Back-end-of-line (BEOL) compatible and high-performance thin-film transistors (TFTs) and emer-ging memory devices trigger significant interest in their integration into 3-D computing and memory systems. In this work, we demonstrate, for the first time, the fully integrated 2T1C memory cells with InGaZnO TFTs and Hf0.5Zr0.5O2 (HZO)-based ferroelectric capacitors (FeCaps). The write and read operations of this recently pro-posed ferroelectric memory structure were systematically studied. The impacts of critical parameters on device per-formances were elucidated, including 1) applied voltage; 2) ferroelectric remnant polarization (P-r); 3) transistor threshold voltage (V-th); and 4) area ratio (AR) between the FeCap and the MOS capacitor of the Read transistor. The device with an AR of 1:8 can be operated with low voltages of 2 V for write and 2.5 V for read. Finally, the reliabilities of our fabricated 2T1C memory cells including retention (>= 10(5) s) and endurance (>= 10(7) cycles) were experimentally characterized.

INTRODUCTION: Although the combination of transcutaneous sacral nerve stimulation (tSNS) and pelvic floor exercises (PFEs) has shown significant effectiveness in treating fecal incontinence (FI) after surgery for congenital anorectal malformation (CARM), not all patients achieve satisfactory continence. Therefore, identifying which individuals will benefit from this method is crucial. METHODS: A prospective cohort study enrolled 92 children with FI. All patients underwent tSNS with PFE treatment, and an improved outcome was defined as a Wexner score ≤4. A predictive model to identify the effects of tSNS with PFEs in FI was developed based on the analysis of magnetic resonance imaging and high-resolution anorectal manometry with area under the receiver-operating characteristic curve to evaluate the predictive value of external anal sphincter (EAS) thickness index and anal squeezing pressure (ASP). RESULTS: tSNS with PFEs improved outcomes in 72 patients and led to poor outcomes in 20 (4 had their rectums deviate from the puborectalis muscle center or puborectal muscle ruptures while 16 lacked EAS with a lower ASP). The areas under the receiver-operating characteristic curve for EAS thickness index and ASP in predicting the effects of tSNS with PFEs were 0.915 (95% confidence interval 0.846–0.983, P = 0.000) and 0.886 (95% confidence interval 0.819–0.952, P = 0.000), respectively. By applying cutoff values of 0.076 for EAS thickness index and 21.95 mm Hg for ASP, tSNS with PFEs was found to be ineffective. DISCUSSION: tSNS with PFEs is effective for most patients with FI after CARM surgery, except when the rectum deviates from the puborectal muscle center, puborectal muscle rupture occurs, or EAS is absent with a low ASP.

Background: Management of intractable constipation is still challenging in children. Fecal impaction has been considered a common cause while retrograde colonic enema(RCE) is an effective method for this condition. Fecal microbiota transplantation(FMT) has also demonstrated great potential in many gastrointestinal diseases. However, the efficacy of RCE with FMT in childhood constipation remains unclear.Methods: A randomized, double-blind, controlled trial with 110 children who met the inclusion criteria was conducted. The subjects were randomly assigned to the FMT with RCE group or the placebo with RCE group. The duration of FMT treatment was 4 weeks, with a 12-week follow-up. The main observations were complete spontaneous bowel movements and bowel function satisfaction, and the adverse effects were assessed based on symptoms.Findings: At the end of follow-up, the effectiveness rates in the FMT with RCE and placebo with RCE groups were 43.64% and 21.82%, respectively (χ2 =11.24, P < 0.05). Compared with the end of treatment, there were eight recurrences (25.00%) in the FMT with RCE group and three recurrences (20.00%) in the placebo with RCE group( P >0.05). Among the primary outcome indicators, 27 patients (49.09%) in the FMT with RCE group and 15 patients (27.27%) in the placebo with RCE group were satisfied with defecation (χ2 =5.55, P <0.05). In total, 22 patients (40.00%) in the FMT with RCE group and 10 patients(18.18%) in the placebo with RCE group had complete spontaneous bowel movements for ≥ 3 weeks (χ2 =6.35, P <0.05). No adverse effects were found in all recruited cases.Interpretation: FMT enhances the efficacy of RCE and the use of RCE based FMT is a safe and effective method in the treatment of intractable constipation in children.Trial Registration Details: The study protocol was registered prospectively (https://clinicaltrials.gov/; registration number: NCT 05035784).Funding Information: This study was supported by the National Natural Science Foundation of China (No. 81570465, 30700917) and the General Funding Project from Department of Education of Liaoning Province (No. JC2019014).Declaration of Interests: We declare no competing interests.Ethics Approval Statement: The Ethics Committee of China Medical University (2018PS427K) approved the protocol, and written informed consent was obtained from all parents.

