Heterogeneous semiconductor photocatalysis is a promising green technology solution to energyand environmental problems.Traditional photocatalyst TiO2,with a wide band gap of3.2eV,canonly be excited by UV light and ut...Heterogeneous semiconductor photocatalysis is a promising green technology solution to energyand environmental problems.Traditional photocatalyst TiO2,with a wide band gap of3.2eV,canonly be excited by UV light and utilizes less than4%of solar energy.Silver phosphate(Ag3PO4)isamong the most active visible‐light‐driven photocatalysts reported.Unfortunately,unwanted photocorrosionis the main obstacle to the practical application of Ag3PO4.Much effort has been made inrecent years to address this issue and further enhance the photocatalytic performance of Ag3PO4.The construction of Z‐scheme photocatalytic systems that mimic natural photosynthesis is a promisingstrategy to improve the photocatalytic activity and stability of Ag3PO4.This brief review conciselysummarizes and highlights recent research progress in Ag3PO4‐based all‐solid‐state Z‐schemephotocatalytic systems with or without a solid‐state electron mediator,focusing on their construction,application,and reaction mechanism.Furthermore,the challenges and future prospects ofAg3PO4‐based Z‐scheme photocatalytic systems are discussed.展开更多
As a basic industry,agriculture has a far-reaching impact on national economy. Based on input-output tables of China in 2005 and2010,this paper gives a deep insight into the relationship between agriculture and nation...As a basic industry,agriculture has a far-reaching impact on national economy. Based on input-output tables of China in 2005 and2010,this paper gives a deep insight into the relationship between agriculture and national economy and its macroeconomic effects by the methods of input-output analysis,industrial correlation and macroeconomic effect analysis. The results show that the agricultural development is highly dependent on the national economy,but makes low contribution; agriculture contributes to promoting employment and improving the structure of national income distribution; despite the government's tax incentive,the agricultural equipments are updated slowly,and the corporate profits are at low level; agricultural export effect is far below the average industry level,but the import effect increases over the years,and final products are often used for domestic consumption. Finally,we set forth recommendations for improving the development of agriculture and national economy.展开更多
ZnO/TiO_(2)composites were synthesized by using the solvothermal method and ultrasonic precipitation followed by heat treatment in order to investigate their photocatalytic degradation of methyl orange(MO)in aqueous s...ZnO/TiO_(2)composites were synthesized by using the solvothermal method and ultrasonic precipitation followed by heat treatment in order to investigate their photocatalytic degradation of methyl orange(MO)in aqueous suspension under UV irradiation.The composition and surface structure of the catalyst were characterized by X-ray diffraction(XRD),field emission scanning electron microscope(FE-SEM),and transmission electron microscopy(TEM).The degradation efficiencies of MO at various pH values were obtained.The highest degradation efficiencies were obtained before 30 min and after 60 min at pH 11.0 and pH 2.0,respectively.A sample analysis was conducted using liquid chromatography coupled with electrospray ionization ion-trap mass spectrometry.Six intermediates were found during the photocatalytic degradation process of quinonoid MO.The degradation pathway of quinonoid MO was also proposed.展开更多
Importance:The safety and efficacy of the bath-plug technique for the closure of cerebrospinal fluid(CSF)leaks in children remain unknown.Objective:We undertook this study to ascertain whether the bath-plug technique ...Importance:The safety and efficacy of the bath-plug technique for the closure of cerebrospinal fluid(CSF)leaks in children remain unknown.Objective:We undertook this study to ascertain whether the bath-plug technique was safe and effective for the repair of CSF leaks.Methods:We retrospectively reviewed patients who underwent endoscopic repair of CSF leaks with the fat graft as a plug-in at Beijing Children’s Hospital from March 2016 to May 2020.Demographic data,medical history,defect sites and sizes,interventions,and clinical outcomes were analyzed.One representative clinical case was additionally selected to highlight the procedure and the healing process.Results:A total of 18 pediatric patients were included in this study.The group was composed of 11 boys and seven girls,aged from 5 to 123 months.The etiologies included congenital CSF leaks(n=9)and head trauma(n=9).Among all patients,12 fistulas(66.7%)were located at the cribriform plate area,two(11.1%)at the roof of the ethmoid sinuses,two(11.1%)in the sphenoid sinus,and two(11.1%)at the frontal sinus.The maximum diameters of fistulas ranged from 5 to 20 mm,with a median value of 8 mm.Encephaloceles were identified in 14(77.8%)patients.No hydrocephalus was recognized.All CSF leaks were successfully repaired with a bath-plug technique.Follow-up ranged from 50 to 70 months.No surgical complications were encountered in any patient.Interpretation:Bath-plug technique is safe and reliable for the endoscopic management of CSF leaks in children.Meticulous peri-operative preparations are important for pediatric patients.展开更多
