From the Cover: Warming enabled upslope advance in western US forest fires

Increases in burned area and large fire occurrence are widely documented over the western United States over the past half century. Here, we focus on the elevational distribution of forest fires in mountainous ecoregions of the western United States and show the largest increase rates in burned area above 2,500 m during 1984 to 2017. Furthermore, we show that high-elevation fires advanced upslope with a median cumulative change of 252 m (−107 to 656 m; 95% CI) in 34 y across studied ecoregions. We also document a strong interannual relationship between high-elevation fires and warm season vapor pressure deficit (VPD). The upslope advance of fires is consistent with observed warming reflected by a median upslope drift of VPD isolines of 295 m (59 to 704 m; 95% CI) during 1984 to 2017. These findings allow us to estimate that recent climate trends reduced the high-elevation flammability barrier and enabled fires in an additional 11% of western forests. Limited influences of fire management practices and longer fire-return intervals in these montane mesic systems suggest these changes are largely a byproduct of climate warming. Further weakening in the high-elevation flammability barrier with continued warming has the potential to transform montane fire regimes with numerous implications for ecosystems and watersheds.

Fire is an integral component of most forested lands and provides significant ecological services (1). However, burned area, fire size, the number of large fires, and the length of fire season have increased in the western United States in recent decades (2, 3). Increasing fire activity and the expansion of wildland urban interface (4) collectively amplified direct and indirect fire-related loss of life and property (5, 6) and contributed to escalating fire suppression costs (7). While increased biomass due to a century of fire exclusion efforts is hypothesized to have partially contributed to this trend (8), climate change is also implicated in the rise of fire activity in the western United States (9–11).Although increases in forest fire activity are evident in all major forested lands in the western United States (2, 12, 13), an abundance of moisture—due to snowpack persistence, cooler temperatures, and delayed summer soil and fuel drying—provides a strong buffer of fire activity (13) and longer fire-return intervals (14) at high elevations. Recent studies, however, point to changing fire characteristics across many ecoregions of the western United States (15), including high-elevation areas of the Sierra Nevada (16), Pacific Northwest, and Northern Rockies (12, 17). These studies complement documented changes in montane environments including amplified warming with elevation (18), widespread upward elevational shift in species (19), and increased productivity in energy-limited high-elevation regions that enhance fuel growth and connectivity (20). These changes have been accompanied by longer snow-free periods (21), increased evaporative demand (9), and regional declines in fire season precipitation frequency (11) across the western United States promoting increased fuel ignitability and flammability that have well-founded links to forest burned area. A warmer climate is also conducive to a higher number of convective storms and more frequent lightning strikes (22).In this study, we explore changes in the elevational distribution of burned forest across the western United States and how changes in climate have affected the mesic barrier for high-elevation fire activity. We focus on changes in high-elevation forests that have endured fewer direct anthropogenic modifications compared to drier low-elevation forests that had frequent low-severity fires prior to European colonization and have been more subject to changes in settlement patterns as well as fire suppression and harvest (23, 24); we also pose the following questions: 1) Has the elevational distribution of fire in the western US forests systematically changed? and 2) What changes in biophysical factors have enabled such changes in high-elevation fire activity? We explore these questions across 15 mountainous ecoregions of the western United States using records from large fires (>405 ha) between 1984 and 2017 [Monitoring Trends in Burn Severity (MTBS) (25)], a 10-m–resolution digital elevation model, and daily high-spatial–resolution surface meteorological data [gridMET (26)].We focus on the trends in Z₉₀—defined as the 90th percentile of normalized annual elevational distribution of burned forest in each ecoregion. Here, the term “normalized” essentially refers to the fraction of forest area burned by elevation. We complement this analysis by examining trends in burned area by elevational bands and using quantile regression of normalized annual forest fire elevation. We then assess the interannual relationships between Z₉₀ and vapor pressure deficit (VPD) and compare the upslope advance in montane fire to elevational climate velocity of VPD during 1984 to 2017. Specifically, we use VPD trends and VPD–high-elevation fire regression to estimate VPD-driven changes in Z₉₀ and BA₉₀— defined as annual burned area above the 90th percentile of forest elevational distribution in each ecoregion—during 1984 to 2017.     

