桂林岩溶石山青冈群落数量分类与排序

植物群落的数量分类和排序可以客观地揭示植物群落与环境之间的关系,从而能为植被恢复与重建、森林经营与管理和生物多样性保护等提供理论依据。基于群落学调查和环境因子测定数据,采用Ward聚类、双向指示种分析(TWINSPAN)和多元回归树(MRT)对桂林岩溶石山青冈群落进行数量分类,选用冗余分析(RDA)进行排序,分析其与环境因子之间的关系。结果表明:(1)3种分类方法所得结果基本一致,可将桂林岩溶石山青冈群落划分为3个群丛类型,分别为青冈-粗糠柴+龙须藤+红背山麻杆-三穗薹草群丛(Ass.Cyclobalanopsis glauca-Mallotus philippensis+Bauhinia championi+Alchornea trewioides-Carex tristachya)、青冈-龙须藤+红背山麻杆+干花豆-宽叶沿阶草+三穗薹草群丛(Ass.Cyclobalanopsis glauca-Bauhinia championi+Alchornea trewioides+Fordia cauliflora-Ophiopogon platyphyllus+Carex tristachya)、青冈-粗糠柴+干花豆-三穗薹草群丛(Ass.Cyclobalanopsis glauca-Mallotus philippensis+Fordia cauliflora-Carex tristachya);(2)冗余分析结果较好地反映出各群丛类型的分布格局及其与环境梯度的相互关系,在10个环境因子中,岩石裸露率、土壤含水量、pH值、全氮、全磷、全钾、速效钾这7个环境因子对群落的分布影响显著。土壤含水量和全钾含量可能是影响该植物群落物种组成与分布的重要生态因子。     

血清NT-proBNP水平在小儿心源性与非心源性呼吸困难诊断鉴别的价值

目的：探究血清B 型利钠肽前体（NT-proBNP）水平在小儿心源性与非心源性呼吸困难诊断鉴别的价值。方法：本研究于 2013 年2月~2015年2 月期间,选择我院收治的急性呼吸困难患儿72 例为研究对象,根据临床诊断将其分为心源性呼吸困难组 （39例）和非心源呼吸困难组（33 例）。采用电化学发光免疫分析法（ECLIA）测量两组患儿血清NT-proBNP 水平,并采用受试者工 作特征曲线（ROC）曲线评估血清NT-proBNP 水平在小儿心源性与非心源性呼吸困难诊断鉴别中的价值。结果：心源性呼吸困难 组患儿血清NT-proBNP水平为(253.23± 39.38)ng/L,明显高于非心源性呼吸困难组患儿血清NT-proBNP水平（76.39± 17.39） ng/L（t=23.882,P<0.05）。小儿血清NT-proBNP 水平诊断心源性呼吸困难和非心源性呼吸困难的曲线下面积为0.914,曲线下面积 的95%的置信区间为（0.861,0.967）,当血清NT-proBNP水平为118.34ng/L 时,约登指数取最大值为0.923,敏感度为97.43% （37/39）、特异度为94.87%（32/33）。结论：NT-proBNP 作为一个特异性指标可用于小儿心源性呼吸困难与非心源性呼吸困难的鉴 别诊断。     

抗肿瘤药物临床药师培训及其参与合理用药的应用进展

临床药学是药学的重要分支,临床药师为病人提供药学监护,优化了使用药物治疗,促进康复,加强了保健和疾病的预防。开展临床药师教育,有利于临床用药审查,并将为培养临床药师的工作提供参考。回顾近年来国内外的临床药师及抗肿瘤药物专业临床药师的培训经验和合理用药的进展情况,分别对临床药师培养模式、理论课程设置、药学查房带教、临床记录书写和业务学习等方面作了总结。本文通过系统性的回顾了和对比了国内外的临床药师的培养方案,从理论和实践两方面的应用进展分析了临床药师在临床中的重要作用。     

