女性假性湿疣104例临床分析

目的 :总结外阴假性湿疣及尖锐湿疣的鉴别诊断。方法 :对各种外阴赘生物患者进行病理学检查 ,以确诊假性湿疣及尖锐湿疣。结果 :对 1 5 2例外阴赘生物患者 ,经病理证实 1 0 4例为假性湿疣 ,4 8例为尖锐湿疣。结论 :外阴假性湿疣发病率逐渐上升 ,不必心理恐慌而应注意个人卫生。     

Mobilization of a Bacterial Vegetation Visualized During Transesophageal Echocardiography

In this report, we describe visualization during transesophageal echocardiography of an embolus leaving the heart from the mitral valve of a patient with infective endocarditis.     

Long-term resistance to simulated climate change in an infertile grassland

Climate shifts over this century are widely expected to alter the structure and functioning of temperate plant communities. However, long-term climate experiments in natural vegetation are rare and largely confined to systems with the capacity for rapid compositional change. In unproductive, grazed grassland at Buxton in northern England (U.K.), one of the longest running experimental manipulations of temperature and rainfall reveals vegetation highly resistant to climate shifts maintained over 13 yr. Here we document this resistance in the form of: (i) constancy in the relative abundance of growth forms and maintained dominance by long-lived, slow-growing grasses, sedges, and small forbs; (ii) immediate but minor shifts in the abundance of several species that have remained stable over the course of the experiment; (iii) no change in productivity in response to climate treatments with the exception of reduction from chronic summer drought; and (iv) only minor species losses in response to drought and winter heating. Overall, compositional changes induced by 13-yr exposure to climate regime change were less than short-term fluctuations in species abundances driven by interannual climate fluctuations. The lack of progressive compositional change, coupled with the long-term historical persistence of unproductive grasslands in northern England, suggests the community at Buxton possesses a stabilizing capacity that leads to long-term persistence of dominant species. Unproductive ecosystems provide a refuge for many threatened plants and animals and perform a diversity of ecosystem services. Our results support the view that changing land use and overexploitation rather than climate change per se constitute the primary threats to these fragile ecosystems.     

From the Cover: 1.36 million years of Mediterranean forest refugium dynamics in response to glacial–interglacial cycle strength

The sediment record from Lake Ohrid (Southwestern Balkans) represents the longest continuous lake archive in Europe, extending back to 1.36 Ma. We reconstruct the vegetation history based on pollen analysis of the DEEP core to reveal changes in vegetation cover and forest diversity during glacial–interglacial (G–IG) cycles and early basin development. The earliest lake phase saw a significantly different composition rich in relict tree taxa and few herbs. Subsequent establishment of a permanent steppic herb association around 1.2 Ma implies a threshold response to changes in moisture availability and temperature and gradual adjustment of the basin morphology. A change in the character of G–IG cycles during the Early–Middle Pleistocene Transition is reflected in the record by reorganization of the vegetation from obliquity- to eccentricity-paced cycles. Based on a quantitative analysis of tree taxa richness, the first large-scale decline in tree diversity occurred around 0.94 Ma. Subsequent variations in tree richness were largely driven by the amplitude and duration of G–IG cycles. Significant tree richness declines occurred in periods with abundant dry herb associations, pointing to aridity affecting tree population survival. Assessment of long-term legacy effects between global climate and regional vegetation change reveals a significant influence of cool interglacial conditions on subsequent glacial vegetation composition and diversity. This effect is contrary to observations at high latitudes, where glacial intensity is known to control subsequent interglacial vegetation, and the evidence demonstrates that the Lake Ohrid catchment functioned as a refugium for both thermophilous and temperate tree species.

