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Xu W, Li Z, Pan Z, He R, Zhang L. Prevalence and associated factors of self-treatment behaviour among different elder subgroups in rural China: a cross-sectional study. Int J Equity Health 2020; 19:32. [PMID: 32164667 PMCID: PMC7069192 DOI: 10.1186/s12939-020-1148-2] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Accepted: 02/27/2020] [Indexed: 12/12/2022] Open
Abstract
Background Self-treatment is a common and widespread behaviour, of which the risks are multiplied in old age. However, the determinants of self-treatment among elders in rural China remain unclear. This study aims to explore the prevalence and associated factors of self-treatment among elders in rural China, trying to discover the vulnerable groups as well as the service gaps among the rural elders. Methods Based on a multi-stage stratified random sampling method, a cross-sectional household survey was conducted among 30 villages in Sinan County, an impoverished county in western China. Data were collected through a household–individual combined questionnaires. The analysis was restricted to elders who reported illness within the last 2 weeks, and the final sample size was 330 (individuals). Bivariate and multiple logistic regression analysis were performed in the whole sample group and four subgroups to obtain the prevalence ratios regarding the associated factors. Results In the present study, 35.2% of the elders with illness within the last 2 weeks reported self-treatment. The variables associated with self-treatment in the whole sample group were health status (OR 6.75, 95%CI 1.93–23.60), recent alcohol consumption (OR 0.42, 95%CI 0.21–0.83) and the utilisation of family practice services (OR 0.59, 95%CI 0.36–0.96); the same predictors were found in the subgroup of elders with chronic diseases. No significant predictors were found in the subgroup of elders without chronic diseases. Empty-nest elders with higher affinity to traditional Chinese medicine (OR 0.39, 95%CI 0.18–0.86) or drinking alcohol recently (OR 0.28, 95%CI 0.09–0.82) were less likely to self-treat, while the non-empty-nest elders who were no less than 75 years old (OR 3.10, 95%CI 1.33, 7.22) or at better health status (OR 9.20, 95%CI 1.73–48.75) were more likely to self-treat. Conclusion Self-treatment was prevalent among the elders in rural China. Better health status, no recent alcohol consumption and no utilisation of family practice are associated with self-treatment among rural elders. Older elders in the non-empty nest group were more likely to self-treat, while the empty-nest elders with self-care habits in traditional Chinese medicine were less likely to self-treat. Deeper understanding of the self-treatment behaviour among rural elders may provide insights for identifying the potential service gaps and developing improvement strategies in the health care delivery system for the elderly in China.
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Affiliation(s)
- Wanchun Xu
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, No 13 Hangkong Road, Qiaokou District, Wuhan, 430030, Hubei, China
| | - Zhong Li
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, No 13 Hangkong Road, Qiaokou District, Wuhan, 430030, Hubei, China
| | - Zijing Pan
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, No 13 Hangkong Road, Qiaokou District, Wuhan, 430030, Hubei, China
| | - Ruibo He
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, No 13 Hangkong Road, Qiaokou District, Wuhan, 430030, Hubei, China
| | - Liang Zhang
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, No 13 Hangkong Road, Qiaokou District, Wuhan, 430030, Hubei, China.
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Xiong J, He R, Yang F, Zou L, Yi K, Lin H, Zhang D. Brassinosteroids are involved in ethylene-induced Pst DC3000 resistance in Nicotiana benthamiana. Plant Biol (Stuttg) 2020; 22:309-316. [PMID: 31758615 DOI: 10.1111/plb.13074] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Accepted: 11/11/2019] [Indexed: 06/10/2023]
Abstract
Plant immunity is regulated by a huge phytohormone regulation network. Ethylene(ET) and brassinosteroids (BRs) play critical roles in plant response to biotic stress; however, the relationship between BR and ET in plant immunity is unclear. We used chemical treatments, genetic approaches and inoculation experiments to investigate the relationship between ET and BR in plant defense against Pst DC3000 in Nicotiana benthamiana. Foliar applications of ET and BR enhanced plant resistance to Pst DC3000 inoculation, while treatment with brassinazole (BRZ, a specific BR biosynthesis inhibitor) eliminated the ET induced plant resistance to Pst DC3000. Silencing of DWARF 4(DWF4, a key BR biosynthetic gene), BRASSINOSTEROID INSENSITIVE 1 (BRI1, aBR receptor) and BRASSINOSTEROID-SIGNALING KINASE 1 (BSK1, downstream of BRI1) also neutralised the ET-induced plant resistance to Pst DC3000. ET can induce callose deposition and reactive oxygen species (ROS) accumulation to resistPst DC3000, BRZ-treated and gene-silenced were completely eliminate this response. Our results suggest BR is involved in ET-induced plant resistance, the involvement of ET in plant resistance is possibly by the induction of callose deposition and ROS accumulation, in a BR-dependent manner.
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Affiliation(s)
- J Xiong
- Key Laboratory of Bio-Resource and Eco-Environment of Ministry of Education, College of Life Sciences, Sichuan University, Chengdu, Sichuan, China
| | - R He
- Key Laboratory of Bio-Resource and Eco-Environment of Ministry of Education, College of Life Sciences, Sichuan University, Chengdu, Sichuan, China
| | - F Yang
- Key Laboratory of Bio-Resource and Eco-Environment of Ministry of Education, College of Life Sciences, Sichuan University, Chengdu, Sichuan, China
| | - L Zou
- Key Laboratory of Southwest China Wildlife Resources Conservation (Ministry of Education), China West Normal University, Nanchong, Sichuan, China
- Ecological Security and Protection Key Laboratory of Sichuan Province and Life Science and Technology College, Mianyang Normal University, Mianyang, Sichuan, China
| | - K Yi
- Environment and Plant Protection Institute, Chinese Academy of Tropical Agricultural Sciences, Haikou, Hainan, China
| | - H Lin
- Key Laboratory of Bio-Resource and Eco-Environment of Ministry of Education, College of Life Sciences, Sichuan University, Chengdu, Sichuan, China
| | - D Zhang
- Key Laboratory of Bio-Resource and Eco-Environment of Ministry of Education, College of Life Sciences, Sichuan University, Chengdu, Sichuan, China
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He R, Wu JX, Zhang Y, Che H, Yang L. LncRNA LINC00628 overexpression inhibits the growth and invasion through regulating PI3K/Akt signaling pathway in osteosarcoma. Eur Rev Med Pharmacol Sci 2019; 22:5857-5866. [PMID: 30280767 DOI: 10.26355/eurrev_201809_15915] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE Osteosarcoma (OS) is the most common primary malignancy, mainly arising from the metaphysic of the long bones of adolescents and young adults. Although osteosarcoma has been studied widely, the underlying molecular mechanism remains unclear. Increasing evidence shows that abnormal long non-coding RNAs (LncRNAs) expression is involved in tumorigenesis. The aim of this study was to identify the detailed role of LncRNA LINC00628 in osteosarcoma. MATERIALS AND METHODS The relative mRNA expression level of LINC00628 in adjacent tissues, osteosarcoma tissues with or without metastasis and osteosarcoma cell lines were detected by qRT-PCR. Overall survival curves for two groups defined by high and low expression level of LINC00628 in osteosarcoma patients. The cell proliferation, invasion and migration in osteosarcoma cells after transfection with lncRNA- NC or lncRNA-LINC00628 were detected. The cell cycle distribution and apoptosis rate in osteosarcoma cells after transfection with lncRNA- NC or lncRNA-LINC00628 were measured using the Flow cytometry analysis. The relative protein expression level of p-PI3K, p-Akt, P53 and Bcl-2 in osteosarcoma cells after transfection with lncRNA- NC or lncRNA-LINC00628 were detected by Western blot. RESULTS LINC00628 expression was significantly decreased in osteosarcoma tissues compared with adjacent tissues. Meanwhile, osteosarcoma tissues with metastasis were significantly associated with a low expression level of LINC00628 and the low expression level of LINC00628 has a lower overall survival rate. LINC00628 expression was increased in osteosarcoma cell lines after transfection with lncRNA-LINC00628 and the cell proliferation, invasion and migration in osteosarcoma cells after transfection with lncRNA-LINC00628 were significantly inhibited. Moreover, the cell cycle was arrested in G0/G1 phase and the apoptosis rate was increased in osteosarcoma cells after transfection with lncRNA-LINC00628. Mechanistically, the relative protein expression level of p-PI3K, p-Akt and Bcl-2 were significantly increased and the relative expression of P53 was significantly decreased in osteosarcoma cells after transfection with lncRNA-LINC00628. CONCLUSIONS LINC00628 expression was decreased in osteosarcoma. The overexpression of LINC00628 inhibited the proliferation, invasion and migration and promoted cell apoptosis in osteosarcoma cells through the inactivation of PI3K/Akt signaling pathway. This lncRNA may be involved in the development and progression of osteosarcoma.
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Affiliation(s)
- R He
- Center for Joint Surgery, Southwest Hospital, Third Military Medical University, Chongqing (Army Medical University), China.
