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Supercapacitors are widely used in electronic systems as energy storage devices. The fabrication of a miniaturized supercapacitor with high specific capacitance has attracted much attention in recent years. Here, we propose a new method to fabricate supercapacitors with a nanoscale electrode gap by using a femtosecond laser. The original femtosecond laser was converted to a nondiffraction Bessel light field with nanoscale beam width and microscale focal depth. Nanoscale processing precision was achieved by regulating the Bessel beam. We fabricated graphene supercapacitors with different electrode gap widths (varying from the microscale to the nanoscale) using this method. Supercapacitors fabricated by this method have advantages in both size miniaturization (electrode gap width down to ∼500 nm) and electrochemical performance improvement (a specific volumetric capacitance of 195 F/cm

Objective: This study compared the clinical effects of two different lipid emulsions in premature infants with gestational age < 32 weeks (VPI) or birth weight < 1500 g (VLBWI) to provide an evidence-based medicine basis for optimizing intravenous lipid emulsion. Methods: This was a prospective multicenter randomized controlled study. A total of 465 VPIs or VLBWIs, admitted to the neonatal intensive care unit of five tertiary hospitals in China from March 1, 2021 to December 31, 2021, were recruited. All subjects were randomly allocated into two groups, namely, medium-chain triglycerides/long-chain triglycerides (MCT/LCT) group (n = 231) and soybean oil, medium-chain triglycerides, olive oil, and fish oil (SMOF) group (n = 234). The two groups were compared for clinical features, biochemical indexes, nutrition support therapy, and complications. Results: No significant differences were found in perinatal data, hospitalization, parenteral and enteral nutrition support between the two groups (P > 0.05). Compared with the MCT/LCT group, the peak value of total bilirubin (TB) > 5 mg/dL (84/231 [36.4% vs. 60/234 [25.6%]), the peak value of direct bilirubin (DB) ≥ 2 mg/dL (26/231 [11.3% vs. 14/234 [6.0%]), the peak value of alkaline phosphatase (ALP) > 900 IU/L (17/231 [7.4% vs. 7/234 [3.0%]), and the peak value of triglycerides (TG) > 3.4 mmol/L (13/231 [36.4% vs. 60/234 [25.6%]) were lower in the SMOF group (P < 0.05). Univariate analysis showed that in the subgroup analysis of < 28 weeks, the incidence of parenteral nutrition-associated cholestasis (PNAC) and metabolic bone disease of prematurity (MBDP) were lower in the SMOF group (P = 0.043 and 0.029, respectively), whereas no significant differences were present in the incidence of PNAC and MBDP between the two groups at > 28 weeks group (P = 0.177 and 0.991, respectively). Multivariate logistic regression analysis revealed that the incidence of PNAC (aRR: 0.38, 95% confidence interval [CI]: 0.20–0.70, P = 0.002) and MBDP (aRR: 0.12, 95% CI: 0.19–0.81, P = 0.029) in the SMOF group were lower than that in the MCT/LCT group. In addition, no significant differences were recorded in the incidence of patent ductus arteriosus, feeding intolerance, necrotizing enterocolitis (Bell’s stage ≥ 2), late-onset sepsis, bronchopulmonary dysplasia, intraventricular hemorrhage, periventricular leukomalacia, retinopathy of prematurity and extrauterine growth retardation between the two groups (P > 0.05). Conclusions: The application of multi-oil fat emulsion in VPI or VLBWI can reduce the risk of plasma TB > 5 mg/dL, DB ≥ 2 mg/dL, ALP > 900 IU/L, and TG > 3.4 mmol/L during hospitalization. SMOF has better lipid tolerance, reduces the incidence of PNAC and MBDP, and exerts more benefits in preterm infants with gestational age < 28 weeks.

