Blood Profiles of Community-Dwelling People with Sarcopenia: Analysis Based on the China Health and Retirement Longitudinal Study.

INTRODUCTION: Routine blood factors can be economical and easily accessible candidates for sarcopenia screening and monitoring. The associations between sarcopenia and routine blood factors remain unclear. This study aimed to examine sarcopenia and blood factor associations based on a nation-wide cohort in China. METHODS: A total of 1,307 participants and 17 routine blood indices were selected from two waves (year 2011 and year 2015) of the China Health and Retirement Longitudinal Study (CHARLS). The diagnosis of sarcopenia was based on the criteria proposed by the Asian Working Group for Sarcopenia (AWGS 2019). Generalized mixed-effects models were performed for association analyses. A logistic regression (LR) model was conducted to examine the predictive power of identifying significant blood factors for sarcopenia. RESULTS: A higher sarcopenia risk was cross-sectionally associated with elevated blood concentrations of high-sensitivity C-reactive protein (hsCRP) (OR = 1.030, 95% CI [1.007, 1.053]), glycated hemoglobin (HbA1c) (OR = 1.407, 95% CI [1.126, 1.758]) and blood urea nitrogen (BUN) (OR = 1.044, 95% CI [1.002, 1.089]), and a decreased level of glucose (OR = 0.988, 95% CI [0.979, 0.997]). A higher baseline hsCRP value (OR = 1.034, 95% CI [1.029, 1.039]) and a greater over time change in hsCRP within 4 years (OR = 1.034, 95% CI [1.029, 1.039]) were associated with a higher sarcopenia risk. A higher BUN baseline value was related to a decreased sarcopenia risk over time (OR = 0.981, 95% CI [0.976, 0.986]), while a greater over time changes in BUN (OR = 1.034, 95% CI [1.029, 1.040]) and a smaller over time change in glucose (OR = 0.992, 95% CI [0.984, 0.999]) within 4 years were also related to a higher sarcopenia risk. LR based on significant blood factors (i.e., hsCRP, HbA1c, BUN, and glucose), and sarcopenia status in year 2015 yielded an area under the curve of 0.859 (95% CI: 0.836-0.882). CONCLUSION: Routine blood factors involved in inflammation, protein metabolism, and glucose metabolism are significantly associated with sarcopenia. In clinical practice, plasma hsCRP, BUN, blood sugar levels, sex, age, marital status, height, and weight might be helpful for sarcopenia evaluation and monitoring.

Dynamic selection of high-affinity aptamers using a magnetically activated continuous deflection microfluidic chip.

To accelerate the discovery of high-affinity aptamers, a magnetically activated continuous deflection (MACD) chip was designed. The MACD chip could achieve dynamic selection in a continuous flow, which meant that the binding and separation were carried out consecutively. Dynamic selection could make selection efficient. Low-affinity sequences could be eluted in time and high-affinity sequences could be enriched via dynamic selection. The stringency of the conditions could be further increased by lowering the target concentration in the dynamic selection. Finally, a C.al3 aptamer with high-affinity and high-specificity for Candida albicans (C. albicans) was obtained through six rounds of selection. Its dissociation constant (Kd) was 7.9 nM. This demonstrated that dynamic selection using a MACD chip was an effective method for high-affinity aptamer selection.

Parameter-Efficient Fine-Tuning Enhances Adaptation of Single Cell Large Language Model for Cell Type Identification.

Single-cell sequencing transformed biology and medicine, providing an unprecedented high-resolution view at the cellular level. However, the vast variability inherent in single-cell sequencing data impedes its utility for in-depth downstream analysis. Inspired by the foundation models in natural language processing, recent advancements have led to the development of single-cell Large Language Models (scLLMs). These models are designed to discern universal patterns across diverse single-cell datasets, thereby enhancing the signal-to-noise ratio. Despite their potential, multiple studies indicate existing scLLMs do not perform well in zero-short settings, highlighting a pressing need for more effective adaptation techniques. This research proposes several adaptation techniques for scLLMs by preserving the original model parameters while selectively updating newly introduced tensors. This approach aims to overcome the limitations associated with traditional fine-tuning practices, such as catastrophic forgetting and computational inefficiencies. We introduce two Parameter-Efficient Fine-Tuning (PEFT) strategies specifically tailored to refine scLLMs for cell type identification. Our investigations utilizing scGPT demonstrate that PEFT can enhance performance, with the added benefit of up to a 90% reduction in parameter training compared to conventional fine-tuning methodologies. This work paves the way for a new direction in leveraging single-cell models with greater efficiency and efficacy in single-cell biology.

