目的:探讨胸腰段脊柱骨折合并急性创伤性脊髓损伤患者术后深静脉血栓的危险因素。方法:选取2018年7月~2020年9月于我院进行手术治疗的T11~L2骨折合并急性创伤性脊髓损伤(spinal cord injury,SCI)患者136例。收集患者的统计患者的年龄、...目的:探讨胸腰段脊柱骨折合并急性创伤性脊髓损伤患者术后深静脉血栓的危险因素。方法:选取2018年7月~2020年9月于我院进行手术治疗的T11~L2骨折合并急性创伤性脊髓损伤(spinal cord injury,SCI)患者136例。收集患者的统计患者的年龄、性别、体重指数、既往病史等一般资料,检测并收集患者总胆固醇(total cholesterol,TC)、甘油三酯(triacylglycerol,TG)、低密度脂蛋白胆固醇(low density lipoprotein cholesterol,LDL-C)、高密度脂蛋白(high density lipoprotein cholesterol,HDL-C)等实验室指标。收集患者术前、术后6个月内的下肢静脉彩超,根据是否出现DVT分为DVT组(n=64)和非DVT组(n=72)。比较两组患者的一般资料,通过单因素分析及多因素Logistic回归分析确定急性创伤性SCI患者术后发生DVT的独立影响因素。通过Spearman法和Pearson法分析各影响因素间的相关性。根据独立影响因素建立并验证列线图模型。结果:单因素分析结果显示,DVT组和非DVT组的体重指数(27.03±2.12kg/m2和24.03±3.32kg/m2)、吸烟人数占比(39.06%和20.83%)、输血人数占比(45.31%和27.78%)、肿瘤病史人数占比(46.89%和23.61%)、出血量>600 mL人数占比(42.19%和22.22%)、ASIA分级A级人数占比(45.31%和18.06%)、肢体气压治疗及踝泵练习人数占比(18.75%和52.78%)、ASIA分级D级人数占比(14.06%和33.33%)、CRP(20.36±4.37和11.45±3.76)、FIB(6.49±1.31和4.51±1.26)以及D-二聚体(1.83±0.39和0.45±0.26)之间的差异均具有统计学意义(P<0.05)。多因素Logistic回归分析显示,输血、ASIA分级A级、FIB>5g/L、D-二聚体>1.6mg/L以及未进行肢体气压治疗及踝泵练习是急性创伤性SCI患者术后DVT的独立危险因素(P<0.05),相关性分析显示,输血、ASIA分级A级、FIB、D-二聚体以及未进行肢体气压治疗及踝泵练习均呈明显的正相关关系(P<0.05)。根据独立影响因素构建列线图预测模型,模型的ROC曲线下面积(area under curve,AU展开更多
Vast grasslands are found in the walnut-fruit forest region of southern Kyrgyzstan,Middle Asia.Located above the worldwide unique walnutfruit forests and used for grazing,they play a pivotal role in the mixed mountain...Vast grasslands are found in the walnut-fruit forest region of southern Kyrgyzstan,Middle Asia.Located above the worldwide unique walnutfruit forests and used for grazing,they play a pivotal role in the mixed mountain agriculture of local farmers.Accordingly,these pastures are subject to an increasing utilization pressure reflecting the changing political and social conditions in the transformation process from a Soviet republic to an independent state.A first detailed analysis of mountain pasture vegetation in the Ferghana Range answers the following questions:What are the main plant community types among Kyrgyzstan's mountain pastures? What are the main environmental gradients that shape their species composition? Which phytogeographical distribution types are predominant? How does grazing affect community composition and species richness in these grasslands? Species composition was classified by cluster analysis;underlying environmental gradients were explored using DCA.A dataset of 395 relevés was used for classification,and a subset of 79 relevés was used in a DCA to analyze the correlation between vegetation,environment,and grazing impact.The investigated pastures were classified into four distinctive plant communities.The site factors altitude,heat load,inclination and grazing impact were found to be the major determinants of the vegetation pattern.A significant overlap between floristic composition and structural and spatial properties was shown.The majority of the species pool consisted of Middle Asian endemics and Eurosiberian species.However,disturbance-tolerant species played a significant role with respect to species composition and coverage of the herbaceous layer in vast areas of southern Kyrgyzstan's mountain pastures.In general,an intense grazing impact is clearly reflected by both species composition and structural variables of plant communities.The highly diverse and unique ecosystem is modified by an increasing utilization pressure.In order to maintain vital processes and functioning of this展开更多
