住院医师“岗位胜任力”自我评价及医疗法律法规培训需求调查分析

为了完善以“岗位胜任力”为导向的住院医师规范化培训体系,本研究采用问卷调查的方法,调查内科及全科住院医师规范化培训基地中60名住院医师的基本信息、医疗法律法规知识掌握情况(主要观察指标),以及“岗位胜任力”自我评价(次要观察指标)等,并对这些数据进行统计学分析。问卷调查结果提示在加强住院医师临床专业知识和技能培训的同时,应当重视住院医师医疗法律法规知识及沟通合作能力的培养。

非酒精性脂肪肝合并2型糖尿病患者的肝脏脂肪含量与各代谢指标的相关性

【目的】探讨超声定量检测2型糖尿病(T2DM)合并非酒精性脂肪肝(NAFLD)患者肝脏脂肪含量(LFC),并分析其与各代谢指标的相关性。【方法】选取T2DM合并NAFLD患者105例(观察组),另选无脂肪肝的单纯T2DM患者43例(对照组)。采用计算机辅助超声定量LFC,全自动生化分析仪检测各代谢指标血尿酸(SUA)、谷丙转氨酶(ALT)、谷草转氨酶(AST)、总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)、血尿素氮(BUN)、游离脂肪酸(FFA)、糖化血红蛋白(HbA1C)、空腹血糖(FPG)、空腹胰岛素(FINS)、尿微量白蛋白(ALB)、尿肌酐(CREA),计算胰岛素抵抗指数(HOMA-IR=FPGF×FINS/22.5)。比较两组各代谢指标的差异并分析LFC与各指标的相关性。【结果】观察组ALT、TG、LDL-C、FPG、CREA、HOMA-IR水平、LFC均高于对照组,HDL-C水平低于对照组,其差异有统计学意义(P<0.05)。相关性分析显示:观察组中LFC与ALT、TG呈正相关;对照组中LFC与ALT、AST、TG呈正相关(P<0.05)。【结论】NAFLD作为T2DM的常见并发症,应用超声定量测定LFC,操作简单、成本低廉、无创便捷,可反映肝功血脂等相关指标变化,可作为入院常规筛检手段,为早期发现肝脏脂肪样变提供依据。

Spatial Distribution of Heavy Metals in Agricultural Soils of an Industry-Based Peri-Urban Area in Wuxi, China

In industry-oriented peri-urban areas, the heavy metal accumulation in soils caused by industrialization has become a potential threat. The top soil samples from 27 paddy fields and 75 vegetable fields were collected from a typical industry-based peri-urban area of about 8 km2 in Wuxi, China, to study the accumulation and distribution of As, Hg, Cu, Zn, Pb, Cr, and Cd in comparison with heavy metal contents in soils near developed industrial sites (Guangzhou, China; Wallsend Burn of Tyneside, UK; and Osnabriick, Germany). Kriging interpolation was used to determine the metals' spatial distribution. The results showed that most soils, compared to the background values, contained elevated contents of As, Hg, Cu, Zn, and Pb with some having elevated contents of Cd and Cr. Except for less than 10% of the soil samples of Cu, Zn and Cd contents, these heavy metal contents were lower than the soil threshold levels of the Grade II criteria for the Chinese environmental quality standard. Probably, because of the scattered distribution and diversity of industries in the study area, spatial distributions of these heavy metals from Kriging interpolation indicated little similarity. Nevertheless, when compared with other areas in the Taihu Lake region, mean contents of Cu, Zn, Pb, and Cd were relatively high in the Wuxi peri-urban area. Additionally, compared to soils in agricultural areas around Guangzhou, Osnabriick, or Wallsend Burn, contents of most heavy metals in soils from this area were lower.

