In vitro assessment of the bacterial stress response and resistance evolution during multidrug-resistant bacterial invasion of the Xenopus tropicalis intestinal tract under typical stresses.

The intestinal microbiome might be both a sink and source of resistance genes (RGs). To investigate the impact of environmental stress on the disturbance of exogenous multidrug-resistant bacteria (mARB) within the indigenous microbiome and proliferation of RGs, an intestinal conjugative system was established to simulate the invasion of mARB into the intestinal microbiota in vitro. Oxytetracycline (OTC) and heavy metals (Zn, Cu, Pb), commonly encountered in aquaculture, were selected as typical stresses for investigation. Adenosine 5'-triphosphate (ATP), hydroxyl radical (OH·-) and extracellular polymeric substance (EPS) were measured to investigate their influence on the acceptance of RGs by intestinal bacteria. The results showed that the transfer and diffusion of RGs under typical combined stressors were greater than those under a single stressor. Combined effect of OTC and heavy metals (Zn, Cu) significantly increased the activity and extracellular EPS content of bacteria in the intestinal conjugative system, increasing intI3 and RG abundance. OTC induced a notable inhibitory response in Citrobacter and exerted the proportion of Citrobacter and Carnobacterium in microbiota. The introduction of stressors stimulates the proliferation and dissemination of RGs within the intestinal environment. These results enhance our comprehension of the typical stresses effect on the RGs dispersal in the intestine.

Spatiotemporal differentiation and convergence characteristics of green economic efficiency in China: from the perspective of pollution and carbon emission reduction.

Accurate quantification of pollution and carbon emission reduction policies, as well as analysis of green economic efficiency (GEE), are of great significance to accelerating green economic development in China and contributing to pollution prevention and carbon peaking. Using data from 2006 to 2022, this study incorporates pollution and carbon emission reduction policies into the evaluation system, and uses a model with slacks-based measures and a directional distance function (SBM-DDF) to calculate the GEE of 30 provinces. The Dagum Gini coefficient, kernel density estimation, and spatiotemporal convergence analysis are used to analyze the spatiotemporal differentiation and convergence characteristics of GEE. The findings show that the strengths of the pollution and carbon emission reduction policies are increasing but vary greatly among the provinces. China's overall GEE has a time trend with the characteristics of "decline-fluctuation-stable." The Dagum Gini coefficient reveals the relative differences between the major regions. Both the intra-regional and inter-regional differences tend to widen over time and the latter explains most of the sources of the overall differences. Kernel density estimation shows that the absolute differences between the provinces are generally widening, whereas the absolute differences between the provinces in the central and western regions are smaller than those in the eastern region. No obvious σ convergence characteristics exist in the country overall and the three major regions, but ß convergence characteristics are present in each region. The factors affecting changes in the GEE of each region are not the same. The study suggests that the China should further improve the implementation of pollution and carbon emission reduction policies, pay attention to the regional differences and convergence issues of GEE, and promote the coordinated development of green economy in different regions. This study innovatively quantifies the policies related to pollution and carbon emission reduction, providing empirical evidence for understanding the performance of pollution and carbon emission reduction policies in various regions. Furthermore, this study incorporates policies as inputs into the GEE evaluation system, reveals the spatiotemporal differentiation of GEE, thereby providing reference for green economic transformation and sustainable development.

[Measures for waste and by-product recycling and circular economy of whole industry chain of traditional Chinese medicine resources facing carbon peak and carbon neutrality (dual carbon) goals].

