从中医“候脉”说起——兼谈核心义与同步构词的作用

中古以来,有“候脉”一词,谓搭脉。“候”的核心义是目光对事物的投射与接触,就是察看。可以是侦察敌方,就是侦候或斥候;可以是巡查下属,就是候望或守候,也包括了对宾客的迎候;可以观察万事万物,如对疾病的观察就是候诊或症候,对天象的观察就是测候或节候。均有动词和名词两种用法。而“候”核心义源于其本义“矢射向靶子之形”,即有聚焦点。用于人目光的聚焦,就是观察。从同步构词的角度看,候脉是属于动宾结构中的看脉类,强调眼部的动作。由此证明核心义和同步构词在词义分析中具有较强的解释力。

Hepatic angiosarcoma with clinical and histological features of Kasabach-Merritt syndrome

Hepatic angiosarcoma is a mesenchymal tumor originating from liver sinusoidal endothelial cells. It is an extremely rare malignant neoplasm accounting for less than 1% of primary malignant liver tumors. The deregulated coagulopathy that can be seen in hepatic angiosarcoma fulfills the clinical diagnostic criteria of disseminated intravascular coagulation. However, the mechanism that governs this coagulopathy has been poorly understood. This case report provides histological evidence of the consumption of coagulation factors along with trapped platelets occurring within the tumor, which is the foundation for the concept of Kasabach-Merritt syndrome(KMS). KMS is characterized by thrombocytopenia and hyperconsumption of coagulation factors within a vascular tumor. However, KMS associated with angiosarcoma has not been well recognized. This case report describes, for the first time, the histological evidence of KMS that occurred in an extremely rare mesenchymal malignant tumor of the liver.

Streamflow response to shrinking glaciers under changing climate in the Lidder Valley,Kashmir Himalayas

The study investigated the streamflow response to the shrinking cryosphere under changing climate in the Lidder valley, Upper Indus Basin(UIB), Kashmir Himalayas. We used a combination of multitemporal satellite data and topographic maps to evaluate the changes in area, length and volume of the glaciers from 1962 to 2013. A total of 37 glaciers from the Lidder valley, with an area of 39.76 km^2 in 1962 were selected for research in this study. It was observed that the glaciers in the valley have lost ~28.89 ±0.1% of the area and ~19.65 ±0.069% of the volume during the last 51 years, with variable interdecadal recession rates. Geomorphic and climatic influences on the shrinking glacier resources were studied. 30-years temperature records(1980-2010) in the study area showed a significant increasing trend in all the seasons. However, the total annual precipitation during the same period showed a nonsignificant decreasing trend except during the late summer months(July, August and September), when the increasing trend is significant. The depletion of glaciers has led to the significant depletion of the streamflows under the changing climate in the valley. Summer streamflows(1971-2012) have increased significantly till mid-nineties but decreased significantly thereafter, suggesting that the tipping point of streamflow peak, due to the enhanced glacier-melt contribution under increasing global temperatures, may have been already reached in the basin. The observed glacier recession and climate change patterns, if continued in future, would further deplete the streamflows with serious implications on water supplies for different uses in the region.

Particular evolution in a 72-year-old diabetic patient with acute coronary syndrome

Diabetes mellitus is an important risk factor for coronary atherosclerosis and many patients present extensive coronary stenosis at coronarography. However, in patients with diabetes, endothelial and microvascular dysfunction also participate in chronic and acute myocardial ischemia. Although the majority of diabetic patients with myocardial infarction have angiographic evidence of significant coronary artery disease.

Effect of Aspect on Climate Variation in Mountain Ranges of Shennongjia Massif, Central China

