hospitalized patients with IM were enrolled between 2018 and 2020 in five children’s hospitals in China. The clinical characteristics were compared among four age groups

Active control of the excessively high heat and particle fluxes on the divertor target plates is of fundamental importance to the steady state operation of tokamaks, especially for fusion reactors. A series of experiments have been carried out on this critical issue to relieve the plasma-wall interactions in the experimental advanced superconducting tokamak (EAST) in the last ten years, not only contributing to the long pulse operation of EAST itself, but also providing physical understandings and potential techniques to the next-generation devices like ITER. We have characterized the power deposition pattern and broadened the divertor footprint width effectively. The plasma-wetted area is actively handled using either 3-dimentional edge magnetic topology or advanced plasma equilibrium, thereby peak heat flux around the strike point is reduced. Active control of detachment or radiation compatible with core plasma performance has progressed significantly in very recent years, with a series of active feedback control modules developed and utilized successfully, based on the divertor physics advances with both experiments and simulation. The upper divertor of EAST was upgraded from graphite to active water-cooling ITER-like tungsten in 2014, exhibiting much enhanced heat removal capability. As for the particle exhaust including both fueling and impurity particles, in addition to wall conditioning and impurity source control, the efficiency of particle flux exhaust is optimized by making full use of the divertor closure and the plasma drifts in both scrape-off layer and divertor volume. These heat and particle exhaust advances contribute greatly to a series of EAST achievements like H-mode operation over 100 s. A brief near-term plan on the integrated control of divertor plasma-wall interactions in long-time scale will also be introduced, aiming to provide favorable divertor operation solution for ITER and CFETR.

Baculoviral inhibitor of apoptosis repeat-containing 5 (BIRC5) is a member of apoptosis inhibition family which suppresses caspase activity. Osteosarcoma tissues have significantly higher BIRC5 and lower microRNA-218 (miR-218) level than adjacent tissues, indicating tumor suppressor role of miR-218 in osteosarcoma. Bioinformatics analysis showed satisfactory targeting correlation between miR-218 and 3'-UTR of BIRC5 mRNA. This study, thus, investigated if dysregulation of miR-218 and BIRC5 affected apoptosis of osteosarcoma cells U2OS.A total of 42 osteosarcoma patients were collected for tumor and adjacent tissues to compare miR-218 and BIRC5 expressions. Dual-luciferase reporter gene assay examined targeted regulation between miR-218 and BIRC5. In vitro cultured U2OS cells were treated with miR-218 mimic and/or si-BIRC5. Caspase-3 activity was measured by spectrometry while flow cytometry was used to test cell apoptosis, plus protein expression assay by Western blot assay.Compared to adjacent tissues, osteosarcoma tissues had significantly depressed miR-218 expression and elevated BIRC5 expression (p0.05). miR-21 targeted 3'-UTR of BIRC5 to suppress its expression. The elevation of miR-218 and/or silencing BIRC5 significantly depressed BRIC5-induced inhibition on caspase-5, and facilitated U2OS cell apoptosis (p0.05).We observed that miR-218 was significantly down-regulated in osteosarcoma tissues, which had elevated BIRC5 expression. MiR-218 targeted and inhibited BIRC5 expression, weakened caspase-5 inhibition by BIRC5, and facilitated U2OS osteosarcoma cell apoptosis.

