Interactive Governance Between and Within Governmental Levels and Functions: A Social Network Analysis of China's Case Against COVID-19.

COVID-19 has created long-lasting yet unprecedented challenges worldwide. In addition to scientific efforts, political efforts and public administration are also crucial to contain the disease. Therefore, understanding how multi-level governance systems respond to this public health crisis is vital to combat COVID-19. This study focuses on China and applies social network analysis to illustrate interactive governance between and within levels and functions of government, confirming and extending the existing Type I and Type II definition of multi-level governance theory. We characterize four interaction patterns-vertical, inter-functional, intra-functional, and hybrid-with the dominant pattern differing across governmental functions and evolving as the pandemic progressed. Empirical results reveal that financial departments of different levels of government interact through the vertical pattern. At the same time, intra-functional interaction also exists in provincial financial departments. The supervision departments typically adopt the inter-functional pattern at all levels. At the cross-level and cross-function aspects, the hybrid interaction pattern prevails in the medical function and plays a fair part in the security, welfare, and economic function. This study is one of the first to summarize the interaction patterns in a multi-level setting, providing practical implications for which pattern should be applied to which governmental levels/functions under what pandemic condition.

Epidemiological investigation of sudden cardiac death in multiethnic Xinjiang Uyghur autonomous region in Northwest China.

BACKGROUND: The epidemiological characteristics of sudden cardiac death (SCD) in the autonomous region of Xinjiang Uygur have been largely unknown. This study aimed to evaluate the incidence and demographic risk factors of SCD in Xinjiang, China. METHODS: This retrospective study reviewed medical records from 11 regions in Xinjiang with different geography (north and south of the Tian Shan mountain range), gross domestic product, and ethnicity (Han, Uyghur, Kazakh, and Hui). SCD was defined as unexpected death due to cardiac reasons within 1 hour after the onset of acute symptoms, including sudden death, unexpected death, and nonviolent death. Monitoring was conducted throughout 2015. Demographic and mortality data were recorded and age-adjusted standardized risk ratio (SRR) was analyzed. RESULTS: Among 3,224,103 residents, there were 13,308 all-cause deaths and 1244 events of SCD (784 men and 460 women; overall incidence 38.6 per 100,000 residents). SCD was associated with age (χ2 = 2105.3), but not geography. Men had an increased risk of SCD compared with women (SRR: 1.75, 95% CI: 1.10-2.79). The risk of SCD was highest in residents of the Uyghur (SRR: 1.59, 95% CI: 1.05-2.42) and Kazakh (SRR: 1.92, 95% CI: 1.29-2.87) compared with those of the Han. Poor economic development was associated with elevated risk of SCD (SRR: 1.55, 95% CI: 1.02-2.38). CONCLUSION: SCD is an important public health issue in China. Our understanding of the demographic differences on SCD in Xinjiang, China may improve the risk stratification and management to reduce the incidence and lethality of SCD.

[Detection of R-wave in Fetal EGG Based on Wavelet Transform and Matched Filtering].

By analyzing the characteristics of maternal abdominal ECG (Electrocardiogram), a method based on wavelet transform and matched filtering is proposed to detect the R-wave in fetal EGG (FECG). In this method, the high-frequency coefficients are calculated by using wavelet transform. First, the maternal QRS template is obtained by using the arithmetic mean scheme. Finally, the R-wave of FECG is detected based on matched filtering. The experimental results show that this method can effectively eliminate the noises, such as the maternal ECG signal and baseline drift, enhancing the accuracy of the detection of fetal ECG.

[Influence of aluminum hydroxide adjuvant on a murine model of allergic rhinitis].