It has become a common consensus that resource conservation and intensive recycling for improving resource utilization efficiency is an important way to achieve carbon peak and carbon neutrality(dual carbon). Traditonal Chinese medicine(TCM)resources as national strategic resources are the material basis and fundamental guarantee for the development of TCM industry and health services. However, the rapid growth of China's TCM industry and the continuous expansion and extension of the industrial chain have exposed the low efficiency of TCM resources. Resource waste and environmental pollution caused by the treatment and discharge of TCM waste have emerged as major problems faced by the development of the industry, which has aroused wide concern. Considering the dual carbon goals, this paper expounds the role and potential of TCM resource recycling and circular economy industry development. Taking the typical model of TCM resource recycling as the case of circular economy industry in reducing carbon source and increasing carbon sink, this paper puts forward the suggestions for the TCM circular economy industry serving the double carbon goals. The suggestions mainly include strengthening the policy and strategic leading role of the double carbon goals, building an objective evaluation system of low-carbon emission reduction in the whole industrial chain of TCM resources, building an industrial demonstration park for the recycling of TCM resources, and promoting the establishment of a circular economy system of the whole industrial chain of TCM resources. These measures are expected to guide the green transformation of TCM resource industry from linear economic model to circular economy model, provide support for improving the utilization efficiency and sustainable development of TCM resources, and facilitate the low-carbon and efficient development of TCM resource industry and the achievement of the double carbon goals.

[Traditional application and modern research progress on new foreign medicinal resources].

Chinese medicinal resources are the material basis for the survival and development of traditional Chinese medicine(TCM)and the sustainable development of Chinese medicinal resources is also an important project for the modernization of TCM in China. With the increasing demand for Chinese medicinal resources in China, over-exploitation has destroyed Chinese medicinal resources, resulting in a shortage of many natural medicinal resources in China and making the sustainable development of TCM in trouble. The introduced new foreign medicinal resources have become effective supplement and replacement for Chinese medicinal resources to some extent. However, the development and utilization of new foreign medicinal resources in China are different. To fully understand the development of new foreign medicinal resources in China, this paper, taking 43 new foreign medicinal resources such as Acacia nilotica as objects, sorted out the introduction forms and policies of new foreign medicinal resources, overviewed its current development status in China, summarized the application experience of new foreign medicinal resources in the place of origin, as well as the research progress and problems of new foreign medicinal resources in China and abroad, and analyzed the research situation, which can enrich Chinese medicinal resources and other uses, promote the sustainable development of Chinese medicinal resources, and provide ideas for further development and research of new foreign medicinal resources.

The Impact of the Medical Insurance System on the Health of Older Adults in Urban China: Analysis Based on Three-Period Panel Data.

The impact of the medical insurance system (MIS) on the health of older adults is a key element of research in the field of social security. Because China's MIS consists of different types of insurance, and the benefits and levels of coverage received by participating in different medical insurance vary, different medical insurance may have a differential impact on the health of older adults. This has rarely been studied before. In this paper, the panel data of the third phase of the China Health and Retirement Longitudinal Study (CHARLS) conducted in 2013, 2015 and 2018 were used to investigate the impact of participation in social medical insurance (SMI) and commercial medical insurance (CMI) on the health of urban older adults and its mechanism relationship. The study found that SMI had a positive impact on the mental health of older adults, but only in the eastern region. Participation in CMI was positively correlated with the health of older adults, but this association was relatively small and was only observed in the sample of older adults aged 75 years and above. In addition, future life security plays an important role in the process of improving the health of older adults through medical insurance. Both research hypothesis 1 and research hypothesis 2 were verified. The results of this paper show that the evidence of the positive effect of medical insurance on the health of older adults in urban areas proposed by scholars is not convincing enough. Therefore, the medical insurance scheme should be reformed, focusing not only on coverage, but on enhancing the benefits and level of insurance, so as to enhance its positive impact on the health of older adults.

Does the Creation of Food Safety Demonstration Cities Promote Agricultural Development? Evidence from China.

The creation of food safety demonstration cities (CFSDC) is among the key measures the Chinese government implemented to address the intensifying food safety problem. While effectively managing food safety issues, whether this measure will have an impact on agricultural development in China remains unknown. In this paper, based on panel data from 277 cities in China from 2011 to 2019, the impact of the construction of food safety demonstration cities on agricultural development is empirically examined using the difference-in-differences (DID) model. The results show that the CFSDC significantly improves the level of agricultural development, which still holds after various robustness tests. Analysis of the underlying mechanism indicates that the CFSDC promotes urban agricultural development by accelerating both technological innovation and industrial restructuring. The results of heterogeneity analysis show that the policy effects of the CFSDC exhibit significant heterogeneous characteristics depending on city size, city location, and city administrative level. The findings contribute to the understanding of the relationship between policy pilot projects and agricultural development and provide empirical support for promoting the governance of food safety issues and agricultural development.

