简介：AbstractImportance:Staphylococcus lugdunensis (S. lugdunensis) is a coagulase-negative staphylococcus (CoNS), found commonly as skin flora in humans. While most species of CoNS are clinically benign, S. lugdunensis can exhibit a similar virulence to that of S. aureus. However, there is scant data concerning S. lugdunensis infection in the pediatric population.Objective:To ascertain local S. lugdunensis infection rates and sensitivity patterns in the pediatric population.Methods:A retrospective analysis was undertaken of all S. lugdunensis isolates across a 6-year period from 2015 to 2020. Data were collected from electronic patient notes and laboratory records. Matrix-assisted laser desorption ionization and time of flight mass spectrometry were used to identify isolates.Results:Ninety-six isolates of S. lugdunensis were identified from 86 patients. Of these, 34 isolates were treated as an infection. Twenty-three (67.6%) were found to have skin as the primary source of infection. While the observed number was small, central nervous system (CNS) sources of S. lugdunensis infection appear to be a significant source: all three isolates cultured from cerebrospinal fluid were clinically managed as infection. All three were associated with ventriculoperitoneal (VP) shunt infection. No cases of S. lugdunensis infective endocarditis were identified. About 18.6% of S. lugdunensis isolates were resistant to flucloxacillin.Interpretation:S. lugdunensis is an uncommon but significant cause of infection in the pediatric population and appears to be a rising cause of CNS infection, particularly when associated with VP shunts. Flucloxacillin is recommended locally as the first choice of antibiotic.

简介：AbstractBackground:The standard treatment for pediatric differentiated thyroid carcinoma (DTC) still requires consideration because of a lack of clinical evidence. The purpose of this study was to summarize the clinical experiences and explore the risk factors for post-operative recurrence through a retrospective analysis to develop better clinical strategies for pediatric DTC.Methods:This study retrospectively analyzed children and adolescents with DTC who were treated between January 1999 and December 2014 at the Cancer Hospital, Chinese Academy of Medical Sciences. Clinicopathological results and outcomes were collected. A log-rank test of Kaplan-Meier curves and the Cox regression model were used to determine the factors associated with recurrence.Results:Data of 150 patients were collected in this study. During the follow-up, there was only one disease-related death. The recurrence rates at 3, 5, and 10 years were 13.6%, 18.7%, and 28.6%, respectively. There was a significant difference in the rate of recurrence according to age (P < 0.001), extrathyroidal extension (P < 0.001), lymph node metastasis (P = 0.023), and invasion of the trachea and esophageal wall (P = 0.004). Cox regression analysis demonstrated that age (P = 0.006) and extrathyroidal extension (P = 0.013) were significant dependent factors of post-operative recurrence.Conclusions:The prognosis of DTC in children and adolescents is favorable. A close follow-up is recommended because of the high recurrence rate. A comparatively higher recurrence rate was observed in the younger age group, and new age-based divisions may be needed to conveniently evaluate the possibility of recurrence.

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简介：AbstractBackground:Endoscopic third ventriculostomy (ETV) has been established as a viable treatment option for obstructive hydrocephalus of children over 6 weeks of age. ETV in pediatric groups may be unsuccessful due to the failure of absorption of cerebrospinal fluid (CSF) or reclosure of ventriculostomy stoma or due to infection. The exact cause is still debatable. Some issues like failure to eliminate the second membrane during the procedure or formation of the new arachnoid membrane at the stoma are still not clear. This study aims to assess the surgical failure of ETV and its predisposing factors.Methods:Thirty-four pediatric patients with hydrocephalus were analyzed retrospectively. The patients’ age limit was between 2.5 months and 14 years. This is a retrospective study of 34 patients in a single private hospital between June 2012 and January 2018. Patients having hydrocephalus in pediatric groups more than 6 weeks of age were included in the study.Results:The mean age of all patients was 51.25 ± 53.90 months and the mean follow-up period was 50.47 ± 20.84 months. Of 34 surgeries, the success rate was 79% and the failure rate was 21%. Within 2 years, the success rate was 68.42% and above 2 years’ success rate was 93.33%. In this series, 7 cases of ETV were re-explored and found ventriculostomy stoma closure in 3 cases, the presence of the second membrane in re-exploration 2 cases, and presence of inflammatory arachnoid membrane in re-exploration 2 cases. The use of dexamethasone around the stoma in inflammatory stoma was useful, having no recurrence. In one patient of the second membrane probably due to absorption failure in communicating hydrocephalus re-exploration was failed and was managed successfully with VP shunt.Conclusions:Predisposing factors causing ETV failure are ventriculostomy stoma closure by new arachnoid granulation tissues, remnants of the second membrane inside the stoma, CSF absorption failure, infection/high protein in CSF and inappropriate patient selection.