Introduction:Rosai-Dorfman disease(RDD)is an uncommon,benign,and idiopathic histiocytic proliferative disorder.Multiple intracranial RDD is extremely rare and treatment varies.Case presentation:A 9-year-old girl was a...Introduction:Rosai-Dorfman disease(RDD)is an uncommon,benign,and idiopathic histiocytic proliferative disorder.Multiple intracranial RDD is extremely rare and treatment varies.Case presentation:A 9-year-old girl was admitted with 3-month history of blurred vision and facial paralysis,a 2-month history of recurrent giggle,and cognitive impairment.Computed tomography and magnetic resonance imaging scans revealed bilateral ventricular masses based on the dural membrane and the diameters of the masses were 9.1 cm and 9.2 cm,respectively.The lesions were completely removed with staging surgeries.Fifteen months after operation,blurred vision was still present but facial paralysis and giggle and cognitive impairment disappeared.Imaging examinations suggested that there were no new or recurring lesions.Conclusion:For multiple large intracranial masses,surgical treatment is necessary and staged surgery benefits perioperative safety.Active follow-up with magnetic resonance imaging is necessary.展开更多
Importance:Medulloblastoma(MB)is the most common malignant brain tumor in children,with metastasis being the primary cause of recurrence and mortality.The tumor microenvironment(TME)plays a critical role in driving me...Importance:Medulloblastoma(MB)is the most common malignant brain tumor in children,with metastasis being the primary cause of recurrence and mortality.The tumor microenvironment(TME)plays a critical role in driving metastasis;however,the mechanisms underlying TME alterations in MB metastasis remain poorly understood.Objective:To develop and validate machine learning(ML)models for predicting patient outcomes in MB and to investigate the role of TME components,particularly immune cells and immunoregulatory molecules,in metastasis.Methods:ML models were constructed and validated to predict prognosis and metastasis in MB patients.Eight algorithms were evaluated,and the optimal model was selected.Lasso regression was employed for feature selection,and SHapley Additive exPlanations values were used to interpret the contribution of individual features to model predictions.Immune cell infiltration in tumor tissues was quantified using the microenvironment cell populations-counter method,and immunohistochemistry was applied to analyze the expression and distribution of specific proteins in tumor tissues.Results:The ML models identified metastasis as the strongest predictor of poor prognosis in MB patients,with significantly worse survival outcomes observed in metastatic cases.High infiltration of CD8+T cells and cytotoxic T lymphocytes(CTLs),along with elevated expression of the TGFB1 gene encoding transforming growth factor beta 1(TGF-β1),were strongly associated with metastasis.Independent transcriptomic and immunohistochemical analyses confirmed significantly higher CD8+T cell/CTL infiltration and TGF-β1 expression in metastatic compared to nonmetastatic MB samples.Patients with both high CD8+T cell/CTL infiltration and elevated TGFB1 expression in the context of metastasis exhibited significantly worse survival outcomes compared to patients with low expression and no metastasis.Interpretation:This study identifies metastasis as the key prognostic factor in MB and reveals the pivotal roles of CD8+T cells,CTLs,and TGF-β1 within the TME in promoting metastasis and poor outcomes.These findings provide a foundation for developing future therapeutic strategies targeting the TME to improve MB patient outcomes.展开更多
