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1.
Immunity ; 44(4): 939-50, 2016 Apr 19.
Artículo en Inglés | MEDLINE | ID: mdl-27067056

RESUMEN

VRC01-class antibodies neutralize diverse HIV-1 strains by targeting the conserved CD4-binding site. Despite extensive investigations, crucial events in the early stage of VRC01 development remain elusive. We demonstrated how VRC01-class antibodies emerged in a Chinese donor by antigen-specific single B cell sorting, structural and functional studies, and longitudinal antibody and virus repertoire analyses. A monoclonal antibody DRVIA7 with modest neutralizing breadth was isolated that displayed a subset of VRC01 signatures. X-ray and EM structures revealed a VRC01-like angle of approach, but less favorable interactions between the DRVIA7 light-chain CDR1 and the N terminus with N276 and V5 glycans of gp120. Although the DRVIA7 lineage was unable to acquire broad neutralization, longitudinal analysis revealed a repertoire-encoded VRC01 light-chain CDR3 signature and VRC01-like neutralizing heavy-chain precursors that rapidly matured within 2 years. Thus, light chain accommodation of the glycan shield should be taken into account in vaccine design targeting this conserved site of vulnerability.


Asunto(s)
Anticuerpos Monoclonales/inmunología , Anticuerpos Neutralizantes/inmunología , Sitios de Unión de Anticuerpos/inmunología , Anticuerpos Anti-VIH/inmunología , Proteína gp120 de Envoltorio del VIH/inmunología , Productos del Gen env del Virus de la Inmunodeficiencia Humana/inmunología , Secuencia de Aminoácidos , Anticuerpos ampliamente neutralizantes , Linfocitos T CD4-Positivos/inmunología , Infecciones por VIH/inmunología , VIH-1/inmunología , Humanos , Datos de Secuencia Molecular
2.
Anal Chem ; 96(27): 11018-11025, 2024 07 09.
Artículo en Inglés | MEDLINE | ID: mdl-38934709

RESUMEN

Bacterial viability assessment plays an important role in food-borne pathogen detection and antimicrobial drug development. Here, we first used GelRed as a DNA-binding stain for a bacterial viability assessment. It was found that live bacteria were able to exclude GelRed, which however could easily penetrate dead ones and be absorbed nonspecifically on the bacterial periplasm. Cations were used to reduce the nonspecific adsorption and greatly increase the red fluorescence ratio of dead to live bacteria. Combined with SYTO 9 (a membrane-permeable dye) for double-staining, a ratiometric fluorescent method was established. Using Escherichia coli O157:H7 as a bacteria model, the ratiometric fluorescent method can probe dead bacteria as low as 0.1%. A linear correlation between the ratiometric fluorescence and the theoretical ratio of dead bacteria was acquired, with a correlation coefficient R2 of 0.97. Advantages in sensitivity, accuracy, and safety of the GelRed/SYTO9-based ratiometric fluorescent method against traditional methods were demonstrated. The established method was successfully applied to the assessment of germicidal efficacy of different heat treatments. It was found that even 50 °C treatment could lead to the death of minor bacteria. The as-developed method has many potential applications in microbial researches, and we believe it could be expanded to the viability assessment of mammalian cells.


Asunto(s)
Escherichia coli O157 , Colorantes Fluorescentes , Viabilidad Microbiana , Escherichia coli O157/aislamiento & purificación , Colorantes Fluorescentes/química , Compuestos Orgánicos/química , Fluorescencia , Espectrometría de Fluorescencia
3.
Toxicol Appl Pharmacol ; 485: 116920, 2024 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-38582373

RESUMEN

Asparaginase-associated pancreatitis (AAP) is a severe and potentially life-threatening drug-induced pancreas targeted toxicity in the combined chemotherapy of acute lymphoblastic leukemia among children and adolescents. The toxicological mechanism of AAP is not yet clear, and there are no effective preventive and treatment measures available clinically. Fibroblast growth factor 21 (FGF21) is a secretory hormone that regulates lipid, glucose, and energy metabolism balance. Acinar tissue is the main source of pancreatic FGF21 protein and plays an important role in maintaining pancreatic metabolic balance. In this study, we found that the decrease of FGF21 in pancreas is closely related to AAP. Pegaspargase (1 IU/g) induces widespread edema and inflammatory infiltration in the pancreas of rats/mice. The specific expression of FGF21 in the acinar tissue of AAP rats was significantly downregulated. Asparaginase caused dysregulation of the ATF4/ATF3/FGF21 axis in acinar tissue or cells, and thus mediated the decrease of FGF21. It greatly activated ATF3 in the acinar, which competed with ATF4 for the Fgf21 promoter, thereby inhibiting the expression of FGF21. Pharmacological replacement of FGF21 (1 mg/kg) or PERK inhibitors (GSK2656157, 25 mg/kg) can significantly mitigate the pancreatic tissue damage and reduce markers of inflammation associated with AAP, representing potential strategies for the prevention and treatment of AAP.