Central Asia(CA)is one of the most drought-prone regions in the world with complex climate regimes,it is extremely vulnerable to water scarcity.Many studies on drought in CA,as a whole,have been carried out,whereas th...Central Asia(CA)is one of the most drought-prone regions in the world with complex climate regimes,it is extremely vulnerable to water scarcity.Many studies on drought in CA,as a whole,have been carried out,whereas there is a lack of studies on the drying and wetting trends of different climatic zones within CA.In this study,CA was divided into three different climatic zones based on the Koppen climate classification method,precipitation climatology,and aridity index.These were the temperate continental(Df),dry arid desert(BW),and Mediterranean continental(Ds)climatic zones.The regional drying and wetting trends during the years 1961—2015 were investigated using the monthly gridded Standardized Precipitation Evapotranspiration Index(SPEI).The empirical orthogonal function(EOF)was applied to analyze spatial and temporal variation patterns.EOF mode 1(EOF1)analysis found increasingly wet conditions throughout CA over the duration of the study,and EOF mode 2(EOF2)analysis found a contrast between northern and southern CA:as Df became drier and BW and Ds became wetter.EOF mode 3(EOF3)analysis found a western and eastern inverse phase distribution.The SPEI displayed a decreasing trend from 1961 to 1974 for CA as a whole,before increasing from 1975 to 2015,with a particularly significant increase over the first seven years of that period.On a regional scale,the BW and Ds zones experienced a wetting trend due to increased precipitation during 1961—2015,but the Df zone experienced a drying trend due to reduced evapotranspiration and an increasing temperature,particularly from 1961 to 1978.Thus,the spatio-temporal patterns in dryness and wetness across CA can be categorized according to climatic regions.展开更多
目的:目前脊髓损伤仍缺乏十分有效的治疗手段,细胞治疗可能是一种很有前景的治疗手段,其中人脐带间充质干细胞由于其具有易获取、低成本、伦理争议少和免疫原性低等优点受到广泛关注。但目前临床上并没有大范围使用人脐带间充质干细胞,...目的:目前脊髓损伤仍缺乏十分有效的治疗手段,细胞治疗可能是一种很有前景的治疗手段,其中人脐带间充质干细胞由于其具有易获取、低成本、伦理争议少和免疫原性低等优点受到广泛关注。但目前临床上并没有大范围使用人脐带间充质干细胞,对其有效性和安全性还有争议。文章使用Meta分析来评价人脐带间充质干细胞治疗脊髓损伤的有效性和安全性。方法:应用计算机检索英文数据库(PubMed、Web of Science、Cochrane、EMbase)和中文数据库(中国知网、万方医学网和维普数据库),搜集人脐带间充质干细胞治疗脊髓损伤的临床研究文献,检索时间为各数据库建库至2021年4月。由2位研究人员独立阅读纳入文献、提取资料和评价质量,随机对照试验使用改良Jadad评分量表对纳入文献进行评分,并使用Cochrane风险偏倚评估工具进行偏倚风险评估,队列研究采用NOS量表进行评价,使用RevMan 5.3软件进行Meta分析。结果:共纳入10篇文献,370例患者,包括6篇随机对照试验,4篇队列研究,文献总体质量较高。Meta分析结果显示:①人脐带间充质干细胞移植组的ASIA感觉功能评分(MD=5.20,95%CI:3.50-6.90,P<0.00001)、AIS分级改善率(RR=2.26,95%CI:1.40-3.65,P=0.0008)、日常生活能力评分(Barthel指数)(MD=5.12,95%CI:1.04-9.20,P=0.01)均高于对照组;②人脐带间充质干细胞移植组在ASIA运动功能评分(MD=3.48,95%CI:-0.14-7.10,P=0.06)、ASIA感觉功能评分中细化的针刺觉(MD=7.58,95%CI:-0.44-15.59,P=0.06)、轻触觉(MD=7.67,95%CI:-0.42-15.77,P=0.06)评分方面,与对照组相比差异无显著性意义;③敏感性分析结果显示,在人脐带间充质干细胞移植组ASIA运动功能评分高于对照组(MD=6.14,95%CI:4.46-7.81,P<0.00001),在日常生活能力评分方面,结论与之前保持一致。纳入的10篇文献中,均报道未有严重不良反应发生,但是个别病例存在轻微的不良反应,经对症治疗后均消�展开更多
The High Mountain Asia(HMA)region,ranging from the Hindu Kush and Tien Shan in thewest totheHimalaya inthe southwith an altitude between 2000 and 8844 m,holds the largest reservoir of glaciers and snow outside Earth P...The High Mountain Asia(HMA)region,ranging from the Hindu Kush and Tien Shan in thewest totheHimalaya inthe southwith an altitude between 2000 and 8844 m,holds the largest reservoir of glaciers and snow outside Earth Polar Regions.In the last decades,numerous glaciers and lake areas there have undergone tremendous changes with water redistribution.In order to increase understanding of the pattern of distribution of water resources,and their dynamic changes at the basin scale,a watershed classification based on the water replenishment patterns dataset was constructed.The input dataset are from the Randolph Glacier Inventory V.6.0 and the vector data of rivers and streams.Four datasets were thus obtained:Glacier-fed