Many studies showed that long non-coding RNAs (lncRNAs) may serve as prospective markers for patients with malignant cancers, including cervical cancer (CC). In this study, we mainly investigate the functions of lncRNA PTENP1 in the progression of human CC.Quantitative Real Time-Polymerase Chain Reaction (qRT-PCR) was performed to detect expression levels of PTENP1, miR-19b and MTUS1 in CC tissues, the adjacent tissues and CC cell lines. The correlations between PTENP1 with miR-19b, miR-19b with MTUS1 and PTENP1 with MTUS1 were analyzed. Overall survival (OS) of patients was analyzed using Kaplan-Meier method. Proliferation capacity was measured by CCK-8 assay and the invasion ability in CC cell line was detected by transwell assay. Western blot (WB) assay was performed to measure protein levels of tissues and CC cell lines. Finally, Dual-Luciferase reporter assay was performed to prove the potential binding sites between PTENP1 and miR-19b, miR-19b and MTUS1.We found that PTENP1 was reduced in CC tissues and CC cell lines, which predicted the poor diagnosis of CC patients. MiR-19b was increased in CC tissues, which was negatively correlated with PTENP1 in CC tissues. MTUS1 was reduced in CC tissues, which was negatively correlated with miR-19b and positively correlated within PTENP1 CC tissues. Furthermore, PTENP1 overexpression inhibited cell proliferation ability and invasion capacity in HeLa cells, as well as repressed expressions of Cyclin D1, N-cadherin, and Vimentin. Moreover, Luciferase gene reporter assays verified that miR-19b was a direct target miRNA of PTENP1, and MTUS1 was identified as a direct target of miR-19b. In addition, the inhibited cell proliferation and invasion abilities in HeLa cells with p-PTENP1 were eliminated following with miR-19b mimic transfection.According to the results, this study showed that PTENP1 was reduced in CC patients and it was a prognostic factor for CC patients. Furthermore, we firstly uncovered that PTENP1 could inhibit cell proliferation and invasion via miR-19b/MTUS1 in CC patients, which uncovered the tumor-suppressive role of PTENP1 in CC and suggested that it might be a potential target for treating human CC.

中枢神经系统肿瘤分类分子信息及实践方法联盟-非WHO官方组织（cIMPACT-NOW）就2016 WHO中枢神经系统肿瘤分类第4版修订版发布以来的神经系统肿瘤部分临床实践中的分类分级、争议问题与研究进展进行了深入的分析研究，发布了4次更新，包括（1）NEC、NOS术语的使用范围；（2）H3K27M突变型弥漫性中线胶质瘤的定义修订；（3）IDH野生型具有胶质母细胞瘤分子特征的弥漫性星形细胞胶质瘤，WHO Ⅳ级的分子遗传特征；（4）以MYB、MYBL1或FGFR1改变或BRAF V600E突变为特征的IDH野生型/H3野生型弥漫性胶质瘤。上述更新将成为未来第5版WHO中枢神经系统肿瘤分类改版建议，在该文中逐一进行分析解读。.

The use of non-fuel pellets is desirable for ITER due to its decoupling ELM pacing from fueling. In this paper, the Neutral Gas Shielding Model (Parks et al., Nucl, Fusion 34(1994)417) has been applied to the ablation of Li pellets in the H-mode pedestal region. The results show that the injection velocity of pellets is a more convenient parameter for one to control the deposition profile and location of the injected species in the pedestal. The information obtained from this work can further be used as input for fluid transport codes to track the trajectories of the impurity species or as input for advanced MHD codes for better understanding the non-linear destabilization of ELMs.

To explore the epidemiological characteristics, trends and relevant factors of pre-hospital mortality due to acute myocardial infarction (AMI) from 1999 to 2016 in Tianjin city, based on mortality surveillance information and household registration population information. Standardized mortality rates were calculated using the year 2000 world standard population. From 1999 to 2016, the research result showed that the pre-hospital crude mortality rates of AMI were 39.47/100 000 to 90.64/100 000 and the standardized mortality rates were 30.92/100 000 to 53.90/100 000. The proportion of pre-hospital AMI deaths was 73.96%-81.92% (利用天津市死因监测信息和户籍人口信息，分析1999—2016年天津市急性心肌梗死（AMI）院前死亡流行病学特征、变化趋势及相关因素，以2000年世界人口为标准人口计算标化死亡率。1999—2016年天津市AMI院前死亡率为39.47/10万~90.64/10万，标化死亡率为30.92/10万~53.90/10万，AMI院前死亡构成比为73.96%~81.92%，呈平稳趋势（