Asunto(s)
Asparaginasa , Factores de Crecimiento de Fibroblastos , Páncreas , Pancreatitis , eIF-2 Quinasa , Animales , Factores de Crecimiento de Fibroblastos/metabolismo , Factores de Crecimiento de Fibroblastos/genética , Asparaginasa/toxicidad , Pancreatitis/inducido químicamente , Pancreatitis/metabolismo , Pancreatitis/patología , Masculino , Ratas , Páncreas/efectos de los fármacos , Páncreas/patología , Páncreas/metabolismo , Ratones , Ratas Sprague-Dawley , Polietilenglicoles/toxicidad , Antineoplásicos/toxicidad , Factor de Transcripción Activador 4/metabolismo , Factor de Transcripción Activador 4/genética , Ratones Endogámicos C57BL
4.
Chemistry ; : e202402886, 2024 Aug 30.
Artículo en Inglés | MEDLINE | ID: mdl-39212526

RESUMEN

The chemoselective [4+2] annulation/aromatization reactions between benzofuran-derived azadienes and N-Ts cyanamides are developed, affording a convenient method for synthesizing benzofuro[3,2-d]pyrimidin-2-amines under mild conditions. Herein, N-Ts cyanamides participated in reactions selectively via carbodiimide anion intermediates and the corresponding cyanamide anion intermediates derived products were not observed. The proposed chemoselective stepwise reaction mechanism was well supported by DFT calculations.

5.
Diabetes Obes Metab ; 26(10): 4490-4500, 2024 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-39075922

RESUMEN

AIM: To evaluate the effects of bariatric arterial embolization (BAE) on gastric emptying of, and the glycaemic response to, an oral glucose load in an obese canine model with impaired glucose tolerance. METHODS: Eleven male dogs were fed a high-fat, high-fructose diet for 7 weeks before receiving BAE, which involved selective embolization of the left gastric artery (n = 5; 14.9 ± 0.8 kg), or the sham (n = 6; 12.6 ± 0.8 kg) procedure. Postprocedural body weight was measured weekly for 4 weeks. Prior to and at 4 weeks postprocedure, a glucose solution containing 13C-acetate was administered orally for evaluation of the gastric half-emptying time (T50) and the glycaemic response. The relationship between the changes in the blood glucose area under the curve over the first 60 minutes (AUC0-60min) and the T50 was also assessed. RESULTS: At 4 weeks postprocedure, BAE reduced body weight (BAE vs. the sham procedure: -5.7% ± 0.9% vs. 3.5% ± 0.9%, P < .001), slowed gastric emptying (T50 at baseline vs. postprocedure: 75.5 ± 2.0 vs. 82.5 ± 1.8 minutes, P = .021 in the BAE group; 73.8 ± 1.8 vs. 74.3 ± 1.9 minutes in the sham group) and lowered the glycaemic response to oral glucose (AUC0-60min at baseline vs. postprocedure: 99.2 ± 13.7 vs. 67.6 ± 9.8 mmol·min/L, P = .043 in the BAE group; 100.2 ± 13.4 vs. 103.9 ± 14.6 mmol·min/L in the sham group). The change in the glucose AUC0-60min correlated inversely with that of the T50 (r = -0.711; P = .014). CONCLUSIONS: In a canine model with impaired glucose tolerance, BAE, while reducing body weight, slowed gastric emptying and attenuated the glycaemic response to an oral glucose load.


