Regional differences in health resource allocation: a longitudinal study in the Chengdu-Chongqing economic circle, China.

OBJECTIVE: To analyse regional differences in health resource allocation in the Chengdu-Chongqing economic circle. DESIGN: A longitudinal analysis that collected data on health resource allocation from 2017 to 2021. SETTING: The number of beds, health technicians, licensed (assistant) physicians, registered nurses and financial allocations per 1000 population in the 42 regions of Chengdu-Chongqing economic circle were used for the analysis. METHODS: The entropy weight technique for order preference by similarity to an ideal solution (TOPSIS) method and the rank sum ratio (RSR) method were used to evaluate the health resource allocation. RESULTS: The number of licensed (assistant) physicians per 1000 population in the Chengdu-Chongqing economic circle (3.01) was lower than the average in China (3.04) in 2021. According to the entropy weight-TOPSIS method, Yuzhong in Chongqing had the largest C-value and the highest ranking. Jiangbei in Chongqing and Chengdu and Ya'an in Sichuan Province had higher C-values and were ranked in the top 10. Jiangjin, Hechuan, Tongnan and Zhongxian in Chongqing and Guang'an in Sichuan Province had lower C-values and were all ranked after the 30th place. According to the RSR method, the 42 regions were divided into three grades of good, medium and poor. The health resource allocations of Yuzhong, Jiangbei, Nanchuan, Jiulongpo and Shapingba in Chongqing and Chengdu and Ya'an in Sichuan Province were of good grade, those of Tongnan, Jiangjin, Yubei and Dazu in Chongqing and Guang'an and Dazhou in Sichuan Province were of poor grade, and the rest of the regions were of medium grade. CONCLUSION: The regional differences in health resource allocation in the Chengdu-Chongqing economic circle were more obvious, the health resource allocation in Chongqing was more polarised and the health resource allocation in Sichuan Province was more balanced, but the advantaged regions were not prominent enough.

Equity and efficiency of health resource allocation in township health centers in Sichuan Province, China.

OBJECTIVE: To analyze the equity and efficiency of health resource allocation in township health centers in Sichuan Province, and to provide a scientific basis for promoting the development of township health centers in Sichuan Province, China. METHODS: The Lorenz curve, Gini coefficient and health resource density index were used to analyze the equity of health resource allocation in township health centers in Sichuan Province from 2017 to 2021, and data envelopment analysis(DEA) was used to analyze the efficiency of health resource allocation in township health centers in Sichuan Province from 2017 to 2021. RESULTS: The Gini coefficient of health resources of township health centers in Sichuan Province is below 0.2 by population in addition to the number of beds in 2020-2021 and practicing (assistant) physicians in 2021, and the Gini coefficient of health resources of township health centers in Sichuan Province is above 0.6 by geography. The Lorentz curve of health resources of township health centers in Sichuan Province is closer to the equity line by population allocation and further from the equity line by geographical allocation. The average level of township health centers in Sichuan Province is used as the standard to calculate the health resource density standard index(W) of each region, the Ws of Panzhihua, Ganzi, Aba and Liangshan are less than 1, and the Ws of Ziyang, Neijiang, Deyang and Meishan are greater than 1. The overall efficiency of township health centers in Sichuan Province in 2017 and 2021 is 1, and the DEA is relatively effective. The overall efficiency of township health centers in Sichuan Province in 2018 and 2019 is not 1, and the DEA is relatively ineffective. The overall efficiency of all health resources in Mianyang and Ziyang is 1, and the DEA is relatively effective. The overall efficiency of all health resources in Suining, Neijiang, Yibin, Aba and Ganzi is not 1, and the DEA is relatively ineffective. CONCLUSION: The equity of health resource allocation by population is better than that by geography in township health centers in Sichuan Province. Combining population and geographical factors, the health resource allocation of Panzhihua, Ganzi, Aba and Liangshan is lower than the average level of Sichuan Province. The efficiency of health resource allocation in township health centers in Sichuan Province is low.

Novel therapeutic role of Ganoderma Polysaccharides in a septic mouse model - The key role of macrophages.

