[Change and Prediction of Water Purification Function in the South Bank of Hangzhou Bay in the Past 20 Years].

The investigation of regional water purification functionality and its influencing factors holds significant pragmatic implications in understanding the potential of regional water purification, guiding context-specific regional comprehensive planning schemes, and environmental conservation measures. The study site, situated along the southern coast of Hangzhou Bay, represents a prototypical region characterized by intricate land-sea interactions that bear substantial economic and ecological functions. By assimilating a meticulously collected topographical and land-use dataset, in conjunction with site-specific meteorological records, the water purification model embedded within the integrated valuation of ecosystem services and trade-offs (InVEST) framework was employed to scrutinize the spatiotemporal dynamics of nitrogen (N) and phosphorus (P) loads, discharges, and removals within the southern coast of Hangzhou Bay. The prime objective of this study was to unravel the differentials in water purification functionality under diverse developmental scenarios. The investigation unearthed distinct temporal discrepancies in N and P discharges and removals over two temporal dimensions. Relative to the benchmark year 2000, the total N load experienced a reduction of 276.72 t, whereas the N discharge and removals decreased by 140.86 and 137.86 t, respectively, in the year 2020. In contrast, the total P load observed an increase of 93.65 t, accompanied by a surge in P discharge and removals by 28.91 and 64.74 t, respectively. Spatially, the distribution pattern of N and P discharges exhibited a general inclination of elevated values in the northern region and subdued values in the southern region, with certain pockets in the southern region exhibiting pronounced peaks, intimately associated with land-use typologies. Simulation analyses conducted under distinct scenarios unveiled that under the natural development priority scenario, the N and P discharges within the study area amounted to 1 682.36 and 115.50 t, respectively. Conversely, under the scenario emphasizing economic development, the regional N and P discharges showed an approximate escalation of 83.02% and 79.93%, correspondingly. In contrast, under the scenario emphasizing environmental conservation, the regional N and P discharges exhibited a notable decline of approximately 79.96% and 56.44%, respectively. Hence, the scenario prioritizing the amalgamation of environmental conservation and development effectively reduced the N and P discharges within the region, bolstering the water purification functionality. The results derived from this study furnish a solid theoretical foundation for effectuating region-specific planning schemes fostering coordinated economic and ecological advancement within the study area.

Spatial Responses of Ecosystem Service Trade-offs and Synergies to Impact Factors in Liaoning Province.

Global ecosystem services (ESs) are experiencing a significant decline, necessitating the development of robust environmental governance policies. To address the lack of integrated planning with heavy industry as the research object and a lack of knowledge of ES trade-offs and synergies in China's ecological and environmental governance. In this study, the spatial and temporal variations of four ESs (water yield (WY), soil conservation (SC), carbon storage (CS), and habitat quality (HQ)) were determined in the study area of Liaoning Province. Explore the mechanisms that shape ecosystem service trade-offs and synergies and the factors that influence them. Spearman's correlation and difference analyses were proposed to determine the spatial and temporal distributions of trade-offs and synergistic relationships among ESs. In addition, we constructed a multiscale geo-weighted regression (MGWR) model to investigate driver spatial heterogeneity affecting trade-offs and synergies. The results revealed that (1) In the study area, ESs were on the rise in Liaoning Province. (2) Temporally, ESs were overwhelmingly dominated by synergies; at the spatial scale, ESs were dominated by trade-offs of varying degrees, with the area of synergy between WY and SC being the highest. (3) ESs demonstrated spatial heterogeneity in intensity and were more impacted by natural factors such as vegetation cover, elevation, and precipitation than by characteristics related to human activity. This study helps improve understanding of the interactions and dependencies among ESs and can provide a reference for ecological governance and improvements in Liaoning Province.

Extrapontine myelinolysis caused by rapid correction of pituitrin-induced severe hyponatremia: A case report.

BACKGROUND: Severe hyponatremia is considered a rare complication of pituitrin, which is widely used for the treatment of pulmonary hemorrhage. However, the management of pituitrin-associated hyponatremia can be challenging because a rapid correction of hyponatremia may cause the development of osmotic demyelination syndrome, resulting in life-threatening neurological injuries. CASE SUMMARY: A 20-year-old Chinese man with massive hemoptysis developed symptomatic hyponatremia (116 mmol/L) after therapy by a continuous intravenous drip of pituitrin. To normalize his serum sodium, a hypertonic saline infusion was applied for 3 d, and the pituitrin administration was stopped concurrently. Then, an overly rapid increase in serum sodium level (18 mmol/L in 24 h) was detected after treatment. One day later, the patient experienced a sudden onset of generalized tonic-clonic seizures, as well as subsequent dysarthria and dystonia. Magnetic resonance imaging revealed increased signal intensity in the bilateral symmetric basal ganglia on the T2-weighted images, compatible with a diagnosis of extrapontine myelinolysis. The patient received an intravenous administration of high-dose corticosteroids, rehabilitation, and neurotrophic therapy. Finally, his clinical abnormalities were vastly improved, and he was discharged with few residual symptoms. CONCLUSION: Physicians should be fully aware that pituitrin can cause profound hyponatremia and its correction must be performed at a controlled rate to prevent the development of osmotic demyelination syndrome.