INTRODUCTION: The management of childhood constipation is challenging. Pelvic floor dysfunction (PFD) is one of the most common causes of childhood constipation. Percutaneous tibial nerve stimulation (PTNS) with pelvic floor exercises (PFE) has achieved a satisfactory outcome in the elderly individuals and women with PFD. The efficacy of PTNS with PFE in childhood constipation has not been established. METHODS: A randomized, double-blind, controlled trial with 84 children who met the inclusion criteria was conducted. All participants were randomly assigned to PTNS with PFE or sham PTNS with PFE groups and received their individual intervention for 4 weeks with a 12-week follow-up evaluation. The spontaneous bowel movements (SBM) ≥3 per week were the main outcomes, and the risk ratio (RR) with 95% confidence interval (CI) were calculated. High-resolution anorectal manometry and surface electromyography were used for the assessment of pelvic floor function, and the adverse effects were assessed based on symptoms. RESULTS: At the end of the follow-up period, 26 patients (61.9%) in the PTNS with PFE group and 15 patients (35.7%) in the sham group had ≥3 SBM per week compared with baseline (net difference 26.2%, 95% CI 5.6%–46.8%; RR 2.750, 95% CI 1.384–5.466; P < 0.05). PFD remission occurred in 49 children, 33 (78.6%) in the PTNS with PFE group and 16 (38.1%) in the sham group (RR 2.063, 95% CI 1.360–3.128, P < 0.05). No adverse effects occurred. DISCUSSION: PTNS with PFE is a safe and effective method in the treatment of childhood constipation, particularly in children with PFD or dyssynergic defecation.

Autoimmune pancreatitis (AIP) is an uncommon fibro-inflammatory disorder precipitated by autoimmune/inflammatory reactions. Currently, there are two clinical subtypes of AIP (type 1 [AIP-1] and type 2 [AIP-2]) that correspond to two histologic descriptors (lymphoplasmacytic sclerosing pancreatitis and idiopathic duct-centric pancreatitis, respectively). While our understanding of AIP-1 has evolved considerably over the years, little is known about AIP-2 due to its rarity, often leading to misdiagnosis, delayed treatment, and even unnecessary surgical resection. Compared to AIP-1, AIP-2 exhibits distinct clinical and histologic features. Because AIP-2 is a pancreas-restricted disease without a specific serum marker, the evaluation of histologic features (e.g., granulocytic epithelial lesions) is essential for an accurate diagnosis. Patients with AIP-2 respond well to glucocorticoids, with anti-tumor necrosis factor-alpha antibodies as a promising alternative therapy. The prognosis of AIP-2 is generally favorable and relapse is uncommon. Here, we provide an overview of our current knowledge on the clinical features, diagnosis, therapeutic regimens, prognosis, and putative mechanisms underlying AIP-2. Notably, the diagnostic differentiation between AIP-2, especially the mass-forming/focal type, and pancreatic cancer is important, but challenging. In this regard, endoscopic ultrasound-guided core biopsy has a key role, but novel diagnostic markers and modalities are clearly needed.

1Department of Pediatrics, Shengjing Hospital of China Medical University, Shenyang, China. Correspondence: Shu-Cheng Zhang, MD. E-mail: [email protected].

5α-reductase type 2 deficiency is an autosomal recessive disease caused by mutation of SRD5A2 gene.It is one of the major types of 46, XY disorder of sex development.Deficiency of 5α-reductase type 2 will block the conversion of testosterone into dihydrotestosterone, leading to dysplasia of urogenital sinus.It is difficult to be diagnosed due to the diverse clinical phenotypes from incomplete virilization to complete feminization.Children raised as females may show signs of virilization at puberty which brings them gender anxiety and decreased quality of life.This paper reviews the pathogenesis, clinical features, diagnosis, treatment and prognosis of 5 α-reductase type 2 deficiency.

Fecal incontinence (FI) is a commonly occurring disease of high concern. It is characterized by voluntary and involuntary defecation in children and adolescents. It is not only a physical disease but also a psychological and behavioral disorder. FI poses a serious burden on individuals and their families and therefore has become a social problem. Unfortunately, the management of FI among children is still a challenge because the etiology varies widely. Constipation has been found to be the most common cause, while sphincter dysfunction and neurogenic abnormalities may also play a role. Currently, no consensus guidelines exist, and the criteria for selecting optional methods remain unclear. It is therefore necessary to improve the efficacy of diagnosis and management strategies of FI in children. This review focused on the classification and etiology, discussed the diagnosis and management methods of FI in children and adolescents, and aimed to guide future studies.

