Regional health-care inequity in children's survival in Zhejiang Province, China

BACKGROUND

China is now under a period of social transition, and inequity is evident in the field of health care. We aimed to investigate regional health-care inequalities in children's survival in Zhejiang Province, China.

METHODS

In our study, monitoring data of Zhejiang Province from 2005 to 2014 was collected. The flow of data collection of community-district-city for urban areas or village-township-county rural areas was followed. The factors affecting equity was analyzed including regional economical level and household registry. We adopted standard measures of concentration curve and concentration index to evaluate degree of income-related inequity and the trend of mortality changes.

RESULTS

From 2005 to 2014, overall mortality rate in children under five decreased, and regional disparity reduced markedly, and with a reduced disparity of mortality rate among children from urban and rural areas. In 2014, the mortality rate in children from urban and rural areas was similar. In contrast, the mortality rate in the children from migrant population was more than two folds of that in the children from native residency (7.82 ‰ vs. 3.89 ‰). The mortality rates of newborns (rs = -0.396, P < 0.001), infants (rs = -0.553, P < 0.001) and children under five (rs = -0.568, P < 0.001) were all negatively correlated with per capita GDP in different regions. CI in the newborns, infants and children under 5 years was -0.105, -0.107 and -0.118, respectively. The concentration curve was near to equity curve. The concentration curve was near to equity curve. The mortality rate of children was negatively related with economical level in this study.

CONCLUSIONS

The survival status was near to equity. Regional economical development can improve children's survival but it was not the only social determinant. Migrant population will be the future monitor focus for reducing disparity on healthcare and increase equity in children's survival.

Biodegradable black phosphorus-based nanospheres for in vivo photothermal cancer therapy

Photothermal therapy (PTT) offers many advantages such as high efficiency and minimal invasiveness, but clinical adoption of PTT nanoagents have been stifled by unresolved concerns such as the biodegradability as well as long-term toxicity. Herein, poly (lactic-co-glycolic acid) (PLGA) loaded with black phosphorus quantum dots (BPQDs) is processed by an emulsion method to produce biodegradable BPQDs/PLGA nanospheres. The hydrophobic PLGA not only isolates the interior BPQDs from oxygen and water to enhance the photothermal stability, but also control the degradation rate of the BPQDs. The in vitro and in vivo experiments demonstrate that the BPQDs/PLGA nanospheres have inappreciable toxicity and good biocompatibility, and possess excellent PTT efficiency and tumour targeting ability as evidenced by highly efficient tumour ablation under near infrared (NIR) laser illumination. These BP-based nanospheres combine biodegradability and biocompatibility with high PTT efficiency, thus promising high clinical potential.

Comparison of the effects of mini-implant and traditional anchorage on patients with maxillary dentoalveolar protrusion

OBJECTIVE

To compare the treatment effects of mini-implants as anchor units with conventional methods of anchorage reinforcement in maxillary dentoalveolar protrusion patients in terms of skeletal, dental, and soft tissue changes.

MATERIALS AND METHODS

We searched the databases of the Cochrane Library, PubMed, OVIDSP, CBM, VIP, WanFang Data, and CNKI covering December 1966 to March 2016 for randomized controlled trials (RCTs) and clinical controlled trials that compared the treatment effects of mini-implants with conventional anchorage reinforcement in maxillary dentoalveolar protrusion patients. Literature filtering, data extraction, and methodological quality evaluation were finished independently by two researchers and disagreements were solved by discussion. Meta-analysis was performed when possible; otherwise descriptive assessment was done.

RESULTS

Through a predefined search strategy, we finally included 14 eligible studies. Eight outcomes were evaluated in this study: maxillary incisor retraction, maxillary molar movement, U1-SN, SNA, SN-MP, UL-E Plane, NLA and G-Sn-Pg.

CONCLUSIONS

Mini-implant anchorage was more effective in retracting the anterior teeth, produced less anchorage loss, and had a greater effect on SN-MP for the high-angle patients than did traditional anchorage. Both mini-implants and traditional anchorage underwent decreases in on U1-SN and SNA. More qualified RCTs are required to make reliable recommendations about the anchorage capacity of mini-implant and traditional anchorage in patients with maxillary dentoalveolar protrusion, especially on the UL-E plane, NLA, and G-Sn-Pg.

