简介：无

简介：AbstractBackground:Intensive phototherapy (IPT) and exchange transfusion (ET) are the main treatments for extreme hyperbilirubinemia. However, there is no reliable evidence on determining the thresholds for these treatments. This multicenter study compared the effectiveness and complications of IPT and ET in the treatment of extreme hyperbilirubinemia.Methods:This retrospective cohort study was conducted in seven centers from January 2015 to January 2018. Patients with extreme hyperbilirubinemia that met the criteria of ET were included. Patients were divided into three subgroups (low-, medium-, and high-risk) according to gestational week and risk factors. Propensity score matching (PSM) was performed to balance the data before treatment. Study outcomes included the development of bilirubin encephalopathy, duration of hospitalization, expenses, and complications. Mortality, auditory complications, seizures, enamel dysplasia, ocular motility disorders, athetosis, motor, and language development were evaluated during follow-up at age of 3 years.Results:A total of 1164 patients were included in this study. After PSM, 296 patients in the IPT only group and 296 patients in the IPT plus ET group were further divided into the low-, medium-, and high-risk subgroups with 188, 364, and 40 matched patients, respectively. No significant differences were found between the IPT only and IPT plus ET groups in terms of morbidity, complications, and sequelae. Hospitalization duration and expenses were lower in the low- and medium-risk subgroups in the IPT only group.Conclusions:In this study, our results suggest that IPT is a safe and effective treatment for extreme hyperbilirubinemia. The indication of ET for patients with hyperbilirubinemia could be stricter. However, it is necessary to have a contingency plan for emergency ET as soon as IPT is commenced especially for infants with risk factors. If IPT can be guaranteed and proved to be therapeutic, ET should be avoided as much as possible.

简介：“体制”是国家基本制度的重要体现形式，这是联系社会三大系统——生产力、生产关系和上层建筑的结合点。就中国的国情分析，目前体制内的单位效益普遍远远好于体制外的单位，如果没有创业的想法，大多数高中生应该主要考虑体制内的专业。

简介：自2001年美国发生911恐怖袭击事件之后，各国政府除强化倡导安全观念之外，也积极进行安全监控设备的采购与布建，加上社会大众也逐渐重视个人、家居及小区的安全防范，安全产业的需求与日俱增，标准化的课题与必要性，也越来越受到重视。

简介：

简介：进入高中后，大家都会面临一个相同的情况——分班。不管是叫“重点班、平行班”，还是叫“实验班、普通版”，抑或是叫“火箭班、蜗牛班”……这种分班现象几乎存在于每一所高中。

简介：Objective:BethesdaSystemforReportingThyroidCytopathology(BSRTC)categoriesⅠ,Ⅲ,andⅤaccountforasignificantproportionoffineneedleaspirationcytology(FNAC)diagnoses.ThisstudyaimedtocomparethediagnosticefficacyofBRAFV600EmutationandtheThyroidImagingReportingandDataSystem(TIRADS)classificationindifferentiatingpapillarythyroidcancers(PTCs)frombenignlesionsamongBSRTCI,III,andVnodules.Methods:Atotalof472patientswith479noduleswereenrolledinthisprospectivestudy.Ultrasound,BRAFV600Emutationtesting,andFNACwereperformedineachnodule,followedbysurgeryorregularultrasoundexamination.Results:IntheBSRTCIcategory,BRAFV600Eshowedsimilarsensitivity,higherspecificity,andloweraccuracywhencomparedwithTIRADS.IntheBSRTCIII/Vcategory,thesensitivity,specificity,andaccuracyofBRAFV600EweresimilartothoseofTIRADS.IncomparisontoBRAFV600Ealone,thecombinationofthetwomethodssignificantlyimprovedsensitivity(BSRTCⅠ:93.6%vs.67.7%,P<0.01;BSRTCⅢ:93.8%vs.75.0%,P<0.01;BSRTCV:96.0%vs.85.3%,P<0.001).WhencomparedwithTIRADSalone,thecombinationimprovedsensitivityinBSRTCⅠnodules(93.6%vs.74.2%,P<0.05),increasedsensitivityanddecreasedaccuracyinBSRTCIIInodules(93.8%vs.75.0%,P<0.01,91.0%vs.93.6%,P<0.01),andimprovedbothsensitivityandaccuracyinBSRTCVnodules(96.0%vs.82.0%,P<0.001;94.2%vs.81.3%,P<0.001).Conclusions:BRAFV600EexhibitedhigherspecificityandloweraccuracycomparedwithTIRADSinBSRTCⅠnodules,whilethetwomethodsshowedsimilardiagnosticvalueinBSRTCⅢ/Ⅴnodules.ThecombinationofthetwomethodsdistinctlyimprovedsensitivityinthediagnosisofPTCsinBSRTCⅠ,Ⅲ,andⅤnodules.