Background Fecal microbiota transplantation (FMT) has been well described in the treatment of pediatric diseases; however, the latest updates regarding its use in children are unclear and the concepts involved need to be revisited. Data sources We performed advanced searches in the MEDLINE, EMBASE, and Cochrane databases using the keywords “Fecal microbiota transplantation OR Fecal microbiota transfer” in the [Title/Abstract] to identify relevant articles published in English within the last five years. To identify additional studies, reference lists of review articles and included studies were manually searched. Retrieved manuscripts (case reports, reviews, and abstracts) were assessed by the authors. Results Among the articles, studies were based on the mechanism ( n = 28), sample preparation ( n = 9), delivery approaches ( n = 23), safety ( n = 26), and indications ( n = 67), including Clostridium difficile infection (CDI) and recurrent C. difficile infection (rCDI; n = 21), non-alcoholic fatty liver disease (NAFLD; n = 10), irritable bowel syndrome (IBS; n = 5), inflammatory bowel disease (IBD; n = 15), diabetes ( n = 5), functional constipation (FC; n = 4), and autism spectrum disorder (ASD; n = 7). Conclusions Concepts of FMT in pediatric diseases have been updated with respect to underlying mechanisms, methodology, indications, and safety. Evidence-based clinical trials for the use of FMT in pediatric diseases should be introduced to resolve the challenges of dosage, duration, initiation, and the end point of treatment.

Heterojunction integrated by two-dimensional/three-dimensional materials has shown great potential applications in optoelectronic devices because of its fast response speed, high specific detectivity and broad spectral response. In this work, the vertical n-Si/p-GaTe heterojunction has been designed and fabricated, which shows a high responsivity up to 5.73 A W-1and a fast response time of 20μs at zero bias benifitting from the high efficiency of light absorption, internal photocurrent gain and strong built-in electrical field. A specific detectivity of 1012Jones and a broad spectral response ranging from 300 to 1100 nm can also be achieved. This work provides an alternative strategy for high-performance self-powered optoelectronic devices.

OBJECTIVES: Management of constipation is still challenging in childhood. The pharmacological effect of XiaojiDaozhi Decoction, a prescription of Chinese Herbal Medicine (CHM), has been well described for the treatment of food and Qi stagnation which account for childhood constipation. However, the efficacy and safety of XiaojiDaozhi Decoction in childhood constipation remains unclear. METHODS: A randomized, double-blind, and placebo-controlled trial was conducted to evaluate the efficacy and safety of XiaojiDaozhi Decoction in childhood constipation. Two hundred children were recruited and randomly allocated to the CHM or placebo group to receive their respective interventions. The duration of treatment was 8 weeks, with a 12-week follow-up. Main outcome measures were complete spontaneous bowel movements and satisfaction with bowel function. Safety and adverse effects were evaluated by blood laboratory measurements. RESULTS: At the end of follow-up, the response rates of CHM and placebo were 62% and 31%, respectively (χ 2 = 19.315, P < 0.01). At the end of treatment, recurrence was found in 7 cases (10.14%) in CHM and 11 cases (26.19%) in placebo (χ 2 = 4.947, P < 0.05). In the main outcome measures, 56 patients (56%) in the CHM group and 25 patients (25%) in the placebo group were satisfied with their bowel movements (χ 2 = 19.940, P < 0.05). Increased complete spontaneous bowel movements ≥3 per week from baseline were found in 40 patients (40%) who received CHM and 19 patients (19%) who received placebo (χ 2 = 10.602, P < 0.05). No serious adverse effects were found in any of the recruited cases. DISCUSSION: CHM XiaojiDaozhi Decoction is a safe and effective method for the treatment of childhood constipation.

Objective: The present study aimed to analyze the risk factors correlated with overactive bladder (OAB), observe the effects of desloratadine in the treatment of OAB, and explore the correlation between OAB and atopic constitution in children.Methods: Correlation and binary logistic regression analysis of the medical data from 447 children clinically diagnosed with OAB from June 2019 to June 2020 were conducted. The data included a history of urticaria, eczema, itchy skin, and allergic rhinitis or allergic cough. The OABSS scores before and after treatment with desloratadine were compared to evaluate the effectiveness of desloratadine for OAB.Results: The risk factors for OAB in children included eczema, allergic rhinitis or allergic cough, itchy skin, and the levels of total blood IgE. Desloratadine was 96.5% effective in treating cases with risk factors including eczema, allergic rhinitis or allergic cough, and itchy skin. There existed statistical significance in the difference in OABSS scores before and after the treatment of desloratadine (P < 0.05).Conclusion: OAB in children was correlated with atopic manifestations such as eczema, itchy skin, allergic rhinitis, or allergic cough. Desloratadine was safe and effective in the treatment of OAB in children with atopic manifestations.