To investigate the risk profile of preterm birth (PTB) in 2018 in China.A prospective multicentre case-control study was conducted in 15 hospitals located in seven provinces throughout three geographical areas (the Eastern, South-Central and North-Western regions) in China. A total of 3147 preterm (37Iatrogenic PTB accounted for 48.1% of preterm mothers. Multivariable analysis showed PTB was significantly associated with six categories of maternal and fetal factors, adverse life-style and psychological conditions (adjusted odds ratio (aOR) 2.063, 95% confidence interval (CI) 1.601-2.657) had the highest PAR% (60.1%). High school and below education level (PAR% = 25.8%), living in town or village (PAR% = 24.4%), low pregnant weight gain (PAR% = 16.8%), hypertensive disorders in pregnancy (aOR: 5.010, 95% CI: 4.039-6.216, PAR% = 15.3%), placental abnormality (aOR: 4.242, 95% CI: 3.454-5.211, PAR% = 14.1%) and multiple pregnancy (aOR: 10.990, 95% CI: 7.743-15.599, PAR% = 11.8%) were significantly associated with PTB with high PAR% value.The main risk factors for PTB in China were placental abnormality, hypertensive disorders in pregnancy and multiple pregnancy. Adverse life-style and psychological conditions and socio-economic disadvantage had high public health significance.

Background Group B streptococcus (GBS)-induced invasive disease is a major cause of illness and death among infants aged under 90 days in China; however, invasive GBS infection remains unknown in China. We aimed to describe the serotype and genotype distributions of early-onset disease (EOD) and late-onset disease (LOD), and to show the clinical correlations among various GBS serotypes and genotypes obtained from infants with invasive GBS infections. Methods Between June 1, 2016 and June 1, 2018, 84 GBS strains were collected from patients younger than 90 days at seven Chinese hospitals. Clinical data were retrospectively reviewed. GBS serotyping was conducted and multi-locus sequence typing was performed. Results Serotypes Ia, Ib, II, III, and V were detected. Serotype III (60.71%) was the most common, followed by Ia (16.67%) and Ib (14.29%). Intrapartum temperature ≥ 37.5 °C, chorioamnionitis, and mortality were noted in 28.57, 42.86, and 28.57% of patients with serotype Ia, respectively, and these rates were higher than those in patients with serotypes Ib and III (P = 0.041, P = 0.031, and P = 0.023, respectively). The incidence of respiratory distress was lower (P = 0.039) while that of purulent meningitis was higher (P = 0.026) in the serotype III group. Eighteen sequence types were detected among isolates, and ST17 [42.86% (36/84)] was the most prevalent. Conclusions GBS isolates belonging to serotypes Ia, Ib, and III are common in southern mainland China, and ST17 is highly prevalent. Differences were found in the clinical manifestations of invasive GBS disease induced by serotypes Ia and III.

Introduction Kawasaki disease (KD) is an acute febrile and eruptive disease with systemic vasculitis of unknown etiology presenting predominantly in early childhood, most commonly in those under 5 years old. Although KD has been reported in almost all populations, it is especially common in North East Asia such as Japan, Korea and Taiwan which has the highest incidence worldwide that in contrast to the US, Europe and Australia. It is reported that more than 1 in 100 Japanese have had KD by 12 years of age. KD is a potentially life-threatening condition because it can cause serious pediatric-acquired heart disease such as asymptomatic coronary artery ectasia or an aneurysm. Intravenous immunoglobulin (IVIG) is a routine and effective treatment for KD and significantly reduces risk of coronary artery abnormalities during the acute phase of illness from approximately 15%–25% to 5%–8%. In spite of its effectiveness, some patient do not respond to this therapy and still develop coronary aneurysms. Chinese herbal medicine (CHM) as a therapy alone for KD was rare. The success of this patient with KD treated by CHM provided a new way of thinking for harmonizing Eastern-Western drug for KD and the potential utilization of CHM as a source of new drugs could be an alternative. Clinical features and outcome A 17 month-old boy suffered from persistent fever, poor appetite, vomiting diarrhea, slight cough, running nose and throat congestion for 2 days and was diagnosed with an upper respiratory infection. He had taken cefprozil suspension plus ankahuangmin 2 days for his symptoms before his final diagnosis of KD, but it was unsuccessful. He continued to have a fever, in addition, he presented with bilateral bulbar conjunctival congestion without exudate, labial and lingual erythema and was diagnosed with KD before his first CHM visit, his parents refused to continue receiving Western medicine. Therefore, his parents sought CHM for further intervention. His symptoms subsided, and the blood tests, electrocardiogram (ECG) and echocardiographies show completely normal after regular therapy with Xiao Chai Hu Tang (小柴胡汤) combined with Bu Yang Huan Wu Tang (补阳还五汤), Huang Lian Jie Du Tang (黄连解毒汤), and Wu Ling San (五苓散) for approximately 21 days. Neither complications nor side-effects were noted during the CHM treatment. Conclusions In this case, CHM may be an effective alternative therapy for the treatment of KD, and furthermore, may also be applied as an option to salvage failed intravenous immunoglobulin procedures. Further controlled trials are warranted to determine whether this is an effective treatment option for other cases of KD.

