BACKGROUND Nutritional support for patients hospitalized in the intensive care unit(ICU)is an important part of clinical treatment and care,but there are significant implementation difficulties.AIM To introduce a modi...BACKGROUND Nutritional support for patients hospitalized in the intensive care unit(ICU)is an important part of clinical treatment and care,but there are significant implementation difficulties.AIM To introduce a modified nutritional support management system for ICU patients based on closed-loop information management and psychological counseling.METHODS The division of functions,personnel training,system construction,development of an intelligent decision-making software system,quality control,and improvement of the whole process were carried out to systematically manage nutritional support for ICU patients.RESULTS Following the implementation of the whole process management system,the scores of ICU medical staff’s knowledge,attitudes/beliefs,and practices regarding nutritional support were comprehensively enhanced.The proportion of hospital bed-days of total enteral nutrition(EN)in ICU patients increased from 5.58%to 11.46%,and the proportion of EN plus parenteral nutrition increased from 42.71%to 47.07%.The rate of EN initiation within 48 h of ICU admission increased from 37.50%to 48.28%,and the EN compliance rate within 72 h elevated from 20.59%to 31.72%.After the implementation of the project,the Self-rating Anxiety Scale score decreased from 61.07±9.91 points to 52.03±9.02 points,the Self-rating Depression Scale score reduced from 62.47±10.50 points to 56.34±9.83 points,and the ICU stay decreased from 5.76±2.77 d to 5.10±2.12 d.CONCLUSION The nutritional support management system based on closed-loop information management and psychological counseling achieved remarkable results in clinical applications in ICU patients.展开更多
Spatial omics technology integrates the concept of space into omics research and retains the spatial information of tissues or organs while obtaining molecular information.It is characterized by the ability to visuali...Spatial omics technology integrates the concept of space into omics research and retains the spatial information of tissues or organs while obtaining molecular information.It is characterized by the ability to visualize changes in molecular information and yields intuitive and vivid visual results.Spatial omics technologies include spatial transcriptomics,spatial proteomics,spatial metabolomics,and other technologies,the most widely used of which are spatial transcriptomics and spatial proteomics.The tumor microenvironment refers to the surrounding microenvironment in which tumor cells exist,including the surrounding blood vessels,immune cells,fibroblasts,bone marrow-derived inflammatory cells,various signaling molecules,and extracellular matrix.A key issue in modern tumor biology is the application of spatial omics to the study of the tumor microenvironment,which can reveal problems that conventional research techniques cannot,potentially leading to the development of novel therapeutic agents for cancer.This paper summarizes the progress of research on spatial transcriptomics and spatial proteomics technologies for characterizing the tumor immune microenvironment.展开更多
The Singing Sand Mountain and Crescent Spring Scenic Spot in Dunhuang,Northwest China is a world-renowned desert attraction that is also an integral component of the Dunhuang UNESCO Global Geopark.This scenic area und...The Singing Sand Mountain and Crescent Spring Scenic Spot in Dunhuang,Northwest China is a world-renowned desert attraction that is also an integral component of the Dunhuang UNESCO Global Geopark.This scenic area underwent a 30-year transformation,i.e.,from a severe sand risk with spring water threatened by sand burial due to dune deformation,to restoration of the original sand flow field and mitigation of the sand burial problem.The current paper summarizes the research on the intensive monitoring of the dynamic change of star dunes near the spring,observation of wind and sand flow movement,and then restoring the harmonic vibration of the sand particles(singing sand)that were previously silenced.The existing and prospective impacts of anthropogenic and natural forces on the deformation of the sand dunes are investigated by integrated methods,guiding the implementation of mitigating measures with significant ameliorative effects.Contrast to common sand control practices that aim to reduce wind speed and stop blown sands,our research highlights the importance of maintaining the natural wind flow field in stabilizing surrounding dunes.These mitigation measures consist of removing excessive vegetation and newly constructed buildings to recover the original wind flow field and sand transport activity.Such research and mitigation efforts ensure the scientific protection and restoration of the special desert landform,and contribute to the mutual enhancement of the conservation and exploitation of this desert scenic spot and similar sites.展开更多
BACKGROUND Isolated gallbladder injury(GI)(IGI)directly induced by abdominal trauma is rare.Symptoms,indications,and imaging examinations of IGI are frequently non-specific,posing tremendous diagnostic challenges,whic...BACKGROUND Isolated gallbladder injury(GI)(IGI)directly induced by abdominal trauma is rare.Symptoms,indications,and imaging examinations of IGI are frequently non-specific,posing tremendous diagnostic challenges,which are simple to overlook and may have severe implications.Improving doctors'understanding of gallbladder injury(GI)facilitates early detection and decreases the likelihood of severe consequences,including death.CASE SUMMARY We report a case of IGI caused by blunt violence(after falling from three meters with the umbilicus as the stress point)and performed laparoscopic repair of the gallbladder rupture,which helps clinicians understand IGI and reduce the severe consequences of delayed diagnosis.Through extensive medical history and dynamic abdominal ultrasound evaluation,doctors can identify GI early and begin surgery,thereby decreasing the devastating repercussions of delayed diagnosis.CONCLUSION This article aims to improve clinicians'understanding of IGI and propose a method for the diagnosis and treatment of GI.展开更多
BACKGROUND It remains unclear whether laparoscopic multisegmental resection and ana-stomosis(LMRA)is safe and advantageous over traditional open multisegmental resection and anastomosis(OMRA)for treating synchronous c...BACKGROUND It remains unclear whether laparoscopic multisegmental resection and ana-stomosis(LMRA)is safe and advantageous over traditional open multisegmental resection and anastomosis(OMRA)for treating synchronous colorectal cancer(SCRC)located in separate segments.AIM To compare the short-term efficacy and long-term prognosis of OMRA as well as LMRA for SCRC located in separate segments.METHODS Patients with SCRC who underwent surgery between January 2010 and December 2021 at the Cancer Hospital,Chinese Academy of Medical Sciences and the Peking University First Hospital were retrospectively recruited.In accordance with the RESULTS LMRA patients showed markedly less intraoperative blood loss than OMRA patients(100 vs 200 mL,P=0.006).Compared to OMRA patients,LMRA patients exhibited markedly shorter postoperative first exhaust time(2 vs 3 d,P=0.001),postoperative first fluid intake time(3 vs 4 d,P=0.012),and postoperative hospital stay(9 vs 12 d,P=0.002).The incidence of total postoperative complications(Clavien-Dindo grade:≥II)was 2.9%and 17.1%(P=0.025)in the LMRA and OMRA groups,respectively,while the incidence of anastomotic leakage was 2.9%and 7.3%(P=0.558)in the LMRA and OMRA groups,respectively.Furthermore,the LMRA group had a higher mean number of lymph nodes dissected than the OMRA group(45.2 vs 37.3,P=0.020).The 5-year overall survival(OS)and disease-free survival(DFS)rates in OMRA patients were 82.9%and 78.3%,respectively,while these rates in LMRA patients were 78.2%and 72.8%,respectively.Multivariate prognostic analysis revealed that N stage[OS:HR hazard ratio(HR)=10.161,P=0.026;DFS:HR=13.017,P=0.013],but not the surgical method(LMRA/OMRA)(OS:HR=0.834,P=0.749;DFS:HR=0.812,P=0.712),was the independent influencing factor in the OS and DFS of patients with SCRC.CONCLUSION LMRA is safe and feasible for patients with SCRC located in separate segments.Compared to OMRA,the LMRA approach has more advantages related to short-term efficacy.展开更多