Scale Effect of Climate and Soil Texture on Soil Organic Carbon in the Uplands of Northeast China

Understanding how spatial scale inffuences commonly-observed effiects of climate and soil texture on soil organic carbon (SOC) storage is important for accurately estimating the SOC pool at different scales. The relationships among climate factors, soil texture and SOC density at the regional, provincial, city, and county scales were evaluated at both the soil surface (0-20 cm) and throughout the soil profile (0-100 cm) in the Northeast China uplands. We examined 1022 profiles obtained from the Second National Soil Survey of China. The results indicated that the relationships between climate factors and SOC density generally weakened with decreasing spatial scale. The provincial scale was optimal to assess the relationship between climate factors and SOC density because regional differences among provinces were covered up at the regional scale. However, the relationship between soil texture and SOC density had no obvious trend with increasing scale and changed with temperature. There were great differences in the impacts of climate factors and soil texture on SOC density at different scales. Climate factors had a larger effect on SOC density than soil texture at the regional scale. Similar trends were seen in Heilongjiang and eastern Inner Mongolia at the provincial scale. But, soil texture had a greater effect on SOC density compared with climate factors in Jilin and Liaoning. At the city and county scales, the inffuence of soil texture on SOC density was more important than climate factors.

National Scale Analysis of Soil Organic Carbon Storage in China Based on Chinese Soil Taxonomy

Patterns of soil organic carbon (SOC) storage and density in various soil types or locations are the foundation for examining the role of soil in the global carbon cycle. An assessment of SOC storage and density patterns in China based on soil types as defined by Chinese Soil Taxonomy (CST) and the recently compiled digital 1:1000000 Soil Database of China was conducted to generate a rigorous database for the future study of SOC storage. First, SOC densities of 7 292 soil profiles were calculated and linked by soil type to polygons of a digital soil map using geographic information system resulting in a 1:1 000 000 SOC density distribution map of China. Further results showed that soils in China covered 9 281×103 km2 with a total SOC storage of 89.14 Gt and a mean SOC density 96.0 t ha-1. Among the 14 CST orders, Cambosols and Argosols constituted high percentage of China's total SOC storage, while Andosols, Vertosols, and Spodsols had a low percentage. As for SOC density, Histosols were the highest, while Primosols were the lowest. Specific patterns of SOC storage of various soil types at the CST suborder, group, and subgroup levels were also described. Results obtained from the study of SOC storage and density of all CST soil types would be not only useful for international comparative research, but also for more accurately estimating and monitoring of changes of SOC storage in China.

Storage and Spatial Variation of Phosphorus in Paddy Soils of China

Due to the growing concern about the agricultural phosphorus (P) losses pollution, an in-depth understanding of P in paddy soils of China would be helpful in providing a national perspective of the environmental impact of P cycling and fertility on China's farms. In this study, we evaluated the P storage and the P density of paddy soils in China, characterized the spatial variations of P among the subgroups of paddy soils and soil regions in China, and evaluated the P data using GIS-based analysis, which included a newly compiled 1:1 000 000 digital soil map of China, and using 1 490 soil profiles. The available and total P densities of paddy soils were 6.7 and 698.5 g m -3 , respectively. Overall in China, the total P storage within 1 m of paddy soils was estimated to be 330.2 Tg. The P density of paddy soils varied substantially with subgroups due to the different soil water regimes such as groundwater table and soil drainage. The P availability in paddy soils, especially in surface layer, was higher in high temperature and precipitation areas. Further research is needed to examine more anthropogenic impact factors, such as increasing use of chemical fertilizer.

Effect of Land Use Conversion from Rice Paddies to Vegetable Fields on Soil Phosphorus Fractions

Excess phosphorus (P) from agricultural soils contributes to eutrophication in water bodies.Samples (n=60) were taken from sites where rice paddies have been converted to vegetable fields for 0,< 10,10-20,and > 20 years and analyzed for five inorganic P (Pi) fractions,three organic P(Po) fractions,and several soil parameters to investigate how land use conversion affects Pi and Po fractions in a peri-urban area of China with soils characteristic of many agricultural areas of Asia.Significant increases of 33,281,293,and 438 mg kg 1 were found for soluble and loosely bound Pi (SL-Pi),aluminum-bound Pi (Al-Pi),calcium-bound P i (Ca-Pi),and iron-bound Pi (Fe-Pi),respectively,after conversion from rice paddies to vegetable fields.Most of the increase in Pi was in the form of Fe-Pi,which increased from 8% of total P (TP) on paddy soil to 31% on the soil with > 20-year vegetable cultivation,followed by Al-Pi,which increased from 2% to 19% of TP.For Po fractions,there was no significant change in P concentrations.The conversion of land use from paddy fields to high intensity vegetable fields was causing significant changes in soil P fractions.Management practices were causing a buildup of soil P,primarily in the Fe-Pi fraction,followed by Ca-Pi and Al-Pi fractions.If current trends continue,a 30%-70% increase in TP could be expected in the next 20 years.Farmers in the area should reduce P application and use to maximize P uptake.

