[The meaning and indication of "Rou Ji"].

"Rou Ji", as a name of disease syndrome, played an important role with its relevant theories and clinical experiences in historical recordings. However, it was treasured neither in modern archives nor by clinical physicians. The concept of "Rou Ji" started in the Spring and Autumn Period and the Warring States Period (770 B.C. - 221 B.C.), and its name was first found in Shan Fan Fang in the Southern and Northern Dynasties (420-589). The symptoms of this disease mainly suggested weakness of limbs caused by exogenous factors. It was gradually developed into following symptoms, such like emaciation or muscle atrophy, fatigue, skin color change, abnormal skin sensation, poor digestion and absorption function of spleen and stomach. Its etiology was changed from exogenous factors into internal injuries and deficiency of congenital Qi. Its treatment was also changed with the change of the understanding of diseases. The dialectical thinking in its treatment in ancient medical materials may have reference value for current clinical diagnosis and treatment.

[A case of cerebral infarction after deep burn tangential excision and skin grafting].

A female patient aged 42 years with deep burn on right lower limb was admitted to Affiliated Hospital of Jining Medical University on January 25, 2019. The patient previously had cerebral infarction, hypertension, and hysteria, with long-term use of aspirin and risperidone. After admission, the patient underwent tangential excision twice. On the third day after the second tangential excision and skin grafting, the muscle strength of the right limb gradually decreased, and the patient was treated with emergency craniocerebral magnetic resonance imaging, which suggested acute cerebral infarction. Improvement of cerebral circulation and vasodilatation were given immediately. The limb muscle strength of the patient gradually recovered on the fifth day after the operation, and no sequela was left when the patient was discharged. After the case was discussed, we think that postoperative decreased blood volume and blood concentration resulting from tangential excision bleeding of deep burn and wound exudate as well as inadequate fluid infusion are the main causes of hemodynamic change, the patient had the basis of multiple cerebral artery stenosis, and superposition of multiple factors led to the occurrence of postoperative acute cerebral infarction. Appropriate increase in the fluid infusion volume during and after surgery and transfusion if necessary to increase blood and oxygen supply to the brain can reduce the occurrence of cerebral infarction.

Eastern Pacific tropical cyclones intensified by El Niño delivery of subsurface ocean heat.

The El Niño Southern Oscillation (ENSO) creates strong variations in sea surface temperature in the eastern equatorial Pacific, leading to major climatic and societal impacts. In particular, ENSO influences the yearly variations of tropical cyclone (TC) activities in both the Pacific and Atlantic basins through atmospheric dynamical factors such as vertical wind shear and stability. Until recently, however, the direct ocean thermal control of ENSO on TCs has not been taken into consideration because of an apparent mismatch in both timing and location: ENSO peaks in winter and its surface warming occurs mostly along the Equator, a region without TC activity. Here we show that El Niño--the warm phase of an ENSO cycle--effectively discharges heat into the eastern North Pacific basin two to three seasons after its wintertime peak, leading to intensified TCs. This basin is characterized by abundant TC activity and is the second most active TC region in the world. As a result of the time involved in ocean transport, El Niño's equatorial subsurface 'heat reservoir', built up in boreal winter, appears in the eastern North Pacific several months later during peak TC season (boreal summer and autumn). By means of this delayed ocean transport mechanism, ENSO provides an additional heat supply favourable for the formation of strong hurricanes. This thermal control on intense TC variability has significant implications for seasonal predictions and long-term projections of TC activity over the eastern North Pacific.

El Nino on the Devil's Staircase: Annual Subharmonic Steps to Chaos.

The source of irregularity in El Niño, the large interannual climate variation of the Pacific ocean-atmosphere system, has remained elusive. Results from an El Niño model exhibit transition to chaos through a series of frequency-locked steps created by nonlinear resonance with the Earth's annual cycle. The overlapping of these resonances leads to the chaotic behavior. This transition scenario explains a number of climate model results and produces spectral characteristics consistent with currently available data.