A Highly Efficient Single-Chain Metal-Organic Nanoparticle Catalyst for Alkyne-Azide "Click" Reactions in Water and in Cells

We show that copper-containing metal-organic nanoparticles (MONPs) are readily synthesized via Cu(II)-mediated intramolecular cross-linking of aspartate-containing polyolefins in water. In situ reduction with sodium ascorbate yields Cu(I)-containing MONPs that serve as highly efficient supramolecular catalysts for alkyne-azide "click chemistry" reactions, yielding the desired 1,4-adducts at low parts per million catalyst levels. The nanoparticles have low toxicity and low metal loadings, making them convenient, green catalysts for alkyne-azide "click" reactions in water. The Cu-MONPs enter cells and perform efficient, biocompatible click chemistry, thus acting as intracellular nanoscale molecular synthesizers.

Species and quantity of airborne pollens in Shanghai as monitored by gravitational and volumetric methods

BACKGROUND

The prevalence of allergic diseases has markedly increased in the last decades. It is therefore important to assess the distribution of airborne pollen, the most important aeroallergen, for allergic disease prevention and control.

OBJECTIVE

To identify the species and quantity of airborne pollens, and observe their distribution characteristics in Shanghai, using gravitational (Durham Sampler) and volumetric (Rotorod Sampler 40) methods simultaneously. In addition, the correlation between both methods was analyzed to provide effective preventive measures for pollen-sensitized individuals.

METHOD

Pollen counts were monitored in the same area from November 1, 2009 to October 31, 2010 by samplers set at the same height and site. Pollen concentrations as well as any association between the two methods were determined.

RESULTS

Two pollen concentration peaks in Shanghai were observed from March to May (spring) and September to October (autumn). In spring, tree pollen was the main species, with a predominance of Broussonetia. In autumn, grass pollen predominated, with mostly Humulus. Thirty-two species were identified by both gravitational and volumetric methods. Five and seven additional species were identified exclusively by the gravitational and volumetric methods, respectively. Pollen counts obtained from both devices were significantly correlated (P<0.05).

CONCLUSIONS

Two methods were used simultaneously for the first time to monitor pollen counts in central urban Shanghai, showing two annual peaks. Broussonetia and Humulus were the predominant spring and autumn pollens, respectively. Pollen counts obtained by both methods were clearly correlated. Regional airborne pollen monitoring offers preventive measures for sensitized individuals and provides useful clinical information.

Psoralidin inhibits proliferation and enhances apoptosis of human esophageal carcinoma cells via NF-κB and PI3K/Akt signaling pathways

Esophageal cancer is the most common gastrointestinal cancer. Psoralidin exhibits antioxidant, anti-apoptotic, anti-inflammatory and antitumor effects, which result in the inhibition of cancer formation. The present study aimed to investigate the effect of psoralidin on esophageal carcinoma proliferation and growth, and to elucidate its underlying mechanism of action. The effect of psoralidin on cell proliferation was investigated using 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay. Using an annexin V-fluorescein isothiocyanate/propidium iodide apoptosis detection kit and 4',6-diamidino-2-phenylindole staining assay, the present study demonstrated that psoralidin significantly enhanced apoptosis of human esophageal carcinoma Eca9706 cells. In addition, caspase-3 activity was analyzed with a caspase-3 colorimetric assay kit, while nuclear factor (NF)-κB activity and protein phosphatidylinositol 3-kinase (PI3K)/Akt expression were measured with an NF-κB enzyme-linked immunosorbent assay kit and western blot analysis, respectively. Eca9706 cells were treated with a PI3K agonist in order to investigate the mechanism of action of psoralidin. It was observed that psoralidin was able to decrease the proliferation and promote the cellular apoptosis of Eca9706 cells in a dose-dependent manner. Furthermore, psoralidin was also able to inhibit the caspase-3 activity of Eca9706 cells in a dose-dependent manner. In addition, psoralidin inhibited NF-κB activity and reduced PI3K and Akt protein expression in Eca9706 cells. Notably, the PI3K agonist was able to reverse the effect of psoralidin on Eca9706 cells. The results of the present study demonstrated that psoralidin was able to inhibit proliferation and enhance apoptosis of human esophageal carcinoma cells via the NF-κB and PI3K/Akt signaling pathways.

Three-step method for the amplification of the coxsackievirus A10 genome

The whole-genome sequencing of coxsackievirus (CV)-A10 does not follow a conventional experimental protocol. To fully understand the genetic variation and evolution of CV-A10, complete genome amplification is necessary. Most previous studies have concentrated on partial sequences of the CV-A10 genome, such as the VP1 gene. The few studies that have investigated CV-A10 at the genomic level have reported only two complete genome sequences to GenBank. The basic fault may be attributed to the regional nature of the genetics and evolution of CV-A10 and to the lack of laboratory procedures for obtaining the genomes. In this study, we present a robust "three-step" protocol performed with A105UF/A820, EVP4/A6141, and A4879/A1005R for the full-length genome amplification of CV-A10. The results revealed that the method is able to accurately and reproducibly amplify three fragments with overlaps of the full-length genome of eight CV-A10 strains. Compared with other methods, this assay is both quick and specific. In addition, the three-step protocol could be capable of amplifying the full-length genomes of CV-A10 strains isolated from different countries and regions. The specific three-step protocol may be particularly useful for investigating samples co-infected with CV-A10 and other viruses.