Asunto(s)
Glucemia , Embolización Terapéutica , Vaciamiento Gástrico , Intolerancia a la Glucosa , Obesidad , Animales , Perros , Vaciamiento Gástrico/efectos de los fármacos , Masculino , Glucemia/metabolismo , Obesidad/terapia , Obesidad/complicaciones , Obesidad/fisiopatología , Intolerancia a la Glucosa/terapia , Embolización Terapéutica/métodos , Periodo Posprandial , Artería Gástrica , Prueba de Tolerancia a la Glucosa , Modelos Animales de Enfermedad
6.
Immunol Invest ; 53(7): 1102-1112, 2024 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-39206848

RESUMEN

INTRODUCTION: Brucellosis is an important zoonosis worldwide, affecting humans and animals. There are no specific medicines available to treat brucellosis. Astragalus polysaccharide (APS) is derived from Astragalus membranaceus and exhibits impressive bioactivity, including anti-aging, anti-tumor, and immunomodulatory functions. METHODS: Mice were intraperitoneally inoculated with Brucella melitensis M5 and then treated with APS intraperitoneally injection daily for 7 d. RESULTS: Compared to the M5-infected group, the lower bacteria loads in the APS-treated groups were proved, especially at the acute stage of infection. APS treatment relieved splenomegaly, excess expressions of several pro-inflammatory cytokines (including CXCL1, IFN-γ, IL-1ß, IL-2, IL-12p70, and TNF-α). The raised level of IL-4 was observed in APS-treated mice. APS contributed to raising the ratio of M1 macrophage and reducing the ratio of M2 macrophage in the blood. DISCUSSION: The present study provides some evidence on the potential application of APS in controlling and treating brucellosis and should be further explored.


Asunto(s)
Brucella melitensis , Brucelosis , Citocinas , Macrófagos , Ratones Endogámicos BALB C , Polisacáridos , Animales , Brucelosis/inmunología , Brucelosis/tratamiento farmacológico , Brucelosis/prevención & control , Polisacáridos/farmacología , Brucella melitensis/inmunología , Ratones , Citocinas/metabolismo , Macrófagos/inmunología , Macrófagos/efectos de los fármacos , Planta del Astrágalo/química , Modelos Animales de Enfermedad , Femenino , Humanos
7.
J Clin Nurs ; 33(5): 1739-1750, 2024 May.
Artículo en Inglés | MEDLINE | ID: mdl-38345142

RESUMEN

INTRODUCTION: In 2015, the term 'intrinsic capacity' (IC) was proposed by the World Health Organisation to promote healthy aging. However, the factors associated with IC are still discrepant and uncertain. AIM: We aim to synthesise the factors connected with IC. METHODS: This scoping review followed the five-stage framework of Arksey and O'Malley and was reported using PRISMA-ScR guidelines. RESULTS: In all, 29 articles were included. IC of older adults is associated with demographic characteristics, socioeconomic factors, disease conditions, behavioural factors, and biomarkers. Age, sex, marital status, occupation status, education, income/wealth, chronic diseases, hypertension, diabetes, disability, smoking status, alcohol consumption, and physical activity were emerged as important factors related to the IC of older adults. CONCLUSIONS: This review shows that IC is related to multiple factors. Understanding these factors can provide the healthcare personnel with the theoretical basis for intervening and managing IC in older adults. RELEVANCE TO CLINICAL PRACTICE: The influencing factors identified in the review help to guide older adults to maintain their own intrinsic capacity, thereby promoting their health and well-being. The modifiable factors also provide evidence for healthcare personnel to develop targeted intervention strategies to delay IC decline. NO PATIENT OR PUBLIC CONTRIBUTION: As this is a scoping review, no patient or public contributions are required.


Asunto(s)
Envejecimiento Saludable , Humanos , Anciano , Masculino , Femenino , Anciano de 80 o más Años , Envejecimiento Saludable/fisiología
8.
Angew Chem Int Ed Engl ; : e202419082, 2024 Oct 31.
Artículo en Inglés | MEDLINE | ID: mdl-39479975