Background：Over past two decades,vagus nerve stimulation （VNS） has been widely used and reported to alleviate seizure frequency worldwide,however,so far,only hundreds of patients with pharmaco-resistant epilepsy （...Background：Over past two decades,vagus nerve stimulation （VNS） has been widely used and reported to alleviate seizure frequency worldwide,however,so far,only hundreds of patients with pharmaco-resistant epilepsy （PRE） have been treated with VNS in China's Mainland.The study aimed to evaluate the effectiveness of VNS for Chinese patients with PRE and compare its relationship with age cohort and gender.Methods：We retrospectively assessed the clinical outcome of 94 patients with PRE,who were treated with VNS at Beijing Fengtai Hospital and Beij ing Tiantan Hospital between November 2008 and April 2014 from our database of 106 consecutive patients.The clinical data analysis was retrospectively examined.Results：Seizure frequency significantly decreased with VNS therapy after intermittent stimulation of the vagus nerve.At last follow-up,we found McHugh classifications of Class Ⅰ in 33 patients （35.1％）,Class Ⅱ in 27 patients （28.7％）,Class Ⅲ in 20 patients （21.3％）,Class Ⅳ in 3 patients （3.2％）,and Class Ⅴ in 11 patients （l 1.7％）.Notably,8 （8.5％） patients were seizure-free while ≥50％ seizure frequency reduction occurred in as many as 60 patients （63.8％）.Furthermore,with regard to the modified Engel classification,12 patients （12.8％） were classified as Class Ⅰ,l l patients （11.7％） were classified as Class Ⅱ,37 patients （39.4％） were classified as Class Ⅲ,34 patients （36.2％） were classified as Class Ⅳ.We also found that the factors of gender or age are not associated with clinical outcome.Conclusions：This comparative study confirmed that VNS is a safe,well-tolerated,and effective treatment for Chinese PRE patients.VNS reduced the seizure frequency regardless of age or gender of studied patients.展开更多
Importance:Neuroblastoma is the most common extracranial malignant solid tumor in children.Multidisciplinary care is critical to improving the survival of pediatric patients with neuroblastoma.Objective:To systematica...Importance:Neuroblastoma is the most common extracranial malignant solid tumor in children.Multidisciplinary care is critical to improving the survival of pediatric patients with neuroblastoma.Objective:To systematically summarize the clinical characteristics of children with neuroblastoma and evaluate their prognosis with multidisciplinary care provided in a single center.Methods:This retrospective study analyzed the clinical data of 1041 patients with neuroblastoma who were diagnosed,treated,and followed-up in the Hematology-Oncology Center of Beijing Children’s Hospital from 2007 to 2019.Results:The median age at diagnosis was 34 months;80.8%of the patients were younger than 5 years of age.Notably,243 patients(23.3%)were classified as low-risk,249 patients(23.9%)were classified as intermediate-risk,and 549(52.7%)were classified as high-risk.Furthermore,956 patients underwent surgical resections;986(94.7%)patients received chemotherapy;and 176 patients with high-risk neuroblastoma received hematopoietic stem cell transplantation.The 5-year event-free survival(EFS)rate was 91.3%and 5-year overall survival(OS)rate was 97.5%in low-risk group;in the intermediate-risk group,these rates were 85.1%and 96.7%,respectively,while they were 37.7%and 48.9%in the high-risk group(P<0.001 for both).The 5-year EFS and OS rates were significantly higher in patients diagnosed between 2015 and 2019 than in patients diagnosed between 2007 and 2014(P<0.001).In total,278 patients(26.7%)exhibited tumor relapse or progression;the median interval until relapse or progression was 14 months.Of the 233 patients who died,83%died of relapse or progression of neuroblastoma and 4.3%died of therapy-related complications.Interpretation:The 5-year OS rate was low in high-risk patients,compared with low-and intermediate-risk patients.Multidisciplinary care is critical for improvement of survival in pediatric patients with neuroblastoma.Additional treatment strategies should be sought to improve the prognosis of patients with high-risk neuroblastoma.展开更多
Importance:Cancer is the main cause of death by disease in children.Children experience the highest incidence of cancer in the first year of life.However,there is no comprehensive registration system for children with...Importance:Cancer is the main cause of death by disease in children.Children experience the highest incidence of cancer in the first year of life.However,there is no comprehensive registration system for children with tumors in China.Objective:To summarize the diagnosis and treatment of infant cancer and analyze the status of standardized diagnosis and management among several treatment centers in Beijing,China,thereby providing evidence to guide further clinical research.Methods:From January 1,2010 to December 31,2019,patients with newly diagnosed infantile malignant solid tumors were admitted to six large tertiary pediatric solid tumor diagnosis and treatment centers in Beijing.The epidemiology,clinical features,and therapeutic effects of tumors in these patients were analyzed retrospectively.All patients were followed up until March 31,2020.Results:In total,938 patients were enrolled in this study.There were 530 boys(56.5%)and 408 girls(43.5%);the median age was 6.0 months(range,0-12.0 months).The three most common tumors were retinoblastoma in 366 patients(39.0%),neuroblastoma in 266 patients(28.4%),hepatoblastoma in 133 patients(14.2%),and central nervous system tumors in 52 patients(5.5%).The estimated 5-year overall survival rate was 81.3%±1.8%,and the 5-year event-free survival rate was 71.8%±2.9%.The 5-year overall survival rates of non-rhabdomyosarcoma soft tissue sarcoma,neuroblastoma,and retinoblastoma were 100%,88%±2.2%,and 86.9%±2.1%,respectively.The 5-year event-free survival rates were 81.1%±2.7%for neuroblastoma,81.6%±9.8%for non-rhabdomyosarcoma soft tissue sarcoma,and 72.7%±14.1%for extracranial malignant germ cell tumors.Interpretation:The three most common infantile malignant solid tumors were retinoblastoma,neuroblastoma,and hepatoblastoma.Multidisciplinary combined diagnosis and treatment is needed for infantile tumors.展开更多
