Anomalous stable hydrogen-oxygen isotope characteristics and water vapor sources of autumn precipitation in the Weihe River basin, Northwest China.

The extreme changes in autumn rain have significant impacts on the ecological environment of Weihe River basin. Based on 117 autumn rain samples and corresponding meteorological data from 2015 to 2021 at Yangling located in the middle of Weihe River basin, we investigated the stable hydrogen and oxygen isotope composition and water vapor sources of precipitation. The results showed that, (1) extreme changes in autumn rainfall in the study area occurred frequently in recent years, which could be divided into extreme-high autumn precipitation year (HAP, 2021), general autumn precipitation year (GAP, 2015-2017, 2019-2020) and extreme-low autumn precipitation year (LAP, 2018) based on the autumn rain index (ARI); (2) the stable isotopes of different types of precipitation differed significantly, with a pattern of LAP>GAP>HAP for both δ2H and δ18O values. the variations of d-excess values and the slopes and intercepts of the meteoric water lines of autumn rain showed opposite trends. The main factor controlling autumn rain anomaly was not the local meteorological parameters, but the El Nino-Southern Oscillation and the Indian Ocean dipole events, which could explain 99% and 93% of the autumn rain isotopic variations, respectively. These coupling phenomena affected water vapor transport intensity of the marine air mass to the northwest inland, which determined autumn rainfall amount and the stable hydrogen-oxygen isotope composition. Our results would be helpful for improving the understanding of autumn rain anomalies in West China, and provide basic data and theoretical support for regional hydrological model building, would thereby better serve water resources management and disaster prevention and reduction.

Study of an Ultrasensitive Label-Free Electrochemiluminescent Immunosensor Fabricated with a Composite Electrode for Detecting the Glutamate Decarboxylase Antibody.

Antibody testing for the glutamic acid decarboxylase 65 antibody (GADA) is widely used as a golden standard for autoimmune diabetes diagnosis, while current methods for antibody testing are not sensitive enough for clinical usage. Here, a label-free electrochemiluminescent (ECL) immunosensor for detecting GADA in autoimmune diabetes is fabricated and investigated. In the designed immunosensor, a composite film including the multiwalled carbon nanotubes (MWCNTs), zinc oxide (ZnO), and Au nanoparticles (AuNPs) was prepared through nanofabrication processes to improve the performance of sensor. The MWCNTs, which can provide a larger specific surface area, ZnO as a good photocatalytic material, and AuNPs that can enhance the ECL signal of luminol and immobilize the GAD65 antigen were applied to prefunctionalize indium tin oxide (ITO) glass based on a nanofabrication process. The GADA concentration was detected using the ECL immunosensor after incubating with GAD65 antigen-coated prefunctionalized ITO glass. After a direct immunoreaction, it is found that the degree of decreased ECL intensity has a good linear regression toward the logarithm of the GADA concentration in the range of 0.01 to 50 ng mL-1 with a detection limit down to 10 pg mL-1. Human serum samples positive or negative for GADA all nicely fell in the expected area. The fabricated immunosensor with excellent sensitivity, specificity, and stability has potential capability for clinical usage in GADA detection.

Comparison of meteoric water lines at different temporal scales and regression methods in inland monsoon region, Northwest China.

The local meteoric water line (LMWL) is an important basis for tracing the regional hydrological processes with stable isotopes. The establishment of LMWL, which can represent the overall characteristics of stable isotopes of local precipitation, is crucial for accurately revealing the hydrological processes. The influences of different temporal scales and regression methods on the established LMWL were analyzed and compared based on nine years of stable isotopic data of precipitation in Changwu Tableland, a typical area of the inland monsoon region of Northwest China. The results showed that, for different regression methods, the LMWL established by stable isotopes of annual precipitation was basically stable, whereas the LWML established by each precipitation event and the monthly precipitation data showed significant differences with different regression methods. The LMWL from the ordinary least squares regression (OLSR), major axis regression (MA) and reduced major axis regression (RMA) methods were significantly different based on the data of precipitation event, monthly precipitation data, and annual precipitation data, respectively. Only when OLSR, MA and RMA considering precipitation weighting were used, the LMWL established by these scale data was relatively close. This suggested that special attention should be paid to the selection of precipitation stable isotope data scale and regression method when LMWL was established in areas with temporal heterogeneity of precipitation and stable isotopic characteristics. For regions where stable isotope observations of precipitation were difficult and data were limited, the precipitation weighted major axis regression or reduced major axis regression methods are recommended during the establishment of representative LMWL.