RESUMEN

Because of the unique and superior optoelectronic properties, metal halide perovskites (MHPs) have attracted great interests in photocatalysis. Element doping strategy is adopted to modify perovskite materials to improve their photocatalytic performance. However, the contribution of bare doping-site onto photocatalytic efficiency, and the correlation between doping locations and activity have not yet to be demonstrated. This promoted us to explore the potential of A-site-doped MHPs for photocatalysis. Herein, we dope potassium (K+) into CsPbBr3 and first reveal that the occupied locations of K+ in CsPbBr3 is lattice incorporation rather than surface segregation, which would change from A-site substitution to interstitial site in lattice with the increase of K+ concentrations. Taking H2 evolution as a model reaction, photocatalytic activity of CsPbBr3 after K+ doping could be significantly improved ~11-fold with A-site substitution, which is superior to that of interstitial site doping. Moreover, other alkali metals including Li, Na, and Rb doping give the same results. The structure of photocatalysts during reaction confirmed the contribution of A-site doping onto enhanced photocatalytic activity. Mechanistic insights show it is a result of the relaxed residual lattice strain induced promoted charge-carriers dynamics and formed upward shifting of band after K+ A-site doping.

9.
Biochem Biophys Res Commun ; 677: 63-69, 2023 Oct 15.
Artículo en Inglés | MEDLINE | ID: mdl-37549603

RESUMEN

The mammalian cell cycle is divided into four sequential phases, namely G1 (Gap 1), S (synthesis), G2 (Gap 2), and M (mitosis). Wee1, whose turnover is tightly and finely regulated, is a well-known kinase serving as a gatekeeper for the G2/M transition. However, the mechanism underlying the turnover of Wee1 is not fully understood. Autophagy, a highly conserved cellular process, maintains cellular homeostasis by eliminating intracellular aggregations, damaged organelles, and individual proteins. In the present study, we found autophagy deficiency in mouse liver caused G2/M arrest in two mouse models, namely Fip200 and Atg7 liver-specific knockout mice. To uncover the link between autophagy deficiency and G2/M transition, we combined transcriptomic and proteomic analysis for liver samples from control and Atg7 liver-specific knockout mice. The data suggest that the inhibition of autophagy increases the protein level of Wee1 without any alteration of its mRNA abundance. Serum starvation, an autophagy stimulus, downregulates the protein level of Wee1 in vitro. In addition, the half-life of Wee1 is extended by the addition of chloroquine, an autophagy inhibitor. LC3, a central autophagic protein functioning in autophagy substrate selection and autophagosome biogenesis, interacts with Wee1 as assessed by co-immunoprecipitation assay. Furthermore, overexpression of Wee1 leads to G2/M arrest both in vitro and in vivo. Collectively, our data indicate that autophagy could degrade Wee1-a gatekeeper of the G2/M transition, whereas the inhibition of autophagy leads to the accumulation of Wee1 and causes G2/M arrest in mouse liver.


Asunto(s)
Apoptosis , Proteómica , Ratones , Animales , Proteínas Tirosina Quinasas/metabolismo , Proteínas Nucleares/metabolismo , Línea Celular Tumoral , Puntos de Control de la Fase G2 del Ciclo Celular , Ciclo Celular/fisiología , Proteínas de Ciclo Celular/metabolismo , Mitosis , Autofagia , Ratones Noqueados , Mamíferos/metabolismo
10.
Hepatology ; 76(4): 1105-1120, 2022 10.
Artículo en Inglés | MEDLINE | ID: mdl-35152446

RESUMEN

BACKGROUND AND AIMS: NAFLD represents an increasing health problem in association with obesity and diabetes with no effective pharmacotherapies. Growing evidence suggests that several FGFs play important roles in diverse aspects of liver pathophysiology. Here, we report a previously unappreciated role of FGF4 in the liver. APPROACH AND RESULTS: Expression of hepatic FGF4 is inversely associated with NAFLD pathological grades in both human patients and mouse models. Loss of hepatic Fgf4 aggravates hepatic steatosis and liver damage resulted from an obesogenic high-fat diet. By contrast, pharmacological administration of recombinant FGF4 mitigates hepatic steatosis, inflammation, liver damage, and fibrogenic markers in mouse livers induced to develop NAFLD and NASH under dietary challenges. Such beneficial effects of FGF4 are mediated predominantly by activating hepatic FGF receptor (FGFR) 4, which activates a downstream Ca2+ -Ca2+ /calmodulin-dependent protein kinase kinase beta-dependent AMP-activated protein kinase (AMPK)-Caspase 6 signal axis, leading to enhanced fatty acid oxidation, reduced hepatocellular apoptosis, and mitigation of liver damage. CONCLUSIONS: Our study identifies FGF4 as a stress-responsive regulator of liver pathophysiology that acts through an FGFR4-AMPK-Caspase 6 signal pathway, shedding light on strategies for treating NAFLD and associated liver pathologies.


