ABSTRACT
During atmospheric precipitation, the evaporation of raindrops falling from the bottom of cloud layer to the ground and passing through unsaturated air, a process was called sub-cloud secondary evaporation, which will change the isotopic composition of precipitation. Using the hydrogen and oxygen stable isotope method to understand the temporal and spatial variation of secondary evaporation effect under clouds and its causes is important to understand regional water cycle process. Based on hourly meteorological data of 187 meteorological stations in Shaanxi-Gansu-Ningxia region from March 2018 to February 2019, the spatial and temporal variations of evaporation surplus ratio (f) and precipitation excess deuterium variation (Δd) were analyzed using the improved Ste-wart model, and the relationships between f and meteorological elements and Δd were examined. The results showed that, at the hourly scale, the minimum values of f and Δd in all provinces of the region appeared in the daytime, and the maximum values appeared in the night, indicating that the secondary evaporation effect under the cloud was more obvious in the daytime. At the monthly scale, the monthly variation trend of f and Δd in each province was relatively consistent, with the minimum value appearing in the summer half year, and the maximum value appearing in the winter half year, indicating that the second evaporation effect under cloud was more significant in the summer half year. From the spatial perspective, the spatial variation of f and Δd values in the region was consistent with that at the seasonal scale. In spring, the eastern and western regions were larger while the central part was smaller. In summer, the northwest region was smaller, and other regions were larger. In autumn, it decreased from south to north. In winter, the central and southern regions were smaller, and the western and northeast regions were larger. The spatial differences of secondary evaporation effects under clouds in different seasons was significant. The slopes of the linear relationship between f and Δd in Shaanxi, Gansu and Ningxia provinces were all less than 1·%-1, which may be caused by the arid and semi-arid climate in this area. When air temperature was higher and the relative humidity, vapor pressure, precipitation and raindrop diameter were smaller, the value of Δd was smaller, and the secondary evaporation effect under the cloud was more obvious.
Subject(s)
Environmental Monitoring , Rain , China , Oxygen Isotopes/analysis , SeasonsABSTRACT
Coronavirus disease 2019 (COVID-19) is a novel and lethal infectious disease, posing a threat to global health security. The number of cases has increased rapidly, but no data concerning kidney transplant (KTx) recipients infected with COVID-19 are available. To present the epidemiological, clinical, and therapeutic characteristics of KTx recipients infected with COVID-19, we report on a case series of five patients who were confirmed as having COVID-19 through nucleic acid testing (NAT) from January 1, 2020 to February 28, 2020. The most common symptoms on admission to hospital were fever (five patients, 100%), cough (five patients, 100%), myalgia or fatigue (three patients, 60%), and sputum production (three patients, 60%); serum creatinine or urea nitrogen levels were slightly higher than those before symptom onset. Four patients received a reduced dose of maintenance immunosuppressive therapy during hospitalization. As of March 4, 2020 NAT was negative for COVID-19 in three patients twice in succession, and their computed tomography scans showed improved images. Although greater patient numbers and long-term follow-up data are needed, our series demonstrates that mild COVID-19 infection in KTx recipients can be managed using symptomatic support therapy combined with adjusted maintenance immunosuppressive therapy.
Subject(s)
Betacoronavirus/isolation & purification , Clinical Laboratory Techniques , Coronavirus Infections/diagnosis , Immunosuppressive Agents/adverse effects , Kidney Transplantation/adverse effects , Opportunistic Infections/diagnosis , Pneumonia, Viral/diagnosis , Transplant Recipients , Adult , Betacoronavirus/genetics , Betacoronavirus/immunology , COVID-19 , COVID-19 Testing , China , Coronavirus Infections/therapy , Coronavirus Infections/virology , Female , Humans , Immunocompromised Host , Immunosuppressive Agents/administration & dosage , Male , Middle Aged , Opportunistic Infections/therapy , Opportunistic Infections/virology , Pandemics , Pneumonia, Viral/therapy , Pneumonia, Viral/virology , Predictive Value of Tests , SARS-CoV-2 , Severity of Illness Index , Time Factors , Treatment OutcomeABSTRACT
<p><b>OBJECTIVE</b>To investigate the effects of health education based on integrative therapy of Chinese and Western medicine for type 2 diabetes mellitus (T2DM) from the aspects of knowledge, attitude and practice (KAP), health-related quality of life (HRQoL), body mass index (BMI) and glucose control.</p><p><b>METHODS</b>Patients were individually randomized into intervention group (receiving integrative education, n=120) and control group (receiving usual education, n=120). The primary outcome was the changes in glycosylated hemoglobin A1c (HbA1c) levels after 3, 6, 9 and 12 months from baseline. Hierarchical linear models (HLMs) were used to assess within-group changes in outcomes over time and between-group differences in patterns of change. Secondary outcomes were KAP scores, HRQoL scores and BMI after 6 and 12 months, paired-sample t test was used to assess within-group changes in outcomes in 6 and 12 months, independent-sample t test was used to assess between-group differences in patterns of change.</p><p><b>RESULTS</b>HbA1c decreased statistically from baseline to 3 months, from 3 to 6 months, from 6 to 9 months and from 9 to 12 months in the intervention group (all P<0.01); and decreased significantly from baseline to 3 months, and from 3 to 6 months in the control group P<0.01). There was a significant between-group difference from baseline to 3 months (P=0.044), from 6 to 9 months (P<0.01) and from 9 to 12 months (P<0.01). Significant improvements in the intervention group along with significant between-group differences were found in KAP and HRQoL scores respectively (all P<0.05). The number in the intervention group of normal weight increased from 56 at baseline to 81 (6 months), 94 (12 months), the number in the control group were 63 (baseline), 69 (6 months), 70 (12 months), the χof hierarchical analysis of BMI were 6.93 (P=0.075), 10.31 (P=0.016), 15.53 (P<0.01), respectively.</p><p><b>CONCLUSION</b>Health education based on integrative therapy of Chinese and Western medicine is beneficial to the control of T2DM and should be recommended for T2DM.</p>