To the editor:A 6-month-old girl presented with poor appetite but no vomiting or other gastrointestinal symptom.There was no significant increase in her body weight for 2 months.Her birth weight was 3.4 kg.She also ha...To the editor:A 6-month-old girl presented with poor appetite but no vomiting or other gastrointestinal symptom.There was no significant increase in her body weight for 2 months.Her birth weight was 3.4 kg.She also had horizontal nystagmus 2 days before her initial visit.Physical examination showed that the patient had bilateral horizontal nystagmus and left esotropia.Poor visual acuity was found on the left side.展开更多
Background:Pleural-subarachnoid fistula(PSF)is a rare disease that is difficult to diagnose and treat.Secondary intracranial hypertension and the treatment are seldom mentioned previously among PSF.Case presentation:A...Background:Pleural-subarachnoid fistula(PSF)is a rare disease that is difficult to diagnose and treat.Secondary intracranial hypertension and the treatment are seldom mentioned previously among PSF.Case presentation:A 1-year-old boy diagnosed PSF developed into secondary intracranial hypertension after conservative treatment.He was finally cured by down-step treatment of mannitol,avoiding form ventricleperitoneal shunt.Then,we reviewed the literature of pleural-subarachnoid fistula.Fifty-six cases have been reported so far.Most of the cases(51.8%)were caused by surgery;only 17.9%were caused by car accidents.Regarding the treatment,half of the cases cured by surgery and the other by conservative measures.Our case is the first one involving secondary intracranial hypertension and cured by down-step treatment of mannitol.Conclusions:A comprehensive examination should be performed before the treatment to avoid any inappropriate medical strategies.Secondary acute intracranial hypertension may be cured by down step treatment of mannitol,evading from the long-term ventriculoperitoneal shunt.展开更多
基金supported by the Youth Foundation of Hebei Education Department(QN2017115)the National Natural Science Foundation of China(51504079)~~
文摘Heterogeneous semiconductor photocatalysis is a promising green technology solution to energyand environmental problems.Traditional photocatalyst TiO2,with a wide band gap of3.2eV,canonly be excited by UV light and utilizes less than4%of solar energy.Silver phosphate(Ag3PO4)isamong the most active visible‐light‐driven photocatalysts reported.Unfortunately,unwanted photocorrosionis the main obstacle to the practical application of Ag3PO4.Much effort has been made inrecent years to address this issue and further enhance the photocatalytic performance of Ag3PO4.The construction of Z‐scheme photocatalytic systems that mimic natural photosynthesis is a promisingstrategy to improve the photocatalytic activity and stability of Ag3PO4.This brief review conciselysummarizes and highlights recent research progress in Ag3PO4‐based all‐solid‐state Z‐schemephotocatalytic systems with or without a solid‐state electron mediator,focusing on their construction,application,and reaction mechanism.Furthermore,the challenges and future prospects ofAg3PO4‐based Z‐scheme photocatalytic systems are discussed.
基金Supported by National Social Science Fund Project(11BJY113)Fundamental Research Funds for the Central Universities(SWU 1509516&1509437)
文摘As a basic industry,agriculture has a far-reaching impact on national economy. Based on input-output tables of China in 2005 and2010,this paper gives a deep insight into the relationship between agriculture and national economy and its macroeconomic effects by the methods of input-output analysis,industrial correlation and macroeconomic effect analysis. The results show that the agricultural development is highly dependent on the national economy,but makes low contribution; agriculture contributes to promoting employment and improving the structure of national income distribution; despite the government's tax incentive,the agricultural equipments are updated slowly,and the corporate profits are at low level; agricultural export effect is far below the average industry level,but the import effect increases over the years,and final products are often used for domestic consumption. Finally,we set forth recommendations for improving the development of agriculture and national economy.