and Runoff-fed Drainage Area(GRDA),Glacier-fed and Runoff-free Drainage Area(GDA),Glacier-free and Runoff-fed Drainage Area(RDA),and the Glacier-free and Runoff-free Drainage Area(NGRDA),and the numbers of these four types of basins are 87,107,32,and 448 separately.The statistical results show GRDA has the largest surface area,accounting for 82.2%of the total basin area in HMA,mainly in the region of the basin with outflow rivers or streams.Dominated by small basins,the GDA area accounts for the smallest area,only 3.86%and the RDA accounts for 5.62%.For NGRDA,most are with small areas,accounting for 8.32%,and mainly distributes in the closed basin of the Qiangtang Plateau.This dataset provides a fundamental classified data source for research on water resources,climate,ecology,and environment in HMA.The published data are available at https://data.4tu.nl/download/uuid:d07d748f-d10b-4308-9626-199ef05cc9af/and http://www.dx.doi.org/10.11922/sciencedb.923.展开更多
Large-scale projects,such as the construction of railways and highways,usually cause an extensive Land Use Land Cover Change(LULCC).The China-Central Asia-West Asia Economic Corridor(CCAWAEC),one key large-scale proje...Large-scale projects,such as the construction of railways and highways,usually cause an extensive Land Use Land Cover Change(LULCC).The China-Central Asia-West Asia Economic Corridor(CCAWAEC),one key large-scale project of the Belt and Road Initiative(BRI),covers a region that is home to more than 1.6 billion people.Although numerous studies have been conducted on strategies and the economic potential of the Economic Corridor,reviewing LULCC mapping studies in this area has not been studied.This study provides a comprehensive review of the recent research progress and discusses the challenges in LULCC monitoring and driving factors identifying in the study area.The review will be helpful for the decision-making of sustainable development and construction in the Economic Corridor.To this end,350 peer-reviewed journal and conference papers,as well as book chapters were analyzed based on 17 attributes,such as main driving factors of LULCC,data collection methods,classification algorithms,and accuracy assessment methods.It was observed that:(1)rapid urbanization,industrialization,population growth,and climate change have been recognized as major causes of LULCC in the study area;(2)LULCC has,directly and indirectly,caused several environmental issues,such as biodiversity loss,air pollution,water pollution,desertification,and land degradation;(3)there is a lack of well-annotated national land use data in the region;(4)there is a lack of reliable training and reference datasets to accurately study the long-term LULCC in most parts of the study area;and(5)several technical issues still require more attention from the scientific community.Finally,several recommendations were proposed to address the identified issues.展开更多
Abdominal contour deformities pose an aesthetic challenge to patients with massive weight loss.This article reviews the similarities and differences in obesity between the Asian and Western populations.A comprehensive...Abdominal contour deformities pose an aesthetic challenge to patients with massive weight loss.This article reviews the similarities and differences in obesity between the Asian and Western populations.A comprehensive classification system combining the objective description of structural deformities with patients’discomfort or physical function is required to classify the abdominal contour deformities.The authors also proposed several controversial issues,including the classification of abdominal deformities,surgical techniques,and complications,providing an evidence-based review for selecting the appropriate surgical method for Asian patients to achieve satisfying clinical outcomes and avoid complications.展开更多