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Hsu CH, Lee M, Lee KH, Numata K, Stein S, Verret W, Hack S, Spahn J, Liu B, Huang C, He R, Ryoo BY. Randomised efficacy and safety results for atezolizumab (Atezo) + bevacizumab (Bev) in patients (pts) with previously untreated, unresectable hepatocellular carcinoma (HCC). Ann Oncol 2019. [DOI: 10.1093/annonc/mdz446.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Lee M, Ryoo BY, Hsu CH, Numata K, Stein S, Verret W, Hack S, Spahn J, Liu B, Abdullah H, He R, Lee KH. Randomised efficacy and safety results for atezolizumab (Atezo) + bevacizumab (Bev) in patients (pts) with previously untreated, unresectable hepatocellular carcinoma (HCC). Ann Oncol 2019. [DOI: 10.1093/annonc/mdz394.030] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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He R, Kanakamedala M, Duggar W, Yang C, Vijayakumar S. Correlation of V12 to the Number of Lesions, Total Tumor Volume and Dose Prescription in Multiple Brain Metastases Stereotactic Radiosurgery Treatment. Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.2475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Kiser K, Meheissen M, Mohamed A, Kamal M, Ng S, Elhalawani H, Jethanandani A, He R, Ding Y, Wang J, Rostom Y, Hegazy N, Fuller C. Quality Assessment of Commercially Available MRI-CT Deformable and Rigid Registration Algorithms. Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.932] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Elhalawani H, He R, Yamazaki T, Gunderson A, Phillips M, McCarty K, McCormick M, Cochran D, Mohamed A, Fuller C, Gough M, Crittenden M, Young K. Multiparametric MRI Measures Correlate with Treatment Response and CD8 T Cell Infiltrate in Phase II Study of Tgfβri Inhibitor with Chemoradiation in Locally Advanced Rectal Cancer. Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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He R, Miao Y, Zhang L, Yang J, Li Z, Li B. Effects of expanding outpatient benefit package on the rationality of medical service utilisation of patients with hypertension: a quasi-experimental trial in rural China. BMJ Open 2019; 9:e025254. [PMID: 31072851 PMCID: PMC6527979 DOI: 10.1136/bmjopen-2018-025254] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2018] [Revised: 02/08/2019] [Accepted: 03/05/2019] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVE To estimate the effects of expanding outpatient benefit package on ameliorating the issues of over-reliance on inpatient services and seeking higher level medical services in rural China. DESIGN A quasi-experimental design. SETTING AND PARTICIPANTS 1673 pairs of patients with hypertension were selected after using propensity score matching from Dangyang county (intervention group) and Zhijiang (control group) county, Hubei province. INTERVENTION The outpatient annual reimbursement capping line was expanding from ¥300 to ¥600, daily capping line from ¥10/12 to ¥150. The compensation scope and institution were also enlarged from January 2016. OUTCOME MEASURES The difference-in-differences model was used to estimate the effects on medical service type selection. χ2 test was used to verify the effects on medical institution selection. We also examined the effects on health outcomes through the length of stay and blood pressure changes. RESULTS The intervention was associated with 3.225 times (p=0.001) increase in total visits. Outpatient visits increased by 3.3 times (p=0.008), whereas the township level presented a maximum increase of 1.932 times (p=0.001). The inpatient visits declined by 0.075 times (p=0.000), whereas county-level inpatient visits reached a maximum decrease of 0.042 times (p=0.033). Meanwhile, the township level exhibited a maximum proportion growth of 14.8% in outpatient (p=0.000) and 13.3% in inpatient visits (p=0.048). Outpatient visits at the county level dropped at 13.2% (p=0.000), whereas inpatients visits declined by 7.7% (p=0.040). The length of stay and blood pressure were decreased, respectively, compared with the control group. CONCLUSION Improving outpatient benefit package alleviated patient dependence on inpatient services through motivating outpatient service utilisation, consolidated the primacy of township health centres and guided patients to return to primary medical institutions. The health insurance reform should 'take the long view' in the future, and more attention should be paid to the rationality of medical service utilisation.
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Affiliation(s)
- Ruibo He
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yudong Miao
- Department of General Medicine, Henan Provincial People’s Hospital, Zhengzhou, China
| | - Liang Zhang
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jian Yang
- Department of Medical Affairs, Guangdong General Hospital, Guangzhou, China
| | - Zhong Li
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Boyang Li
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Abstract
OBJECTIVE This study aimed to define the end-of-life (EOL) healthcare utilisation and its cost and determinants for cancer patients and to proactively inform related strategies in mainland China. DESIGN A population-based retrospective study. SETTING AND PARTICIPANTS Data from 894 cancer patients were collected in urban Yichang, China from 01 July 2015 to 30 June 2017. OUTCOME MEASURES Emergency department (ED) visits, outpatient and inpatient hospitalisation services, intensive care unit (ICU) admission and total costs were used as the main outcomes. RESULTS In this study, 66.8% of the 894 patients were male, and the average age was 60.4 years. Among these patients, 37.6% died at home, and patients had an average of 4.86 outpatient services, 2.23 inpatient hospitalisation services and 1.44 ED visits. Additionally, 5.9% of these patients visited the ICU at least once. During the EOL periods, the costs in the last 6 months, 3 months, 1 month and 1 week were US$18 234, US$13 043, US$6349 and US$2085, respectively. The cost increased dramatically as death approached. The estimation results of generalised linear regression models showed that aggressive care substantially affected expenditure. Patients with Urban Employee Basic Medical Insurance spent more than those with Urban Resident-based Basic Medical Insurance or the New Rural Cooperative Medical Scheme. The place of death and the survival time are also risk factors for increased EOL cost. CONCLUSION The findings suggested that the EOL cost for cancer patients is associated with aggressive care, insurance type and survival time. Timing palliative care is urgently needed to address ineffective and irrational healthcare utilisation and to reduce costs. ETHICS AND DISSEMINATION This study was approved by the Ethics Committee of the Tongji Medical College, Huazhong University of Science and Technology (IORG No.: IORG0003571). All the data used in this study were de-identified.
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Affiliation(s)
- Zhong Li
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Zijing Pan
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Liang Zhang
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Ruibo He
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Shan Jiang
- School of Health Policy and Management, Nanjing Medical University, Nanjing, China
| | - Chengzhong Xu
- Yichang Center for Disease Control and Prevention, Yichang, China
| | - Fangfang Lu
- Yichang Center for Disease Control and Prevention, Yichang, China
| | - Pei Zhang
- Yichang Center for Disease Control and Prevention, Yichang, China
| | - Boyang Li
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Miao Y, Yuan X, Gu J, Zhang L, He R, Sandeep S, Wu J. Constructing a value-based healthcare system for hypertensive patients through changing payment mode: evidence from a comparative study in rural China. J Med Econ 2019; 22:245-251. [PMID: 30547700 DOI: 10.1080/13696998.2018.1558864] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
OBJECTIVE To construct a value-based healthcare system for rural Chinese hypertensive patients through an increasing outpatient care reimbursement ratio. METHODS This comparative study sampled two similar counties, Dangyang County and Zhijiang County, in Hubei Province of China, as the intervention group and the control group, respectively. The Social Health Insurance Fund of the intervention group budgeted 600 yuan per capita per year to insured patients with third stage hypertension to cover their outpatient expenditures, while the outpatient expenditures of the control group were not covered by its Social Health Insurance Fund. The inpatient expenditure reimbursement policies in both groups were not adjusted during the study. Value improvement in this study was defined as reduction in medical costs and improvement in health outcomes within the pilot healthcare system. A propensity score matching model combined with a difference-in-differences model was used to estimate the changes in medical costs and health outcomes. RESULTS In total, 1,673 pairs of patients were enrolled into statistical analysis after the propensity score matching. The intervention increased per capita annual outpatient expenditure by 81.2 (+31.8%) yuan (p > .05), but decreased the per capita annual inpatient expenditure and total medical expenditure by 475.4 (-40.7%) yuan and 394.2 (-27.7%) yuan, respectively (p < .05). Accordingly, the per capita annual total medical expenditure reimbursement decreased by 192.3 (-28.5%) yuan (p < .05), and the per capita annual total out-of-pocket expenditure by 201.9 (-29.9%) yuan (p < .05). The diastolic blood pressure of the intervention group decreased significantly by 2.9 mmHg (p < .05), but no significant change was found in systolic blood pressure and prevalence of hypertension complications (p > .05). CONCLUSION Increasing the outpatient expenditures, the reimbursement ratio was beneficial to the value of the healthcare system for hypertensive patients. Outpatient care for patients with chronic diseases should be prioritized for rural China and healthcare settings with inadequate health insurance funds.
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Affiliation(s)
- Yudong Miao
- a Department of General Medicine of Henan Provincial People's Hospital , Zhengzhou , China
- b School of Health Policy and Management , Nanjing Medical University , Nanjing , China
| | - Xiangdong Yuan
- c Guangdong General Hospital , Guangdong Academy of Medical Sciences , Guangzhou , China
| | - Jianqin Gu
- a Department of General Medicine of Henan Provincial People's Hospital , Zhengzhou , China
| | - Liang Zhang
- d School of Medicine and Health Management , Tongji Medical College, Huazhong University of Science & Technology , Wuhan , China
| | - Ruibo He
- d School of Medicine and Health Management , Tongji Medical College, Huazhong University of Science & Technology , Wuhan , China
| | - Sandeep Sandeep
- d School of Medicine and Health Management , Tongji Medical College, Huazhong University of Science & Technology , Wuhan , China
| | - Jian Wu
- e College of Public Health , Zhengzhou University , Zhengzhou , China
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Liu X, Zhang L, He R, Li Z, Wu Y, Li B. Measuring the effect of health on the income of people living in extreme poverty: A comparative cross-sectional analysis. Int J Health Plann Manage 2019; 34:714-726. [PMID: 30706968 DOI: 10.1002/hpm.2730] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2018] [Revised: 12/15/2018] [Accepted: 12/18/2018] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Through a review of the literature, we have observed that existing studies primarily focus on defining and measuring poverty, identifying the factors that affect poverty, and proposing anti-poverty strategies. The impact of health on income in the context of extreme poverty has not been adequately studied. In China, 30 million people live below the poverty line, and poverty caused by illness accounts for nearly 44% of the total number of recorded incidents. Health impaired by disease has become the largest obstacle to escaping extreme poverty. OBJECTIVE To determine whether health has a greater effect on the incomes of individuals in the extreme poverty group compared with the nonimpoverished group. METHODS The poverty threshold of China in 2010 was adopted for the definition of extreme poverty. The China Health and Nutrition Survey (CHNS) Database 2014 was selected as the data source. Ordinary least squares (OLS) test was conducted to estimate the model, and the endogeneity of the variables was analyzed by the random effects model. Waist-to-hip ratio (WHR) was used instead of body mass index (BMI) to perform the robustness test. RESULTS We found that the influence of individual health conditions on income was augmented in the case of extreme poverty, which indicates that health indeed influences income more strongly for individuals in the extreme poverty group. CONCLUSIONS In addition to education, investment, and social security projects, further public policy attention should be given to the improvement of the health status of the extremely impoverished population.
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Affiliation(s)
- Xuejiao Liu
- Department of Social Medicine and Health Management, School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Liang Zhang
- Department of Social Medicine and Health Management, School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Ruibo He
- Department of Social Medicine and Health Management, School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Zhong Li
- Department of Social Medicine and Health Management, School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yue Wu
- Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China
| | - Boyang Li
- Department of Social Medicine and Health Management, School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Lv Z, He R, Huang M, Zhao G, Ma J, Chen G. Targeting genes and signaling pathways of transcriptional suppressor ZHX2 in hepatocellular carcinoma: a Chromatin Immunoprecipitation-sequencing (ChIP-seq) investigation. Neoplasma 2019; 66:437-445. [DOI: 10.4149/neo_2018_180806n593] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2018] [Accepted: 12/11/2018] [Indexed: 11/08/2022]
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Li Z, Jiang S, He R, Dong Y, Pan Z, Xu C, Lu F, Zhang P, Zhang L. Trajectories of Hospitalization Cost Among Patients of End-Stage Lung Cancer: A Retrospective Study in China. Int J Environ Res Public Health 2018; 15:ijerph15122877. [PMID: 30558272 PMCID: PMC6313636 DOI: 10.3390/ijerph15122877] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/22/2018] [Revised: 11/24/2018] [Accepted: 12/10/2018] [Indexed: 12/24/2022]
Abstract
This study was conducted to investigate the trajectory of hospitalization costs, and to assess the determinants related to the membership of the identified trajectories, with the view of recommending future research directions. A retrospective study was performed in urban Yichang, China, where a total of 134 end-stage lung cancer patients were selected. The latent class analysis (LCA) model was used to investigate the heterogeneity in the trajectory of hospitalization cost amongst the different groups that were identified. A multi-nominal logit model was applied to explore the attributes of different classes. Three classes were defined as follows: Class 1 represented the trajectory with minimal cost, which had increased over the last two months. Classes 2 and 3 consisted of patients that incurred high costs, which had declined with the impending death of the patient. Patients in class 3 had a higher average cost than those in Class 2. The level of education, hospitalization, and place of death, were the attributes of membership to the different classes. LCA was useful in quantifying heterogeneity amongst the patients. The results showed the attributes were embedded in hospitalization cost trajectories. These findings are applicable to early identification and intervention in palliative care. Future studies should focus on the validation of the proposed model in clinical settings, as well as to identify the determinants of early discharge or aggressive care.
