从五运六气角度探析己亥年冬瘟

2019年为己亥之年,土运不足,厥阴风木司天,少阳相火在泉。下半年相火淫胜,火气流行,克金、刑水。风木盛则克制土运,土运本不足,致虚者更虚,强者更强,此谓之不相得,不相得则病;且气克运,古称之为天刑,天刑之年多灾害。2019年,冬季主气太阳寒水之上少阳相火客临,致冬不藏反长,天不寒反暖。地气封藏不固,水中阳气不藏,本应该被抑制或杀灭的微生物却因火热而未灭,并得少阳火毒助长而毒性更猛,化生为火疫。2020年为庚子年,主行金运,金克木,可平复2019年偏盛之木运,故瘟毒会被2020年之金运削弱或肃杀。针对此次瘟疫,未病之人预防要点为:虚邪贼风,避之有时;精神内守,病安从来;正气存内,邪不可干;饮食宜忌,尤为重要;避秽化浊,芳香化湿。已病之人的治疗,依据此次瘟疫"少阳火毒夹湿"病机,以咸补之,以甘泻之,以咸耎之,岁谷宜丹,间谷宜豆。此次瘟毒的性质虽为湿热火毒,但患者体质却有寒热虚实之别,感染后症状、病情和预后亦不同,故中医临证时应遵循辨证论治,三因治宜的原则;若体质素有湿热,邪从本气而化,可遵循运气病机施治;若体质本热,湿去而化为火毒,则应以制火为主;若体质本寒,热去而化寒湿,则应温化寒湿,芳香化浊;若体质素虚,出现危重证候,则应在祛邪时,重视固护元气。     

气象因素对钉螺密度变化的影响分析

目的 研究自然条件下气象因素对钉螺密度变化的影响,为控制血吸虫病及其钉螺扩散提供科学依据。方法 收集1990－2014年湖北省潜江市春季查螺资料及地面气象观测数据,采用一阶自回归分析方法对实际钉螺密度进行趋势拟合与分解,利用相关分析法对钉螺密度变化率与不同时段、不同气象要素进行相关性分析。结果 对钉螺密度影响最大的气象因子是温度,其次为降水;其中1月平均最低气温和冬季平均最低气温分别是钉螺密度变化率、活螺框变化率影响最大的温度因子;1月平均最低温度升高(或降低)1 ℃,将会导致钉螺密度上升(或下降) 5.080%～6.710%;冬季平均最低温度升高(或降低)1 ℃,活螺框变化率上升(或下降)15.521%～15.928%。降水对钉螺密度影响最大的时段是上年11月至当年4月,该时段内降水偏少20%以上,有利于降低钉螺密度。9－11月日照与钉螺密度变化率、活螺框变化率存在一定相关性。在相关分析基础上分别建立了钉螺密度变化率、活螺框变化率与气象因子的统计回归模型。结论 在12月到来之前清除有螺区杂草有利于降低地表温度和土壤水分含量,能取得一定的灭螺效果。伴随全球气候变化湖北省冬季温度升高趋势明显,可能引发钉螺密度升高。     

豫北地区现代护理事业的起步

直至20世纪20年代，河南豫北地区现代护理事业才开始真正起步。随着先进护理理念的引入，加拿大护理人员先后到来，现代化专业性质的医院开始建立，专门的护理学校建成，中国第一批专业护理人员毕业，这些都标志着现代护理事业在豫北扎下根基。究其原因，既有中国社会不断向现代化转变的宏观历史因素，它促使中国人主动接纳西方的、现代的医学；也有许多具体的原因，其中外国护理人员高尚的奉献精神、精湛的专业素养，起到了关键作用。     

Winter Temperature Inversions and Emergency Department Visits for Asthma in Salt Lake County, Utah, 2003�C2008