The aim of this study was to better understand the mechanisms of regional climate variation in mountain ranges with contrasting aspects as mediated by changes in global climate. It may help predict trends of vegetation variations in native ecosystems in natural reserves. As measures of climate response, temperature and precipitation data from the north, east, and south-facing mountain ranges of Shennongjia Massif in the coldest and hottest months(January and July), different seasons(spring, summer, autumn, and winter) and each year were analyzed from a long-term dataset(1960 to 2003) to tested variations characteristics, temporal and spatial quantitative relationships of climates. The results showed that the average seasonal temperatures and precipitation in the north, east, and south aspects of the mountain ranges changed at different rates. The average seasonal temperatures change rate ranges in the north, east, and south-facing mountain ranges were from –0.0210℃/yr to 0.0143℃/yr, –0.0166℃/yr to 0.0311℃/yr, and –0.0290 ℃/yr to 0.0084℃/yr, respectively, and seasonal precipitation variation magnitude were from –1.4940 mm/yr to 0.6217 mm/yr, –1.6833 mm/yr to 2.6182 mm/yr, and –0.8567 mm/yr to 1.4077 mm/yr, respectively. The climates variation trend among the three mountain ranges were different in magnitude and direction, showing a complicated change of the climates in mountain ranges and some inconsistency with general trends in global climate change. The climate variations were significantly different and positively correlated cross mountain ranges, revealing that aspects significantly affected on climate variations and these variations resulted from a larger air circulation system, which were sensitive to global climate change. We conclude that location and terrain of aspect are the main factors affecting differences in climate variation among the mountain ranges with contrasting aspects.

Synedra ulna var.repanda,a new variety of Synedra (Bacillariophyta) from Xinjiang,China

Synedra ulna var, repanda Q. X. Wang ＆ Q. M. You, a new variety of Synedra （Bacillariophyta） from Xinjiang, China, is described and illustrated, and the characteristic of the variety： includes undulate-linear valves and straight pseudoraphe, differs from other species of Synedra.

Changes of Temperature and Precipitation Extremes in Hengduan Mountains,Qinghai-Tibet Plateau in 1961-2008

Variations and trends in extreme climate events are more sensitive to climate change than the mean values, and so have received much attention. In this study, twelve indices of temperature extremes and 11 indices of precipita- tion extremes at 32 meteorological stations in Hengduan Mountains were examined for the period 1961-2008. The re- suits reveal statistically significant increases in the temperature of the warmest and coldest nights and in the frequen- cies of extreme warm days and nights. Decreases of the diurnal temperature range and the numbers of frost days and ice days are statistically significant. Regional averages of growing season length also display the trends consistent and significant with warming. At a large proportion of the stations, patterns of temperature extremes are consistent with warming since 1961： warming trends in minimum temperature indices are greater than those relating to maximum temperature. As the center of the Shaluli Mountain, the warming magnitudes decrease from inner to outer. Changes in precipitation extremes is low： trends are difficult to detect against the larger inter-annual and decadal-scale variability of precipitation, and only the wet day precipitation and the regional trend in consecutive dry days are significant at the 0.05 level. It can be concluded that the variation of extreme precipitation events is not obvious in the Hengduan Mountains, however, the regional trends generally decrease from the south to the north. Overall, the spatial distribution of temporal changes of all extreme climate indices in the Hengduan Mountains illustrated here reflects the climatic complexity in mountainous regions.

How to select the appropriate candidate of pulmonary arterial hypertension： specific therapy in elderly patients with pulmonary hypertension

Recent reports from pulmonary arterial hypertension （PAH） registries suggest that the mean age at diagnosis is increasing in a growing proportion of elderly patients. The combination of several reasons such as aging popula- tion, increase in life expectancy, growing PAH awareness of physicians and patients, and availability of more treatment options could explain the changing picture of PAH. PAH should be considered as an emerging entity in the elderly.

Projections of the impacts of climate change on the water deficit and on the precipitation erosive indexes in Mantaro River Basin, Peru

Projections of climate change are essential to guide sustainable development plans in the tropical Andean countries such as Peru. This study assessed the projections of precipitation and potential evaporation, rain erosive potential, and precipitation concentration in the Mantaro River Basin, in the Peruvian Andes, which is important for agriculture and energy production in Peru. We assumed the Intergovernmental Panel on Climate Change （IPCC） AIB greenhouse gas emission scenario and simulated the global climate change by the HadCM3 global climate model. Due to the steepness of the mountain slopes and the narrowness of the river valley, this study uses the downscaling of the global model simulations by the regional Eta model down to 2o-km resolution. The downscaling projections show decrease in the monthly precipitation with respect to the baseline period, especially during the rainy season, between February and April, until the end of the 21st century. Meanwhile, a progressive increase in the monthly evaporation from the baseline period is projected. The Modified Fournier Index （MFI） shows a statistically significant downward trend in the Mantaro River Basin, whieh suggests a possible reduction in the rain erosive potential. The Precipitation Concentration Index （PCI） shows a statistically significant increasing trend, which indicates increasingly more irregular temporal distribution of precipitation towards the end of the century. The results of this study allow us to conclude that there should be a gradual increase in water deficit and precipitation concentration. Both changes can be negative for agriculture, power generation, and water supply in the Mantaro River Basin in Peru.