Objectives Because of immature development, preterm infants are prone to respiratory and digestive symptoms, such as dyspnea, vomiting, and aspiration pneumonia. These symptoms are often observed in infants with gastroesophageal reflux (GER). However, the relationship between GER and these symptoms remains unclear.Methods A cohort of 61 preterm infants born at 32 weeks of gestation or earlier with respiratory or digestive symptoms were retrospectively reviewed. All the preterm infants underwent 24-hour pH-multichannel intraluminal impedance monitoring. Clinical data were analyzed using logistic regression analyses.Results Among the 61 symptomatic preterm infants, 34 were positive for pathologic GER with a prevalence of 55.7%. The GER-associated symptoms included apnea (42.6%), cyanosis (19.7%), vomiting (14.8%), pneumonia (9.8%), and poor weight gain (13.1%). These respiratory and digestive symptoms were more frequent in infants with pathologic GER than in those without (p<0.05). The risk factors for GER included severe bronchopulmonary dysplasia (odds ratio [OR], 6.890; 95% confidence interval [CI], 1.125-42.209). Probiotics and delayed full oral feeds reduced the risk of GER (OR, 0.642; 95% CI, 0.457-0.901, p<0.05; OR, 0.234, 95% CI, 0.069-0.794, p<0.05). Conclusions The prevalence of GER is high in symptomatic preterm infants. GER aggravates the respiratory and digestive symptoms; however, such symptoms are not always GER-associated. Probiotics and delayed full oral feeds can decrease the prevalence of GER.

Recently, two-dimensional materials have shown great potential in the application of memories due to their atomic thickness and excellent electrical properties. Furthermore, van der Waals heterostructures consisting a variety of two-dimensional materials provide more possibilities for memory research. Here, we design a simple memory device based on the molybdenum disulfide/germanium diselenide (MoS2/GeSe2) van der Waals heterostructure, which exhibits a large memory window of about 10 V in the gate range of ±10 V. Its ratio of program/erase current reaches over 102 and remains after more than 2 × 103 s and 103 cycles, showing good stability and reliability. Compared to conventional floating gate memory, the device based on this structure provides promising advantages in the reduction of the device size and simplification of manufacturing.

BACKGROUND: Bronchopulmonary dysplasia (BPD) is the most common respiratory disorder in extremely low birth weight infants. Although most symptoms of BPD improve, some late complications exist, even with regular treatment. Gastroesophageal reflux (GER), also common in extremely premature infants, may be related to many cardiorespiratory symptoms. However, the potential of GER as a risk factor for late complications associated with BPD is still unclear. RESEARCH QUESTION: The goal of this study was to determine if GER increases the risk of late complications of BPD in infants. STUDY DESIGN AND METHODS: A multicenter prospective cohort of 131 infants (79 male subjects, 52 female subjects) with BPD was enrolled. The development of late complications was assessed over an 18-month follow-up period. Twenty-four-hour pH-multichannel intraluminal impedance and gastric sodium concentrations were analyzed in all infants at 36 weeks' postmenstrual age and at the last interview. Prevalence and risk factors of late complications of BPD were analyzed by using forward logistic regression. RESULTS: The prevalence of late complications in BPD infants was 63.79% and included respiratory symptoms (49.14%), vomiting (38.79%), retinopathy of prematurity (25.86%), hypoxic-ischemic injury (3.45%), rehospitalization (26.72%), and sudden death (0.86%). Respiratory diseases constituted the most frequent complication. The prevalence of GER in BPD was 42.24% and included acid GER (18.10%) and duodenogastroesophageal reflux (DGER; 24.14%). Risk factors for respiratory symptoms were gestational age <= 30 weeks (OR, 3.213; 95% CI, 1.221-8.460), birth weight < 1,500 g (OR, 2.803; 95% CI, 1.014-7.749), invasive ventilation > 7 days (OR, 4.952; 95% CI, 1.508-16.267), acid GER (OR, 4.630; 95% CI, 1.305-16.420), and DGER (OR, 5.588; 95% CI, 1.770-17.648). Infants with BPD and DGER were more prone to late complications than those with acid GER or no reflux. INTERPRETATION: The prevalence of late complications is high in infants with BPD. GER (and in particular, DGER) poses a tentative risk for these late complications.