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Affiliation(s)
- Zhong Li
- School of Medicine and Health Management, Huazhong University of Science and Technology, Wuhan 430030, China.
| | - Shan Jiang
- School of Health Policy and Management, Nanjing Medical University, Nanjing 211166, China.
| | - Ruibo He
- School of Medicine and Health Management, Huazhong University of Science and Technology, Wuhan 430030, China.
| | - Yihan Dong
- School of Medicine and Health Management, Huazhong University of Science and Technology, Wuhan 430030, China.
| | - Zijin Pan
- School of Medicine and Health Management, Huazhong University of Science and Technology, Wuhan 430030, China.
| | - Chengzhong Xu
- Yichang Center for Disease Control and Prevention, Yichang 443000, China.
| | - Fangfang Lu
- Yichang Center for Disease Control and Prevention, Yichang 443000, China.
| | - Pei Zhang
- Yichang Center for Disease Control and Prevention, Yichang 443000, China.
| | - Liang Zhang
- School of Medicine and Health Management, Huazhong University of Science and Technology, Wuhan 430030, China.
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He R, Ye T, Wang J, Zhang Y, Li Z, Niu Y, Zhang L. Medical Service Quality, Efficiency and Cost Control Effectiveness of Upgraded Case Payment in Rural China: A Retrospective Study. Int J Environ Res Public Health 2018; 15:E2839. [PMID: 30551561 PMCID: PMC6313562 DOI: 10.3390/ijerph15122839] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/21/2018] [Revised: 12/05/2018] [Accepted: 12/10/2018] [Indexed: 11/30/2022]
Abstract
Background: As the principal means of reimbursing medical institutions, the effects of case payment still need to be evaluated due to special environments and short exploration periods, especially in rural China. Methods: Xi County was chosen as the intervention group, with 36,104, 48,316, and 59,087 inpatients from the years 2011 to 2013, respectively. Huaibin County acted as the control group, with 33,073, 48,122, and 51,325 inpatients, respectively, from the same period. The inpatients' information was collected from local insurance agencies. After controlling for age, gender, institution level, season fixed effects, disease severity, and compensation type, the generalised additive models (GAMs) and difference-in-differences approach (DID) were used to measure the changing trends and policy net effects from two levels (the whole county level and each institution level) and three dimensions (cost, quality and efficiency). Results: At the whole-county level, the cost-related indicators of the intervention group showed downward trends compared to the control group. Total spending, reimbursement fee and out-of-pocket expense declined by ¥346.59 (p < 0.001), ¥105.39 (p < 0.001) and ¥241.2 (p < 0.001), respectively (the symbol ¥ represents Chinese yuan). Actual compensation ratio, length of stay, and readmission rates exhibited ascending trends, with increases of 7% (p < 0.001), 2.18 days (p < 0.001), and 1.5% (p < 0.001), respectively. The intervention group at county level hospital had greater length of stay reduction (¥792.97 p < 0.001) and readmission rate growth (3.3% p < 0.001) and lower reimbursement fee reduction (¥150.16 p < 0.001) and length of stay growth (1.24 days p < 0.001) than those at the township level. Conclusions: Upgraded case payment is more reasonable and suitable for rural areas than simple quota payment or cap payment. It has successfully curbed the growth of medical expenses, improved the efficiency of medical insurance fund utilisation, and alleviated patients' economic burden of disease. However, no positive effects on service quality and efficiency were observed. The increase in readmission rate and potential hidden dangers for primary health care institutions should be given attention.
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Affiliation(s)
- Ruibo He
- School of Medicine and Health Management, Huazhong University of Science and Technology, Wuhan 430030, China.
| | - Ting Ye
- School of Medicine and Health Management, Huazhong University of Science and Technology, Wuhan 430030, China.
| | - Jing Wang
- School of Medicine and Health Management, Huazhong University of Science and Technology, Wuhan 430030, China.
| | - Yan Zhang
- School of Medicine and Health Management, Huazhong University of Science and Technology, Wuhan 430030, China.
| | - Zhong Li
- School of Medicine and Health Management, Huazhong University of Science and Technology, Wuhan 430030, China.
| | - Yadong Niu
- School of Medicine and Health Management, Huazhong University of Science and Technology, Wuhan 430030, China.
| | - Liang Zhang
- School of Medicine and Health Management, Huazhong University of Science and Technology, Wuhan 430030, China.
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Elgohari B, Mohamed A, Ng S, Elhalawani H, Elsayes A, He R, Ding Y, Wang J, Elawadi M, Awad I, Hutcheson K, Gunn G, Frank S, Garden A, Rosenthal D, Lai S, Fuller C. Diffusion-Weighted MRI As an Early Biomarker of Xerostomia in Oropharyngeal Cancer Patients Treated with Radiation Therapy. Int J Radiat Oncol Biol Phys 2018. [DOI: 10.1016/j.ijrobp.2018.07.747] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Wang L, Chen M, He R, Sun Y, Yang J, Xiao L, Cao J, Zhang H, Zhang C. DUCHENNE MUSCULAR DYSTROPHY – IMAGING AND BIOMARKERS. Neuromuscul Disord 2018. [DOI: 10.1016/j.nmd.2018.06.059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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68
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He R. Pro-inflammatory responses to PM0.25 from airport and urban traffic emissions. Toxicol Lett 2018. [DOI: 10.1016/j.toxlet.2018.06.787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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69
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He R, Zhang O, Liu YW. [Subcutaneous implantable cardioverter defibrillator implantation in a hemodialysis patient with myocardial infarction and malignant arrhythmias]. Zhonghua Xin Xue Guan Bing Za Zhi 2018; 46:651-652. [PMID: 30139019 DOI: 10.3760/cma.j.issn.0253-3758.2018.08.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
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Lv J, Xiong Y, Li W, Cui X, Cheng X, Leng Q, He R. IL-37 inhibits IL-4/IL-13-induced CCL11 production and lung eosinophilia in murine allergic asthma. Allergy 2018; 73:1642-1652. [PMID: 29319845 DOI: 10.1111/all.13395] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/29/2017] [Indexed: 01/10/2023]
Abstract
BACKGROUND IL-37 is emerging as an anti-inflammatory cytokine, particularly in innate inflammation. However, the role of IL-37 in Th2-mediated allergic lung inflammation remains uncertain. We sought to determine the role and the underlying mechanisms of IL-37 in the development of house dust mites (HDM)-induced murine asthma model. METHODS We examined the effect of IL-37 administration during the sensitization or challenge phase on Th2-mediated allergic asthma induced by inhaled HDM. Cellular source of CCL11 and distribution of IL-37 receptors, IL-18Rα and IL-1R8, were determined in HDM-exposed lungs. Finally, we examined the effect of IL-37 on CCL11 production and STAT6 activation in different primary lung structural cell types upon IL-4/IL-13 stimulation. RESULTS IL-37 had no effect on HDM sensitization, but when administrated during the challenge phase, significantly attenuated pulmonary eosinophilia, CCL11 production, and airway hyper-reactivity (AHR). Interestingly, IL-37 treatment had no significant effects on lung infiltrating T cells and Th2 cytokine production. Intranasal co-administration of CCL11 reversed the inhibiting effect of IL-37 on HDM-induced pulmonary eosinophilia and AHR. Furthermore, we demonstrated that CCL11 was primarily expressed by fibroblasts and airway smooth muscle cells (AMSC), while IL-37 receptors by tracheobronchial epithelial cells (TEC). In vitro study showed that IL-37 inhibited IL-4/IL-13-induced STAT6 activation and CCL11 production by fibroblasts and AMSC, which was dependent on its direct action on TEC. Moreover, cell contact was required for the inhibitory effect of IL-37-treated TEC. CONCLUSIONS IL-37 attenuates HDM-induced asthma, possibly by inhibiting IL-4/IL-13-induced CCL11 production by fibroblasts and AMSC via its direct act on TEC.