基金the Doctoral Fund of Ministry of Education of China(Grant No.200800550011)the Chinese Academy for Environmental Planning(Grant No.2008AW01).
文摘ZnO/TiO_(2)composites were synthesized by using the solvothermal method and ultrasonic precipitation followed by heat treatment in order to investigate their photocatalytic degradation of methyl orange(MO)in aqueous suspension under UV irradiation.The composition and surface structure of the catalyst were characterized by X-ray diffraction(XRD),field emission scanning electron microscope(FE-SEM),and transmission electron microscopy(TEM).The degradation efficiencies of MO at various pH values were obtained.The highest degradation efficiencies were obtained before 30 min and after 60 min at pH 11.0 and pH 2.0,respectively.A sample analysis was conducted using liquid chromatography coupled with electrospray ionization ion-trap mass spectrometry.Six intermediates were found during the photocatalytic degradation process of quinonoid MO.The degradation pathway of quinonoid MO was also proposed.
基金National Clinical Research Center for Respiratory Diseases(HXZX-20210501)
文摘Importance:The safety and efficacy of the bath-plug technique for the closure of cerebrospinal fluid(CSF)leaks in children remain unknown.Objective:We undertook this study to ascertain whether the bath-plug technique was safe and effective for the repair of CSF leaks.Methods:We retrospectively reviewed patients who underwent endoscopic repair of CSF leaks with the fat graft as a plug-in at Beijing Children’s Hospital from March 2016 to May 2020.Demographic data,medical history,defect sites and sizes,interventions,and clinical outcomes were analyzed.One representative clinical case was additionally selected to highlight the procedure and the healing process.Results:A total of 18 pediatric patients were included in this study.The group was composed of 11 boys and seven girls,aged from 5 to 123 months.The etiologies included congenital CSF leaks(n=9)and head trauma(n=9).Among all patients,12 fistulas(66.7%)were located at the cribriform plate area,two(11.1%)at the roof of the ethmoid sinuses,two(11.1%)in the sphenoid sinus,and two(11.1%)at the frontal sinus.The maximum diameters of fistulas ranged from 5 to 20 mm,with a median value of 8 mm.Encephaloceles were identified in 14(77.8%)patients.No hydrocephalus was recognized.All CSF leaks were successfully repaired with a bath-plug technique.Follow-up ranged from 50 to 70 months.No surgical complications were encountered in any patient.Interpretation:Bath-plug technique is safe and reliable for the endoscopic management of CSF leaks in children.Meticulous peri-operative preparations are important for pediatric patients.
文摘Introduction:Rosai-Dorfman disease(RDD)is an uncommon,benign,and idiopathic histiocytic proliferative disorder.Multiple intracranial RDD is extremely rare and treatment varies.Case presentation:A 9-year-old girl was admitted with 3-month history of blurred vision and facial paralysis,a 2-month history of recurrent giggle,and cognitive impairment.Computed tomography and magnetic resonance imaging scans revealed bilateral ventricular masses based on the dural membrane and the diameters of the masses were 9.1 cm and 9.2 cm,respectively.The lesions were completely removed with staging surgeries.Fifteen months after operation,blurred vision was still present but facial paralysis and giggle and cognitive impairment disappeared.Imaging examinations suggested that there were no new or recurring lesions.Conclusion:For multiple large intracranial masses,surgical treatment is necessary and staged surgery benefits perioperative safety.Active follow-up with magnetic resonance imaging is necessary.
