血清趋化因子CCL21水平对妊娠期高血压患者心血管不良事件的预测价值

目的探讨血清趋化因子CCL21水平对妊娠期高血压患者心血管不良事件的预测价值。方法选取2018年3月至2020年1月北京丰台医院收治的45例妊娠期高血压患者(病例组)和45例同期血压正常妊娠女性(对照组)纳入研究,入院后第2天清晨进行采血,采用酶联免疫吸附实验(ELISA)测定其血清CCL21水平,出院后均随访3年,比较两组产妇的心血管危险因素[体质量指数(BMI)、总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、空腹血糖(FPG)、收缩压(SBP)、舒张压(DBP)]及心血管不良事件发生率;同时比较有心血管不良事件和无心血管不良事件产妇的血清CCL21水平,且通过受试者工作特征曲线(ROC)分析血清CCL21水平对妊娠期高血压患者心血管不良事件的预测价值。结果病例组产妇的血清CCL21水平为(160.34±21.57)ng/L,明显高于对照组的(125.48±16.53)ng/L,差异有统计学意义(P<0.05);产后3年,病例组产妇的FPG、TG、SBP、DBP水平分别为(5.60±0.75)mmol/L、(1.08±0.46)mmol/L、(123.89±12.93)mmHg、(86.80±9.34)mmHg,明显高于对照组的(5.07±0.64)mmol/L、(0.76±0.34)mmol/L、(111.58±10.76)mmHg、(78.81±8.42)mmHg,差异均具有统计学意义(P<0.05),但产后3年,两组产妇的BMI、TC、HDL-C、LDL-C水平比较差异均无统计学意义(P>0.05);病例组产妇产后3年的心血管不良事件发生率为13.33%,而对照组产后3年无心血管不良事件发生,差异具有统计学意义(P<0.05);有心血管不良事件患者的血清CCL21水平为(173.14±16.86)ng/L,明显高于无心血管不良事件者的(155.76±15.92)ng/L,差异有统计学意义(P<0.05);经ROC分析结果显示,血清CCL21对妊娠期高血压患者产后3年发生心血管不良事件的曲线下面积(AUC)为0.80,血清CCL21临界值为160.24 ng/L时,诊断灵敏度为0.620,特异度为0.950。结论血清CCL21水平对妊娠期高血压患者心血管不良事件有一定的预测价值。

2021年甘肃省尿标本病原菌分布及耐药性

目的 分析2021年甘肃省医院临床尿标本分离病原菌的分布特点及耐药情况。方法 收集甘肃省2021年细菌耐药监测网成员单位临床尿标本病原菌的耐药监测资料,根据临床实验室标准化协会(CLSI)2021版标准判断药物敏感性,应用WHONET 5.6软件进行数据统计分析。结果 2021年尿标本中纳入分析的细菌共13 980株,革兰阴性菌占76.5%(10 692株),革兰阳性菌占23.5%(3 288株)。男性患者检出菌株占40.5%(5 656株),女性患者占59.5%(8 324株)。耐碳青霉烯类鲍曼不动杆菌的检出率较高,男性患者中>30%。大肠埃希菌和奇异变形杆菌对氨苄西林的耐药率>75%。铜绿假单胞菌对碳青霉烯类的耐药率<10%。肠球菌对万古霉素、利奈唑胺和替考拉宁耐药率<2%。粪肠球菌对氨苄西林的耐药率<20%,屎肠球菌对氨苄西林的耐药率>85%。结论 不同性别患者尿标本检出病原菌分布及耐药率均有不同,临床可根据本地区耐药监测情况规范、合理使用抗菌药物。

肺炎链球菌脑膜炎中血脑屏障和中枢神经系统结局的研究进展

肺炎链球菌是引起脑膜炎的主要病原体,过半数幸存者有长期神经系统后遗症。肺炎链球菌跨越血脑屏障发生易位是肺炎链球菌脑膜炎发病机制中一个关键步骤。肺炎链球菌入侵使其毒素的作用及颅内细胞因子、趋化因子和活性氧等宿主炎症环境加剧,使血脑屏障功能紊乱,最终神经系统受损。本综述旨在讨论肺炎链球菌跨越血脑屏障迁移到中枢神经系统的毒力因素和其与宿主炎症反应之间的关系,探索脑膜炎的急性和长期中枢神经系统结局。

