基于加速康复外科理念的早期康复训练联合八段锦前四式在乳腺癌改良根治术后患者中的应用效果研究

摘要 目的：研究基于加速康复外科（ERAS）理念的早期康复训练联合八段锦前四式在乳腺癌改良根治术后患者中的应用效果。方法：选择2019年9月~2022年5月期间在湖南中医药大学第一附属医院行乳腺癌改良根治术的128例乳腺癌患者。按照随机数字表法将患者分为对照组（基于ERAS理念的早期康复训练,n=64）和研究组（对照组的基础上接受八段锦前四式干预,n=64）。对比两组抑郁自评量表（SDS）评分、健康调查简表（SF-36）、焦虑自评量表（SAS）评分、Constant-Murley肩关节功能评分、疼痛视觉模拟评分（VAS）和肩关节活动度。结果：与对照组相比,研究组干预后SDS、SAS评分更低（P<0.05）。与对照组相比,研究组情感/生理职能、躯体疼痛、社会/生理功能、活力、总体/精神健康评分更高（P<0.05）。与对照组相比,研究组干预后VAS评分更低,Constant-Murley肩关节功能评分更高（P<0.05）。与对照组相比,研究组干预后前屈、后伸、外展关节活动度更大（P<0.05）。结论：基于ERAS的早期康复训练联合八段锦前四式应用于乳腺癌改良根治术后患者,可提高患者的生活质量,可能与缓解焦虑、抑郁情绪,减轻术后疼痛,促进肩关节功能恢复有关。     

Gradation in Nutrient Composition and Photosynthetic Pathways Across the Restinga Vegetation of Brazil

The restinga comprises coastal vegetation formations which dominate the Atlantic seaboard of Brazil. Exposed sand ridges and associated lagoon systems have poorly developed soils subject to pronounced water deficits. Distinct vegetation zones support a high diversity of life forms, and a comparative study has been undertaken to investigate interactions between degree of exposure, nutrient supply and photosynthetic pathway (C₃, or CAM) in selected species across the restinga. A number of species occurring throughout the restinga were chosen as representative species of different life forms, comprising C₃ pioneer shrubs (Eugenia rotundifolia and Erythroxylum ovalifolium), impounding (tank) terrestrial bromeliad (Neoregelia cruenta: CAM) and the atmospheric epiphyte (Tillandsia stricta: CAM). Comparisons of plant and soil nutrient composition, and airborne deposition were conducted for each zone. Soil nutrient content and organic matter were closely related, reaching a maximum in zone 4, the seaward face of the inner dune. Salt concentration in leaves was independent of atmospheric deposition for the terrestrial species, in contrast to the atmospheric epiphyte T. stricta. In the slack area, vegetation formed characteristic “islands” with the soil beneath enriched in nutrients, suggesting a complex interplay between plants and soil during the development of vegetation succession. Here, two additional trees were investigated, C₃ and CAM members of the Clusiaceae, respectively Clusia lanceolata and C. fluminensis. Stable isotope composition of nitrogen (δ¹⁵N) was generally more negative (depleted in ¹⁵N) in plants with low total nitrogen content. This was exemplified by the atmospheric bromeliad, T. stricta, with an N content of 2.91 g/kg and δ¹⁵N of ?12.3 per mil. Stable isotopes of carbon (δ¹³C) were used to identify the distribution of photosynthetic pathways, and while the majority of bromeliads and orchids were CAM, analysis of the soil organic matter suggested that C₃ plants made the major contribution in each zone of the restinga. Since δ¹³C of plant material also suggested that water supply was optimal in zone 4, we conclude that succession and high diversity in the restinga is dependent on exposure, edaphic factors, and perhaps a critical mass of vegetation required to stabilize nutrient relations of the system.     

Pflanzenvergesellschaftungen mit Riccia-Arten in Südwestafrika (Namibia)

Three associations of the Nanocyperion teneriffae Lebrun 1947 (Sporoboletalia festivi Lebrun 1947) are described. They are physiognomically and ecologically similar to associations of the Mediterranean Isoeto-Nanojuncetea Br.-Bl. et Tx. 1943 and Helianthemetalia guttati Br.-Bl. 1940. They are rich in very specialized therophytes and resurrection plants.

Meinem Lehrer H. Walter, Stuttgart gewidmet.     

Patterns and controls of the variability of radiation use efficiency and primary productivity across terrestrial ecosystems

Aim The controls of gross radiation use efficiency (RUE), the ratio between gross primary productivity (GPP) and the radiation intercepted by terrestrial vegetation, and its spatial and temporal variation are not yet fully understood. Our objectives were to analyse and synthesize the spatial variability of GPP and the spatial and temporal variability of RUE and its climatic controls for a wide range of vegetation types. Location A global range of sites from tundra to rain forest. Methods We analysed a global dataset on photosynthetic uptake and climatic variables from 35 eddy covariance (EC) flux sites spanning between 100 and 2200 mm mean annual rainfall and between ?13 and 26°C mean annual temperature. RUE was calculated from the data provided by EC flux sites and remote sensing (MODIS). Results Rainfall and actual evapotranspiration (AET) positively influenced the spatial variation of annual GPP, whereas temperature only influenced the GPP of forests. Annual and maximum RUE were also positively controlled primarily by annual rainfall. The main control parameters of the growth season variation of gross RUE varied for each ecosystem type. Overall, the ratio between actual and potential evapotranspiration and a surrogate for the energy balance explained a greater proportion of the seasonal variation of RUE than the vapour pressure deficit (VPD), AET and precipitation. Temperature was important for determining the intra‐annual variability of the RUE at the coldest energy‐limited sites. Main conclusions Our analysis supports the idea that the annual functioning of vegetation that is adapted to its local environment is more constrained by water availability than by temperature. The spatial variability of annual and maximum RUE can be largely explained by annual precipitation, more than by vegetation type. The intra‐annual variation of RUE was mainly linked to the energy balance and water availability along the climatic gradient. Furthermore, we showed that intra‐annual variation of gross RUE is only weakly influenced by VPD and temperature, contrary to what is frequently assumed. Our results provide a better understanding of the spatial and temporal controls of the RUE and thus could lead to a better estimation of ecosystem carbon fixation and better modelling.     