Spatial distribution of morphometric parameters of glacial cirques in the Central Pyrenees(Aran and Boí valleys)

Glacial cirques are typical landscape features of mid-latitude mountain environments like the Central Pyrenees. Their morphology as well as their spatial distribution provides insights about past glaciers and climates. In this study, we examine the distribution, morphometrical and topographical characteristics of glacial cirques in two U-shaped glacial valleys located in the Central Pyrenees – the Aran and the Boí valleys. They are located in different aspects of this mountain range(north vs south) under different climatic influences that promoted distinct glaciation patterns during the late Pleistocene. The spatial mapping of these landforms was carried out using high-resolution imagery and field observations. We analysed the data of the morphometrical and topographical variables of the glacial cirques by using different statistical and geospatial methods in order tounveil the factors controlling their formation and development. A total of 186 glacial cirques were mapped in the study area, including 119 in the Aran and 67 in the Boí valleys. The local topography and microclimate conditions lead to substantial differences in both areas in terms of the morphology and dimensions of the cirques. Glacial cirques in Boí are distributed at slightly higher elevations than in Aran and they are also larger, though their dimensions decrease with elevation in both valleys. Aran cirques are mostly oriented NE, while Boí landforms do not show any prevailing aspect. Even though lithology does not control the distribution of the glacial cirques, some specific lithological settings may favour the development of larger cirques. In general, glacial cirques in the Aran and the Boí valleys show morphometrical properties similar to those reported in other mid-latitude mountain ranges.

Impact of meteorological conditions and PM2.5 on the onset of acute aortic dissection in monsoonal climate

Objective To investigate the impact of meteorological conditions and PM2.5 on the onset of acute aortic dissection in monsoonal climate. Methods A linear regression analysis was performed in monsoonal climate epidemiological survey for a period of four years on the impact of meteorological factors （minimal temperature, mean temperature, maximal temperature, average daily surface temperature, day temperature range, relative humidity, mean wind speed, and atmospheric pressure） and PM2.5 concentration on the daily incidences of acute aortic dissections. Meteorological variables and PM2.5 concentration were retrieved on a daily basis from Beijing Regional Climate Center and the Ministry of Environmental Protection of the People’s Republic of China’s website, and the daily incidences of acute aortic dissections were retrieved from the Clinical Data Analysis and Reporting System in the Emergency and Critical Care Center of Beijing Anzhen Hospital. Results During the study period （from January 2011 to December 2014）, 1164 patients were identified as having acute aortic dissections. The corresponding incidences in spring and autumn were 0.96 and 1.00, respectively, which significantly higher than that in summer and winter. The incidences of acute aortic dissection in a day could be predicted by diurnal temperature range （DTR） using the following linear multiple regression models： incidences of acute aortic dissection = 0.543 ＋ 0.025 × DTR. Conclusion This is the first study to show an attributable effect of DTR on acute aortic events in monsoonal climate. Our study confirms that meteorological variables were important factors influencing the incidence of acute aortic dissection.

Relationship between syndrome elements and anterior communicating artery opening in patients with smptomatic severe carotid artery stenosis/occlusion

Objective To study the relationship between syndrome elements and anterior communicating artery(ACoA)opening in patients with symptomatic severe carotid artery stenosis/occlusion.Methods Thirty-six patients with symptomatic severe carotid stenosis/occlusion were collected,including 26 patients with cerebral infarction and 10 patients with transient ischemic attack(TIA).Syndrome elements at five time points were collected.Computer tomography angiography(CTA)combined with magenic resonance angiograp(MRA)was used to evaluate the primary collateral circulation,and the prognosis and syndrome elements were statistically analyzed according to whether the ACoA was open or not.Results The ACoA was open more in the primary collateral circulation among patients with symptomatic severe carotid stenosis/occlusion.There was a statistically significant difference in national institute of health stroke scale(NIHSS)score improvement and good prognosis[the modified rankin scale(mRS)≤2]between the ACoA open group and the ACoA nonopen group on the 90th day(P<0.05).The proportion of patients with internal wind syndrome,blood stasis syndrome,Qi deficiency syndrome,and Yin deficiency syndrome in the ACoA non-open group was higher than that in the open group.Conclusion In the patients with severe carotid artery stenosis/occlusion,the group with presence of anterior communicating artery had better prognosis.The syndrome elements are more complex in the group without the presence of anterior communicating artery.The proportion of Qi deficiency syndrome was positively correlated with the non-opening of anterior communicating artery.The imaging evaluation of collateral circulation can provide guidance for syndrome differentiation and treatment.