Ganoderma lucidum polysaccharides (G. PS) have been recognized for their immune-modulating properties. In this study, we investigated the impact of G. PS in a sepsis mouse model, exploring its effects on survival, inflammatory cytokines, Treg cell differentiation, bacterial load, organ dysfunction, and related pathways. We also probed the role of macrophages through chlorphosphon-liposome pretreatment. Using the cecal ligation and puncture (CLP) model, we categorized mice into normal, PBS, and G. PS injection groups. G. PS significantly enhanced septic mouse survival, regulated inflammatory cytokines (TNF-α, IL-17A, IL-6, IL-10), and promoted CD4+Foxp3+ Treg cell differentiation in spleens. Additionally, G. PS reduced bacterial load, mitigated organ damage, and suppressed the NF-κB pathway. In vitro, G. PS facilitated CD4+ T cell differentiation into Treg cells via the p-STAT5 pathway. Chlorphosphon-liposome pretreatment heightened septic mortality, bacterial load, biochemical markers, and organ damage, emphasizing macrophages' involvement. G. PS demonstrated significant protective effects in septic mice by modulating inflammatory responses, enhancing Treg cell differentiation, diminishing bacterial load, and inhibiting inflammatory pathways. These findings illuminate the therapeutic potential of G. PS in sepsis treatment.

Perturbations in gut and respiratory microbiota in COVID-19 and influenza patients: a systematic review and meta-analysis.

Objectives: Coronavirus disease-19 (COVID-19)/influenza poses unprecedented challenges to the global economy and healthcare services. Numerous studies have described alterations in the microbiome of COVID-19/influenza patients, but further investigation is needed to understand the relationship between the microbiome and these diseases. Herein, through systematic comparison between COVID-19 patients, long COVID-19 patients, influenza patients, no COVID-19/influenza controls and no COVID-19/influenza patients, we conducted a comprehensive review to describe the microbial change of respiratory tract/digestive tract in COVID-19/influenza patients. Methods: We systematically reviewed relevant literature by searching the PubMed, Embase, and Cochrane Library databases from inception to August 12, 2023. We conducted a comprehensive review to explore microbial alterations in patients with COVID-19/influenza. In addition, the data on α-diversity were summarized and analyzed by meta-analysis. Results: A total of 134 studies comparing COVID-19 patients with controls and 18 studies comparing influenza patients with controls were included. The Shannon indices of the gut and respiratory tract microbiome were slightly decreased in COVID-19/influenza patients compared to no COVID-19/influenza controls. Meanwhile, COVID-19 patients with more severe symptoms also exhibited a lower Shannon index versus COVID-19 patients with milder symptoms. The intestinal microbiome of COVID-19 patients was characterized by elevated opportunistic pathogens along with reduced short-chain fatty acid (SCFAs)-producing microbiota. Moreover, Enterobacteriaceae (including Escherichia and Enterococcus) and Lactococcus, were enriched in the gut and respiratory tract of COVID-19 patients. Conversely, Haemophilus and Neisseria showed reduced abundance in the respiratory tract of both COVID-19 and influenza patients. Conclusion: In this systematic review, we identified the microbiome in COVID-19/influenza patients in comparison with controls. The microbial changes in influenza and COVID-19 are partly similar.

Human Resources Allocation of the Centers for Disease Control and Prevention in China.

Objective: To analyze the equity of human resources allocation of the Centers for Disease Control and Prevention (CDCs) and to predict the development in the next five years in China, and to provide a scientific basis for promoting the development of human resources. Methods: The data of the CDCs from 2017 to 2021 were obtained from the "China Health Statistical Yearbook", and descriptive analysis, health resource density index (HRDI), Theil index, and health resource agglomeration degree (HRAD) were used to evaluate the equity, and the grey prediction model GM (1, 1) was used to predict the development from 2022 to 2026. Results: Measured by the HRDI, the shortage of human resources in the western region was relatively obvious, with a shortage of more than 11,656 health technicians, more than 6418 licensed (assistant) physicians, and more than 693 registered nurses. The Theil index of human resources allocation by population was between 0.016 and 0.071, and the Theil index of human resources allocation by geography was between 0.312 and 0.359. The allocation of human resources by geography was more unequal than those allocated by population. In terms of HRAD, human resources are over-allocated equitably by geography in the eastern and central regions, while they are under-allocated equitably by geography in the western region. In terms of the difference between the HRAD and PAD, the eastern region has a shortage of human resources relative to the concentration population, and the western region has an excess of human resources relative to the concentration population. Conclusion: The human resources allocation of the CDCs in China was uneven. The human resources of the CDCs were allocated more equitably by population than by geography. There was a situation where the equity of human resource allocation of the CDCs was contrary to the actual demand for medical care.