Assessing economic sustainability and ecological efficiency with genuine progress indicator: a case study of the Yangtze River Delta from 2000 to 2018.

To achieve urban sustainability, it is critical to enhance the environment, economy, and society simultaneously. This study adopted the revised genuine progress indicator (GPI) and ecological footprint (EF) to evaluate the ecological efficiency and economic sustainability of the Yangtze River Delta from 2000 to 2018. Spatial analysis was utilized to identify spatial autocorrelation. A total of 27 cities were then partitioned through k-means cluster analysis. The results showed that GPI and ecological efficiency improved rapidly, but economic sustainability showed a downward trend. GPI and GDP had a high degree of spatial correlation, especially in Suzhou-Wuxi-Changzhou Metropolitan Area. However, no spatial correlation existed between GPI and EF. The city with high GEE can reach 3000 $/gha, indicating the city consumed 1 global hectare to create $3000 of genuine economic growth. Shanghai, Hangzhou, and Taizhou were cities with the highest level of economic sustainability and ecological efficiency. The spatiotemporal characteristics of economic sustainability and ecological efficiency revealed in this study will provide theoretical guidance for alleviating ecological pressure and promoting economic sustainable development.

[Geographical views in traditional Chinese medicine].

Interdisciplinary integration is a major feature of current scientific and technological development and also an inherent demand of economic and social development. The classic works in traditional Chinese medicine(TCM), such as Huangdi's Internal Classic(Huang Di Nei Jing) and Shennong's Classic of Materia Medica(Shen Nong Ben Cao Jing), contain rich and distinctive geographic ideas about the origin of Chinese medicine and prescriptions. There are many TCM schools and the distribution of each school has obvious geographical characteristics. The difference in geographical space is a major factor causing the difference in schools. There have been records of drugs and places of origin in previous documents of the Han Dynasty. Many drug names in Shennong's Classic of Materia Medica begin with ancient country names or ancient place names, indicating that the compilers attached great importance to the relationship between drugs and places of origin. Doctors in the Tang Dynasty have realized that the quality of medicinal materials was closely related to the place of origin, and each place of origin had herbalists to support the harvesting. The national yearly harvested drugs were all distributed with the places of origin. In the Song Dynasty, there were more records about the origin of drugs than in the Tang Dynasty, and the drawings attached to the Materia Medica Arranged According to Pattern(Zheng Lei Ben Cao) were titled with the names of the origins. In the Jin and Yuan dynasties, the literature on Chinese materia medica inherited the relationship between the origin and quality of drugs and contained rich geographical views in the "medication method". In the Ming Dynasty, the literature on Chinese materia medica was the first to clearly label the Daodi origin, and recognized the differences in quality and application of drugs between different origins. In the Qing Dynasty, doctors realized that there were variations and differences in the origins of drugs used by doctors in different periods, and the problem of origin was one of the reasons for the ineffectiveness of drugs. During the period of the Republic of China, doctors also paid great attention to the relationship between the origin of drugs and the quality of drugs, and the changes in the origin of drugs. TCM and geography share a common philosophical foundation. To inherit and develop the experience of doctors in the past dynasties on the relationship between drugs and origins, it is necessary to combine "Chinese materia medica" with "geography" to carry out the research on the geography of Chinese medicine, conduct multidisciplinary integration, build a new way to inherit and innovate the essence of TCM, promote the connection between philosophy of Yi, medical science, pharmacology, and geography, better serve the production practice of TCM, and promote the solution of problems related to the development of the Chinese medicine industry.