Paired-like homeobox (PHOX)2B is considered to be the causative gene of congenital central hypoventilation syndrome (CCHS), a dominant genetic disorder that results in abnormal central respiratory ...

Background: As no population-based studies of group B Streptococcus (GBS) colonization rates in late pregnancy (at 35–37 weeks of gestation) have been conducted in China, the incidence of and risk factors for neonatal early-onset GBS disease (GBS-EOD) in China remains poorly understood. Objectives: To determine the GBS colonization rate in late pregnancy and neonatal GBS infection in Xiamen, China, and to assess the effectiveness of intrapartum antibiotic prophylaxis (IAP) for the prevention of neonatal GBS-EOD. Methods: A total of 49,908 pregnant women were enrolled between April 1, 2014 and March 31, 2017. Bacterial culture was used to diagnose GBS infection in both pregnant women and neonates. Women with GBS colonization received IAP during parturition or rupture of fetal membranes. Results: The GBS colonization rate was 13.89% (6,933/49,908); 50,772 neonates were born to 49,908 pregnant women, of whom 75 (1.48 per 1,000) were diagnosed with GBS-EOD. The incidence of GBS-EOD among neonates born to GBS-positive mothers (8.77‰; 62/7,068) was 29 times higher than that of neonates born to GBS-negative mothers (0.30‰; 13/43,704). Logistic regression analysis indicated that gestational bacteriuria, GBS disease in infants from previous pregnancies, and chorioamnionitis were risk factors for GBS-EOD (p = 0.007, p = 0.000, and p = 0.018, respectively). IAP effectively protected against neonatal GBS-EOD (p = 0.011). Conclusions: GBS colonization was detected in nearly 14% of late pregnant women. The IAP for reducing GBS-EOD was effective. Therefore, universal screening of maternal GBS and subsequent IAP for those with GBS colonization should be implemented in China.

Background Escherichia coli (E. coli) is one of the important causative pathogens of neonatal invasive infection. The epidemiological and clinical profile of invasive E. coli infection in Chinese newborns is not well characterized. Methods Ninety-four infants with invasive E. coli infection were categorized into E. coli early onset disease (EOD) group (onset ≤72 h after birth) (n = 46) and E. coli late onset disease (LOD) group (onset > 72 h) (n = 48). We compared and analyzed the clinical characteristics and drug sensitivity profile of early-onset and late-onset E. coli invasive infection in neonates. Results The incidence of E. coli-EOD and E.coli-LOD was 0.45/1000 live births (LBs) and 0.47/1000 LBs, respectively. The incidence of gestational diabetes mellitus, perinatal fever, urinary tract infection, chorioamnionitis, and positive E. coli culture among mothers in the E. coli-EOD group were significantly higher than that in E. coli-LOD group. The incidence of premature birth, low-birth-weight, nosocomial infection, and hospitalization time were significantly higher in the E. coli-LOD group. The main disease in E. coli-EOD group was pneumonia (main clinical manifestation: dyspnea). The main disease in E. coli-LOD group was sepsis (main clinical manifestation: fever). The sensitivity rates of E. coli strains to ampicillin and piperacillin were low (25.00–28.79%); sensitivity to cephalosporins was also low except ceftazidime (lowest sensitivity rate: 57.14%). Sensitivity to compound preparations containing β-lactamase inhibitors was high, even for extended spectrum β-lactamase-positive strains (nearly 100%). Conclusion E. coli is an important cause of invasive infection of newborns in Xiamen, China. E. coli-EOD was largely attributable to perinatal factors, while E. coli-LOD was largely related to nosocomial infection. Compound preparations containing β-lactamase inhibitor or carbapenem antibiotics should be preferred for neonatal invasive infection by E. coli.