Natural forests and stands subjected to little to moderate human impact are continuously declining worldwide and with these,their biodiversity and ecosystem services.Many Nothofagus forests in the south of the South A...Natural forests and stands subjected to little to moderate human impact are continuously declining worldwide and with these,their biodiversity and ecosystem services.Many Nothofagus forests in the south of the South American continent are in a pristine state or only moderately impacted by humans.Forest grazing by livestock,in the past and still today often practiced in a non-sustainable way is,however,increasingly under discussion to meet current environmental and socio-economic challenges.Accordingly,we investigate the regeneration of Nothofagus dombeyi,a keystone species of the Patagonian Andes,in secondary forests in Argentinian northern Patagonia,particularly addressing the role of disturbance through grazing by livestock at various intensities.We test the hypothesis that the regeneration of this tree species is favored by grazing impact and,thus,disturbance of the herb layer and soil surface.In support of our hypothesis,Nothofagus dombeyi regeneration was significantly higher in terms of individuals and height classes in moderately grazed forests.Multivariate analysis shows significant positive effects of moderate grazing pressure,herb layer cover,and the occurrence of bare soil on the regeneration of Nothofagus dombeyi.Our results show that an integration of livestock grazing and forest regeneration is possible and that agroforestry systems can be an adequate management option for stakeholders in the region.A grazing management can also be part of a forest fire prevention strategy.However,the regeneration success and grazing pressure should be continuously monitored.展开更多
A three-dimensional graphene-based composite was prepared by a simple one-step in-site reduced-oxide method under atmospheric pressure. The obtained hydrogel was modified with 4-amino-benzenesulfonic acid and connecte...A three-dimensional graphene-based composite was prepared by a simple one-step in-site reduced-oxide method under atmospheric pressure. The obtained hydrogel was modified with 4-amino-benzenesulfonic acid and connected with ethylenediamine, and freeze-dried into an aerogel, which was characterized. Then the surface interaction with platinum (Pt, IV) was explored. The obtained aerogel showed good adsorption for Pt (IV) at acid conditions, giving a rising to the adsorption rate > 98% while pH ≥ 6. Using hexadecyl trimethyl ammonium bromide of 2% (m/V) as an eluent to desorb the Pt (IV) from the surface of the aerogel, a desorption rate of 81.1% was obtained in this process. Urea, buffer aquation and other surfactants were used in the desorption experiment to understand the adsorption mechanism between the aerogel and Pt (IV). In this work, hydrogen bond, van der Waals force and electronic interaction force mainly drove the adsorption process. For obtaining more purified Pt (IV), we used 0.5% CTAB to desorb Pd (II). A new three-dimensional graphene-based composite was prepared and the surface interaction between Pt (IV) and composite was experimented for understanding the adsorption mechanism and exploring its potential application in sample preparation in low concentration.展开更多
In this study,we used remotely sensed data,GIS modeling,and statistical methods to evaluate the damage caused by the Wenchuan Earthquake (May 12,2008) to the giant panda (Ailuropoda melanoleuca) habitat in the World N...In this study,we used remotely sensed data,GIS modeling,and statistical methods to evaluate the damage caused by the Wenchuan Earthquake (May 12,2008) to the giant panda (Ailuropoda melanoleuca) habitat in the World Nature Heritage Sichuan Giant Panda Sanctuary (WHSGPS) in China.A landscape ecological analysis found increases of landscape heterogeneity,complexity,and fragmentation in the giant panda habitat after the earthquake.A terrain analysis found that slope and elevation are directly associated with the distribution of the damaged areas.As slope and elevation increase,the size of the damaged area keeps increase until to a peak,and then starts to drop.The total area of the damaged vegetation in our study area is 114.26 km 2,accounting for 3.78% of the study area;30.46% of that 114.26 km 2 is located in the Core Zone of WHSGPS.There are 18.57km 2 of the damaged vegetation located in the identified suitable giant panda habitat,accounting for 1.75% of the total area of suitable giant panda habitats in the study area.Based on these findings,we conclude that the Wenchuan Earthquake does not have significant impact on the WHSGPS as a whole.展开更多
The study aims to compare the differences of macrofauna communities of wetlands at 3-year-forest- age, 5-year-forest-age Sonneratia apetala artificial mangroves, 5-year-forest-age Kandelia candel ar- tificial mangrove...The study aims to compare the differences of macrofauna communities of wetlands at 3-year-forest- age, 5-year-forest-age Sonneratia apetala artificial mangroves, 5-year-forest-age Kandelia candel ar- tificial mangroves with the same restoration background, and the naked tidal flat in the Qi'ao Island Mangrove Nature Reserve of Zhuhai, Guangdong Province. The results show that there were signif- icant structural differences in macrofauna communities among four kinds of habitats. The increase of biomass and species diversity of macrofauna at 3-year-forest-age S. apetala artificial mangroves was obviously faster than that at 5-year-forest-age K. candel artificial mangroves whose average tree height was close to that of 3-year-forest-age S. apetala artificial mangroves. The BIOENV analysis shows that it was related to the rapid growth of S. apetala, which rapidly changed the light level and shading conditions in the forests. The 5-year-forest-age S. apetala artificial mangroves had lower macrofauna species diversity but higher density and biomass than K. candel artificial mangroves with the same forest age. This was due to the rapid changes of physical and chemical properties of habitat soil by the ecological restoration of S. apetala artificial mangroves as well as the changed food sources possibly caused by the leaf-litter of such non-indigenous mangrove species S. apetala. However, further survey should be conducted on whether there are any negative ecological impacts of large-scale cultivation of S. apetala on macrofauna communities, so as to evaluate correctly S. apetala's role in the restoration of coastal mangrove ecosystems.展开更多