[Effect of transcutaneous electrical acupoint stimulation combined with auricular acupressure on sexual hormone level and gonadal development in girls with precocious puberty].

OBJECTIVE: To explore the effect of transcutaneous electrical acupoint stimulation (TEAS) combined with auricular acupressure on serum sexual hormone level, and the ovarian, follicular and uterine development in the girls with precocious puberty. METHODS: Sixty girls with precocious puberty were randomly divided into a control group (30 cases, 2 cases dropped off) and a treatment group (30 cases, 3 cases dropped off). In both the control group and the treatment group, the healthy life-style intervention was provided for 12 weeks. Besides, in the treatment group, TEAS was delivered for 20 minutes each time, twice a week; and bilateral auricular acupressure was combined. The duration of treatment was 12 weeks. The levels of serum luteinizing hormone (LH), follicle stimulating hormone (FSH) and estradiol (E2), as well as ovarian volume, maximum follicular diameter and uterine volume before and after treatment were detected, and the safety was evaluated separately. RESULTS: Compared with before treatment, the contents of serum LH and FSH were increased (P<0.05), and the ovarian volume and the maximum follicle diameter were increased (P<0.05) in the control group after treatment; the contents of serum FSH and E2 were decresed (P<0.05), and the maximum follicular diameter was reduced significantly (P<0.05) in the treatment group after treatment. Compared with the control group, the contents of serum LH, FSH and E2 were decreased (P<0.05), while the ovarian volume and the maximum follicle diameter were decreased (P<0.05) in the treatment group after treatment. CONCLUSION: TEAS combined with auricular acupressure can effectively decrease the level of sex hormone, improve the ovarian and uterine development and retard the gonadal development. Such combined therapy is of high safety and conductive to regulating the development for the girls with precocious puberty.

[Analysis of Hydrogen and Oxygen Stable Isotope Characteristics and Vapor Sources of Precipitation in the Guanzhong Plain].

To improve the understanding of hydrogen and oxygen stable isotope characteristics and vapor sources in the Guanzhong Plain, we collected 98 precipitation samples and corresponding meteorological data between 2015 and 2018 in Yangling, Shanxi Province, which is located in the central area of the Guanzhong Plain. The composition characteristics of the local hydrogen and oxygen stable isotopes of precipitation (δ2H, δ18O, and δ17O) and their environmental controls were analyzed, and the local meteoric water line (LMWL) and the meteoric water line of the triple oxygen isotopes were established. Three indicators (δ18O, d-excess, and 17O-excess) were used to explore the possible vapor sources of local precipitation and to quantify the contributions of ocean-source and inland-source water vapor to the precipitation. The results showed that there were obvious seasonal changes in the hydrogen and oxygen stable isotopes of precipitation in the Yangling area:water isotopes were depleted in the wet season (May to October) and enriched in the dry season (November to April of the next year). Both the slope (7.7) and intercept (9.1) of the LMWL were lower than those of the global meteoric water line (GMWL), indicating that the annual precipitation in the research area experienced variable degrees of secondary evaporation under cloud cover. The slope of the meteoric water line of the triple oxygen isotopes is 0.528, which is between that of seawater equilibrium fractionation (0.529) and water vapor diffusion into dry air (0.518), consistent with the fact that the Guanzhong area is located on the migration path of marine air mass to inland arid regions. Comprehensive analysis of δ18O, d-excess, and 17O-excess confirmed that the precipitation in the study area is jointly contributed to by the warm and humid air mass from the southeast monsoon and the dry and cold air mass from the westerly wind. Of these, approximately 55%-79% of the precipitation water vapor comes from the ocean, mainly in June to August, and about 21%-45% of the water vapor comes from inland and local evaporation, mainly from October to April. The water vapor sources of precipitation in May and September are complex and may intermittently originate from ocean and inland water vapor.

