Introduction: The COVID-19 pandemic has affected all aspects of life worldwide. The aim of the present study was to review and describe and acknowledge the impact of COVID-19 on the pediatric health care system at a pediatric tertiary hospital in Wenzhou. Methods: A retrospective study was conducted at Yuying Children's Hospital of Wenzhou Medical University, a public pediatric tertiary hospital in Southern Zhejiang Province that specializes in pediatrics. The data regarding the primary diagnosis of patients were extracted from the electronic medical records system of the hospital. Data for outpatients and inpatients treated at the pediatric department were analyzed in the time frame of 22 weeks since the beginning of the pandemic (from December 30, 2019 to June 2, 2020) and compared with data from the same period in 2019. Results: The total number of outpatient cases in the previous 22 weeks of the year declined from 560,620 in 2019 to 247,030 in 2020, and inpatient cases decreased from 14,177 to 7,555. This negative trend settled by week 6 and 7 and subsequently approached the 2019 numbers. The most noticeable decrease in the number of cases was observed in children of preschool age. Moreover, the number of weekly visits decreased at the beginning of the epidemic, reached the lowest value during the lockdown period, and recovered after the lockdown. Conclusion: Based on the results of this study, clinical practice in a pediatric department in Wenzhou was substantially affected by the epidemic and measures such as physical distancing and increased personal hygiene, particularly in preschool-age children. An understanding of the trends and impacts of the pandemic on pediatric patients and health systems will facilitate better preparation of pediatricians in the future.

Patients with neuromyelitis optica (NMO) often have an accompanying autoimmune disease, most commonly, but not limited to Sjögren's syndrome (SS). The aim of this study was to compare clinical and laboratory features between NMO patients with and without SS and to investigate the prognosis of NMO in patients with and without SS. Twenty-three NMO patients with SS and 42 NMO patients without SS were included. Clinical and laboratory profiles were compared, including annual relapse rate and time from onset of NMO to Expanded Disability Status Scale (EDSS) scores of 4.0 and 6.0. More NMO patients with SS than those without SS had anti-nuclear antibody, anti-SS-A/Ro and anti-SS-B/La antibodies (91.3 vs. 35.7%, p < 0.001, 87.0 vs. 2.3%, p < 0.001, and 34.8 vs. 0.0%, p < 0.001, respectively). Serum immunoglobulins (IgA, IgM and IgG) were markedly increased in NMO patients with SS in comparison with those without SS. Annual relapse rate and the time from disease onset to an EDSS score of 4.0 and 6.0 were not significantly different between the two groups. No differences between the two groups were found for the other parameters, including AQP-4 antibody status, length of spinal cord lesion and brain lesions. These results imply that NMO in SS more likely represents coexistence with SS rather than representing the result of direct central nervous system involvement in SS. Autoimmune response appears to be more intense in the NMO group with SS, but did not cause a more severe prognosis in comparison with the group without SS, indicating that we should pay attention to the potential benefit of the antinuclear antibodies in NMO.

With the rapid development of the global information technology and the widespread application, enterprises put higher forward requirements on the implementation of ERP performance management. In order to solve the problem that majority of enterprises performance evaluation system of ERP attach importance to financial index system, light the future value creation, pay attention to performance of tangible assets, light intangible assets value of light, think highly of result, light process and other issues, this paper absorb and digest theoretical research about the Balanced Scorecard combined with system dynamics. In view of these, this paper aims to provide a dynamic balanced scorecard based on the performance evaluation model of ERP implementation. Then, for enterprises implemented ERP as an example, this paper establishes the dynamic model of ERP performance evaluation, which uses Vensim software and combines the status of enterprises. Also, this thesis mainly put this dynamic model into empirical analysis. Finally, according to the empirical analysis, we can draw the conclusion that the system dynamics not only can effectively make up for the lack of balance score card, such as the time lag and lack of system feedback, but also can prove the effectiveness of information dynamic evaluation model, which can provide support and reference for decision-making and performance management, avoiding subjective thinking defect of managers.

This paper rushes from unit to surge to make in the theoretical intension of function the unified theory and method that signal divides into to fold , this theory is normalized more , is clear.

Z-pins reinforced 2D ceramic matrix composites (CMCs), integratedly designed new materials, are developed to enhance 2D CMCs through-thickness in the form of Z-pins and to ensure significant increase in interlaminar fracture toughness, delamination resistance and impact resistance, and Z-pins reinforced 2D CMCs have much application. Finite element method was adopted to analyze stress distributions of Z-pins reinforced woven CMCs; the interlaminar shear tests were employed to measure interlaminar shear strength; fractographies were observed to examine failure mechanisms. The results are shown as the following: the insertion of Z-pins reduces concentrated stress fields and enhances the uniform stress distribution on the expected fracture plane. Interlaminar shear strength of Z-pins reinforced woven CMCs is increased as Z-pins insertion reaches a certain number. Interlaminar shear strength goes up with the rise of the number of inserted Z-pins. Z-pins shearing and fabric/matrix debonding are interlaminar failure mechanisms of Z-pins reinforced CMCs.