Costs, Trends, and Related Factors in Treating Lung Cancer Patients in 67 Hospitals in Guangxi, China.

Lung cancer is a common disease with high mortality in China. Recent economic advances have led to improved medical capabilities, while costs associated with treating this disease have increased. Such change contributes to a commonly held belief that healthcare costs are out of control. However, few studies have examined this issue. Here, we use 34,678 hospitalization summary reports from 67 Guangxi hospitals (period 2013-2016) to document costs, temporal trends, and associated factors. Findings from this study are surprising in that they debunk the myth of uncontrolled healthcare costs. In addition, results and experiences from Guangxi are informative for other comparable regions.

Interaction of Ferulic Acid with Glutathione S-Transferase and Carboxylesterase Genes in the Brown Planthopper, Nilaparvata lugens.

Plant phenolics are crucial defense phytochemicals against herbivores and glutathione S-transferase (GST) and carboxylesterase (CarE) in herbivorous insects are well-known detoxification enzymes for such xenobiotics. To understand relationship between a plant phenolic and herbivore GST or CarE genes, we evaluated the relationship between a rice phenolic ferulic acid and resistance to brown planthopper (BPH, Nilaparvata lugens), and investigated the interaction of ferulic acid with GST or CarE genes in BPH. The results indicate that ferulic acid content in tested rice varieties was highly associated with resistance to BPH. Bioassays using artificial diets show that the phenolic acid toxicity to BPH was dose dependent and the LC25 and LC50 were 5.81 and 23.30 µg/ml at 72 hr, respectively. Activities of the enzymes BPH GST and CarE were increased at concentrations below the LC50 of ferulic acid. Moreover, low ferulic acid concentrations (< LC25) upregulated the transcriptional levels of NlGSTD1 and NlGSTE1 of the GST family and NlCE of the CarE family. By using dsRNA-induced gene silencing (DIGS) of GST or CarE, it was shown that suppressed expression levels of NlGSTD1, NlGSTE1 and NlCE were 14.6%-21.2%, 27.8%-34.2%, and 10.5%-19.8%, respectively. Combination of NlGSTD1, NlGSTE1 or NlCE knockdown with ferulic acid increased nymph mortality by 92.9%, 119.9%, or 124.6%, respectively. These results suggest that depletion of detoxification genes in herbivorous insects by plant-mediated RNAi technology might be a new potential resource for improving rice resistance to BPH.

The cytotoxicology of momordicins I and II on Spodoptera litura cultured cell line SL-1.

Momordicin I and II are secondary metabolites from bitter melon (Momordica charantia L.) that are toxic to the Spodoptera litura ovary cell line (SL-1 cell). Both momordicin I and II significantly inhibited SL-1 cells proliferation. IC50 values after 24 h were 8.35 and 82.31 µg/mL, 6.11 and 77.49 µg/mL for 36 h, 4.93 and 49.42 µg/mL for 48 h for cells treated by momordicin I and II, respectively. IC50 values of the azadirachtin A control were 149.63, 54.54 and 23.66 µg/mL at 24, 36 and 48 h respectively, indicating that the cytotoxicity of momordicin I was significantly higher than that of momordicin II and azadirachtin A. Using inverted phase contrast microscopy we found that after 24 h exposure to momordicin I and II, cell shapes changed to circular, swelling increased, adherence ability declined and the cellular membrane bubbled. After 48 h exposure to momordicin I, most cells were suspended and dead; vacuole deformation and cytoplasm leakage indicated that momordicin I was more toxic to the cytoskeleton than momordicin II. Cells treated with momordicin I and II inhibited glucose absorption by 23.04 and 13.38% after 48 h and 47.60 and 20.92% after 60 h. Flow cytometry analysis suggested that SL-1 cells treated with momordicin I and II dramatically accumulated during the G2/M phase of the cell cycle, and total cell protein content increased by 56.93 and 35.81% respectively after 48 h treatment. Following treatment with momordicin I and II the karyotheca dissolved, the chromatin condensed abnormally and the nucleoli were damaged, migrated, or disappeared. The PI fluorescent value by FCM showed that the relative fluorescent intensity of SL-1 cells induced by momordicin I and II increased to 521.45 and 370.17, higher than 135.04 induced by control group treatment for 48 h. This indicated significant damage to the cytomembrane. Overall, the results demonstrate that suppression of cytoskeletal function, interference of mitotic figures and destruction of nuclear structure are effects of momordicin I and II exposure. These effects play major roles in momordicin I and II inhibition of SL-1 cells growth. The mode of action by which momordicins inhibit insect cell growth and development may be useful in the development of novel pest control formulations containing cucurbitane-type triterpene glycosides.

