Driving forces of China's provincial bilateral carbon emissions and the redefinition of corresponding responsibilities.

The carbon transfers caused by inter-provincial commodity flows account for about 35 % of the total carbon emissions in China. There are great differences between the production-side and consumption-side carbon emissions for each province. Therefore, under the constraints of carbon peak and carbon neutralization, bilateral carbon emissions management is crucial to mitigate carbon emissions and the driving forces of bilateral carbon emissions must first be identified. Based on China's inter-provincial input-output data and carbon emissions data released by China Emissions Accounts and Datasets (CEADs), this paper uses a multi-regional input-output model (MRIO) to calculate the bilateral carbon emissions in 30 China's provinces from 2007 to 2017 and then apply structural decomposition analysis (SDA) to measure the influencing factors of these emissions. We also use counterfactual analysis to investigate the adjustment of provincial responsibilities for carbon emissions. The results show that the provinces in central and northern China undertake major net carbon inflows from other provinces in the eastern and southern coastal region. According to the results of SDA, the technological effect is an important factor in curbing the bilateral carbon emissions and the demand effect promotes the bilateral carbon emissions, but their contribution rates show a downward trend. By contrast, the variation in structural effect has significantly restrictive effects on the bilateral carbon emissions. Based on the provincial contribution to emissions mitigation, the adjusted consumption-side carbon emission embodies the principle of "more emission reduction, more compensation". We suggest implementing differentiated bilateral carbon emission management, taking the adjusted consumption-side carbon emission as the evaluation standard, and promoting inter-provincial carbon compensation.

[Territorially ecological restoration zoning and optimization strategy in Guyuan City of Ningxia, China: Based on the balance of ecosystem service supply and demand]. / 基于生态系统服务供需平衡的宁夏固原生态修复分区与优化策略.

Scientifically identifying the territorially ecological restoration zoning is a vital prerequisite for implementing ecological restoration projects and enhancing environmental quality. Based on remote sensing data, we syste-matically assessed supply and demand for ecosystem service and their relationship in Guyuan City, China by using the InVEST model, coordination degree model, and spatial autocorrelation analysis. We carried out territorially ecological restoration zoning by coupling the ecosystem service supply and demand. Furthermore, the corresponding optimization strategies were put forward according to the regional characteristics of natural resources and socio-economic development. The results showed that the areas with high water yield, carbon storage, soil conservation and habitat quality were mainly located in the southern part of Guyuan City. The areas with high population density, economic development level and high ecological demand were mainly located in the central urban area and the location towns of the county government. The spatial mismatch of supply and demand for ecosystem services in Guyuan City was dominant, as indicated by the fact that the areas with high ecological supply having low ecological demand and low ecological supply having high ecological demand. The average coordination index was 0.5, indicating that the relationship between ecological supply and ecological demand was basically coordinated. Based on the diffe-rences between supply and demand of ecosystem services and regional natural geographical pattern, the administrative township units in Guyuan could be classified into six ecological restoration zonings: key ecological restoration area, potential ecological restoration area, ecological economic reconstruction area, characteristic agricultural development area, ecological core protection area, and ecological industry construction area. Different management strategies were proposed to provide scientific support for ecological restoration.

Chinese Consensus Report on Family-Based Helicobacter pylori Infection Control and Management (2021 Edition).

OBJECTIVE: Helicobacter pylori infection is mostly a family-based infectious disease. To facilitate its prevention and management, a national consensus meeting was held to review current evidence and propose strategies for population-wide and family-based H. pylori infection control and management to reduce the related disease burden. METHODS: Fifty-seven experts from 41 major universities and institutions in 20 provinces/regions of mainland China were invited to review evidence and modify statements using Delphi process and grading of recommendations assessment, development and evaluation system. The consensus level was defined as ≥80% for agreement on the proposed statements. RESULTS: Experts discussed and modified the original 23 statements on family-based H. pylori infection transmission, control and management, and reached consensus on 16 statements. The final report consists of three parts: (1) H. pylori infection and transmission among family members, (2) prevention and management of H. pylori infection in children and elderly people within households, and (3) strategies for prevention and management of H. pylori infection for family members. In addition to the 'test-and-treat' and 'screen-and-treat' strategies, this consensus also introduced a novel third 'family-based H. pylori infection control and management' strategy to prevent its intrafamilial transmission and development of related diseases. CONCLUSION: H. pylori is transmissible from person to person, and among family members. A family-based H. pylori prevention and eradication strategy would be a suitable approach to prevent its intra-familial transmission and related diseases. The notion and practice would be beneficial not only for Chinese residents but also valuable as a reference for other highly infected areas.

Applicability of the adjusted graded prognostic assessment for lung cancer with brain metastases using molecular markers (Lung-molGPA) in a Chinese cohort: A retrospective study of multiple institutions.