Variation in δ^(15)N of a lacustrine sedimentary sequence in the Nanling Mountains and its potential implication for climatic conditions over the past ~16000 years

Although extensive studies have been performed on nitrogen isotopes in lake sediments, understanding the complexity of the δ15N variation related to past environmental and climatic conditions still remains unclear. Supported by multi-proxy records including litho-units, organic carbon isotopes, ration of total organic carbon and total nitrogen, organic matter content, bulk dry density, the accumulation rate of organic matter, median grain size, magnetic susceptibility, and Rb/Sr and Ca/Mg ratios obtained from a sedimentary sequence in a small lake （i.e., Dahu Swamp） in the eastern Nanling Mountains in South China, we deduce that variation in the δ15N values results primarily from the sources of organic matter, which are significantly influenced by climatic conditions over the past -16 000 years. A low （or high） lake level resulting from dry （or wet） conditions would lead to more （or fewer） vascular plant remains in the sediments and stronger （or weaker） denitrification associated with hypolimnetic anoxia, resulting in lower （or higher） 615N values. In addition, dry （or wet） conditions would favor weakened （or strengthened） biogeochemical activity in the catchment, which could result in less （or more） external input of δ15N-enriched OM, thus leading to decreased （or increased） δ15N values. Our results indicate that the lake sediment δ15N record in the Nanling Mountains has the potential to provide valuable insight into past East Asian monsoon climate- driven environmental changes.

Vegetation Geo-climatic Zonation in the Rocky Mountains, Northern Utah, USA

We developed a vegetation geo-climatic zonation incorporating the zonal concept, gradient and discriminant analysis in Wasatch Range, northern Utah, USA. Mountainous forest ecosystems were sampled and described by vegetation, physiographic features and soil properties. The Snowpack Telemetry and National Weather Service Cooperative Observer Program weather station networks were used to approximate the climate of sample plots. We analysed vegetation and environmental data using clustering, ordination, classification, and ANOVA techniques to reveal environmental gradients affecting a broad vegetation pattern and discriminate these gradients. The specific objective was to assess and classify the response of the complex vegetation to those environmental factors operating at a coarse-scale climatic level. Ordination revealed the dominant role of regional, altitude-based climate in the area. Based on vegetation physiognomy, represented by five tree species, climatic data and taxonomic classification of zonal soils, we identified two vegetation geo-climatic zones:(1) a montane zone, with Rocky Mountain juniper and Douglas-fir; and(2) a subalpine zone, with Engelmann spruce and subalpine fir as climatic climax species. Aspen was excluded from the zonation due to its great ecological amplitude. We found significant differences between the zones in regional climate and landformgeomorphology/soils. Regional climate was represented by elevation, precipitation, and air and soil temperatures; and geomorphology by soil types. This coarse-scale vegetation geo-climatic zonation provides a framework for a comprehensive ecosystem survey, which is missing in the central Rocky Mountains of the United States. The vegetation-geoclimatic zonation represents a conceptual improvement on earlier classifications. This framework explicitly accounts for the influence of the physical environment on the distribution of vegetation within a complex landscape typical of the central Rocky Mountains and in mountain ranges elsewhere.

The Role of Chilean Mountain Areas in Time of Drought and Energy Crisis:New Pressures and Challenges for Vulnerable Ecosystems

In the summer of 2010/2011 Chile suffered the third most severe energy and water supply crisis in only one decade. This may be surprising as the Andes which accompany the country along 4,200 km are a water tower and could provide more electricity and water than needed. On top of that, it has to be mentioned that Chile also counts with sunny and windy climates and with excellent geothermal energy resources and thus has a huge potential as far as renewable energies are concerned. After analyzing the existing natural conditions, the infrastructure and the present challenges of climate change, it has to be asked in which way Chile can make use of this potential in the near future, considering the legal and political situation and the technological opportunities. It seems that the resources are still hidden in the Andes, and only the key is missing to realize the country＇s natural potential. This research has been based on the analysis of existing literature, media, quantitative data from government institutions and other antecedents obtained by the authors in field work done in the South of Chile in 2OLO. The added value of this compilation lies in the comprehensive perspective, linking the knowledge of climatologists, hydrologists, mountain researchers and energy experts in order to support a sustainable energy and water supply for the future in Chile. From this present research, it can be concluded that Chile necessarilyhas to adopt new energy-related strategies, particularly those aimed at diminishing the strong dependence on traditional sources of energy and establishing new techniques and technologies for generating electrieity and utilizing the vast potential that the country is ready to offer, such as that provided by the Andes along 4,200 kilometers.

