也谈《嘉禾吏民田家莂》中“二年常限”田的涵义

《田家》中的“二年常限”田 ,是指吏民租佃及缴纳相应亩租额年限只有二年的零星国有土地。“二年常限”田的亩租额高于余力田。期限一到 ,吏民须重新佃种 ,封建政府也有权另行确定亩租额。

吴简《嘉禾吏民田家莂》“二年常限”解

厘清吴简《嘉禾吏民田家》中常见“二年常限”的确切含义 ,是理解吴国吏民租佃土地性质的关键。“常限”应作“一定标准”解 ,“年”应作“熟稔”解。根据六朝及唐后期的“二稔职田”所涉及的水稻耕作方式特点 ,所谓“二年常限” 。

再论吴简“二年常限”田的含义

对走马楼吴简“二年常限”田的含义,已有解读可分为租佃年限说、嘉禾二年说及“二年一垦”说。根据简文和传世文献考辨,嘉禾二年说或“二年一垦”说均难以成立,“二年”当为租佃年限。“二年常限”田就是在嘉禾四、五年间按固定的数额或标准缴纳米、钱和布的国有土地。其中“旱田”可定义为因缺乏灌溉等条件被人为划定的低产田,而“熟田”可定义为因具备一定的灌溉等条件被人为划定的高产田。在熟田中又有租田与税田之分,租田每亩纳米0.585斛,或0.586斛,税田每亩纳米1.2斛,并有着多样化的耕种者身份。这表明“二年常限”田是国有土地高度发展的产物,也是孙吴加强对劳动者人身控制的手段和工具。

探讨老年肺炎患者临床诊断中检验血清C反应蛋白(CRP)、血沉(ESR)、以及D-二聚体(D-D)水平的临床价值

目的探讨老年肺炎患者临床诊断中检验血清C反应蛋白(CRP)、血沉(ESR)、以及D-二聚体(D-D)水平的临床价值。方法随机选择该院2015年1月—2016年12月期间收治的50例老年肺炎病例为观察组研究对象,并以同期自愿参与研究的50名健康老年体检者为对照组研究对象,比较两组血清C反应蛋白(CRP)、血沉(ESR)、以及D-二聚体(D-D)水平。结果观察组老年患者血清CRP(103.2±23.4)mg/L、ESR(35.8±6.5)μg/L、D-D(1 152.4±43.1)mm/h水平均显著高于对照组(8.9±1.2)mg/L、(10.2±1.4)μg/L、(182.6±14.8)mm/h,差异有统计学意义(P<0.05)。将观察组以80岁为临界值分组,80岁以上患者CRP(102.4±21.8)mg/L、ESR(34.8±5.8)μg/L、D-D(1 148.7±45.2)mm/h与80岁以下患者(103.8±22.1)mg/L、(35.4±6.2)μg/L、(1 142.3±43.9)mm/h,差异无统计学意义(P>0.05)。结论临床上可行血清C反应蛋白、血沉及D-二聚体检测来诊断老年肺炎的情况,为治疗和预后提供有效依据。

老年髋关节置换术应用不同麻醉方式的价值探析

目的探讨老年髋关节置换术应用不同麻醉方式的价值。方法回顾2016年1月—2017年2月84例老年髋关节置换术患者并分组。对照组用全麻方式,研究组用腰硬联合麻醉方式。比较两组老年髋关节置换术麻醉优良率;麻醉起效时间、麻醉后心率、血压变化;麻醉不良事件出现率。结果研究组老年髋关节置换术麻醉优良率高于对照组,P<0.05;研究组麻醉起效时间、麻醉后心率、血压变化优于对照组,P<0.05;研究组麻醉不良事件出现率低于对照组,P<0.05。结论老年髋关节置换术应用腰硬联合麻醉的价值高,可更快起效,稳定生命体征,减少并发症发生,安全和可行性高。

論走馬樓吴簡詞語的時代性和地域性

不少學者提倡注意詞語的時代性和地域性,汪維輝先生更是專文對此進行探討。[1]他説:'每一個詞都有其時代性和地域性,揭示詞的時代性和地域性是詞彙史學科的基本任務之一,也是正確訓釋詞義的一個重要因素。'然而漢語的發展源遠流長,漢語詞彙經歷了歷代的積澱和沉積。

Multi-dimensional frailty and its risk factors among older residents in long-term care facilities in Shanghai,China