小儿复发性肠套叠的微创治疗研究

目的：探讨小儿复发性肠套叠（套叠3 次及以上）的微创治疗。方法：回顾性分析2007 年12 月~2013 年1 月期间收治的21 例复发性肠套叠（套叠3 次及以上）患儿的临床资料。结果：21 例患儿均予以腹腔镜探查,3 例患儿仅发现回肠末端肠系膜淋巴结 增生,18 例探及原发病灶：其中Meckel憩室10 例,结肠息肉3 例,肠重复畸形2 例,非霍奇金淋巴瘤1 例,异位胰腺1 例,小肠腺 瘤1 例。20 例术后随访至今均未再次复发,1 例失访。结论：年龄＞2 岁,有多次复发肠套叠病史（套叠3 次及以上）,尤其是短期内 复发频繁的患儿,大多存在肠道器质性病变,应积极手术治疗,且以腹腔镜治疗为佳。     

The impact of vitamin D3 supplementation on muscle function among HIV-infected children and young adults: a randomized controlled trial

Objectives:

We tested the hypothesis that daily vitD₃ supplementation increases neuromuscular motor skills, jump power, jump energy, muscular force, and muscular strength.

Methods:

This was a secondary analysis of a randomized controlled trial of 12-months of oral 7,000 IU/day vitD₃ supplementation or placebo among 56 persons living with HIV aged 9-25 years. Neuromuscular motor skills were quantified using the Bruininks-Oseretsky Test of Motor Proficiency. Power was quantified using peak jump power, and energy was quantified using peak jump height. Muscular force was quantified using isometric ankle plantar- and dorsiflexion, isokinetic knee flexion and extension. Muscular strength was quantified using isometric handgrip strength.

Results:

After 12-months, serum 25-hydroxyvitamin D [25(OH)D] was higher with supplementation versus placebo (β=12.1 ng/mL; P<0.001). In intention-to-treat analyses, supplementation improved neuromuscular motor skills versus placebo (β=1.14; P=0.041). We observed no effect of supplementation on jump power, jump energy, muscular force, or muscular strength outcomes versus placebo.

Conclusions:

Among HIV-infected children and young adults supplementation with daily high-dose vitD₃ increased concentration of serum 25(OH)D and improved neuromuscular motor skills versus placebo.     

Blood markers of oxidative stress predict weaning failure from mechanical ventilation

Patients undergoing mechanical ventilation (MV) often experience respiratory muscle dysfunction, which complicates the weaning process. There is no simple means to predict or diagnose respiratory muscle dysfunction because diagnosis depends on measurements in muscle diaphragmatic fibre. As oxidative stress is a key mechanism contributing to MV‐induced respiratory muscle dysfunction, the aim of this study was to determine if differences in blood measures of oxidative stress in patients who had success and failure in a spontaneous breathing trial (SBT) could be used to predict the outcome of MV. This was a prospective analysis of MV‐dependent patients (≥72 hrs; n = 34) undergoing a standard weaning protocol. Clinical, laboratory and oxidative stress analyses were performed. Measurements were made on blood samples taken at three time‐points: immediately before the trial, 30 min. into the trial in weaning success (WS) patients, or immediately before return to MV in weaning failure (WF) patients, and 6 hrs after the trial. We found that blood measures of oxidative stress distinguished patients who would experience WF from patients who would experience WS. Before SBT, WF patients presented higher oxidative damage in lipids and higher antioxidant levels and decreased nitric oxide concentrations. The observed differences in measures between WF and WS patients persisted throughout and after the weaning trial. In conclusion, WF may be predicted based on higher malondialdehyde, higher vitamin C and lower nitric oxide concentration in plasma.     

不同经营类型毛竹林土壤活性有机碳的差异

以起始于1984年的长期不同经营类型毛竹林为研究对象,探讨了秋季毛竹林集约经营后土壤有机碳库的变化。结果表明:(1)集约经营后0—10 cm土层毛竹林土壤总有机碳、易氧化碳、水溶性有机碳和轻组有机质含量分别下降了8.64%,14.11%,8.29%,29.70%(0—20 cm),差异均达到显著水平。(2)两种毛竹林土壤各种碳的剖面特征均随土层深度的增加而呈下降趋势,但下降幅度不同。集约经营在一定程度上影响了毛竹土壤易氧化碳、水溶性有机碳的剖面特征。(3)土壤各活性有机碳之间,土壤总有机碳、易氧化碳、水溶性有机碳与土壤全氮、水解氮、速效K、Ca、Mg之间相关性均达到显著或极显著水平(水溶性有机碳与速效磷相关性不显著),轻组有机质含量除与速效钙极显著相关外,与其它土壤养分之间相关性均不显著。(4)集约经营降低了土壤易氧化碳碳素有效率、水溶性有机碳碳素有效率及土壤碳库活度,并在土壤剖面部分土层达到显著水平。因此,集约经营的毛竹林,通过配施恰当比例的有机无机肥,结合土壤垦复、除草、合理的竹株留养和采伐等综合竹林经营技术,以达到改善土壤质量和实现毛竹林可持续经营的目的。     

