八段锦联合心脏运动康复对急性心肌梗死急诊PCI术后患者心功能、运动耐力和生活质量的影响

摘要 目的：观察八段锦联合心脏运动康复对急性心肌梗死（AMI）急诊经皮冠状动脉介入术（PCI）后患者心功能、运动耐力和生活质量的影响。方法：选择2019年6月~2021年6月期间我院收治的AMI急诊PCI术后患者100例,根据随机数字表法分为对照组（心脏运动康复干预,50例）和观察组（八段锦联合心脏运动康复干预,50例）,观察两组患者心功能、运动耐力及生活质量改善情况,对比两组心脏不良事件发生率。结果：干预后,两组左心室射血分数（LVEF）较干预前升高,且观察组高于对照组（P<0.05）。干预后,两组左室舒张末期内径（LVDD）、左室收缩末期内径（LVDS）、B型脑利钠肽（BNP）较干预前下降,且观察组低于对照组（P<0.05）。干预后,两组运动持续时间（ED）、峰值摄氧量（VO₂peak）及无氧阈值（AT）较干预前升高,且观察组高于对照组（P<0.05）。干预后,两组健康调查简表（SF-36）各维度评分较干预前升高,且观察组高于对照组（P<0.05）。观察组的心脏不良事件发生率低于对照组（P<0.05）。结论：八段锦联合心脏运动康复用于AMI急诊PCI患者的术后干预中,可促进心功能恢复,改善患者的运动耐力及生活质量,同时还可降低心脏不良事件发生率。     

盆底肌肉康复训练联合盆底重建术对女性盆底功能障碍性疾病患者炎症反应及应激反应的影响

目的:观察盆底肌肉康复训练联合盆底重建术治疗女性盆底功能障碍性疾病(PFD)的疗效及对炎症反应及应激反应的影响。方法:选择2019年1月~2021年1月期间我院收治的PFD患者200例,按乱数表法分为对照组(100例)和研究组(100例)。对照组患者接受盆底重建术治疗,研究组患者接受盆底肌肉康复训练联合盆底重建术治疗。观察两组治疗后的疗效及术后并发症发生情况,对比两组相关量表评分、炎症反应及应激反应指标。结果:研究组治疗后盆底功能影响问卷简表(PFIQ-7)、盆底不适调查表简表(PFDI-20)评分低于对照组(P<0.05)。研究组治疗后盆底Ⅰ类肌纤维肌电压、盆底Ⅱ类肌纤维肌电压高于对照组(P<0.05)。研究组治疗后白介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、超敏C反应蛋白(hs-CRP)低于对照组(P<0.05)。研究组治疗后皮质醇(COR)、去甲肾上腺素(NE)、前列腺素E2(PGE2)低于对照组(P<0.05)。研究组术后并发症发生率低于对照组(P<0.05)。结论:盆底肌肉康复训练联合盆底重建术治疗PFD,可促进盆底功能恢复,减轻机体炎症反应及应激反应,降低术后并发症发生率。     

早期综合康复联合穴位按摩对缺氧缺血性脑病患儿智力发育、生长发育和血清脑组织损伤标志物的影响

摘要 目的：探讨早期综合康复联合穴位按摩对缺氧缺血性脑病（HIE）患儿智力发育、生长发育和血清脑组织损伤标志物的影响。方法：选取2016年1月- 2021年12月期间西安医学院第二附属医院收治的126例HIE患儿作为观察对象。根据双色球法将患儿分为对照组和观察组,其中对照组63例,在常规治疗基础上联合早期综合康复;观察组63例,在常规治疗基础上接受早期综合康复联合穴位按摩。对比两组患儿临床症状恢复时间、智力发育、生长发育、神经系统后遗症发生率、神经功能和血清脑组织损伤标志物变化。结果：观察组的原始反射、肌张力、意识、可吸吮、眼部运动功能恢复时间及呼吸衰竭纠正时间均短于对照组（P<0.05）。两组干预1个月后体质量、身高、摄入奶量较干预前升高,且观察组的变化大于对照组（P<0.05）。两组干预1个月后精细运动、大运动、适应性、语言及社交能力较干预前升高,且观察组的变化大于对照组（P<0.05）。两组干预1个月后神经元特异性烯醇化酶（NSE）、髓鞘碱性蛋白（MBP）、S100β蛋白较干预前下降,新生儿神经行为（NABA）评分较干预前升高,且观察组的变化大于对照组（P<0.05）。观察组神经系统后遗症发生率较对照组低（P<0.05）。结论：早期综合康复联合穴位按摩可促进HIE患儿智力发育、生长发育,减轻脑损伤,降低神经系统后遗症发生风险。     