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Affiliation(s)
- J. Lv
- Department of Immunology; School of Basic Medical Sciences; Fudan University; Shanghai China
- Institute for Immunology; Tsinghua University-Peking University Joint Center for Life Sciences; Tsinghua University School of Medicine; Beijing China
| | - Y. Xiong
- Department of Immunology; School of Basic Medical Sciences; Fudan University; Shanghai China
| | - W. Li
- Department of Immunology; School of Basic Medical Sciences; Fudan University; Shanghai China
| | - X. Cui
- Department of Immunology; School of Basic Medical Sciences; Fudan University; Shanghai China
| | - X. Cheng
- Department of Medical Microbiology and Parasitology; School of Basic Medical Sciences; Fudan University; Shanghai China
| | - Q. Leng
- CAS Key Laboratory of Molecular Virology & Immunology; Institute Pasteur of Shanghai; Chinese Academy of Sciences; Shanghai China
| | - R. He
- Department of Immunology; School of Basic Medical Sciences; Fudan University; Shanghai China
- Department of Laboratory Animal Science; Fudan University; Shanghai China
- State Key Laboratory of Medical Neurobiology; Institutes of Brain Science; Fudan University; Shanghai China
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71
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He R, Jianzhong F. The analysis of force and surface electromyogram of agonist and antagonist during isometric elbow flexion at different joint angles. Ann Phys Rehabil Med 2018. [DOI: 10.1016/j.rehab.2018.05.932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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72
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Miao Y, Gu J, Zhang L, He R, Sandeep S, Wu J. Improving the performance of social health insurance system through increasing outpatient expenditure reimbursement ratio: a quasi-experimental evaluation study from rural China. Int J Equity Health 2018; 17:89. [PMID: 29940956 PMCID: PMC6019724 DOI: 10.1186/s12939-018-0799-8] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2018] [Accepted: 06/11/2018] [Indexed: 11/10/2022] Open
Abstract
Background China has set up a universal coverage social health insurance system since the 2009 healthcare reform. Due to the inadequate funds, the social health insurance system reimbursed the inpatient expenditures with much higher ratio than outpatient expenditure. The gap in reimbursement ratios resulted in a rapid rising hospitalization rate but poor health outcomes among the Chinese population. A redistribution of social health insurance funds has become one of the main challenges for the performance of Social Health Insurance. Methods Two comparable counties, Dangyang County and Zhijiang County, in Hubei Province of China, were sampled as the intervention group and the control group, respectively. The Social Health Insurance Management Department of the intervention group budgeted 600 yuan per capita per year to the patients with 3rd stage hypertension to cover their outpatient expenditures. The outpatient spending in the control group were paid out-of-pocket. The inpatient expenditures reimbursement policies in both groups were not changed. Besides, the Social Health Insurance Management Department of the intervention group budgeted 100 yuan per patient per year to township physicians and hospitals to provide health management services for the patients. While, the health management services in the control group were still provided by health workers. A Propensity Score Matching model and Difference-in-differences model were used to estimate the net effects of the intervention in dimensions of medical services utilization, medical expenditures, SHI reimbursement, and health outcomes. Results One thousand, six hundred and seventy three pairs of patients were taken as valid subjects to conduct Difference-in-differences estimation after the Propensity Score Matching. The net intervention effect is to increase outpatient frequency by 3.3 (81.0%) times (P < 0.05), to decrease hospitalization frequency by 0.075 (− 60.0%) times (P < 0.05), and to increase the per capita total medical service utilization frequency by 3.225 (76.8%) times (P < 0.05). The per capita total medical expenditure decreased 394.2 (− 27.7%) yuan. The SHI reimbursed 90.3 yuan more per capita for the outpatient spending, but the per capita inpatient expenditure reimbursement and per capita total medical expenditure reimbursement decreased significantly by 282.6 (− 44.0%) yuan and 192.3 (− 28.5%) yuan, respectively (P < 0.05). The intervention reduced the per capita inpatient out-of-pocket expenditure and the per capita total out-of-pocket expenditure by 192.8 (− 36.7%) yuan and 201.9 (− 29.9%) yuan, respectively (P < 0.05). The intervention significantly decreased the diastolic blood pressure of the intervention group by 2.9 mmHg (P < 0.05) but had no significant impact on the systolic blood pressure (− 7.9 mmHg, P > 0.05). Conclusion For China and countries attempting to establish a universal coverage SHI with inadequate funds, inpatient services were expensive but might not produce good health outcomes. Outpatient care for patients with chronic diseases should be fundamental, and outpatient expenditures should be reimbursed with a higher ratio.
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Affiliation(s)
- Yudong Miao
- Henan Provincial People's Hospital, 7 Weiwu Road, Zhengzhou, 450003, Henan Province, China.,School of Health Policy and Management, Nanjing Medical University, Nanjing, China
| | - Jianqin Gu
- Henan Provincial People's Hospital, 7 Weiwu Road, Zhengzhou, 450003, Henan Province, China.
| | - Liang Zhang
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, China
| | - Ruibo He
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, China
| | - Sandeep Sandeep
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, China
| | - Jian Wu
- College of Public Health, Zhengzhou University, Zhengzhou, China
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Guo W, Li D, He R, Wu M, Chen W, Gao F, Zhang Z, Yao Y, Yu L, Chen S. Synthesizing value-added products from methane by a new Methylomonas. J Appl Microbiol 2018; 123:1214-1227. [PMID: 28888065 DOI: 10.1111/jam.13581] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2017] [Revised: 07/23/2017] [Accepted: 08/11/2017] [Indexed: 01/08/2023]
Abstract
AIMS Methane and methanol are potential carbon sources of industrial micro-organisms in addition to crop-derived bio-carbon sources. Methanotrophs that can utilize these simple, stable and large amounts chemicals are expected to be developed into 'cell factories' for the production of specific chemicals. In this study, a methanotroph that can synthesize lycopene, C30 carotenoid and exopolysaccharides (EPS) with relative better performances from C1 substrates was isolated, and its performances were evaluated. METHODS AND RESULTS The isolated strain was identified as Methylomonas sp. ZR1 based on 16S rRNA sequence analysis. Its maximum specific growth rate achieved 0·200 h-1 under flask culture conditions, and 0·386 h-1 in bubble column reactors. ZR1 was able to utilize 35 g l-1 of methanol and even exhibited slight growth in the presence of 40 g l-1 of methanol. Furthermore, ZR1 was proved to synthesize lycopene (C40 carotenoids) besides the C30 carotenoids through HPLC-DAD and HPLC-MS/MS analysis methods. Its carotenoid extracts exhibited excellent antioxidative activities measured by the ABTS+ method. Plenty of polysaccharides were also synthesized by ZR1, the components of the polysaccharides were identified as glucose, mannose and galactose with a proportion of 1 : 2 : 1 by GC-MS, and its yield achieved 0·13 g g-1 cell dry weight. CONCLUSIONS The isolated strain has great potential for the production of value-added bioproducts from C1 compounds because of its excellent C1 substrate utilizing abilities and its abilities to naturally synthesize lycopene, C30 carotenoids and EPS. SIGNIFICANCE AND IMPACT OF THE STUDY In this study, we isolated a fast-growing methanotroph, its C1 carbon substrate utilizing ability is excellent in comparison with reported methanotrophs. Furthermore, besides polysaccharides and C30 carotenoids which were commonly synthesized by methanotrophs, our findings suggested that C40 lycopene could also be naturally synthesized from methane by methanotrophs.
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Affiliation(s)
- W Guo
- Tianjin Key Laboratory for Industrial Biological Systems and Bioprocessing Engineering, Tianjin Institute of Industrial Biotechnology, Chinese Academy of Science, Tianjin, China
| | - D Li
- Tianjin Key Laboratory for Industrial Biological Systems and Bioprocessing Engineering, Tianjin Institute of Industrial Biotechnology, Chinese Academy of Science, Tianjin, China
| | - R He
- Tianjin Key Laboratory for Industrial Biological Systems and Bioprocessing Engineering, Tianjin Institute of Industrial Biotechnology, Chinese Academy of Science, Tianjin, China
| | - M Wu
- Food and Environmental Department, Dalian University of Technology, Panjin, China
| | - W Chen
- Tianjin Key Laboratory for Industrial Biological Systems and Bioprocessing Engineering, Tianjin Institute of Industrial Biotechnology, Chinese Academy of Science, Tianjin, China
| | - F Gao
- Tianjin Key Laboratory for Industrial Biological Systems and Bioprocessing Engineering, Tianjin Institute of Industrial Biotechnology, Chinese Academy of Science, Tianjin, China
| | - Z Zhang
- Technology Support Center, Tianjin Institute of Industrial Biotechnology, Chinese Academy of Science, Tianjin, China
| | - Y Yao
- Technology Support Center, Tianjin Institute of Industrial Biotechnology, Chinese Academy of Science, Tianjin, China
| | - L Yu
- Department of Biological Systems Engineering, Washington State University, Pullman, WA, USA
| | - S Chen
- Tianjin Key Laboratory for Industrial Biological Systems and Bioprocessing Engineering, Tianjin Institute of Industrial Biotechnology, Chinese Academy of Science, Tianjin, China
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Qiu T, He R, Abunassar C, Hossainy S, Zhao L. Effect of two-year degradation on mechanical interaction between a bioresorbable scaffold and blood vessel. J Mech Behav Biomed Mater 2018; 78:254-265. [DOI: 10.1016/j.jmbbm.2017.11.031] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2017] [Revised: 11/18/2017] [Accepted: 11/21/2017] [Indexed: 11/26/2022]
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Abstract
BACKGROUND Global budget (GB) is considered one of the most important payment methods available. Since a new round of healthcare system reforms in 2009, the Chinese government has been paying attention to this prospective payment. However, it is unclear whether GB has influenced cost control and how it works in rural China. METHODS YC county was chosen as the intervention group, with 33,175 inpatients before and 36,883 inpatients after the reform (2012 and 2014, respectively). ZJ county acted as the control group, with 23,668 and 29,555 inpatients, respectively. The inpatients' information was collected from a local insurance agency. The difference-in-difference method (controlling for age, gender, living status, severity of the disease, whether the patient had surgery, the level of medical institutions, and the secular trends of the two groups) was applied to estimate the effects on total spending (TS), reimbursement expense (RE), out-of-pocket payment (OOP), readmission rate, and seven kinds of medical service items. RESULTS At per practice level, the GB was associated with a ¥263.35 (p < .001) and ¥447.46 (p < .001) decrease in growth of TS and RE, respectively, while OOP increased by ¥188.06 (p < .001). At per capital level, the decrease in growth of TS and RE was ¥64.39 (p = .301) and ¥467.45 (p < .001), respectively, whereas the increase of OOP was more significant at ¥408.19 (p < .001). Savings were concentrated in unclassified items (¥197.68, p < .001), drug prescription (¥69.03, p < .001), surgery (¥40.18, p < .001), cure (¥4.95, p = .565), and diagnosis (¥3.61, p = .064). Meanwhile, the readmission rate increased by 11.4% (p < .001). CONCLUSIONS The GB has a prominent impact on curbing the growth of insurance fund expenditures, as well as drug and medical consumable costs. However, the patients' out-of-pocket payment has risen. Doctors decomposed hospitalization to deal with supervision, which was harmful to patients. Any medical insurance payment reform should be undertaken prudently, and its likely outcomes should be weighed comprehensively.