Asunto(s)
Enfermedad del Hígado Graso no Alcohólico , Proteínas Quinasas Activadas por AMP/metabolismo , Animales , Caspasa 6/metabolismo , Caspasa 6/farmacología , Dieta Alta en Grasa/efectos adversos , Ácidos Grasos/metabolismo , Factor 4 de Crecimiento de Fibroblastos/metabolismo , Factor 4 de Crecimiento de Fibroblastos/farmacología , Factor 4 de Crecimiento de Fibroblastos/uso terapéutico , Humanos , Hígado/patología , Ratones , Ratones Endogámicos C57BL , Enfermedad del Hígado Graso no Alcohólico/patología , Receptores de Factores de Crecimiento de Fibroblastos/metabolismo , Receptores de Factores de Crecimiento de Fibroblastos/uso terapéutico
11.
Mol Pharm ; 20(10): 5214-5225, 2023 10 02.
Artículo en Inglés | MEDLINE | ID: mdl-37733628

RESUMEN

Chemotherapeutic agents targeting energy metabolism have not achieved satisfactory results in different types of tumors. Herein, we developed an RNA interference (RNAi) method against adenosine triphosphate (ATP) by constructing an interfering plasmid-expressing ATP-binding RNA aptamer, which notably inhibited the growth of prostate cancer cells through diminishing the availability of cytoplasmic ATP and impairing the homeostasis of energy metabolism, and both glycolysis and oxidative phosphorylation were suppressed after RNAi treatment. Further identifying the mechanism underlying the effects of ATP aptamer, we surprisingly found that it markedly reduced the activity of membrane ionic channels and membrane potential which led to the dysfunction of mitochondria, such as the decrease of mitochondrial number, reduction in the respiration rate, and decline of mitochondrial membrane potential and ATP production. Meanwhile, the shortage of ATP impeded the formation of lamellipodia that are essential for the movement of cells, consequently resulting in a significant reduction of cell migration. Both the downregulation of the phosphorylation of AMP-activated protein kinase (AMPK) and endoplasmic reticulum kinase (ERK) and diminishing of lamellipodium formation led to cell apoptosis as well as the inhibition of angiogenesis and invasion. In conclusion, as the first RNAi modality targeting the blocking of ATP consumption, the present method can disturb the respiratory chain and ATP pool, which provides a novel regime for tumor therapies..


Asunto(s)
Adenosina Trifosfato , Neoplasias de la Próstata , Masculino , Humanos , Adenosina Trifosfato/metabolismo , Interferencia de ARN , Metabolismo Energético , Glucólisis , Fosforilación Oxidativa , Neoplasias de la Próstata/genética , Neoplasias de la Próstata/terapia
12.
Environ Res ; 216(Pt 3): 114719, 2023 01 01.
Artículo en Inglés | MEDLINE | ID: mdl-36356666

RESUMEN

The significance of water resource spatial equilibrium (WRSE) research is to maximally remove the spatial restrictions of water on regional development, including social development, economic development and eco-environmental maintenance. Although great achievements have been made, national-scale WRSE research is rare; besides, the spatiotemporal patterns and decoupling effects of WRSE have been poorly studied in current research. Thus, the aim of this research is to measure the WRSE in China for the period 2008-2019 by using an improved coupling coordination model and to empirically analyse its distribution dynamics and decoupling effects. The results show that the WRSE status of China's 31 provincial administrative regions from 2008 to 2019 is at a moderate level. Based on the spatiotemporal patterns and decoupling effects analysis, areas in urgent need of improving WRSE status are identified, and tailored countermeasures are provided for each area. To our knowledge, this paper is the first nationwide study of the spatiotemporal patterns and decoupling effects of WRSE.