BACKGROUND: In this era of precision medicine, prognostic heterogeneity is an important feature of patients with non-small cell lung cancer (NSCLC) with brain metastases (BM). This multi-institutional study is aimed to verify the applicability of the adjusted Lung-molGPA model for NSCLC with BM in a Chinese cohort. METHODS: This retrospective study included 1903 patients at three hospitals in Southwest China. The performance of the Lung-molGPA model was compared with that of the adjusted DS-GPA model in terms of estimating the survival of NSCLC with BM. RESULTS: The median OS of this patient cohort was 27.0 months, and the adenocarcinoma survived longer than the non-adenocarcinoma (28.0 months vs 18.7 months, p < 0.001). The adjusted Lung-molGPA model was more accurate in predicting survival of adenocarcinoma patients than the adjusted DS-GPA model (C-index: 0.615 vs 0.571), and it was not suitable for predicting survival of non-adenocarcinoma patients (p = 0.286, 1.5-2.0 vs 2.5-3.0; p = 0.410, 2.5-3.0 vs 3.5-4.0). CONCLUSIONS: The adjusted Lung-molGPA model is better than the DS-GPA model in predicting the prognosis of adenocarcinoma patients. However, it failed to estimate the prognosis for non-adenocarcinoma patients.

Crizotinib versus chemotherapy: a real-world cost-effectiveness study in China.

Aim: To assess the cost-effectiveness of crizotinib verses platinum-based doublet chemotherapy as the first-line treatment for anaplastic lymphoma kinase (ALK)-positive non-small-cell lung cancer (NSCLC) in the real-world setting. Methods: Data from 163 advanced ALK positive NSCLC patients were collected from West China Hospital, Sichuan University (Chengdu, China). They were categorized into two groups as treated with crizotinib (n = 83) or chemotherapy (n = 80) as a first-line therapy. The progression-free survival (PFS) as the primary clinical outcome, and the direct medical costs were collected from hospital information systems. Incremental cost-effectiveness ratio (ICER) was calculated with costs, quality-adjusted life-years, as well as the costs discounted at 3% annually. Additionally, two different kinds of medical insurance (MI) for pharma-economic assessment were considered. Results: Crizotinib improved PFS versus chemotherapy in ALK positive patients (median PFS 19.67 m vs 5.47 m; p < 0.001). Moreover, crizotinib obtained an ICER of US$36,285.39 before the end of 2016, when crizotinib, pemetrexed and anti-angiogenesis drugs were not MI covered. This is more than the willingness to pay threshold (three-times of gross domestic product per capita in mainland China or Sichuan Province). However, ICER was US$7321.16, which is less than willingness to pay, when crizotinib and all chemotherapy drugs were covered by MI from the end of 2016. Sensitivity analysis demonstrated a 99.7% probability for crizotinib to be more cost-effective than chemotherapy, when crizotinib and all anticancer drugs were MI covered. One-way sensitivity analysis for the reimbursement ratio of crizotinib indicated that cost-effective tendency for crizotinib increased as reimbursement ratio increased. Conclusion: Crizotinib could be an effective, and cost-effective first-line treatment for ALK positive advanced NSCLC with the MI coverage currently available in Chengdu, Sichuan Province, China.

[Disease burden of patients with advanced schistosomiasis in Jiangsu Province].

OBJECTIVE: To understand the disease burden of patients with advanced schistosomiasis in Jiangsu Province. METHODS: Totally 450 patients with advanced schistosomiasis from southern, northern and central Jiangsu were chosen by the stratified sampling method, and surveyed by the self-designed economic burden questionnaire in 2015. The economic burden of the patients was analyzed by the descriptive analysis method, and its determinants were explored by the multiple linear regression analysis. RESULTS: A total of 450 subjects were surveyed and 434 valid questionnaires were recovered with the recovery rate of 96.44%. The per capita economic burden of advanced schistosomiasis patients was 10 217 Yuan in Jiangsu Province in 2015, including 7 221 Yuan in direct economic burden and 2 996 Yuan in indirect economic burden. The average lost labor force time was 140 days for the patients, and was 23 days for the family. The multiple linear regression analysis showed that the marital status, hospitalization health service utilization, and self-reported health score impacted on the disease economic burden. CONCLUSIONS: The disease burden of patients with advanced schistosomiasis in Jiangsu Province is heavy.

Assessment of programmed cell death ligand-1 expression with multiple immunohistochemistry antibody clones in non-small cell lung cancer.

BACKGROUND: Programmed cell death-1 (PD-1) and programmed cell death ligand-1 (PD-L1) have been identified as novel targets for immunotherapy, with PD-L1 as a potential predictive biomarker. However, a specific antibody for PD-L1 expression is an immediate requirement. Meanwhile, the clinicopathological identification of patients with positive PD-L1 remains unclear. METHODS: The present study adopted three anti-PD-L1 IHC antibodies, SP142, SP263, and UMAB228 to test PD-L1 expression in 84 non-small cell lung cancer (NSCLC) specimens. The concordance among antibodies was examined by analytical comparison, and the association between PD-L1 expression and clinicopathological factors was assessed. RESULTS: The samples from 41 (48.8%), 51 (60.7%), and 50 (59.5%) patients were detected as PD-L1 positive evaluated by antibody SP142, SP263, and UMAB228, respectively. The kappa coefficient was 0.53, 0.58, and 0.46 for SP263 vs. SP142, SP263 vs. UMAB228, and SP142 vs. UMAB228, respectively. On the other hand, the univariate analysis of consensus cases indicated that the PD-L1 expression was significantly correlated with tobacco use (χ2=4.25, P=0.04). CONCLUSIONS: The analytical comparison showed moderate concordance between SP142, SP263 and UMAB228, whereas SP263 exhibited higher overall positive rate. Moreover, PD-L1 positive rate was significantly higher in patients with smoking history, which might help in identifying patients who would benefit from PD-1/PD-L1 checkpoint inhibitors.

