A Simple and Low-cost Preliminary Quantification of Target Membrane Protein in Single Cells.

To study the heterogeneity of target membrane proteins in single cells with cellular integrity, we proposed a simple and low-cost method to obtain the copy number of the membrane proteins. HeLa cells were labeled by FITC affinity bodies specifically targeting HER2 membrane proteins. The immunolabeled HeLa cells were quantified by a laboratory-built laser induced fluorescence detector. A series of fluorescent microspheres with known number of FITC molecules on the surface were used to establish the calibration curve, instead of the standard fluorescent solutions, because the morphology of the microspheres was similar to the cells, and the distribution of FITC on the spheres were similar to the distribution of HER2 on the HeLa. The fluorescence intensity of the cells was converted to the molecule number of HER2 by the calibration curve. A capillary electrophoresis system was used to drive the microspheres and cells through the detection window. The copy number of HER2 in HeLa cells ranged from 4,036 to 1,224,920 ± 100 (2.5-97.5%), and the median of copy numbers were 104,438 ± 100 per cell. This method for measuring low-abundance membrane proteins can be utilized for the initial exploration of proteomics in ordinary laboratories.

Multi-Index Comprehensive Assessment Optimized Critical Flavonoids Extraction from Semen Hoveniae and Their In Vitro Digestive Behavior Evaluation.

Critical flavonoids from Semen Hoveniae have huge potential bioactivities on hypoglycemic. A multi-index comprehensive assessment based on Analytic Hierarchy Process (AHP) method was performed to optimize the extraction process of flavonoids from Semen Hoveniae, which taking dihydromyricetin, taxifolin, myricetin and quercetin as indexes, and, then, an in vitro simulated gastrointestinal digestion model was established to investigate the changes of flavonoids contents and their antioxidant capacity before and after digestion. The results showed that three influence factors acted significantly with the order of ethanol concentration > solid-liquid ratio > ultrasound time. The optimized extraction parameters were as follows: 1:37 w/v of solid-liquid ratio, 68% of ethanol concentration and 45 min for ultrasonic time. During in vitro digestion, the order of remaining ratio of four flavonoids in the extract was dihydromyricetin > taxifolin > myricetin > quercetin in gastric digestion, and remaining ratio of taxifolin was 34.87% while others were restructured in intestinal digestion. Furthermore, the 1,1-dipheny-2-picryhydrazyl free radical (DPPH ·) scavenging ability and oxygen radical absorption capacity (ORAC) of extract were more stable in gastric digestion. After an hour's intestinal digestion, the extract had no DPPH antioxidant capacity, but amazingly, its ORAC antioxidant capacity was retained or increased, which implied that substances were transformed and more hydrogen donors were produced. This study has carried out a preliminary discussion from the perspective of extraction and put forward a new research idea, to improve the in vivo bioavailability of the critical flavonoids from Semen Hoveniae.

An independent inter- and intra-observer agreement assessment of Yeom classification for bone cement leakage following vertebroplasty/kyphoplasty.

STUDY DESIGN: An inter- and intra-observer agreement study. BACKGROUND: In recent years, vertebroplasty and kyphoplasty have been widely used in treating osteoporotic vertebral compression fractures (OVCF) though the clinical efficacy of them is still controversial. However, there are also inevitable complications, first and foremost is bone cement leakage (BCL). Yeom classification is commonly used to evaluate BCL. The objective of this study is to assess its reliability and reproducibility, and to explore its clinical application value. METHODS: All 58 patients with BCL following vertebroplasty/kyphoplasty were involved. Six spine surgeons were selected to be evaluators as they were unaware of the identity of the patients and the treatment they received. They classified BCL according to Yeom system, we used kappa (K) to assess the inter- and intra-observer agreement. After 12 weeks, we repeated the analysis. RESULTS: The inter-observer reliability of Yeom classification was substantial with K value of 0.71 (1st assessment) and 0.73 (2nd assessment). The intra-observer reproducibility of Yeom classification was near perfect with K value of 0.88. CONCLUSION: Yeom classification system has substantial inter-observer reliability and near perfect intra-observer reproducibility in BCL following vertebroplasty/kyphoplasty, which can be widely used in clinical care as an appropriate instrument for early observation, mechanism and severity cognition, and prognosis predicting of BCL. Besides, the adding of type M (the mixed type) may improve the classification.

Do Double-Edged Swords Cut Both Ways? The Role of Technology Innovation and Resource Consumption in Environmental Regulation and Economic Performance.