Asunto(s)
Desarrollo Económico , Recursos Hídricos , China
13.
Neurol Sci ; 44(1): 191-197, 2023 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-36098886

RESUMEN

BACKGROUND: Constipation, rapid eye movement sleep behavior disorder (RBD) and hyposmia are common prodromal symptoms of Parkinson's disease (PD), and they may represent two distinct types of disease origin, from the body or the brain. Our study aimed to compare the clinical characteristics of de novo PD patients with and without constipation and identify which prodromal symptoms were associated with constipation. METHODS: A total of 111 de novo, drug-naïve Chinese PD patients were consecutively enrolled from Jan 2017 to Sept 2021. Patients were classified into PD with and without constipation based on item 5 of the Scales for Outcomes in Parkinson's disease-Autonomic Dysfunction (SCOPA-AUT). The demographic data, motor, and non-motor symptoms were compared between the two groups. The associated factors of constipation were analyzed by the multivariate logistic regression analysis. RESULTS: In total, 44.1% (n = 49) of de novo PD patients had constipation. PD patients with constipation were older (p = 0.028), had higher proportions of Hoehn and Yahr (H-Y) stage [Formula: see text] 2 (p = 0.002), clinical possible RBD (cpRBD) (p = 0.002) and depression (p = 0.023), as well as marginal increase of hyposmia (p = 0.058) and freezing of gait (p = 0.069). After adjusting for H-Y stage and other confounding factors, cpRBD (OR = 3.508, p = 0.009), rather than hyposmia or depression, was closely related to constipation in de novo Chinese PD patients. CONCLUSIONS: RBD is closely associated with constipation in de novo Chinese PD patients. Our results support the theory that prodromal symptoms that represent the same pathological origin are closely related to each other.


Asunto(s)
Trastornos Neurológicos de la Marcha , Enfermedad de Parkinson , Trastorno de la Conducta del Sueño REM , Humanos , Enfermedad de Parkinson/complicaciones , Enfermedad de Parkinson/epidemiología , Enfermedad de Parkinson/diagnóstico , Trastorno de la Conducta del Sueño REM/diagnóstico , Anosmia/complicaciones , Síntomas Prodrómicos , Pueblos del Este de Asia , Estreñimiento/complicaciones
14.
BMC Health Serv Res ; 23(1): 531, 2023 May 24.
Artículo en Inglés | MEDLINE | ID: mdl-37226241

RESUMEN

BACKGROUND: In 2013, the Shanghai Hospital Development Center issued a policy to advocate public hospitals to report their information about costs on diseases. The objective was to evaluate the impact of interhospital disclosure of costs on diseases on medical costs and compare costs per case following information disclosure between hospitals of different rankings. METHODS: The study uses the hospital-level performance report issued by Shanghai Hospital Development Center in the fourth quarter of 2013, which covers quarterly aggregated hospital-level discharge data from 14 tertiary public hospitals participating in thyroid malignant tumors and colorectal malignant tumors information disclosure from the first quarter of 2012 to the third quarter of 2020. An interrupted time series model with segmented regression analysis is employed to examine changes in quarterly trends with respect to costs per case and length of stay before and after information disclosure. We identified high- and low-cost hospitals by ranking them on a costs per case basis per disease group. RESULTS: This research identified significant differences in cost changes for thyroid malignant tumors and colorectal malignant tumors between hospitals after disclosing information. A hospital's discharge costs per case for thyroid malignant tumors increased significantly among top-cost hospitals (1629.251 RMB, P = 0.019), while decreased for thyroid and colorectal malignant tumors among low-cost hospitals (-1504.189 RMB, P = 0.003; -6511.650 RMB, P = 0.024, respectively). CONCLUSION: Our findings indicate that information disclosure of costs on diseases results in changes in discharge costs per case. And low-cost hospitals continued to maintain their leading edge, whereas the high-cost hospitals changed their position in the industry by reducing discharge costs per case after information disclosure.


Asunto(s)
Neoplasias Colorrectales , Revelación , Humanos , Proyectos Piloto , China , Hospitales Públicos , Neoplasias Colorrectales/terapia
15.
BMC Health Serv Res ; 23(1): 568, 2023 Jun 02.
Artículo en Inglés | MEDLINE | ID: mdl-37264450