央地两级政府生态治理行动的演化博弈分析——基于财政分权视角

生态环境是人类社会经济发展过程中的重要组成部分,然而由于粗放的经济发展模式,生态系统退化严重,影响人类幸福感和可持续发展。中央政府和地方政府是生态环境的主要治理主体,因此研究两类群体在生态治理过程中的行为互动机制具有较强的现实意义。基于财政分权的背景,从微观主体的收益函数出发,构建央地两级政府生态治理行动的演化博弈模型,探究两类主体的行为特征及其影响因素。根据复制动态方程分析参与主体的演化规律,采用MATLAB仿真工具分析不同情形下演化均衡状态及收敛趋势。研究结果表明,中央政府与地方政府在一定程度上都是"理性经济人",系统稳定均衡策略取决于地方政府"严格执行"生态治理的净收益和中央政府"严格监管"的净收益,其中关键指标包括:地方政府生态治理执行力度和成本、政绩考核体系中生态指标和经济指标的权重系数、中央政府的监管成本、监管力度和惩罚金额。据此提出"财政分权同时创新地方政绩考核机制、发展比较优势、拓宽监管渠道"等对策建议,引导央地两级政府共同促进生态治理工作有效实施。     

统一山水林田湖草生态保护修复标准体系研究

加强山水林田湖草生态保护修复标准体系建设,是统一行使国土空间生态保护修复的基础性工作。我国现行山水林田湖草生态保护修复有关标准多达350多项,存在标准体系不统一、内容交叉重复、协调性差、发布时间长、关键标准缺少等问题。在梳理相关领域标准的基础上,结合我国山水林田湖草生态保护修复试点工程实践,提出以矿山、水环境、森林、农田、湖泊、草原、湿地、海洋、农村、城市等为对象,以生态问题和修复工程为重点,围绕生态目标控制、调查监测评价、规划设计、工程技术、生态维护管理等功能需求,研究提出建立统一的山水林田湖草生态保护修复标准体系,指导当前我国山水林田湖草生态保护修复工程建设和国土空间生态修复。     

Large‐scale coral reef rehabilitation after blast fishing in Indonesia

The severely degraded condition of many coral reefs worldwide calls for active interventions to rehabilitate their physical and biological structure and function, in addition to effective management of fisheries and no‐take reserves. Rehabilitation efforts to stabilize reef substratum sufficiently to support coral growth have been limited in size. We documented a large coral reef rehabilitation in Indonesia aiming to restore ecosystem functions by increasing live coral cover on a reef severely damaged by blast fishing and coral mining. The project deployed small, modular, open structures to stabilize rubble and to support transplanted coral fragments. Between 2013 to 2015, approximately 11,000 structures covering 7,000 m² were deployed over 2 ha of a reef at a cost of US$174,000. Live coral cover on the structures increased from less than 10% initially to greater than 60% depending on depth, deployment date and location, and disturbances. The mean live coral cover in the rehabilitation area in October 2017 was higher than reported for reefs in many other areas in the Coral Triangle, including marine protected areas, but lower than in the no‐take reference reef. At least 42 coral species were observed growing on the structures. Surprisingly, during the massive coral bleaching in other regions during the 2014–2016 El Niño–Southern Oscillation event, bleaching in the rehabilitation area was less than 5% cover despite warm water (≥30°C). This project demonstrates that coral rehabilitation is achievable over large scales where coral reefs have been severely damaged and are under continuous anthropogenic disturbances in warming waters.     