Forest volume,the major component of forest biomass,is an important issue in forest resource monitoring.It is estimated from tree volume tables or equations.Based on tree volume data of 1840 sample trees from Chinese ...Forest volume,the major component of forest biomass,is an important issue in forest resource monitoring.It is estimated from tree volume tables or equations.Based on tree volume data of 1840 sample trees from Chinese fir(Cunninghamia lanceolata)plantations in Guizhou Province in southwestern China,parallel one-and two-variable tree volume tables and tree height curves for central and other areas were constructed using an error-in-variable modeling method.The results show that,although the one-variable tree volume equations and height curves between the central and other areas were significantly different,the two-variable volume equations were sufficiently close,so that a generalized two-variable tree volume equation could be established for the entire province.展开更多
Experiments were conducted to evaluate the physiological and the biochemical characteristics of waxy wheat seeds under accelerated aging conditions. Five waxy wheat lines, which were Waxy 1, Waxy 4, Waxy 8, Waxy 9, an...Experiments were conducted to evaluate the physiological and the biochemical characteristics of waxy wheat seeds under accelerated aging conditions. Five waxy wheat lines, which were Waxy 1, Waxy 4, Waxy 8, Waxy 9, and Waxy 15; and five non-waxy wheat lines: S-39, 04J89, Jan-81, Ⅲ42-4, and Ⅲ10 were studied. The seeds were subjected to accelerated aging at 40℃, 45℃, 50℃, 55℃, and 60℃, and 90% relative humidity for 0, 2, 4, 6, and 8 days, respectively. The results showed a gradual increase in conductivity and decrease in germination rate during accelerated aging. SOD, POD and CAT activities increased at low-grade treatment, but decreased at severe treatment. On the other hand, the soluble protein content decreased at 45℃, but successively increased, then decreased 50℃. From the above study, it showed that 90% RH at 55℃ was the best accelerated aging condition for optimum efficiency in a shorter period.展开更多
Wastewater, which involves easy-soluble reactive dyes, especially non-degradable dyes, is very difficult to decolor efficiently by normal processes such as coagulation process and biological treatment. The high chroma...Wastewater, which involves easy-soluble reactive dyes, especially non-degradable dyes, is very difficult to decolor efficiently by normal processes such as coagulation process and biological treatment. The high chromaticity se- riously hinders the reuse of reactive dye waste water. In this paper, a new method by bentonite adsorption and coagulation (PAC) is employed for removing color from synthetic dye waste water which contains reactive red K-2G, K-RN blue, K-GR blue, X-3B red, K-GN orange, KB-3G yellow, K-2BP red, K-RN yellow and K-6G yellow. Bentonite pre- treated by 4% CTMAB and milled to 160 order screen is proven to the best decoloring agent. For a 100 mL reactive red K-2G sample (CODcr 400 mg/L, 25 000 chromaticity color), 0.5 g bentonite pretreated and 2.5 mL PAC is enough to decolor wastewater up to 99.92% and the sediment time is short. Non-degradable dyes such as active red X-3B and K-GN orange are declored completely as well. Raw sewage (low chromaticity color) is decolored completely at a ben-tonite dosage of 0.001g. More researches prove the high practical value of this process.展开更多
目的描述初产妇与经产妇分娩恐惧和产时疼痛强度的特点并比较差异,探讨实际疼痛缓解情况与分娩恐惧的关系。方法采用便利抽样法,2018年2月至2019年8月选取广州市某三级甲等专科医院自然临产或引产的阴道分娩产妇共260名,其中初产妇97名...目的描述初产妇与经产妇分娩恐惧和产时疼痛强度的特点并比较差异,探讨实际疼痛缓解情况与分娩恐惧的关系。方法采用便利抽样法,2018年2月至2019年8月选取广州市某三级甲等专科医院自然临产或引产的阴道分娩产妇共260名,其中初产妇97名,经产妇163名。从结构化电子病历系统提取产妇和新生儿的临床资料,通过问卷收集其他一般资料,如职业、家庭人均月收入。采用数字评定量表(the Numeric Rating Scale,NRS)和中文版分娩态度问卷(the Chinese version of the Childbirth Attitude Questionnaire,C-CAQ)对产妇分娩时疼痛程度和分娩恐惧程度进行评估。产妇的产时麻醉药消耗量和手动按压补充给药次数从自控硬膜外镇痛泵查看并记录。结果82名(84.5%)初产妇和99名(60.7%)经产妇接受了硬膜外自控镇痛方式(P<0.001)。在采用硬膜外镇痛组中,初产妇分娩恐惧得分高于经产妇(36.46±10.93比32.06±10.23,P=0.007)。然而,经产妇分娩时疼痛得分[8.0(8.0,9.0)比8.0(7.0,8.0)]、每小时成功手动补充给药次数[2.68(1.65,3.85)比1.77(0.90,2.47)]、每小时麻醉药消耗剂量[23.00(16.00,28.25)比17.24(11.52,21.36)]mL、平均每公斤消耗麻醉药剂量依次为[0.35(0.24,0.45)比0.26(0.19,0.35)]mL/kg均高于初产妇(P<0.05)。Spearman相关分析显示,分娩疼痛最大值与分娩恐惧之间呈弱相关(r=0.09),与每小时麻醉药消耗量(r=0.16)和平均每公斤体重麻醉药消耗量(r=0.17)呈正相关(P<0.01)。麻醉药物消耗量与产妇的分娩恐惧得分无相关性。结论分娩恐惧是产时疼痛程度的潜在预测因素。产次并不是镇痛需求的决定性因素,特别是在资源有限的情况下,产科医护团队不应紧依靠产次来分配镇痛资源。展开更多
Three stochastic mathematical models for calculation of the reservoir flood regulation process,river course flood release,and flood risk rate under flood control were established based on the theory of stochastic diff...Three stochastic mathematical models for calculation of the reservoir flood regulation process,river course flood release,and flood risk rate under flood control were established based on the theory of stochastic differential equations and features of flood control systems in the middle reach of the Huaihe River from Xixian to the Bengbu floodgate,comprehensively considering uncertain factors of hydrology,hydraulics,and engineering control.They were used to calculate the flood risk rate with flood regulation of five key reservoirs,including the Meishan,Xianghongdian,Nianyushan,Mozitan,and Foziling reservoirs in the middle reach of the Huaihe River under different flood frequencies,the flood risk rate with river course flood release under design and check floods for the trunk of the Huaihe River in conjunction with relevant flood storage areas,and the flood risk rate with operation of the Linhuaigang Project under design and check floods.The calculated results show that(1) the five reservoirs can withstand design floods,but the Xianghongdian and Foziling reservoirs will suffer overtopping accidents under check floods;(2) considering the service of flood storage areas under the design flood conditions of the Huaihe River,the mean flood risk rate with flood regulation of dykes and dams from Xixian to the Bengbu floodgate is about 0.2,and the trunk of the Huaihe River can generally withstand design floods; and(3) under a check flood with the flood return period of 1 000 years,the risk rate of overtopping accidents of the Linhuaigang Project is not larger than 0.15,indicating that it has a high flood regulation capacity.Through regulation and application of the flood control system of the Linhuigang Project,the Huaihe River Basin can withstand large floods,and the safety of the protected area can be ensured.展开更多
Ag/AgCl electrode has been prepared using pressed powder techniques. In order to verify the feasibility of this type of electrode used as detecting electric field generated by vessels in seawater,its characteristics o...Ag/AgCl electrode has been prepared using pressed powder techniques. In order to verify the feasibility of this type of electrode used as detecting electric field generated by vessels in seawater,its characteristics of DC resistance,low frequency AC impedance,and receiving impedance in artificial seawater have been studied by polarization measurements,low frequency electrochemical impedance spectra,the open and short circuit cell conditions. The results show that the electrode can keep a low resistance when it responses the weak electrostatic field in seawater. The AC impedance of the electrode decreases as the frequency of the signal increasing. The receiving impedance decreases when the frequency of external field increases too. The valid detection bandwidth is determined by the properties of the impedance and the reactions occurring on the surface of the electrode.展开更多