RESUMEN

BACKGROUND: In 2018, an innovative case-based payment scheme called Diagnosis-Intervention Packet (DIP) was piloted in a large developed city in southern China. This study aimed to investigate the impact of the new payment method on total medical expenditure per case, length of stay (LOS), and in-hospital mortality rate across different hospitals. METHODS: We used the de-identified patient-level discharge data of hospitalized patients from 2016 to 2019 in our study city. The interrupted time series model was used to examine the impact of the DIP payment reform on inflation-adjusted total expenditure per case, LOS, and in-hospital mortality rate across different hospitals, which were stratified into different hospital ownerships (public and private) and hospital levels (tertiary, secondary, and primary). RESULTS: We included 2.08 million and 2.98 million discharge cases of insured patients before and after the DIP payment reform, respectively. The DIP payment reform resulted in a significant increase of the monthly trend of adjusted total expenditure per case in public (1.1%, P = 0.000), tertiary (0.6%, P = 0.000), secondary (0.4%, P = 0.047) and primary hospitals (0.9%, P = 0.039). The monthly trend of LOS increased significantly in public (0.022 days, P = 0.041) and primary (0.235 days, P = 0.032) hospitals. The monthly trend of in-hospital mortality rate decreased significantly in private (0.083 percentage points, P = 0.002) and secondary (0.037 percentage points, P = 0.002) hospitals. CONCLUSIONS: We conclude that implementing the DIP payment reform yields inconsistent consequences across different hospitals. DIP reform encouraged public hospitals and high-level hospitals to treat patients with higher illness severities and requiring high treatment intensity, resulting in a significant increase in total expenditure per case. The inconsistencies between public and private hospitals may be attributed to their different baseline levels prior to the reform and their different responses to the incentives created by the reform.


Asunto(s)
Gastos en Salud , Hospitales Públicos , Humanos , China , Análisis de Series de Tiempo Interrumpido , Tiempo de Internación
16.
BMC Health Serv Res ; 23(1): 160, 2023 Feb 15.
Artículo en Inglés | MEDLINE | ID: mdl-36793088

RESUMEN

CONTEXT: A patient classification-based payment system called diagnosis-intervention packet (DIP) was piloted in a large city in southeast China in 2018. OBJECTIVE: This study evaluates the impact of DIP payment reform on total costs, out-of-pocket (OOP) payments, length of stay (LOS), and quality of care in hospitalised patients of different age. METHODS: An interrupted time series model was employed to examine the monthly trend changes of outcome variables before and after the DIP reform in adult patients, who were stratified into a younger (18-64 years) and an older group (≥ 65 years), further stratified into young-old (65-79 years) and oldest-old (≥ 80 years) groups. RESULTS: The adjusted monthly trend of costs per case significantly increased in the older adults (0.5%, P = 0.002) and oldest-old group (0.6%, P = 0.015). The adjusted monthly trend of average LOS decreased in the younger and young-old groups (monthly slope change: -0.058 days, P = 0.035; -0.025 days, P = 0.024, respectively), and increased in the oldest-old group (monthly slope change: 0.107 days, P = 0.030) significantly. The changes of adjusted monthly trends of in-hospital mortality rate were not significant in all age groups. CONCLUSION: Implementation of the DIP payment reform associated with increase in total costs per case in the older and oldest-old groups, and reduction in LOS in the younger and young-old groups without deteriorating quality of care.


Asunto(s)
Gastos en Salud , Pacientes Internos , Anciano , Anciano de 80 o más Años , Humanos , China , Análisis de Series de Tiempo Interrumpido , Tiempo de Internación
17.
J Environ Manage ; 339: 117786, 2023 Aug 01.
Artículo en Inglés | MEDLINE | ID: mdl-37080105

RESUMEN

Water, energy and carbon are three basic environmental factors that affect countries. An in-depth study of the water-energy-carbon (WEC) nexus is of great significance for realizing regional sustainable development. However, at present, research on the evaluation and prediction of large-scale WEC nexus based on multiple perspectives is not sufficiently mature, especially the prediction of WEC nexus efficiency. This study evaluates and predicts the WEC nexus efficiency in 30 regions of China based on a new comprehensive perspective. The WEC efficiency and the slack variables of 30 regions from 2006 to 2020 were calculated by using the slack-based measure model. The 30 regions were divided into 4 efficiency groups using hierarchical cluster analysis. Efficiency trends in 2006-2020 were analyzed for specific regions. The coupling interaction between the WEC nexus is studied based on the perspective of the coupling degree and coupling coordination degree. More importantly, this study is the first to quantitatively predict the WEC efficiency of 30 regions in China from 2021 to 2030, using the rank set pair analysis model. The following results were obtained in this paper. The WEC efficiency has a slow decreasing trend in 2006-2020. A total of 16.7% and 33.3% of the regions are in the extreme and high coupling coordination stages, respectively, and are mainly concentrated in the northern and southeastern parts of China. Fifty percent of the regions have moderate coupling coordination, mainly concentrated in the central and southern regions. From 2021 to 2030, the WEC efficiency of Beijing, Tianjin and Qinghai will remain at a high level; the WEC efficiency of Shandong and other regions will remain at a low level; and 70% of the regions' water efficiency will remain low. This paper has important guiding significance for promoting the regional WEC nexus balance and sustainable development of the economy, society and environment. According to the characteristics of the four efficiency groups, some valuable suggestions on regional sustainable development are proposed.