The Guangdong-Hong Kong-Macao Greater Bay Area (GBA) is one of the significant regions with the strongest economic vitality in China. This study focuses on environmental regulation in the eleven Greater Bay Area cities to explore the relationship between it and economic performance for the period 2000-2016. In doing so, we employ spatial panel models (including the spatial instrumental variable method) to investigate the nonlinear relationship between economic growth and environmental regulation. We confirm the existence of a U-shaped relationship between economic growth and environmental regulation in the Greater Bay Area. In the first half of the inverted U shape, the higher the economic development level, the stronger the environmental regulation strength; however, the latter begins to decrease after the peak point. The doubled-edged sword does not cut both ways. This paper verifies that technology innovation and resource consumption are two important mechanisms. Further, we find that both economic growth and environmental regulation have negative spatial externalities; innovation has a positive impact on the environmental regulation of the local city as well as surrounding cities, while resource consumption is on the contrary. In conclusion, this paper provides policy recommendations to further promote economic growth and environmental technologies, and to enhance energy efficiency in GBA.

Multimorbidity in Hospitalized Patients Admitted to General Practice Departments and Its Implications for the General Practice Healthcare System: A Four-Year Longitudinal Study in China.

Objective: China and many developing countries has placed high expectations on the general practice healthcare system in terms of lowering medical costs and improving the health status of the multimorbid population in recent years. However, the prevalence of multimorbidity among inpatients attending the general practice department of hospitals and its policy implications are largely unknown. The current study aimed to analyze the prevalence of comorbidities among inpatients attending the general practice department of the tertiary Grade-A Hospitals in China, and put forward evidence-based policy recommendations. Methods: Between December 2016 and November 2020, 351 registered general practitioners from 27 tertiary hospitals were selected, and their direct admissions were evaluated. The rate and composition ratio were used for descriptive analysis of the clinical and epidemiological characteristics of multimorbidity. A backward stepwise algorithm was used to explore independent variables. The absence of multicollinearity and plausible interactions among variables were tested to ensure the robustness of the logistic regression model. The pyramid diagram was used to show the link between gender and the involved human body system in multimorbidity. Results: Multimorbidity was present in 93.1% of the 64, 395 patients who were admitted directly. Multimorbidity was significantly more prevalent in patients aged 45-59 years (OR=3.018, 95% CI=1.945-4.683), 60-74 years (OR = 4.349, 95% CI = 2.574-7.349), ≥75 years (OR = 7.804, 95% CI = 3.665-16.616), and those with body mass index (BMI) ≥ 28 kg/m2 (OR = 3.770, 95% CI = 1.453-9.785). The circulatory system was found to be the most commonly involved human body system in multimorbidity, accounting for 79.2% (95% CI = 78.8-79.5%) of all cases. Significant gender inequity was further observed in the involved human body system in multimorbidity. Conclusion: Multimorbidity is likely common among the inpatients attending the general practice department of hospitals in China and many developing countries, with significant gender inequity in the involved human body systems. Effective countermeasures include establishing a GP-PCIC multimorbidity prevention and control model and enhancing the multimorbidity of elderly and obese patients at both the clinical and healthy lifestyle levels. The diagnosis and treatment capabilities of GPs on the circulatory, endocrine, metabolic, digestive, and respiratory systems should be prioritized.

Occupational exposure to respirable dust from the coal-fired power generation process: sources, concentration, and health risk assessment.

To investigate the contamination levels of respirable dust released in the work environment and the induced workers' health risk at a coal-fired power plant, we collected 405 dust samples from different dusty workstations by personal sampling during the coal-fired power generation process. Then, an inhalation risk assessment model from the USEPA was combined with the Monte Carlo simulation method to quantitatively evaluate the health risk caused by dust inhalation. Of 10 workstations researched, the dust concentration in the most workstations exceeded the prescribed occupational exposure limit. Workers engaged in ash removal suffered the highest health risk at 4.08 × 10-6 ± 2.85 × 10-6 (95% CI), closely followed by those involved in other job categories. The results can contribute to the formulation of targeted dust prevention measures and implementation of risk management for the coal-fired power sector.

Effect of propensity of seeking medical care on the bias of the estimated effectiveness of rotavirus vaccines from studies using a test-negative case-control design.