[Spatial Distribution Characteristics of Soil Carbon and Nitrogen in Citrus Orchards on the Slope of Purple Soil Hilly Area].

Since the 1990s, a large area of sloping farmland in a purple soil hilly region of southwest China was converted into an orchard to prevent soil erosion, increase soil fertility, and elevate economic benefits for farmers. In order to explore the spatial distribution of soil carbon (C) and nitrogen (N) fractions on the slope of returning arable lands to citrus orchards in purple soil hilly areas, a soil sampling event was carried out in a citrus orchard at the Yanting Agro-ecological Experimental Station of Purple Soil, Chinese Academy of Sciences, to examine the differences in soil C and N fractions and their influencing factors. The results showed that the slope position had significant effects on the contents of soil total nitrogen (TN), nitrate nitrogen (NO3--N), and dissolved organic carbon (DOC) (P < 0.05), but the effects were not obvious regarding the total organic carbon (SOC) and ammonia nitrogen (NH4+-N) of the soil (P > 0.05). For topsoil (0-30 cm), the variation trend of soil NO3--N content along the slope was upper slope < middle slope < lower slope, whereas the TN and DOC contents along the slope exhibited the trend of upper slope > middle slope > lower slope. The contents of soil C and N in each slope position generally showed a downward trend with increasing soil depth (0-30 cm). The contents of soil TN, SOC, NO3--N, and DOC were significantly affected by soil depth (P < 0.05). The TN storage (0-30 cm) significantly decreased from the top to the bottom within the soil slope, with a value of 2.37, 1.89, and 1.62 t·hm-2 (reported as N) for the upper slope, middle slope, and lower slope, respectively. There was no significant difference in SOC reserves along the slope, with a range from 56.12 to 58.48 t·hm-2 (reported as C). Our results provide scientific basis for understanding the spatial distribution of soil nutrients of the restored farmland in purple soil hilly areas. Our research suggests that the spatial distribution of soil carbon and nitrogen storage should not be ignored when predicting the response of soil nutrients to land use change.

Degradation of atrazine by electro-peroxone enhanced by Fe and N co-doped carbon nanotubes with simultaneous catalysis of H2O2 and O3.

Fe and N co-doped carbon nanotubes (Fe-N-CNT) was synthesized and attempted as efficient heterogeneous catalysts for simultaneous catalysis of H2O2 and O3 to improve electro-peroxone (Fe-N-CNT/EP) process efficiency for atrazine (ATZ) degradation. The removal and mineralization of ATZ was significantly enhanced, obtaining the degradation rate constant (k) by Fe-N-CNT/EP (0.23 min-1) about two times that of EP (0.12 min-1) owing to the formation of Fe0 and Fe-N coordination in Fe-N-CNT catalyst for co-catalysis of H2O2 and O3. The important factors such as applied current and ozone concentration were investigated, demonstrating that the optimized performance could be achieved at current of 30 mA and ozone concentration of 55 mg L-1. The oxidation capacity of Fe-N-CNT/EP maintained stably under wide pH range of 3∼7, obtaining the degradation rate constant 1.23-1.92 times that of EP and overcoming the defect of EP at acidic and neutral conditions. Capture experiments and electron paramagnetic resonance (EPR) experiments verified that .OH, generated by accelerating decomposition of H2O2/O3 and peroxone reaction, was the dominant active specie in Fe-N-CNT/EP. Besides, Fe-N-CNT showed high catalytic activity and good stability during six cycles. This work provides an efficient activator for enhanced EP process, exhibiting a promising prospect for water and wastewater purification.

Coexistence of microplastics and Cd alters soil N transformation by affecting enzyme activity and ammonia oxidizer abundance.

Interactions between heavy metal and microplastics represent a serious threat to ecosystems and human health, but the effect of their coexistence on the soil N transformation processes is unclear. The mechanism in which metal-polluted soil reacts to additional microplastics stress and their toxicology interactions on soil N transformation were determined by investigating the dynamics of soil microbial N transformation in response to Cd stress and different doses of polythene (PE) microplastics by conducting a 14 days aerobic 15N microcosmic incubation experiment. The gross nitrification rates (n_gross) were decreased by 7.47% and 12.5% in the 1% and 2% (w/w) PE groups, respectively, through the direct effect on enzyme activity (ß-glucosidase, N-acetylglucosaminidase, and leucine-aminopeptidase) and the abundance and community composition of ammonia oxidizer. It also exerted indirect effect by reducing nitrification substrate concentrations. PE microplastics (>1% [w/w]) significantly increased the gross N immobilization rate, and this change could have been driven by C/N stoichiometry. Cd stress alone led to a rapid short-term mineralization-immobilization turnover (1.67 times of the control). However, such effect was offset when Cd coexisted with PE microplastics, possibly because Cd was directly adsorbed by PE microplastics, and/or microplastics satisfied the C demand by microorganisms under Cd stress. Our findings demonstrated that the coexistence of microplastics and Cd significantly altered soil N nitrification and immobilization, which would change the N bioavailability in soil and alter the effect N cycling on the ecological environment.