OBJECTIVE: To investigate the influence of aluminum hydroxide adjuvant on a murine model of allergic rhinitis (AR) and to confirm an appropriate method of establishing a mouse model of AR. METHOD: Establishing two types of BALB/c mice models of AR, one was identified as Local group which was characterized through intranasal sensitization and challenge using ovalbumin (OVA), and the other Systemic group which was made by intraperitoneal sensitization with OVA plus aluminum hydroxide and intranasal challenge through OVA. Then the numbers of sneezing and nasal rubbing were counted after the last challenge and the eosinophils in the nasal mucosa of mice models were observed and counted though Luna stain. Furthermore, morphological hyperplasia was examined in intraepithelial goblet cells and submucosal glands with HE stain. In addition, interlukin (IL) -4, IL-5, OVA specific IgE (sIgE) and interferon (IFN)-gamma in nasal lavage fluid (NLF) and serum of mice were examined u sing enzyme linked immunosorbent assay (ELISA). RESULT: The counts of sneezing and nasal rubbing in local group were more than those in systemic group and eosinophilia in the nasal mucosa of former group was greater than that in the latter one. Morphological hyperplasia was stronger in intraepithelial goblet cells and submucosal glands in local group compared with that in systemic group. Furthermore, the contents of IL-4, IL-5 and sIgE increased in the NLF and serum of mice of local group compared to those of systemic one. However, the production of IFN-gamma of mice in local group decreased when compared with that in Systemic group. CONCLUSION: OVA plus aluminum hydroxide adjuvant may promote Th1 type immune response as well as Th2 response. OVA intranasal sensitization and challenge locally is an appropriate way in the establishment of AR mice models.

[Treatment of allergic rhinitis with normal saline nasal irrigation at different temperature].

OBJECTIVE: To investigate the influence of normal saline nasal irrigation with different temperature on allergic rhinitis (AR) and to confirm the appropriate temperature of nasal irrigation. METHODS: Sixty patients with AR were randomly divided into 3 groups (according to random number table) and received 15 °C, 25 °C or 40 °C normal saline nasal irrigation respectively, and 20 healthy controls received no treatment. Visual analogue scale ( VAS) was used to assess the symptoms among the control group and the various intervention groups and the enzyme linked immunosorbent assay (ELISA) was applied to detect the contents of histamine, leukotriene C4 (LTC4), house dust mite D1 specific IGE (sIGE) and eosinophil cationic protein (ECP) among the control group and the various intervention groups. GraphPad Prism 5 software was used to analyze the data. RESULTS: There was no statistical difference between 15 °C normal saline nasal irrigation group and 25 °C normal saline nasal irrigation group. Pre-intervention and post intervention whether is VAS scores of rhinorrhea, sneezing, nasal obstruction and nasal pruritis or in contents of histamine, LTC4, sIgE and ECP showed no difference (all P > 0.05). However, the symptoms of (sneezing VAS score: 3.765 ± 0.291; nasal obstruction VAS score: 3.529 ± 0.365). The difference was significant (t = 4.678, P < 0.001; t = 3.901, P < 0.01). The contents of histamine [ (21.78 ± 0.62) ng/ml] and LTC4 (17.43 ± 0.67 ng/ml) were also decreased after intervention of 40 °C normal saline nasal irrigation [ histamine content: (18.82 ± 0.52) ng/ml; LTC4 content: (13.14 ± 0.59) ng/ml ]. The difference was significant (t = 3.632, P < 0.01; t = 4.79, P < 0.001). Nonetheless, there were no statistical differences in VAS scores of rhinorrhea (t = 2.02, P = 0.051) and nasal pruritis (t = 1.984, P =0.056) and in contents of sIgE (t = 1.891, P = 0.066) and ECP (t = 2.021, P = 0.05). There were statistical differences between the 40 °C group and the 25 °C group normal saline nasal irrigation group in symptoms of sneezing (t = 2.060, P = 0.048) and nasal obstruction (t = 2.1053, P = 0.048). and inflammatory factors of histamine (t = 2.078, P = 0.045) and LTC4 (t = 2.149, P = 0.038). In symptoms of rhinorrhea and nasal pruritis and local production of sIgE and ECP, there was no statistical difference (all P > 0.05). CONCLUSION: 40 °C normal saline nasal irrigation can improve the symptoms of sneezing and nasal obstruction and can alleviate the local levels of inflammatory factors like histamine and LTC4 in AR patients, and is the appropriate irrigation temperature.

[Clinicopathological characteristics of hypopharyngeal carcinosarcoma].