甲状腺切除术后甲状旁腺功能减退的危险因素分析

分析甲状腺切除术后甲状旁腺功能减退的危险因素。回顾性分析2015年6月—2017年6月我院行甲状腺切除术患者113例的临床资料,根据患者术后是否发生甲状旁腺激素减退分为减退组(甲状旁腺激素水平<12 pg/mL)和正常组(甲状腺激素水平≥12 pg/mL)。收集两组患者一般临床资料及相关可疑危险因素,采用单因素和多因素Logistic回归分析甲状腺切除术后甲状旁腺功能减退发生的影响因素。单因素分析结果显示,两组在年龄、术前合并甲状腺功能亢进、术前合并甲状腺炎、开放手术、恶性肿块、肿块直径、甲状腺切除范围、甲状旁腺误切、管食管沟淋巴结清扫、纳米碳应用等差异有统计学意义(P<0.05)。多因素分析结果显示,开放性手术、恶性肿块、肿块直径、甲状腺切除范围、甲状旁腺误切、食管沟淋巴结清扫、纳米碳应用是甲状腺切除术后甲状旁腺功能减退的危险因素,临床应针对相关危险因素进行预防和干预,降低甲状旁腺功能减退发生率,提高术后患者生活质量。

Extracellular superoxide dismutase VdSOD5 is required for virulence in Verticillium dahliae

Plants produce reactive oxygen species(ROS) to defend pathogens. To counteract this attack, certain pathogens express superoxide dismutases(SODs) to scavenge host-derived ROS. However, the roles of SODs in Verticillium dahliae, an important vascular pathogen, are not clear. Our previous study has shown that a putative extracellular SOD(VdSOD5) of V. dahliae is significantly induced by culturing in cotton tissues, suggesting that VdSOD5 may play an important role in host–pathogen interactions and virulence. Here, we showed that VdSOD5 encoded a superoxide dismutase with a cofactor copper-binding site and a functional signal peptide that can conduct protein secretion in an invertase-mutated yeast strain. The mutations in VdSOD5(ΔVdSOD5) did not change the normal vegetative growth and conidial production but reduced the virulence of V. dahliae on susceptible host cotton. Further studies showed that the transcription of Vd SOD5 was significantly up-regulated during the early stage of infection, and the loss-of-function of VdSOD5 decreased culture filtrate and fungal tissue SOD activities of V. dahliae by 74 and 28%, respectively. Compared to the wild-type strain Vd991, the ΔVdSOD5 showed the same sensitivity to the intracellular ROS generator menadione. Furthermore, nitroblue tetrazolium(NBT) staining demonstrated that VdSOD5 functioned in the detoxification of superoxides generated by host roots during infection. These results suggest that VdSOD5 of V. dahliae is an important virulence factor, secreted out of cells to combat host-derived ROS.

行政法视阈下垃圾焚烧项目邻避冲突中的公众参与

垃圾焚烧发电是我国处理生活垃圾的主要方式,如何破解由垃圾焚烧发电项目引发的邻避冲突已成为当前政府生态环境管理面临的迫切问题。本文在行政法视阈下分析垃圾焚烧项目邻避冲突中的公众参与,试图探索垃圾焚烧项目邻避冲突治理的合理路径。

关于连续状态非齐次马氏链的绝对平均强遍历性

引进连续状态非齐次马氏链绝对平均强遍历的概念,研究连续状态非齐次马氏链满足这种强遍历的一个充分条件,并给出绝对平均强遍历性在马氏决策过程中的应用.