Does Low-Carbon City Construction Improve Total Factor Productivity? Evidence from a Quasi-Natural Experiment in China.

Low-carbon city construction (LCC) is an important strategy for countries desiring to improve environmental quality, realize cleaner production, and achieve sustainable development. Low-carbon cities have attracted widespread attention for their attempts to coordinate the relationship between environmental protection and economic development. Using the panel data from 2006 to 2017 of prefecture-level cities in China, this study applied the difference-in-differences (DID) method to analyze the effects of LCC on the total factor productivity (TFP) of the cities and its possible transmission mechanism. The results show significantly positive effects on TFP, but the effects on each component of TFP are different. Although the LCC has promoted technical progress and scale efficiency, it has inhibited technical efficiency. The accuracy of the results has been confirmed by several robustness tests. Mechanism analysis showed that the pilot policy of low-carbon cities has promoted technical progress and scale efficiency by technological innovation and the upgrading of industrial structure, but resource mismatches among enterprises have been the main reason for reduced technical efficiency. Regional heterogeneity analysis showed that the effects on TFP in the eastern region have been more significant than in the central and western regions. In the eastern region, they have promoted technical progress, while in the central and western regions, they have promoted technical progress and scale efficiency but hindered technical efficiency. This paper presents our findings for the effects of LCC on economic development and provides insightful policy implications for the improvement of technical efficiency in low-carbon cities.

[Strategies for efficacy and function positioning of new resources of Chinese materia medica].

Chinese materia medica( CMM) serves as an important cornerstone for the development of traditional Chinese medicine( TCM) culture and industry due to its unique ecological,medical,economic,scientific and technological,and cultural values. The supply shortage and unstable quality of some CMM resources have hindered the development of TCM. Ensuring the sustainable use of CMM resources has become essential for the development of TCM in China. Enriching CMM resources is the key to ensuring the sustainable utilization of TCM resources in China,which can be achieved via expanding the medicinal parts,developing the substitutes,seeking for analogues,exploring the ethnic and folk medicines,or introducing foreign medicinal materials. CMM efficacy or function positioning plays a very important role in the transformation of new CMM resources. The strategies and methods for efficacy or function positioning of new CMM resources,including analogy,plant genetic relationship exploration,medicinal property deduction,ethnobotanical investigation,text mining,network pharmacology,and structure-activity relationship exploration,were systematically proposed in this study based on CMM theory,textual research,and modern methodologies. This paper is expected to provide a theoretical reference for the continuous enrichment and development of CMM resources and the high-quality development of TCM culture and industry.

Assessment of relationships among clinicopathological characteristics, morphological computer tomography features, and tumor cell proliferation in stage I lung adenocarcinoma.

BACKGROUND: Surgically resected stage I lung adenocarcinoma (ADC) has wide variation in prognosis. It is significant to identify high-risk patients and optimize therapeutic strategy. This study aimed to investigate the relationships among histological grade, serum tumor marker index (TMI), morphological computer tomography (CT) features, and a well-established prognosticator cell proliferation (Ki-67) in stage I ADC. METHODS: Preoperative CT was performed in 182 patients with stage I ADC confirmed by pathology. The Ki-67 expression was acquired by immunohistochemistry. TMI was the square root of standardized serum carcinoembryonic antigen (CEA) and cytokeratin 19 fragments (CYFRA 21-1) values. Tumor shadow disappearance rate (TDR) and other morphological CT features were interpreted by two radiologists. Histological grade, TMI, CT features were statistically evaluated to explore the associations with Ki-67 expression. RESULTS: In univariate analysis, gender, smoking history, pack-year, histological grade, TNM stage (IA and IB), serum CEA and CYFRA 21-1 status, TMI status, as well as TDR, long-axis diameter, short-axis diameter, lobulation, spiculation, attenuation types, vacuolation, vascular invasion, vascular convergence, thickened bronchovascular bundles, pleural attachment and peripheral fibrosis were significantly associated with Ki-67 expression (all P<0.05). Solid-predominant ADC had the highest Ki-67 expression, followed by micropapillary, papillary and acinar-predominant ADC, while lepidic-predominant ADC had the lowest Ki-67 expression (P<0.001). TDR was negatively correlated with Ki-67 (r =-0.478, P<0.001). Multivariate logistic regression analysis revealed that gender, histological grade, TDR and attenuation types were independent factors associated with Ki-67 expression. CONCLUSIONS: Ki-67 expression differed distinctly according to ADC histological subtypes. High Ki-67 expression is independently associated with male patients of stage I ADC with worse differentiation, lower TDR and solid tumors, which might be of prognostic value for poor prognosis in stage I ADC.