Vancomycin-Stabilized Platinum Nanoparticles with Oxidase-like Activity for Sensitive Dopamine Detection.

The development of efficient, reliable, and sensitive dopamine detection methods has attracted much attention. In this paper, vancomycin-stabilized platinum nanoparticles (Van-Ptn NPs, n = 0.5, 1, 2) were prepared by the biological template method, where n represented the molar ratio of vancomycin to Pt. The results show that Van-Pt2 NPs had oxidase-like activity and peroxidase-like activity, and the mechanism was due to the generation of reactive oxygen 1O2 and OH. Van-Pt2 NPs exhibited good temperature stability, storage stability, and salt solution stability. Furthermore, Van-Pt2 NPs had almost no cytotoxicity to A549 cells. More importantly, the colorimetric detection of DA in human serum samples was performed based on the oxidase-like activity of Van-Pt2 NPs. The linear range of DA detection was 10-700 µM, and the detection limit was 0.854 µM. This study establishes a rapid and reliable method for the detection of dopamine and extends the application of biosynthetic nanoparticles in the field of biosensing.

The role of adiponectin for immune cell function in metabolic diseases.

Adiponectin, as an indispensable regulator of the immune system, is the most abundant adipokine and is mainly produced by white adipose tissue. Adiponectin mediates the positive effects on systemic metabolism by regulating associated downstream signalling pathways; however, accumulating evidence shows that adiponectin plays an important role in regulating the function of innate and adaptive immune cells in the development of obesity and its related diseases. In this review, we focus on the biological function of adiponectin in regulating innate and adaptive immunity and outline the key role of adiponectin in various metabolic diseases, which will highlight a potential direction for adiponectin-based therapeutic interventions for metabolic diseases.

An Artificial Neural Network-Based Approach to Optimizing Energy Efficiency in Residential Buildings in Hot Summer and Cold Winter Regions.

Resource depletion and ecological crisis have prompted human beings to reflect on the behavior patterns based on industrial civilization so as to seek ways of sustainable development of human society, economy, technology, and environment. The energy consumed in the construction process, commonly known as building energy consumption, accounts for more and more of the total social energy consumption, and with the continuous development of social economy and the improvement of living standards, this proportion will be larger and larger. The structure of the neural network directly determines its performance and work efficiency. The structure optimization of the neural network is not only a hot issue in this field but also an insurmountable key step in engineering applications. With the increase of network depth, the structural optimization difficulty index of the neural network increases, so solving this problem has important theoretical and practical significance for the design and application of the neural network. In this paper, the energy saving of buildings is optimized based on the optimization of structures such as particle swarm optimization (PSO) algorithm and restricted Boltzmann machine. The experimental results show that the BPNN optimized by the improved PSO algorithm is significantly better than the non-optimized BPNN and the BPNN optimized by the basic PSO algorithm. The comprehensive output rate of the optimized neural network can reach 64.5%. In general, the error rate of the optimized artificial neural network (ANN) will be 57.65% lower than the original one.

Murine double minute 2 aggravates adipose tissue dysfunction through ubiquitin-mediated six-transmembrane epithelial antigen of prostate 4 degradation.