2019—2021年甘肃省老年患者临床分离菌分布及耐药性分析

目的分析2019—2021年甘肃省老年患者临床分离菌的分布特点及其耐药性。方法收集甘肃省2019年1月—2021年12月各个医院≥65岁的老年患者临床分离菌,用药敏纸片扩散法、最低抑菌浓度(MIC)法和E试验法测定细菌对抗菌药物敏感性,根据CLSI标准判读结果,采用WHONET 5.6软件分析结果。结果甘肃省2019—2021年≥65岁的老年患者临床分离菌均以革兰阴性菌为主,占比分别为79.4%、80.4%和79%,均以大肠埃希菌的检出率最高,革兰阳性菌中以金黄色葡萄球菌的检出率最高,近3年均在35%左右,其中耐甲氧西林金葡菌(MRSA)的检出率分别为35.2%、37.5%和36%,耐甲氧西林凝固酶阴性葡萄球菌(MRCNS)的检出率分别为67.9%、66.8%和71.1%,且MRSA和MRCNS对抗菌药物的耐药率均高于甲氧西林敏感金黄色葡萄球菌(MSSA)和甲氧西林敏感凝固酶阴性葡萄球菌(MSCNS),未发现对万古霉素、替考拉宁耐药的菌株。粪肠球菌近3年检出率呈上升趋势,屎肠球菌的检出率维持在2.5%左右;第三代头孢菌素类耐药的大肠埃希菌的检出率高于肺炎克雷伯菌;铜绿假单胞菌对妥布霉素、多黏菌素B的耐药率有下降趋势,分别从11.5%下降到7.6%,从2.3%下降到1.3%,而对头孢哌酮/舒巴坦的耐药率有上升趋势,鲍曼不动杆菌多各类抗菌药物的耐药率均高于铜绿假单胞菌。结论甘肃省老年患者临床分离病原体以革兰阴性菌为主,耐药现状严重,对老年患者临床病原菌进行耐药性分析,有助于临床为老年患者合理运用抗菌药物,以减少抗菌药物的滥用。

儿童继发性噬血细胞综合征的临床特征及预后分析

目的探讨儿童继发性噬血细胞综合征(HLH)的病因、临床特征及预后。方法回顾性分析四川大学华西第二医院84例继发性HLH患儿的病因、临床特征、实验室指标及预后结局。结果 84例患儿中,63例(75.0%)为感染性,其中EB病毒(EBV)感染45例,11例(13.1%)为免疫性,10例(11.9%)为血液肿瘤性。临床主要表现为持续发热(100%)、肝肿大(83.3%)、脾肿大(67.9%)、淋巴结肿大(59.5%),其次为皮肤瘀斑(26.2%)、皮疹(19.0%)、消化道症状(15.5%)及神经系统症状(9.5%)。实验室检查以外周血两系及以上减少、凝血功能障碍、肝酶升高、高甘油三酯血症、血清铁蛋白升高及NK细胞数量减少为主,73.8%的患儿骨髓查见噬血现象。84例患儿中放弃治疗4例,好转58例,死亡16例,失访6例,3年累积生存率为77.2%±5.1%,不同病因组间累积生存率差异无统计学意义(P>0.05)。死亡与存活患儿的年龄、中枢神经系统累及率、血小板(PLT)、凝血酶原时间(PT)、活化部分凝血酶原时间(APTT)、纤维蛋白原(Fg)、乳酸脱氢酶(LDH)、白蛋白(ALB)差异有统计学意义(P<0.05)。Logistic多因素回归结果显示LDH>2000U/L及ALB<30g/L是HLH死亡的独立预后因素(P<0.05)。结论儿童继发性HLH由多种病因所致,以感染为主;临床表现多样,进展迅速,血清白蛋白和LDH水平是影响其预后的危险因素,应尽早诊断,及时治疗。

当代美国悬疑侦探剧中的女侦探对女英雄形象的重构

在以德里达,福柯为代表的解构主义主张解构菲勒斯中心主义,抗拒二元对立,反本质主义,反权威、反传统,打破单一的,模式化意义的语境中,当代美国悬疑侦探剧作为受众最为广泛的电视剧类型之一深受其影响,其通过对剧中女侦探形象的塑造解构了传统意义上的女英雄形象,重构了平民女英雄、柔美女英雄、理性女英雄、人性女英雄,呈现出多元化的女英雄形象。