Object-Based Analysis of Multispectral RS Data and GIS for Detection of Climate Change Impact on the Karakoram Range Northern Pakistan

Changing climate has a great impact on northern area of Pakistan＇s environment and is more prone to environmental changes impacts than rest of the country due to its high elevation. However, melting glaciers effect not only the local environment but also the whole country with frequent and heavy floods. Remote sensing （RS） from Satellites and Airplanes used in Geographical Information Systems （GIS） are technologies that can aid in understanding the on-going environmental processes. Furthermore, help researchers to observe, understand, forecast and suggest response to changes that occur. It can be natural disasters or man-made disasters and human induced factors. Still analysis accuracy issues play a vital role for the formulation of any strategy. To achieve better results, object based analysis methods have been tested. Various algorithms are developed by the analysts to calculate the magnitude of land cover changes. However, they must be evaluated for each environment that is under observation as mountainous areas. Here were object-based methods evaluated in comparison with pixel based. Landslides, soil moisture, soil permeability, snow cover and vegetation cover can be effectively monitored by those methods.

Misdiagnosed coronary artery disease-acute aortic syndrome： A case report

It is estimated that 15% of traffic accidents cause trauma to large vessels. In about 70%-95% of cases, aortic rupture took place in the distal ligament of the left subclavian artery, whereas in the remaining cases rupture occurred in the ascending aorta above the aortic valve. Trauma to the aortic sinus and coronary arteries is rarely found in traffic accident victims. Therefore, coronary artery trauma is often misdiagnosed as coronary atherosclerotic heart disease. The present case is a 42 years old male who survived from a traffic accident. He presented with aortic sinus and left coronary artery trauma. He was misdiagnosed as having coronary atherosclerotic heart disease, and therefore wrongly given antiplatelet medicine, such as aspirin, in another hospital. Definite diagnosis was achieved in our hospital, and the patient underwent Bentall and mitral valve replacement, as well as tricuspid valvuloplasty. The aortic occlusion time during surgery was 47 min, and the total cardiopulmonary bypass time was 63 rain. After surgery, transthoracic echocardiography confirmed that all the artificial valves worked sufficiently. The patient felt good and symptoms such as asthma and decreased exercise tolerance disappeared. This case taught us that acute aortic syndrome cannot be ignored when patients present with pectoralgia; antiplatelet medication should not be given before definite diagnosis.

Response of Asiatic ibex(Capra sibirica) under Climate Change Scenarios

We investigated the effects of climate change on the distribution of the Asiatic ibex(Capra sibirica)in eastern Tajikistan.No existing climate change studies have been conducted on the habitat of a wild goat species in Asia.We conducted ecological niche modelling to compare potential present and future distributions of suitable environmental conditions for ibex.Projecting to 2070,18%(2689 km^2)of the current suitable areas would be lost,mostly located in the southeastern and northwestern regions of the study area.However,new suitable habitats could expand outside the current ibex range—about 30%(4595 km^2)expansion until 2070.We found that the elevation,terrain roughness,seasonal temperature,and precipitation of warmest quarter were the most important factors in the models and had strong correlations to ibex distribution.The losses in the southeastern portion overlapped most of the current locations of ibex in that region.These losses were observed in the much lower elevations of the study area(3500 m to 4000 m).When considering both loss and gain,the ibex could see a net expansion to new suitable habitats.About 30%(1379 km^2)of the average habitat gains for the Asiatic ibex in 2070 showed a shift to northern lower temperature habitats.Our results are beneficial in planning for the potential effects on biodiversity conservation in the eastern mountain region of Tajikistan under climate change scenarios.Special attention should be given to the ibex populations in the southeastern region,where habitats could become unsuitable for the species as a result of the climate-induced effects on the mountain ecosystem.