Healthy adipose tissue is crucial to maintain normal energy homeostasis. Little is known about the role of murine double minute 2 (MDM2), an E3 ubiquitin ligase and has been highlighted in oncopathology, in adipose tissue. Our results indicated that MDM2 expression was associated with nutritional status. Mdm2 adipocyte-specific knock-in (Mdm2-AKI) mice exhibited exacerbated weight gain, insulin resistance, and decreased energy expenditure. Meanwhile, chronic high-fat diet (HFD) exposure caused obvious epididymal white adipose tissue (eWAT) dysfunction, such as senescence, apoptosis, and chronic inflammation, thereby leading to hepatic steatosis in Mdm2-AKI mice. Mechanically, MDM2 could interact with six-transmembrane epithelial antigen of prostate 4 (STEAP4) and inhibit STEAP4 expression through ubiquitin-mediated STEAP4 degradation. Thereinto, the K18 and K161 sites of STEAP4 were ubiquitin-modificated by MDM2. Finally, STEAP4 restoration in eWAT of Mdm2-AKI mice on a HFD rescued MDM2-induced adipose dysfunction, insulin resistance, and hepatic steatosis. Summary, the MDM2-STEAP4 axis in eWAT plays an important role in maintaining healthy adipose tissue function and improving hepatic steatosis.

Socio-economic disparities in child-to-adolescent growth trajectories in China: Findings from the China Health and Nutrition Survey 1991-2015.

Backgrounds: Socio-economic disparities in growth trajectories of children from low-/middle-income countries are poorly understood, especially those experiencing rapid economic growth. We investigated socio-economic disparities in child growth in recent decades in China. Methods: Using longitudinal data on 5095 children/adolescents (7-18 years) from the China Health and Nutrition Survey (1991-2015), we estimated mean height and BMI trajectories by socio-economic position (SEP) and sex for cohorts born in 1981-85, 1986-90, 1991-95, 1996-2000, using random-effects models. We estimated differences between high (urbanization index ≥median, household income per capita ≥median, parental education ≥high school, or occupational classes I-IV) and low SEP groups. Findings: Mean height and BMI trajectories have shifted upwards across cohorts. In all cohorts, growth trajectories for high SEP groups were above those for low SEP groups across SEP indicators. For height, socio-economic differences persisted across cohorts (e.g. 3.8cm and 2.9cm in earliest and latest cohorts by urbanization index for boys at 10 year, and 3.6cm and 3.1cm respectively by household income). For BMI, trends were greater in high than low SEP groups, thus socio-economic differences increased across cohorts (e.g. 0.5 to 0.8kg/m2 by urbanization index, 0.4 to 1.1kg/m2 by household income for boys at 10 year). Similar trends were found for stunting and overweight/obesity by SEP. There was no association between SEP indicators and thinness. Interpretation: Socio-economic disparities in physical growth persist among Chinese youth. Short stature was associated with lower SEP, but high BMI with higher SEP. Public health interventions should be tailored by SEP, in order to improve children's growth while reducing overweight/obesity. Funding: MG is supported by UCL Overseas Research Scholarship and China Scholarship Council for her PhD study. WJ is supported by a UK Medical Research Council (MRC) New Investigator Research Grant (MR/P023347/1) and acknowledges support from the National Institute for Health Research (NIHR) Leicester Biomedical Research Centre, which is a partnership between University Hospitals of Leicester NHS Trust, Loughborough University, and the University of Leicester.

Organo-Soluble Decanoic Acid-Modified Ni-Rich Cathode Material LiNi0.90Co0.07Mn0.03O2 for Lithium-Ion Batteries.

Ni-rich layered oxides as cathode materials deliver a higher capacity than those used currently, in hopes of improving the energy density of Li-ion batteries. However, the surface residual alkali and the interfacial parasitic reactions caused by the rich nickel bring a series of problems such as surface slurrying, structure deterioration, mechanical fracture, and capacity decay. Herein, different from the common surface coating strategies with inorganics, an organo-soluble acid modification approach is proposed to meet the challenges. For LiNi0.90Co0.07Mn0.03O2 (NCM90), decanoic acid can react with the residual lithium salts on the surface to form an organic lithium salt-dominant modification layer. During cycling, an organic lithium-involved cathode/electrolyte interface (CEI) layer is rapidly formed. Specially, the solubility of decanoic acid in the organic electrolyte makes the CEI layer keep strong interaction with NCM90, thin but effective. Consequently, the modified NCM90 exhibits notable performances in terms of structural stability, mechanical integrity, and capacity retention.