Effect of Soil Sampling Density on Detected Spatial Variability of Soil Organic Carbon in a Red Soil Region of China

Spatial variability of soil organic carbon (SOC) of different land use patterns and soil types was examined in a county-wide red soil region of South China,using six sampling densities,14,34,68,130,255,and 525 samples designed by the method of grid sampling in 6 different grid sizes,labeled as D14,D34,D68,D130,D255,and D525,respectively.The results showed that the coefficients of variation (CVs) of SOC decreased gradually from 62.8% to 47.4% with the increase in soil sampling densities.The SOC CVs in the paddy field change slightly from 30.8% to 28.7%,while those of the dry farmland and forest land decreased remarkably from 58.1% to 48.7% and from 99.3% to 64.4%,respectively.The SOC CVs of the paddy soil change slightly,while those of red soil decreased remarkably from 82.8% to 63.9%.About 604,500,and 353 (P < 0.05) samples would be needed a number of years later if the SOC change was supposedly 1.52 g kg-1,based on the CVs of SOC acquired from the present sampling densities of D14,D68,and D525,respectively.Moreover,based on the same SOC change and the present time CVs at D255,the ratio of samples needed for paddy field,dry farmland,and forest land should be 1:0.81:3.33,while the actual corresponding ratio in an equal interval grid sampling was 1:0.74:0.46.These indicated that the sampling density had important effect on the detection of SOC variability in the county-wide region,the equal interval grid sampling was not efficient enough,and the respective CV of each land use or soil type should be fully considered when determining the sampling number in the future.

Regional Simulation of Soil Organic Carbon Dynamics for Dry Farmland in East China by Coupling a 1:500000 Soil Database with the Century Model

Changes in soil organic carbon (SOC) in agricultural soils influence soil quality and greenhouse gas concentrations in the atmosphere. Dry farmland covers more than 70% of the whole cropland area in China and plays an important role in mitigating carbon dioxide (CO2) emissions. In this study, 4109 dry farmland soil polygons were extracted using spatial overlay analysis of the soil layer (1:500000) and the land use layer (1:500000) to support Century model simulations of SOC dynamics for dry farmland in Anhui Province, East China from 1980 to 2008. Considering two field-validation sites, the Century model performed relatively well in modeling SOC dynamics for dry farmland in the province. The simulated results showed that the area-weighted mean soil organic carbon density (SOCD) of dry farmland increased from 18.77 Mg C ha1 in 1980 to 23.99 Mg C ha1 in 2008 with an average sequestration rate of 0.18 Mg C ha1 year?1. Approximately 94.9% of the total dry farmland area sequestered carbon while 5.1% had carbon lost. Over the past 29 years, the net SOC gain in dry farmland soils of the province was 19.37 Tg, with an average sequestration rate of 0.67 Tg C year1. Augmentation of SOC was primarily due to increased consumption of nitrogen fertilizer and farmyard manure. Moreover, SOC dynamics were highly differentiated among dry farmland soil groups. The integration of the Century model with a fine-scale soil database approach could be conveniently utilized as a tool for the accurate simulation of SOC dynamics at the regional scale.

Effect of Intensive Greenhouse Vegetable Cultivation on Selenium Availability in Soil