Effect of two intensive insulin therapy regimens on perioperative glycemic control in bone fracture patients with type 2 diabetes mellitus.

BACKGROUND: Currently, there are no uniform standards and methods for perioperative glycemic control in bone fracture patients with Type 2 diabetes mellitus (T2DM). We retrospectively analyzed the efficacy and safety of two intensive insulin therapy regimens administered to bone fracture patients with T2DM in the perioperative period, to explore the best method of achieving perioperative glycemic control. METHODS: A number of 159 bone fracture patients with T2DM were divided into two groups. One group (n = 81) received multiple subcutaneous insulin injections (MSII group) and the other (n = 78) received continuous subcutaneous insulin infusion (CSII group). Blood glucose (BG) levels, time to achieve glycemic target, insulin dosage, and the incidence of hypoglycemia and complications were compared between groups. RESULTS: Both regimens reduced BG to desired levels before surgery. The time to reach glycemic target in CSII group (2.5 days) was significantly shorter than that in the MSII group (7.3 days; P < 0.001). Mean insulin dosage in the CSII group (0.66 IU×kg(-1)×d(-1)) was significantly lower than that in the MSII group (0.74 IU×kg(-1)×d(-1); P = 0.005), as were the incidences of hypoglycemia (15.4% vs 32.1%) and infection (6.4% vs. 23.5%). Multiple regression analysis showed that the time to reach glycemia target was associated with the insulin therapy regimen and dosage. The insulin dosage on reaching glycemia target was positively associated with body mass index (BMI), diabetes mellitus course, glycated hemoglobin A1c (HbA1c), and ß-hydroxybutyric acid, and was negatively associated with age. CONCLUSION: The efficacy and safety of CSII was superior to that achieved with MSII, suggesting that CSII should be considered as initial therapy to control perioperative BG in bone fracture patients with T2DM.

Overexpression of TOB1 confers radioprotection to bronchial epithelial cells through the MAPK/ERK pathway.

The aim of this study was to investigate the effects and mechanisms of antiproliferative transducer of erbB2, 1 (TOB1) on the radiosensitivity of the normal human bronchial epithelial cell line HBE. After exposure to different doses of irradiation or a certain dose for different time intervals, the expression of TOB1 mRNA and protein in HBE cells was determined by semi-quantitative RT-PCR and western blot analysis. Liposome-induced recombinant plasmid transfection and G418 selection were performed to establish a stably transfected TOB1-overexpressing HBE cell line. A clonogenic assay was used to determine the radiosensitivity of the HBE cells with different TOB1 expression statuses. The cell cycle distribution was detected by flow cytometry. The ionizing radiation (IR)-induced γ-H2AX foci formation was detected by immunofluorescence assay. The related mechanism was explored by western blot analysis. TOB1 expression in the HBE cells was not induced by IR, neither dose-dependently nor time-dependently. Compared to the parental or 'mock' transfected HBE cells, the radiosensitivity of HBE cells overexpressing TOB1 was significantly decreased (P<0.05). Exogenous TOB1 prevented HBE cells from apoptosis after IR, in contrast to the control cells (P<0.05), and significantly decreased the IR-induced γ-H2AX foci formation. After IR, the expression of DNA damage repair proteins such as XRCC1, MRE11, FEN1 and ATM was increased in the TOB1­overexpressing HBE cells when compared with the expression levels in the control cells. HBE/TOB1 cells presented a much higher phosphorylated ERK1/2 and phosphorylated p53 when compared with the levels in the control cell lines when receiving 6 Gy of X-rays. Notably, the increased expression of phosphorylated p53 in HBE/TOB1 cells after IR was sufficiently blocked by U0126, a specific inhibitor of MEK1/2. Different from its functions in several lung cancer cell lines, TOB1 demonstrated a radioprotective function in the immortalized normal human bronchial epithelial cell line HBE via the MAPK/ERK signaling pathway.