基金National Natural Science Foundation of China,Grant/Award Number:82101204Beijing Hospital’s Authority Clinical Medicine Development of Special Funding,Grant/Award Number:XMLX202144
文摘Importance:Medulloblastoma(MB)is the most common malignant brain tumor in children,with metastasis being the primary cause of recurrence and mortality.The tumor microenvironment(TME)plays a critical role in driving metastasis;however,the mechanisms underlying TME alterations in MB metastasis remain poorly understood.Objective:To develop and validate machine learning(ML)models for predicting patient outcomes in MB and to investigate the role of TME components,particularly immune cells and immunoregulatory molecules,in metastasis.Methods:ML models were constructed and validated to predict prognosis and metastasis in MB patients.Eight algorithms were evaluated,and the optimal model was selected.Lasso regression was employed for feature selection,and SHapley Additive exPlanations values were used to interpret the contribution of individual features to model predictions.Immune cell infiltration in tumor tissues was quantified using the microenvironment cell populations-counter method,and immunohistochemistry was applied to analyze the expression and distribution of specific proteins in tumor tissues.Results:The ML models identified metastasis as the strongest predictor of poor prognosis in MB patients,with significantly worse survival outcomes observed in metastatic cases.High infiltration of CD8+T cells and cytotoxic T lymphocytes(CTLs),along with elevated expression of the TGFB1 gene encoding transforming growth factor beta 1(TGF-β1),were strongly associated with metastasis.Independent transcriptomic and immunohistochemical analyses confirmed significantly higher CD8+T cell/CTL infiltration and TGF-β1 expression in metastatic compared to nonmetastatic MB samples.Patients with both high CD8+T cell/CTL infiltration and elevated TGFB1 expression in the context of metastasis exhibited significantly worse survival outcomes compared to patients with low expression and no metastasis.Interpretation:This study identifies metastasis as the key prognostic factor in MB and reveals the pivotal roles of CD8+T cells,CTLs,and TGF-β1 within the TME in promoting metastasis and poor outcomes.These findings provide a foundation for developing future therapeutic strategies targeting the TME to improve MB patient outcomes.
文摘Background：Over past two decades,vagus nerve stimulation （VNS） has been widely used and reported to alleviate seizure frequency worldwide,however,so far,only hundreds of patients with pharmaco-resistant epilepsy （PRE） have been treated with VNS in China's Mainland.The study aimed to evaluate the effectiveness of VNS for Chinese patients with PRE and compare its relationship with age cohort and gender.Methods：We retrospectively assessed the clinical outcome of 94 patients with PRE,who were treated with VNS at Beijing Fengtai Hospital and Beij ing Tiantan Hospital between November 2008 and April 2014 from our database of 106 consecutive patients.The clinical data analysis was retrospectively examined.Results：Seizure frequency significantly decreased with VNS therapy after intermittent stimulation of the vagus nerve.At last follow-up,we found McHugh classifications of Class Ⅰ in 33 patients （35.1％）,Class Ⅱ in 27 patients （28.7％）,Class Ⅲ in 20 patients （21.3％）,Class Ⅳ in 3 patients （3.2％）,and Class Ⅴ in 11 patients （l 1.7％）.Notably,8 （8.5％） patients were seizure-free while ≥50％ seizure frequency reduction occurred in as many as 60 patients （63.8％）.Furthermore,with regard to the modified Engel classification,12 patients （12.8％） were classified as Class Ⅰ,l l patients （11.7％） were classified as Class Ⅱ,37 patients （39.4％） were classified as Class Ⅲ,34 patients （36.2％） were classified as Class Ⅳ.We also found that the factors of gender or age are not associated with clinical outcome.Conclusions：This comparative study confirmed that VNS is a safe,well-tolerated,and effective treatment for Chinese PRE patients.VNS reduced the seizure frequency regardless of age or gender of studied patients.
基金Capital's Funds for Health Improvement and Research(No.CFH2018-2-2095)。
文摘Importance:Neuroblastoma is the most common extracranial malignant solid tumor in children.Multidisciplinary care is critical to improving the survival of pediatric patients with neuroblastoma.Objective:To systematically summarize the clinical characteristics of children with neuroblastoma and evaluate their prognosis with multidisciplinary care provided in a single center.Methods:This retrospective study analyzed the clinical data of 1041 patients with neuroblastoma who were diagnosed,treated,and followed-up in the Hematology-Oncology Center of Beijing Children’s Hospital from 2007 to 2019.Results:The median age at diagnosis was 34 months;80.8%of the patients were younger than 5 years of age.Notably,243 patients(23.3%)were classified as low-risk,249 patients(23.9%)were classified as intermediate-risk,and 549(52.7%)were classified as high-risk.Furthermore,956 patients underwent surgical resections;986(94.7%)patients received chemotherapy;and 176 patients with high-risk neuroblastoma received hematopoietic stem cell transplantation.The 5-year event-free survival(EFS)rate was 91.3%and 5-year overall survival(OS)rate was 97.5%in low-risk group;in the intermediate-risk group,these rates were 85.1%and 96.7%,respectively,while they were 37.7%and 48.9%in the high-risk group(P<0.001 for both).The 5-year EFS and OS rates were significantly higher in patients diagnosed between 2015 and 2019 than in patients diagnosed between 2007 and 2014(P<0.001).In total,278 patients(26.7%)exhibited tumor relapse or progression;the median interval until relapse or progression was 14 months.Of the 233 patients who died,83%died of relapse or progression of neuroblastoma and 4.3%died of therapy-related complications.Interpretation:The 5-year OS rate was low in high-risk patients,compared with low-and intermediate-risk patients.Multidisciplinary care is critical for improvement of survival in pediatric patients with neuroblastoma.Additional treatment strategies should be sought to improve the prognosis of patients with high-risk neuroblastoma.