OBJECTIVE: To study the clinicopathological characteristics, diagnosis and differential diagnosis of hypopharyngeal carcinosarcoma. METHOD: Clinical data of one case with hypopharyngeal carcinosarcoma proved by pathology were analyzed retrospectively. The related literatures were reviewed. RESULT: The masses were surgically removed,and the postoperative diagnosis was confirmed to be carcinosarcoma by histopathological examination. After radiotherapy and chemotherapy, the patient recovered well postoperatively without recurrence during 18-month follow-up. CONCLUSION: Carcinosarcoma of the hypopharynx is an extremely rare malignant tumor with distinctive histological, clinical and immunohistochemical features. The final diagnosis depends on histopathology. This tumor should be differentiated from other tumors such as sarcomatoid carcinoma and the reaction of radiotherapy of carcinoma. Surgery is the proper treatment strategy for carcinosarcoma of the hypopharynx. The patients with locally advanced, postoperative residual tumor or tumor without clear safe surgical margin should undergo radiotherapy, and the postoperative follow up should be in time.

Influence of Orai1 intervention on mouse airway epithelium reactions in vivo and in vitro.

BACKGROUND: Orai1 is crucial for store-operated Ca2(+) entry and Ca2(+) release-activated Ca2(+) channel activities. However, little is known about its function in allergic diseases. OBJECTIVE: To assess the influence of Orai1 intervention on mouse airway epithelium reactions in vivo and in vitro. METHODS: We used immunohistochemical staining, enzyme-linked immunosorbent assay, and real-time reverse transcription-polymerase chain reaction to evaluate Orai1 expression in nasal and tracheal mucosa epithelium of nonsensitized, control, and 2-aminoethoxydiphenyl borate (2-APB)-treated groups in vivo and in vitro. In addition, we analyzed concentrations of interleukin 1ß, interleukin 6, macrophage inflammatory protein 2, and tumor necrosis factor α in nasal lavage fluid, bronchoalveolar lavage fluid, and culture supernatant and their messenger RNAs in nasal and tracheal mucosa and cultured nasal and tracheal epithelium. RESULTS: Administration of 2-APB into the nostrils suppressed Orai1 expression in nasal and tracheal mucosa of treated mice compared with that in control mice and restrained the mediators in nasal lavage fluid, bronchoalveolar lavage fluid, and airway mucosa of treated groups compared with those in control groups. Similarly, the 2-APB intervention also alleviated Orai1 and the production of the mediators in culture supernatant and cultured airway epithelium under allergic conditions. CONCLUSIONS: Our results indicate that 2-APB could effectively ameliorate reactions of upper and lower airway epithelial cells in mice in allergic states in vivo and in vitro.

Radiologic and histologic characterization of silk fibroin as scaffold coating for rabbit tracheal defect repair.

OBJECTIVES: To explore the feasibility of silk fibroin as a biomaterial coating used in tracheal defect reconstruction. METHODS: Silk fibroin was subcutaneously embedded in three rabbits and as an artificial implant material coating to reconstruct 12 rabbits' tracheal defects. The postoperative radiologic and histologic characterization was summarized. RESULTS: The thickness of the fibroblasts layer covering the porus and nonporus silk fibroin film was 240.4 +/- 9.9 and 302.3 +/- 10.5 microm, respectively, and there was no statistical difference (P > 0.05) within each group. There was no foreign-body granuloma or macrophagocyte infiltration around the silk film. The tracheal reconstruction study showed a normal mucous membrane with normal cilial growth on the artificial implant and no visible granulation tissue in the reconstructed tracheal cavity. CONCLUSIONS: Silk fibroin is a potential new biomaterial coating for tracheal defect reconstruction. The mechanism of silk fibroin appears to promote tracheal mucous membrane, which may be related to its molecular structure and biology.

[Applied anatomic study on the repair of the facial nerve defect by the anastomosis of the facial nerve with the phrenic nerve].

OBJECTIVE: To explore of the anatomic basis of the anastomosis of the facial nerve with the phrenic nerve. METHOD: Bilateral microsurgical dissection was performed on eleven human cadavers fixed with formalin. The following length data were measured with calipers: the distance between the bifurcation of the facial nerve trunk and the phrenic nerve root, the useful length of the facial nerve trunk and the phrenic nerve, and the distance between the overlapped nerve ends. RESULT: The length from the root of the the phrenic nerve to the level of the subclavian vein was (7.2 +/- 1.6) cm. The length from the root of the phrenic nerve to the bifurcation of the facial nerve trunk was (7.23 +/- 0.9) cm. The length from the bifurcation of the facial nerve trunk to the level below the horizontal semicircular canal was 2.7-3.5 cm, 1.0-1.5 cm longer than that cut below the level of the stylomastoid foramen. The cutting nerve ends were placed side by side. The distance between the overlapped nerve ends was 0.4-1.8 cm. CONCLUSION: In 20 specimens the tension-free anastomosis of the facial nerve with the phrenic nerve that cut in the subclavian vein level can be achieved, in 2 specimens the tension-free anastomosis can not be achieved.