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Affiliation(s)
- Ruibo He
- a School of Medicine and Health Management , Huazhong University of Science and Technology , Wuhan , PR China
| | - Yudong Miao
- a School of Medicine and Health Management , Huazhong University of Science and Technology , Wuhan , PR China
| | - Ting Ye
- a School of Medicine and Health Management , Huazhong University of Science and Technology , Wuhan , PR China
| | - Yan Zhang
- a School of Medicine and Health Management , Huazhong University of Science and Technology , Wuhan , PR China
| | - Wenxi Tang
- b School of International Pharmaceutical Business , China Pharmaceutical University , Nanjing , PR China
| | - Zhong Li
- a School of Medicine and Health Management , Huazhong University of Science and Technology , Wuhan , PR China
| | - Liang Zhang
- a School of Medicine and Health Management , Huazhong University of Science and Technology , Wuhan , PR China
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Gao XM, He R, Guan JF, Tian L. Effects of heparin catheter-sealing solution for implantable venous access ports on D-dimer levels in older cancer patients. Eur Rev Med Pharmacol Sci 2017; 21:97-101. [PMID: 28745782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
OBJECTIVE To investigate the effects of different concentrations of heparin catheter-sealing solution for implantable venous access ports (VAPs) on D-dimers (D-D) in older cancer patients. PATIENTS AND METHODS A total of 208 older cancer patients who received intravenous chemotherapy for the first time were randomly divided into four groups: the normal saline group, the low concentration heparin group (25 U/ml), the medium concentration heparin group (50 U/ml), and the high concentration heparin group (75 U/ml), with 52 patients in each group. VAPs were sealed by the positive pressure technique every day before and after perfusion, as well as at the end of a course of chemotherapy when the butterfly needle was removed. The patients were followed-up for three courses of chemotherapy, and comparisons of the clinical effects were conducted. RESULTS Before treatment and at the end of follow-up, no significant differences among groups were found in platelet count, prothrombin time, thrombin time, or activated partial thromboplastin time (p>0.05). At the end of follow-up, the high concentration heparin group had reduced fibrinogen (FIB) and increased D-D compared with the other groups, and the differences were statistically significant (p<0.05). The other three groups showed no significant differences in FIB or D-D before treatment or at the end of follow-up (p>0.05). The high concentration heparin group had higher local bleeding rate, while the saline group had higher partial and complete prevalence of blockage compared with the other groups. The differences were statistically significant (p<0.05). CONCLUSIONS 25-50 U/ml heparin catheter-sealing solution had little effect on blood circulation and coagulation. Additionally, it did not increase the risk of local bleeding or thrombotic blockage.
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Affiliation(s)
- X-M Gao
- Department I of Oncology, The Second Hospital of Dalian Medical University, Dalian, Liaoning Province, China.
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Wang T, He R, Zhao J, Mei JC, Shao MZ, Pan Y, Zhang J, Wu HS, Yu M, Yan WC, Liu LM, Liu F, Jia WP. Negative pressure wound therapy inhibits inflammation and upregulates activating transcription factor-3 and downregulates nuclear factor-κB in diabetic patients with foot ulcerations. Diabetes Metab Res Rev 2017; 33. [PMID: 27883358 DOI: 10.1002/dmrr.2871] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2016] [Revised: 10/18/2016] [Accepted: 11/13/2016] [Indexed: 12/31/2022]
Abstract
BACKGROUND Negative pressure wound therapy (NPWT) is one of the most important treatments for diabetic foot, but the underlying mechanisms of its benefits still remain elusive. This study aims to evaluate the inflammatory signals involved in the effects of negative pressure therapy on diabetic foot ulcers. METHODS We enrolled 22 patients with diabetic foot ulceration, 11 treated with NPWT and the other 11 treated with traditional debridement. All patients were treated and observed for 1 week. Granulation tissues were harvested and analyzed in both groups, and then were histologically and immunohistochemically analyzed. Enzyme-linked immunosorbent assay, Western blot analysis, and real-time PCR were performed to evaluate the expression of interleukin-6 (IL-6), tumor necrosis factor α (TNF-α), inducible nitric oxide synthase (iNOS), nuclear factor-κB (NF-κB) p65, Ik B-α, and activating transcription factor-3 (ATF-3). RESULTS After 7 days of treatment, NPWT could obviously promote diabetic wound healing because of the mild inflammation and the dense cell-deposited matrix. Meanwhile, NPWT significantly decreased the expression of TNF-α, IL-6, and iNOS (all P < .05). The result of Western blotting and real-time PCR indicated that NPWT obviously decreased the level of Ik B-α and NF-κB p65, and increased the level of ATF-3 (all P < .05). CONCLUSION NPWT exerts an anti-inflammatory effect, possibly through the suppression of proinflammatory enzymes and cytokines resulting from Ik B-α inhibition and ATF-3 activation, which may prevent the activation of the NF-κB pathway in human diabetic foot wounds.
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Affiliation(s)
- T Wang
- Department of Vascular Surgery, Shanghai Clinical Medical Center of Diabetes, Multidisciplinary Collaboration Center of Diabetic Foot, Shanghai Jiao-Tong University Affiliated Sixth People's Hospital of Shanghai, Shanghai, China
| | - R He
- Department of Endocrinology and Metabolism, Shanghai Key Laboratory of Diabetes, Shanghai Clinical Medical Center of Diabetes, Shanghai Key Clinical Center of Metabolic Diseases, Multidisciplinary Collaboration Group of Diabetic Foot, Shanghai Institute for Diabetes, Shanghai Jiao-Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - J Zhao
- Department of Vascular Surgery, Shanghai Clinical Medical Center of Diabetes, Multidisciplinary Collaboration Center of Diabetic Foot, Shanghai Jiao-Tong University Affiliated Sixth People's Hospital of Shanghai, Shanghai, China
| | - J C Mei
- Department of Vascular Surgery, Shanghai Clinical Medical Center of Diabetes, Multidisciplinary Collaboration Center of Diabetic Foot, Shanghai Jiao-Tong University Affiliated Sixth People's Hospital of Shanghai, Shanghai, China
| | - M Z Shao
- Department of Vascular Surgery, Shanghai Clinical Medical Center of Diabetes, Multidisciplinary Collaboration Center of Diabetic Foot, Shanghai Jiao-Tong University Affiliated Sixth People's Hospital of Shanghai, Shanghai, China
| | - Y Pan
- Department of Vascular Surgery, Shanghai Clinical Medical Center of Diabetes, Multidisciplinary Collaboration Center of Diabetic Foot, Shanghai Jiao-Tong University Affiliated Sixth People's Hospital of Shanghai, Shanghai, China
| | - J Zhang
- Department of Vascular Surgery, Shanghai Clinical Medical Center of Diabetes, Multidisciplinary Collaboration Center of Diabetic Foot, Shanghai Jiao-Tong University Affiliated Sixth People's Hospital of Shanghai, Shanghai, China
| | - H S Wu
- Department of Vascular Surgery, Shanghai Clinical Medical Center of Diabetes, Multidisciplinary Collaboration Center of Diabetic Foot, Shanghai Jiao-Tong University Affiliated Sixth People's Hospital of Shanghai, Shanghai, China
| | - M Yu
- Department of Vascular Surgery, Shanghai Clinical Medical Center of Diabetes, Multidisciplinary Collaboration Center of Diabetic Foot, Shanghai Jiao-Tong University Affiliated Sixth People's Hospital of Shanghai, Shanghai, China
| | - W C Yan
- Department of Vascular Surgery, Shanghai Clinical Medical Center of Diabetes, Multidisciplinary Collaboration Center of Diabetic Foot, Shanghai Jiao-Tong University Affiliated Sixth People's Hospital of Shanghai, Shanghai, China
| | - L M Liu
- Department of Endocrinology and Metabolism, Shanghai Key Laboratory of Diabetes, Shanghai Clinical Medical Center of Diabetes, Shanghai Key Clinical Center of Metabolic Diseases, Multidisciplinary Collaboration Group of Diabetic Foot, Shanghai Institute for Diabetes, Shanghai Jiao-Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - F Liu
- Department of Endocrinology and Metabolism, Shanghai Key Laboratory of Diabetes, Shanghai Clinical Medical Center of Diabetes, Shanghai Key Clinical Center of Metabolic Diseases, Multidisciplinary Collaboration Group of Diabetic Foot, Shanghai Institute for Diabetes, Shanghai Jiao-Tong University Affiliated Sixth People's Hospital, Shanghai, China
| | - W P Jia
- Department of Endocrinology and Metabolism, Shanghai Key Laboratory of Diabetes, Shanghai Clinical Medical Center of Diabetes, Shanghai Key Clinical Center of Metabolic Diseases, Multidisciplinary Collaboration Group of Diabetic Foot, Shanghai Institute for Diabetes, Shanghai Jiao-Tong University Affiliated Sixth People's Hospital, Shanghai, China
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He R, Wang H, Su Y, Chen C, Xie L, Chen L, Yu J, Toledo Y, Abayaweera GS, Zhu G, Bossmann SH. Incorporating 131I into a PAMAM (G5.0) dendrimer-conjugate: design of a theranostic nanosensor for medullary thyroid carcinoma. RSC Adv 2017. [DOI: 10.1039/c7ra00604g] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
We report the synthesis and purification of a targeting probe for Medullary Thyroid Carcinoma (MTC) by incorporating 131I into PAMAM (G5.0) dendrimers.
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Affiliation(s)
- R. He
- Department of Nuclear Medicine
- First Affiliated Hospital of Kunming Medical University
- Kunming
- China
| | - H. Wang
- Department of Chemistry
- Kansas State University
- Manhattan
- USA
| | - Y. Su
- Department of Nuclear Medicine
- First Affiliated Hospital of Kunming Medical University
- Kunming
- China
| | - C. Chen
- Department of Nuclear Medicine
- First Affiliated Hospital of Kunming Medical University
- Kunming
- China
| | - L. Xie
- Department of Nuclear Medicine
- First Affiliated Hospital of Kunming Medical University
- Kunming
- China
| | - L. Chen
- Department of Nuclear Medicine
- First Affiliated Hospital of Kunming Medical University
- Kunming
- China
| | - J. Yu
- Department of Chemistry
- Kansas State University
- Manhattan
- USA
| | - Y. Toledo
- Department of Chemistry
- Kansas State University
- Manhattan
- USA
| | | | - G. Zhu
- Department of Nuclear Medicine
- First Affiliated Hospital of Kunming Medical University
- Kunming
- China
| | - S. H. Bossmann
- Department of Chemistry
- Kansas State University
- Manhattan
- USA
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He R, Du X, Liu SW, Sun LJ, Li Y, Zeng H, Li YY, Sun C, Zhang Y, Ma CS, Gao W. [Current status of antiarrhythmic drug use and safety assessment in Chinese patients with atrial fibrillation]. Zhonghua Xin Xue Guan Bing Za Zhi 2016; 44:935-939. [PMID: 27903390 DOI: 10.3760/cma.j.issn.0253-3758.2016.11.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Objective: To investigate the current status of antiarrhythmic drugs (AADs) use in Chinese patients with atrial fibrillation(AF) and assess the safety of AADs in this patient cohort. Methods: From January 2011 to December 2013, a total of 4 008 AF patients treated with AADs was enrolled in this study and patients were followed up for 24 months. Detailed information of prescribed drug, the causes of drug discontinuation and side effects were recorded. Results: Amiodarone was prescribed to 64.3%(2 579 cases) and propafenone to 31.1%(1 247 cases) of the enrolled patients, only 148 patients(3.7%) were treated with sotalol and 34 patients (0.8%) were treated with moracizine. The prevalence of heart failure (4.0%(102/2 579) vs. 1.4%(17/1 247, P<0.001), coronary heart disease (13.5% (348/2 579) vs. 7.4%(93/1 247), P<0.001) and non-ischemic cardiomyopathy (3.1%(78/2 579) vs. 0.7%(9/1 247), P<0.001) was significantly higher in patients treated with amiodarone than in the patients treated with propafenone. During the follow-up period, the discontinuation rate of amiodarone, propafenone, sotalol and moracizine was 28.8%(743/2 579), 25.1%(313/1 247), 14.2%(21/148) and 32.4%(11/34) respectively. The reasons of discontinuing amiodarone were: follow physicians' decision (75.7%, 563 cases), no effect (3.0%, 22 cases), side effects (4.3%, 32 cases) and patients' own decision (17.0%, 126 cases). The side effects of amiodarone included thyroid dysfunction (56.3%, 18 cases), bradycardia (12.5%, 4 cases), interstitial pneumonitis/pulmonary interstitial fibrosis (6.2%, 2 cases) and others (gastrointestinal symptom, rash, hepatic dysfunction, etc.). Conclusions: Amiodarone and propafenone are the most common AADs used in Chinese patients with atrial fibrillation. The prescription of AADs is essentially in accordance to the guideline of AF treatment. However, the discontinuation rates of AADs are high in Chinese AF patients. Lacking of better AADs is still a major problem in AF pharmacotherapy. Clinical Trial Registry Chinese Clinical Trial Registry, ChiCTR-OCH-13003729.