从女性主义视角探究当代美国悬疑侦探剧

当代美国悬疑侦探剧中极具女性主义意义的女侦探角色的设置让其进入到女性主义视域。在女性取得了选举权、受教育权、财产权等基本人权后,女性主义也逐渐发展成熟,不再如前期一般激烈地强调男女之间的对立,也不再偏颇地将男女平等理解为“男女都一样”而抹杀女性性征,而是在承认差异性的基础上积极地寻求两性的和谐共存。探讨后现代女性主义语境中当代美国悬疑侦探剧对于姐妹情谊和双性和谐的建构。

卫宁平原包气带水分运移特征研究

降雨、灌溉入渗和潜水蒸发在卫宁平原地下水循环中有重要的作用。为了准确评价卫宁平原地下水垂向入渗补给量和蒸发量,通过设立中卫、中宁两个包气带原位试验点,观测期为2013年6月~2013年11月和2014年4月~2014年10月,获取了两个试验点不同埋深处的土壤水负压、温度、岩性及水分运移参数,并采用定位通量法计算试验点的地表蒸散发、入渗量和潜水面蒸发、入渗量。结果显示:在包气带岩性相同、灌溉期相同(7~10月)、总灌溉量相近条件下,作物的灌溉模式决定了灌溉对潜水的补给强度:玉米少次大量(150 mm·次^-1)灌溉对潜水的补给量为373.65 mm,远远大于茄子多次小量(50 mm·次^-1)的灌溉模式下的152.3 mm;而在包气带岩性相同、种植作物相同、灌溉模式不变的前提下,同时期潜水面净补给强度相近:中宁试验点2013年7~10月份潜水面净通量为32.88 mm,2014年同期为57.42 mm。在降雨情况或灌溉量较小(50 mm)的情况下,植被的生长会阻碍水分在包气带中的下渗;在灌溉量较大(100 mm和150 mm)的情况下,植被的生长会促进包气带水分的下渗。

肺炎链球菌新型疫苗研究进展

肺炎链球菌是引起肺炎的主要病原体,肺炎链球菌性疾病是全球严重的公共卫生问题之一,每年约导致160万人死亡。目前,已明确的肺炎链球菌血清型高达100种,已上市的预防肺炎链球菌感染的疫苗只覆盖了部分肺炎链球菌血清型,无法预防非疫苗血清型和不可分型肺炎链球菌感染。因此,新型“通用型”肺炎链球菌疫苗的研发迫在眉睫,本综述旨在总结目前在用或在研究疫苗策略的优势和局限性,为进一步研发肺炎链球菌疫苗提供新的参考思路。

Development of a new method for efficiently calculating of evaporation from the phreatic aquifer in variably saturated flow modeling

In this paper, we proposed a new method that has been developed based on the surface soil moisture content(SSMC) to more efficiently calculate the groundwater evaporation in variably saturated flow modeling. In this method, the empirical formula to calculate evaporation was modified and the value of the formula varies from zero to one as a closed interval. In addition, the simulation code for calculating the groundwater evaporation based on the SSMC method was incorporated into the EOS9 module of Tough2, a variably saturated flow modeling code. Finally, two numerical tests and a case simulation were conducted to verify the feasibility and accuracy of the SSMC method. Simulation results indicate that the SSMC method is capable of appropriately simulating the characteristics of water flow in vadose zone and the amount of evaporation with the variable water table. And such results are in coincidence with the value calculated by the logistic function method, and fit well with the measured data globally rather than locally.

Review of the algebraic linear methods and parallel implementation in numerical simulation of groundwater flow

The desire to increase spatial and temporal resolution in modeling groundwater system has led to the requirement for intensive computational ability and large memory space. In the course of satisfying such requirement, parallel computing has played a core role over the past several decades. This paper reviews the parallel algebraic linear solution methods and the parallel implementation technologies for groundwater simulation. This work is carried out to provide guidance to enable modelers of groundwater systems to make sensible choices when developing solution methods based upon the current state of knowledge in parallel computing.

Column test-based features analysis of clogging in artificial recharge of groundwater in Beijing