[Role of titanium mesh coated with silk fibroin in rabbit tracheal reconstruction].

OBJECTIVE: To Compare the curative effects between titanium mesh coated with or without silk fibroin and in the treatment of larger trachea circumferential defects. To explore the merits of titanium mesh coated with silk fibroin in promoting mucous healing and decreasing related complications. METHODS: Twenty-five New Zealand white rabbits were chosen , divided randomly as follows: group one: titanium mesh coated with silk fibroin (n = 12), group two: pure titanium mesh without silk fibroin (n = 12); Titanium mesh coated with silk fibroin and those titanium without silk fibroin were embedded in the anterior of 7-12th tracheal rings respectively, in 2 weeks we removed the anterior and lateral wall of 7-12th tracheal rings about 8 mm x 6mm (more than half ring) and used the two different materials to reconstruct tracheal defects. All these rabbits were euthanized in 4, 8 and 12 weeks and tracheal CT scan, tracheal endoscopy, histopathological examination and scanning electron microscopic examinations were performed. All complications such as death, local inflammation, tracheal stenosis were documented. Group three, leave one normal rabbit as controlled study , removed the anterior and lateral wall of 7-12th tracheal rings, and histopathological examination, scanning electron microscopy were performed as controlled study. RESULTS: The CT scan, tracheal endoscopy of those with silk fibroin showed there was no apparent tracheal stenosis. Histopathological examination showed there was no obvious granulation tissue and scar. The mucous membrane and cilia grow normally. The silk fibroin was not entirely absorbed and the remains showed good biocompatibility. The scanning electron microscopy showed that the cilia grew better and more orderly than that of group two, and in 12 weeks, the cilia became normal. In group two, there were 5 rabbits died in succession from suffocation in 4, 5, 7, 17, 60 days after surgery. All rabbits had local or general subcutaneous emphysema. The CT scan, tracheal endoscopy and pathological examination showed that there were apparent granulation tissue, scar hypertrophy, and tracheal stenosis. The mortality of group two (41.7%) for suffocation compare to that of group one (0), the incidence rate of subcutaneous emphysema in group two (100%) to that of group one (25.0%) and the average cross section stenosis area in group two (18.15 +/- 7.85) mm2 to that of group one (3.15 +/- 1.58) mm2, there are significant statistically differences in these postoperative complications (P <0.05) and stenosis degree (P <0.05) between the two groups. In addition, there was one rabbit died of diarrhea in each group except group three. CONCLUSIONS: Silk fibroin and titanium mesh coated with silk fibroin showed good biocompatibility. Titanium mesh coated with silk fibroin used in tracheal reconstruction of rabbits can promote agglutination of mucous membrane and decrease postoperative complications, such as subcutaneous emphysema, tracheostenosis. It may be a prospective biomaterial which can be used in clinical circumferential trachea defect reconstruction.

[Reconstruction of tissue defects in external nose].

OBJECTIVE: To discuss and sum up the methods and experience of aesthetic reconstruction of tissue defects in external nose. METHOD: By respective repair based on aesthetic subunits principle of the nose proposed by Yotsuyanagi et al, 47 tissue defects in external nose were reconstructed using random flap of nasolabial groove, local rhomboid flap, the insular skin flap of forehead,the insular skin flap of nasolabial groove with retrograde facial artery and forearm flap with pedicle etc. RESULT: Satisfactory resconstructive effects were obtained in all cases. CONCLUSION: Good aesthetic result can be achieved using local flaps or forearm flap with pedicle.

Normal mode analyses of methyl palmitate all-trans and disordered forms in wagging progressive region.

Normal mode analyses are made for methyl palmitate molecule having all-trans or conformational disorders around the ester head group, in order to explain characteristic observed frequency shifts in the wagging progressive region between all-trans and disorder chains in triglyceride molecules. It was found that one gauche conformation at C(alpha)-C(beta) position and 90 degrees rotation of the ester head group in an alkyl chain produce frequency shifts for twisting mode as observed. For wagging modes, contamination of the disorders around the head group makes assignments change and apparent frequency shifts occur.