关节镜下半月板部分切除术与理疗治疗不稳定半月板撕裂的前瞻性对照研究

目的：评估针对不稳定半月板撕裂,关节镜下半月板部分切除术（APM）是否优于单纯理疗。方法：纳入36 例经磁共振确诊 为不稳定半月板撕裂的患者,平均年龄35 岁,其中9 例伴轻度骨关节炎。所有患者于前8 周,每周行3 次物理治疗,包括股四头 肌功能锻炼和神经-肌肉功能锻炼。完成康复训练后1 周行关节镜下半月板部分切除术。在治疗前、理疗结束后以及术后第4 周 随访时行VAS 评分进行疼痛评估并行Lysholm 评分进行功能评估。结果：36 例患者的VAS 评分由治疗前的5.66± 1.10,改善为 理疗结束后的4.39± 0.95（P＜0.05）,行APM 术后则达到1.82± 0.77（P＜0.05）,并且理疗对VAS 的改善不如APM 明显（P＜ 0.05）。治疗前,伴骨关节炎患者的疼痛症状更为明显,而APM 术后则与不伴骨关节炎的患者无明显差异（P＞0.05）。患者 Lysholm 评分理疗结束后由58.11± 8.06 提高到62.11± 8.34（P＜0.05）,APM术后则达到86.78± 5.50（P＜0.05）。相对于骨关节炎 患者,不伴骨关节炎患者的Lysholm 评分更高（P＜0.05）。结论：物理治疗能有效减轻疼痛和肿胀症状,但是对关节活动受限等改 善不明显。APM相对于理疗能有效缓解症状,改善膝关节功能。     

Soil moisture dynamics and restoration of self‐sustaining native vegetation ecosystem on an open‐cut coal mine

Post‐mining landscape reconstruction on open‐cut coal mines aims to support restoration of self‐sustaining native vegetation ecosystems that in perpetuity require no extra inputs relative to unmined analogs. Little is known about the soil moisture retention capacity of the limited layer of topsoil replaced (often <30 cm deep), impacts of deep ripping of the profile, and the combined impacts of these on plant available water during the mine restoration process. We examined changes in soil moisture parameters (soil water potential, Ψ, and soil water content, Θ) daily using automated soil sensors installed at 30 and 45–65 cm depths on mine restoration sites aged between 3 and 22 years and on adjacent remnant vegetation sites following heavy rainfall events at Meandu mine, southeast Queensland, Australia. Consistent patterns in soil moisture attributes were observed among rehabilitated sites with generally marked differences from remnant sites. Remnant site soil profiles had generally higher Θ after drying than rehabilitated sites and maintained high Ψ for extended periods after rain events. There was a relatively rapid decline of Ψ on reconstructed soil profiles compared with remnant sites although the times of decline onset varied. This response indicated that vegetation restoration sites released soil moisture more rapidly than remnant sites but the rate of drying decreased with increasing rehabilitation age and increased with increasing tree stem density. The rapid drying of mine rehabilitated sites may threaten the survival of some remnant forest species, limit tree growth, and delay restoration of self‐sustaining native ecosystem.     

Nutritional status assessment in complete denture wearers

doi: 10.1111/j.1741‐2358.2011.00620.x Nutritional status assessment in complete denture wearers Background and objectives: The relationship between oral health and the nutritional status in the elderly is complex and controversial. It has been suggested that poor oral health and a decreased ability to chew have a profound influence on food selection, diet and thereby the nutritional status of the individual. This study aimed to evaluate the effect of edentulousness and prosthetic treatment on the nutritional status of the individual. Methods: A total of 94 patients were selected for the study, which was conducted over a period of 16 months. The nutritional status was assessed using the Mini Nutritional Assessment Form (MNA) before the complete denture treatment and after an interval of 6 months and 9 months following the treatment. The individual scores obtained for each question and the total scores at the baseline study were compared with those obtained after 6 and 9 months. Proportions were compared using chi‐squared test of significance. Results: The results showed statistically significant differences in the total MNA scores between the baseline study and after 6 and 9 months. The edentulous patients without complete dentures had significantly lower MNA scores. Conclusion: Prosthetic rehabilitation of the edentulous patients with complete dentures, along with the dietary counselling, improved the nutritional status of these patients.     

Living Rivers: Trends and Challenges in Science and Management

This paper discusses and summarizes the major conclusions of the special issue entitled ‘Living rivers: trends and challenges in science and management’ of Hydrobiologia/Developments in Hydrobiology. It is structured along three lines: (1) Functioning of river systems; (2) Ecological rehabilitation of river systems; (3) Challenges and obstacles to sustainable management. Sustainable river basin management requires a thorough understanding of natural, physical, chemical and ecological processes as well as socio-economic functioning. Environmental rehabilitation of river systems inevitably requires an ecosystem-based approach involving solutions supported by the public. The challenge is to combine ecological and socio-economic sustainability. Rethinking our efforts in both directions must lead to more innovative solutions than those available at present.