Background: Winter temperature inversions—layers of air in which temperature increases with altitude—trap air pollutants and lead to higher pollutant concentrations. Previous studies have evaluated associations between pollutants and emergency department (ED) visits for asthma, but none have considered inversions as independent risk factors for ED visits for asthma.Objective: We aimed to assess associations between winter inversions and ED visits for asthma in Salt Lake County, Utah.Methods: We obtained electronic records of ED visits for asthma and data on inversions, weather, and air pollutants for Salt Lake County, Utah, during the winters of 2003 through 2004 to 2007 through 2008. We identified 3,425 ED visits using a primary diagnosis of asthma. We used a time-stratified case-crossover design, and conditional logistic regression models to calculate odds ratios (ORs) and 95% confidence intervals (CIs) to estimate rate ratios of ED visits for asthma in relation to inversions during a 4-day lag period and prolonged inversions. We evaluated interactions between inversions and weather and pollutants.Results: After adjusting for dew point and mean temperatures, the OR for ED visits for asthma associated with inversions 0–3 days before the visit compared with no inversions during the lag period was 1.14 (95% CI: 1.00, 1.30). The OR for each 1-day increase in the number of inversion days during the lag period was 1.03 (95% CI: 1.00, 1.07). Associations were only apparent when PM₁₀ and maximum and mean temperatures were above median levels.Conclusions: Our results provide evidence that winter inversions are associated with increased rates of ED visits for asthma.     

Vitamin D and musculoskeletal status in Nova Scotian women who wear concealing clothing

Bone and muscle weakness due to vitamin D deficiency is common among Muslim women who reside in sunny, equatorial countries. The purpose of this study was to determine if living in a northern maritime location additionally disadvantages women who wear concealing clothes. A cross-sectional matched pair design was used to compare women who habitually wore concealing clothing with women who dressed according to western norms. Each premenopausal hijab-wearing woman (n = 11) was matched by age, height, weight and skin tone with a western-dressed woman. Subjects were tested by hand grip dynamometry to assess muscular strength and by quantitative ultrasound at the calcaneus to assess bone status. Nutritional intake was obtained by 24 h recall. Serum 25-hydroxyvitamin D (s-25(OH)D) status was determined in seven matched pairs. The hijab group had lower s-25(OH)D than women who wore western clothes (40 ± 28 vs. 81 ± 32 nmol/L, p= 0.01). Grip strength in the right hand was lower in the hijab-wearing women (p = 0.05) but this appeared to be due to less participation in intense exercise. Bone status did not differ between groups (p= 0.9). Dietary intake of vitamin D was lower in the hijab-wearers (316 ± 353 vs. 601 ± 341 IU/day, p= 0.001). This pilot study suggests that women living in a northern maritime location appear to be at risk for vitamin D insufficiency and therefore should consider taking vitamin D supplements.     

胰腺癌组织表皮生长因子mRNA表达的意义

目的探讨ＥＧＦｍＲＮＡ的表达与胰腺癌发生、发展及预后的关系．方法应用Ｎｏｒｔｈｅｒｎｂｌｏｔ杂交方法，检测胰腺癌２７例和正常胰组织７例中ＥＧＦｍＲＮＡ表达．结果正常胰腺组织７例未检测到ＥＧＦｍＲＮＡ表达，胰腺癌２７例ＥＧＦｍＲＮＡ阳性表达率６６７％（１８例），经卡方检验发现，ＥＧＦｍＲＮＡ表达与胰腺癌病理分级、临床分期及伴随局部淋巴结转移呈显著相关（Ｐ＜００５）．结论ＥＧＦｍＲＮＡ表达与胰腺癌发生有关，胰腺癌ＥＧＦｍＲＮＡ表达可作为胰腺癌预后的参考指标     

Regional drought-induced reduction in the biomass carbon sink of Canada's boreal forests

The boreal forests, identified as a critical "tipping element" of the Earth's climate system, play a critical role in the global carbon budget. Recent findings have suggested that terrestrial carbon sinks in northern high-latitude regions are weakening, but there has been little observational evidence to support the idea of a reduction of carbon sinks in northern terrestrial ecosystems. Here, we estimated changes in the biomass carbon sink of natural stands throughout Canada's boreal forests using data from long-term forest permanent sampling plots. We found that in recent decades, the rate of biomass change decreased significantly in western Canada (Alberta, Saskatchewan, and Manitoba), but there was no significant trend for eastern Canada (Ontario and Quebec). Our results revealed that recent climate change, and especially drought-induced water stress, is the dominant cause of the observed reduction in the biomass carbon sink, suggesting that western Canada's boreal forests may become net carbon sources if the climate change-induced droughts continue to intensify.