Xpert MTB/RIF Assay for Pulmonary Tuberculosis and Rifampicin Resistance in Children: a Meta-Analysis

BACKGROUND

The Xpert MTB/RIF assay has been recommended by WHO to replace conventional microscopy, culture, and drug resistance tests. It simultaneously detects both Mycobacterium tuberculosis infection (TB) and resistance to rifampicin (RIF) within two hours. The objective was to review the available research studies on the accuracy of the Xpert MTB/RIF assay for diagnosing pulmonary TB and RIF-resistance in children.

METHODS

A comprehensive search of Pubmed and Embase was performed up to October 28, 2014. We identified published articles estimating the diagnostic accuracy of the Xpert MTB/RIF assay in children with or without HIV using culture or culture plus clinical TB as standard reference. QUADAS-2 tool was used to evaluate the quality of the studies. A summary estimation for sensitivity, specificity, diagnostic odds ratios (DOR), and the area under the summary ROC curve (AUC) was performed. Meta-analysis was used to establish the overall accuracy.

RESULTS

11 diagnostic studies with 3801 patients were included in the systematic review. The overall analysis revealed a moderate sensitivity and high specificity of 65% (95% CI: 61 - 69%) and 99% (95% CI: 98 - 99%), respectively, and a pooled diagnostic odds ratio of 164.09 (95% CI: 111.89 - 240.64). The AUC value was found to be 0.94. The pooled sensitivity and specificity for paediatric rifampicin resistance were 94.0% (95% CI: 80.0 - 93.0%) and 99.0% (95% CI: 95.0 - 98.0%), respectively. Hence, the Xpert MTB/RIF assay has good diagnostic and rifampicin performance for paediatric pulmonary tuberculosis.

CONCLUSIONS

The Xpert MTB/RIF is sensitive and specific for diagnosing paediatric pulmonary TB. It is also effective in detecting rifamnicin resistance. It can, therefore, be used as an initial diagnostic tool.

[Degradation Characteristics of Three Aniline Compounds in Simulated Aerobic Sewage Treat System]

The removal rates of 4-nitroaniline, 4-isopropyl aniline and 2-chloro-4-nitroaniline under different hydraulic retention time (HRT) were tested by employing a simulation method of aerobic biochemical sewage treatment technology in this study. The results showed that when HRT was 6 h, 12 h, and 24 h, the removal rates of dissolved organic carbon (DOC) were 70.2%, 80.3% and 88.3%, the removal rates of 4-nitroaniline were 48%, 64.7% and 75%; and the removal rates of 4-isopropyl aniline were 66%, 76% and 91%, respectively. It was concluded that increasing HRT could promote the removal rates of DOC and aniline chemicals. In contrast, 2-chloro-4-nitroaniline was difficult to be removed. The removal rates were less than 20% under all tested conditions. The kinetics analysis showed that the biodegradation of 4-nitroaniline, 4-isopropyl aniline and 2-chloro-4-nitroaniline in aerobic activated sewage (3 g x L(-1)) accorded with the first order kinetics and the regression coefficients were > 0.95. The half-life time of biodegradation was 6.01 h, 16.16 h, 123.75 h, respectively. In general, functional groups such as isopropyl had a positive effect on the biodegradation of aniline chemicals, whereas substituents such as nitro group and chlorine atom had an inhibitory effect.

[Development of Chemical Exposure Prediction Model for Aerobic Sewage Treatment Plant for Biochemical Wastewaters]