[No-tillage:core strategies for sustainable development of ecological agriculture of Chinese materia medica].

Ecological agriculture is a crucial way for agriculture of Chinese materia medica, which emphasizes the application of ecological principles in the cultivation of traditional Chinese medicine. While long-term intensive farming and modern chemical agriculture have threatened soil health, the sustainable development of ecological agriculture of Chinese materia medica is constrained. No-til-lage can reduce both frequency and intensity of tillage. Compared with conventional agriculture, no-tillage can reduce soil disturbance, maintain no-tillage for a long or permanent period and keep mulching. The application of no-tillage has a long history. More and more studies have shown that no-tillage has many advantages over conventional tillage, and the ecological and economic benefits of no-tillage are particularly outstandingin long-term. The cultivation of Chinese medicinal materials adheres to the principle of not grabbing land from farmland, making full use of the soil resources under forests, mountains and wasteland. Reducing the risk of soil loss and sustai-nable utilization are the core issues in the process of new land cultivation. No-tillage application, which not only inherits the traditional Chinese concept of natural farming, but also integrates the laws of ecological agriculture, will become the core strategies of sustainable development of Chinese materia medica ecological agriculture. This study will introduce the basic concepts and development process of no-tillage, analyze their ecological benefits in ecological agriculture of Chinese materia medica, and put forward their application strategies.

Does Government Intervention Ensure Food Safety? Evidence from China.

Food safety is related to public health, social welfare, and human survival, all of which are important and pressing areas of concern all over the world. The government plays an increasingly important role in the supervision of food safety. The role of the government, however, is also controversial. Using provincial panel data of China from 2005 to 2015, the present study intends to shed light on the associations between government intervention and food safety performance under two scenarios of local government-competition and noncompetition. This will be accomplished through an exploratory spatial data analysis and a spatial econometric model. The results reveal negative associations between food safety performance and government intervention without considering local government competition. As was also observed, government intervention not only inhibits the improvement of food safety in the region, but also has a negative spatial spillover effect on food safety in neighboring provinces. This is the result after considering government competition, thus, showing the competitive strategic interaction of the "race to the bottom". Further analysis reveals that, if geographically similar regions are selected as reference objects, the food safety performance of each province will have a stronger tendency to compete for the better. If regions with similar economic development levels are selected as reference objects, food safety performance will have a stronger tendency to compete for the worse. This work provides new evidence for the relationships between government intervention and food safety, and, also, proposes some insightful implications for policymakers for governing food safety.

Assessment of China's contributions to the Regional Network for Asian Schistosomiasis and Other Helminth Zoonoses: a questionnaire survey.