文摘目的:探讨胸腰段脊柱骨折合并急性创伤性脊髓损伤患者术后深静脉血栓的危险因素。方法:选取2018年7月~2020年9月于我院进行手术治疗的T11~L2骨折合并急性创伤性脊髓损伤(spinal cord injury,SCI)患者136例。收集患者的统计患者的年龄、性别、体重指数、既往病史等一般资料,检测并收集患者总胆固醇(total cholesterol,TC)、甘油三酯(triacylglycerol,TG)、低密度脂蛋白胆固醇(low density lipoprotein cholesterol,LDL-C)、高密度脂蛋白(high density lipoprotein cholesterol,HDL-C)等实验室指标。收集患者术前、术后6个月内的下肢静脉彩超,根据是否出现DVT分为DVT组(n=64)和非DVT组(n=72)。比较两组患者的一般资料,通过单因素分析及多因素Logistic回归分析确定急性创伤性SCI患者术后发生DVT的独立影响因素。通过Spearman法和Pearson法分析各影响因素间的相关性。根据独立影响因素建立并验证列线图模型。结果:单因素分析结果显示,DVT组和非DVT组的体重指数(27.03±2.12kg/m2和24.03±3.32kg/m2)、吸烟人数占比(39.06%和20.83%)、输血人数占比(45.31%和27.78%)、肿瘤病史人数占比(46.89%和23.61%)、出血量>600 mL人数占比(42.19%和22.22%)、ASIA分级A级人数占比(45.31%和18.06%)、肢体气压治疗及踝泵练习人数占比(18.75%和52.78%)、ASIA分级D级人数占比(14.06%和33.33%)、CRP(20.36±4.37和11.45±3.76)、FIB(6.49±1.31和4.51±1.26)以及D-二聚体(1.83±0.39和0.45±0.26)之间的差异均具有统计学意义(P<0.05)。多因素Logistic回归分析显示,输血、ASIA分级A级、FIB>5g/L、D-二聚体>1.6mg/L以及未进行肢体气压治疗及踝泵练习是急性创伤性SCI患者术后DVT的独立危险因素(P<0.05),相关性分析显示,输血、ASIA分级A级、FIB、D-二聚体以及未进行肢体气压治疗及踝泵练习均呈明显的正相关关系(P<0.05)。根据独立影响因素构建列线图预测模型,模型的ROC曲线下面积(area under curve,AU
基金the joint project "The Impact of the Transformation Process on Human-Environmental Interactions in Southern Kyrgyzstan" supported by the Volkswagen Foundation
文摘Vast grasslands are found in the walnut-fruit forest region of southern Kyrgyzstan,Middle Asia.Located above the worldwide unique walnutfruit forests and used for grazing,they play a pivotal role in the mixed mountain agriculture of local farmers.Accordingly,these pastures are subject to an increasing utilization pressure reflecting the changing political and social conditions in the transformation process from a Soviet republic to an independent state.A first detailed analysis of mountain pasture vegetation in the Ferghana Range answers the following questions:What are the main plant community types among Kyrgyzstan's mountain pastures? What are the main environmental gradients that shape their species composition? Which phytogeographical distribution types are predominant? How does grazing affect community composition and species richness in these grasslands? Species composition was classified by cluster analysis;underlying environmental gradients were explored using DCA.A dataset of 395 relevés was used for classification,and a subset of 79 relevés was used in a DCA to analyze the correlation between vegetation,environment,and grazing impact.The investigated pastures were classified into four distinctive plant communities.The site factors altitude,heat load,inclination and grazing impact were found to be the major determinants of the vegetation pattern.A significant overlap between floristic composition and structural and spatial properties was shown.The majority of the species pool consisted of Middle Asian endemics and Eurosiberian species.However,disturbance-tolerant species played a significant role with respect to species composition and coverage of the herbaceous layer in vast areas of southern Kyrgyzstan's mountain pastures.In general,an intense grazing impact is clearly reflected by both species composition and structural variables of plant communities.The highly diverse and unique ecosystem is modified by an increasing utilization pressure.In order to maintain vital processes and functioning of this
基金funded by National Key Research and Development Program of China(2018YFC1507101)National Natural Science Foundation of China(U1903113)+1 种基金China Desert Meteorological Science Research Foundation(SQJ2017012)Sichuan Science and Technology Program(2020JDJQ0050).