Identification and protection of past forest refugia, supporting a relict population, has gained interest in light of projected forest responses to anthropogenic climate change (1–4). Understanding the past and present composition of Mediterranean forest refugia is central to the study of long-term survival of tree taxa and the systematic relation between forest dynamics and climate (5). The Quaternary vegetation history of Europe, studied for over a century, is characterized by successive loss of tree species (6–8). Species loss was originally explained by the repeated migration across east–west oriented mountain chains during glacial–interglacial (G–IG) cycles (9). Later views gave more importance to the survival of tree populations during warm and arid stages in southern refugia (10, 11). Tree survival likely depends on persistence of suitable climate and tolerable levels of climate variability, as well as niche differentiation and population size at the refugium (12), although the precise relation between regional extinctions, climate variability, and local edaphic factors is not well known (13). Mediterranean mountain regions are considered to serve as forest refugia over multiple glacial cycles and frequently coincide with present-day biodiversity hotspots (14). Across the Mediterranean, increases in aridity and fire occurrence have impacted past vegetation communities (15–18). Comprehensive review of available Quaternary Mediterranean records indicates that Early (2.58 to 0.77 Ma) and Middle Pleistocene (0.77 to 0.129 Ma) tree diversity was higher compared to the present (13, 19–21). Particularly drought intolerant, thermophilic taxa were more abundant and diverse (8) but with strong spatial and temporal variations in tree diversity across the region. Long-term relationships between refugia function and environmental change over multiple G–IG cycles are hard to quantify due to the rarity of long, uninterrupted records.The Early–Middle Pleistocene Transition (EMPT), between 1.4 and 0.4 Ma (22), is of particular importance for understanding the relation between past climate change, vegetation dynamics, and biodiversity in the Mediterranean region. The EMPT is characterized by a gradual transition of G–IG cycle duration from obliquity (41 thousand years; kyr) to eccentricity (100 kyr) scale with increasing amplitude of each G–IG cycle (e.g., refs. 23, 24). The EMPT was accompanied by long-term cooling of the deep and surface ocean and was likely caused by atmospheric CO₂ decline and ice-sheet feedbacks (25–30). In Europe, the EMPT is associated with pronounced vegetation changes and local extinction and isolation of small tree populations (31).Here, we document vegetation history of the last 1.36 Ma in the Lake Ohrid (LO) catchment, located at the Albanian/North Macedonian border at 693 m above sea level (m asl, Fig. 1), the longest continuous sedimentary lake record in Europe (32, 33). The chronology of the DEEP core (International Continental Scientific Drilling Program site 5045-1; 41°02’57’’ N, 20°42’54’’ E, Fig. 1) is based on tuning of biogeochemical proxy data to orbital parameters with independent tephrostratigraphic and paleomagnetic age control (32, 33). The Balkan Peninsula has long been considered an important glacial forest refugium for presently widespread taxa such as Abies, Picea, Carpinus, Corylus, Fagus Ostrya, Quercus, Tilia, and Ulmus (7, 34–36). More than 60% of the Balkans is currently located >1,000 m asl (36), providing steep latitudinal and elevational gradients to support refugia under both cold and warm conditions. Today, the LO catchment is dominated by (semi) deciduous oak (Quercus) and hornbeam (Carpinus/Ostrya) forests. Above 1,250 m elevation, mixed mesophyllous forest with montane elements occurs (Fagus and at higher elevations Abies), which above 1,800 m elevation develops into subalpine grassland with Juniperus shrubs (see ref. 37 for site details). Isolated populations of Pinus peuce and Pinus nigra currently grow in the area (37–40).Open in a separate windowFig. 1.(A) Location of LO and TP on the Balkan Peninsula. (B) Local setting around LO, bathymetry (81), and DEEP coring site (adapted from ref. 32).Previous analysis of pollen composition of the last 500 kyr at the DEEP site revealed that the LO has been an important refugium. Arboreal pollen (AP) is deposited continuously and changes in abundance on multimillennial timescales in association with G–IG cycles, whereas millennial-scale variability is tightly coupled to Mediterranean sea-surface temperature variations (37, 41–45). Subsequent studies confirm the refugial character of the site recording Early Pleistocene (1.365 to 1.165 Ma) high relict tree diversity and abundance—and significant hydrological changes, including an increase in lake size and depth (38). Here, we present a continuous palynological record from LO with millennial resolution (∼2 kyr) back to 1.36 Ma to assess the systematic relationships between tree pollen abundance, forest diversity, and G–IG climate variability.Our objective is as follows: 1) infer the impact of past climate variability on local vegetation across the EMPT, 2) estimate tree species diversity in the catchment, and 3) examine how the amplitude and duration of preceding G–IG intervals affected the vegetation development and plant species diversity in this refugial area.     

