三级医院病人就诊流向探讨

研究通过对包括专科医院在内的多家三级医院住院病人资料的分析，将疾病种类按ICD－9编码分为19类，研究各类疾病应往低级别医院分流的比例。结果表明：各大类疾病的分流比例不同，分流比例较高的主要是常见病和多发病，总的分流比大约在60％左右。     

Osteohistology of Greererpeton provides insight into the life history of an early Carboniferous tetrapod

The vertebrate transition to land is one of the most consequential, yet poorly understood periods in tetrapod evolution. Despite the importance of the water–land transition in establishing modern ecosystems, we still know very little about the life histories of the earliest tetrapods. Bone histology provides an exceptional opportunity to study the biology of early tetrapods and has the potential to reveal new insights into their life histories. Here, we examine the femoral bone histology from an ontogenetic series of Greererpeton, an early tetrapod from the Middle-Late Mississippian (early Carboniferous) of North America. Thin-sections and micro-CT data show a moderately paced rate of bone deposition with significant cortical thickening through development. An interruption to regular bone deposition, as indicated by a zone of avascular tissue and growth marks, is notable at the same late juvenile stage of development throughout our sample. This suggests that an inherent aspect to the life history of juvenile Greererpeton resulted in a temporary reduction in bone deposition. We review several possible life history correlates for this bony signature including metamorphosis, an extended juvenile phase, environmental stress, and movement (migration/dispersal) between habitats. We argue that given the anatomy of Greererpeton, it is unlikely that events related to polymorphism (metamorphosis, extended juvenile phase) can explain the bony signature observed in our sample. Furthermore, the ubiquity of this signal in our sample indicates a taxon-level rather than a population-level trait, which is expected for an environmental stress. We conclude that movement via dispersal represents a likely correlate, as such events are a common life history strategy of aquatically bound vertebrates.     

Discrete nanoparticles induce loss of Legionella pneumophila biofilms from surfaces

Nanoparticles (NPs) have been shown to induce dispersal events in microbial biofilms but the mechanism of the dispersal is unknown. Biofilms contaminate many man-made aquatic systems such as cooling towers, spas and dental lines. Within these biofilms, Legionella pneumophila is a primary pathogen, leading to these environments serving as sources for disease outbreaks. Here we show a reduction in biofilm bio-volume upon treatment with citrate-coated 6-nm platinum NPs, polyethylene glycol (PEG)-coated 11-nm gold NPs, and PEG-coated 8-nm iron oxide NPs. Treatment with citrate-coated 8-nm silver NPs, however, did not reduce biomass. The synthesis of NPs that remain dispersed and resist irreversible aggregation in the exposure media appears to be a key factor in the ability of NPs to induce biofilm dispersal.     

Wind-borne insects mediate directional pollen transfer between desert fig trees 160 kilometers apart

The question of how far pollen can move between plants has implications for topics as diverse as habitat fragmentation, conservation management, and the containment of genetically modified crops. The monoecious African fig tree Ficus sycomorus L. relies on the small, short-lived, night-flying, host-specific fig wasp Ceratosolen arabicus Mayr for pollination. We used microsatellite markers to characterize a geographically isolated riparian population of F. sycomorus growing along the Ugab River in the Namib Desert, Namibia, together with paternity analysis of seedlings from known mothers, to map pollen movement within this population. In this way we tracked insect movements between individually recognizable trees by means of their pollen cargo and documented the movement of C. arabicus between known trees separated by more than 160 km, with a mean distance for confirmed successful pollination events of 88.6 km. The predominant observed movement of pollinators was in a westerly direction, toward the sea, reflecting seasonal nighttime wind direction and the wind-borne dispersal of fig wasps. Our results suggest the existence of an extensive panmictic population of trees that are well suited to overcome the effects of geographical isolation.     

Comparative population genetics of two invading ticks: Evidence of the ecological mechanisms underlying tick range expansions

Two species of ixodid tick, Ixodes affinis Neumann and Amblyomma maculatum Koch, are simultaneously expanding their ranges throughout the mid-Atlantic region of the US. Although we have some understanding of the ecology and life history of these species, the ecological mechanisms governing where and how new populations establish and persist are unclear. To assess population connectivity and ancestry, we sequenced a fragment of the 16S mitochondrial rRNA gene from a representative sample of individuals of both species from populations throughout the eastern US. We found that despite overlapping host preferences throughout ontogeny, each species exhibited very different genetic and geographic patterns of population establishment and connectivity. I. affinis was of two distinct mitochondrial clades, with a clear geographic break separating northern and southern populations. Both I. affinis populations showed evidence of recent expansion, although the southern population was more genetically diverse, indicating a longer history of establishment. A. maculatum exhibited diverse haplotypes that showed no significant relationship with geographic patterns and little apparent connectivity between sites. Heteroplasmy was also observed in the 16S mitochondrial rRNA gene in 3.5% of A. maculatum individuals. Genetic evidence suggests that these species rely on different key life stages to successfully disperse into novel environments, and that host vagility, habitat stability and habitat connectivity all play critical roles in the establishment of new tick populations.     