This study is aimed at exploring the effect of pulmonary surfactant (PS) combined with noninvasive positive pressure ventilation on the levels of Keratin-14 (KRT-14) and Endothelin-1 (ET-1) in peripheral blood and the therapeutic effect of neonatal respiratory distress syndrome (NRDS). Altogether 137 cases of neonates with respiratory distress syndrome treated in our hospital from April 2016 to July 2018 were collected. Among them, 64 cases treated with noninvasive positive pressure ventilation were considered as the control group, and 73 cases treated with PS combined with noninvasive positive pressure ventilation were considered as the observation group. The expression of KRT-14 and ET-1 in the two groups was compared. The therapeutic effect, death, complications, and blood gas indexes PaO2, PaCO2, and PaO2/FiO2 in the two groups were compared. Receiver operating characteristic curve (ROC) was applied to analyze the diagnostic value of KRT-14 and ET-1 in the therapeutic effect of NRDS. The effective rate of the observation group was higher than that of the control group. After treatment, PaO2 and PaO2/FiO2 in both groups were notably higher than that before treatment, while PaCO2 was notably lower than that before treatment. And after treatment, the levels of PaO2 and PaO2/FiO2 in the observation group were remarkably higher than that in the control group; PaCO2 was notably lower than that in the control group. After treatment, the levels of KRT-14 and ET-1 in the two groups were remarkably lower than those before treatment, and the levels of KRT-14 and ET-1 in the observation group were considerably lower than those in the control group after treatment. ROC curve showed that the area under the curve (AUC) of KRT-14 was 0.791, and the AUC of ET-1 was 0.816. PS combined with noninvasive positive pressure ventilation can notably improve the therapeutic effect of NRDS. KRT-14 and ET-1 levels may be potential therapeutic diagnostic indicators.