The coast of the Dapeng Peninsula has been honored as one of "the eight most beautiful coasts in China". The most precious tourism resource for the peninsula is headland bay beaches, among which the beach at...The coast of the Dapeng Peninsula has been honored as one of "the eight most beautiful coasts in China". The most precious tourism resource for the peninsula is headland bay beaches, among which the beach at Xichong on the southern coast of the peninsula is the longest and the most important one. The information of the stability, sedimentary source and shape change of the beach is very important for maintaining the beach in terms of sustainable development of the peninsula. Heavy minerals in the sand of the beach and the inland stream at Xichong are compared with those of a nearby beach on the same coast to determine the beach sand source; with help of a computer software, MEPBAY, the equilibrium planforms of the beaches on the peninsula are compared with those of an island without rivers to evaluate the stream's effects on the beach stability; cross shore profiles along the Xichong beach are also surveyed in different seasons of a year to assess the annual shore normal beach changes affected by the stream input, and the relation between the equilibrium planform state and cross shore changes of the beach. It is shown that(1) stream is the main sedimentary source of the beach and the weathering materials of the rocky headlands on both sides of the bay transported by waves are the second source for the beach but it is limited, sand from an inner shelf is not the sedimentary source for the beach at present and was not even during the Holocene transgression;(2) the Xichong beach cannot reach static equilibrium around the entire bay shoreline, the segment of the shoreline where a stream outlet is located is in dynamic equilibrium, and the unstable section occurs in the wave shadow region in the lee of an offshore island;(3) no matter whether the section of the beach shoreline at Xichong is in an equilibrium state or not, it is eroded in the typhoon season and recovered after the season, the maximum change in erosion and accretion occurs in the unstable segment;(4) the Xichong beach can only have small sand body since it is supplied with sand mainly form inland streams, resulting in a possible danger in which sand loss induced by human activities or huge storms cannot be replenished naturally.展开更多
China implemented the public hospital reform in 2012. This study utilized bootstrapping data envelopment analysis(DEA) to evaluate the technical efficiency(TE) and productivity of county public hospitals in Eastern, C...China implemented the public hospital reform in 2012. This study utilized bootstrapping data envelopment analysis(DEA) to evaluate the technical efficiency(TE) and productivity of county public hospitals in Eastern, Central, and Western China after the 2012 public hospital reform. Data from 127 county public hospitals(39, 45, and 43 in Eastern, Central, and Western China, respectively) were collected during 2012–2015. Changes of TE and productivity over time were estimated by bootstrapping DEA and bootstrapping Malmquist. The disparities in TE and productivity among public hospitals in the three regions of China were compared by Kruskal–Wallis H test and Mann–Whitney U test. The average bias-corrected TE values for the four-year period were 0.6442, 0.5785, 0.6099, and 0.6094 in Eastern, Central, and Western China, and the entire country respectively, with average non-technical efficiency, low pure technical efficiency(PTE), and high scale efficiency found. Productivity increased by 8.12%, 0.25%, 12.11%, and 11.58% in China and its three regions during 2012–2015, and such increase in productivity resulted from progressive technological changes by 16.42%, 6.32%, 21.08%, and 21.42%, respectively. The TE and PTE of the county hospitals significantly differed among the three regions of China. Eastern and Western China showed significantly higher TE and PTE than Central China. More than 60% of county public hospitals in China and its three areas operated at decreasing return scales. There was a considerable space for TE improvement in county hospitals in China and its three regions. During 2012–2015, the hospitals experienced progressive productivity; however, the PTE changed adversely. Moreover, Central China continuously achieved a significantly lower efficiency score than Eastern and Western China. Decision makers and administrators in China should identify the causes of the observed inefficiencies and take appropriate measures to increase the efficiency of county public hospitals in the three areas of China, especially in Central China.展开更多
The aim of this study was to evaluate the diagnostic value of the cerebrospinal fluid(CSF) T‐SPOT.TB test for the diagnosis of TB meningitis(TBM). A retrospective analysis of 96 patients with manifested meningitis wa...The aim of this study was to evaluate the diagnostic value of the cerebrospinal fluid(CSF) T‐SPOT.TB test for the diagnosis of TB meningitis(TBM). A retrospective analysis of 96 patients with manifested meningitis was conducted; T‐SPOT.TB test was performed for diagnosing TBM to determine the diagnostic sensitivity, specificity, positive predictive value(PPV), and negative predictive value(NPV). A receiver operating characteristic(ROC) curve was also drawn to assess the diagnostic accuracy. The sensitivity, specificity, PPV, and NPV of CSF T‐SPOT.TB test were 97.8%, 78.0%, 80.3%, and 97.5%, respectively, for 52 patients(54.2%) of the 96 enrolled patients. The area under the curve(AUC) was 0.910, and the sensitivities of CSF T‐SPOT.TB for patients with stages I, II, and III of TBM were 96.7%, 97.2%, and 98.9%, respectively. CSF T‐SPOT.TB test is a rapid and accurate diagnostic method with higher sensitivity and specificity for diagnosing TBM.展开更多
Shedao pit-vipers(Gloydius shedaoensis) on Snake Island in the Liaoning Province,China,are among the most imperiled species in China.The isolated and unique populations are crucial in the recovery of this endangered s...Shedao pit-vipers(Gloydius shedaoensis) on Snake Island in the Liaoning Province,China,are among the most imperiled species in China.The isolated and unique populations are crucial in the recovery of this endangered species by providing a way for conservation and management.Research based on the ecological simulation tools can evaluate alternative mitigation strategies in terms of their benefits to the populations,which are vital for informed decision-making.In this paper,using the program VORTEX 9.42,we developed a population viability analysis(PVA) for the Shedao pit-viper to:(1) address the extinction likelihood of the population;(2) simulate population dynamics under various environment events,and(3) evaluate the efficacy of current protection and management strategies.Overall,we found the population to be susceptible to the factors of catastrophic events,mortality and environment capacity.The population is recovering slowly at present on account of improvement of habitat and greater food availability.Under the current conditions,the probability of extinction in 100 years is approximately zero.These data coincide with the evidence that the wild population may be arriving at K.Our results strengthen the view that protection and management can create a pronounced effect on populations of this endangered species.展开更多
基金Supported by Research Project of Zhejiang Provincial Department of Education,No.Y202045115.