文摘Central Asia(CA)is one of the most drought-prone regions in the world with complex climate regimes,it is extremely vulnerable to water scarcity.Many studies on drought in CA,as a whole,have been carried out,whereas there is a lack of studies on the drying and wetting trends of different climatic zones within CA.In this study,CA was divided into three different climatic zones based on the Koppen climate classification method,precipitation climatology,and aridity index.These were the temperate continental(Df),dry arid desert(BW),and Mediterranean continental(Ds)climatic zones.The regional drying and wetting trends during the years 1961—2015 were investigated using the monthly gridded Standardized Precipitation Evapotranspiration Index(SPEI).The empirical orthogonal function(EOF)was applied to analyze spatial and temporal variation patterns.EOF mode 1(EOF1)analysis found increasingly wet conditions throughout CA over the duration of the study,and EOF mode 2(EOF2)analysis found a contrast between northern and southern CA:as Df became drier and BW and Ds became wetter.EOF mode 3(EOF3)analysis found a western and eastern inverse phase distribution.The SPEI displayed a decreasing trend from 1961 to 1974 for CA as a whole,before increasing from 1975 to 2015,with a particularly significant increase over the first seven years of that period.On a regional scale,the BW and Ds zones experienced a wetting trend due to increased precipitation during 1961—2015,but the Df zone experienced a drying trend due to reduced evapotranspiration and an increasing temperature,particularly from 1961 to 1978.Thus,the spatio-temporal patterns in dryness and wetness across CA can be categorized according to climatic regions.
文摘目的:目前脊髓损伤仍缺乏十分有效的治疗手段,细胞治疗可能是一种很有前景的治疗手段,其中人脐带间充质干细胞由于其具有易获取、低成本、伦理争议少和免疫原性低等优点受到广泛关注。但目前临床上并没有大范围使用人脐带间充质干细胞,对其有效性和安全性还有争议。文章使用Meta分析来评价人脐带间充质干细胞治疗脊髓损伤的有效性和安全性。方法:应用计算机检索英文数据库(PubMed、Web of Science、Cochrane、EMbase)和中文数据库(中国知网、万方医学网和维普数据库),搜集人脐带间充质干细胞治疗脊髓损伤的临床研究文献,检索时间为各数据库建库至2021年4月。由2位研究人员独立阅读纳入文献、提取资料和评价质量,随机对照试验使用改良Jadad评分量表对纳入文献进行评分,并使用Cochrane风险偏倚评估工具进行偏倚风险评估,队列研究采用NOS量表进行评价,使用RevMan 5.3软件进行Meta分析。结果:共纳入10篇文献,370例患者,包括6篇随机对照试验,4篇队列研究,文献总体质量较高。Meta分析结果显示:①人脐带间充质干细胞移植组的ASIA感觉功能评分(MD=5.20,95%CI:3.50-6.90,P<0.00001)、AIS分级改善率(RR=2.26,95%CI:1.40-3.65,P=0.0008)、日常生活能力评分(Barthel指数)(MD=5.12,95%CI:1.04-9.20,P=0.01)均高于对照组;②人脐带间充质干细胞移植组在ASIA运动功能评分(MD=3.48,95%CI:-0.14-7.10,P=0.06)、ASIA感觉功能评分中细化的针刺觉(MD=7.58,95%CI:-0.44-15.59,P=0.06)、轻触觉(MD=7.67,95%CI:-0.42-15.77,P=0.06)评分方面,与对照组相比差异无显著性意义;③敏感性分析结果显示,在人脐带间充质干细胞移植组ASIA运动功能评分高于对照组(MD=6.14,95%CI:4.46-7.81,P<0.00001),在日常生活能力评分方面,结论与之前保持一致。纳入的10篇文献中,均报道未有严重不良反应发生,但是个别病例存在轻微的不良反应,经对症治疗后均消�
基金This work was implemented in the Key Laboratory of Digital Earth Sciences,Chinese Academy of Sciences,and supported by the Strategic Priority Research Program of the Chinese Academy of Sciences[XDA19070201]the National Key Research and Development Program of China,MARIS Project[2017YFE0111700]the International Cooperation Program of the Chinese Academy of Sciences,[131211KYSB20150035].