Comparison of autogenous tendon reconstruction with coracoclavicular ligament combined with hook plate and simple hook plate fixation in the treatment of acromioclavicular joint dislocation / 中国组织工程研究

BACKGROUND: Hook plate is usual and satisfactory for the treatment of acromioclavicular joint dislocation, but there are still many problems. The comparative analysis is seldom reported between reconstruction of coracoclavicular ligament by autogenous tendon combined with hook plate and simple hook plate. OBJECTIVE: To compare the clinical efficacy of reconstruction of coracoclavicular ligament combined with hook plate and simple hook plate fixation for acromioclavicular joint dislocation. METHODS: A total of 38 patients with acromioclavicular dislocation were randomly divided into two groups. The patients were treated with plantar tendon "V" reconstruction with coracoclavicular ligament combined with hook plate fixation (combination group) and with a simple hook plate fixation (simple hook plate group). We compared the operation time, blood loss, hospitalization days, average hospitalization costs, the time taken for internal fixation, the motion range of shoulder joint at postoperative 12 months, the Constant-Murley function score, the reduction of shoulder joint and the Visual Analogue Scale scores between the two groups. RESULTS AND CONCLUSION: (1) Patients in both groups were followed up for 12 months. In the combination group, the hook plate was removed at postoperative 3 months. In the simple hook plate group, the hook plate was removed at approximately postoperative 12 months. In follow-up, no dislocation appeared in both groups. (2) No significant difference in hospitalization days, motion range of shoulder joint, Constant-Murley function score, the reduction of shoulder joint and the Visual Analogue Scale scores was determined between the two groups (P > 0.05). (3) Operation time was longer; blood loss was more; and average hospitalization costs were higher in the combination group than in the simple hook plate group (P < 0.05). (4) These findings indicate that plantar tendon reconstruction of coracoclavicular ligament combined with hook plate meets biomechanical requirements in the treatment of acromioclavicular joint dislocation. The plate can be removed early using a fixator. The lower extremity has an incision, but the follow-up results are satisfactory. Simple hook plate fixation for acromioclavicular joint dislocation takes a long time, and can obtain average effect, but there is the risk of re-dislocation (this case does not experience re-dislocation). The appropriate treatment can be chosen according to the patient's condition, needs, and economic conditions.

Lefty A protein inhibits TGF-ß1-mediated apoptosis in human renal tubular epithelial cells.

This study aimed to examine the effects of Lefty A protein on transforming growth factor-ß1 (TGF-ß1)-mediated apoptosis in human renal tubular epithelial cells (HK-2). HK-2 cells were transfected with the human Lefty gene to induce the secretion of endogenous Lefty A protein. Following exposure of the HK-2 cells to recombinant human TGF-ß1 (10 ng/ml), p-Smad2/3 protein levels were examined by western blot analysis, and cellular apoptosis was detected by flow cytometry 6, 12, 24 and 48 h following TGF-ß1 treatment. Coculture of renal tubular epithelial cells with TGF-ß1 resulted in a significant increase in p-Smad2/3 protein levels and the rate of cell apoptosis, which were attenuated by liposome-mediated transfection with the Lefty gene. Lefty A protein was able to inhibit the TGF-ß1/Smad signaling pathway and markedly attenuate TGF-ß1-mediated apoptosis in human renal tubular epithelial cells. Taken together, these results indicated that the TGF-ß1/Smad signaling pathway most likely mediates apoptosis in renal tubular epithelial cells. In addition, Lefty A protein is capable of inhibiting the TGF-ß1/Smad pathway to reduce TGF-ß1/Smad-mediated apoptosis in renal tubular epithelial cells. This study may provide novel insights into the prevention and treatment of urinary tract obstruction disease using Lefty A protein.

Meningoencephalitis as an initial manifestation of neuromyelitis optica spectrum disorder.

Two patients presented with initial symptoms of headache and fever, and two weeks later had disturbance of consciousness. Cerebrospinal fluid (CSF) showed pleocytosis >500×10²/L. Magnetic resonance imaging (MRI) showed multiple brain lesions at sites of high aquaporin-4 (AQP-4) expression. Case 1 presented optic neuritis four years after the first attack and case 2 had symptoms of myelitis three weeks after headache. Serum AQP-4 antibody was positive in both cases, and the diagnosis of neuromyelitis optica spectrum disorder (NMOSD) was made. Accordingly, NMOSD can initially present as meningoencephalitis mimicking intracranial infection, and the characteristic MRI imaging is quite critical for differentiation.