Background: To investigate the current situation of neonatal care resources (NCR), newborn mortality rates (NMR), regional differences and existing challenges in China. Methods: By using a self-designed questionnaire form and the cross-sectional method, we conducted a survey of all hospitals equipped with neonatal facilities in China from March 2019 to March 2020 with respect to the level and nature of these hospitals, the number of newborn beds and NICU beds, the number of neonatal pediatricians, and the development of therapeutic techniques. The data about the newborn births and deaths were retrieved from the annual statistics of the health commissions of the related provinces, autonomous regions and municipalities. Finding: Included in this nationwide survey were 3,020 hospitals from all 22 provinces, 5 autonomous regions and 4 municipalities directly under the Central Government of Mainland China, with a 100% response rate. They included 1,183 (39.2%) level-3 (L3) hospitals, 1629 (53.9%) L-2 hospitals and 208 (6.9%) L-1 hospitals. Geographically, 848 (31.4%) hospitals were distributed in Central China, 983 (32.5%) hospitals in East China, and 1,089 (36.1%) in West China. The 3,020 included hospitals were altogether equipped with 75,679 newborn beds, with a median of 20 (2-350) beds, of which 2,286 hospitals (75.7%) were equipped with neonatal intensive care units (NICU), totaling 28,076 NICU beds with a median of 5 (1-160) beds. There were altogether 27,698 neonatal pediatricians in these hospitals, with an overall doctor-bed ratio of 0.366. There were 48.18 newborn beds and 17.87 NICU beds per 10,000 new births in China. In East, Central and West China, the number of neonatal beds, NICU beds, neonatal pediatricians, and attending pediatricians or pediatricians with higher professional titles per 10,000 newborns was 42.57, 48.64 and 55.67; 17.07, 18.66 and 18.17; 16.26, 16.51 and 20.81; and 10.69, 10.81 and 11.29, respectively. However, when the population and area are taken into consideration and according to the health resources density index (HRDI), the number of newborn beds, NICU beds and neonatal pediatricians in West China was significantly lower than that in Central and East China. In addition, only 10.64% of the neonatal pediatricians in West China possessed the Master or higher degrees, vs. 31.7% in East China and 20.14% in Central China. On the contrary, the number of neonatal pediatricians with a lower than Bachelor degree in West China was significantly higher than that in Central and East China (13.28% vs. 7.36% and 4.28%). Technically, the application rate of continuous positive airway pressure (CPAP) and conventional mechanical ventilation (CMV) in L-1 hospitals of West China was lower than that in Central and East China. According to the statistics in 2018, the newborn mortality rate (NMR) in West China was significantly higher than that in Central and East China. Interpretation: China has already possessed relatively good resources for neonatal care and treatment, which is the primary reason for the rapid decrease in the NMR in China. However, there are still substantial regional differences. The density of health resources, the level of technical development and educational background of neonatal pediatricians in West China still lag behind those in other regions of China and need to be further improved and upgraded. Funding: This research work was funded by National Natural Science Foundation of China (81671504) and United Nations International Children's Emergency Fund (CHINA-UNICEF501MCH). 【摘要】: 目的 了解中国新生儿救治资源及新生儿死亡率现状,地区差异及存在的挑战.方法 2019年3月至2020年3月, 设计调查表格, 采取横断面调查方式, 对全国设置有新生儿床位的医院进行调查, 内容包括医院级别,性质,新生儿床位,NICU床位数,新生儿医师数量及救治技术开展情况等.新生儿出生数和死亡率来源于各省卫生健康委年度统计数据.结果 共纳入除港澳台地区外全国31个省3020家医院, 反馈率100%, 其中三级医院1183家 (39.2%), 二级医院1629家 (53.9%), 一级医院208家 (6.9%) .按地区分布, 中部地区948家 (31.4%), 东部983家 (32.5%), 西部1089家 (36.1%) .3020家医院共有新生儿床位75679张, 床位中位数20张 (2-350张), 其中2286家 (75.7%) 医院设置有NICU床位共28076张, NICU床位中位数为5张 (1-160张), 共拥有新生儿科医师27698人, 总医/床比为0.366.全国每万名出生新生儿拥有新生儿床位48.18张, 其中NICU床位17.87张.东部,中部,西部每万名出生新生儿拥有新生儿床位数分别为42.57张,48.64张和55.67张, 其中NICU床位分别为17.07张, 18.66张和18.17张, 拥有新生儿科医师分别为16.26人,16.51人和20.81人, 其中主治医师以上分别为10.69人,10.81人和11.29人.但如考虑到人口和面积, 按HRDI指数计算, 西部地区新生儿床位,NICU床位及新生儿科医师人数仍明显低于东,中部地区.且西部地区新生儿科医师中拥有硕士以上学历者仅10.64%, 明显低于东部 (31.7%) 和中部 (20.14%), 而本科以下学历比例为13.28%, 远高于东部 (4.28%) 和中部地区 (7.36%) .从技术开展情况看, 西部地区一级医院在CPAP,常频通气等技术开展率低于东,中部地区.西部地区2018年新生儿死亡率也明显低于东,中部地区.结论 中国已拥有较好的新生儿医疗救治资源, 这是新生儿死亡率得以迅速下降的基础.但地区差异仍较大, 西部地区卫生资源密度,技术发展水平和医师学历仍相对滞后, 需要进一步加强.

To construct the index system of influencing factors for the successful implementation of ERP system and identify the key influencing factors and their ranking, so as to provide factor reference and policy guidance for the practice process of the implementation of ERP system in the manufacturing industry. In the successful implementation of ERP published five years related text using Nvivo software on the basis of objective data, using qualitative research method of grounded theory to level 3 codes, to build index system of ERP system implementation success factors, and applied to decision making and laboratory (DEMATEL) algorithm to determine important degree of the factors affecting the successful implementation of ERP system. From the four levels of organization, personnel, technology and environment, 13 related indexes were constructed to influence the successful implementation of ERP system, and the key factors were identified: the strength of management support, the level of institutional management, the quality of the system, the strategic literacy level and the strength of education and training. The construction of index system of ERP system implementation success factors from the perspective of exploratory excavation and improve the ERP system online implementation of intrinsic connection between the relevant factors in the process perfects in on-line implementation and maintenance for manufacturing ERP system to provide the reference in the process of theoretical basis, so as to improve the success rate of enterprise implement ERP and provides relevant policy suggestions and reference.