Cucurbitane-type triterpenoids from the leaves of Momordica charantia.

Phytochemical investigation of the ethanol extract from the leaves of Momordica charantia L. led to the isolation of two new (1, 2) and four known (3-6) cucurbitane-type triterpenoids. Their structures were elucidated on the basis of extensive analyses of spectroscopic data including IR, UV, MS, 1D, and 2D NMR. Also the absolute configurations of momordicines I (3) and II (4) were determined for the first time by application of the modified Mosher's method, acid hydrolysis, and GC analysis.

Quantification of electron accumulation at grain boundaries in perovskite polycrystalline films by correlative infrared-spectroscopic nanoimaging and Kelvin probe force microscopy.

Organic-inorganic halide perovskites are emerging materials for photovoltaic applications with certified power conversion efficiencies (PCEs) over 25%. Generally, the microstructures of the perovskite materials are critical to the performances of PCEs. However, the role of the nanometer-sized grain boundaries (GBs) that universally existing in polycrystalline perovskite films could be benign or detrimental to solar cell performance, still remains controversial. Thus, nanometer-resolved quantification of charge carrier distribution to elucidate the role of GBs is highly desirable. Here, we employ correlative infrared-spectroscopic nanoimaging by the scattering-type scanning near-field optical microscopy with 20 nm spatial resolution and Kelvin probe force microscopy to quantify the density of electrons accumulated at the GBs in perovskite polycrystalline thin films. It is found that the electron accumulations are enhanced at the GBs and the electron density is increased from 6 × 1019 cm-3 in the dark to 8 × 1019 cm-3 under 10 min illumination with 532 nm light. Our results reveal that the electron accumulations are enhanced at the GBs especially under light illumination, featuring downward band bending toward the GBs, which would assist in electron-hole separation and thus be benign to the solar cell performance. Correlative infrared-spectroscopic nanoimaging by the scattering-type scanning near-field optical microscopy and Kelvin probe force microscopy quantitatively reveal the accumulated electrons at GBs in perovskite polycrystalline thin films.

Accurately Predicting the Radiation Enhancement Factor in Plasmonic Optical Antenna Emitters.

Plasmonic optical antennas (POAs), often constructed from gold or silver nanostructures, can enhance the radiation efficiency of emitters coupled to POAs and are applied in surface-enhanced Raman spectroscopy (SERS) and light-emitting devices. Over the past four decades, radiation enhancement factors (REFs) of POA-emitter systems were considered to be difficult to calculate directly and have been predicted indirectly and approximately, assuming POAs are illuminated by electromagnetic plane waves without emitters. The validity of this approximation remains a significant open problem in SERS theory. Herein, we develop a method based on the rigorous optical reciprocity theorem for accurately calculating the REFs of emitters in nanoparticle-substrate nanogaps for single-molecule SERS and scanning probe-substrate nanogaps for tip-enhanced Raman spectroscopy. We show that the validity of the plane wave approximation breaks down if high-order plasmonic modes are excited. The as-developed method paves the way toward designing high-REF POA nanostructures for luminescence-related devices.

Assessment of potential factors associating with costs of hospitalizing cardiovascular diseases in 141 hospitals in Guangxi, China.