不同海拨对鹤庆县血吸虫病流行和控制的影响

目的了解不同海拔对云南省鹤庆县血吸虫病流行和控制的影响。方法收集鹤庆县全县及血吸虫病流行区基本情况、血吸虫病疫情、不同海拔地区自然植被分布情况并对资料进行分析。结果根据鹤庆县境内不同海拔地区自然植被的垂直分布规律,全县各行政村按海拔可分为2900～3953m、1800～2899m、1500～1799m、1500m以下4个地区,海拔>2900m地区没有血吸虫病流行,其余3个地区均有血吸虫病流行。血吸虫病疫情原来以海拔为1800～2900m的地区最为严重,流行村数、人口数、历史累计病人数、历史累计晚期血吸虫病(以下简称晚血)人数、历史累计钉螺面积占全县流行区比例分别为96.36%、97.57%、99.62%、100.00%、99.46%,1970年该地区血吸虫人群感染率为30.46%。2011年全县查出血吸虫病人数、晚血病例、血吸虫人群感染率、钉螺面积较历史累计病人数、历史累计晚血病人数、1970年血吸虫人群感染率、历史累计钉螺面积分别下降了99.99%、80.89%、99.99%、96.41%,没有发现感染性钉螺。2011年海拔1800～2900m的地区血吸虫人群感染率为0.003%,2011年现存晚血病例、查出病人全部分布在该地区,钉螺面积占全县钉螺面积的95.78%。2011年钉螺面积百分比以海拔<1500m的地区为高,有螺环境出现率、有螺框出现率、活螺平均密度、活螺最高密度均以海拔为1800～2900m的地区为高。结论研究不同海拔地区的自然植被分布对钉螺分布和控制、血吸虫病流行和控制的影响具有一定的实际意义。     

Echodetection of disseminated endocardial vegetations in a patient with active IV drug abuse

Infective endocarditis is a known complication of intravenous (IV) drug abuse and typically involves cardiac valves, sparing the myocardial endocardium. We present the case of a young IV drug using patient who developed sepsis. Although cardiac symptoms and signs were minimal, an echocardiogram was done as patient had a history of IV drug abuse and was in sepsis. Echocardiogram demonstrated disseminated vegetations involving the left ventricular and right ventricular endocardium while sparing the valves. Although diagnosis of infective endocarditis was made on two-dimensional transthoracic echocardiogram, two-dimensional and three-dimensional transesophageal echocardiograms demonstrated the pattern of endocarditis with clarity. This patient had severe sepsis and bacteremia with Methicillin sensitive Staphylococcus aureus.     

Influence of coastal vegetation on the 2004 tsunami wave impact in west Aceh

In a tsunami event human casualties and infrastructure damage are determined predominantly by seaquake intensity and offshore properties. On land, wave energy is attenuated by gravitation (elevation) and friction (land cover). Tree belts have been promoted as "bioshields" against wave impact. However, given the lack of quantitative evidence of their performance in such extreme events, tree belts have been criticized for creating a false sense of security. This study used 180 transects perpendicular to over 100 km on the west coast of Aceh, Indonesia to analyze the influence of coastal vegetation, particularly cultivated trees, on the impact of the 2004 tsunami. Satellite imagery; land cover maps; land use characteristics; stem diameter, height, and planting density; and a literature review were used to develop a land cover roughness coefficient accounting for the resistance offered by different land uses to the wave advance. Applying a spatial generalized linear mixed model, we found that while distance to coast was the dominant determinant of impact (casualties and infrastructure damage), the existing coastal vegetation in front of settlements also significantly reduced casualties by an average of 5%. In contrast, dense vegetation behind villages endangered human lives and increased structural damage. Debris carried by the backwash may have contributed to these dissimilar effects of land cover. For sustainable and effective coastal risk management, location of settlements is essential, while the protective potential of coastal vegetation, as determined by its spatial arrangement, should be regarded as an important livelihood provider rather than just as a bioshield.     