The transport properties and line emissions of the intrinsic carbon in the stochastic layer of the Large Helical Device have been investigated with the three-dimensional edge transport code EMC3-EIRENE. The simulations of impurity transport and emissivity have been performed to study the dedicated experiment in which the carbon emission distributions are measured by a space-resolved EUV spectrometer system. A discrepancy of the CIV impurity emission between the measurement and simulation is obtained, which is studied with the variation of the ion thermal force, friction force and the perpendicular diffusivity in the impurity transport model. An enhanced ion thermal force or a reduced friction force in the modelling can increase the CIV impurity emission at the inboard X-point region. Furthermore, the impact of the perpendicular diffusivity Dimp is studied which shows that the CIV impurity emission pattern is very sensitive to Dimp. It is found that the simulation results with the increased Dimp tend to be closer to the experimental observation. (© 2016 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim)

From 1999 to 2015, there were 6 186 cases of leukemia deaths in tianjin residents, the males accounted for 58.28% (3 605) and 52.31% (3 236) deaths lived in urban areas; the crude mortality rate of Leukemia increased from 3.47/100 000 to 4.28/100 000 [1999—2015年天津市居民白血病死亡病例共6 186例，男性占58.28%（3605），城市地区病例占52.31%（3236）；天津市白血病死亡粗率为3.47/10万~4.28/10万，呈上升趋势[

Studies of edge plasma and impurity transport with the toroidally and poloidally localized liquid lithium limiter (LLL) on EAST have been performed by the three-dimensional (3D) edge transport code EMC3-EIRENE. The transport behavior of the Li1+ and Li2+ ions shows a non-axisymmetric distribution in the toroidal direction while an axisymmetric distribution is obtained for the Li3+ ions. The spatial structure of the charge state and excitation radiation patterns of lithium impurity can be understood by using field line tracing, which shows that the Li ions with different charge states exhibit different parallel transport behaviors. The 3D line-integrated LiII emission pattern simulated by EMC3-EIRENE shows a reasonable qualitative agreement with the experiment results measured by the CCD camera system on EAST. An unresolved issue in the LLL experiment is that the species emitting the strong visible spectrum observed around the edge plasma region cannot be distinguished by the current experimental diagnostics on EAST. The detailed numerical analysis of the carbon and deuterium emissions has been carried out to resolve this issue. The simulated deuterium emission pattern shows the same qualitative behavior as the experimental observation at the lower divertor region. The strong radiation experimentally observed at the upper divertor region is perhaps due to the mixing of the lithium and deuterium emissions.

We described the time trend of acute myocardial infarction (AMI) from 1999 to 2013 in Tianjin incidence rate with Cochran-Armitage trend (CAT) test and linear regression analysis, and the results were compared. Based on actual population, CAT test had much stronger statistical power than linear regression analysis for both overall incidence trend and age specific incidence trend (Cochran-Armitage trend采用Cochran-Armitage趋势（CAT）检验和线性回归（LR）两种统计学方法，分析天津市居民1999－2013年急性心肌梗死（AMI）发病率的时间趋势，比较两种方法结果的差别。结果显示，以实际人口为基础，无论是总的发病率时间趋势，还是按年龄分亚组后的时间趋势，CAT检验的统计效能均大于LR（CAT

Osteosarcoma (OS) is the most common type of malignant bone tumor in adults and children. Despite the great strides in biology and medicine, the survival rate of patients with metastatic disease remains very poor. This rate has been staggering with recurrence and metastasis. In the present study, we proposed Wnt/β-catenin pathway as a key biological target for the effective treatment in OS. Wnt signaling has been reported to play important roles in osteoblastogenesis. We hypothesized that docetaxel (DTX) will effectively arrest the osteosarcoma progression by suppressing the Wnt/β-catenin pathway in OS cells. Our results show that DTX significantly inhibited the cell proliferation of U2OS and SaOS-2 cancer cells in a time-dependent and dose-dependent manner. DTX inhibited the intrinsic transcriptional activity of β-catenin/Tcf in U2OS cancer cells and SaOS-2 cancer cells. GSK-3βinhibitor (SB216763) treatment remarkably increased the β-catenin/Tcf transcriptional activities. The transcriptional activities have been increased by around ~200% due to the decrease in the degradation of β-catenin mediated through GSK-3β. Summarizing, present study clearly showed that DTX inhibited Wnt/β-catenin signalling pathways and significantly reduced the matrix metallopeptodase 9 (MMP-9) protein expressions and its activity. Taken together, our findings provide novel insight on the effect of anticancer small molecules to improve the outcomes in osteosarcoma.

