Previous investigations suggest that ataxia is common and often one of the most reliable warning signs of high altitude cerebral edema(HACE). The aim of this study was to investigate the diagnostic role of ataxia in a...Previous investigations suggest that ataxia is common and often one of the most reliable warning signs of high altitude cerebral edema(HACE). The aim of this study was to investigate the diagnostic role of ataxia in acute mountain sickness(AMS)and HACE among mountain rescuers on the quake areas,and in approaching the relation between AMS and HACE. After the earthquake on April 14,2010,approximately 24 080 lowland rescuers were rapidly transported from sea level or lowlands to the mountainous rescue sites at 3 750 ~ 4 568 m,and extremely hardly worked for an emergency treatment after arrival. Assessments of acute altitude illness on the quake areas were using the Lake Louise Scoring System. 73 % of the rescuers were found to be developed AMS. The incidence of high altitude pulmonary edema(HAPE)and HACE was 0.73 % and 0.26 %,respectively,on the second to third day at altitude. Ataxia sign was measured by simple tests of coordination including a modified Romberg test. The clinical features of 62 patients with HACE were analyzed. It was found that the most frequent,serious neurological symptoms and signs were altered mental status(50/62,80.6 %)and truncal ataxia(47/62,75.8 %). Mental status change was rated slightly higher than ataxia,but ataxia occurred earlier than mental status change and other symptoms. The earliest sign of ataxia was a vague unsteadiness of gait,which may be present alone in association with or without AMS. Advanced ataxia was correlated with the AMS scores,but mild ataxia did not correlate with AMS scores at altitudes of 3 750~4 568 m. Of them,14 patients were further examined by computerized tomographic scanning of the brain and cerebral magnetic resonance imagines were examined in another 15 cases. These imaging studies indicated that the presence of the cerebral edema was in 97 % of cases who were clinically diagnosed as HACE(28/29). Ataxia seems to be a reliable sign of advanced AMS or HACE,so does altered mental status.展开更多
Pollen diversity offers abundant clues into the floristic diversity and history of vegetation change. Few palynological studies investigated modem pollen diversity or the past floristic diversity on the Tibetan Plate...Pollen diversity offers abundant clues into the floristic diversity and history of vegetation change. Few palynological studies investigated modem pollen diversity or the past floristic diversity on the Tibetan Plateau （TP）. Based on modem pollen assemblages from 37 topsoils and 63 surface lake sediments in the Nam Co catchment on the central TP, this study quantitatively explored spatial distribution of modem pollen diversity using Shannon-Wiener index （H） and palynological richness （E（Tn）, n=600）. Pollen diversity indices showed spatial variability among vegetation types, reflecting the differences in terrestrial floristic diversity in the lake catchment. Their values were high in the southeastern region of the lake catchment which is covered by alpine steppe, while values were low for alpine meadow and marsh meadow. The pollen diversity in lacustrine pollen assemblage could be an effective proxy to document past floristic diversity. The past floristic diversity in the lake catchment, recovered from a fossil pollen record ofNMLC-1, showed a long-term change of ascending overlaid by several rapid diversity changes during the last 8400 years due to the downward shift of altitudinal vegetation belt driven by a general climatic cooling. The results imply that under the environmental challenge of climate warming and vegetation degradation, alpine vegetation restoration in the Nam Co catchment and the central TP should pay attention to altitudinal vegetation belt and zonal vegetation of alpine steppe, and use the long-term change of floristic diversity as a historical analogue.展开更多
基金"973"National Key Basic Research and Development Program(No.2012CB518202)Project of Qinghai Development of Science and Technology(No.2011-N-150)
文摘Previous investigations suggest that ataxia is common and often one of the most reliable warning signs of high altitude cerebral edema(HACE). The aim of this study was to investigate the diagnostic role of ataxia in acute mountain sickness(AMS)and HACE among mountain rescuers on the quake areas,and in approaching the relation between AMS and HACE. After the earthquake on April 14,2010,approximately 24 080 lowland rescuers were rapidly transported from sea level or lowlands to the mountainous rescue sites at 3 750 ~ 4 568 m,and extremely hardly worked for an emergency treatment after arrival. Assessments of acute altitude illness on the quake areas were using the Lake Louise Scoring System. 73 % of the rescuers were found to be developed AMS. The incidence of high altitude pulmonary edema(HAPE)and HACE was 0.73 % and 0.26 %,respectively,on the second to third day at altitude. Ataxia sign was measured by simple tests of coordination including a modified Romberg test. The clinical features of 62 patients with HACE were analyzed. It was found that the most frequent,serious neurological symptoms and signs were altered mental status(50/62,80.6 %)and truncal ataxia(47/62,75.8 %). Mental status change was rated slightly higher than ataxia,but ataxia occurred earlier than mental status change and other symptoms. The earliest sign of ataxia was a vague unsteadiness of gait,which may be present alone in association with or without AMS. Advanced ataxia was correlated with the AMS scores,but mild ataxia did not correlate with AMS scores at altitudes of 3 750~4 568 m. Of them,14 patients were further examined by computerized tomographic scanning of the brain and cerebral magnetic resonance imagines were examined in another 15 cases. These imaging studies indicated that the presence of the cerebral edema was in 97 % of cases who were clinically diagnosed as HACE(28/29). Ataxia seems to be a reliable sign of advanced AMS or HACE,so does altered mental status.
基金supported by the National Natural Science Foundation of China(Grant Nos.41471169,41690113,41271226,41571189&41330105)
文摘Pollen diversity offers abundant clues into the floristic diversity and history of vegetation change. Few palynological studies investigated modem pollen diversity or the past floristic diversity on the Tibetan Plateau （TP）. Based on modem pollen assemblages from 37 topsoils and 63 surface lake sediments in the Nam Co catchment on the central TP, this study quantitatively explored spatial distribution of modem pollen diversity using Shannon-Wiener index （H） and palynological richness （E（Tn）, n=600）. Pollen diversity indices showed spatial variability among vegetation types, reflecting the differences in terrestrial floristic diversity in the lake catchment. Their values were high in the southeastern region of the lake catchment which is covered by alpine steppe, while values were low for alpine meadow and marsh meadow. The pollen diversity in lacustrine pollen assemblage could be an effective proxy to document past floristic diversity. The past floristic diversity in the lake catchment, recovered from a fossil pollen record ofNMLC-1, showed a long-term change of ascending overlaid by several rapid diversity changes during the last 8400 years due to the downward shift of altitudinal vegetation belt driven by a general climatic cooling. The results imply that under the environmental challenge of climate warming and vegetation degradation, alpine vegetation restoration in the Nam Co catchment and the central TP should pay attention to altitudinal vegetation belt and zonal vegetation of alpine steppe, and use the long-term change of floristic diversity as a historical analogue.
