Fetoscopic tracheal occlusion for treatment of non-isolated congenital diaphragmatic hernia

Fetoscopic endotracheal occlusion (FETO) is a prenatal treatment that may increase survival in severe congenital diaphragmatic hernia (CDH). In the USA, FETO is offered for isolated severe left-sided CDH in the context of an FDA-approved feasibility study. FETO in non-isolated cases of severe CDH is only performed with a compassionate use exemption from US regulatory bodies. Anomalies frequently associated with CDH include congenital cystic lesions of the lung and cardiac defects. We describe two cases of non-isolated severe left-sided CDH that underwent prenatal FETO, survived after birth and underwent postnatal surgical repair. The potential benefit of FETO in this setting is discussed. © 2017 John Wiley & Sons, Ltd.     

贵阳市表层土壤中镉的环境地球化学基线研究

以土壤环境地球化学研究为主线,以贵州省贵阳市8　046　km²为研究区域,将土壤重金属污染元素镉的空间分布规律与环境地球化学机理研究相结合,建立区域土壤环境地球化学基线,选用合适的判别指标判识自然作用过程与人类活动过程对土壤环境的影响.通过对487个样品的镉含量的统计分析,结果表明,贵阳市表层土壤中镉的基线值为0.068　mg/kg,镉元素含量大于1.010　mg/kg的样品可能遭受人为污染的影响.地质累积指数分析结果显示,贵阳市40%的表层土壤未受镉污染,19%的表层土壤在无污染与中度污染之间,14%受中度污染,19%的表层土壤介于中度污染到强污染之间,7%受强污染,1%的表层土壤介于强污染到极强污染之间.污染程度指数分析则显示,贵阳市57.9%的表层土壤未受到镉污染,镉的污染程度最大为12.1,96%的表层土壤污染程度小于4,总污染程度大于0,即总体受到污染.     

Severe bilateral renal disease: Correlation of antenatal and autopsy findings

We report 20 infants with severe bilateral renal disease examined by prenatal ultrasound and by autopsy. In 17, the prenatal and pathologic diagnoses correlated well. Although the prenatal and autopsy findings differed in the three remaining cases, the autopsy confirmed the presence of severe bilateral renal abnormalities. All 20 pregnancies were complicated by oligohydramnios, which was severe in 60 per cent. Most of these fetuses had malformation of other organ systems. This series supports the utility of prenatal ultrasound examinations, but emphasizes the need for postnatal evaluation of congenital renal disease including pathologic examination of tissue when possible for correct classification and genetic counselling.     

高原高寒地域中重型车辆发动机预热起动辅助装置研究

目的提高中重型车辆装备在高原高寒环境下的低温起动性能。方法研制一种适应高原高寒地域低温低气压环境的冷却液加热器,加热器将燃油燃烧产生的热量传递给冷却液,通过冷却液的循环对发动机机体进行预热。结果在低温试验室内-41℃常压环境下,使用冷却液加热器预热25 min后起动发动机,一次起动成功。在高原进行环境适应性试验,预热时间在25 min内,发动机一次起动成功。结论发动机预热可有效提高-30^-41℃温度地域的发动机低温起动性能。     

Effect of land use and land cover change on soil erosion and the spatio-temporal variation in Liupan Mountain Region, southern Ningxia, China

The Liupan Mountains are located in the southern Ningxia Hui Autonomous Region of China, that forms an important divide between landforms and biogeographic regions. The populated part of the Liupan Mountain Region has suffered tremendous ecological damage over time due to population pressure, excessive demand and inappropriate use of agricultural land resources. To present the relationship between land use/cover change and spatio-temporal variation of soil erosion, data sets of land use between the late 1980s and 2000 were obtained from Landsat Thematic Mapper (TM) imagery, and spatial models were used to characterize landscape and soil erosion conditions. Also, soil erosion in response to land use and land cover change were quantified and analyzed using data from geographical information systems and remote sensing. Soil erosion by water was the dominant mode of soil loss, while soil erosion by wind was only present on a relatively small area. The degree of soil erosion was classified into five severity classes: slight, light, moderate, severe, and very severe. Soil erosion in the Liupan Mountain Region increased between the late 1980s and 2000, both in terms of acreage and severity. Moderate, severe, and very severe eroded areas accounted for 54.86% of the total land area. The lightly eroded area decreased, while the moderately eroded area increased by 368817 ha (22%) followed by severe erosion with 146552 ha (8.8%), and very severe erosion by 97067.6 ha (5.8%). Soil loss on sloping cropland increased with slope gradients. About 90% of the cropland was located on slopes less than 15°. Most of the increase in soil erosion on cropland was due to conversion of steep slopes to cropland and degradation of grassland and increased activities. Soil erosion was severe on grassland with a moderate or low grass cover and on dry land. Human activities, cultivation on steep slopes, and overgrazing of pastures were the main reasons for the increase in erosion severity.     