Evaluation of efficacy and safety after replacement of methyl hydrogen with deuterium at methyl formate of Clopidogrel.

BACKGROUND AND PURPOSE: Despite being a first-line clinical drug, thienopyridines have many unsatisfactory aspects, including the low bioavailability of clopidogrel(CLP) and the high bleeding risk of prasugrel. We synthesized deuterium clopidogrel(D-CL, patented in China) to alleviate the deficiency of CLP in clinical, such as a slow onset, a greater influence of gene polymorphism, and a high frequency of drug-drug interaction. EXPERIMENTAL APPROACH: Molecular docking was used to analyze the affinity between D-CL and the P2Y12 receptor. The levels of active metabolites of D-CL were detected using HPLC/MS-MS and the activities of main metabolic enzymes were analyzed; Subsequently, platelet aggregation function, thrombus model were used to evaluate the pharmacodynamics of D-CL. Finally, the safety of D-CL were evaluated through examination of blood routine, PT, APTT, bleeding time, serological tests, liver pathological biopsy, liver cell apoptosis and detection of apoptosis-related proteins. KEY RESULTS: The introduction of deuterium made the binding of CLP to P2Y12 receptor more stable, improved the concentration of active metabolites, and substantially reduced the inhibition of major metabolic enzymes, including CYP2B6, CYP2C9, and CYP2C19, thereby, exerting better antiplatelet effects without increasing the risk of bleeding, along with a concomitant decrease in the apoptosis of hepatocytes.

The impact of the Covid-19 pandemic on maternal delivery experiences and breastfeeding practices in China: data from a cross-sectional study.

BACKGROUND: The COVID-2019 pandemic has placed extensive pressure on health systems and posed a severe public health challenge worldwide. Lockdown measures implemented in many countries have delayed virus spread. However, a considerable number of people have faced unprecedented pressure, especially pregnant and breast-feeding women, because face-to-face professional support has been reduced during the lockdown in many countries. OBJECTIVES: To compare the delivery and infant feeding experiences of women who delivered before (BL) versus during (DL) the Covid-19 pandemic in Beijing, China and to investigate predictors of breastfeeding at 6-months. METHODS: Women aged ≥18 years with an infant ≤18 months of age completed an anonymous survey. Information/links were shared online and via local clinics in Beijing. Logistic regression was performed to assess predictors of breastfeeding during the first 6-months. RESULTS: One thousand eight hundred seven women provided data; BL 1231 (68.1%), DL 576 (31.9%). Significantly more mothers in DL group reported the lockdown had moderate to high impact to their household income (p = 0.013) and the convenience of purchasing daily necessities(p = 0.014). Compared to BL mothers, significantly more mothers in the DL groups thought their birth location and breastfeeding intention had been effected by the COVID-19 (p < 0.001, p = 0.036 respectively). Mostly breastfeeding (MBF, mainly breastfeeding with few non-formula fluids added) at 6 months was predicted by delivery during the lockdown period (OR1.43, 95% confidence interval (CI) 1.08, 1.90), younger maternal age (OR 0.96, 95%CI 0.93, 0.99), getting support from friends or relatives (OR 1.95, 95%CI 1.06, 3.59), and discussing health issues in online groups > four times a week (OR 1.66, 95%CI 1.09, 2.53). CONCLUSION: The COVID-19 pandemic and lockdown measures influenced mothers' planned birth location and breastfeeding intention. However, breastfeeding practice was maintained during the pandemic. Our results highlight the importance of feeding support as well as potential beneficial effects of increased mother-infant contact during the lockdown period which is relevant even under normal circumstances.

De novo assembly and transcriptome characterization: Novel insights into the mechanisms of primary ovarian cancer in Microtus fortis.