基金Special Fund of The Pediatric Medical Coordinated Development Center of Beijing Municipal Administration of Hospitals(No.XTYB201803)Capitafs Funds for Health Improvement and Research(No.2018-2-2095)National Science and Technology Key Projects(No.2017ZX09304029)。
文摘Importance:Cancer is the main cause of death by disease in children.Children experience the highest incidence of cancer in the first year of life.However,there is no comprehensive registration system for children with tumors in China.Objective:To summarize the diagnosis and treatment of infant cancer and analyze the status of standardized diagnosis and management among several treatment centers in Beijing,China,thereby providing evidence to guide further clinical research.Methods:From January 1,2010 to December 31,2019,patients with newly diagnosed infantile malignant solid tumors were admitted to six large tertiary pediatric solid tumor diagnosis and treatment centers in Beijing.The epidemiology,clinical features,and therapeutic effects of tumors in these patients were analyzed retrospectively.All patients were followed up until March 31,2020.Results:In total,938 patients were enrolled in this study.There were 530 boys(56.5%)and 408 girls(43.5%);the median age was 6.0 months(range,0-12.0 months).The three most common tumors were retinoblastoma in 366 patients(39.0%),neuroblastoma in 266 patients(28.4%),hepatoblastoma in 133 patients(14.2%),and central nervous system tumors in 52 patients(5.5%).The estimated 5-year overall survival rate was 81.3%±1.8%,and the 5-year event-free survival rate was 71.8%±2.9%.The 5-year overall survival rates of non-rhabdomyosarcoma soft tissue sarcoma,neuroblastoma,and retinoblastoma were 100%,88%±2.2%,and 86.9%±2.1%,respectively.The 5-year event-free survival rates were 81.1%±2.7%for neuroblastoma,81.6%±9.8%for non-rhabdomyosarcoma soft tissue sarcoma,and 72.7%±14.1%for extracranial malignant germ cell tumors.Interpretation:The three most common infantile malignant solid tumors were retinoblastoma,neuroblastoma,and hepatoblastoma.Multidisciplinary combined diagnosis and treatment is needed for infantile tumors.
基金Beijing Hospitals Authority Clinical Medicine Development of special funding support,code:XMLX202144
文摘To the editor:A 6-month-old girl presented with poor appetite but no vomiting or other gastrointestinal symptom.There was no significant increase in her body weight for 2 months.Her birth weight was 3.4 kg.She also had horizontal nystagmus 2 days before her initial visit.Physical examination showed that the patient had bilateral horizontal nystagmus and left esotropia.Poor visual acuity was found on the left side.
文摘Background:Pleural-subarachnoid fistula(PSF)is a rare disease that is difficult to diagnose and treat.Secondary intracranial hypertension and the treatment are seldom mentioned previously among PSF.Case presentation:A 1-year-old boy diagnosed PSF developed into secondary intracranial hypertension after conservative treatment.He was finally cured by down-step treatment of mannitol,avoiding form ventricleperitoneal shunt.Then,we reviewed the literature of pleural-subarachnoid fistula.Fifty-six cases have been reported so far.Most of the cases(51.8%)were caused by surgery;only 17.9%were caused by car accidents.Regarding the treatment,half of the cases cured by surgery and the other by conservative measures.Our case is the first one involving secondary intracranial hypertension and cured by down-step treatment of mannitol.Conclusions:A comprehensive examination should be performed before the treatment to avoid any inappropriate medical strategies.Secondary acute intracranial hypertension may be cured by down step treatment of mannitol,evading from the long-term ventriculoperitoneal shunt.