Visualization of fetal intra-abdominal organs in second-trimester severe oligohydramnios by intraperitoneal infusion

Fetal intraperitoneal infusion of saline was performed in two patients with severe oligohydramnios at 24 and 25 weeks' gestation in order to enhance visualization of intra-abdominal organs. Renal agenesis was easily diagnosed. The technique can be considered as an alternative to artificial instillation of amniotic fluid in the differential diagnosis of conditions associated with severe oligohydramnios.     

Hypomandibular faciocranial dysostosis in consanguineous parents revealed by ultrasound prenatal diagnosis

We report here the fourth case of hypomandibular faciocranial dysostosis (HFD). The diagnosis was made at birth on the association of severe retrognathia, microstomia, severe hypoglossia with glossoptosis, persistent buccopharyngeal membrane, median cleft palate, bifid uvula, down-slanting palpebral fissures, short nose with anteverted nares, laryngeal hypoplasia, and low-set ears. A severe microstomia and micrognathia were detected by ultrasound at 31 weeks of gestation. Interestingly, even though the present case exhibits many facial dysmorphic features characteristic of HFD, craniosynostosis was absent. This report suggests that craniosynostosis is not mandatory for the diagnosis of this condition. Furthermore, we present a new argument for an autosomal recessive mode of inheritance for HFD. Copyright © 2002 John Wiley & Sons, Ltd.     

基于信息扩散和模糊评价方法的四川盆地气候干旱综合评价

利用1961~2005年历史气象资料,以受旱天数、湿润度指数、标准化降水指数、温度距平、日照距平百分率等5个要素作为干旱评价指标,应用信息扩散方法建立了各单个评价指标的春、夏、伏旱旱情等级划分标准,采用模糊综合评价方法对1961~2006年四川盆地气候干旱进行评价,并给出了各市干旱出现的频率。结果表明:2006年四川盆地发生了严重的春旱、夏旱和特别严重的伏旱,盆区17个市均有伏旱发生,其中有13个市伏旱特别严重;伏旱期少雨天气平均为30年一遇,高温天气平均为60年一遇,约29%的台站的少雨和90%的台站的高温为50年以上一遇;春、夏旱主要出现在盆地西北部和盆地南部,约2.5年出现一次,伏旱则主要出现在盆地东部,约2年出现一次。     

临安本底站酸雨长期观测特征分析

利用临安本底站酸雨长期观测资料,分析了该站酸雨年际变化及月变化,并对其变化特征进行了归因,同时分析了酸雨与气象因子之间的关系.结果表明,1985~2012年期间,临安本底站的酸雨总体呈增加趋势,且有2次明显加重和2次明显减弱过程.近20年酸雨的月变化表现为以7月为中心月份,降水酸度及强酸雨发生频率向两侧月份增加,弱酸雨发生频率向两侧月份减小.酸雨发生受降水强度、风速、风向影响,小雨时强酸雨发生频率高、弱酸雨发生频率低,而暴雨时弱酸雨发生频率高、强酸雨发生频率低;随风速等级升高,酸雨发生频率及强酸雨所占比重逐渐降低,降水pH值逐渐升高;弱酸雨发生日主导风向多集中于S-W扇区,而强酸雨发生日主导风向更倾向于N-E扇区.临安本底站酸雨的月变化主要归因于降水量变化以及各月SSE-WSW和NWN-ENE风向扇区来风的增多和减少,酸雨的年际变化可归因于江浙沪能源消耗量增加及重大环保措施实行的综合影响.     

Have the results of the TOTAL-trials changed the attitude and practice of maternal-fetal medicine specialists?

Objective

To explore the views and practices of maternal-fetal medicine specialists on offering fetoscopic endoluminal tracheal occlusion (FETO) for left- and right-sided congenital diaphragmatic hernia (LCDH, RCDH) in the post Tracheal Occlusion To Accelerate Lung growth (TOTAL)-trial era.

Method

Cross-sectional knowledge, attitude and practice survey was conducted among 105 attendees of the 19th World Congress of Fetal Medicine.