BACKGROUND: Rotavirus is the leading cause of severe diarrhea among children worldwide, and vaccines can reduce morbidity and mortality by 50-98%. The test-negative control (TNC) study design is increasingly used for evaluating the effectiveness of vaccines against rotavirus and other vaccine-preventable diseases. In this study design, symptomatic patients who seek medical care are tested for the pathogen of interest. Those who test positive (negative) are classified as cases (controls). METHODS: We use a probability model to evaluate the bias of estimates of rotavirus vaccine effectiveness (VE) against rotavirus diarrhea resulting in hospitalization in the presence of possible confounding and selection biases due to differences in the propensity of seeking medical care (PSMC) between vaccinated and unvaccinated children. RESULTS: The TNC-based VE estimate corrects for confounding bias when the confounder's effects on the probabilities of rotavirus and non-rotavirus related hospitalizations are equal. If this condition is not met, then the estimated VE may be substantially biased. The bias is more severe in low-income countries, where VE is known to be lower. Under our model, differences in PSMC between vaccinated and unvaccinated children do not result in selection bias when the TNC study design is used. CONCLUSIONS: In practice, one can expect the association of PSMC (or other potential confounders) with the probabilities of rotavirus and non-rotavirus related hospitalization to be similar, in which case the confounding effects will only result in small bias in the VE estimate from TNC studies. The results of this work, along with those of our previous paper, confirm the TNC design can be expected to provide reliable estimates of rotavirus VE in both high- and low-income countries.

Effects of Integrated Case Payment on Medical Expenditure and Readmission of Inpatients with Chronic Obstructive Pulmonary Disease: A Nonrandomized, Comparative Study in Xi County, China.

In the past few decades, Chinese government attempted to reduce the economic burden of chronic diseases and lower family financial risk of patients by establishing a nationwide coverage of Social Health Insurance system. However, the payment mode of Social Health Insurance varies across Chinese healthcare settings, and the effectiveness of each mode differs. This study aimed to evaluate the effects of integrated case payment on medical expenditure and readmission of inpatients with chronic obstructive pulmonary disease (COPD), a complex, multicomponent, chronic condition. A nonrandomized, comparative method was used in this study. Inpatients with COPD before (n=1569) and after the integrated case payment reform (n=4764) were selected from the inpatient information database of the New Cooperative Medical Scheme Agency of Xi County. The integrated case payment comprises the case payment (including price-cap case payment and fixed-reimbursement case payment) and clinical pathway (including clinical pathway A, clinical pathway B and clinical pathway C). Effects of integrated case payment were evaluated with indicators of per capita total medical expense and readmission within 30 days. A multivariate linear regression and a binary logistic regression were used to conduct statistical analysis. The results showed that case payment, comprising price-cap case payment ß=2382.988, P<0.001) and fixed-reimbursement case payment ß=2613.564, P<0.001), and clinical pathway C ß=1996.467, P<0.001) were risk factors of per capita total medical expenses. Clinical pathway A ß=1443.409, P<0.001) and clinical pathway B ß=1583.791, P<0.001) were protective factors. The interactive effects of case payment with hospital level ß=0.710, P<0.001) lowered the readmission rate within 30 days. Meanwhile, clinical pathways A ß=18.949, P<0.001), B (ß=19.152, PO.OOl) and C ß=1.882, P<0.001) were associated with the rate increase. The findings revealed that integrated case payment ensured the quality of care for inpatients with COPD to some extent. However, this payment mode increased the per capita total medical expense. Further, policy-makers should set reasonable reimbursement standards of case payment, unify the type of case payment, and strengthen the supervision of the reform to enhance its function on medical cost control.

A compact and low-cost laser induced fluorescence detector with silicon based photodetector assembly for capillary flow systems.

A compact and low-cost laser induced fluorescence (LIF) detector based on confocal structure for capillary flow systems was developed and applied for analysis of Her2 protein on single Hela cells. A low-power and low-cost 450 nm laser diode (LD) instead of a high quality laser was used as excitation light source. A compact optical design together with shortened optical path length improved the optical efficiency and detection sensitivity. A superior silicon based photodetector assembly was used for fluorescence detection instead of a photomultiplier (PMT). The limit of detection (LOD) for fluorescein sodium was 3 × 10-12 M or 165 fluorescein molecules in detection volume measured on a homemade capillary electroosmotic driven (EOD)-LIF system, which was similar to commercial LIFs. Compared to commercial LIFs, the whole volume of our LIF was reduced to 1/2-1/3, and the cost was less than 1/3 of them.

The mediating role of resilience in the relationship between stress and life satisfaction among Chinese medical students: a cross-sectional study.