文摘BACKGROUND Nutritional support for patients hospitalized in the intensive care unit(ICU)is an important part of clinical treatment and care,but there are significant implementation difficulties.AIM To introduce a modified nutritional support management system for ICU patients based on closed-loop information management and psychological counseling.METHODS The division of functions,personnel training,system construction,development of an intelligent decision-making software system,quality control,and improvement of the whole process were carried out to systematically manage nutritional support for ICU patients.RESULTS Following the implementation of the whole process management system,the scores of ICU medical staff’s knowledge,attitudes/beliefs,and practices regarding nutritional support were comprehensively enhanced.The proportion of hospital bed-days of total enteral nutrition(EN)in ICU patients increased from 5.58%to 11.46%,and the proportion of EN plus parenteral nutrition increased from 42.71%to 47.07%.The rate of EN initiation within 48 h of ICU admission increased from 37.50%to 48.28%,and the EN compliance rate within 72 h elevated from 20.59%to 31.72%.After the implementation of the project,the Self-rating Anxiety Scale score decreased from 61.07±9.91 points to 52.03±9.02 points,the Self-rating Depression Scale score reduced from 62.47±10.50 points to 56.34±9.83 points,and the ICU stay decreased from 5.76±2.77 d to 5.10±2.12 d.CONCLUSION The nutritional support management system based on closed-loop information management and psychological counseling achieved remarkable results in clinical applications in ICU patients.
基金supported by Basic and Applied Basic Research Foundation of Guangdong Province(No.2022A1111220217)Medical Scientific Research Foundation of Guangdong Province(Nos.A2023216,A2022124)+3 种基金Science and Technology Program of Guangzhou(Nos.202201010840,202201010810,202102080132,202002030032,202002020023)Health Commission Program of Guangzhou(20212A010021,20201A010081,20211A011116)Science and Technology Project of Panyu,Guangzhou(2022-Z04-009,2022-Z04-090,2022-Z04-072,2021-Z04-013,2020-Z04-026,2019-Z04-02)Scientific Research Project of Guangzhou Panyu Central Hospital(Nos.2022Y002,2021Y004,2021Y002).
文摘Spatial omics technology integrates the concept of space into omics research and retains the spatial information of tissues or organs while obtaining molecular information.It is characterized by the ability to visualize changes in molecular information and yields intuitive and vivid visual results.Spatial omics technologies include spatial transcriptomics,spatial proteomics,spatial metabolomics,and other technologies,the most widely used of which are spatial transcriptomics and spatial proteomics.The tumor microenvironment refers to the surrounding microenvironment in which tumor cells exist,including the surrounding blood vessels,immune cells,fibroblasts,bone marrow-derived inflammatory cells,various signaling molecules,and extracellular matrix.A key issue in modern tumor biology is the application of spatial omics to the study of the tumor microenvironment,which can reveal problems that conventional research techniques cannot,potentially leading to the development of novel therapeutic agents for cancer.This paper summarizes the progress of research on spatial transcriptomics and spatial proteomics technologies for characterizing the tumor immune microenvironment.
基金the National Key R&D Program of China(2018YFD1100104)the National Science Foundation of China(42071014)the Youth Innovation Promotion Association of the Chinese Academy of Sciences(Y202085).
文摘The Singing Sand Mountain and Crescent Spring Scenic Spot in Dunhuang,Northwest China is a world-renowned desert attraction that is also an integral component of the Dunhuang UNESCO Global Geopark.This scenic area underwent a 30-year transformation,i.e.,from a severe sand risk with spring water threatened by sand burial due to dune deformation,to restoration of the original sand flow field and mitigation of the sand burial problem.The current paper summarizes the research on the intensive monitoring of the dynamic change of star dunes near the spring,observation of wind and sand flow movement,and then restoring the harmonic vibration of the sand particles(singing sand)that were previously silenced.The existing and prospective impacts of anthropogenic and natural forces on the deformation of the sand dunes are investigated by integrated methods,guiding the implementation of mitigating measures with significant ameliorative effects.Contrast to common sand control practices that aim to reduce wind speed and stop blown sands,our research highlights the importance of maintaining the natural wind flow field in stabilizing surrounding dunes.These mitigation measures consist of removing excessive vegetation and newly constructed buildings to recover the original wind flow field and sand transport activity.Such research and mitigation efforts ensure the scientific protection and restoration of the special desert landform,and contribute to the mutual enhancement of the conservation and exploitation of this desert scenic spot and similar sites.
文摘BACKGROUND Isolated gallbladder injury(GI)(IGI)directly induced by abdominal trauma is rare.Symptoms,indications,and imaging examinations of IGI are frequently non-specific,posing tremendous diagnostic challenges,which are simple to overlook and may have severe implications.Improving doctors'understanding of gallbladder injury(GI)facilitates early detection and decreases the likelihood of severe consequences,including death.CASE SUMMARY We report a case of IGI caused by blunt violence(after falling from three meters with the umbilicus as the stress point)and performed laparoscopic repair of the gallbladder rupture,which helps clinicians understand IGI and reduce the severe consequences of delayed diagnosis.Through extensive medical history and dynamic abdominal ultrasound evaluation,doctors can identify GI early and begin surgery,thereby decreasing the devastating repercussions of delayed diagnosis.CONCLUSION This article aims to improve clinicians'understanding of IGI and propose a method for the diagnosis and treatment of GI.