Results

On average, respondents were knowledgeable about CDH, involved in research, and provided antenatal treatment options. Four out of five (82%) agreed that neonatal survival in LCDH can be reliably predicted in the prenatal period. Few respondents considered the exact risks and benefits of FETO for severe LCDH as being unclear (16%), yet half were uncertain about this for moderate LCDH (57%) and severe RCDH (45%). Most respondents offer FETO for severe LCDH (97%) and RCDH (79%), but only 59% offer it for moderate LCDH. However, half of respondents (58%) stated that not offering FETO for moderate LCDH would be a psychological burden for parents.

Conclusion

Respondents consider the risk-benefit ratio of FETO for severe LCDH clear and consistently offer FETO, but not for moderate LDCH and severe RCDH. However, not offering the option of FETO to parents was considered a psychological burden.     

基于微脉冲激光雷达的上海浦东地区不同强度霾研究

利用微脉冲激光雷达(MPL)对上海浦东2008年12月1日至2010年11月31日期间连续观测的霾期间气溶胶的消光特性进行分析,讨论了上海浦东地区不同强度霾和无霾时气溶胶的垂直分布日变化与季节变化.结果表明,重、中度霾的气溶胶主要分布在500m以下,小时平均消光系数值在0~1.2km-1范围内波动;轻度霾及轻微霾时段,小时平均消光系数波动范围约在0~0.5km-1;无霾时段小时平均消光系数波动范围约在0~0.2km-1;中-重度霾时段消光系数春>冬>夏>秋;夏季低层大气消光较大,春季高层大气消光较大,冬秋两季随高度增加消光逐渐减小;夏冬两季较易发生中、重度霾.     

基于地面微脉冲激光雷达的上海冬季霾强度及高度分析

利用2009—2013年冬季地面气象观测数据筛选出非霾和不同强度霾的影响时次,采用能见度与消光系数的定量关系和冬季波长系数对微霾冲激光雷达反演修正得到的气溶胶消光系数,分析了上海地区气溶胶在垂直高度上的集中范围,当地面出现轻微霾、轻度霾、中度霾、重度霾时气溶胶分别主要集中于近地面0.81、0.49、0.41、0.40 km以下,非霾时气溶胶主要集中在近地面1.35 km以下;在此基础上,根据判别不同强度霾的能见度标准和能见度与消光系数的定量关系,将能见度换算为消光系数,再对微脉冲激光雷达反演消光系数进行修正,从而判断高空霾的强度及所处的高度;另外还探讨了云对产生重度霾的影响、降水与中度霾和重度霾的关系以及颗粒物质量浓度与不同强度霾的关系,发现48.53%的重度霾是受云影响而产生的,37.11%中度霾发生前后伴有降水现象,51.14%的重度霾发生前后伴有降水现象,非霾、轻微霾,轻度霾、中度霾、重度霾期间的颗粒物浓度和细颗粒物占的比例依次增大.     

Fetal therapy: practical ethical considerations

Progress in prenatal diagnosis can lead to the diagnosis of severe fetal abnormalities for which natural history anticipates a fatal outcome or the development of severe disability despite optimal postnatal care. Intrauterine therapy can be offered in these selected cases. Prenatal diagnosis is the only field of medicine in which termination is an option in the management of severe diseases. Fetal therapy has therefore developed as an alternative to fatalist expectant prenatal management as well as to termination of pregnancy (TOP). There are few standards of fetal care that have gone beyond the stage of equipoise and even fewer have been established based on appropriate studies comparing pre- and postnatal care. Several ethical questions are being raised as fetal surgery develops, including basic Hippocratic principles of patients' autonomy and doctors' duty of competence moving the boundaries between experimental surgery, therapeutic innovation and standard care. In addition, the technical success of a fetal intervention can only rarely fully predict the postnatal outcome. Managing uncertainty regarding long-term morbidity and the possibility for fetal therapy to change the risk of perinatal death into that of severe handicap remains a critical factor affecting women's choice for TOP as an alternative to fetal therapy. Copyright © 2011 John Wiley & Sons, Ltd.     