With the completion of South-North Water Transfer Project in China, plenty of high quality water will be transported to Beijing. To restore the groundwater level in Beijing, part of transferred water is planned to be used for artificial recharge. Clogging is an unavoidable challenge in the artificial recharge process. Therefore, a test is designed to analyse clogging duration and scope of influence and to test the reinjection properties of different recharge media. The test employs the self-designed sand column system with variable spacing and section monitoring, composed of four parts: Sand column, water-supply system, pressure-test system and flow-test system, to simulate the clogging of artificial recharge of sand and gravel pits. The hydraulic conductivity levels of all sand column sections are obtained to analyse the clogging of the injection of different concentrations in media of different particle sizes. In this experiment, two kinds of media are used–round gravel from sand and gravel pit in Xihuang village and the sand from sand and gravel pit by the Yongding River. The concentrations of recharge fluid are respectively 0.5 g/L and 1 g/L. The results show that clogging usually lasts for 20 hrs., and the hydraulic conductivity drops to the original 10%. Clogging usually occurs at 0–12 cm section of the sand column. The scope of influence is 0–60 cm. In column 3 and 4, whose average particle sizes are larger, section 20–50 cm also suffers from clogging, apart from section 0–12 cm. The effective recharge times are respectively 33 hrs. in column 1, 14 hrs. in column 2, 12 hrs. in column 3 and 12 hrs. in column 4. The larger the average particle size is, the quicker the clogging occurs. In media of larger particles, the change in suspension concentration does not have significant influence on the development of clogging. In conclusion, it is suggested that during artificial recharge, the conditions of reinjection medium should be fully considered and effective method of recharge be employed in order to improve effective recharge time.

Evaluation on water resources carrying capacity of Changchun-Jilin Region

Based on such principles as sustainable development and ecological cycle, this paper evaluates the water resources carrying capacity(WCC) of Changchun-Jilin region using a population-economy-water resources correlation evaluation model built on the basis of WCC evaluation method as elaborated in the methodology of Functional Zoning of Population Development. Results show that the annual WCC of Changchun-Jilin region is able to support the population there, as a basic balance is struck between population and water resources. The incorporation of WCC into overall urban planning is one of the building blocks for sustainable city development with an advisable size.

黄河流域生态保护的司法协调机制研究

2019年9月18日,习近平在河南省郑州市召开黄河流域生态保护与高质量发展专题研讨会,为加强黄河流域生态保护,促进优质生态建设作出重大安排。按照习近平在座谈会上的讲话精神,最高人民法院、中共中央办公厅、国务院办公厅先后发布了一系列有关黄河流域生态保护,促进优质发展的规范性文件。可以看出,黄河流域生态司法保障机制正在形成当中,但需要进一步深入研究的问题还较多。本文在分析黄河流域生态保护司法协调机制的现状及困境的基础上,提出了改善黄河流域生态保护司法协调机制的对策,以期为黄河流域生态保护和高质量发展提供有益的建议。

Research on hydrogen and oxygen isotopes of paleoclimate reconstruction in Nuomuhong

As a typical alluvial-proluvial fan area in the Qaidam Basin, Nuomuhong is important to the research on paleoclimate reconstruction in proluvial fan areas and basin climate change and ecological protection. This paper analyzes features of 2H, 3H, 18 O and 14 C isotopes in Nuomuhong and reconstructs paleoclimate in this area. According to the results: since 28 ka B.P., the ground average temperature decreases and then increases in the Qaidam watershed, reaching the lowest in 17.7 ka B.P. before increasing gradually. In the past 30 000 years, average temperature has changed ranged from 1 ℃ to 5 ℃ in this area; the lowest temperature was different from today’s temperature only by 3 ℃. This shows that climate conditions and natural environment in this area have been relatively stable in the past 30 000 years.

Research Progress of the Geological Environment in Ecological Planning

The geological environment is the basis of ecological planning. In this article, the factor analysis combined with Analytic Hierarchy Process(AHP) and GIS(geographic information technology) was used. The method sets geological disasters, landform type,surface slope, soil type and erosion as ecological suitability of geology factor; distribution of surface water,precipitation distribution,hydraulic engineering and degree of groundwater development as ecology suitability of water resources. Huairou, located in Beijing, was set as an example through the method. The article evaluated the suitability of the geological environment to ecology and solved quantitative description about the key technologies of the degree of influence to ecology which is affected by the geological environment. In the end, a theoretical guidance and a kind of technical method of establishing a scientific ecological planning system and guiding ecological planning were provided.

Research on numerical simulation of the groundwater funnels restoration in Shijiazhuang

In order to simulate the recovery of groundwater funnels under the condition of reducing groundwater abstraction, hydrogeological conditions of recoverability construction of Shijiazhuang groundwater funnel were analyzed, and a numerical simulation method was used based on the change of various parameters. The results show that the groundwater flow model can accurately reflect groundwater hydrogeological characteristics, and can guarantee the reliability of groundwater restoration prediction. The research has set up four schemes for rural water-saving, planting structure adjustment, urban reducing abstraction and integrated method. The effect of four restoration schemes on the restoration of groundwater funnels was compared with water table variations of two observation well. Comparison results show that the level changes of plan Three and Four are different from the other two kinds of exploitation and the drop trend of water table in the funnel area is flat. So we can conclude that Plan Three and Four have significant effect on the groundwater funnel restoration of Shijiazhuang.