Objectives:The integrated model of frailty shifted the physiologically-dominated view to an integrated and multidisciplinary view of frailty and adopted an integrated and holistic approach to the complex challenges facing frail older adults and their caregivers.There is an urgent need for researchers to identify multi-faceted frailty among older adults and to explore contributors to it.We assessed the level of frailty among older residents in long-term care(LTC)facilities in Shanghai,China and explored risk factors of multiple dimensions of frailty among older residents.Methods:It is a cross-sectional descriptive study.We interviewed 218 older residents from nine LTC facilities.We used Tilburg Frailty Indicator to assess older residents’physiological,psychological,and social frailty.The Geriatric Depression Scale,Mini-Mental state examination,Athens Insomnia Scale,and Activity of Daily Living(ADL)Scale were used to assess their depressive symptoms,cognitive function,sleep quality and ADL abilities,respectively.Results:Older residents have a moderate level of frailty in physiological,psychological and social domains.There is a high correlation among dimensions of frailty.Older residents’depressive symptoms have remained positively associated with their overall and each domain of frailty.Older residents’actual activity participation and exercise in LTC facilities are negatively associated with older residents’overall,physiological and social frailty.Conclusions:Frailty is a multi-dimensional concept and is prevalent among older residents in LTC facilities.It is important to take an integrated view on frailty and carry out appropriate and comprehensive interventions to prevent adverse outcomes and provide holistic care for frail older residents in LTC facilities.There is an urgent need to improve the quality and expand the number of activities offered within LTC facilities that would engage older residents in a person-centered way,despite their age,ADL abilities,frailty and functional limitations.

Interannual Variability of the Hadley Circulation Associated with Tropical Pacific SST Anomaly

The seasonal and interannual variability of zonal mean Hadley circulation are analyzed, and the important effects of sea surface temperature(SST), especially the tropical Pacific SST, on the meridional circulation are discussed. Following results are obtained: 1) the Hadley circulation presents a single clockwise(anticlockwise) cross-equator circulation in the Northern(Southern) Hemisphere winter,while it is a double-ring-shaped circulation quasi-symmetric about the equator in spring and autumn. The annual mean state just indicates the residual of the Hadley cell in winter and summer. 2) The first mode of interannual anomalies shows a single cell crossing the equator like the climatology in winter and summer but with narrower width. The second mode shows a double ring-shaped cell quasi-symmetric about the equator which is similar to the Hadley cell in spring or autumn. 3) Vertical motion of the Hadley circulation is driven by sea surface temperature(SST) through latent and sensible heat in the tropics, and the interannual anomalies are mainly driven by the SST anomaly(SSTa) in the tropical Pacific. 4) The meridional gradient of SSTa is well consistent with the lower meridional wind of Hadley circulation in the interannual part. For the spatial distribution, the meridional gradient of SSTa in the Pacific plays a major role for the first two modes while the effects of the Indian Ocean and the Atlantic Ocean can be ignored.

Large-scale circulation features associated with the heat wave over Northeast China in summer 2018

In late July and early August 2018,Northeast China suffered from extremely high temperatures,with the maxium temperature anomaly exceeding 6°C.In this study,the large-scale circulation features associated with this heat wave over Northeast China are analyzed using station temperature data and NCEP–NCAR reanalysis data.The results indicate that strong anomalous positive geopotential height centers existed from the lower to upper levels over Northeast China,and the related downward motions were directly responsible for the extreme high-temperature anomalies.The northwestward shift of the western Pacific subtropical high(WPSH)and the northeastward shift of the South Asian high concurrently reinforced the geopotential height anomalies and descending flow over Northeast China.In addition,an anomalous Pacific–Japan pattern in the lower troposphere led to the northwestward shift of the WPSH,jointly favoring the anomalous geopotential height over Northeast China.Two wave trains emanating from the Atlantic region propagated eastwards along high latitudes and midlatitudes,respectively,and converged over Northeast China,leading to the enhancement of the geopotential height anomalies.

Polysplenia syndrome with preduodenal portal vein detected in adults

Polysplenia syndrome, defined as the presence of multiple spleens of almost equal volume, is a rare condition involving congenital anomalies in multiple organ systems. We report this anomaly in a 41-year-old female who underwent a left lateral sectionectomy due to recurrent cholangitis and impacted left lateral duct stones. Polysplenia syndrome with preduodenal vein was diagnosed preoperatively by computed to-mography (CT) and surgery was done safely. Although the polysplenia syndrome with preduodenal portal vein (PDPV) in adult is rarely encountered, surgeons need to understand the course of the portal vein and exercise caution in approaching the biliary tract.