湖南罕见的一次低温雨雪冰冻灾害天气分析及预警预报

2008年1月中旬至2月初,湖南出现历史上罕见的低温、雨雪、冰冻灾害天气。对此次冰冻灾害进行了分析并与历史同期进行了比较,结果表明：此次冰冻灾害天气的主要特征是影响范围广、持续时间长、灾害强度大。＂拉尼娜＂事件和大气环流异常为此次持续的灾害性天气提供了重要的气候背景,在此背景下欧亚大气环流的持续稳定则是此次湖南持续低温雨雪灾害的直接原因。通过对这次冰冻灾害的成因分析,得出了冰冻预报的着眼点,提出了各级气象台站如何做好预报预警服务的基本思路,为冰冻灾害天气的准确预报、预警服务提供参考,对各级台站重大灾害性天气的预报服务和应急响应,具有重要的指导意义。     

云浮Tl污染区水体重金属分布特征及污染评价

对广东云浮黄铁矿Tl污染区地表溪流水和沉积物中Tl、Cd、Cr、Pb、Ni、As、Cu、Zn的分布特征进行了调查和分析,并采用沉积物基准法、Hakanson潜在生态指数法等方法评估了重金属的环境风险.结果表明,矿区溪流各采样点水体中Tl的含量为0.19～65.25μg/L,均高于国家地表水质量标准(0.1 μg/L);...     

三种与地质灾害相关的突发性气象灾害应急预报系统研究新进展

本文介绍了在火山灰、核放射性物质和强沙尘暴引发的沙尘粒子的长距离输送数值模拟领域里近年来获得的有关新进展。其基本进展是:1)引进美国NOAA空气资源研究所的HYSPLIT-4模式。并以此为核心形成火山灰、核放射性物质和强沙尘暴的浓度与轨迹数值模拟与预报系统。2)提出一个非连续性空间分布污染场的平流输送方案。3)新发现一个数值模式中的误差污染机制。     

基于随机微分方程的重度污染区域河流水质检测研究

为了治理重度污染区域中的河流,需要对重度污染区域中的河流水质进行检测,当前河流水质检测方法对重度污染区域中的河流水质进行检测时,与实际结果不符,检测结果不准确。提出一种基于随机微分方程的重度污染区域河流水质检测方法。在重度污染区域的河流中设置检测点,确定水质检测的指标,采用随机微分方程计算重度污染区域中河流水质的初始输入值、水力参数、水质参数,通过统计矩对随机微分方程进行求解,完成重度污染区域中河流水质的检测。实验结果表明,所提方法可以准确的对重度污染区域中的河流水质进行检测。     

纯苯储罐腐蚀状况分析与预防对策

针对苯储罐外壁局部腐蚀严重和储罐内壁自上而下逐渐严重的均匀腐蚀现象,结合实际,对储罐内、外壁的腐蚀机理及影响因素进行了分析,指出了引起罐壁内、外腐蚀的主要原因,提出了加强储罐定期检查,减缓罐壁腐蚀等措施。     

Hyperechogenic fetal bowel and Down syndrome. Results of a French collaborative study based on 680 prospective cases

Hyperechogenic fetal bowel is prenatally detected by ultrasound during the second trimester of pregnancy in 0.1% to 1.8% of foetuses. It has been described as a normal variant and has often been associated with severe diseases, notably Down syndrome. The aim of the present study was to determine the risk of trisomy 21 in a prospective study of 680 fetuses with hyperechogenic foetal bowel. Karyotyping was performed on amniotic cells in 632 cases, and outcome was known in 655 cases. A 2.5% risk of Down syndrome and a 1% risk of other severe chromosomal anomalies were observed. Hyperechogenicity was isolated in 11/17 Down syndrome cases, and associated with other ultrasound anomalies in all seven cases of severe chromosomal anomalies. In conclusion, fetal bowel hyperechogenicity indicates a risk of chromosomal anomalies ten-fold higher than that expected on the basis of maternal age, therefore justifying invasive procedures. Copyright © 2002 John Wiley & Sons, Ltd.     

石家庄市一次大气重污染过程的边界层特征和成因分析

针对石家庄市2015年12月5—14日出现的重污染过程,利用石家庄市逐日地基微波辐射计、风廓线雷达、地面气象观测资料以及同期的污染物观测资料,分析了重污染过程期间大气边界层温度、湿度、风变化特征及对PM_(2.5)的影响,采用Hysplit后向气团轨迹模式对污染来源进行分析。此次重污染以局地排放为主要形成源,期间冷空气势力弱,地面日平均风速均在1.5 m/s以下,日平均相对湿度均在70%以上,风速小、湿度大,稳定的大气环流形势为重污染提供了持续稳定的大气环境背景。逆温形成及快速增厚导致重污染开始,逆温层平均厚度为683 m,逆温层厚、强、不易消散,导致重污染持续时间长、污染重。近地面小风层厚(平均700 m左右),通风能力弱,导致污染物难以稀释扩散。同时近地层湿度大、厚度厚,使得PM_(2.5)更容易形成和积累,对重污染加重起到了促进作用。