胸水结核抗体对结核性胸膜炎的诊断意义

目的 了解结核性胸膜炎的诊断意义。方法 检查205例胸水的病因分析。结果 胸水结核抗体对结核性胸膜炎阳性率最高83.1%。结论 胸水结核抗体对鉴别结核性胸膜炎有较高实用价值。     

Clear cell carcinoma of exocrine pancreas: a rare tumor with an unusual presentation

Metastatic clear cell carcinomas are relatively common from primary tumors arising in the kidney, female genital tract, adrenal cortex, and lung, but they rarely occur from primary tumors of the pancreas. We report a case of metastatic pancreatic tumor with marked clear cell changes in a 46-year-old white man presenting with a pseudocyst of the pancreas. At laparotomy, there was a hard area in the head of the pancreas and another hard nodule was present in the omentum. The histologic and immunohistochemical test of the excised omental nodule exhibited features consistent with clear cell carcinoma from pancreatic primary. To our knowledge, this is the first report of a metastatic clear cell pancreatic tumor with such an unusual presentation.     

Food groups and bone health

Studies aimed at determining the relationship between key nutrients (especially calcium) and bone health have examined directly the effect of a specific nutrient (or, in some cases, various nutrients) commonly consumed in the human diet. Consideration of the foods man actually consumes rather than the nutrients contained within them is an alternative strategy that has been adopted in other disciplines examining the relationship between diet and disease. Two studies indicate that a high fruit and vegetable, intake is protective for the skeleton, whereas high candy consumption is associated with lower bone mass, irrespective of gender. These data also suggest that a high intake of fatty, sugary foods is detrimental to bone health around the time of menopause. Because milk and milk products provide greater than 50% of the total calcium in the Western diet as well as a number of other key nutrients including phosphorus, magnesium, and zinc, they have a fundamental role in bone health determination. Milk supplementation also improves the nutritional quality of postmenopausal women's diets to a greater extent than calcium. Data for alcohol consumption are also intriguing. Recently, a positive association was noted between tea drinking and bone mass in postmenopausal women and may point to the influence of flavonoids contained in tea on bone health.     

Hypertension produced by constriction of the renal artery in sympathectomized dogs

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1. Complete sympathectomy, in seven dogs, did not prevent the development of hypertension from compression of the renal arteries.     

Tracking sustainable development with a national barometer for South Africa using a downscaled “safe and just space” framework

