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Vegetation restoration is an important requirement for ecological protection and high-quality development in the Yellow River Basin. In-depth understanding the temporal and spatial differentiation of vegetation has important practical significance. With the four Landsat TM/OLI remote sensing images as the data source, the pixel binary model was used to estimate vegetation coverage. The transfer matrix, geological information map, and the center of gravity migration model were used to analyze the temporal and spatial variations of vegetation coverage in Yan'an City in the middle of the Yellow River Basin from 1988 to 2018. The spatial variation of vegetation cover to elevation and slope was explored using terrain distribution index combined with terrain data. The results showed that vegetation coverage in Yan'an was low in the north region and high in the south region. The vegetation coverage increased significantly due to policy changes. From 1988 to 2018, the vegetation change pattern in Yan'an was dominated by continuous improvement and stability. Vegetation coverage increased in about 50% of the area. 83% of the study area with high vegetation coverage remained stable. At each elevation and slope level, the advantage of high vegetation cove-rage increased with time. At each slope level, vegetation cover increased with slope. The transition direction of vegetation cover of different levels in Yan'an was basically consistent with the overall spatial change trend of vegetation cover, with the overall shift being from north to west. The vegetation construction in Yan'an has achieved remarkable results, though the vegetation coverage in the north still needs to be improved. Optimizing vegetation types and structures is an important direction for future vegetation construction.

Objective: To evaluate pregnancy outcomes of multiparae in women with advanced age (≥35 yr.) after the 2008 Wenchuan earthquake., Methods: Clinical data of 542 pregnant women with prenatal care in Wenchuan during 20082013 were reviewed,comparing preconception conditions,pregnant rates,pregnant complications,and perinatal outcomes between those younger ( n =176) and older ( n =366) than 35 years., Results: In the 542 women,622 conceptions were reported,with 517 deliveries and 522 live births. The women with advanced age had lower cumulative pregnancy rate (twoyear),higher incidence of hypertensive disorders of pregnancy,gestational diabetes,multiple pregnancy,fetal distress,low birth weight and birth defects than their younger counterparts. The younger women also had higher term live birth rate and lower miscarriage rate. But the differences showed no statistical significance., Conclusion: Prenatal care brings similar pregnant outcomes to multiparae in women with advance aged and younger aged.

Objective: To retrospectively analyze the effects of allogeneic hematopoietic stem cell transplantation (allo-HSCT) on childhood chronic myelogenous leukemia (CML)., Method: Of the 24 consecutive cases, 16 were boys and 8 were girls. The median age of patients was 12 (3 - 16) years old; 16 cases were in chronic phase (CP) of CML, 1 case in accelerated phase (AP) and 5 cases in blastic phase (BP). Allo-HSCT from HLA identical siblings were performed for 5 cases, HLA haplotype was performed for 14 cases and unrelated allo-HSCT for 5 cases. Twenty-four cases underwent allo-HSCT with conditioning regimen of BUCY. Prophylaxis of graft versus host disease (GVHD) included CsA + MTX plus MMF. The average follow-up was 36 months., Result: All of patients were successfully engrafted. The 5-year overall survival (OS) of the 24 cases was 81%. Four patients died after allo-HSCT including 3 cases in BP from haploidentical donors and 1 case in CP from HLA identical sibling. The 5 cases who received unrelated allo-HSCT have been alive. Among the 10 cases who survived over 5 years, 3 had chronic GVHD., Conclusion: Children with CML could be treated effectively with allo-HSCT. There were no significant differences among different donors. Transplantation to children with CML should be performed as early as possible. Preparative regimen adjustment before transplantation, the transplantation of associated comorbidities and effective prevention and treatment for CML patients after prolonged graft survival of high quality have important significance.

Objective: Studying the proven and probable invasive pulmonary aspergillosis (IPA) cases of some hospitals in Shanghai to provide evidence for the improvement of IPA clinical diagnosis and therapy., Methods: Forty-nine IPA cases were retrospectively analyzed for demography data, host factors, underlying conditions, chest CT, microorganism and histopathology examination, as well as therapy and clinical outcome., Results: Of 49 subjects including 19 (38.8%) proven and 30 (61.2%) probable IPA, 3 patients (6.1%) had no host factors, 25 patients (51.0%) had IPA associated host factors and underlying conditions, while 21 patients (42.9%) had uncertain fundamental diseases. Chest CT evaluation demonstrated that radiological lesions include nodules in 29 patients, patching in 15, mass in 12, consolidation in 10, cavitation in 34, Halo sign in 19, air bronchogram in 18, crescentic sign in 6, bilateral in 33 and multifocal lesions in 38. The yielding rate of fungus culture in sputum was 26.5% (13/49), and in bronchoalveolar lavage fluid was 66.7% (10/15). Eleven of thirty-six patients (30.6%) had positive results of serum galactomannan antigen tests. Nineteen of twenty-one patients (90.5%) were proven as IPA by lung histologic examinations. Aspergillus fumigatus was the most common pathogen 81.0% (17/21). The responding rate to initial anti-fungus therapy was 50% (21/42)., Conclusion: Our study suggests that in IPA patients, bilateral, multifocal and nodular lesion could be the most common radiological characteristic, while Halo and crescentic sign occur occasionally. Invasive technologies are more valuable to IPA diagnosis.