Regional and local determinants of drought resilience in tropical forests

The increase in severity of droughts associated with greater mortality and reduced vegetation growth is one of the main threats to tropical forests. Drought resilience of tropical forests is affected by multiple biotic and abiotic factors varying at different scales. Identifying those factors can help understanding the resilience to ongoing and future climate change. Altitude leads to high climate variation and to different forest formations, principally moist or dry tropical forests with contrasted vegetation structure. Each tropical forest can show distinct responses to droughts. Locally, topography is also a key factor controlling biotic and abiotic factors related to drought resilience in each forest type. Here, we show that topography has key roles controlling biotic and abiotic factors in each forest type. The most important abiotic factors are soil nutrients, water availability, and microclimate. The most important biotic factors are leaf economic and hydraulic plant traits, and vegetation structure. Both dry tropical forests and ridges (steeper and drier habitats) are more sensitive to droughts than moist tropical forest and valleys (flatter and wetter habitats). The higher mortality in ridges suggests that conservative traits are not sufficient to protect plants from drought in drier steeper habitats. Our synthesis highlights that altitude and topography gradients are essential to understand mechanisms of tropical forest''s resilience to future drought events. We described important factors related to drought resilience, however, many important knowledge gaps remain. Filling those gaps will help improve future practices and studies about mitigation capacity, conservation, and restoration of tropical ecosystems.     

Nitric oxide production in the basal forebrain is required for recovery sleep

Sleep homeostasis is the process by which recovery sleep is generated by prolonged wakefulness. The molecular mechanisms underlying this important phenomenon are poorly understood. Here, we assessed the role of the intercellular gaseous signaling agent NO in sleep homeostasis. We measured the concentration of nitrite and nitrate, indicative of NO production, in the basal forebrain (BF) of rats during sleep deprivation (SD), and found the level increased by 100 +/- 51%. To test whether an increase in NO production might play a causal role in recovery sleep, we administered compounds into the BF that increase or decrease concentrations of NO. Infusion of either a NO scavenger, 2-(4-carboxyphenyl)-4,4,5,5-tetramethylimidazoline-1-oxyl-3-oxide, or a NO synthase inhibitor, N(omega)-nitro-L-arginine methyl ester (L-NAME), completely abolished non-rapid eye movement (NREM) recovery sleep. Infusion of a NO donor, (Z)-1-[N-(2-aminoethyl)-N-(2-ammonioethyl)amino]diazen-1-ium-1,2diolate (DETA/NO), produced an increase in NREM that closely resembled NREM recovery after prolonged wakefulness. The effects of inhibition of NO synthesis and the pharmacological induction of sleep were effective only in the BF area. Indicators of energy metabolism, adenosine, lactate and pyruvate increased during prolonged wakefulness and DETA/NO infusion, whereas L-NAME infusion during SD prevented the increases. We conclude that an increase in NO production in the BF is a causal event in the induction of recovery sleep.     

Localization of aluminium in the leaves of some aluminium-accumulating species

Summary Transverse sections of leaves of some aluminium-accumulating and nonaccumulating species of the cerrado vegetation of central Brazil were coloured using aluminon to identify the tissues where aluminium occurs or is deposited. None of the tissues of the nonaccumulating species showed evidence of high concentrations of Al. All of the aluminium accumulating species showed high concentrations of Al in all of the elements of the phloem of the midrib and the secondary veins and total absence of it in the vessel members, xylem fibres and the palisade parenchyma. Walls and contents of the collenchyma of the midrib, epidermal cells, guard cells of the stomata and spongy parenchyma showed evidence of high concentrations of Al in the accumulating species.     

The effect of plant density on epiphytic macroinvertebrates associated with a submerged macrophyte,Lagarosiphon ilicifolius Obermeyer,in Lake Kariba,Zimbabwe

The effect of variations in the density of a submerged macrophyte, Lagarosiphon ilicifolius, on epiphytic macroinvertebrate community structure in the shallow waters of a sheltered bay of Lake Kariba were investigated. The body size class distributions of a mayfly, Cloeon (Ephemeroptera: Baetidae), and the damselfly family, Coenagrionidae, were also assessed with respect to variation in vegetation density. Macroinvertebrates were sampled from low-, moderate- and high-density beds of L. ilicifolius. There were no significant differences in individual taxon and total macroinvertebrate abundances, macroinvertebrate richness and diversity with respect to vegetation density. In all three density categories the functional feeding group (FFG) composition was dominated by collector-gatherers and collector-filterers. The abundance of the two FFGs did not change significantly within each, as well as among, the three vegetation-density categories (ANOVA, p > 0.05). The largest size class of Cloeon occurred only in high-density beds, whereas the largest coenagrionid individuals were obtained from low- and moderate-density beds and were absent from high-density beds. The results suggest that variation in the density of Lagarosiphon does not affect epiphytic macroinvertebrate community structure, but does affect body-size distributions of macroinvertebrate taxa, probably by affecting predator-prey interactions.