贺氏火针温通法治疗肱骨外上髁炎临床观察

目的 观察贺氏火针温通法对肱骨外上髁炎的疗效。方法 收集2014年1月至2014年12月首都医科大学附属北京中医医院针灸科肱骨外上髁炎患者60例,按就诊顺序将患者分为治疗组和对照组,每组30例。对照组每日毫针刺肘髎、曲池、手三里、合谷穴,治疗组加用贺氏火针隔日点刺阿是穴,两组均连续治疗10 d。以疼痛视觉模拟量表（visual analogue scale,VAS）、Mayo肘关节功能评分表（mayo elbow performance score,MEPS）为观察指标,判定临床疗效。结果 与治疗前比较,治疗后两组VAS评分均显著降低（P<0.05）,MEPS评分均显著升高（P<0.05）,治疗组VAS评分降低值和MEPS评分升高值均显著大于对照组（P<0.05）。结论 贺氏火针温通法可有效缓解肱骨外上髁炎的疼痛程度,改善肘关节功能。     

Fire-free land use in pre-1492 Amazonian savannas

The nature and scale of pre-Columbian land use and the consequences of the 1492 "Columbian Encounter" (CE) on Amazonia are among the more debated topics in New World archaeology and paleoecology. However, pre-Columbian human impact in Amazonian savannas remains poorly understood. Most paleoecological studies have been conducted in neotropical forest contexts. Of studies done in Amazonian savannas, none has the temporal resolution needed to detect changes induced by either climate or humans before and after A.D. 1492, and only a few closely integrate paleoecological and archaeological data. We report a high-resolution 2,150-y paleoecological record from a French Guianan coastal savanna that forces reconsideration of how pre-Columbian savanna peoples practiced raised-field agriculture and how the CE impacted these societies and environments. Our combined pollen, phytolith, and charcoal analyses reveal unexpectedly low levels of biomass burning associated with pre-A.D. 1492 savanna raised-field agriculture and a sharp increase in fires following the arrival of Europeans. We show that pre-Columbian raised-field farmers limited burning to improve agricultural production, contrasting with extensive use of fire in pre-Columbian tropical forest and Central American savanna environments, as well as in present-day savannas. The charcoal record indicates that extensive fires in the seasonally flooded savannas of French Guiana are a post-Columbian phenomenon, postdating the collapse of indigenous populations. The discovery that pre-Columbian farmers practiced fire-free savanna management calls into question the widely held assumption that pre-Columbian Amazonian farmers pervasively used fire to manage and alter ecosystems and offers fresh perspectives on an emerging alternative approach to savanna land use and conservation that can help reduce carbon emissions.     

基于“少火生气,壮火食气”理论治疗硬皮病

硬皮病是临床难治性自身免疫性疾病,常累及全身多个系统,其发病机制尚不明确,且进展迅速,预后多不良,目前尚缺乏特效治疗药物,治疗棘手。本病隶属于中医学中“皮痹”范畴,中医对其病因病机有着深入的认识,治疗效果显著,不良反应较小。现阐述《内经》中“少火生气、壮火食气”的理论内涵,浅析中医对硬皮病认识,探讨该理论对中医治疗硬皮病的指导作用,并举汤小虎教授临床验案1例,以期为临床多角度认识和治疗硬皮病提供有价值的思路。     

欣生静片治疗广泛性焦虑症的随机、双盲、双模拟、多中心平行对照Ⅲ期临床试验研究

目的：评价欣生静片治疗广泛性焦虑症（心肝火旺证）的有效性和安全性。方法：采用随机、双盲双模拟、多中心平行对照试验设计,试验组和对照组分别给予欣生静片和丁螺环酮治疗4周。结果：试验组的总有效率和疗效指数均优于对照组（P＜0.05）。两组均能显著改善HAMA评分,组间差异具有统计学意义（P＜0.01）。两组患者的中医症状均能改善,但试验组的总有效率及中医证候的愈显率和评分均优于对照组（P＜0.01）。两组的HAMD17项评分均有显著改善（P＜0.01）,试验组优于对照组（P＜0.01）。试验组的不良反应发生率、严重程度显著低于对照组（P＜0.01）。结论：欣生静片治疗广泛性焦虑症安全、有效,显著优于丁螺环酮,临床应用价值高。     

珍龙膏联合雷火灸治疗压疮的临床疗效研究

目的 观察珍龙膏联合雷火灸治疗压疮的临床疗效及安全性,为临床治疗压疮提供新思路。方法 将38例压疮患者按随机数字表法分为观察组和对照组,每组各19例。对照组采用常规综合治疗方法,观察组采用珍龙膏外用联合雷火灸治疗的方法,分别干预2周,观察两组患者的压疮愈合计分(PUSH)、疼痛评分(VAS)、安全性评价。结果 干预后观察组PUSH评分、VAS评分均低于对照,差异有统计学意义(P<0.05);两组均未发生不良反应。结论 珍龙膏联合雷火灸治疗压疮临床疗效明显,无毒副作用,值得临床应用及推广。     