Symptom diagnosis is a challenging yet profound problem in natural language processing. Most previous research focus on investigating the standard electronic medical records for symptom diagnosis, while the dialogues between doctors and patients that contain more rich information are not well studied. In this paper, we first construct a dialogue symptom diagnosis dataset based on an online medical forum with a large amount of dialogues between patients and doctors. Then, we provide some benchmark models on this dataset to boost the research of dialogue symptom diagnosis. In order to further enhance the performance of symptom diagnosis over dialogues, we propose a global attention mechanism to capture more symptom related information, and build a symptom graph to model the associations between symptoms rather than treating each symptom independently. Experimental results show that both the global attention and symptom graph are effective to boost dialogue symptom diagnosis. In particular, our proposed model achieves the state-of-the-art performance on the constructed dataset.

Paired-like homeobox (PHOX)2B is considered to be the causative gene of congenital central hypoventilation syndrome (CCHS), a dominant genetic disorder that results in abnormal central respiratory control with resulting hypoventilation during sleep. In this study, we report a novel c.676_677insG (p.Ala226fs) mutation in a patient with severe CCHS, and we evaluated the function of this mutation. The mutation reduced the translation of the mutant PHOX2B protein and impaired its ability to activate the PHOX2A promoter, due to a haploinsufficiency effect. The mutant PHOX2B was able to interact with wildtype PHOX2B, resulting in retention of PHOX2B on the nuclear membrane, which may impair the normal function of the nuclear membrane, and leading to cellular morbidity. Our study provides useful information for the functional studies of PHOX2B and understanding the pathogenesis of CCHS, and thus is beneficial for the prognosis of, genetic counseling for, and development of pharmaceuticals for PHOX2B-associated diseases. CITATION: Ye G, Han D, Jiang Y, Wang Z, Zhou Y, Lin X, Chen W, Chen M, Xu J, Yang Y, Guo Q. A novel c.676_677insG PHOX2B mutation in congenital central hypoventilation syndrome. J Clin Sleep Med. 2019;15(3):509–513.

OBJECTIVES: We retrospectively investigated incidence, morbidity, and mortality of neonatal respiratory failure (NRF) in China, with special emphasis on surfactant treated very immature infants. METHODS: NRF was defined as respiratory hypoxemia requiring mechanical ventilation and/or nasal continuous positive airway pressure for at least 24 hours. RESULTS: There were 6864 cases of NRF, composing 19.7% of total admissions to 55 NICUs in 2008. Of these cases, 62.8% were preterm, and 16.4% of very low birth weight (VLBW

This experimental study was designed to explore the possible mechanisms of Cariporide, a kind of Na+/H+ exchanger inhibitor, for protecting the lung from warm ischemia/reperfusion injury (WI/RI) of isolated rat lung model. Thirty isolated rat lungs were established on the Langendorff apparatus and randomly divided to three groups (n = 10, each): control group (C group), ischemia/reperfusion group (IR group) and Cariporide group (CP group). Mean pulmonary artery pressure (MPAP) and peak airway pressure (pAwP) were monitored continuously. At the end of reperfusion, right bronchoalveolar lavage was performed, bronchoalveolar lavage fluid (BALF) recovery rate (BALFRR) was recorded, and protein content in BALF was measured. Lung water content (LWC), malondialdehyde (MDA) and superoxide dismutase (SOD)of left lung tissue were measured; histomorphology evaluation was performed under light microscope and transmission electron microscope. In comparison with the data from IR group, BALF protein concentration, LWC, MDA content and MPAP content of reperfusion were significantly decreased, but SOD activity was increased in CP group. Histomorphologic feature also showed that pathological change significantly reduced in CP group. In this rat WI/RI model, the mechanism by which the selective Na+/H+ exchanger inhibitor (Cariporide) attenuates lipid peroxidation induced by WI/IR may be: preventing Ca2+ overload via inhibiting the transport of Na+/H2 exchanger-1 (NHE1) in the context of the coupled exchanger, thereby reducing the activation of xanthine oxidase pathway and oxygen free radical liberation which is dependent on certain intracellular Ca2+ concentration, and lastly promoting the endogenous antioxidative mechanism.