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关键词： Paediatric atypical choroid plexus papilloma   Choroid plexus tumour   Management   Outcomes  

摘要： Introduction Choroid Plexus Tumours (CPTs) account for 1-4% of all brain tumours in children. Atypical choroid plexus papillomas (aCPPs) are a subset of these tumours, defined over a decade ago, yet no consensus exists on the optimal approach to their management. Methods We conducted a retrospective analysis of all patients treated for CPTs at the Hospital for Sick Children between January 1, 2000, and December 31, 2018, and focused on patients with aCPP. Data extracted from the patient records for analysis included: demographic and clinical features, radiological imaging, surgical and adjuvant therapies, key pathological features, immunohistochemical staining for TP53 and tumour karyotype. Six of seven aCPP samples were profiled using Illumina HumanMethylationEPIC arrays and the top 10,000 most variably methylated probes were visualized using tSNE. Copy number inferencing was also performed. Results Twenty-nine patients were diagnosed with CPT, seven of whom had a diagnosis of aCPP as confirmed by histological review. Methylation profiling demonstrated that aCPPs clustered with both choroid plexus papillomas (CPPs) and choroid plexus carcinomas (CPCs). Complete resection of the tumour was pursued in all cases of aCPP and no patient received adjuvant therapy. All aCPP patients were alive at last follow up. Conclusions This limited case series suggests that paediatric aCPP can be successfully managed with surgical resection alone, followed by a 'watch and wait' approach thus avoiding adjuvant therapies. A deeper understanding of the biology of aCPP is required to identify objective markers which can help provide robust risk stratification and inform treatment strategies.

关键词： 幼儿教育   科学领域   STEAM教育理念   课程重构  

摘要： 随着STEAM教育理念的内涵不断发展,证明了幼儿在STEAM教育理念进行科学教育的可行性和必要性。激发兴趣、体验过程和培养能力的幼儿园科学教育核心与STEAM教育理念核心不谋而同。教育实践视角下,幼儿园科学领域的STEAM教育可以从理念更新、课程重构和教学策略三个维度不断推进。

关键词： Fontan   Single ventricle   Exercise limitation   Determinants  

摘要： Background: Although various determinants of exercise limitation in Fontan patients have been studied, most research has been performed in patients who underwent different surgical procedures with differing haemodynamic characteristics. The aim of the current study was to evaluate non-invasively measured cardiovascular parameters and their influence on exercise performance in paediatric Fontan patients with an extracardiac conduit and moderate-good systolic ventricular function. Methods: Fontan patients, between 8 and 18 years of age, with moderate to good systolic ventricular function and an extracardiac conduit were included. Exercise performance and cardiovascular assessment, comprising echocardiography, aortic stiffness measurement and ambulatory measurement of cardiac autonomous nervous activity were performed on the same day. Healthy subjects served as controls. Results: Thirty-six Fontan patients (age 14.0 years) and thirty-five healthy subjects (age 12.8 years) were included. Compared to controls, Fontan patients had reduced diastolic ventricular function and increased arterial stiffness. No differences were found in heart rate (HR) and cardiac parasympathetic nervous activity. In Fontan patients, maximal as well as submaximal exercise capacity was impaired, with the percentage of predicted capacity ranging between 54 and 72%. Chronotropic competence, however, was good with a peak HR of 174 (94% of predicted). Lower maximal and submaximal exercise capacity was correlated with a higher HR at rest, higher pulse wave velocity of the aorta and a lower ratio of early and late diastolic flow velocity. Conclusion: Contemporary paediatric Fontan patients have an impaired exercise capacity with preserved chronotropic competence. Exercise performance correlates with heart rate at rest, diastolic function and aortic stiffness.

关键词： 幼儿园   小学化   模仿体验   游戏活动  

摘要： 近些年来我国的幼儿教育受到了社会各界的广泛关注,而为了让幼儿教育取得更加优良的成效,需要明确幼儿发展过程当中所存在的特殊性。现阶段我国的幼儿教育多数是以游戏的形式开展的,但是由于现实当中存在许多特殊因素,导致大部分幼儿园的开设了接近小学的一些教育课程,如此是期望能够实现“去小学化”帮助幼儿在入小学之前就能够尽早的接触一些小学的学习知识,另一个因素是小学化的教育帮助幼儿能够以小学的学习方式和生活习惯,来开展幼儿教育,以便让幼儿能够快速的使用小学是学习状态,如此这种教学情况存在着一定的约束和标准化的教学形式,因此此种教学内容和形式虽然存在一定的优势,但是对于孩童的身心发展会有不同程度的影响,所以在“去小学化”的教学方式当中,更应当开展积极的游戏活动教学,本文则是在此方面进行了有效的探究。希望本文的论述能够为我国幼儿“去小学化”教学取得更加优良的成效。

摘要： 幼儿深度学习是指学习者以高级思维的发展和实际问题的解决为目标,以整合的知识为内容,积极主动地学习新的经验,并将它们融入原有的经验,且能将已有的经验迁移到新的情境中的一种学习.深度学习是幼儿自主学习的进步,是幼儿终身发展的必备能力,同时班级科学区域是幼儿进行科学探究的自主学习主要场所.基于此,本文结合自己的教学经验浅谈促进大班幼儿科学区深度学习的支持策略研究.

摘要： Nutrition in paediatrics has always been one of the most important factors for optimal growth. Children with chronic kidney disease (CKD) need special consideration for better long-term outcomes, including nutritional status, optimal height, and cognitive function. Nonetheless, there are many obstacles to overcome to attain optimal linear growth and nutritional status in children with CKD. This review highlights the need for tools to assess the growth parameters in CKD. In addition, recommendations for dietary intake play a major role in controlling electrolyte disturbances in patients with CKD. For example, it is still unclear whether it is better to restrict phosphate sources in inorganic, organic, or food additives. The review also summarises different factors such as fluid intake, route of feeding, and essential nutrients that require particular attention in paediatric patients with CKD. In summary, a multidisciplinary team is needed to devise individual nutritional plans to achieve the best outcome and improve the quality of life of patients.

关键词： 案例描述   探究兴趣   老师   幼儿科学教育   道德视角   科学探究活动   善于质疑   思考教育  

摘要： 曾老师:您好。感谢您提出了这么好的一个问题,相信很多老师带领孩子进行科学探究活动时,都面临过类似的问题:当幼儿的探究兴趣与对生命的爱护发生冲突时,我们该如何取舍。从您的案例描述中可以看出,您是一位善于质疑和思考的老师,是一位以儿童为中心,能从育人的角度出发思考教育和自己的工作的老师。