Influence of Alkali Activator Type on the Hydrolytic Stability and Intumescence of Inorganic Polymers Based on Waste Glass

The main objective of this study is the synthesis and characterization of low cost alkali-activated inorganic polymers based on waste glass (G-AAIPs) using a mixture of NaOH and Ca(OH)₂ as alkali activators, in order to improve their hydrolytic stability. This paper also presents detailed information about the influence of composition determined by X Ray Diffraction (XRD), microstructure determined by Scanning Electronic Microscopy (SEM) and processing parameters on the main properties of G-AAIP pastes. The main factors analyzed were the glass fineness and the composition of the alkaline activators. The influence on intumescent behavior was also studied by heat treating of specimens at 600 °C and 800 °C. The use of Ca(OH)₂ in the composition of the alkaline activator determines the increase of the hydrolytic stability (evaluated by underwater evolution index) of the G-AAIP materials compared to those obtained by NaOH activation. In this case, along with sodium silicate hydrates, calcium silicates hydrates (C-S-H), with good stability in a humid environment, were also formed in the hardened pastes. The highest intumescence and an improvement of hydrolytic stability (evaluated by underwater evolution index and mass loss) was achieved for the waste glass powder activated with a solution containing 70% NaOH and 30% Ca(OH)₂. The increase of the waste glass fineness and initial curing temperature of G-AAIPs have a positive effect on the intumescence of resulted materials but have a reduced influence on their mechanical properties and hydrolytic stability.     

清肝解郁和健脾补肾法在治疗肝火上亢型慢性肾衰合并高血压中的应用

目的:观察清肝解郁和健脾补肾法治疗肝火上亢型慢性肾衰(CRF)合并高血压患者的临床效果。方法:选取2016年6月至2018年6月京东誉美医院收治的肝火上亢型CRF合并高血压患者90例作为研究对象,按照随机数字表法随机分为对照组和观察组,每组45例。对照组给予口服硝苯地平控释片治疗,观察组在对照组治疗基础上给予清肝解郁、健脾补肾汤治疗,每4周为1个疗程,均治疗3个疗程。比较治疗前后中医症状评分、收缩压(SBP)、舒张压(DBP)变化;比较2组临床疗效;比较治疗前后肾功能指标:尿素氮(BUN)、血肌酐(Scr)、24 h尿蛋白定量(24 hPRO);统计治疗期间2组不良反应发生情况。结果:治疗前观察组与对照组中医症状评分、SBP、DBP、BUN、Scr、24 hPRO比较,差异均无统计学意义(P>0.05),治疗后2组患者中医症状评分、SBP、DBP、BUN、Scr、24 hPRO均显著降低(P<0.05),观察组均低于对照组,差异有统计学意义(P<0.05);2组临床疗效比较,差异有统计学意义(P<0.05),且观察组总有效率显著高于对照组,差异有统计学意义(P<0.05);观察组和对照组不良反应发生率分别为2.22%和6.67%,2组比较差异无统计学意义(P>0.05)。结论:清肝解郁、健脾补肾法辅助治疗肝火上亢型CRF合并高血压疗效确切,可较好控制血压,并且可显著改善肾功能,减少不良反应发生情况。     

火针膝周密刺对膝关节骨性关节炎鼠关节形态及软骨LOXL2的影响

目的:探讨火针膝周密刺对膝关节骨性关节炎(Knee Osteoarthritis,KOA)大鼠行为学、关节形态及软骨中赖氨酰氧化酶相关蛋白2(LOXL2)影响性。方法:选择30只健康雄性大鼠,10只作为对照不作任何处理。20只大鼠建立KOA模型,成模后随机分成2组,分别予普通针刺和火针膝周密刺,1次/3 d,连续6次。观察各组大鼠Leauesne MG评分、关节软骨细胞情况,外周血及关节软骨转化生长因子-β1(TGF-β1)、肿瘤坏死因子-α(TNF-α)、基质金属蛋白酶3(MMP-3)、LOXL2水平变化。结果:治疗后火针组Leauesne MG评分中的局部疼痛刺激反应、步态、关节活动范围、关节肿胀度较对照组、模型组差异有统计学意义(P<0.05)。血清及关节软骨MMP-3、TGF-β1、TNF-α含量水平显著低于模型组(P<0.05),LOXL2显著高于模型组(P<0.05)。火针组电镜下软骨细胞形状规则、细胞核完整且饱满,微绒毛少量存在,内质网丰富,有散在的染色质。结论:火针膝周密刺能减轻K0A关节软骨损伤,降低炎性反应,改善软骨LOXL2水平,这可能是火针治疗KOA一个作用机制。