The natural incidence of primary epithelial ovarian cancer (OVC) in adult female voles of some established strains of Microtus fortis is relatively high. M. fortis OVC has some pathological similarities to human epithelial OVC, therefore M. fortis represents the latest and most valuable animal model for studying human OVC. The lack of available genetic information for M. fortis limits the use of common immunological methods; thus, high­throughput sequencing technologies have been used to reveal the mechanisms of primary OVC in M. fortis. The individuals with cancer were diagnosed using histopathologic hematoxylin and eosin staining. The present study used RNA­sequencing (RNA­seq) technology to establish a de novo assembly of the M. fortis transcriptome produced 339,830 unigenes by the short reads assembly program Trinity. Comparisons were made between OVC and healthy ovarian tissue (OV) and between fallopian tube cancer (FTC) and healthy fallopian tube (FT) tissues using RNA­seq analysis. A total of 3,434 differentially expressed genes (DEGs) were identified in OVC tissue compared with OV tissue using RNA­Seq by Expectation­Maximization software, including 1,950 significantly upregulated and 1,484 significantly downregulated genes. There were 2,817 DEGs identified in the FTC tissues compared with the FT tissue, including 1,762 significantly upregulated and 1,055 significantly downregulated genes. Pathway enrichment analysis revealed that upregulated transcripts in the OVC vs. OV groups were involved in cell growth and proliferation­associated pathways, whereas the downregulated DEGS in the OVC vs. OV groups were enriched in steroid biosynthesis­related pathways. Furthermore, the tumor suppressor gene, p53, was downregulated in the FTC and OVC compared with the FT and OV groups, respectively; whereas, genes that promoted cell migration, such as Ras­related protein Rap­1b, Ras homolog family member A and RAC1, were upregulated. In summary, to the best of our knowledge, the present study characterized the M. fortis de novo transcriptome of OV and FT tissues and to perform RNA­seq quantification to analyze the differences in healthy and cancerous OV and FT tissues. These results identified pathways that differed between cancerous and healthy M. fortis tissues. Analysis of these pathways may help to reveal the pathogenesis of primary OVC in M. fortis in future work.

Secular trends in blood pressure trajectories in Chinese children and adolescents: the impact of changing physical growth.

BACKGROUND: Globally, 80% of cardiovascular disease (CVD) occur in low-income /middle-income countries. High blood pressure (BP), a major risk factor for CVD, has its origins in early-life. We investigated how age trajectories of BP (childhood to late-adolescence) have changed recently in China and the mediating roles of physical growth. METHODS: Using the longitudinal data on 3785 children from the China Health and Nutrition Survey 1991-2015, we estimated mean BP trajectories (7-18 years) for cohorts born in 1981-1985, 1986-1990, 1991-1995 and 1996-2000 using random effect models. Models were adjusted for BMI and/or height growth to assess their impact on BP trends. RESULTS: BP trajectories shifted upwards across cohorts. Compared with the earliest cohort, mean BP was higher in the latest cohort throughout childhood to late adolescence. For example, the increment in SBP was 4.4 mmHg (95% confidence interval: 2.9-5.8) in boys and 4.0 mmHg (2.6-5.5) in girls at 9 years, narrowed slightly during adolescence, and was 3.0 mmHg (0.7-5.4) and 2.6 mmHg (0.4-4.8) respectively at 17 years. BMI and height trajectories also shifted upwards. The overall increment was greater for height than BMI. When adjusting for physical growth, the increment in BP trajectories reduced (more for height than BMI), but remained in childhood (P < 0.05). CONCLUSION: The upward shift of BP trajectories among Chinese youths was largely explained by trends in physical growth, especially increasing height. Other early-life factors might have also contributed to the BP trends. Substantial increases in mean BP in children within a short time frame is a public health concern and will affect future CVD, especially in the developing world.

Self-supporting dual-confined porous Si@c-ZIF@carbon nanofibers for high-performance lithium-ion batteries.

Dual-confined porous Si@c-ZIF@carbon nanofibers (Si@c-ZIF@CNFs) are fabricated that possess excellent antioxidant capacity, high surface area and abundant pores, which enhances conductivity, relieves volume expansion and facilitates electrolyte penetration during cycling. When evaluated as self-supporting anodes for lithium-ion batteries, the Si@c-ZIF@CNFs exhibit excellent cycling and rate performance.

Maternal mental health and well-being during the COVID-19 pandemic in Beijing, China.