Sewage treatment plant (STP) is a key transfer station for chemicals distributed into different environment compartment, and hence models of exposure prediction play a crucial role in the environmental risk assessment and pollution prevention of chemicals. A mass balance model namely Chinese Sewage treatment plant (C-STP(O)) was developed to predict the fate and exposure of chemicals in a conventional sewage treatment plant. The model was expressed as 9 mixed boxes by compartment of air, water, suspended solids, and settled solids. It was based on the minimum input data required on the notification in new chemicals, such as molecular weight, absorption coefficient, vapor pressure, water solubility, ready or inherent biodegradability. The environment conditions ( Temperature = 283 K, wind speed = 2 m x s(-1)) and the classic STP scenario parameters of China, especially the scenario parameters of water quality and sludge properties were adopted in C-STP( 0) model to reflect Chinese characteristics, these parameters were sewage flow of 35 000 m3 x d(-1), influent BOD5 of 0.15 g x L(-1), influent SS of 0.2 kg x m(-3), effluent SS of 0.02 kg x m(-3), BOD5 removal in aerator of 90% sludge density of 1.6 kg x L(3) and organic carbon content of 0.18-0.19. It adopted the fugacity express for mechanism of linear absorption, first-order degradation, Whitman two resistances. An overall interphase transfer constant which was the sum of surface volatilization and stripping was used to assess the volatilization in aerator. The most important and uncertain input value was the biodegradation rate constant, and determination of which required a tier test strategy from ready or inherent biodegradability data to simulate test in STP. An extrapolated criterion of US EPA to derive biodegradation rate constant using the results of ready and inherent biodegradability was compared with that of EU and was recommended. C-STP ( 0 ) was valid to predict the relative emission of volatilization, absorption, degradation and effluent, on ground of both successful simulation of the removal of 26 chemicals from references with an accuracy rate of 81% and consistency of prediction and test with absolute difference of 2.5%-6.3% for 5 phenols. In cases of prediction of three chemicals with different properties, 1,1, 2-trichloroethane, Naphthalene and DEHP, the predicted fate well satisfied the monitor data. The model is therefore believed to be a simple, robust and useful tool in fate study and exposure assessment of chemicals.

LC-MS/MS: a rapid and simple new method for the determination of carbapenem β-lactamases

We investigated the application of liquid chromatography-tandem mass spectrometry (LC-MS/MS) for pan-drug-resistant Acinetobacter baumannii (PDR-AB) with carbapenem resistance. Eight strains were randomly selected from 84 clinical isolates of PDR-AB strains obtained by the Kirby-Bauer and agar dilution methods. An efflux pump inhibition test was used to screen for the efflux pump phenotype. An ethylenediaminetetraacetic acid (EDTA) synergy test was used to screen for the β-lactamase phenotype, and a three-dimensional test was used to detect extended spectrum β-lactamase (ESBL) and ampicillin C, KPC, and carbapenemase. ESBL genes were amplified by polymerase chain reaction and sequenced. Outer membrane proteins were extracted from a sensitive strain and the PDR-AB strains by sodium dodecyl sulfate-polyacrylamide gel electrophoresis, and subjected to LC-MS/MS. Peptide mass fingerprinting data were retrieved, and proteins with differential expression were identified. Results of the efflux pump inhibition tests showed that the minimum inhibitory concentrations for meropenem were decreased in 4 of the 8 strains by at least 25% of the original value. The results of the EDTA synergy test were negative, and the modified Hodge's tests were positive for all strains. PCR and sequencing confirmed that seven, five, and all eight of the PDR-AB strains contained blaOXA-23, blaTEM-1, and KPC-2, respectively. OXA-23 and CsuC proteins were differentially expressed between the drug-resistant and -sensitive strains. Production of blaOXA-23 enzyme and pilus molecular chaperone to guide synthesis of CsuC protein may be involved in the resistance of A. baumannii to carbapenems. LC-MS/ MS provides a quick and easy method for carbapenemase detection.

Differential effect of psoralidin in enhancing apoptosis of colon cancer cells via nuclear factor-κB and B-cell lymphoma-2/B-cell lymphoma-2-associated X protein signaling pathways

Worldwide, colon cancer is the third most common cancer in terms of incidence, following lung and breast cancer. Resistance to psoralidin frequently occurs following its use as an anticancer treatment. However, the mechanisms underlying the effects of psoralidin on colon cancer, remain to be elucidated. Hence, the present study investigated the anticancer effects and potential mechanism of action of psoralidin on SW480 human colon cancer cells. In the present study, an MTT assay was performed to measure the viability of SW480 cells. Additionally, an Annexin V-fluorescein isothiocyanate/propidium iodide apoptosis detection kit, DAPI staining assay and caspase-3 colorimetric assay kits were used to analyze the cellular apoptosis of SW480 cells. The nuclear factor-κB (NF-κB) p65 activity and B-cell lymphoma-2 (Bcl-2)/Bcl-2-associated X protein (Bax) protein expression of SW480 cells was detected using NF-κB colorimetric assay kits and western blot analysis, respectively. Bcl-2 inhibitor ABT-737 was added to SW480 cells and the subsequent effects and mechanism of action of psoralidin on SW480 colon cancer cells was studied. In the present study, psoralidin reduced SW480 cell viability and enhanced the cellular apoptosis of SW480 cells in a dose-dependent manner. Caspase-3 activity of SW480 cells was increased following treatment with psoralidin. Additionally, psoralidin was able to reduce the NF-κB p65 activity of SW480 cells. Furthermore, psoralidin was able to reduce Bcl-2 protein expression and increase Bax protein expression in SW480 cells. Notably, Bcl-2 inhibitor was observed to enhance the effects of psoralidin on SW480 cells. The results of the present study suggest that psoralidin may be a candidate drug for the treatment of colon cancer by inhibition of the NF-κB and Bcl-2/Bax signaling pathways.