In this paper, we present an improved convergence analysis of full Nesterov---Todd step feasible interior-point method for semidefinite optimization, and extend it to the infeasible case. This improvement due to a sharper quadratic convergence result, which generalizes a known result in linear optimization and leads to a slightly wider neighborhood for the iterates in the feasible algorithm and for the feasibility steps in the infeasible algorithm. For both versions of the full Nesterov---Todd step interior-point methods, we derive the same order of the iteration bounds as the ones obtained in linear optimization case.

To investigate the effect of fertilization practice on dissolved organic nitrogen (DON) in aggregates, the study was conducted and involved four fertilization treatments: no fertilizer; mineral fertilizer (MF); pig manure matched with mineral fertilizer (MFP) and crop straw matched with mineral fertilizer (MFR). The results showed that DON content and storage were the highest in > 5 mm aggregates and were the lowest in 5 mm by 404.7% and 184.4%. In comparison with MFR, DON content and storage in > 5 mm aggregates for MFP were significantly enhanced by 77.5% and 75.0%. A significantly positive linear correlation relationship between DON content and microbial biomass carbon content was observed in aggregates (R-2 = 0.84; P < 0.01). The results suggest that pig manure matched with mineral fertilizer is a preferred strategy for retaining DON nutrient due to enhanced microbial biomass in aggregates on sloping upland of purple soil.

To investigate the effect of low soil pH caused by fertilization on soil available zinc in calcareous soil, this study was conducted based on a long-term experiment consisting of: (a) no fertilization (CT); (b) mineral fertilizer application coupled with 7500 kg/ha of wheat straw (WS-NPK); (c) mineral fertilizer application coupled with 3750 kg/ha of wheat straw (1/2WS-NPK); (d) mineral fertilizer application alone (NPK). Long-term fertilization results in a significant increase in soil DTPA-extractable zinc. However, the increased soil DTPA-extractable zinc is unavailable to crops and mainly confined to 0.25 mm > and 0.25 mm to 1 mm aggregates. Compared to CT, soil DTPA-extractable zinc under fertilization is more than 9.67% and 122.36% higher in 0.25 mm > and 0.25 mm to 1 mm aggregates, respectively. Furthermore, plant-available zinc in the 0–15 cm soil layer and wheat grain zinc are both significantly positive related to soil DTPA-extractable zinc in > 2 mm aggregates. Therefore, plant-available zinc in the 0–15 cm layer is closely associated with DTPA-extractable zinc in > 2 mm aggregates, and the low soil pH caused by longterm fertilization could not enhance plant-available zinc in the surface soil layer nor elevate wheat grain zinc concentration because of the occlusive effect of soil aggregates.

To investigate the effects of returning wheat straw to croplands on soil compaction and nutrient availability, this trial was designed: (1) planted crops without fertilization (NF); (2) natural land without human activities (CT); (3) applied mineral fertilizers in combination with 7500 kg/ha wheat straw (WS-NPK); (4) applied mineral fertilizers in combination with 3750 kg/ha wheat straw (1/2WS-NPK); and (5) applied mineral fertilizers alone (NPK). It is found that, compared with NPK, the soil bulk density in 1/2WS-NPK and WS-NPK both decreased by more than 10% in the 0 cm to 15 cm layer, and by 6.93% and 9.14% in the 15 cm to 20 cm, respectively. Furthermore, in contrast to NPK, the soil available nitrogen in the 0 cm to 25 cm layer in 1/2WS-NPK and WS-NPK were higher by 17.43% and 35.19%, and the soil available potassium were higher by 7.66% and 17.47%, respectively. For soil available phosphorus in the depth of 5 cm to 25 cm, it was higher by 18.51% in 1/2WS-NPK and by 56.97% in WS-NPK, respectively. Therefore, returning wheat straw to croplands effectively improves soil compaction and nutrients availability, and the improvement in soil nitrogen and phosphorus availability is closely related to the amount of wheat straw.