BACKGROUND: The aim of this study is to evaluate the impact of the coronavirus disease 2019 (COVID-19) pandemic on breastfeeding women and to identify predictors of maternal mental health and coping. METHODS: Mothers aged ≥ 18 years with a breast-fed infant ≤ 18 months of age during the COVID-19 pandemic in Beijing, China, completed a questionnaire. Descriptive analysis of lockdown consequences was performed and predictors of these outcomes were examined using stepwise linear regression. RESULTS: Of 2233 participants, 29.9%, 20.0% and 34.7% felt down, lonely, and worried, respectively, during the lockdown; however, 85.3% felt able to cope. Poorer maternal mental health was predicted by maternal (younger age, higher education) and infant (older age, lower gestation) characteristics, and social circumstances (husband unemployed or working from home, receiving advice from family, having enough space for the baby, living close to a park or green space). Conversely, better maternal mental health was predicted by higher income, employment requiring higher qualifications, more personal space at home, shopping or walking > once/week and lack of impact of COVID-19 on job or income. Mothers with higher education, more bedrooms, fair division of household chores and attending an online mother and baby group > once/week reported better coping. CONCLUSION: The findings highlight maternal characteristics and circumstances that predict poorer mental health and reduced coping which could be used to target interventions in any future public health emergencies requiring social restrictions.

Yttrium Surface Gradient Doping for Enhancing Structure and Thermal Stability of High-Ni Layered Oxide as Cathode for Li-Ion Batteries.

The high-nickel layered oxides are potential candidate cathode materials of next-generation high energy lithium-ion batteries, in which higher nickel/lower cobalt strategy is effective for increasing specific capacity and reducing cost of cathode. Unfortunately, the fast decay of capacity/potential, and serious thermal concern are critical obstacles for the commercialization of high-nickel oxides due to structural instability. Herein, in order to improve the structure and thermal stability of high-nickel layered oxides, we demonstrate a feasible and simple strategy of the surface gradient doping with yttrium, without forming the hard interface between coating layer and bulk. As expected, after introducing yttrium, the surface gradient doping layer is formed tightly based on the oxidation induced segregation, leading to improved structure and thermal stability. Correspondingly, the good capacity retention and potential stability are obtained for the yttrium-doped sample, together with the superior thermal behavior. The excellent electrochemical performance of the yttrium-doped sample is primarily attributed to the strong yttrium-oxygen bonding and stable oxygen framework on the surface layer. Therefore, the surface manipulating strategy with the surface gradient doping is feasible and effective for improving the structure and thermal stability, as well as the capacity/potential stability during cycling for the high-Ni layered oxides.

Co-immobilization of multi-enzyme on reversibly soluble polymers in cascade catalysis for the one-pot conversion of gluconic acid from corn straw.

The difficulties in the process of cellulose cascade conversion based on immobilization technology lies in the recycling enzymes from rich solid-containing straw hydrolysate and the incompatibility of conventional immobilization with this process. In this study, three types of enzyme (cellulase, glucose oxidase and catalase) were successfully immobilized on a reversible soluble Eudragit L-100. Through the determination of the preparation conditions, enzymatic properties and catalytic conditions, the co-immobilized enzyme was applied to the catalytic reaction of one-pot conversion of corn straw to gluconic acid. The yield of gluconic acid achieved 0.28 mg/mg, conversion rate of cellulose in corn straw to gluconic acid reached 61.41%. The recovery of co-immobilized enzyme from solid substrate was achieved by using reversible and soluble characteristics of the carrier. After 6 times of recycling, the activity of co-immobilized enzyme was maintained at 52.38%, confirming the feasibility of multi-enzyme immobilization strategy using reversible soluble carrier in cascade reactions.

Causal Effect of Honorary Titles on Physicians' Service Volumes in Online Health Communities: Retrospective Study.