Impact of diabetes on the prognosis of hip fracture: a cohort study in the Chinese population.

BACKGROUND: Diabetes has been associated with increased risk of fracture and impaired fracture healing. The aim of this study was to examine the influence of diabetes on perioperative complications, length of stay and ambulatory ability recovery in individuals with hip fracture, and to determine whether changes could be made to improve treatment outcome. METHODS: The study included 707 hip fracture patients treated at Beijing Jishuitan Hospital between July 2009 and December 2010. The medical history and perioperative complications were compared between non-diabetic and diabetic groups. Length of stay, days awaiting surgery, and days of hospitalization after surgery were also analyzed. Ambulatory ability was compared at 1-year follow-up using the Chi-square test and Fisher's exact test. An independent Student's t-test was used to compare normally distributed continuous data. RESULTS: Patients with diabetes were more likely than non-diabetic patients to develop cardiac perioperative complications (8.9% vs. 3.0%, P = 0.021), urinary tract infections (12.0% vs. 2.8%, P < 0.001), and gastrointestinal symptoms (15.0% vs. 6.8%, P = 0.003). No difference in perioperative complications was observed between the groups. Days awaiting surgery and length of hospital stay were both longer in the diabetic group ((8.0 ± 5.1) vs. (6.2 ± 3.7) days and (16.5 ± 3.8) vs. (13.3 ± 3.8) days, P < 0.001, respectively). Before the occurrence of fracture, patients with diabetes were less likely to be ambulatory outdoors (71.9% vs. 85.9%, P < 0.001) and had more restricted walking ability. After at least 1-year follow-up, similar proportions of patients in the non-diabetic and diabetic groups (16.1% and 15.9%, respectively), who were able to ambulate outdoors before the fracture, became housebound till the final follow-up. CONCLUSIONS: Diabetics are at increased risk of specific complications and have a longer time to surgery and longer in-hospital stay, but generally have similar recovery to non-diabetics thereafter.

Multiple factors related to detrusor overactivity in Chinese patients with benign prostate hyperplasia.

BACKGROUND: Detrusor overactivity (DO) is a known cause of lower urinary tract symptoms and occurs in 50% - 75% of benign prostate hyperplasia (BPH) patients. We sought to investigate the clinical and urodynamic factors that are associated with the presence of DO in Chinese BPH patients. METHODS: Two hundred and eighty-seven consecutive patients with clinical BPH were retrospectively evaluated in this study. Each patient underwent urodynamic evaluation and completed the International Prostate Symptom Score (IPSS) and Quality of Life (QoL) questionnaire. Patients with neurological symptoms or other diseases likely to affect detrusor functions were strictly excluded. The 184 BPH patients included in the study were divided into groups according to the presence of DO as shown in urodynamic tests. Univariate analysis of factors associated with the presence of DO were performed using Student's t-test and the Mann-Whitney test; multivariate analysis used stepwise Logistic regressions. The relationship between degree of bladder outlet obstruction (BOO) and DO was also investigated using a linear-by-linear association test. RESULTS: Of 184 BPH patients, DO was present in 76 (41.3%). On univariate analysis, patients with DO were older (P = 0.000), and showed smaller maximal bladder capacity (MBC, P = 0.000) and voided volume (P = 0.000), higher maximal detrusor pressure (P = 0.000) and projected isovolumetric pressure (PIP) (P = 0.005), higher Abrams-Griffiths number (P = 0.000) and degree of bladder outlet obstruction (P = 0.000), higher IPSS (P = 0.000) and irritative IPSS subscores (P = 0.000). Stepwise Logistic regression analysis showed that PIP (OR = 1.012, 95% CI 1.002 - 1.023, P = 0.019), age (OR = 1.030, 95%CI 1.005 - 1.067, P = 0.059), and MBC (OR = 0.993, 95%CI 0.990 - 0.996, P = 0.000) were independent risk factors for DO in BPH patients. Linear-by-linear association tests indicated a positive linear association between DO and severity of BOO, with incidence of DO increasing with BOO grade (P = 0.000). CONCLUSIONS: In Chinese BPH patients, PIP, MBC, and age were independent factors affecting the presence of DO. DO incidence continuously increases with the degree of BOO.