BACKGROUND: The Regional Network for Asian Schistosomiasis and Other Helminth Zoonoses (RNAS+) was established in 1998, which has developed close partnerships with Asian countries endemic for schistosomiasis and other helminthiasis in Asia. RNAS+ has provided an ideal regional platform for policy-makers, practitioners and researchers on the prevention, control and research of parasitic diseases in Asian countries. China, one of the initiating countries, has provided significant technical and financial support to the regional network. However, its roles and contributions have not been explored so far. The purpose of this study was to assess China's contributions on the supporting of RNAS+ development. METHODS: An assessment research framework was developed to evaluate China's contributions to RNAS+ in four aspects, including capacity building, funding support, coordination, and cooperation. An anonymous web-based questionnaire was designed to acquire respondents' basic information, and information on China's contributions, challenges and recommendations for RNAS+development. Each participant scored from 0 to 10 to assess China's contribution: "0" represents no contribution, and "10" represents 100% contribution. Participants who included their e-mail address in the 2017-2019 RNAS+ annual workshops were invited to participate in the assessment. RESULTS: Of 71 participants enrolled, 41 responded to the survey. 37 (37/41, 90.24%) of them were from RNAS+ member countries, while the other 4 (4/41, 9.76%) were international observers. Most of the respondents (38/41, 92.68%) were familiar with RNAS+. Respondents reported that China's contributions mainly focused on improving capacity building, providing funding support, coordination responsibility, and joint application of cooperation programs on RNAS+ development. The average scores of China's contributions in the above four fields were 8.92, 8.64, 8.75, and 8.67, respectively, with an overall assessment score of 8.81 (10 for a maximum score). The challenge of RNAS+ included the lack of sustainable funding, skills, etc. and most participants expressed their continual need of China's support. CONCLUSIONS: This survey showed that China has played an important role in the development of RNAS+ since its establishment. This network-type organization for disease control and research can yet be regarded as a great potential pattern for China to enhance regional cooperation. These findings can be used to promote future cooperation between China and other RNAS+ member countries.

[Cultivation strategy on cluster brand of ecological agriculture of Dao-di herbs].

The cluster brand is the embodiment of the core competitiveness of an industry. Developing and cultivating cluster brand of ecological agriculture of Dao-di herbs not only helps to optimize the value chain of the Chinese medicinal materials(CMMs) industry cluster, realize the value-added of the CMMs industry cluster, but also enhance the visibility and influence of the industrial cluster, enhance the core competitiveness of the industrial cluster. This has important practical significance for promoting the "orderly" "safe" and "effective" development of the Dao-di herbs. Based on the industry development status of CMMs, this article introduces several concepts related to cluster brands and their relationships, and focuses on the cultivation models and strategies of cluster brand in the CMMs industry. Based on the current status of the development of the CMMs industry, this article introduces several concepts related to cluster brands and their interrelationships. It discusses the cultivation models and strategies of cluster brands in the CMMs industry, industry associations, Chinese medicine companies and individual growers as the support, insists on the ecological cultivation of authentic medicinal materials and the cultivation of cluster brands. Finally, it points out the direction for the high-quality development of the ecological agriculture of CMMs.

[Value discovery and resource utilization of by-products in production process of medicinal materials are important ways for poverty alleviation with Chinese herbal medicine industry].

Poverty alleviation by Chinese herbal medicine industry is an important way to implement the major strategic plan of the government and to effectively alleviate poverty and increase income of poor farmers in areas with high resource's endowment of Chinese medicinal materials. Based on the analysis of the existing achievements and problems in poverty alleviation by Chinese herbal medicine industry, this paper proposes that improving the comprehensive benefits of Chinese herbal medicine industry is an important direction for poverty alleviation in the poverty-stricken areas with the high endowment of traditional Chinese medicine resources in the future. Then, based on the concept of resource recycling of traditional Chinese medicinal materials, the feasibility and strategies of utilizing by-products in the production process of Chinese medicinal materials and expanding the ways of poverty alleviation were analyzed and discussed. The aim of all these works was to provide the support for enhancing the comprehensive competitiveness of the industry in poverty-stricken regions, enlarging the poverty alleviation effect of Chinese herbal medicine industry, and consolidating the achievements of poverty alleviation.

Serial Quantitative Chest CT Assessment of COVID-19: A Deep Learning Approach.