简介：要过年喽!几个小孩儿在院子里点着爆竹，一些老太太买回大红的窗花贴上，一个个打工族急匆匆奔向车站……大街小巷零星传来的爆竹声在酝酿，年味在发酵中越加浓郁了。“独在异乡为异客，每逢佳节倍恩亲。”此情此景，只让人想念一件事，那就是回家过年。

简介：

简介：AbstractBackground:Although existing mycological tests (bronchoalveolar lavage [BAL] galactomannan [GM], serum GM, serum (1,3)-β-D-glucan [BDG], and fungal culture) are widely used for diagnosing invasive pulmonary aspergillosis (IPA) in non-hematological patients with respiratory diseases, their clinical utility in this large population is actually unclear. We aimed to resolve this clinical uncertainty by evaluating the diagnostic accuracy and utility of existing tests and explore the efficacy of novel sputum-based Aspergillus assays.Methods:Existing tests were assessed in a prospective and consecutive cohort of patients with respiratory diseases in West China Hospital between 2016 and 2019 while novel sputum assays (especially sputum GM and Aspergillus-specific lateral-flow device [LFD]) in a case-controlled subcohort. IPA was defined according to the modified European Organization for Research and Treatment of Cancer/Mycoses Study Group criteria. Sensitivity and specificity were computed for each test and receiver operating characteristic (ROC) curve analysis was performed.Results:The entire cohort included 3530 admissions (proven/probable IPA = 66, no IPA = 3464) and the subcohort included 127 admissions (proven/probable IPA = 38, no IPA = 89). Sensitivity of BAL GM (≥1.0 optical density index [ODI]: 86% [24/28]) was substantially higher than that of serum GM (≥0.5 ODI: 38% [39/102]) (χ2 = 19.83, P < 0.001), serum BDG (≥70 pg/mL: 33% [31/95]) (χ2 = 24.65, P < 0.001), and fungal culture (33% [84/253]) (χ2 = 29.38, P < 0.001). Specificity varied between BAL GM (≥1.0 ODI: 94% [377/402]), serum GM (≥0.5 ODI: 95% [2130/2248]), BDG (89% [1878/2106]), and culture (98% [4936/5055]). Sputum GM (≥2.0 ODI) had similar sensitivity (84% [32/38]) (Fisher’s exact P = 1.000) to and slightly lower specificity (87% [77/89]) (χ2 = 5.52, P = 0.019) than BAL GM (≥1.0 ODI). Area under the ROC curve values were comparable between sputum GM (0.883 [0.812-0.953]) and BAL GM (0.901 [0.824-0.977]) (P = 0.734). Sputum LFD had similar specificity (91% [81/89]) (χ2 = 0.89, P = 0.345) to and lower sensitivity (63% [24/38]) (χ2 = 4.14, P = 0.042) than BAL GM (≥1.0 ODI), but significantly higher sensitivity than serum GM (≥0.5 ODI) (χ2 = 6.95, P = 0.008), BDG (χ2 = 10.43, P = 0.001), and fungal culture (χ2 = 12.70, P < 0.001).Conclusions:Serum GM, serum BDG, and fungal culture lack sufficient sensitivity for diagnosing IPA in respiratory patients. Sputum GM and LFD assays hold promise as rapid, sensitive, and non-invasive alternatives to the BAL GM test.

简介：

简介：随着社会公众对环境问题关注度的提升,越来越多的企业在营销活动中采用绿色广告。随之而来的问题是,与非绿色广告相比,绿色广告在什么条件下能发挥更大的有效性？已有文献从产品类型、动机以及环保关注度角度进行了相关研究,但忽视了消费者认知对绿色广告有效性的影响。本文基于消费者解释水平理论,探讨解释水平对绿色广告有效性的影响以及这种影响的中介机制。研究采用情景模拟实验法,实验一探讨了解释水平与绿色广告/非绿色广告对说服效果的交互作用,实验二探讨了加工流畅性的中介作用。结果表明,解释水平与绿色广告/非绿色广告对说服效果具有交互作用,当消费者倾向于高解释水平时,绿色广告的说服效果好于非绿色广告,而当消费者倾向于低解释水平时,非绿色广告的说服效果好于绿色广告,并且加工流畅性在这一交互作用中具有中介效应。