文摘BACKGROUND It remains unclear whether laparoscopic multisegmental resection and ana-stomosis(LMRA)is safe and advantageous over traditional open multisegmental resection and anastomosis(OMRA)for treating synchronous colorectal cancer(SCRC)located in separate segments.AIM To compare the short-term efficacy and long-term prognosis of OMRA as well as LMRA for SCRC located in separate segments.METHODS Patients with SCRC who underwent surgery between January 2010 and December 2021 at the Cancer Hospital,Chinese Academy of Medical Sciences and the Peking University First Hospital were retrospectively recruited.In accordance with the RESULTS LMRA patients showed markedly less intraoperative blood loss than OMRA patients(100 vs 200 mL,P=0.006).Compared to OMRA patients,LMRA patients exhibited markedly shorter postoperative first exhaust time(2 vs 3 d,P=0.001),postoperative first fluid intake time(3 vs 4 d,P=0.012),and postoperative hospital stay(9 vs 12 d,P=0.002).The incidence of total postoperative complications(Clavien-Dindo grade:≥II)was 2.9%and 17.1%(P=0.025)in the LMRA and OMRA groups,respectively,while the incidence of anastomotic leakage was 2.9%and 7.3%(P=0.558)in the LMRA and OMRA groups,respectively.Furthermore,the LMRA group had a higher mean number of lymph nodes dissected than the OMRA group(45.2 vs 37.3,P=0.020).The 5-year overall survival(OS)and disease-free survival(DFS)rates in OMRA patients were 82.9%and 78.3%,respectively,while these rates in LMRA patients were 78.2%and 72.8%,respectively.Multivariate prognostic analysis revealed that N stage[OS:HR hazard ratio(HR)=10.161,P=0.026;DFS:HR=13.017,P=0.013],but not the surgical method(LMRA/OMRA)(OS:HR=0.834,P=0.749;DFS:HR=0.812,P=0.712),was the independent influencing factor in the OS and DFS of patients with SCRC.CONCLUSION LMRA is safe and feasible for patients with SCRC located in separate segments.Compared to OMRA,the LMRA approach has more advantages related to short-term efficacy.
基金supported by funds of the Federal Ministry of Food and Agriculture (BMEL) based on a decision of the Parliament of the Federal Republic of Germany via the Federal Office for Agriculture and Food (BLE,grant No.281-042-01)
文摘Natural forests and stands subjected to little to moderate human impact are continuously declining worldwide and with these,their biodiversity and ecosystem services.Many Nothofagus forests in the south of the South American continent are in a pristine state or only moderately impacted by humans.Forest grazing by livestock,in the past and still today often practiced in a non-sustainable way is,however,increasingly under discussion to meet current environmental and socio-economic challenges.Accordingly,we investigate the regeneration of Nothofagus dombeyi,a keystone species of the Patagonian Andes,in secondary forests in Argentinian northern Patagonia,particularly addressing the role of disturbance through grazing by livestock at various intensities.We test the hypothesis that the regeneration of this tree species is favored by grazing impact and,thus,disturbance of the herb layer and soil surface.In support of our hypothesis,Nothofagus dombeyi regeneration was significantly higher in terms of individuals and height classes in moderately grazed forests.Multivariate analysis shows significant positive effects of moderate grazing pressure,herb layer cover,and the occurrence of bare soil on the regeneration of Nothofagus dombeyi.Our results show that an integration of livestock grazing and forest regeneration is possible and that agroforestry systems can be an adequate management option for stakeholders in the region.A grazing management can also be part of a forest fire prevention strategy.However,the regeneration success and grazing pressure should be continuously monitored.
文摘A three-dimensional graphene-based composite was prepared by a simple one-step in-site reduced-oxide method under atmospheric pressure. The obtained hydrogel was modified with 4-amino-benzenesulfonic acid and connected with ethylenediamine, and freeze-dried into an aerogel, which was characterized. Then the surface interaction with platinum (Pt, IV) was explored. The obtained aerogel showed good adsorption for Pt (IV) at acid conditions, giving a rising to the adsorption rate > 98% while pH ≥ 6. Using hexadecyl trimethyl ammonium bromide of 2% (m/V) as an eluent to desorb the Pt (IV) from the surface of the aerogel, a desorption rate of 81.1% was obtained in this process. Urea, buffer aquation and other surfactants were used in the desorption experiment to understand the adsorption mechanism between the aerogel and Pt (IV). In this work, hydrogen bond, van der Waals force and electronic interaction force mainly drove the adsorption process. For obtaining more purified Pt (IV), we used 0.5% CTAB to desorb Pd (II). A new three-dimensional graphene-based composite was prepared and the surface interaction between Pt (IV) and composite was experimented for understanding the adsorption mechanism and exploring its potential application in sample preparation in low concentration.
基金supported by Sichuan Foundation of Excellent Scientists (Grant No.2010JZ0002)the Directional Project of Chinese Academy of Sciences (Grant No.KZX2-YW-333)
文摘In this study,we used remotely sensed data,GIS modeling,and statistical methods to evaluate the damage caused by the Wenchuan Earthquake (May 12,2008) to the giant panda (Ailuropoda melanoleuca) habitat in the World Nature Heritage Sichuan Giant Panda Sanctuary (WHSGPS) in China.A landscape ecological analysis found increases of landscape heterogeneity,complexity,and fragmentation in the giant panda habitat after the earthquake.A terrain analysis found that slope and elevation are directly associated with the distribution of the damaged areas.As slope and elevation increase,the size of the damaged area keeps increase until to a peak,and then starts to drop.The total area of the damaged vegetation in our study area is 114.26 km 2,accounting for 3.78% of the study area;30.46% of that 114.26 km 2 is located in the Core Zone of WHSGPS.There are 18.57km 2 of the damaged vegetation located in the identified suitable giant panda habitat,accounting for 1.75% of the total area of suitable giant panda habitats in the study area.Based on these findings,we conclude that the Wenchuan Earthquake does not have significant impact on the WHSGPS as a whole.
基金The Science and Technology Project of Guangdong under contract No. 2009B030600006National Science and Technology Support Program sub-topics under contract No. 2009BADB2B0401-02Appropriative Researching Fund for Professors and Doctors, Guangdong University of Education under contract No. 10ARF01
文摘The study aims to compare the differences of macrofauna communities of wetlands at 3-year-forest- age, 5-year-forest-age Sonneratia apetala artificial mangroves, 5-year-forest-age Kandelia candel ar- tificial mangroves with the same restoration background, and the naked tidal flat in the Qi'ao Island Mangrove Nature Reserve of Zhuhai, Guangdong Province. The results show that there were signif- icant structural differences in macrofauna communities among four kinds of habitats. The increase of biomass and species diversity of macrofauna at 3-year-forest-age S. apetala artificial mangroves was obviously faster than that at 5-year-forest-age K. candel artificial mangroves whose average tree height was close to that of 3-year-forest-age S. apetala artificial mangroves. The BIOENV analysis shows that it was related to the rapid growth of S. apetala, which rapidly changed the light level and shading conditions in the forests. The 5-year-forest-age S. apetala artificial mangroves had lower macrofauna species diversity but higher density and biomass than K. candel artificial mangroves with the same forest age. This was due to the rapid changes of physical and chemical properties of habitat soil by the ecological restoration of S. apetala artificial mangroves as well as the changed food sources possibly caused by the leaf-litter of such non-indigenous mangrove species S. apetala. However, further survey should be conducted on whether there are any negative ecological impacts of large-scale cultivation of S. apetala on macrofauna communities, so as to evaluate correctly S. apetala's role in the restoration of coastal mangrove ecosystems.