PURPOSE: To quantitatively evaluate lung burden changes in patients with coronavirus disease 2019 (COVID-19) by using serial CT scan by an automated deep learning method. MATERIALS AND METHODS: Patients with COVID-19, who underwent chest CT between January 1 and February 3, 2020, were retrospectively evaluated. The patients were divided into mild, moderate, severe, and critical types, according to their baseline clinical, laboratory, and CT findings. CT lung opacification percentages of the whole lung and five lobes were automatically quantified by a commercial deep learning software and compared with those at follow-up CT scans. Longitudinal changes of the CT quantitative parameter were also compared among the four clinical types. RESULTS: A total of 126 patients with COVID-19 (mean age, 52 years ± 15 [standard deviation]; 53.2% males) were evaluated, including six mild, 94 moderate, 20 severe, and six critical cases. CT-derived opacification percentage was significantly different among clinical groups at baseline, gradually progressing from mild to critical type (all P < .01). Overall, the whole-lung opacification percentage significantly increased from baseline CT to first follow-up CT (median [interquartile range]: 3.6% [0.5%, 12.1%] vs 8.7% [2.7%, 21.2%]; P < .01). No significant progression of the opacification percentages was noted from the first follow-up to second follow-up CT (8.7% [2.7%, 21.2%] vs 6.0% [1.9%, 24.3%]; P = .655). CONCLUSION: The quantification of lung opacification in COVID-19 measured at chest CT by using a commercially available deep learning-based tool was significantly different among groups with different clinical severity. This approach could potentially eliminate the subjectivity in the initial assessment and follow-up of pulmonary findings in COVID-19.Supplemental material is available for this article.© RSNA, 2020.

Home Videos as a Cost-Effective Tool for the Diagnosis of Paroxysmal Events in Infants: Prospective Study.

BACKGROUND: The diagnosis of paroxysmal events in infants is often challenging. Reasons include the child's inability to express discomfort and the inability to record video electroencephalography at home. The prevalence of mobile phones, which can record videos, may be beneficial to these patients. In China, this advantage may be even more significant given the vast population and the uneven distribution of medical resources. OBJECTIVE: The aim of this study is to investigate the value of mobile phone videos in increasing the diagnostic accuracy and cost savings of paroxysmal events in infants. METHODS: Clinical data, including descriptions and home videos of episodes, from 12 patients with paroxysmal events were collected. The investigation was conducted in six centers during pediatric academic conferences. All 452 practitioners present were asked to make their diagnoses by just the descriptions of the events, and then remake their diagnoses after watching the corresponding home videos of the episodes. The doctor's information, including educational background, profession, working years, and working hospital level, was also recorded. The cost savings from accurate diagnoses were measured on the basis of using online consultation, which can also be done easily by mobile phone. All data were recorded in the form of questionnaires designed for this study. RESULTS: We collected 452 questionnaires, 301 of which met the criteria (66.6%) and were analyzed. The mean correct diagnoses with and without videos was 8.4 (SD 1.7) of 12 and 7.5 (SD 1.7) of 12, respectively. For epileptic seizures, mobile phone videos increased the mean accurate diagnoses by 3.9%; for nonepileptic events, it was 11.5% and both were statistically different (P=.006 for epileptic events; P<.001 for nonepileptic events). Pediatric neurologists with longer working years had higher diagnostic accuracy; whereas, their working hospital level and educational background made no difference. For patients with paroxysmal events, at least US $673.90 per capita and US $128 million nationwide could be saved annually, which is 12.02% of the total cost for correct diagnosis. CONCLUSIONS: Home videos made on mobile phones are a cost-effective tool for the diagnosis of paroxysmal events in infants. They can facilitate the diagnosis of paroxysmal events in infants and thereby save costs. The best choice for infants with paroxysmal events on their initial visit is to record their events first and then show the video to a neurologist with longer working years through online consultation.

[Background and overall design of Chinese medicine resources assessment].