清热祛瘀法并早期脑超声治疗脑出血临床观察

目的:观察清热祛瘀中药联合早期脑超声治疗急性少量脑出血的疗效.方法:90例脑出血患者被随机分为治疗组60例、对照组30例.对照组采用甘露醇脱水控制血压等常规治疗,并加用清开灵注射液静脉滴注.治疗组在对照组常规治疗基础上于发病后第1～3 d开始静脉滴注脉络宁注射液20 ml,每日1～2次;在生命体征平稳的条件下,于发病第3～5 d开始使用脑超声治疗,每次30 min,每日1～2次.观察两组患者治疗20 d后血肿吸收情况和神经功能缺损评分.结果:治疗组总有效率为91.7%,对照组总有效率为73.3%,两者比较有显著性差异(P<0.01).治疗组神经功能缺损评分减少的程度明显好于对照组(P<0.05);脑出血吸收量也明显大于对照组(P<0.05).结论:应用清热、祛瘀并脑超声三联疗法治疗脑出血较单纯使用清热的清开灵注射液能明显促进血肿吸收,改善神经功能,提高临床疗效,降低致残率.     

放射损伤细胞中高尔基体弥散现象及香兰素衍生物的防护作用

目的：通过观察辐射对高尔基体形态的影响,确定香兰素衍生物VND3207对受照细胞高尔基体的防护作用。方法采用免疫荧光技术检测放射损伤细胞中高尔基体弥散现象并统计弥散面积,检测细胞周期变化,分析细胞存活率,同时对高尔基体蛋白的表达水平进行检测。结果免疫荧光检测结果显示,照射后高尔基体的弥散面积增加,具有一定的剂量效应和时间效应;VND3207能减轻γ射线对高尔基体的损伤,其表现为与未加药组相比,在抑制不同剂量照射后可使高尔基体弥散面积增加;细胞周期测定结果显示,4 Gy γ线照射后G2／M期阻滞峰值约出现在12 h后;免疫印迹结果显示DNA损伤引起的G2／M期阻滞也在12 h后解除;而高尔基体弥散在细胞周期阻滞解除后12和24 h仍然存在;平板克隆结果显示,VND3207促进了受照细胞的存活。结论放射损伤能引起剂量依赖性高尔基体弥散效应,且这种弥散与DNA损伤诱导的周期阻滞无关,VND3207对放射损伤引起的高尔基体弥散有一定的抑制作用,可能与受照细胞受到保护有关。     

Dispersers shape fruit diversity in Ficus (Moraceae)

Seed dispersal by vertebrates is one of the most common and important plant–animal mutualisms, involving an enormous diversity of fruiting plants and frugivorous animals. Even though plant reproduction depends largely on seed dispersal, evolutionary ecologists have been unable to link co-occurring traits in fruits with differences in behavior, physiology, and morphology of fruit-eating vertebrates. Hence, the origin and maintenance of fruit diversity remains largely unexplained. Using a multivariate phylogenetic comparative test with unbiased estimates of odor and color in figs, we demonstrate that fruit traits evolve in concert and as predicted by differences in the behavior, physiology (perceptive ability) and morphology of their frugivorous seed dispersers. The correlated evolution of traits results in the convergence of general appearance of fruits in species that share disperser types. Observations at fruiting trees independently confirmed that differences in fig traits predict differences in dispersers. Taken together, these results demonstrate that differences among frugivores have shaped the evolution of fruit traits. More broadly, our results underscore the importance of mutualisms in both generating and maintaining biodiversity.     

Laridae: A neglected reservoir that could play a major role in avian influenza virus epidemiological dynamics

Abstract

Avian influenza viruses (AIVs) are of great concern worldwide due to their economic impact and the threat they represent to human health. As wild birds are the natural reservoirs of AIVs, understanding AIV dynamics in different avian taxa is essential for deciphering the epidemiological links between wildlife, poultry and humans. To date, only the Anatidae (ducks, geese and swans) have been widely studied. Here, we aim to shed light on the current state of knowledge on AIVs in Laridae (gulls, terns and kittiwakes) versus that in Anatidae by setting forth four fundamental questions: how, when, where and to which host species are AIVs transmitted? First, we describe ecological differences between Laridae and Anatidae and discuss how they may explain observed contrasts in preferential transmission routes and the evolution of specific AIV subtypes. Second, we highlight the dissimilarities in the temporal patterns of AIV shedding between Laridae and Anatidae and address the role that immunity likely plays in shaping these patterns. Third, we underscore that Laridae may be key in promoting intercontinental exchanges of AIVs. Finally, we emphasize the crucial epidemiological position that Laridae occupy between wildlife, domestic birds and humans.