少年游泳运动员冬训期间HbA_2百分含量的规律性变化

 本研究用聚丙烯酰胺凝胶垂直板电泳,双波长扫描仪对少年游泳运动员的HbA_2百分含量进行测定。发现大运动量训练对HbA_2水平是有影响的。经六天训练(星期二、五为大运动量训练),星期日休息一天,次周的星期一晨HbA_2百分含量升高,星期二大运动量训练后的次日晨HbA_2百分含量显著下降。运动性贫血的运动员,其HbA_2百分含量一周中的变化趋势与正常运动员相似,但HbA_2百分含量比正常运动员高。     

儿童重症监护病房医院感染暴发白色念珠菌血流感染4例分析

摘要 目的：探讨儿童重症监护病房白色念珠菌血流感染暴发的临床表现、危险因素、控制措施等,为预防和控制院内白色念珠菌血流感染暴发提供科学依据。方法：以2018年7月我院儿童重症监护病房发生的4例白色念珠菌血流感染暴发患儿为研究对象,分析患儿临床情况、临床特征、危险因素、暴发原因以及采取的预防控制措施。结果：4例医院感染暴发白色念珠菌血流感染患儿均存在基础疾病、有机械通气史、存在中心静脉或动脉置管、静脉或动脉置管前后均使用碘伏消毒、曾使用广谱抗生素、输血制品,白色念珠菌血流感染后最突出的临床表现均是发热。药敏方面,医院感染暴发的4例白色念珠菌感染患儿对唑类及5-氟胞嘧啶均耐药,但对两性霉素B均敏感。经拔除血管置管、减少或者避免广谱抗菌药的应用,根据药敏使用卡泊芬净及两性霉素B抗真菌等积极治疗,1例患儿放弃治疗后死亡,3例患儿顺利出院。通过Fisher确切概率法分析可知,留置中心静脉或动脉置管是儿童重症监护病房发生医院感染暴发白色念珠菌血流感染的危险因素（P<0.05）。结论：留置中心静脉或动脉置管是儿童重症监护病房发生医院感染暴发白色念珠菌血流感染的危险因素,医院感染暴发白色念珠菌血流感染患儿最突出的临床表现是发热,唑类及5-氟胞嘧啶耐药的患儿使用卡泊芬净及两性霉素B可能获得较好的治疗效果。     

早期强化步行基本功训练对脑卒中的预后分析

目的：分析早期强化步行基本功训练对脑卒中预后的影响。方法：选取我院2008年10月一2011年10月收治的176例恢复期脑卒中患者,按照随机数字表分为观察组及对照组,各88例,均接受常规药物治疗和康复训练,观察组在此基础上接受早期强化步行基本功训练,对比两组患者的预后。结果：两组患者治疗后FMA—LE、BBS及MBI评分均见上升,观察组较对照组上升程度更为明显（P〈0．05）,T2时期观察组评分亦见升高,而对照组评分与T1时期相比无明显统计学差异（P〉0．05）;两组患者治疗后步长、步宽及步速均见上升,观察组较对照组上升程度更为明显（P〈0．05）,T2时期观察组步态参数亦见升高,而对照组步态参数与T1时期相比无明显统计学差异（P〉0．05）。结论：早期强化步行基本功训练能够有效改善脑卒中患者下肢运动功能和平衡能力,保证治疗后步行功能,避免生活质量下降,该康复方法值得广泛推广。     

Ecological total-factor energy efficiency of China’s energy intensive industries

This paper uses a meta-frontier slack-based DEA model to measure the ecological total-factor energy efficiency as well as the energy conservation potential of China’s four energy intensive subsectors. We incorporate both desirable and undesirable output together in the period, 2000–2013. The conclusions are: firstly, under the meta-frontier, the four subsectors of energy intensive industries have low average level of ecological total-factor energy efficiencies. They are 0.137, 0.212, 0.238, and 0.307 in the non-metallic mineral products manufacturing industry, raw chemical materials and chemical products manufacturing industry, smelting and pressing of ferrous metals industry, and smelting and pressing of non-ferrous metals industry, respectively. Secondly, the ecological energy efficiency in East China is the highest among three regions. Central China and West China are behind, but they are extremely close to each other. Thirdly, East China almost has no technology gap pertaining to energy efficiency, while Central China and West China almost have the same gap. Finally, Sichuan is considered to be the best province in West China under group frontier due to its perform in the three energy intensive subsectors. For Central and East China, no province has higher ecological energy efficiency in more than two energy intensive subsectors.     