儿童分泌性中耳炎与腺样体肥大的相关性研究

 目的探讨儿童分泌性中耳炎与腺样体肥大之间的相关性。方法选取经鼻咽X线侧位片检查诊断为腺样体肥大的患儿170例和腺样体大小正常、患扁桃体肥大或慢性扁桃体炎的患儿58例作为对照进行回顾性研究,根据鼻咽X线侧位片A/N比值的结果将全部病例按腺样体肥大程度分为腺样体正常组、中度肥大组和重度肥大组。分析各组间腺样体肥大程度与分泌性中耳炎发病率的相关性。结果腺样体正常组与中度肥大组比较,分泌性中耳炎发病率无明显差异;腺样体正常组与重度肥大组比较,分泌性中耳炎发病率的差异有统计学意义(P<0.01)。结论腺样体肥大程度与分泌性中耳炎的发病率呈正相关。腺样体越大对鼻咽腔阻塞的程度越大,造成分泌性中耳炎的几率越高。     

若尔盖白河牧场地上生物量与遥感植被指数关系研究

目的：为探讨利用遥感影像进行草原地上生物量估测,更好服务于保护区内的植被生态建设。方法：本文采用TM影像研究若尔盖地区白河牧场地上生物量与遥感植被指数的关系,分别建立了7种植被指数（NDVI、RVI、DVI、SAVI、MSAVI、PVI、GVI）与地上生物量的线性和6种非线性（对数、反函数、二次多项式、三次多项式、复合、幂函数）回归模型。结果：植被指数MSAVI、NDVI、SAVI、RVI、GVI、DVI、PVI与白河牧场地上生物量模型表现出三次多项式回归模型最优,其次是二次多项式、反函数曲线模型、对数曲线模型、线性模型、幂函数曲线模型、复合曲线模型。结论：基于MSAVI的地上生物量的三次多项式模型的模拟效果最好,复相关系数R2=0.823005,精度检验结果表明该模型的平均误差为38.7%,拟合精度达到61.3%,能够满足中尺度地上生物量的估测。     

血清中炎症介质和细胞因子与儿童腺样体肥大相关性研究

目的 探讨儿童腺样体肥大(adenoid vegetation)患者血清中肿瘤坏死因子-α(TNF-α) 、白介素-4(IL-4)、嗜酸细胞阳离子蛋白(ECP)水平变化及与其肥大程度、体质量指数之间的关系。方法 经鼻咽部X线侧位片及查体确诊的87例单纯腺样体肥大患者(实验组)及49例体检正常儿童(对照组),测定其身高、体质量,计算体质量指数(BMI)即体质量/身高2,用腺样体与鼻咽部口径的比值(A/N )来代表腺样体的相对大小;清晨抽取空腹静脉血,应用酶联免疫法(ELISA)测定血清中TNF-α、IL-4水平及Pharmacia CAP System ECP FEIA荧光酶标法测定血清中ECP水平,分析腺样体肥大程度、BMI与血清中TNF-α 、IL-4、ECP水平之间的关系,采用SPASS 17.0软件进行统计学分析。结果 实验组的血清TNF-α水平为(492.50±13.24)mg/L,与对照组(310.25±10.32)mg/L相比,差异具有统计学意义(P<0.05);实验组与对照组血清IL-4水平分别为(252.91±14.31)pg/mL、(174.37±11.23)pg/mL,差异有统计学意义(P<0.05);ECP水平分别为(6.12±1.18)μg/L、(5.56±0.87)μg/L,差异无统计学意义(P>0.05)。TNF-α水平与腺样体肥大程度分别呈正相关(轻度：r=0.98, P<0.05;中度：r=0.92, P<0.05;重度：r=0.94, P<0.05); IL-4水平与其肥大程度亦分别呈正相关(轻度：r=0.95, P<0.05;中度：r=0.94, P<0.05;重度：r=0.99, P<0.05),且均与BMI无关;ECP水平在两组检测结果中无明显差别(P>0.05)。 结论 腺样体肥大患者血清中TNF-α 、IL-4水平存在不同程度的升高且其水平与腺样体肥大程度呈正相关,与BMI无关;而ECP与腺样体肥大与否及其肥大程度无明显相关性。