Objective: To study the effect of rosiglitazone on serum high-sensitivity C-reactive protein (hs-CRP), interleukin-1beta (IL-1beta), IL-6, tumor necrosis factor-alpha (TNF-alpha) and insulin resistance in obese patients with newly diagnosed type 2 diabetes., Methods: This study involved 118 patients with newly diagnosed type 2 diabetes and obesity, who were randomly assigned into two groups for a 12-week treatment with rosiglitazone (4 mg/day, group A) or sulfonylureas (group B). Serum hs-CRP, IL-1beta, IL-6, TNF-alpha, fasting plasma glucose (FPG) and fasting insulin (FINS) were measured before and after the treatment. Insulin resistance index was calculated according to the HOMA Model., Results: In group A, rosiglitazone treatment resulted in significantly reduced serum hs-CRP, IL-1beta, IL-6, TNF-alpha, FPG and insulin resistance index (P<0.01). No difference in FPG was found between the two groups after the treatment (P>0.05), but serum hs-CRP, IL-1beta, IL-6, TNF-alpha and insulin resistance index were significantly lower in group A than in group B (P<0.05)., Conclusion: Rosiglitazone can decrease FPG, reduce the inflammation reaction and improve insulin resistance in obese patients with type 2 diabetes.

Objective: To assess the value of comprehensive prevention measures to ventilator-associated pneumonia (VAP) of patients more than 60 years old and to investigate the pathogenesis of VAP., Methods: With a prospective, randomized, case-control design, patients more than 60 year of age with expected mechanical ventilation > 48 h were randomly assigned to a control group receiving a standard endotracheal tube or a comprehensive intervention group including semi-recumbent, mosapride citrate, and endotracheal tube for continuous subglottic secretions drainage. The duration of mechanical ventilation, length of ICU/hospital stay, the incidence, mortality, contributable mortality, relative risk as well as the bacterial concordance in gastric juice or lower respiratory tract between two groups were compared. The rates of methylene blue found in lower respiratory tract were also observed., Results: Eighty-six cases were enrolled in this trial, including 41 in the intervention group and 45 in the control group. The duration of mechanical ventilation, length of ICU/hospital stay in the intervention group were all less than the control group. However, no significant difference existed in mortality and attributable mortality. Same types of bacterial pathogens were found between gastric juice and lower respiratory tract of the VAP patient. The RR of the incidence of VAP in two groups was 0.259 (95% CI 0.106 - 0.634). The rate of the same bacterial type or methylene blue detected in lower respiratory tract/oropharynx under microscope in the intervention group were lower than the control group (P < 0.05)., Conclusions: The comprehensive prevention measures can reduce the incidences of VAP. The astro-pulmonary route is one of the pathogenesis of VAP.

Objective: To investigate the effects of short-term continuous subcutaneous insulin infusion (CSII) on newly diagnosed type 2 diabetes and to identify the influencing factors for the curative effects of CSII., Methods: 138 newly diagnosed type 2 diabetic patients with fasting plasma glucose > 11.1 mmol/L were treated with CSII for 2 weeks. Intravenous glucose tolerance test (IVGTT) was performed before and after CSII. The target of glycemic control were fasting blood glucose < 6.1 mmol/L and postprandial blood glucose (PBG) < 8.0 mmol/L. The age, body mass index (BMI), fasting and postprandial plasma glucose, hemoglobin A(1C) (GHbA(1C)), Homa beta, Homa IR, area under the curve of insulin (AUC) during IVGTT were compared between the good glycemic control group and the inadequate glycemic control group., Results: After 2 weeks' CSII treatment, good glycemic control was achieved in 126 patients (group A) but not in the remaining 12 patients (group B). There were no differences in age, BMI, postprandial plasma glucose, GHbA(1C), and Homa IR between the two groups before and after CSII treatment. But the fasting plasma glucose was higher and Homa B was lower in group B than in group A before CSII treatment. The DeltaAUC (AUC after CSII subtracted from that before CSII) representing the recovery of beta-cell function was much greater in group A than in group B. The insulin dose of group B was significantly higher than that of the good glycemic control group., Conclusion: More severe hyperglycemia and relative beta-cell function deficiency may be the main reasons responsible for not achieving good glycemic control in newly diagnosed type 2 diabetic patients with short-term intensive CSII treatment.