Health-related quality of life in type-2 diabetes patients: a cross-sectional study in East China.

BACKGROUND: Used the EuroQoL-5 dimension (EQ-5D) to evaluate the health status of 5310 residents who live in East China, and compared the health-related quality of life (HRQoL) with 311 patients with type 2 diabetes as well as to explore the main influence factors to HRQoL in East China. METHODS: The cohort includes 5310 participants aged 18-89 years old lived in East China. EuroQoL-5 dimension (EQ-5D) scale was used for the assessment of health-related quality of life. RESULTS: The mean age of the cohort was 52.2 ± 13.4 years of which 43.7% were male. A moderate level of health-related quality of life was measured of that EQ-5D index and EQ-VAS scores were 0.939 ± 0.111 and 80.06 ± 11.58, respectively. There was a significant difference between diabetes patients and non-diabetes (p = 0.029, p < 0.001, respectively). The age had an inverse correlation with the EQ-5D scores both in general population and diabetes patients. The EQ-5D Vas was weakly adversely associated with the FPG, HbA1c and HOMA-IR. CONCLUSION: The overall health-related quality of life of population in East-China was moderate. Diabetes patients had lower score of health-related quality. The healthy-related quality was associated with the age, gender, economic development of region, level of education and marital status.

[Analysis of commercial specifications and grades of wild and cultivated Gentianae Macrophyllae Radix based on multi-indicative constituents].

The study is aimed to analyze the commercial specifications and grades of wild and cultivated Gentianae Macrophllae Radix based on multi-indicative constituents. The seven kinds of main chemical components containing in Gentianae Macrophyllae Radix were determined by UPLC, and then the quality levels of chemical component of Gentianae Macrophyllae Radix were clustered and classified by modern statistical methods (canonical correspondence analysis, Fisher discriminant analysis and so on). The quality indices were selected and their correlations were analyzed. Lastly, comprehensively quantitative grade division for quality under different commodity-specifications and different grades of same commodity-specifications of wild and planting were divided. The results provide a basis for a reasonable division of specification and grade of the commodity of Gentianae Macrophyllae Radix. The range of quality evaluation of main index components (gentiopicrin, loganin acid and swertiamarin) was proposed, and the Herbal Quality Index (HQI) was introduced. The rank discriminant function was established based on the quality by Fisher discriminant analysis. According to the analysis, the quality of wild and cultivated Luobojiao, one of the commercial specification of Gentianae Macrophyllae Radix was the best, Mahuajiao, the other commercial specification, was average , Xiaoqinjiao was inferior. Among grades, the quality of first-class cultivated Luobojiao was the worst, of second class secondary, and the third class the best; The quality of the first-class of wild Luobojiao was secondary, and the second-class the best; The quality of the second-class of Mahuajiao was secondary, and the first-class was the best; the quality of first-class Xiaoqinjiao was secondary, and the second-class was the better one between the two grades, but not obvious significantly. The method provides a new idea and method for evaluation of comprehensively quantitative on the quality of Gentianae Macrophyllae Radix.

Assessment of a passive immunity mouse model to quantitatively analyze the impact of neutralizing antibodies on adeno-associated virus-mediated gene transfer.

Adeno-associated viruses (AAVs) are common infective agents of primates. As such, healthy primates carry a large pool of AAV-specific neutralizing antibodies (NAbs), which inhibit AAV-mediated gene transfer therapeutic strategies. Thus, a clinical method to screen patient candidates for AAV-specific NAbs prior to treatment, especially with the frequently used AAV8 capsid component, will facilitate individualized treatment design and enhance therapeutic efficacy. In this study, we evaluated the efficacy and sensitivity of a passive immunity mouse model to quantitatively assess anti-AAV8 NAb titers, as compared to an in vitro immunoassay. The passive transfer model was established in C57BL/6 mice by tail vein injection of pre-defined sera from 23 male rhesus monkeys. The mice were then administered low dose (3e10 GC/mouse) self-complementary (sc) AAV8. The in vitro NAb assay indicated that 69.57% of the rhesus donors had pre-existing anti-AAV8 NAb. The in vivo NAb assay, however, was better able to detect low NAb titer (≤ 1:5), which can mediate neutralization in vivo. Indeed, 17 rhesus donors (74.0%) had pre-existing anti-AAV8 neutralization by in vivo NAb assay. Our findings indicated that the in vivo NAb assay is superior to the in vitro assay for detecting low NAb titers.