BACKGROUND: The rising cost of healthcare is of great concern in China, as evidenced by the media features negative reports almost daily. However there are only a few studies from well-developed cities, like Beijing or Shanghai, and little is known about healthcare costs in rest of the country. In this study, we use hospitalization summary reports (HSRs) from admitted cardiovascular diseases patients in Guangxi hospitals during 2013-2016, and we investigate temporal trends of healthcare costs and associated factors. METHODS: By generalized additive model, we compute temporal trends of cost per stay (CPS), cost per day (CPD) and others. We then use generalized linear models to assess which factors associate with CPS and CPD. FINDINGS: Using a total of 760,000 HSRs, we find that CPS appears to be stabilized around $1040 until the middle of year 2015, before exhibiting a downward trend. Similarly, CPD exhibits similar stable pattern. Meanwhile, surgery-specific CPS showed an increase in year 2013-2014, and then stabilized. Drug costs account for over 1/3 of CPS, but they are gradually declining. Costs associated with physicians' and nurses' services represent less than 5% of CPS. We found that age, sex, marital status, occupation and payment methods are significantly associated with CPS or CPD. Interestingly, we found no association between patient ethnicity and these costs. However, we did find that minority patients use more secondary hospitals than Han patients. INTERPRETATIONS: Healthcare costs in Guangxi are stable, contrary to the rise portrayed by Chinese mass media. Several factors can be associated with healthcare costs, and these may be useful for developing evidence-based policies. In particular, there is a need to encourage more Han patients to seek care in primary and secondary hospitals.

Glutathione S-transferase of brown planthoppers (Nilaparvata lugens) is essential for their adaptation to gramine-containing host plants.

Plants have evolved complex processes to ward off attacks by insects. In parallel, insects have evolved mechanisms to thwart these plant defenses. To gain insight into mechanisms that mediate this arms race between plants and herbivorous insects, we investigated the interactions between gramine, a toxin synthesized by plants of the family Gramineae, and glutathione S transferase (GST), an enzyme found in insects that is known to detoxify xenobiotics. Here, we demonstrate that rice (Oryza sativa), a hydrophytic plant, also produces gramine and that rice resistance to brown planthoppers (Nilaparvata lugens, BPHs) is highly associated with in planta gramine content. We also show that gramine is a toxicant that causes BPH mortality in vivo and that knockdown of BPH GST gene nlgst1-1 results in increased sensitivity to diets containing gramine. These results suggest that the knockdown of key detoxification genes in sap-sucking insects may provide an avenue for increasing their sensitivity to natural plant-associated defense mechanisms.

[Antifeedant and antioviposition activities of Momordica charantia leaf ethanol extract against Liriomyza sativae].

Liriomyza sativae Blanchard (Diptera: Agromyzidae) is one of the important pests harming a wide variety of vegetables and ornamental plants throughout the world. The leaf ethanol extract of Momordica charantia at the concentration of 2000-4000 microg x ml(-1) displayed significant antifeedant and antioviposition activities against L. sativae adults. For further purifying the extract, four solvents, i. e., cyclohexane, ethyl acetate, n-butanol and water, were used to extract the ethanol extract, and the antifeedant and antioviposition activities of the extracts against L. sativae adults were tested. The results showed that after treated with the extracts at the concentration of 1000 microg x ml(-1) for 2 days, the antifeedant index (AFI) of cyclohexane-, ethyl acetate-, n-butanol- and water extracts against L. sativae adults was 11.08%, 34.89%, 22.99% and 0, and the antioviposition index (AOI) was 0, 30.91%, 6.45% and 0, respectively. Ethyl acetate extract had the highest bioactivity. At the concentration of 4000 microg x ml(-1), the AFI and AOI of ethyl acetate extract were 70.95% and 69.49%, respectively. The ethyl acetate extract was then isolated by silica gel column chromatography, and three compounds, i.e., (19S, 23E)-5beta,19-epoxy-19-methoxy-cucurbita-6,23-dien-3beta and 25-diol (compound 1), (19R, 23E)-5beta,19-epoxy-19-methoxy-cucurbita-6,23-dien-3beta and 25-diol (compound 2), and 3beta, 7beta,25-trihydroxycucurbita-5,23-dien-19-al-3-O-beta-D-glucopyranoside (compound 3), were obtained. These three compounds at concentration of 100-400 microg x ml(-1) all had inhibitory effects on the feeding and oviposition of L. sativae. At the concentration of 400 microg x ml(-1), the AFI and AOI were 66.89% , 53.53% and 78.02% , and 76.32%, 58.36% and 78.36% for compound 1, 2 and 3, respectively.