BACKGROUND: The psychological distress of medical students has been widely acknowledged. However, few studies focused on positive well-being among medical students. The purpose of this study was to investigate related demographic factors of life satisfaction among Chinese medical students, to examine the relationship between stress and life satisfaction among this group of people, and to explore the mediating role of resilience in this relationship. METHODS: This multicenter cross-sectional study was carried out in June 2014. Self-reported questionnaires consisting of Perceived Stress Scale (PSS), Wagnild and Young Resilience Scale (RS-14), Satisfaction with Life Scale (SWLS), as well as demographic section were distributed to students at four medical colleges and universities in Liaoning province, China. A total of 2925 students (effective response rate: 83.6%) became our subjects. Hierarchical linear regression models were used to explore the mediating role of resilience. RESULTS: Among the demographic factors, life satisfaction was significantly different in gender (P = 0.001) and study programs (P < 0.001). Stress was negatively correlated with life satisfaction (r = -0.35, P < 0.01). After adjusting for the demographic factors, stress accounted for 12% of the variance in life satisfaction (ß = -0.34, P < 0.001) while resilience explained an additional 18% of the variance (ß = 0.46, P < 0.001). Resilience functioned as a partial mediator in the relationship between stress and life satisfaction among Chinese medical students. CONCLUSIONS: Both stress and resilience played a big role in life satisfaction among Chinese medical students. Besides reducing perceived stress, the university authorities should adopt evidence-based intervention strategies to enhance their resilience in order to promote life satisfaction among the students.

The mediating role of psychological capital on the association between occupational stress and job burnout among bank employees in China.

Although job burnout is common among bank employees, few studies have explored positive resources for combating burnout in this population. This study aims to explore the relationship between occupational stress and job burnout among Chinese bank employees, and particularly the mediating role of psychological capital. A cross-sectional study was conducted in Liaoning, China, during June to August of 2013. A questionnaire that included the effort-reward imbalance scale, the Psychological Capital Questionnaire and the Maslach Burnout Inventory-General Survey, as well as demographic and working factors, was distributed to 1739 employees of state-owned banks. This yielded 1239 effective respondents (467 men, 772 women). Asymptotic and resampling strategies explored the mediating role of psychological capital in the relationship between occupational stress and job burnout. Both extrinsic effort and overcommitment were positively associated with emotional exhaustion and depersonalisation. Meanwhile, reward was negatively associated with emotional exhaustion and depersonalisation, but positively associated with personal accomplishment. There was a gender difference in the mediating role of Psychological capital on the occupational stress-job burnout. In male bank employees, Psychological capital mediated the relationships of extrinsic effort and reward with emotional exhaustion and depersonalization; in female bank employees, it partially mediated the relationships of extrinsic effort, reward and overcommitment with emotional exhaustion and depersonalisation, as well as the relationship between reward and personal accomplishment. Psychological capital was generally a mediator between occupational stress and job burnout among Chinese bank employees. Psychological capital may be a potential positive resource in reducing the negative effects of occupational stress on job burnout and relieving job burnout among bank employees, especially female bank employees.

[A cost-effectiveness analysis of comprehensive rehabilitation treatment of hand burn].

OBJECTIVE: To observe the effect of comprehensive rehabilitation treatment on hand burn, and to make a cost-effectiveness analysis. METHODS: Sixty-two patients with ninety-eight affected hands were divided into rehabilitation group (32 cases, 48 hands) and control group (30 cases, 50 hands). Patients in rehabilitation group received comprehensive rehabilitation treatment at early stage after burn; patients in control group were given instructions for function training at the same time. The functions of the hands to be restored including grasp, hold, pinch, nip, forearm pronation and supination, fetching, laying, and writing abilities of patients in both groups were quantitatively evaluated with Carroll's upper extremity function test before treatment and 5 months after. Direct medical costs of patients in both groups within 5 months were respectively added up to make a cost-effectiveness analysis. RESULTS: In rehabilitation group, function of digital opposition, palmar opposition, holding, and pinching of 37 hands recovered well, with which patients could pick food, put on clothes, go to toilet, and self-care etc. independently. Function of digital opposition, palmar opposition, holding, pinching half recovered in 7 hands, accompanied with well recovered of metacarpophalangeal function, but recovery of function of interphalangeal joint was less satisfactory. Although patients could grasp and hold, they were still poor in fine and harmonized activities. Joint ranges of motion of 4 hands were poor with limited function, and this was resulted from not strictly following treatment for remaining granulation wound. In control group, 23 hands received reconstructive surgery, 14 of them recovered with good function, but were poor in most of fine and harmonized activities. Severe claw hands were found in 13 hands. The ratio between total mean cost value and total function increment value in rehabilitation group (181 +/- 11) was obviously lower than that in control group (298 +/- 30, P < 0.01). CONCLUSIONS: Comprehensive rehabilitation treatment at early stage after hand burn has a good effect on prevention and treatment of hand deformity, promoting recovery of hand function and improving hand appearance. It is also less costly.