Removal of bisphenol A in a heterogeneous Fenton system via biochar synthesized using different Fe precursors: Properties, effects, and mechanisms.

The reactivity and mechanism of the Fe-doped biochar (FeBC) Fenton reaction are typically influenced by the amount and type of Fe species in materials. This study investigated the effects of different Fe precursors (FeSO4, Fe(NO)3, FeCl2, and FeCl3) used to prepare Fenton catalyst FeBCs (FeSBC, FeNBC, FeC2BC, and FeC3BC) on the physicochemical characteristics, pH resistance, and reactivity for bisphenol A (BPA) removal. In addition to the FeSBC/H2O2 (0.007 min-1) system, FeNBC/H2O2 (1.143 min-1), FeC2BC/H2O2 (0.278 min-1), and FeC3BC/H2O2 (0.556 min-1) completely removed BPA within 20 min under the optimal conditions (FeBCs: 0.1 g/L; H2O2: 1 mM; BPA: 20 mg/L; pH 3). FeBCs/H2O2 systems demonstrated good stability and resistance to inorganic anions and natural organic matter under appropriate initial pH conditions. However, FeC2BC and FeC3BC exhibited better pH applicability than FeNBC. Characterization results indicated that the physicochemical properties of FeBCs were dependent on the Fe precursor, which correlated with the degree of Fe corrosion and the production of distinct reactive oxygen species (ROS). Quenching experiments and electron spin resonance detection results indicated that OH, 1O2, and O2- species were all engaged in BPA removal; the ROS concentrations were significantly influenced by the initial pH and Fe precursor. The results indicate that Fe precursors significantly impact the performance and characteristics of Fe-based biochar materials, which are tailorable to specific applications.

Biological and chemical nitrification inhibitors exhibited different effects on soil gross N nitrification rate and N2O production: a 15N microcosm study.

Nitrification inhibitors (NIs) are considered as an effective strategy for reducing nitrification rate and related environmental nitrogen (N) loss. However, whether plant-derived biological NIs had an advantage over chemical NIs in simultaneously inhibiting nitrification rate and N2O production remains unclear. Here, we conducted an aerobic 15N microcosmic incubation experiment to compare the effects of a biological NI (methyl 3-(4-hydroxyphenyl) propionate, MHPP) with three chemical NIs, 2-chloro-6-(trichloromethyl) pyridine (nitrapyrin), dicyandiamide (DCD), and 3,4-dimethylpyrazole phosphate (DMPP) on (i) gross N mineralization and nitrification rate and (ii) the relative importance of nitrification and denitrification in N2O emission in a calcareous soil. The results showed that DMPP significantly inhibited m_gross rate (P < 0.05), whereas DCD, nitrapyrin, and MHPP only numerically inhibited it. Gross N nitrification (n_gross) rates were inhibited by 9.48% in the DCD treatment to 51.5% in the nitrapyrin treatment. Chemical NIs primarily affected the amoA gene abundance of ammonia-oxidizing bacteria (AOB), whereas biological NIs affected the amoA gene abundance of ammonia-oxidizing archaea (AOA) and AOB. AOB's community composition was more susceptible to NIs than AOA, and NIs mainly targeted Nitrosospira clusters of AOB. Chemical NIs of DCD, DMPP, and nitrapyrin proportionally reduced N2O production from nitrification and denitrification. However, the biological NI MHPP stimulated short-term N2O emission and increased the proportion of N2O from denitrification. Our findings showed that the influence of NIs on gross N mineralization rate (m_gross) was dependent on the NI type. MHPP exhibited a moderate n_gross inhibitory capacity compared with the three chemical NIs. The mechanisms of chemical and biological NIs inhibiting n_gross can be partly attributed to changes in the abundance and community of ammonia oxidizers. A more comprehensive evaluation is needed to determine whether biological NIs have advantages over chemical NIs in inhibiting greenhouse gas emissions.