Two-dimensional layered SnS2 is attracting more and more attention due to its good electronic and optoelectronic properties. Herein, high yield and high quality SnS2 single crystals have been grown by chemical vapor transport method using muffle furnace instead of the traditional tube furnace. In addition, we report a modified mechanical exfoliation method, which is based on strong adhesion between gold decorated substrate and bulk SnS2, to produce high yield few-layered SnS2 with typical area size of nearly thousands of square microns. The electrical properties of FETs based on few-layered SnS2 further confirm the high quality of layered SnS2 with the carrier mobility of 2.8 cm(2) V-1 s(-1) and the current on/off ratio up to 10(5). It suggests that the exfoliation method introduced here provides an effective way to produce large-area, high-quality few-layeredSnS(2) materials for future application.

探讨酪酸梭菌二联活菌散联合肠动力药用于婴幼儿便秘治疗的可行性、有效性及安全性.选取2018年1月至2019年12月于本院便秘门诊和小儿消化门诊确诊为婴幼儿便秘的患儿作为研究对象,随机分为基础治疗组(C组,n=60例)、肠动力药+益生菌+基础治疗组(T1,n=60例),肠动力药+基础治疗组(T2,n=60例),益生菌+基础治疗组(T3,n=60例).患者治疗方案均由监护人签署知情同意书.疗程8周,随访12周.对治疗及随访后的疗效(患儿主观感受和能是否自主排便)进行评定.结果显示,治疗结束时T1组有效率最高;与C组比较,T1组、T2组、T3组治疗有效率差异均有统计学意义(均P<0.05).与C组比较,T1组患儿主观感受,自主排便次数,大便硬度和排便费力、哭闹或便中带血症状均得到显著改善(均P<0.05).所有患儿未出现腹痛、腹泻、黄疸等不良反应.因此认为酪酸梭菌二联活菌散联合肠动力药是治疗婴幼儿便秘的有效方法,安全性高,值得推广应用.

便秘是儿童期常见的消化道症状之一,严重影响患儿的身体健康和生活质量.对于儿童便秘目前有很多治疗措施,如行为治疗、药物治疗、生物反馈治疗及中医药疗法等,其中某些干预手段的顺利实施需要医生、患儿家长以及患儿本人的配合协作.每种方法 具有自身适应证,并非适用于所有类型的便秘.本文对儿童便秘治疗手段进行简要回顾,并对这些治疗手段的应用指证进行探讨.

Molybdenum disulfide (MoS2) with excellent properties has been widely reported in recent years. However, it is a great challenge to achieve p-type conductivity in MoS2 because of its native stubborn n-type conductivity. Substitutional transition metal doping has been proved to be an effective approach to tune their intrinsic properties and enhance device performance. Herein, we report the growth of Nb-doping large-area monolayer MoS2 by a one-step salt-assisted chemical vapor deposition method. Electrical measurements indicate that Nb doping suppresses n-type conductivity in MoS2 and shows an ambipolar transport behavior after annealing under the sulfur atmosphere, which highlights the p-type doping effect via Nb, corresponding to the density functional theory calculations with Fermi-level shifting to valence band maximum. This work provides a promising approach of two-dimensional materials in electronic and optoelectronic applications.

Objective. Neural crest stem cells (NCSCs) are prototypically migratory cells immigrating from the dorsal neural tube to specific embryonic sites where they generate a variety of cell types. A lot of biomarkers for NCSCs have been identified. However, which biomarkers are the most specific is still unclear. Methods. The rat embryos harvested in embryonic day 9 (E9), E9.5, E10, E10.5, E11, E12, E13, and E14 were paraffin-embedded and sectioned in transverse. NCSCs were spatiotemporally demonstrated by immunohistochemical staining with RET, p75NTR, Pax7, and Sox10. NCSCs were isolated, cultured, and stained with RET, p75NTR, Pax7, and Sox10. Results. In the paraffin sections of rat embryos, the immunohistochemical staining of RET, p75NTR, and Sox10 can all be used in demonstrating NCSCs. Sox10 was positive mainly in NCSCs while RET and p75NTR were positive not only in NCSCs but also in other tissue cells. In primary culture cells, Sox10 was mainly in the nucleus of NCSCs, RET was mainly in the membrane, and p75NTR was positive in cytoplasm and membrane. Conclusions. Sox10 is the specific marker for immunohistochemical staining of NCSCs in paraffin sections. In cultured cells, Sox10, p75NTR, and RET presented a similar staining effect.