基金supported by the Agricultural Science and Technique Foundation of Guizhou Province, China (No. 2008-3059)the Research Funds of Forestry Administration of Guizhou Province, China (Nos. 2010-01-08, 2010-01, 200625)
文摘Forest volume,the major component of forest biomass,is an important issue in forest resource monitoring.It is estimated from tree volume tables or equations.Based on tree volume data of 1840 sample trees from Chinese fir(Cunninghamia lanceolata)plantations in Guizhou Province in southwestern China,parallel one-and two-variable tree volume tables and tree height curves for central and other areas were constructed using an error-in-variable modeling method.The results show that,although the one-variable tree volume equations and height curves between the central and other areas were significantly different,the two-variable volume equations were sufficiently close,so that a generalized two-variable tree volume equation could be established for the entire province.
基金Supported by National Natural Science Foundation of China (31000712)National Natural Science Fund (31000712)Yunnan Provincial Education Department Scientific Research Program (08Y0166)
文摘Experiments were conducted to evaluate the physiological and the biochemical characteristics of waxy wheat seeds under accelerated aging conditions. Five waxy wheat lines, which were Waxy 1, Waxy 4, Waxy 8, Waxy 9, and Waxy 15; and five non-waxy wheat lines: S-39, 04J89, Jan-81, Ⅲ42-4, and Ⅲ10 were studied. The seeds were subjected to accelerated aging at 40℃, 45℃, 50℃, 55℃, and 60℃, and 90% relative humidity for 0, 2, 4, 6, and 8 days, respectively. The results showed a gradual increase in conductivity and decrease in germination rate during accelerated aging. SOD, POD and CAT activities increased at low-grade treatment, but decreased at severe treatment. On the other hand, the soluble protein content decreased at 45℃, but successively increased, then decreased 50℃. From the above study, it showed that 90% RH at 55℃ was the best accelerated aging condition for optimum efficiency in a shorter period.
文摘Wastewater, which involves easy-soluble reactive dyes, especially non-degradable dyes, is very difficult to decolor efficiently by normal processes such as coagulation process and biological treatment. The high chromaticity se- riously hinders the reuse of reactive dye waste water. In this paper, a new method by bentonite adsorption and coagulation (PAC) is employed for removing color from synthetic dye waste water which contains reactive red K-2G, K-RN blue, K-GR blue, X-3B red, K-GN orange, KB-3G yellow, K-2BP red, K-RN yellow and K-6G yellow. Bentonite pre- treated by 4% CTMAB and milled to 160 order screen is proven to the best decoloring agent. For a 100 mL reactive red K-2G sample (CODcr 400 mg/L, 25 000 chromaticity color), 0.5 g bentonite pretreated and 2.5 mL PAC is enough to decolor wastewater up to 99.92% and the sediment time is short. Non-degradable dyes such as active red X-3B and K-GN orange are declored completely as well. Raw sewage (low chromaticity color) is decolored completely at a ben-tonite dosage of 0.001g. More researches prove the high practical value of this process.
文摘目的描述初产妇与经产妇分娩恐惧和产时疼痛强度的特点并比较差异,探讨实际疼痛缓解情况与分娩恐惧的关系。方法采用便利抽样法,2018年2月至2019年8月选取广州市某三级甲等专科医院自然临产或引产的阴道分娩产妇共260名,其中初产妇97名,经产妇163名。从结构化电子病历系统提取产妇和新生儿的临床资料,通过问卷收集其他一般资料,如职业、家庭人均月收入。采用数字评定量表(the Numeric Rating Scale,NRS)和中文版分娩态度问卷(the Chinese version of the Childbirth Attitude Questionnaire,C-CAQ)对产妇分娩时疼痛程度和分娩恐惧程度进行评估。产妇的产时麻醉药消耗量和手动按压补充给药次数从自控硬膜外镇痛泵查看并记录。结果82名(84.5%)初产妇和99名(60.7%)经产妇接受了硬膜外自控镇痛方式(P<0.001)。在采用硬膜外镇痛组中,初产妇分娩恐惧得分高于经产妇(36.46±10.93比32.06±10.23,P=0.007)。然而,经产妇分娩时疼痛得分[8.0(8.0,9.0)比8.0(7.0,8.0)]、每小时成功手动补充给药次数[2.68(1.65,3.85)比1.77(0.90,2.47)]、每小时麻醉药消耗剂量[23.00(16.00,28.25)比17.24(11.52,21.36)]mL、平均每公斤消耗麻醉药剂量依次为[0.35(0.24,0.45)比0.26(0.19,0.35)]mL/kg均高于初产妇(P<0.05)。Spearman相关分析显示,分娩疼痛最大值与分娩恐惧之间呈弱相关(r=0.09),与每小时麻醉药消耗量(r=0.16)和平均每公斤体重麻醉药消耗量(r=0.17)呈正相关(P<0.01)。麻醉药物消耗量与产妇的分娩恐惧得分无相关性。结论分娩恐惧是产时疼痛程度的潜在预测因素。产次并不是镇痛需求的决定性因素,特别是在资源有限的情况下,产科医护团队不应紧依靠产次来分配镇痛资源。
基金supported by the National Natural Science Foundation of China(Grant No.51139001)
文摘Three stochastic mathematical models for calculation of the reservoir flood regulation process,river course flood release,and flood risk rate under flood control were established based on the theory of stochastic differential equations and features of flood control systems in the middle reach of the Huaihe River from Xixian to the Bengbu floodgate,comprehensively considering uncertain factors of hydrology,hydraulics,and engineering control.They were used to calculate the flood risk rate with flood regulation of five key reservoirs,including the Meishan,Xianghongdian,Nianyushan,Mozitan,and Foziling reservoirs in the middle reach of the Huaihe River under different flood frequencies,the flood risk rate with river course flood release under design and check floods for the trunk of the Huaihe River in conjunction with relevant flood storage areas,and the flood risk rate with operation of the Linhuaigang Project under design and check floods.The calculated results show that(1) the five reservoirs can withstand design floods,but the Xianghongdian and Foziling reservoirs will suffer overtopping accidents under check floods;(2) considering the service of flood storage areas under the design flood conditions of the Huaihe River,the mean flood risk rate with flood regulation of dykes and dams from Xixian to the Bengbu floodgate is about 0.2,and the trunk of the Huaihe River can generally withstand design floods; and(3) under a check flood with the flood return period of 1 000 years,the risk rate of overtopping accidents of the Linhuaigang Project is not larger than 0.15,indicating that it has a high flood regulation capacity.Through regulation and application of the flood control system of the Linhuigang Project,the Huaihe River Basin can withstand large floods,and the safety of the protected area can be ensured.