京郊典型集约化"农田-畜牧"生产系统氮素流动特征

城郊畜牧业的集约化发展在满足人们日益增长的肉蛋奶等动物性产品需求的同时,也带来了巨大的环境压力。本文利用养分流动和模型分析的方法,分析北京市郊区某村三种不同类型"农田-畜牧"生产系统(大型集约化种猪场、种养结合小规模生态养殖园和集约化单一种植区)的氮素流动特征。结果表明:饲料是集约化种猪场和生态养殖园氮素输入的主要来源,饲料投入氮量分别为12469.0和9268.5 kg.hm-.2a-1);集约化种猪场农牧体系间生产脱节,致使农田氮素输入主要依赖于化肥投入,化肥氮输入量(435.0 kg.hm-.2a-1)占农田氮素输入量的82.7%。相反,生态养殖园农牧体系结合紧密,猪粪尿氮还田比例达28.6%,这使得园区化肥氮输入量仅为135.0 kg.hm-.2a-1,因此畜禽粪尿的合理循环利用可作为减少化肥投入的有效途径;集约化种猪场、生态养殖园和单一种植区农牧生产系统氮素利用效率分别为18.8%、20.6%和17.3%,均处于较低水平;集约化种猪场猪粪尿在猪舍和储藏处理过程的氮素损失率为15.8%和25.4%,分别低于小规模生态养殖园相应损失率约8.7和4.8个百分点;生态养殖园粪肥氮还田量高,导致农田氮素盈余量高达1962.8 kg.hm-.2a-1,未能实现生态型养殖的理想效果,优化氮素管理、确定合理的消纳畜禽粪尿的农田面积和调整畜禽养殖密度是解决该问题的关键。     

Plasma copeptin in the assessment of febrile neutropenia

Copeptin, the surrogate marker of arginine vasopressin (AVP), has been suggested to be a useful biomarker in monitoring sepsis reflecting hemodynamic imbalance and stress state. This prospective study conducted at a hematology ward in a Finnish University Hospital aimed to investigate whether plasma copeptin predicts the development of complicated course of neutropenic fever (bacteremia or need for treatment at intensive care unit) in 100 hematological patients experiencing their first neutropenic fever episode after intensive chemotherapy for hematological malignancy. Contrary to study presumptions, not elevated copeptin but the lack of a proper initial increase of plasma copeptin (<0.02 ng/mL from day 0 to day 1) predicted blood culture positive sepsis (p=0.023) and gram-negative bacteremia (p=0.045). No correlation was observed with plasma sodium, blood pressure or evaluated osmolality. Plasma copeptin correlated inversely with the same day pentraxin 3 on day 0-day 2 (all p-values <0.001) and with C-reactive protein on day 1 (p=0.015). In conclusion, copeptin did not correlate with disease severity, but the lack of a proper initial increase was associated with bacteremic complications of febrile neutropenia in hematological patients. The findings suggest the possibility of central dysregulation of AVP release and do not support the use of copeptin as a biomarker of septic complications in this patient group.     

Soil formation under progressive accelerated succession of forest ecosystems in the North of Russia

The paper presents experimental data on restoration of soil, an ecosystem component. Each trial plot was treated differently. It is shown that the use of a combination of techniques, namely grass sowing and mineral and organic fertilization of soil, aimed at restoration of biological rotation of plants, radically intensifies the soil restoration. The developed organic-accumulating layer is the main indicator of successful soil restoration. The importance of soil as a structural element of an ecosystem is determined by its capacity to retain and accumulate nutrients thus ensuring stable conditions for self-restoration of ecosystem components.