Distribution and ultrastructure of pigment cells in the skins of normal and albino adult turbot, Scophthalmus Maximus

The distribution and ultrastructure of pigment cells in skins of normal and albino adult turbots were examined with transmission electron microscopy （TEM）. Three types of pigment cells of melanophore, iridophore and xanthophore have been recognized in adult turbot skins. The skin color depends mainly on the amount and distribution of melanophore and iridophore, as xanthophore is quite rare. No pigment cells can be found in the epidermis of the skins. In the pigmented ocular skin of the turbot, melanophore and iridophore are usually co-localized in the dermis. This is quite different from the distribution in larvae skin. In albino and white blind skins of adult turbots, however, only iridophore monolayer still exists, while the melanophore monolayer disappears. This cytological evidence explains why the albino adult turbot, unlike its larvae, could never resume its body color no matter what enviroumental and nutritional conditions were provided. Endocytosis is quite active in the cellular membrane of the iridophore. This might be related to the formation of reflective platelet and stability of the iridophore.

Enhanced correlation between ENSO and western North Pacific monsoon during boreal summer around the 1990s

The correlation between summertime Nino3.4 index and western North Pacific(WNP)summer monsoon index has strikingly enhanced since the early 1990 s,with nonsignificant correlation before the early1990 s but significant correlation afterward.This observed interdecadal change around the 1990 s may be associated with more frequent occurrences of central Pacific(CP)El Nino and the interdecadal changes in ENSO-associated SST anomalies.During the post-1990 s period(the pre-1990 s period),highly noticeable tropical Atlantic(Indian)Ocean SST anomalies tend to co-occur with the summertime Nino3.4 SST anomalies.The concurrent tropical Atlantic(Indian)Ocean SST anomalies could constructively reinforce(destructively mitigate)the WNP monsoon circulation anomalies induced by the summertime Nino3.4 SST,thus boosting(muting)the correlation between summertime Nino3.4 SST and WNP monsoon.In addition,the faster decaying pace of preceding-winter El Nino after the 1990 s,which may have been mainly induced by the influences from the spring tropical North Atlantic SST anomalies,could also have contributed to the enhanced correlation between the summertime Nino3.4 index and WNP monsoon.These results suggest that the enhanced influences from the tropical Atlantic SST may have triggered the intensified correlation between summertime ENSO and WNP monsoon since the early 1990 s.

Use of antiarrhythmic drugs in elderly patients

Human aging is a global issue with important implications for current and future incidence and prevalence of health conditions and disability. Cardiac arrhythmias, including atrial fibrillation, sudden cardiac death, and bradycardia requiring pacemaker placement, all increase exponentially after the age of 60. It is important to distinguish between the normal, physiological consequences of aging on cardiac electrophysiology and the abnormal, pathological alterations. The age-related cardiac changes include ventricular hypertrophy, senile amyloidosis, cardiac valvular degenerative changes and annular calcification, fibrous infiltration of the conduction system, and loss of natural pacemaker cells and these changes could have a profound effect on the development of arrhythmias. The age-related cardiac electrophysiological changes include up- and down-regulation of specific ion channel expression and intmcellular Ca2＋ overload which promote the development of cardiac arrhythmias. As ion channels are the substrates of antiarrhythmic drugs, it follows that the pharmacokinetics and pharmacodynamics of these drugs will also change with age. Aging alters the absorption, distribution, metabolism, and elimination of antiarrhythmic drugs, so liver and kidney function must be monitored to avoid potential adverse drug effects, and antiarrhythmic dosing may need to be adjusted for age. Elderly patients are also more susceptible to the side effects of many antiarrhytbanics, including bradycardia, orthostatic hypotension, urinary retention, and falls. Moreover, the choice of antiarrhythmic drugs in the elderly patient is frequently complicated by the presence of co-morbid conditions and by polypharmacy, and the astute physician must pay careful attention to potential drug-drug interactions. Finally, it is important to remember that the use of antiarrhythmic drugs in elderly patients must be individualized and tailored to each patient＇s physiology, disease processes, and medication regimen.

Multidecadal Trends in Large-Scale Annual Mean SATa Based on CMIP5 Historical Simulations and Future Projections