[The impact of proton pump inhibitors on esophageal acid exposure in gastroesophageal reflux disease].

OBJECTIVE: To explore the effects of proton pump inhibitors (PPIs) therapy on esophageal acid exposure of patients with gastroesophageal reflux disease (GERD), and the correlation of anxiety and depression with recurrence of acid-related symptoms after discontinuation of PPIs. METHODS: From February 2010 to June 2011, 28 patients with GERD diagnosed by ambulatory 24 h esophageal pH monitoring admitted to Beijing Jishuitan Hospital were treated with esomeprazole 20 mg 2 times/d for 8 weeks (male 16, female 12). Symptoms after drug discontinuation were monitored. Ambulatory 24 h esophageal pH monitoring was performed on patients, whose symptom recurred within 8 weeks after treatment. BMI, Self-rating Anxiety Scale (SAS), and Self-rating Depression Scale (SDS) were detected. RESULTS: Among the 28 patients with GERD, 15 (53.6%) recurred symptoms after withdraw of PPIs. Compared with the asymptomatic group after withdraw of PPIs, the pretreatment duration of pH 4 (supine), 24 h total acid reflux time, number of time periods with acid reflux > 5 minutes, the maximal acid reflux time and 24 h total number of acid reflux in the symptomatic recurrence group were statistically significantly increased (11.7% vs 4.5%, 138.8 minutes vs 62.1 minutes, 6.0 vs 2.0, 27.0 minutes vs 12.4 minutes, 74.0 times vs 43.0 times, respectively, all P values < 0.05). There were no significant differences in BMI, SAS and SDS between the two groups. CONCLUSIONS: The basic level of esophageal acid exposure of patients with GERD before PPIs therapy may influence the esophageal acid exposure after PPIs therapy and then may affect the recurrence of symptoms. Although anxiety and depression is common in patients with GERD, it is not found that the recurrence of acid-related symptoms after the discontinuation of PPIs therapy is related to the anxiety and depression.

[Impact of short-time treatment of prophylactic antibiotics for surgical site infection in cervical spinal surgery].

OBJECTIVES: This study is designed to determine the impact of the short-time usage of prophylactic antibiotics to prevent postoperative wound infection in spinal surgery. METHODS: The medical records of 965 patients who underwent cervical spinal operation between 2009 and 2011 were collected for the assessment. These patients were divided into two groups based on antibiotic selection and duration of prophylactic antibiotic treatment:234 patients treated with prophylactic antibiotics for a short period of time were set as Group A, whereas Group B included 731 patients treated with prophylactic antibiotics for experience-based length of time. All the patients' records, including personal information, preoperational medical records, surgical records, postoperative medical information and the development of surgical site infections, were collected for analysis. RESULTS: In Group A, 153 patients were treated by second generation cephalosporins and 81 patients were treated by clindamycin. The duration of treatment was 1.17 ± 0.38 days. In Group B, 41 patients were treated by penicillin, 375 and 2 patients were treated by second and third generation cephalosporins, respectively, 128 patients were treated by clindamycin, 42 patients were treated by cephamycin, 128 patients were treated by quinolone, other antibiotic was used by 1 patient and other 14 patients were treated by combinations of antibiotics. The duration of the treatment in Group B was 5.72 ± 1.63 days. The significant differences between the length of treatment time in Group A and B were observed (P < 0.001). There were no statistical differences of pre-/post-operational leukocytes number compared between Group A and B. In addition, although the neutrophils in Group A and B are 70.70% ± 9.71% and 67.09% ± 9.78% respectively, indicating a subtle difference (t = 2.921, P = 0.004), however, these numbers were in normal range; therefore, no clinical significance was found from the comparison of neutrophils in groups. A total of 7 cases (0.73%) of surgical site infection were recorded, including 4 cases (1.71%) in Group A and 3 cases (0.41%) in Group B, all of which were posterior laminoplasty. With Fisher analysis (P = 0.063), these infection rates were not statistically significant. CONCLUSIONS: An appropriate usage of prophylactic antibiotics in a short period of time in cervical spinal surgery did not increase the rate of surgical site infection.