Nations in the 21st century face a complex mix of environmental and social challenges, as highlighted by the on-going Sustainable Development Goals process. The “planetary boundaries” concept [Rockström J, et al. (2009) Nature 461(7263):472–475], and its extension through the addition of social well-being indicators to create a framework for “safe and just” inclusive sustainable development [Raworth K (2012) Nature Climate Change 2(4):225–226], have received considerable attention in science and policy circles. As the chief aim of this framework is to influence public policy, and this happens largely at the national level, we assess whether it can be used at the national scale, using South Africa as a test case. We developed a decision-based methodology for downscaling the framework and created a national “barometer” for South Africa, combining 20 indicators and boundaries for environmental stress and social deprivation. We find that it is possible to maintain the original design and concept of the framework while making it meaningful in the national context, raising new questions and identifying priority areas for action. Our results show that South Africa has exceeded its environmental boundaries for biodiversity loss, marine harvesting, freshwater use, and climate change, and social deprivation is most severe in the areas of safety, income, and employment. Trends since 1994 show improvement in nearly all social indicators, but progression toward or over boundaries for most environmental indicators. The barometer shows that achieving inclusive sustainable development in South Africa requires national and global action on multiple fronts, and careful consideration of the interplay between different environmental domains and development strategies.Human impact on the Earth’s biophysical processes and resources is a global concern. It is seen by many as a new geological era, the Anthropocene (1), with natural resource consumption accelerating in the past 50 y—food, freshwater, and fossil fuel use have more than tripled (2)—and these trends are likely to continue as global population grows to 9.6 billion by 2050 (3). This concern has led to international treaties that seek to address global environmental challenges through negotiation and agreement among the nations of the world, such as the United Nations (UN) Convention for the Protection of the Ozone Layer, the UN Convention on Biological Diversity (UNCBD), and the UN Framework Convention on Climate Change (UNFCCC). This impact has also led to the proliferation of sustainable development indicators (SDIs). The outcome of the 1992 UN Conference on Environment and Development, Agenda 21, calls for SDIs to “provide solid bases for decision-making at all levels and to contribute to a self-regulating sustainability of integrated environment and development system” (4). Over 900 SDI initiatives have been undertaken to date (5), in recognition of the fact that indicators provide a quantitative and rational basis for decision making (6), simplify a complex reality to a manageable level (7), create a body of knowledge and comparable data for policy applications, measure progress (8), and allow the public to evaluate society and its leaders (9). Individual indices, such as the Human Development Index and the Ecological Footprint, have been used to compare countries, and sustainability frameworks, such as Ostrom’s framework for social-ecological systems (10) and the “ecosystems approach” adopted by the UNCBD (11), have been developed to better understand the relationships between social and ecological systems.In 2009 a new conceptual framework, “planetary boundaries,” was proposed by Rockström et al. (12, 13) as “a bid to reform environmental governance at multiple scales” (14). The planetary boundaries are an estimated “safe distance” from thresholds associated with nine global environmental change processes that, when crossed, will take humanity into unchartered environmental territory (13). The nine processes (or dimensions) are: climate change, ocean acidification, freshwater use, land-use change, biodiversity loss, nutrient cycles (nitrogen and phosphorous), ozone depletion, atmospheric aerosol loading, and chemical pollution. Three of these global boundaries (climate change, biodiversity loss, and nitrogen fixation) have been transgressed and several others are in danger of being exceeded. Rockstrom et al. proposed there should be a global goal to stay within the “safe operating space for humanity” defined by these boundaries.Despite a mixed reaction from the academic community, who have raised concerns about the existence of global tipping points for some of the dimensions (15–17) and the specific metrics used (18–23), the planetary boundaries concept has been used in proposals for defining the UN Sustainable Development Goals (SDGs) (24–26). The SDGs will guide the international sustainable development agenda after 2015 and they represent an opportunity for science to inform policy making (27–29), for the UN to implement the lessons from the Millennium Development Goals (MDGs) and to expand them to include all countries, and for greater integration of environmental and social metrics in decision-making. In this context, the planetary boundaries concept was extended by Raworth (30, 31) to include a set of 11 social dimensions, defining “a social foundation” below which exists unacceptable human deprivation. This approach highlighted the notion that access to the benefits of natural resources is also of global concern, and Raworth (30) argued that ending current global deprivation could be achieved with a minimal impact on the planetary boundaries. Raworth reframed Rockström et al.’s (12, 13) planetary boundaries concept as a “safe and just space for humanity”; this new framework brought together the dual objectives of poverty eradication and environmental sustainability as socio-economic priorities (30).Raworth’s safe and just space (SJS) framework has gained interest from the UN General Assembly (32), policy think tanks (e.g., ref. 33), and development agencies (e.g., ref. 34) because it provides a platform for integrated analysis and debate about global goals. The framework appears in the Worldwatch Institute’s latest State of the World report (35) and Griggs et al. (25) have since developed a similar framework to reframe the UN paradigm of three pillars of sustainable development as a nested concept.However, social and environmental concerns are intrinsically scale-dependent and need to take local circumstances into account if they are to be acted upon by national governments, which are ultimately responsible for taking action. The downscaling of the SJS to subglobal spatial scales, with heterogeneity of biophysical and social conditions and the instruments of governance, is not straightforward. The particular challenges for the biophysical dimensions are highlighted by Nykvist et al. (36), who assessed national “environmental performance” on four planetary boundaries (climate change, water, land, and nitrogen) for 60 countries. Because the chief aim of the SJS is to influence public policy, and this happens largely at the national level, our objective in this report is to assess whether the SJS concept can be used at the national scale, using South Africa as a test case.In this report we first review the SJS concept and explore how it might be applied at the national scale. We then present a decision-based methodology and results for our case study on South Africa. Finally, we discuss the applicability of the tool in South Africa, the local-regional-global links and the SDGs, and the data limitations, scientific challenges, and further research needs.