Patterns of plant invasions in China: Taxonomic, biogeographic, climatic approaches and anthropogenic effects

This study was aimed to determine the patterns as well as the effects of biological, anthropogenic, and climatic factors on plant invasions in China. About 270 volumes of national and regional floras were employed to compile a naturalized flora of China. Habit, life form, origin, distribution, and uses of naturalized plants were also analyzed to determine patterns on invasion. Correlations between biological, anthropogenic and climatic parameters were estimated at province and regional scales. Naturalized species represent 1% of the flora of China. Asteraceae, Fabaceae, and Poaceae are the dominant families, but Euphorbiaceae and Cactaceae have the largest ratios of naturalized species to their global numbers. Oenothera, Euphorbia, and Crotalaria were the dominant genera. Around 50% of exotic species were introduced intentionally for medicinal purposes. Most of the naturalized species originated in tropical America, followed by Asia and Europe. Number of naturalized species was significantly correlated to the number of native species/log area. The intensity of plant invasion showed a pattern along climate zones from mesic to xeric, declining with decreasing temperature and precipitation across the nation. Anthropogenic factor, such as distance of transportation, was significantly correlated to plant invasions at a regional scale. Although anthropogenic factors were largely responsible for creating opportunities for exotic species to spread and establish, the local biodiversity and climate factors were the major factors shaping the pattern of plant invasions in China. The warm regions, which are the hot spots of local biodiversity, and relatively developed areas of China, furthermore, require immediate attentions

Anesthesia in anti‐N‐methyl‐D‐aspartate receptor encephalitis – is general anesthesia a requisite? A case report = Anestesia em encefalite antirreceptor de N‐metil‐ d ‐aspartato – a anestesia geral é um requisito? Relato de caso

Anti‐N‐methyl‐D‐aspartate receptor encephalitis is a recently described neurological disorder and an increasingly recognized cause of psychosis, movement disorders and autonomic dysfunction. We report 20‐year‐old Chinese female who presented with generalized tonic–clonic seizures, recent memory loss, visual hallucinations and abnormal behavior. Anti‐N‐methyl‐D‐aspartate receptor encephalitis was diagnosed and a computed tomography scan of abdomen reviewed a left adnexal tumor. We describe the first such case report of a patient with anti‐N‐methyl‐D‐aspartate receptor encephalitis who was given a bilateral transversus abdominis plane block as the sole anesthetic for removal of ovarian tumor. We also discuss the anesthetic issues associated with anti‐N‐methyl‐D‐aspartate receptor encephalitis. As discovery of tumor and its removal is the focus of initial treatment in this group of patients, anesthetists will encounter more such cases in the near future

Accelerated surgery versus standard care in hip fracture (HIP ATTACK) : an international, randomised, controlled trial

Background: Observational studies have suggested that accelerated surgery is associated with improved outcomes in patients with a hip fracture. The HIP ATTACK trial assessed whether accelerated surgery could reduce mortality and major complications. Methods: HIP ATTACK was an international, randomised, controlled trial done at 69 hospitals in 17 countries. Patients with a hip fracture that required surgery and were aged 45 years or older were eligible. Research personnel randomly assigned patients (1:1) through a central computerised randomisation system using randomly varying block sizes to either accelerated surgery (goal of surgery within 6 h of diagnosis) or standard care. The coprimary outcomes were mortality and a composite of major complications (ie, mortality and non-fatal myocardial infarction, stroke, venous thromboembolism, sepsis, pneumonia, life-threatening bleeding, and major bleeding) at 90 days after randomisation. Patients, health-care providers, and study staff were aware of treatment assignment, but outcome adjudicators were masked to treatment allocation. Patients were analysed according to the intention-to-treat principle. This study is registered at ClinicalTrials.gov (NCT02027896). Findings: Between March 14, 2014, and May 24, 2019, 27 701 patients were screened, of whom 7780 were eligible. 2970 of these were enrolled and randomly assigned to receive accelerated surgery (n=1487) or standard care (n=1483). The median time from hip fracture diagnosis to surgery was 6 h (IQR 4\u20139) in the accelerated-surgery group and 24 h (10\u201342) in the standard-care group (p<0\ub70001). 140 (9%) patients assigned to accelerated surgery and 154 (10%) assigned to standard care died, with a hazard ratio (HR) of 0\ub791 (95% CI 0\ub772 to 1\ub714) and absolute risk reduction (ARR) of 1% ( 121 to 3; p=0\ub740). Major complications occurred in 321 (22%) patients assigned to accelerated surgery and 331 (22%) assigned to standard care, with an HR of 0\ub797 (0\ub783 to 1\ub713) and an ARR of 1% ( 122 to 4; p=0\ub771). Interpretation: Among patients with a hip fracture, accelerated surgery did not significantly lower the risk of mortality or a composite of major complications compared with standard care. Funding: Canadian Institutes of Health Research