Effect of apolipoprotein B mRNA-editing catalytic polypeptide-like protein-3G in cervical cancer

Cervical cancer is one of the most common gynecologic cancers. The role of apolipoprotein B mRNA-editing catalytic polypeptide-like protein-3G (APCBEC-3G) in cervical cancer has yet to be elucidated. This study intends to explore the effect of APCBEC-3G on cervical cancer cell proliferation and invasion. In vitro, the cervical cancer cell line Hela was transfected by APCBEC-3G plasmid. The mRNA and protein expression levels of APCBEC-3G were detected by Real-time PCR and Western blot, respectively. Cervical cancer cell proliferation was determined by MTT. Transwell assay was applied to measure the effect of APCBEC-3G on cell invasion. APCBEC-3G mRNA and protein increased significantly after transfection (P<0.05) and cervical cancer cell proliferation and invasive ability were decreased significantly (P<0.05). APOBEC-3G serves as a suppressor of cervical cancer cell proliferation and invasion. Our research provides theoretical basis for further investigation APOBEC-3G effect in cervical cancer occurrence and development.

Differentiating the extent of cartilage repair in rabbit ears using nonlinear optical microscopy

Nonlinear optical microscopy (NLOM) was used as a noninvasive and label-free tool to detect and quantify the extent of the cartilage recovery. Two cartilage injury models were established in the outer ears of rabbits that created a different extent of cartilage recovery based on the presence or absence of the perichondrium. High-resolution NLOM images were used to measure cartilage repair, specifically through spectral analysis and image texture. In contrast to a wound lacking a perichondrium, wounds with intact perichondria demonstrated significantly larger TPEF signals from cells and matrix, coarser texture indicating the more deposition of type I collagen. Spectral analysis of cells and matrix can reveal the matrix properties and cell growth. In addition, texture analysis of NLOM images showed significant differences in the distribution of cells and matrix of repaired tissues with or without perichondrium. Specifically, the decay length of autocorrelation coefficient based on TPEF images is 11.2 ± 1.1 in Wound 2 (with perichondrium) and 7.5 ± 2.0 in Wound 1 (without perichondrium), indicating coarser image texture and faster growth of cells in repaired tissues with perichondrium (p < 0.05). Moreover, the decay length of autocorrelation coefficient based on collagen SHG images also showed significant difference between Wound 2 and 1 (16.2 ± 1.2 vs. 12.2 ± 2.1, p < 0.05), indicating coarser image texture and faster deposition of collagen in repaired tissues with perichondrium (Wound 2). These findings suggest that NLOM is an ideal tool for studying cartilage repair, with potential applications in clinical medicine. NLOM can capture macromolecular details and distinguish between different extents of cartilage repair without the need for labelling agents.

A clinical study evaluating dendritic and cytokine-induced killer cells combined with concurrent radiochemotherapy for stage IIIB non-small cell lung cancer

To compare the efficacy of dendritic and cytokine-induced killer cells (DC-CIK) therapy combined with concurrent radiochemotherapy on stage IIIB non-small cell lung cancer. Sixty-three patients with stage IIIB non-small cell lung cancer were randomly divided into the study and control groups. The study group, comprising 30 patients, was treated with DC-CIK combined with docetaxel-cisplatin chemotherapy and synchronization conformal radiotherapy. The control group including 33 patients was only treated with docetaxel-cisplatin chemotherapy and synchronization conformal radiotherapy. The efficacy, Karnofsky performance score (KPS), tumor markers, 6-month and 12-month survival rate, T cell subsets, and adverse reactions of the two groups were compared. The response rate of the study group was 83.3% (25/30), and that of the control group was only 54.5% (18/33). Furthermore, the KPS, T cell subsets, and 12-month survival rate was significantly higher in the study group, and there were significant differences between the two groups. The two groups had no significant difference in adverse reactions. The combined DC-CIK therapy, with synchronous radiotherapy and chemotherapy to treat stage IIIB non-small cell lung cancer was superior to single synchronous radiotherapy and chemotherapy. The combined therapy can improve the life quality and prolong the survival time of the patients.