Sulfate Radical in (Photo)electrochemical Advanced Oxidation Processes for Water Treatment: A Versatile Approach.

The search for a simple and clean approach toward the production of sulfate radicals for water treatment gave rise to electrochemical and photoelectrochemical activation techniques. The photoelectrochemical activation method does not just distinguish itself as a promising activation method, it is also used as an efficient water treatment method with the ability to treat a myriad of pollutants due to the complementary effects of highly reactive oxidizing species. This perspective highlights some merits that distinguish sulfate monoanion radicals from hydroxyl radicals. It highlights the electrochemical, photoelectrochemical, and in situ photoelectrochemical routes of generating sulfate radicals for advanced oxidation process approach to water treatment. We provide a detailed account of the few known applications of sulfate radical enhanced photoelectrochemical treatments of water laden with organics. Finally, we placed this area of research in perspective by providing outlooks and conclusive remarks.

Insights into Electrochemical Dehalogenation by Non-Noble Metal Single-Atom Cobalt with High Efficiency and Low Energy Consumption.

It is critical to discover a non-noble metal catalyst with high catalytic activity capable of replacing palladium in electrochemical reduction. In this work, a highly efficient single-atom Co-N/C catalyst was synthesized with metal-organic frameworks (MOFs) as a precursor for electrochemical dehalogenation. X-ray absorption spectroscopy (XAS) revealed that Co-N/C exhibited a Co-N4 configuration, which had more active sites and a faster charge-transfer rate and thus enabled the efficient removal of florfenicol (FLO) at a wide pH, achieving a rate constant 3.5 and 2.1 times that of N/C and commercial Pd/C, respectively. The defluorination and dechlorination efficiencies were 67.6 and 95.6%, respectively, with extremely low Co leaching (6 µg L-1), low energy consumption (22.7 kWh kg-1), and high turnover frequency (TOF) (0.0350 min-1), demonstrating excellent dehalogenation performance. Spiking experiments and density functional theory (DFT) verified that Co-N4 was the active site and had the lowest energy barrier for forming atomic hydrogen (H*) (ΔGH*). Capture experiments, electron paramagnetic resonance (EPR), electrochemical tests, and in situ Fourier transform infrared (FTIR) proved that H* and direct electron transfer were responsible for dehalogenation. Toxicity assessment indicated that FLO toxicity decreased significantly after dehalogenation. This work develops a non-noble metal catalyst with broad application prospects in electrocatalytic dehalogenation.

Comprehensive analysis of research trends and prospects in electrochemical advanced oxidation processes (EAOPs) for wastewater treatment.

Electrochemical advanced oxidation processes (EAOPs) have emerged as a promising approach for efficient wastewater treatment. However, despite their promising potential, there is a lack of comprehensive analysis regarding the research trends, bibliometric data, and research frontiers of EAOPs. To address this gap, this study conducted a thorough and comprehensive analysis of 2347 related articles in the Web of Science Core Collection Database from 2012 to 2022. The analysis included information on countries, authors, institutions, and more, with a focus on summarizing trends and cutting-edge research hotspots in the field. The University of Barcelona in Spain is the most effective institution. Brillas E. is the most productive author in the world. Research hotspots in EAOPs have evolved from traditional anodic oxidation (AO) to novel electro-Fenton (EF) technology, which focuses on efficient generation of H2O2 and the use of metal-organic frameworks to enhance performance and efficiency. Through systematic research hotspot analysis, the importance of performance comparison of different types of EAOPs, development of new materials, optimization of device parameters, and toxicity assessment of byproducts is highlighted. Concurrently, the rise and mechanisms of emerging EAOPs are predicted and analyzed. Finally, future research on EAOPs technologies should focus on technological coupling, development of new materials, reduction of energy consumption and cost, evaluation and minimization of toxicity, and exploration of green renewable energy sources for larger-scale applications in wastewater treatment pilot plants. In this way, these technologies can contribute to the sustainability of larger industrial wastewater treatment applications and make an important contribution to environmental protection and scientific and technological progress.

Heterogenous electro-Fenton degradation of sulfamethoxazole on a polyethylene glycol-coated magnetite nanoparticles catalyst.