甘肃省74所医院肺泡灌洗液细菌分布及耐药性

目的分析2019年甘肃省医院标本中肺泡灌洗液临床分离菌的分布特点及其耐药性。方法收集甘肃省2019年1月-2019年12月74所医院中肺泡灌洗液(BALF)细菌的耐药监测资料,用药敏纸片扩散法、最低抑菌浓度(MIC)法和E试验法测定细菌对抗菌药物敏感性。结果甘肃省2019年BALF标本中纳入分析的细菌总数为1 043株,其中革兰阳性菌270株占比25.89%,革兰阴性菌773株占比74.11%,耐甲氧西林金黄色葡萄球菌(MRSA)和耐甲氧西林凝固酶阴性葡萄球菌(MRCNS)的检出率较高,且MRSA对抗菌药物的耐药率高于甲氧西林敏感金黄色葡萄球菌(MSSA),未发现对万古霉素、替考拉宁和利奈唑胺耐药的菌株。大肠埃希菌中超广谱β-内酰胺酶(ESBLs)的检出率高于肺炎克雷伯菌;鲍氏不动杆菌对碳青霉烯类的耐药率高于铜绿假单胞菌。结论甘肃省BALF标本分离病原菌以革兰阴性菌为主,耐药现状严重,对肺泡灌洗液细菌进行耐药性分析,有助于临床对各类肺部感染患者合理运用抗菌药物,以减少抗菌药物的滥用。

玉米赤霉烯酮对小鼠血清生化指标及肝脏、肾脏组织结构的影响

将80只4周龄体质量18~22g昆明雌性小鼠随机分为4组。对照组饲喂基础日粮,试验1、2、3组在基础日粮中分别添加50,100,150mg/kg ZEA,预试期7d,试验期20d。结果显示,饲粮中添加100~150mg/kg ZEA后,发情前期和发情期血清中BUN和LDL含量极显著升高(P<0.01),TP、HDL、TC、TG的含量变化没有明显的规律;发情前期和发情期血清中MDA含量极显著升高(P<0.01),T-AOC、T-SOD、GSH-Px活性极显著降低(P<0.01);肾小球和肾小管萎缩。结果表明,饲粮中添加100~150mg/kg ZEA后,极显著的降低了小鼠抗氧化能力,肾实质损伤显著。

玉米赤霉烯酮对小鼠血清性激素、脂肪因子及子宫结构的影响

4周龄雌性小鼠120只,随机分为4个处理组,每组30只。对照组饲喂基础日粮,试验1～3组在基础日粮中分别添加50,100,150 mg/kg的玉米赤霉烯酮(ZEA)。饲喂20 d后,采集发情前期、发情期及产仔后次日小鼠血液,并测定血清性激素、脂肪因子水平。制备子宫石蜡切片,观察ZEA对子宫形态结构的影响。分娩后记录产仔数。结果显示:(1)发情前期,1组和3组子宫内膜增厚(P<0.01),3组子宫肌层增厚(P<0.05)。随着ZEA添加量的增加,子宫内膜的腺体增多,腺腔变大。P_4、LH水平随ZEA剂量增加而降低(P<0.01),低剂量ZEA使FSH水平降低(P<0.05),内脂素水平升高(P<0.01)。中、高剂量ZEA使E_2、LEP水平升高(P<0.01)。(2)发情期,中、高剂量ZEA使子宫内膜增厚(P<0.01),3个试验组均使子宫肌膜增厚(P<0.01)。随ZEA添加量的增加,E_2、LEP、内脂素水平均升高(P<0.01),P_4、FSH、LH水平均降低(P<0.01)。(3)产仔后期,中剂量ZEA组子宫腔闭合,腺腔变大。不同ZEA添加量均使E2水平升高(P<0.01),中剂量ZEA使FSH水平极显著降低(P<0.01)、LH水平降低(P<0.05),高剂量ZEA使LEP、内脂素水平升高(P<0.01)。(4)小鼠产仔数没有明显变化(P>0.05),但试验组均出现死胎。结果表明,ZEA能够引起雌性小鼠子宫形态结构变化,激素分泌紊乱,并出现死胎。ZEA通过增加脂肪沉积而影响动物生殖功能可能是其类雌激素样作用机制之一。