This paper comprehensively analyses the background and meaning of The Technological Guiding Principle for Assessment of Chinese Medicine Resources enacted by the former CFDA ( China Food and Drug Administration), moreover, it also points out that the Chinese medicine resources assessment with the purpose of guaranteeing the sustainable supplying capacity of Chinese medicine resources is the premise of new drug development; the Chinese medicine resources assessment which takes quality guarantee as the core is a significant action to promote the fixing of place of origin and quality-management antedisplacement for the traditional Chinese medicine industry; in this regard, the Chinese medicine resources assessment which aims at realizing the whole-process traceability is the key to building the high-quality modern traditional Chinese medicine brand. The Chinese medicine resources assessment which takes the classical prescription as the entry point is the embodiment of the protection of traditional Chinese medicine resources and international vision of regulation, which aims at clarifying the thinking for the relevant enterprises to carry out the Chinese medicine resources assessment. Base on the general thinking of ensuring that the "total amount of Chinese medicine resources is fixed and the supply is guaranteed", this paper clarifies two methods of Chinese medicine resources assessment: "family property assessment" of Chinese medicine resources based on "fixed total amount", "supply and demand balance assessment" of Chinese medicine resources based on "supply guarantee". In this regard, the basic strategy of "supply and demand balance assessment" of Chinese medicine resources based on "guaranteed supply" is put forward and it is believed that the resources assessment will lead to the significant adjustment of traditional Chinese medicinal materials production. It becomes the only way for the development of various Chinese medicine production enterprises to realize the comprehensive improvement of Chinese medicine quality, brand construction, the establishment of preferential price mechanism.

Bioaccessibility and risk assessment of heavy metals, and analysis of arsenic speciation in Cordyceps sinensis.

BACKGROUND: Cordyceps sinensis (C. sinensis) is a famous and precious Traditional Chinese Medicine (TCM), while frequent reports of heavy metals, especially arsenic, exceeding standards in C. sinensis in recent years have raised concerns of its safety. Therefore, it is urgent for a research on heavy metals (Cu, Pb, As, Cd, Hg) in C. sinensis, of its bioaccessibility, dietary exposure estimation, arsenic speciation analysis and health risks assessment to human body. METHODS: Three 30 g batches of mixed wild growth C. sinensis samples were collected from Qinghai Province and each batch were divided into three parts: the whole C. sinensis, the stroma and the caterpillar body. The in vitro gastrointestinal method was used to evaluate the bioaccessibility of the heavy metals in the samples. The arsenic speciation analysis in the in vitro gastrointestinal solutions and dilute nitric acid extracted solutions were conducted using high performance liquid chromatography-inductively coupled plasma mass (HPLC-ICP-MS) method. Finally, the target hazard quotient (THQ) developed by the US EPA (1989) was used to assess the health risks of heavy metals in C. sinensis. RESULTS: The contents of Cu, Pb, Cd and Hg in the stroma were higher than those in the caterpillar body. In contrast, As was mainly found in the caterpillar body. In the whole C. sinensis, the average bio-accessibilities of Cu, Pb, As, Hg and Cd were 41.29, 40.11, 64.46, 18.91, and 81.14%, respectively. While in the caterpillar body, the corresponding bio-accessibilities values were 48.26, 42.92, 66.15, 12.86, 87.07%, respectively, and were 38.30, 30.53, 30.18, 7.46, and 82.30%, respectively in the stroma part. Different arsenic speciations of arsenite [As(III)], arsenate [As(V)] and trace amounts of methylarsonic acid [MMA] were detected. Of the total As, 8.69% was in inorganic form, which was also the major form of dissolved As. Among the extracted inorganic species, the concentrations of As(III) and As(V) were 0.56 ± 0.16 and 0.29 ± 0.06 mg kg-1, respectively. In the gastrointestinal solutions, only As(III) and As(V) could be detected; the sum content of the two species was 2.00-2.73%. The bioaccessibility target hazard quotient (BTHQ) values for Cu, Pb, As, Cd and Hg in C. sinensis were 0.0041, 0.0040, 0.5334, 0.0020 and 0.0005, respectively, all less than 1. CONCLUSION: None of the five heavy metals in C. sinensis can be 100% absorbed by human body. The content of arsenic in C. sinensis is high, but the strong toxic inorganic arsenic accounted for only 8.69%. The heavy metals in C. sinensis presented no obvious risks to human health in a reasonable taking way.