Asunto(s)
Carbono , Agua , Abastecimiento de Agua , Desarrollo Sostenible , China , Eficiencia , Desarrollo Económico
18.
Angew Chem Int Ed Engl ; 62(23): e202302126, 2023 Jun 05.
Artículo en Inglés | MEDLINE | ID: mdl-37051748

RESUMEN

Supramolecular self-assembly is a promising strategy for stabilizing the photo-sensitive components in photocatalysis. However, the underlying correlation between the enhanced photostability and supramolecular structure at the molecular level has not yet been fully understood. Herein, we develop a biomimetic vesicular membrane-based polyporphyrin photocatalyst exhibiting excellent photocatalytic stability with at least activity time of 240 h in hydrogen generation. Time-domain ab initio modelling together with transient absorption spectroscopy, visual frontier orbitals and Gibbs free energy calculation disclose that the ordered aggregation of porphyrin units in the vesicle membrane facilitates "hot" electron relaxation and the rapid dissipation of photo-generated charges, thereby contributing to the longevity. This work deepens the molecular-level understanding on photostability and photocatalytic mechanism of supramolecular photocatalysts.

19.
Angew Chem Int Ed Engl ; 62(7): e202214944, 2023 Feb 06.
Artículo en Inglés | MEDLINE | ID: mdl-36510781

RESUMEN

A new way to form fluorenones via the direct excitation of substrates instead of photocatalyst to activate the C(sp2 )-H bond under redox-neutral condition is reported. Our design relies on the photoexcited aromatic aldehyde intermediates that can be intercepted by cobaloxime catalyst through single electron transfer for following ß-H elimination. The generation of acyl radical and successful interception by a metal catalyst cobaloxime avoid the use of a photocatalyst and stoichiometric external oxidants, affording a series of highly substituted fluorenones, including six-membered ketones, such as xanthone and thioxanthone derivatives in good to excellent yields, and with hydrogen as the only byproduct. This catalytic system features a readily available metal catalyst, mild reaction conditions and broad substrate scope, in which sunlight reaction and scale-up experiments by continuous-flow approach make the new methodology sustainable and amenable for potentially operational procedures.

20.
J Am Chem Soc ; 144(37): 17261-17268, 2022 09 21.
Artículo en Inglés | MEDLINE | ID: mdl-36070360

RESUMEN

Direct CAr-F arylation is effective and sustainable for synthesis of polyfluorobiaryls with different degrees of fluorination, which are important motifs in medical and material chemistry. However, with no aid of transition metals, the engagement of CAr-F bond activation has proved difficult. Herein, an unprecedented transition-metal-free strategy is reported for site-selective CAr-F arylation of polyfluoroarenes with simple (het)arenes. By merging N,N-bis(2,6-diisopropylphenyl)perylene-3,4,9,10-bis(dicarboximide)-catalyzed electrophotocatalytic reduction and anodic nitroxyl radical oxidation in an electrophotocatalytic cell, various polyfluoroaromatics (2F-6F and 8F), especially inactive partially fluorinated aromatics, undergo sacrificial-reagents-free C-F bond arylation with high regioselectivity, and the yields are comparable to those for reported transition-metal catalysis. This atom- and step-economic protocol features a paired electrocatalysis with organic mediators in both cathodic and anodic processes. The broad substrate scope and good functional-group compatibility highlight the merits of this operationally simple strategy. Moreover, the easy gram-scale synthesis and late-stage functionalization collectively advocate for the practical value, which would promote the vigorous development of fluorine chemistry.


Asunto(s)
Perileno , Elementos de Transición , Catálisis , Flúor/química , Estructura Molecular
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