文摘The High Mountain Asia(HMA)region,ranging from the Hindu Kush and Tien Shan in thewest totheHimalaya inthe southwith an altitude between 2000 and 8844 m,holds the largest reservoir of glaciers and snow outside Earth Polar Regions.In the last decades,numerous glaciers and lake areas there have undergone tremendous changes with water redistribution.In order to increase understanding of the pattern of distribution of water resources,and their dynamic changes at the basin scale,a watershed classification based on the water replenishment patterns dataset was constructed.The input dataset are from the Randolph Glacier Inventory V.6.0 and the vector data of rivers and streams.Four datasets were thus obtained:Glacier-fed and Runoff-fed Drainage Area(GRDA),Glacier-fed and Runoff-free Drainage Area(GDA),Glacier-free and Runoff-fed Drainage Area(RDA),and the Glacier-free and Runoff-free Drainage Area(NGRDA),and the numbers of these four types of basins are 87,107,32,and 448 separately.The statistical results show GRDA has the largest surface area,accounting for 82.2%of the total basin area in HMA,mainly in the region of the basin with outflow rivers or streams.Dominated by small basins,the GDA area accounts for the smallest area,only 3.86%and the RDA accounts for 5.62%.For NGRDA,most are with small areas,accounting for 8.32%,and mainly distributes in the closed basin of the Qiangtang Plateau.This dataset provides a fundamental classified data source for research on water resources,climate,ecology,and environment in HMA.The published data are available at https://data.4tu.nl/download/uuid:d07d748f-d10b-4308-9626-199ef05cc9af/and http://www.dx.doi.org/10.11922/sciencedb.923.
基金This research was jointly funded by the Strategic Priority Research Program of the Chinese Academy of Science(CAS)(XDA19030303)the National Natural Science Foundation of China(41631180,41701432,41571373)+1 种基金the Youth Innovation Promotion Association CAS(grant 2019365)the CAS-TWAS President’s Fellowship for International Doctoral Students.
文摘Large-scale projects,such as the construction of railways and highways,usually cause an extensive Land Use Land Cover Change(LULCC).The China-Central Asia-West Asia Economic Corridor(CCAWAEC),one key large-scale project of the Belt and Road Initiative(BRI),covers a region that is home to more than 1.6 billion people.Although numerous studies have been conducted on strategies and the economic potential of the Economic Corridor,reviewing LULCC mapping studies in this area has not been studied.This study provides a comprehensive review of the recent research progress and discusses the challenges in LULCC monitoring and driving factors identifying in the study area.The review will be helpful for the decision-making of sustainable development and construction in the Economic Corridor.To this end,350 peer-reviewed journal and conference papers,as well as book chapters were analyzed based on 17 attributes,such as main driving factors of LULCC,data collection methods,classification algorithms,and accuracy assessment methods.It was observed that:(1)rapid urbanization,industrialization,population growth,and climate change have been recognized as major causes of LULCC in the study area;(2)LULCC has,directly and indirectly,caused several environmental issues,such as biodiversity loss,air pollution,water pollution,desertification,and land degradation;(3)there is a lack of well-annotated national land use data in the region;(4)there is a lack of reliable training and reference datasets to accurately study the long-term LULCC in most parts of the study area;and(5)several technical issues still require more attention from the scientific community.Finally,several recommendations were proposed to address the identified issues.
基金grants from National Natural Science Foundation of China(81671923)National Natural Science Foundation of China(81971839).
文摘Abdominal contour deformities pose an aesthetic challenge to patients with massive weight loss.This article reviews the similarities and differences in obesity between the Asian and Western populations.A comprehensive classification system combining the objective description of structural deformities with patients’discomfort or physical function is required to classify the abdominal contour deformities.The authors also proposed several controversial issues,including the classification of abdominal deformities,surgical techniques,and complications,providing an evidence-based review for selecting the appropriate surgical method for Asian patients to achieve satisfying clinical outcomes and avoid complications.