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简介：AbstractImportance:As the most common subtype of pediatric rhabdomyosarcoma (RMS), the prognosis of embryonal RMS has rarely been investigated solely.Objective:To perform a population-based study to characterize the prognosis of embryonal RMS in children and adolescents.Methods:Demographic and clinical features were retrospectively evaluated in selected patients with embryonal RMS registered in the Surveillance, Epidemiology, and End Results (SEER) program from 1988 to 2016. Survival curves were compared using the log-rank test. A multivariate Cox proportional hazards model was developed to assess the impact of each factor on the overall survival. A nomogram was constructed based on the results of Cox regression model.Results:A total of 464 patients were included in the analysis, among which 64.6% were male and 70.2% were white patients. About 38.6% and 26.3% of the patients were at 1-4 years and 5-9 years, respectively. Cox analysis showed that patients at age group 5-9 years had the lowest risk of mortality (hazard ratio [HR], 0.277; 95% confidential interval [CI], 0.123-0.620), compared with patients diagnosed at less than 1-year-old, and age group 1-4 years had the second-best prognosis. Patients having distant tumors had significantly higher mortality risk (HR, 4.842; 95% CI, 2.804-8.362) than the patients with localized tumor. Compared with receiving no surgery or radiotherapy, receiving any combination of surgery and radiotherapy would lower the risk of mortality significantly (for surgery without radiotherapy: HR, 0.418; for radiotherapy without surgery: HR, 0.405; and for surgery plus radiotherapy: HR, 0.410).Interpretation:Age, stage at diagnosis, and treatment received were found to be the most important predictors of the overall survival of pediatric embryonal RMS.

简介：SincetheimplementationofthenewlyrevisedLawonProtectionoftheRightsandInterestsoftheElderly,thesocietyhasattachedcontinuousconcerntothefeasibility,andlegalandethicalboundariesoftheclauseofchildren'visitinghomeoften'.Howtosupportfamily-basedseniornursinghasbecomeanimportantareafordiscussion.

简介：BackgroundPrematureventricularcontractions(PVCs)arefrequentlyseeninchildren.However,therearelesssystematicandlongerfollowing-upstudiesexaminingtheprognosisofPVCsinchildren.TheaimofthisstudywastoevaluatethemediumtolongtermprognosisofPVCsinchildhoodandwhetherthereisadifferentialprognosisindifferentprimarydiseasesofPVCs.MethodsThisstudyreviewedthedataof106pediatricpatients(49F/57M,7.5±3.8years)seenattheAffiliatedHospitalofQingdaoUniversitywiththediagnosisofPVCsbetween1999and2005.Dataondemographics,clinicalpresentation,laboratorytests,andechocardiogramsofpatientswereextractedfromtheavailableclinicalrecords.ResultsAtotalof35(33.0%)childrenpresentedwithPVCsduetomyocarditis,7(6.6%)duetocardiomyopathies,7(6.6%)duetomitralvalveprolapse(MVP),10(9.4%)duetooperationforcongenitalheartdisease(O-CHD),16(15.2%)duetoleftventricularfalsetendons(LVFT),and31(29.2%)duetounknowncause.HolterdidnotshowPVCsduringfollow-upperiodin100%ofmyocarditispatients,57%ofcardiomyopathypatients,71%ofMVPpatients,60%ofO-CHDpatients,88%ofLVFTpatients,87%ofunknowncausepatients.ThePVCsdisappearedin93%ofpatientswhodidnotuseanti-arrhythmicdrugsandin76%ofpatientswhousedantiarrhythmicdrugs.Therewasnoasignificantdifferenceinprognosisbetweenmyocardialnutritioncombinedwithintravenousinjectionofimmunoglobulin(IVIG)groupandpropafenonegroup.ConclusionsPVCscausedbydifferentprimarydiseaseshasafavorableprognosisinchildren.Usually,thePVCswillreduceevendisappearduringfollow-up.ThepatientswithPVCsduetomyocarditisshouldbepreferredusemyocardialnutrientcombinedwithIVIG.