Soil properties dramatically change after long-term greenhouse vegetable cultivation, which further affects soil selenium(Se)nutritional status and plant Se uptake. An evaluation of Se availability after long-term greenhouse vegetable cultivation(GVC) can help in better understanding its influential factors under GVC conditions and will also facilitate further regulation of soil Se nutrition in GVC systems. Two typical GVC bases were chosen: one with clayey and acidic soil in Nanjing, southern China, and the other with sandy alkaline soil in Shouguang, northern China. Twenty-seven surface soil samples at the Nanjing base and 61 surface soil samples at the Shouguang base were collected according to cultivation duration and cultivation intensity. Soil properties including soil available Se(PO3-4-Se) and total Se(T-Se) were analyzed. The results showed that soil PO3-4-Se was significantly and negatively correlated with soil Olsen-P, available K(A-K), and electrical conductivity(EC) at the Nanjing base. At the Shouguang base, however, no significant correlation was found between soil PO3-4-Se and Olsen-P and EC, and soil PO3-4-Se increased with increasing soil organic matter(OM). Intensively utilized greenhouse vegetable cultivation caused significant changes in soil properties and further affected soil Se availability. Due to different management practices, the dominant factors affecting Se availability varied between the two GVC bases. At the Nanjing base, the dominant influential factor on soil Se availability was soil nutritional status, especially Olsen-P and A-K status. At the Shouguang base, where organic fertilizers were applied at high rates, soil OM was the dominant influential factor.

Regional Diferences in the Efect of Climate and Soil Texture on Soil Organic Carbon

The agricultural soil carbon pool plays an important role in mitigating greenhouse gas emission and understanding the soil organic carbon-climate-soil texture relationship is of great significance for estimating cropland soil carbon pool responses to climate change.Using data from 900 soil profiles,obtained from the Second National Soil Survey of China,we investigated the soil organic carbon(SOC)depth distribution in relation to climate and soil texture under various climate regimes of the cold northeast region(NER)and the warmer Huang-Huai-Hai region(HHHR)of China.The results demonstrated that the SOC content was higher in NER than in HHHR.For both regions,the SOC content at all soil depths had significant negative relationships with mean annual temperature(MAT),but was related to mean annual precipitation(MAP)just at the surface 0–20 cm.The climate efect on SOC content was more pronounced in NER than in HHHR.Regional diferences in the efect of soil texture on SOC content were not found.However,the dominant texture factors were diferent.The efect of sand content on SOC was more pronounced than that of clay content in NER.Conversely,the efect of clay on SOC was more pronounced than sand in HHHR.Climate and soil texture jointly explained the greatest SOC variability of 49.0%(0–20 cm)and 33.5%(20–30 cm)in NER and HHHR,respectively.Moreover,regional diferences occurred in the importance of climate vs.soil texture in explaining SOC variability.In NER,the SOC content of the shallow layers(0–30 cm)was mainly determined by climate factor,specifically MAT,but the SOC content of the deeper soil layers(30–100 cm)was more afected by texture factor,specifically sand content.In HHHR,all the SOC variability in all soil layers was predominantly best explained by clay content.Therefore,when temperature was colder,the climate efect became stronger and this trend was restricted by soil depth.The regional diferences and soil depth influence underscored the importance of explicitly considering them in modeling long-term soil responses to climate change and predicting potential soil carbon sequestration.

Effect of Farming Practices on the Variability of Phosphorus Status in Intensively Managed Soils

Phosphorus(P) in agricultural soils is an important factor for soil quality and environmental protection. Understanding of P and its fractions in soils on a regional scale is imperative for effective management or utilization of P and the improvement of P availability in soils. To study spatial variability and changes of soil P and its fractions as affected by farming practices, soil samples were taken in Rugao County, Jiangsu Province of China, an intensive agricultural area in the Yangtze River Delta region, in years of 1982(n = 1 514), 1997(n = 1 651), and 2002(n = 342). High spatial variabilities of Olsen P and total P(TP) were observed throughout the study area. Loamy Stagnic Anthrosols and clay or loamy Aquic Cambosols had significantly higher concentrations of Olsen P and TP than sandy Ustic Cambosols and Aquic Cambosols. Olsen P and TP were increased from 1982 to 2002. The accumulations of Olsen P and TP in the cultivated soils were likely related to the increased application of P fertilizer, organic input,and soil incorporation of crop residues as well as conversion of soil use. Accumulated soil P was dominantly in labile and semi-labile P fractions. These P fractions may be utilized by future crop production by adjusting management practices, but they also pose a serious threat to nearby water bodies. Future strategies should include decreasing P fertilization in soils and supporting sustainable management. The information from this study can be used to monitor changes in soil fertility and environmental risks so that the use of fertilizers can become more rational.