BACKGROUND: An OHC online health community (OHC) is an interactive platform for virtual communication between patients and physicians. Patients can typically search, seek, and share their experience and rate physicians, who may be involved in giving advice. Some OHC providers provide incentives in form of honorary titles to encourage the web-based involvement of physicians, but it is unclear whether the award of honorary titles has an impact on their consultation volume in an OHC. OBJECTIVE: This study is designed to identify the differential treatment effect of the incentive policy on the service volumes for the subgroups of treatment and control in an OHC. This study aims to answer the following questions: Does an honorary title for physicians impact their service volumes in an OHC? During the period of discontinuity, can we identify the sharp effect of the incentive award on the outcomes of physicians' service volumes? METHODS: We acquired the targeted samples based on treatment, namely, physicians with an honorary title or not and outcomes measured before and after the award of the 2 subgroups. A regression discontinuity design was applied to investigate the impact of the honorary titles incentive as a treatment in an OHC. There was a sharply discontinuous effect of treatment on physicians' online health service performance. The experimental data set consisted of 346 physicians in the treatment group (with honorary titles). Applying the propensity score matching method, the same size of physicians (n=346) was matched and selected as the control group. RESULTS: A sharp discontinuity was found at the time of the physician receiving the honorary title. The results showed that the parametric estimates of the coefficient were significantly positively (P<.001) associated with monthly home page views. The jump in the monthly volumes of home page views was much sharper than that of the monthly consultations. CONCLUSIONS: The changes in the volumes of monthly consultations and home page views reflect the differential treatment effect of honorary titles on physicians' service volumes. The effect of the incentive policy with honorary titles is objectively estimated from both the perspective of online and offline medical services in an OHC. Being named with honorary titles significantly multiplied monthly home page views, yet it did not significantly impact monthly consultations. This may be because consultation capacity is limited by the physician's schedule for consultations.

[Status of acupuncture service quality control].

In order to guarantee and improve the quality of acupuncture service, the developments of the control of acupuncture service quality in the World Health Organization (WHO) and various countries were summarized. A number of normative documents that could improve acupuncture service security and effectiveness have been developed in WHO and many countries, in which, acupuncture training, safety manipulation and the guidelines for clinical practice of disease have been included. There are great differences in the qualification authentication and management of acupuncture practitioners among different countries. In China and South Korea, the official government departments are in charge of the management, but, in most of the countries, the qualification attestation examination of acupuncture is conduced mainly by the national/local industry organizations authorized by the state and operated by the commissioned experts. The medical service quality evaluation system is complicated. Because of the specific characteristics of acupuncture discipline itself, it is necessary to develop the service quality assessment system and the standard which is especially adaptable in acupuncture discipline.

Yishenhuoxue formula regulates TGF-ß/Smad signal transduction to protect rats against Diabetic kidney disease injury.

TGF-ß signal pathway activation is vital in the pathogenesis of DKD. We aim to investigate the role of Yishenhuoxue formula on TGF-ß/Smad signal transduction in DKD rats. 60 male adult Wistar rats were enrolled and randomly allocated into four groups: N group, M group (given STZ 60mg/kg, ip), H group (given Yishenhuoxue formula 1.0g/kg/day, ig) and L group (given Yishenhuoxue formula 0.5g/kg/day, ig). The levels of BW, 24h UV, SCr, UCr, mALB were measured after 8 weeks treatment, while the levels of KW/BW index, CCr and UAER were calculated by relevant formula. The rats' left kidneys were harvested to detect histological changes by PAS staining and right kidneys were harvested to detect the levels of TGF-ß, Smad2/3, phosphorylated Smad 2/3, Smad 7 and CTGF by western blot analysis. We found that Yishenhuoxue formula treatment can protect kidneys from DKD injury, which is illustrated with following criteria: 1) a significant decrement in KW/BW index, 24h UV, SCr, mALB and UAER, while a significant increment in BW, UCr, CCr (p<0.05 vs. M group); 2) minor and segmental changes as slight expansion of the glomerular basement membrane compared with M group; 3) an apparent decrease in levels of TGF-ß1, phosphorylated Smad 2/3 and CTGF, while an apparent increase in levels of Smad 2/3 and Smad7 compared with M group (p<0.05). The studies confirm that Yishenhuoxue formula has strong inhibitory effect on TGF-ß/Smad signal transduction in DKD rats' kidneys by decreasing expression of TGF-ß1, weakening of Smad 2/3 phosphorylation and increasing expression of Smad 7.