简介：AbstractBackground:The neoadjuvant chemotherapy is increasingly used in advanced gastric cancer, but the effects on safety and survival are still controversial. The objective of this meta-analysis was to compare the overall survival and short-term surgical outcomes between neoadjuvant chemotherapy followed by surgery (NACS) and surgery alone (SA) for locally advanced gastric cancer.Methods:Databases (PubMed, Embase, Web of Science, Cochrane Library, and Google Scholar) were explored for relative studies from January 2000 to January 2021. The quality of randomized controlled trials and cohort studies was evaluated using the modified Jadad scoring system and the Newcastle-Ottawa scale, respectively. The Review Manager software (version 5.3) was used to perform this meta-analysis. The overall survival was evaluated as the primary outcome, while perioperative indicators and post-operative complications were evaluated as the secondary outcomes.Results:Twenty studies, including 1420 NACS cases and 1942 SA cases, were enrolled. The results showed that there were no significant differences in overall survival (P = 0.240), harvested lymph nodes (P = 0.200), total complications (P = 0.080), and 30-day post-operative mortality (P = 0.490) between the NACS and SA groups. However, the NACS group was associated with a longer operation time (P < 0.0001), a higher R0 resection rate (P = 0.003), less reoperation (P = 0.030), and less anastomotic leakage (P = 0.007) compared with SA group.Conclusions:Compared with SA, NACS was considered safe and feasible for improved R0 resection rate as well as decreased reoperation and anastomotic leakage. While unbenefited overall survival indicated a less important effect of NACS on long-term oncological outcomes.

简介：正当第三代流动电话(3G)发牌在世界各地，包括欧、美、日等，受到广泛关注之际，香港电讯管理局(电管局)现正计画3G发牌事宜，将会批出四个频谱牌照。

简介：基因同样源自赛道基因向经典致敬保时捷718BoxsterS与上一代最明显的差异,自然是在车尾首次挂上了“718”的头衔.相比保时捷911,可能大家对“718”有点陌生,这是一款以保时捷经典车型550Spyder为基础衍生出的赛车专用车型,采用了中置双座敞篷设定,且发动机盖下搭载了一台1.5升四缸发动机.所以全新718BoxsterS也传承了718经典的中置敞篷搭配四缸动力的设计.718在1957～1962年间活跃于各大赛场,并且多次夺得优异的成绩.其中,亮相第二年便拿下了勒芒24小时耐力赛的冠军与季军.1959年,718还斩获了TargaFlorio赛事的总冠军,此后的911Targa车型之名便来源于此.最后甚至被改装为单座配置,并代表保时捷出战二级方程式大赛.因此对于保时捷来说“718”并不仅仅是一串数字或一部车款,“718”所代表的是保时捷勇往直前的运动精神.

简介：用二本分数上一本大学众所周知，咱们国家的大学是有“等级”的，“出身”不同，“身价”也不同。这个“等级”制最明显的标志反映在录取批次的排序上。即：重点本科分数线，一般本科分数线，民办、独立学院分数线，专科分数线。这四条分数线是呈金字塔状分布的。

简介：

简介：THENEWCARCHALLENGE新上市的宝马5系固然很棒,但你们不觉得这类车型越来越中庸,越来越无聊了吗?对于骨子里是个不安分的人来说,花差不多的钱绝对会选择辣味十足的钢炮,比如今天对决的这两款.自我介绍高尔夫家族最最强悍的车型思域家族最最强悍的车型亮点已经是最快的“神车”了,还需要别的亮点吗在人人都以刷纽博格林赛道纪录为荣的当下,我们吃不准新思域TypeR是不是最快量产前驱者纪录的创造者或者保持者,只知道它的成绩是7分43.8秒.

简介：约翰·福尔斯（JohnFowles）是20世纪英国文坛红极一时的作家，被评论界誉为“战后英国最有才华、最严肃的小说家”，是英国后现代小说的代言人。福尔斯的小说神秘离奇之中带有悬念，既有后现代主义的实验性特点，同时又保留了传统的小说情节和人物刻画，因此，他的小说在当代英语国家久盛不衰。福尔斯以长篇小说著称，《收藏家》、《魔法师》、

简介：截至2007年5月，“台风”战斗机的4个项目发起国英国、德国、西班牙和意大利，加上一个采购国奥地利共签订了购买638架“台风”战斗机的协议，其中402架是确定订单；相比之下，“阵风”战斗机的订单就少的多，目前其总需求量估计为292架，其中仅112架为确定订单。