Case-control study on percutaneous compressing plating and proximal femoral nail antirotation in treating in tertrochanteric fracture with risk external wall / 中国骨伤

<p><b>OBJECTIVE</b>To compare clinical effects between percutaneous compressing plating (PCCP) and proximal femoral nail antirotation (PFNA) for the treatment of patients with intertrochanteric fracture with risk external wall.</p><p><b>METHODS</b>From September 2007 to June 2010, 43 patients with intertrochanteric fracture with risk external wall were treated by PCCP or PFNA according to different kinds of internal fixations. There were 22 cases in PCCP, including 9 males and 13 females with an average age of 68.4 (ranged, 60 to 86) years old, and 13 cases with type A2.2 and 9 cases with type A2.3; while 21 cases in PFNA, including 7 males and 14 females with an average age of 67.7 (ranged, 57 to 93) years old, and 10 cases with type A2.2 and 11 cases with type A2.3. Blood loss, operation time, hospital stay, fracture healing time, complications and Harris score after 1 years' following-up were observed and compared.</p><p><b>RESULTS</b>All patients were followed up for 12 to 22 (means 18.4) months, and all patients were obtained fracture healing, and recovered walking ability as before injury. There were no significant differences in blood loss, operation time, hospital stay, fracture healing time, complications and Harris score after 1 years' following-up (P>0.05). One case occurred displacement on the top of greater trochanter, and 1 case injuried weakness of hip abduction. One case occurred screw breakage in PCCP, while 1 case occurred hip joint pain in PFNA.</p><p><b>CONCLUSION</b>Both of PCCP and PFNA in treating patients with intertrochanteric fracture with risk external wall can receive good clinical effects, while the effects and therapy strategy for displacement of bone on the top of lateral wall should further study.</p>

Treatment of refractory sinus in the lower leg with modified VSD technique / 中国骨伤

<p><b>OBJECTIVE</b>To investigate the effects of modified vacuum sealing drainage (VSD) technique in treating refractory sinus in the lower leg.</p><p><b>METHODS</b>From January 2010 to December 2011, 11 patients with refractory sinus in the lower leg, including 7 males and 4 females, with an average age of 34.5 years (ranged,23 to 56). These patients were treated with modified VSD technique after thorough cleaning sinus and continuous washing. After 14 to 21 days of treatment, removed VSD and re-debrided the sinus and sutured wound.</p><p><b>RESULTS</b>Infections got control after operation, sinus in the lower leg healed. All patients were followed up from 6 to 14 months with an average of 10 months, no recidivations were found.</p><p><b>CONCLUSION</b>Modified VSD technique is an effective method in the treatment of stubborn sinus in the lower leg.</p>

Pure word deafness associated with extrapontine myelinolysis.

Extrapontine myelinolysis and pure word deafness are very uncommon disorders. Here, we report a case of a 19-year-old woman who suffered from osmotic demyelination syndrome with coincidence of typical pure word deafness. As a consequence of rapid correction of hyponatremia, the patient demonstrated an initial onset of cortical deafness, and then progressed to generalized auditory agnosia, which eventually developed into confined verbal auditory agnosia (pure word deafness). Bilateral extrapontine myelinolysis was confirmed using brain magnetic resonance imaging. This case suggests that verbal and nonverbal stimuli may involve separate thalamocortical pathways.

Determinants of lexical access in pure-anomic recovery: a longitudinal study.

Many studies involving lexical access in picture-naming tasks have been undertaken at a point in time, mainly focusing on age of acquisition (AoA). To identify the real determinates of lexical access in recovery and their traces in the brain, we carried out a longitudinal study on a Chinese pure anomic patient using multiple logistic regression analysis. We found that AoA played an important role in early recovery but not in total recovery, whereas familiarity was significant in the whole process. From a new dynamic point of view, our results indicate that AoA and familiarity are the main determinants of lexical access in anomia recovery. We suggest that the changing effects of AoA during recovery may be related to the pathologic process; AoA and familiarity should be taken into account in constructing materials to assess and treat anomic patients.

Clinical application of free upper limb lateral bone-skin flap in hand surgery field / 中华显微外科杂志

Objective To report the surgical method and treatment outecome of transfer of free upper limb lateral bone-skin flap for repair of bone defects and nonunion in hand and forearm.Methods 17 cases of hand composite trauma,5 cases of forearm composite trauma and 2 cases of nonunion in forearm were treated with free bone-skin flaps in distal humerus,whose pedicle was the posterior branch of radical collateral artery. Area of the flap was 2cm?3cm to 8cm?10cm,length of exseeted bone was 3～6 cm.Results All the bone-skin flaps completely survived,the donor area all achieved primary healing,On postoperative 1～4 years follow-up,the texture of the flap was excellent,and bone union was obtained in all transplants,the donor area of distal lateral humerus became thicker and thicker with new cortical bones formed.According to the upper arm function assessment criterion issued by hand surgery association of Chinese medical association.The hand function had excellent results in 17 cases and good results in 2 cases.Conclusion The bone-skin flap has following advantages:easy dissection,reliable blood supply,and no major vessel needed to be sacrificed,so it is an effective method for repair of skin and soft tissue with bone defects in hand and forearm,It.also can be used to repair refractory nonunion in ulna and radius.