Based on observations and Coupled Model lntercomparison Project Phase 5 （CMIP5） results, multidecadal variations and trends in annual mean surface air temperature anomalies （SATa） at global, hemispheric, and hemispheric land and ocean scales in the past and under the future scenarios of two representative concentration pathways （RCPs） are analyzed. Fifteen models are selected based on their performances in capturing the temporal variability, long-term trend, multidecadal variations, and trends in global annual mean SATa. Observational data analysis shows that the multidecadal variations in annual mean SATa of the land and ocean in the northern hemisphere （NH） and of the ocean in the southern hemisphere （SH） are similar to those of the global mean, showing an increase during the 1900-1944 and 1971-2000 periods, and flattening or even cooling during the 1945-1970 and 2001-2013 periods. These observed characteristics are basically reproduced by the models. However, SATa over SH land show an increase during the 1945-1970 period, which differs from the other hemispheric scales, and this feature is not captured well by the models. For the recent hiatus period （2001-2013）, the projected trends of BCC-CSM1-1-m, CMCC-CM, GFDL-ESM2M, and NorESM1-ME at the global and hemispheric scales are closest to the observations based on RCP4.5 and RCP8.5 scenarios, suggesting that these four models have better projection capability in SATa. Because these four models are better at simulating and projecting the multidecadal trends of SATa, they are selected to analyze future SATa variations at the global and hemispheric scales during the 2006-2099 period. The selected multi-model ensemble （MME） projected trends in annual mean SATa for the globe, NH, and SH under RCP4.5 （RCP8.5） are 0.17 （0.29） ℃, 0.22 （0.36） ℃, and 0.11 （0.23） ℃-decade-1 in the 21st century, respectively. These values are significantly lower than the projections of CMIP5 MME without model selection.

Basal Cell Carcinoma at Pediatric Age Gorlin-Goltz Syndrome Clinic Experience

The nevoid basal cell carcinoma syndrome is an autosomal dominant inherited disease, associated with PTCH gene mutation. Its presentation is polymorphous, being frequent to appear the clinical triad carcinomas basal cell, odontogenic cysts and skeletal abnormalities. Skin lesions are a very frequent reason for consultation in the paediatric age, being evaluated in most cases in primary care. Sometimes, patients need the intervention of other specialists to deep in a given area. The medical literature shows a fragmented view of the disease, possibly related to the low frequency of appearance of this syndrome, and by the need for intervention of not transversal knowledge specialist, which is why we feel interesting to evaluate the role of specialist who is developing the activity at primary care, with patients who require a multidisciplinary intervention.

Chronic Myelomonocytic Leukemia with t （3; 9） （p21; p13） as a Sole Abnormal Appearance： One Case Report

Chronic myelomonocytic leukemia, （CMML） is a clinically rare chronic myeloid leukemia, with an incidence rate of about 1-2/ 100,000/year, and the age of the predominant cases is over 60 years. The median age of onset is 65-70 years, and the ratio of the incidence between male and female is about 1.5 ： 3.1. Specific etiological factors of the disease are not clear, but may be associated with the exposure to ionizing radiation,

Treatment of dyslipidemia in the elderly

Dyshpidemia is a well-established risk factor for atherosclerosis. Treating dyslipidemia in elderly patients requires specific knowledge and understanding of common dyslipidemias and the relative safety of various pharmacologic agents in the presence of possible multiple comorbidities. Lifestyle modification remains the first step in the treatment of dyslipidemia; however, it can be difficult to sustain and achieve acceptable compliance in the elderly and it is best used in combination with drug therapy. Statins are widely accepted as the first-line therapy. Several recent studies have demonstrated that statins are safe and effective in the elderly. However, it is important to note that there is very limited data regarding the effects of dyslipidemia treatment on morbidity and mortality in patients over 85 years of age. In summary, the clinicians must recognize that the presence of dyslipidemia in the elderly poses substantial risk of coronary events and stroke. The available evidence has demonstrated that in most elderly patients who are at increased risk for cardiovascular morbidity and mortality, treatment of dyslipidemia with appropriate therapy reduces the risk, and when used carefully with close monitoring for safety, the treatment is generally well tolerated. With increasing life expectancy, it is critical for physicians to recognize the importance of detection and treatment of dyslipidemia in the elderly.

CHARACTERISTICS OF ZONAL ANOMALY OF ANNUAL PRECIPITATION IN THE NORTHEASTERN CHINA

The characteristics of zonal anomaly and change rule of temporal distribution of annual precipitation in the northeastern China are revealed in this paper with EOF (Empirical Orthogonal Function) and REOF (Rotated Empirical Orthogonal Function) methods and results are drawn in the standard relief maps with GIS technology for practical application. Data used in the study were obtained from 208 meteorological stations over the northeastern China from 1961 to 2001. EOF results show that the first 3 loading vectors could give entire spatial anomaly structure of annual precipitation. In the Northeast Plain including the Songneng Plain and the Liaohe Plain, there is a regional compatibility (whether wet or dry) of annual precipitation change and this precipitation pattern has occurred since the late 1980s to the present. There also exist annual precipitation patterns of wet (or dry) in south and dry (or wet) in north and wet (or dry) in east and dry (or wet) in west. REOF results display 8 principal precipitation anomaly areas by the first 8 rotated loading vectors: the west plain, the Liaodong hills, the Sanjiang Plain, the Liaoxi hills, the Changbai Mountains, the Hulun Buir Plateau, the southwest plateau and the Liaodong Peninsula.