Disease distribution and medical resources during the Beijing 2008 Olympic and Paralympic Games.

BACKGROUND: Appropriate planning and staffing for medical services at large-scale athletic events is essential to provide for a safe and successful competition. There are few well-documented accounts describing the demand for such services. The present study provided the data from the Beijing 2008 Olympics and Paralympics, with a view to provide the guidance for planning future events. METHODS: A total of 22 029 and 8046 patients, who received medical care from a physician at an Olympic or Paralympic medical station, were included. The patient proportion among different personnel, various disease proportions at different kinds of venues, and the disease spectrum at specified venues at the Olympics and Paralympics were analyzed. RESULTS: At both games, the patient proportion varied by accreditation status. The staff accounted for the largest number of visits at the Olympics (44.83%) and Paralympics (36.95%), with respiratory diseases the most common. Various disease spectrums were discovered at the different kinds of venues. Surgical diseases were the most frequently listed reason for visits, both at competition and non-competition venues, especially during the Paralympics. The sport-related injuries accounted for a majority of the surgical cases during both games. At training venues, ear nose and throat diseases accounted for the greatest number of visits during both games. CONCLUSIONS: During both games, people contracted different diseases at different venues. Adequate surgeons should be designated to offer assistance mostly in trauma situations. Appropriate numbers of physicians in respiratory diseases and otorhinolaryngology is of great importance.

Comparison of the clinical accuracy of cervical (C2-C7) pedicle screw insertion assisted by fluoroscopy, computed tomography-based navigation, and intraoperative three-dimensional C-arm navigation.

BACKGROUND: The complicated anatomy of the cervical spine and the variation among pedicles reduces the accuracy and increases the risk of neurovascular complications associated with screw implantation in this region. In this study, we compared the accuracy of cervical (C2-C7) pedicle screw fixation assisted by X-ray fluoroscopy, computed tomography (CT)-based navigation, or intraoperative three-dimensional (3D) C-arm navigation. METHODS: This prospective cohort study was performed in 82 consecutive patients who underwent cervical pedicle screw fixation. The accuracy of screw insertion was assessed by postoperative CT scan with 3D reconstruction. The accuracy of screw insertion was assessed as: excellent (screw completely within pedicle); acceptable (≤ 1 mm screw outside pedicle cortex); poor (> 1 mm screw outside pedicle cortex). RESULTS: A total of 145 screws were inserted in 24 patients who underwent C-arm fluoroscopy. Of these, 96 screws (66.2%) were excellent, 37 (25.5%) were acceptable, and 12 (8.3%) were poor. One hundred and fifty-nine screws were inserted in 29 patients in the CT-based navigation group. Among these, 141 (88.7%) were excellent, 14 (8.8%) were acceptable, and 4 (2.5%) were poor. A total of 140 screws were inserted in 29 patients in the intraoperative 3D C-arm navigation group, of which 127 (90.7%) were excellent, and 13 (9.3%) were acceptable. No severe or permanent neurovascular complications associated with screw insertion were observed in any patient. CONCLUSIONS: CT-based and intraoperative 3D C-arm navigation were similarly accurate, and were both significantly more accurate than C-arm fluoroscopy for guiding cervical pedicle screw fixation. They were able to accurately guide the angle and depth of screw placement using visual 3D images. These two techniques are therefore preferable for high-risk cervical pedicle screw fixation. The ease and convenience of intraoperative 3D C-arm navigation suggests that it may replace virtual-fluoroscopy and CT-based navigation systems in future clinical applications.