文摘Ag/AgCl electrode has been prepared using pressed powder techniques. In order to verify the feasibility of this type of electrode used as detecting electric field generated by vessels in seawater,its characteristics of DC resistance,low frequency AC impedance,and receiving impedance in artificial seawater have been studied by polarization measurements,low frequency electrochemical impedance spectra,the open and short circuit cell conditions. The results show that the electrode can keep a low resistance when it responses the weak electrostatic field in seawater. The AC impedance of the electrode decreases as the frequency of the signal increasing. The receiving impedance decreases when the frequency of external field increases too. The valid detection bandwidth is determined by the properties of the impedance and the reactions occurring on the surface of the electrode.
基金Shenzhen Dapeng Peninsula National Geopark Project of China under contract No.340775the Natural Science Foundation of Guangdong Province of China unde contract No.S2012010008610the National Natural Science Foundation of China under contract No.40871020
文摘The coast of the Dapeng Peninsula has been honored as one of "the eight most beautiful coasts in China". The most precious tourism resource for the peninsula is headland bay beaches, among which the beach at Xichong on the southern coast of the peninsula is the longest and the most important one. The information of the stability, sedimentary source and shape change of the beach is very important for maintaining the beach in terms of sustainable development of the peninsula. Heavy minerals in the sand of the beach and the inland stream at Xichong are compared with those of a nearby beach on the same coast to determine the beach sand source; with help of a computer software, MEPBAY, the equilibrium planforms of the beaches on the peninsula are compared with those of an island without rivers to evaluate the stream's effects on the beach stability; cross shore profiles along the Xichong beach are also surveyed in different seasons of a year to assess the annual shore normal beach changes affected by the stream input, and the relation between the equilibrium planform state and cross shore changes of the beach. It is shown that(1) stream is the main sedimentary source of the beach and the weathering materials of the rocky headlands on both sides of the bay transported by waves are the second source for the beach but it is limited, sand from an inner shelf is not the sedimentary source for the beach at present and was not even during the Holocene transgression;(2) the Xichong beach cannot reach static equilibrium around the entire bay shoreline, the segment of the shoreline where a stream outlet is located is in dynamic equilibrium, and the unstable section occurs in the wave shadow region in the lee of an offshore island;(3) no matter whether the section of the beach shoreline at Xichong is in an equilibrium state or not, it is eroded in the typhoon season and recovered after the season, the maximum change in erosion and accretion occurs in the unstable segment;(4) the Xichong beach can only have small sand body since it is supplied with sand mainly form inland streams, resulting in a possible danger in which sand loss induced by human activities or huge storms cannot be replenished naturally.
基金supported by the National Natural Science Foundation of China(No.71473099)
文摘China implemented the public hospital reform in 2012. This study utilized bootstrapping data envelopment analysis(DEA) to evaluate the technical efficiency(TE) and productivity of county public hospitals in Eastern, Central, and Western China after the 2012 public hospital reform. Data from 127 county public hospitals(39, 45, and 43 in Eastern, Central, and Western China, respectively) were collected during 2012–2015. Changes of TE and productivity over time were estimated by bootstrapping DEA and bootstrapping Malmquist. The disparities in TE and productivity among public hospitals in the three regions of China were compared by Kruskal–Wallis H test and Mann–Whitney U test. The average bias-corrected TE values for the four-year period were 0.6442, 0.5785, 0.6099, and 0.6094 in Eastern, Central, and Western China, and the entire country respectively, with average non-technical efficiency, low pure technical efficiency(PTE), and high scale efficiency found. Productivity increased by 8.12%, 0.25%, 12.11%, and 11.58% in China and its three regions during 2012–2015, and such increase in productivity resulted from progressive technological changes by 16.42%, 6.32%, 21.08%, and 21.42%, respectively. The TE and PTE of the county hospitals significantly differed among the three regions of China. Eastern and Western China showed significantly higher TE and PTE than Central China. More than 60% of county public hospitals in China and its three areas operated at decreasing return scales. There was a considerable space for TE improvement in county hospitals in China and its three regions. During 2012–2015, the hospitals experienced progressive productivity; however, the PTE changed adversely. Moreover, Central China continuously achieved a significantly lower efficiency score than Eastern and Western China. Decision makers and administrators in China should identify the causes of the observed inefficiencies and take appropriate measures to increase the efficiency of county public hospitals in the three areas of China, especially in Central China.
文摘The aim of this study was to evaluate the diagnostic value of the cerebrospinal fluid(CSF) T‐SPOT.TB test for the diagnosis of TB meningitis(TBM). A retrospective analysis of 96 patients with manifested meningitis was conducted; T‐SPOT.TB test was performed for diagnosing TBM to determine the diagnostic sensitivity, specificity, positive predictive value(PPV), and negative predictive value(NPV). A receiver operating characteristic(ROC) curve was also drawn to assess the diagnostic accuracy. The sensitivity, specificity, PPV, and NPV of CSF T‐SPOT.TB test were 97.8%, 78.0%, 80.3%, and 97.5%, respectively, for 52 patients(54.2%) of the 96 enrolled patients. The area under the curve(AUC) was 0.910, and the sensitivities of CSF T‐SPOT.TB for patients with stages I, II, and III of TBM were 96.7%, 97.2%, and 98.9%, respectively. CSF T‐SPOT.TB test is a rapid and accurate diagnostic method with higher sensitivity and specificity for diagnosing TBM.
基金funded by the Dalian City Environment Protection Bureau
文摘Shedao pit-vipers(Gloydius shedaoensis) on Snake Island in the Liaoning Province,China,are among the most imperiled species in China.The isolated and unique populations are crucial in the recovery of this endangered species by providing a way for conservation and management.Research based on the ecological simulation tools can evaluate alternative mitigation strategies in terms of their benefits to the populations,which are vital for informed decision-making.In this paper,using the program VORTEX 9.42,we developed a population viability analysis(PVA) for the Shedao pit-viper to:(1) address the extinction likelihood of the population;(2) simulate population dynamics under various environment events,and(3) evaluate the efficacy of current protection and management strategies.Overall,we found the population to be susceptible to the factors of catastrophic events,mortality and environment capacity.The population is recovering slowly at present on account of improvement of habitat and greater food availability.Under the current conditions,the probability of extinction in 100 years is approximately zero.These data coincide with the evidence that the wild population may be arriving at K.Our results strengthen the view that protection and management can create a pronounced effect on populations of this endangered species.