简介：AbstractImportance:Clostridium difficile-associated diarrhea (CDAD) is a severe type of antibiotic-associated diarrhea (AAD). However, the risk factors for CDAD in children with AAD have not yet been clarified.Objective:To investigate the distribution and risk factors for CDAD among hospitalized children in Beijing Children’s Hospital.Methods:Stool samples from 197 children with AAD were tested for the C. difficile pathogenic genes (tcdA, tcdB, tcdC, tcdD, tcdE, cdtA, and cdtB) using polymerase chain reaction between January 2011 and January 2014. Children who tested positive for tcdA or tcdB were included in the CDAD group, and those remaining comprised the non-CDAD group.Results:The rate of CDAD among the 197 children with AAD was 42.6% (84/197). The age distribution was 1-15.6 years, among which the majority of children (54.8%, 46/84) were aged 1-4 years. Differences in the CDAD-positive rates among AAD children belonging to different age groups were not statistically significant. Univariate analysis revealed that the duration of antibiotic therapy, the length of hospitalization prior to diarrhea, and gastrointestinal tract operations were significant risk factors (P < 0.05). Children with CDAD underwent more antibiotic therapy and had longer periods of hospitalization prior to diarrhea onset than children in the non-CDAD group. Using multivariate regression analysis, hospitalization for ≥ 10 days prior to diarrhea was found to be an independent risk factor for CDAD.Interpretation:This study revealed that the length of hospitalization (≥ 10 days) prior to diarrhea was an independent risk factor for CDAD in children with AAD.

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简介：此栏目所刊登的文章均为地道的原汁英语，适合高二学生阅读，也可作为老师们出题的参考材料，每期题裁各异，以便老师们灵活使用。

简介：此栏目所刊登的文章均为地道的原汁英语，可作为期中、期末考试及高考命题的素材，每期题裁各异，请同学们认真阅读。

简介：Laws(法律)forchildrenaregoodthings.Onehundredyearsagoinsomecountries,childrenworkedeighteenhoursadayinafactory1ageseven.Thefactoryownercouldbeatachild2fell

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简介：Asthmaisverycommoninchildren;inWesterncountries,itisthemostcommondiagnosisinchilrenadmittedtohospital.Mostsurveysreportthatatlesst10%ofchildrenhavebeendiagnosedwithasthma,andrecentstudiesnotethatupto40-50%ofpre-schoolchildrenhavehadrecurrentwheezeoverthepreceding12mohths.Thereisnowlittledoubtthattheprevalenceofasthmahasincreasedworldwideoverthelast10-20years(Figure1).

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简介：TheReverend(牧师或神父)J.LSinghwasthemanagerofanorphanage(孤儿院)inMidnapore.India.

简介：我住在澳大利亚的内陆我住在澳大利亚的内陆。我是一个土著——澳大利亚的原住居民。为了一些特别的仪式，我们在身体上画彩绘。

简介：SHEclambersuparock,reachesbothhandsintocranniesintheshabbycementwallandheavesherselfup,beingcarefulnottocatchherschoolbagontheprotrudingbricks.Shestraddlesthetopandthengingerlyjumpsdownontothestonygroundbesidetherailwayline.