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Affiliation(s)
- R He
- *Department of Cardiology, Peking University Third Hospital, Key Laboratory of Cardiovascular Molecular Biology and Regulatory Peptides of Ministry of Health, Key Laboratory of Molecular Cardiovascular Sciences of Ministry of Education, Beijing 100191, China
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80
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Zhou BD, He R, Cui M. [A case of pulse indicator continuous cardiac output guided treatment in a myocardial infarction patient complicating heart failure and severe pneumonia]. Zhonghua Xin Xue Guan Bing Za Zhi 2016; 44:897-898. [PMID: 27903379 DOI: 10.3760/cma.j.issn.0253-3758.2016.10.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
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81
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Kun Q, Peng B, Huang D, Huang P, Li H, He R, Sihoe A. P-231NON-INTUBATED UNIPORTAL ANATOMICAL LUNG RESECTION: A PROPENSITY SCORE MATCHED ANALYSIS SHOWS THAT FASTER RECOVERY IS POSSIBLE EVEN IN THE EARLY EXPERIENCE. Interact Cardiovasc Thorac Surg 2016. [DOI: 10.1093/icvts/ivw260.229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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82
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83
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He R, Morris B, Duggar N, Markovich A, Standford J, Lu J, Yang C. SU-F-P-32: A Phantom Study of Accuracy of Four-Dimensional Cone-Beam CT (4D-CBCT) Vs. Three-Dimensional Cone Beam CT (3D-CBCT) in Image Guided Radiotherapy. Med Phys 2016. [DOI: 10.1118/1.4955739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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84
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Chen H, He R, Wang ZL, Wang SY, Chen Y, Zhu ZC, Chen XM. Genetic diversity and variability in populations of the white wax insect Ericerus pela, assessed by AFLP analysis. Genet Mol Res 2015; 14:17820-7. [PMID: 26782427 DOI: 10.4238/2015.december.22.6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
The white wax insect Ericerus pela Chavannes (Hemiptera: Coccoidea) is an economically valuable insect species that has been used for over a thousand years in China. The present study focuses on assessing the genetic variability in different populations of E. pela collected from seven Chinese provinces. The amplified fragment length polymorphism technique was used to generate DNA fingerprints of individuals from each population using nine primer combinations (EcoRI-MseI). A total of 435 polymorphic loci were generated; fragment sizes ranged from 200 to 1000 bp. The percentage of polymorphic loci was 85.29%. Nei's genetic diversity and Shannon index indicated consistency in the results, which showed that the Sichuan population had the highest diversity, followed by Yunnan and Zhejiang populations. Dendrogram analysis showed the shortest genetic distance between the Sichuan and Yunnan populations, suggesting that they probably form sister groups. High genetic differentiation between population values among all sampled populations indicated a low degree of genetic variability within each population (40.85%) and higher variation among populations (59.15%). Gene flow estimate values were low in all samples, suggesting low gene flow from events such as interbreeding and migration. Low gene flow values also suggested that populations among species of E. pela might become genetically heterogeneous, due to counteracting forces such as strong differential selection. Our data support the probability that E. pela will remain localized, and has a low potential to spread beyond current habitats.
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Affiliation(s)
- H Chen
- Research Institute of Resource Insects, Chinese Academy of Forestry, Bailongsi, Kunming, China
| | - R He
- The Key Laboratory of Cultivating and Utilization of Resources Insects of State Forestry Administration, Kunming, China
| | - Z L Wang
- Research Institute of Resource Insects, Chinese Academy of Forestry, Bailongsi, Kunming, China
| | - S Y Wang
- Research Institute of Resource Insects, Chinese Academy of Forestry, Bailongsi, Kunming, China
| | - Y Chen
- Research Institute of Resource Insects, Chinese Academy of Forestry, Bailongsi, Kunming, China
| | - Z C Zhu
- Leshan Academy of Forestry, Leshan, China
| | - X M Chen
- Research Institute of Resource Insects, Chinese Academy of Forestry, Bailongsi, Kunming, China.,The Key Laboratory of Cultivating and Utilization of Resources Insects of State Forestry Administration, Kunming, China
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85
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Mourad W, Packianathan S, Russell G, Ma J, Shourbaji R, Ryniak M, Rabatic B, Zaenger D, He R, Mobit P, Yang C, Shasha D, Vijayakumar S. Radiation Prophylaxis of Heterotopic Ossification at the Elbow: Is It Time for XRT Dose-Deescalation? Int J Radiat Oncol Biol Phys 2015. [DOI: 10.1016/j.ijrobp.2015.07.1735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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86
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Mobit PN, Packianathan S, He R, Yang CC. Comparison of Axxent-Xoft, (192)Ir and (60)Co high-dose-rate brachytherapy sources for image-guided brachytherapy treatment planning for cervical cancer. Br J Radiol 2015; 88:20150010. [PMID: 25996576 DOI: 10.1259/bjr.20150010] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
Abstract
OBJECTIVE To evaluate the dosimetric differences and similarities between treatment plans generated with Axxent-Xoft electronic brachytherapy source (Xoft-EBS), (192)Ir and (60)Co for tandem and ovoids (T&O) applicators. METHODS In this retrospective study, we replanned 10 patients previously treated with (192)Ir high-dose-rate brachytherapy. Prescription was 7 Gy × 4 fractions to Point A. For each original plan, we created two additional plans with Xoft-EBS and (60)Co. The dose to each organ at risk (OAR) was evaluated in terms of V(35%) and V(50%), the percentage volume receiving 35% and 50% of the prescription dose, respectively, and D(2cc), highest dose to a 2 cm(3) volume of an OAR. RESULTS There was no difference between plans generated by (192)Ir and (60)Co, but the plans generated using Xoft-EBS showed a reduction of up to 50% in V(35%), V(50%) and D(2cc). The volumes of the 200% and 150% isodose lines, however, were 74% and 34% greater than the comparable volumes generated with the (192)Ir source. Point B dose was on average only 16% of the Point A dose for plans generated with Xoft-EBS compared with 30% for plans generated with (192)Ir or (60)Co. CONCLUSION The Xoft-EBS can potentially replace either (192)Ir or (60)Co in T&O treatments. Xoft-EBS offers either better sparing of the OARs compared with (192)Ir or (60)Co or at least similar sparing. Xoft-EBS-generated plans had higher doses within the target volume than (192)Ir- or (60)Co-generated ones. ADVANCES IN KNOWLEDGE This work presents newer knowledge in dosimetric comparison between Xoft-EBS, (192)Ir or (60)Co sources for T&O implants.
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Affiliation(s)
- P N Mobit
- 1 Department of Radiation Oncology, University of Mississippi Medical Center, Jackson, MS, USA.,2 Cameroon Oncology Center, PO Box 1870, Douala, Cameroon
| | - S Packianathan
- 1 Department of Radiation Oncology, University of Mississippi Medical Center, Jackson, MS, USA
| | - R He
- 1 Department of Radiation Oncology, University of Mississippi Medical Center, Jackson, MS, USA
| | - C C Yang
- 1 Department of Radiation Oncology, University of Mississippi Medical Center, Jackson, MS, USA
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87
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Huang J, Ding C, Chen X, He R, Chen N. Association ofTGF-β1−509C/T, +869T/C, and +915G/C polymorphisms with periodontitis susceptibility. Oral Dis 2014; 21:443-50. [PMID: 25385297 DOI: 10.1111/odi.12297] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2014] [Revised: 11/03/2014] [Accepted: 11/03/2014] [Indexed: 11/28/2022]
Affiliation(s)
- J Huang
- Physical Examination Center; The Affiliated Hospital of Hangzhou Normal University; Hangzhou China
| | - C Ding
- Department of Stomatology; The Affiliated Hospital of Hangzhou Normal University; Hangzhou China
| | - X Chen
- Department of Stomatology; The Affiliated Hospital of Hangzhou Normal University; Hangzhou China
| | - R He
- Department of Stomatology; The Affiliated Hospital of Hangzhou Normal University; Hangzhou China
- School of Medicine; Hangzhou Normal University; Hangzhou China
| | - N Chen
- Hangzhou Geriatric Hospital; Hangzhou China
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88
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He R, Shen J, Liu F, Zeng H, Li L, Yu H, Lu H, Lu F, Wu Q, Jia W. Vitamin D deficiency increases the risk of retinopathy in Chinese patients with type 2 diabetes. Diabet Med 2014; 31:1657-64. [PMID: 25186653 DOI: 10.1111/dme.12581] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2014] [Revised: 06/26/2014] [Accepted: 08/27/2014] [Indexed: 12/29/2022]
Abstract
AIMS To investigate the relationship between vitamin D deficiency and diabetic retinopathy. METHODS In total, 1520 patients with Type 2 diabetes were recruited and divided into three groups according to their fundus oculi results: no diabetic retinopathy (n = 625, 41.12%); non-sight-threatening diabetic retinopathy (n = 562, 36.97%); and sight-threatening diabetic retinopathy (n = 333, 21.91%). Vitamin D deficiency was defined as a serum circulating 25-hydroxyvitamin D level < 20 ng/ml. Clinical characteristics and biochemical parameters were detected and compared. RESULTS The patients with sight-threatening diabetic retinopathy had significantly lower serum 25-hydroxyvitamin D concentrations and higher prevalence of vitamin D deficiency than other two groups (all P < 0.05). In addition, there was a downward trend in average 25-hydroxyvitamin D level with the increased stages of diabetic retinopathy (P < 0.01). The prevalence of diabetic retinopathy and sight-threatening diabetic retinopathy in patients with vitamin D deficiency was also higher than in those without vitamin D deficiency (both P < 0.01). After adjusting for all potential confounders, vitamin D deficiency was still associated with increased risk of diabetic retinopathy (odds ratio 1.93) and sight-threatening diabetic retinopathy (odds ratio 2.42) (both P < 0.01). Logistical regression analysis further revealed that vitamin D deficiency was an independent risk factor for diabetic retinopathy (β = 0.66) and sight-threatening diabetic retinopathy (β = 0.93) (both P < 0.01). ROC analysis indicated that a serum 25-hydroxyvitamin D level < 15.57 ng/ml suggested the occurrence of sight-threatening diabetic retinopathy (odds ratio 2.38, P < 0.01). CONCLUSIONS Vitamin D deficiency is an independent risk factor for diabetic retinopathy and sight-threatening diabetic retinopathy. The prevalence of sight-threatening diabetic retinopathy doubles when the serum 25-hydroxyvitamin D level is < 15.57 ng/ml.