Delayed inflammation decrease is associated with mortality in Tocilizumab-treated critically ill SARS-CoV-2 patients: A retrospective matched-cohort analysis

Little is known about the immuno-inflammatory response to Tocilizumab and its association with outcome in critically-ill SARS-CoV2 pneumonia. In this multicenter retrospective cohort of SARS-CoV-2 patients admitted to three intensive care units between March and April 2020, we matched on gender and SAPS II 21 Tocilizumab-treated patients to 42 non-treated patients. Need for mechanical ventilation was 76% versus 79%. IL-6, C-reactive protein, and fibrinogen had been collected within the first days of admission (T1), 3 d (T2) and 7 d (T3) later. Tocilizumab-treated patients had persistently higher IL-6 plasma levels and persistently lower C-Reactive protein and fibrinogen levels. Among Tocilizumab-treated patients, baseline levels of inflammatory biomarkers were not different according to outcome. Conversely, C-reactive protein and fibrinogen decrease was delayed in non-survivors. C-Reactive protein decreased at T1 in survivors (45 [30–98] vs 170 [69–204] mg/l, P < 0.001) but only at T2 in non-survivors (37 [13–74] vs 277 [235–288], P = 0.03). Fibrinogen decreased at T2 in survivors (4.11 [3.58–4.69] vs 614 [5.61–7.85] g/l, P = 0.005) but not in non-survivors (4.79 [4.12–7.58] vs 7.24 [6.22–9.24] g/l, P = 0.125). Tocilizumab treatment was thus associated with a persistent both increase in plasma IL-6, and decrease in C-reactive protein and fibrinogen. Among Tocilizumab-treated patients, the decrease in inflammatory biomarkers was delayed in non-survivors.     

综合性医院重症监护病房病原菌分离情况分析

目的探讨重症监护病房（Icu）医院内感染的临床特点及病原菌种类、分布情况,为临床合理使用抗菌药物、预防和控制医院感染提供参考和依据。方法采用前瞻性监测与回顾性调查相结合的方法,对ICU患者的临床资料进行统计分析。结果ICU病人标本中分离出病原菌593株,得出菌种分布与感染情况。结论重症监护病房医院内感染发生率高,以呼吸道感染为主,主要病原菌以革兰阴性非发酵菌为主,加强ICU患者感染的控制,可减少ICU医院内感染的发生。     

Species distribution and antifungal susceptibility patterns of <Emphasis Type="Italic">Candida</Emphasis> spp. bloodstream isolates from a Brazilian tertiary care hospital

In this work, we collect data from surveys of bloodstream Candida isolates performed in Brazil from 1996 to 2004. Besides, we analyzed the species distribution of bloodstream Candida isolates together with potential risk factors for candidemia and the susceptibility profile of these isolates in patients from Hospital das Clínicas in Goiania city, Brazil. Blood samples were collected in the admission day and on every 7 days, in the intensive care unit (ICU) of a tertiary hospital. Candida isolates were identified by standard protocols that included germ tube formation, chlamydoconidia production on cornmeal agar and sugar fermentation and assimilation tests. Data of patients were recorded and analyzed according to age at the time of diagnosis, gender and presence of potential risk factors. Statistical analysis was used to determine if the time of hospital permanence increased Candida colonization in ICU patients’ blood. The antifungal susceptibility testing was performed by broth microdilution method according to document NCCLS/CLSI M27–A2. Among the 345 blood samples cultured, candidemia was recovered in 33 patients, which were isolated 51.5% of Candida non-albicans. Fungemia was associated with long-term hospitalization. Fluconazole, itraconzole, voriconazole and amphotericin B exhibited a potent activity against all isolates of Candida. Voriconazole MICs were much low for all isolates tested. This work confirms data of increase of Candida non-albicans species in bloodstream in ICU and shows that voriconazole in vitro activity was higher than those of itraconazole, fluconazole and amphotericin B.     

Effects of climate change on the delivery of soil‐mediated ecosystem services within the primary sector in temperate ecosystems: a review and New Zealand case study

Future human well‐being under climate change depends on the ongoing delivery of food, fibre and wood from the land‐based primary sector. The ability to deliver these provisioning services depends on soil‐based ecosystem services (e.g. carbon, nutrient and water cycling and storage), yet we lack an in‐depth understanding of the likely response of soil‐based ecosystem services to climate change. We review the current knowledge on this topic for temperate ecosystems, focusing on mechanisms that are likely to underpin differences in climate change responses between four primary sector systems: cropping, intensive grazing, extensive grazing and plantation forestry. We then illustrate how our findings can be applied to assess service delivery under climate change in a specific region, using New Zealand as an example system. Differences in the climate change responses of carbon and nutrient‐related services between systems will largely be driven by whether they are reliant on externally added or internally cycled nutrients, the extent to which plant communities could influence responses, and variation in vulnerability to erosion. The ability of soils to regulate water under climate change will mostly be driven by changes in rainfall, but can be influenced by different primary sector systems' vulnerability to soil water repellency and differences in evapotranspiration rates. These changes in regulating services resulted in different potentials for increased biomass production across systems, with intensively managed systems being the most likely to benefit from climate change. Quantitative prediction of net effects of climate change on soil ecosystem services remains a challenge, in part due to knowledge gaps, but also due to the complex interactions between different aspects of climate change. Despite this challenge, it is critical to gain the information required to make such predictions as robust as possible given the fundamental role of soils in supporting human well‐being.