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Affiliation(s)
- R He
- Department of Endocrinology and Metabolism
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89
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Fuentes D, Contreras J, Yu J, He R, Castillo E, Castillo R, Guerrero T. Morphometry-based measurements of the structural response to whole-brain radiation. Int J Comput Assist Radiol Surg 2014; 10:393-401. [PMID: 25408306 DOI: 10.1007/s11548-014-1128-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2014] [Accepted: 11/03/2014] [Indexed: 10/24/2022]
Abstract
PURPOSE Morphometry techniques were applied to quantify the normal tissue therapy response in patients receiving whole-brain radiation for intracranial malignancies. METHODS Pre- and Post-irradiation magnetic resonance imaging (MRI) data sets were retrospectively analyzed in N = 15 patients. Volume changes with respect to pre-irradiation were quantitatively measured in the cerebrum and ventricles. Measurements were correlated with the time interval from irradiation. Criteria for inclusion included craniospinal irradiation, pre-irradiation MRI, at least one follow-up MRI, and no disease progression. The brain on each image was segmented to remove the skull and registered to the initial pre-treatment scan. Average volume changes were measured using morphometry analysis of the deformation Jacobian and direct template registration-based segmentation of brain structures. RESULTS An average cerebral volume atrophy of -0.2 and -3% 3% was measured for the deformation morphometry and direct segmentation methods, respectively. An average ventricle volume dilation of 21 and 20% was measured for the deformation morphometry and direct segmentation methods, respectively. CONCLUSION The presented study has developed an image processing pipeline for morphometric monitoring of brain tissue volume changes as a response to radiation therapy. Results indicate that quantitative morphometric monitoring is feasible and may provide additional information in assessing response.
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Affiliation(s)
- D Fuentes
- Department of Imaging Physics, The University of Texas M.D. Anderson Cancer Center, Houston, TX, 77030, USA,
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90
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Hu Y, Ruan C, Stanford J, Duggar W, Rajaguru P, He R, Yang C. SU-E-J-06: A Feasibility Study On Clinical Implementation of 4D-CBCT in Lung Cancer Treatment. Med Phys 2014. [DOI: 10.1118/1.4888057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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91
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He R, Kumar P, Hu Y, Suggs J, Yang C, Giri S. SU-E-T-504: Usefulness of CT-MR Fusion in Radiotherapy Planning for Prostate Cancer Patient with Bilateral Hip Replacements. Med Phys 2014. [DOI: 10.1118/1.4888837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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92
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Nguyen A, Hu Y, He R, Paul T, Plowman A, Mobit P, Ma J, Packianathan S, Kanakamedala M, Yang C. SU-E-T-414: TG-129 Implementation On BrachyvisionTM. Med Phys 2014. [DOI: 10.1118/1.4888747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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93
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Zhao L, Yang W, Yang X, Lin Y, Lv J, Dou X, Luo Q, Dong J, Chen Z, Chu Y, He R. Chemerin suppresses murine allergic asthma by inhibiting CCL2 production and subsequent airway recruitment of inflammatory dendritic cells. Allergy 2014; 69:763-74. [PMID: 24758146 DOI: 10.1111/all.12408] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/04/2014] [Indexed: 02/01/2023]
Abstract
BACKGROUND Chemerin has been implicated to play opposing roles, either pro-inflammatory or anti-inflammatory, in various tissue inflammation processes primarily through the regulation of tissue recruitment of immune cells. However, the effect of chemerin in allergic asthma has not yet been explored. We sought to investigate the role of chemerin in the murine model of allergic asthma and explore the underlying mechanism. METHODS We examined the effect of intranasal (i.n.) administration of chemerin during antigen challenge in murine models of asthma. Moreover, we examined whether administration of CCL2 or bone marrow-derived dendritic cells (BMDCs) transfer reversed the effects of chemerin on ovalbumin-induced asthma. We finally examined the effect of chemerin on CCL2 expression in activated lung epithelial cells in vitro. RESULTS The administration of chemerin attenuated allergic airway inflammation and airway hyperreactivity during antigen challenge. Chemerin treatment caused significant decreases in BALF CD4(+) T-cell accumulation and mRNA expression of Th2-attracting chemokines, CCL17 and CCL22, which was accompanied by significantly decreased BALF CD11c(+) CD11b(+) inflammatory DC accumulation and CCL2 production. Furthermore, airway administration of exogenous CCL2 or adoptive transfer of CD11c(+) CD11b(+) BMDCs abrogated the suppressive effects of chemerin on allergic asthma. Finally, in vitro study showed that chemerin inhibited CCL2 secretion by low-dose LPS-stimulated lung epithelial cells, which led to decreased chemotaxis of BMDCs. CONCLUSIONS Our study demonstrates that chemerin plays a protective role in allergic asthma by suppressing airway recruitment of inflammatory CD11c(+) CD11b(+) DCs through the inhibition of CCL2 secretion by active lung epithelial cells.
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Affiliation(s)
- L. Zhao
- Key Laboratory of Medical Molecular Virology of Ministries of Education and Health; Department of Immunology; School of Basic Medical Sciences; Fudan University; Shanghai China
| | - W. Yang
- Key Laboratory of Medical Molecular Virology of Ministries of Education and Health; Department of Immunology; School of Basic Medical Sciences; Fudan University; Shanghai China
| | - X. Yang
- Key Laboratory of Medical Molecular Virology of Ministries of Education and Health; Department of Immunology; School of Basic Medical Sciences; Fudan University; Shanghai China
| | - Y. Lin
- Key Laboratory of Medical Molecular Virology of Ministries of Education and Health; Department of Immunology; School of Basic Medical Sciences; Fudan University; Shanghai China
| | - J. Lv
- Key Laboratory of Medical Molecular Virology of Ministries of Education and Health; Department of Immunology; School of Basic Medical Sciences; Fudan University; Shanghai China
| | - X. Dou
- Department of Dermatology; Huashan Hospital; Shanghai China
| | - Q. Luo
- Institute of Chinese Integrative Medicine; Huashan Hospital; Shanghai China
| | - J. Dong
- Institute of Chinese Integrative Medicine; Huashan Hospital; Shanghai China
| | - Z. Chen
- Department of Pulmonary Disease; Zhongshan Hospital; Shanghai China
| | - Y. Chu
- Key Laboratory of Medical Molecular Virology of Ministries of Education and Health; Department of Immunology; School of Basic Medical Sciences; Fudan University; Shanghai China
- Biotherapy Research Center; Fudan University; Shanghai China
| | - R. He
- Key Laboratory of Medical Molecular Virology of Ministries of Education and Health; Department of Immunology; School of Basic Medical Sciences; Fudan University; Shanghai China
- Biotherapy Research Center; Fudan University; Shanghai China
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94
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Nguyen A, Rajaguru P, Kaurin D, Paul T, He R, Plowman A, Yang C. SU-F-BRE-16: VMAT Commissioning and Quality Assurance (QA) of An Elekta Synergy-STM Linac Using ICOM Test HarnessTM. Med Phys 2014. [DOI: 10.1118/1.4889054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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95
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Ding Y, Fuller C, Mohamed A, He R, Wang J, Frank S, Rosenthal D, Colen R, Hazle J. SU-E-QI-05: Denoising Intravoxel Incoherent Motion Magnetic Resonance Images Using Non-Local Mean Technique for Oropharyngeal Cancer Study. Med Phys 2014. [DOI: 10.1118/1.4888985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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96
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McGillicuddy DJ, Brosnahan ML, Couture DA, He R, Keafer BA, Manning JP, Martin JL, Pilskaln CH, Townsend DW, Anderson DM. A red tide of Alexandrium fundyense in the Gulf of Maine. Deep Sea Res 2 Top Stud Oceanogr 2014. [PMID: 25170191 DOI: 10.1016/j.dsr2.2013.01.037] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
In early July 2009, an unusually high concentration of the toxic dinoflagellate Alexandrium fundyense occurred in the western Gulf of Maine, causing surface waters to appear reddish brown to the human eye. The discolored water appeared to be the southern terminus of a large-scale event that caused shellfish toxicity along the entire coast of Maine to the Canadian border. Rapid-response shipboard sampling efforts together with satellite data suggest the water discoloration in the western Gulf of Maine was a highly ephemeral feature of less than two weeks in duration. Flow cytometric analysis of surface samples from the red water indicated the population was undergoing sexual reproduction. Cyst fluxes downstream of the discolored water were the highest ever measured in the Gulf of Maine, and a large deposit of new cysts was observed that fall. Although the mechanisms causing this event remain unknown, its timing coincided with an anomalous period of downwelling-favorable winds that could have played a role in aggregating upward-swimming cells. Regardless of the underlying causes, this event highlights the importance of short-term episodic phenomena on regional population dynamics of A. fundyense.
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Affiliation(s)
- D J McGillicuddy
- Department of Applied Ocean Physics and Engineering, Woods Hole Oceanographic Institution, Woods Hole, MA 02543, USA
| | - M L Brosnahan
- Biology Department, Woods Hole Oceanographic Institution, Woods Hole, MA 02543, USA
| | - D A Couture
- Resource Access International, Brunswick, ME 04011, USA
| | - R He
- Department of Maine, Earth, and Atmospheric Sciences, North Carolina State University, Raleigh, NC 27695, USA
| | - B A Keafer
- Biology Department, Woods Hole Oceanographic Institution, Woods Hole, MA 02543, USA
| | - J P Manning
- National Oceanic Atmospheric Administration, Northeast Fisheries Science Center, Woods Hole, MA 02543, USA
| | - J L Martin
- St. Andrews Biological Station, Fisheries and Oceans Canada, St. Andrews, NB E5B 2L9, Canada
| | - C H Pilskaln
- School of Marine Sciences, University of Massachusetts Dartmouth, North Dartmouth, MA 02747, USA
| | - D W Townsend
- School of Marine Sciences, University of Maine, Orono, ME 04469, USA
| | - D M Anderson
- Biology Department, Woods Hole Oceanographic Institution, Woods Hole, MA 02543, USA
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97
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McGillicuddy D, Brosnahan M, Couture D, He R, Keafer B, Manning J, Martin J, Pilskaln C, Townsend D, Anderson D. A red tide of Alexandrium fundyense in the Gulf of Maine. Deep Sea Res 2 Top Stud Oceanogr 2014; 103:174-184. [PMID: 25170191 PMCID: PMC4142651 DOI: 10.1016/j.dsr2.2013.05.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
In early July 2009, an unusually high concentration of the toxic dinoflagellate Alexandrium fundyense occurred in the western Gulf of Maine, causing surface waters to appear reddish brown to the human eye. The discolored water appeared to be the southern terminus of a large-scale event that caused shellfish toxicity along the entire coast of Maine to the Canadian border. Rapid-response shipboard sampling efforts together with satellite data suggest the water discoloration in the western Gulf of Maine was a highly ephemeral feature of less than two weeks in duration. Flow cytometric analysis of surface samples from the red water indicated the population was undergoing sexual reproduction. Cyst fluxes downstream of the discolored water were the highest ever measured in the Gulf of Maine, and a large deposit of new cysts was observed that fall. Although the mechanisms causing this event remain unknown, its timing coincided with an anomalous period of downwelling-favorable winds that could have played a role in aggregating upward-swimming cells. Regardless of the underlying causes, this event highlights the importance of short-term episodic phenomena on regional population dynamics of A. fundyense.
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Affiliation(s)
- D.J. McGillicuddy
- Department of Applied Ocean Physics and Engineering, Woods Hole Oceanographic Institution, Woods Hole, MA 02543, USA
- Corresponding author: Tel.: +508 289 2683; fax: +508 457 2194.,
| | - M.L. Brosnahan
- Biology Department, Woods Hole Oceanographic Institution, Woods Hole, MA 02543, USA
| | - D.A. Couture
- Resource Access International, Brunswick, ME 04011, USA
| | - R. He
- Department of Maine, Earth, and Atmospheric Sciences, North Carolina State University, Raleigh, NC 27695, USA
| | - B.A. Keafer
- Biology Department, Woods Hole Oceanographic Institution, Woods Hole, MA 02543, USA
| | - J.P. Manning
- National Oceanic Atmospheric Administration, Northeast Fisheries Science Center, Woods Hole, MA 02543, USA
| | - J.L. Martin
- St. Andrews Biological Station, Fisheries and Oceans Canada, St. Andrews, NB E5B 2L9, Canada
| | - C.H. Pilskaln
- School of Marine Sciences, University of Massachusetts Dartmouth, North Dartmouth, MA 02747, USA
| | - D.W. Townsend
- School of Marine Sciences, University of Maine, Orono, ME 04469, USA
| | - D.M. Anderson
- Biology Department, Woods Hole Oceanographic Institution, Woods Hole, MA 02543, USA
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98
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Xia F, Su Y, Wei X, He Y, Wu Z, Ghulam A, He R. Diversity and activity of sulphur-oxidizing bacteria and sulphate-reducing bacteria in landfill cover soils. Lett Appl Microbiol 2014; 59:26-34. [DOI: 10.1111/lam.12240] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2013] [Revised: 02/21/2014] [Accepted: 02/23/2014] [Indexed: 11/30/2022]
Affiliation(s)
- F.F. Xia
- Department of Environmental Engineering; Zhejiang University; Hangzhou China
| | - Y. Su
- Department of Environmental Engineering; Zhejiang University; Hangzhou China
| | - X.M. Wei
- Department of Environmental Engineering; Zhejiang University; Hangzhou China
| | - Y.H. He
- Environment Protection and Resources Conservation Committee of Zhejiang Provincial People's Congress; Hangzhou China
| | - Z.C. Wu
- Department of Environmental Engineering; Zhejiang University; Hangzhou China
| | - A. Ghulam
- Department of Environmental Engineering; Zhejiang University; Hangzhou China
- Department of Chemical Engineering; University of Gujrat; Gujrat Pakistan
| | - R. He
- Department of Environmental Engineering; Zhejiang University; Hangzhou China
- Zhejiang Province Key Laboratory of solid waste treatment and recycling; Zhejiang Gongshang University; Hangzhou China
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99
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Qiao XJ, Salamon N, Wang DJJ, He R, Linetsky M, Ellingson BM, Pope WB. Perfusion deficits detected by arterial spin-labeling in patients with TIA with negative diffusion and vascular imaging. AJNR Am J Neuroradiol 2013; 34:2125-30. [PMID: 23721895 DOI: 10.3174/ajnr.a3551] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE A substantial portion of clinically diagnosed TIA cases is imaging-negative. The purpose of the current study is to determine if arterial spin-labeling is helpful in detecting perfusion abnormalities in patients presenting clinically with TIA. MATERIALS AND METHODS Pseudocontinuous arterial spin-labeling with 3D background-suppressed gradient and spin-echo was acquired on 49 patients suspected of TIA within 24 hours of symptom onset. All patients were free of stroke history and had no lesion-specific findings on general MR, DWI, and MRA sequences. The calculated arterial spin-labeling CBF maps were scored from 1-3 on the basis of presence and severity of perfusion disturbance by 3 independent observers blinded to patient history. An age-matched cohort of 36 patients diagnosed with no cerebrovascular events was evaluated as a control. Interobserver agreement was assessed by use of the Kendall concordance test. RESULTS Scoring of perfusion abnormalities on arterial spin-labeling scans of the TIA cohort was highly concordant among the 3 observers (W = 0.812). The sensitivity and specificity of arterial spin-labeling in the diagnosis of perfusion abnormalities in TIA was 55.8% and 90.7%, respectively. In 93.3% (70/75) of the arterial spin-labeling CBF map readings with positive scores (≥2), the brain regions where perfusion abnormalities were identified by 3 observers matched with the neurologic deficits at TIA onset. CONCLUSIONS In this preliminary study, arterial spin-labeling showed promise in the detection of perfusion abnormalities that correlated with clinically diagnosed TIA in patients with otherwise normal neuroimaging results.
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Affiliation(s)
- X J Qiao
- Departments of Radiological Sciences
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100
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Xiao L, Yang X, Lin Y, Li S, Jiang J, Qian S, Tang Q, He R, Li X. Large adipocytes function as antigen-presenting cells to activate CD4(+) T cells via upregulating MHCII in obesity. Int J Obes (Lond) 2013; 40:112-20. [PMID: 26248660 PMCID: PMC4722243 DOI: 10.1038/ijo.2015.145] [Citation(s) in RCA: 73] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2015] [Revised: 06/28/2015] [Accepted: 07/26/2015] [Indexed: 02/07/2023]
Abstract
BACKGROUND/OBJECTIVES Although obesity is associated with low-grade inflammation and metabolic disorders, clinical studies suggested some obese people were metabolically healthy with smaller adipocyte size compared with metabolically abnormal obese (MAO). This indicated adipocyte size may be an important predictor underlay the distinction between MAO and metabolically healthy obese. As recent study has shown that adipocytes expressed class II major histocompatibility complex (MHCII), which functioned as APCs during obesity. However, the relationship between adipocyte hypertrophy and MHCII expression was not involved. Here we hypothesize that hypertrophic adipocytes could be associated with upregulating MHCII to influence adipose tissue metabolism. METHODS Adipocytes were sorted by fluorescence-activated cell sorting (FACS) according to the cell size from MAO mice. The activation of MHCII, T cells and related signaling molecules were examined by FACS, ELISA and western blotting. 3T3-L1 cell line and primary adipocytes were used to examine the effect of free fatty acids (FFA) on adipocytes enlargement and MHCII expression. RESULTS MAO mice had a significant increase in adipocytes size and FFA concentration. The large adipocytes from both obese and non-obese mice expressed higher levels of MHCII than small adipocytes. Importantly, large adipocytes from obese mice stimulated CD4(+) T cells to secrete more interferon (IFN)-γ. Furthermore, the activation of the JNK-STAT1 pathway was involved in upregulation of MHCII in large adipocytes. In vitro FFA treatment promoted adipocyte hypertrophy and expression of MHCII-associated genes. CONCLUSIONS This study demonstrates that large adipocytes highly express MHCII and function as APC to stimulate IFN-γ-expressing CD4(+) T cells, in which FFA may have important roles before IFN-γ elevated. These findings suggest that adipocyte hypertrophy, rather than overall obesity, is the major contributor to adipose tissue inflammation and insulin resistance.
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Affiliation(s)
- L Xiao
- Key Laboratory of Metabolic Molecular Medicine, Ministry of Education, Department of Biochemistry and Molecular Biology, Fudan University Basic Medical School, Shanghai, PR China
| | - X Yang
- Key Laboratory of Medical Molecular Virology of Ministries of Education and Health, Department of Immunology, Fudan University Basic Medical School, Shanghai, PR China
| | - Y Lin
- Key Laboratory of Medical Molecular Virology of Ministries of Education and Health, Department of Immunology, Fudan University Basic Medical School, Shanghai, PR China
| | - S Li
- Key Laboratory of Metabolic Molecular Medicine, Ministry of Education, Department of Biochemistry and Molecular Biology, Fudan University Basic Medical School, Shanghai, PR China
| | - J Jiang
- Key Laboratory of Metabolic Molecular Medicine, Ministry of Education, Department of Biochemistry and Molecular Biology, Fudan University Basic Medical School, Shanghai, PR China
| | - S Qian
- Key Laboratory of Metabolic Molecular Medicine, Ministry of Education, Department of Biochemistry and Molecular Biology, Fudan University Basic Medical School, Shanghai, PR China
| | - Q Tang
- Key Laboratory of Metabolic Molecular Medicine, Ministry of Education, Department of Biochemistry and Molecular Biology, Fudan University Basic Medical School, Shanghai, PR China
| | - R He
- Key Laboratory of Medical Molecular Virology of Ministries of Education and Health, Department of Immunology, Fudan University Basic Medical School, Shanghai, PR China
| | - X Li
- Key Laboratory of Metabolic Molecular Medicine, Ministry of Education, Department of Biochemistry and Molecular Biology, Fudan University Basic Medical School, Shanghai, PR China
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