We report the preparation and application of poly (ethylene) glycol (PEG) coated magnetite nanoparticles (MNPs) catalyst for the heterogeneous electro-Fenton (HEF) degradation of sulfamethoxazole in real wastewater PEG-coated MNPs of four MNP:PEG ratios were synthesised using the co-precipitation method. The synthesised MNP were characterised using FTIR, XRD, EDX, TEM, and CHN elemental analysis. It was observed that the coating of MNP with PEG influences the nanoparticle size, agglomeration tendencies and catalytic efficiency of MNPs properties in the HEF degradation process. A 1:1 optimal MNP:PEG catalyst yielded 91% sulfamethoxazole degradation and 48% total organic carbon removal in 60 min, which is an improvement of 11% over degradation with the uncoated MNP. The PEG-coated MNP showed higher stability in 10 consecutive reaction cycles, reduced leaching, and improved performance at a lower dosage and broader pH range than the uncoated MNPs. These results show that coating MNP with PEG enhances HEF catalytic performance in the degradation of sulfamethoxazole in wastewater.

A pilot scale of electrochemical integrated treatment technology and equipment driven by solar energy for decentralized domestic sewage treatment.

Based on the natural air diffusion electrode (NADE) cathode, a solar-driven electrochemical integrated sewage treatment technology and equipment in a pilot scale was developed to treat dispersed rural wastewater. The non-aeration NADE had efficient and stable H2O2 production performance, maintaining the H2O2 output between 1474 and 1535 mg h-1 within 50 h with the current efficiency of 77.4%-80.6%. This electrochemical integrated wastewater treatment system was coupled with technologies such as dual-cathode electro-Fenton, peroxi-coagulation and photoelectro-Fenton, which effectively improved the conversion and utilization efficiency of H2O2. It integrated Fenton-like oxidation, electro-oxidation and UV/H2O2, as well as Fe(OH)3-dominated flocculation, which could effectively remove various pollutants in wastewater. The integrated sewage treatment equipment (500 L d-1) realized the effective treatment of a rural decentralized domestic sewage, achieving simultaneous removal of chemical oxygen demand (COD), NH3-N, total phosphorus (TP) and bacteria. Driven by solar energy, its application feasibility, superiority and stability have been proved, providing theoretical and technical support for the efficient and low-consumption treatment of dispersed organic wastewater.

Equity and prediction of health resource allocation of traditional Chinese medicine in China.

OBJECTIVE: To analyze the equity of health resource allocation of Traditional Chinese Medicine(TCM) and predict its development during the 14th Five-Year Plan period, and to provide a scientific basis for promoting the improvement of TCM service capacity. METHODS: The Chinese Mainland (excluding Hong Kong, Macao and Taiwan) was divided into the Northeast, Eastern, Central and Western regions, and the number of TCM medical institutions, the number of TCM beds, practitioners (assistants) of TCM and Chinese pharmacists from 2016 to 2020 were selected as evaluation indicators, and the equity of health resource allocation of TCM was evaluated by Concentration index(CI), Theil index(T) and Health resource agglomeration degree (HRAD), and the development of health resource of TCM during the 14th Five-Year Plan period was predicted by grey prediction model GM (1,1). RESULTS: The Concentration index of the number of TCM medical institutions and TCM beds is negative, and the allocation tends to the regions with low economic development level. The Concentration index of practitioners (assistants) of TCM and Chinese pharmacists is positive, and the allocation tends to the regions with higher economic development level. The number of TCM medical institutions, TCM beds, practitioners (assistants) of TCM and Chinese pharmacists' Theil index allocated by geography is larger than that allocated by population, which indicates that the equity of TCM health resources allocated by population is better than that allocated by geography. The number of TCM medical institutions, practitioners (assistants) of TCM and Chinese pharmacists in between regions by population contributed more than 72% to the Theil index, indicating that the inequity mainly comes from between regions. The number of TCM medical institutions, TCM beds, practitioners (assistants) of TCM and Chinese pharmacists in within regions by geography contributed more than 80% to the Theil index, indicating that the inequity mainly comes from within regions. The HRAD in the Eastern and Central regions is greater than 1, indicating that the equity is better by geography. The HRAD in the Western region is less than 1, indicating insufficient equity by geography. The HRAD/PAD of the Central region (except for the number of TCM beds in 2020) is less than 1, indicating that it cannot meet the medical needs of the agglomerated population. The HRAD/PAD of the Western region (excluding for the Chinese pharmacists) is greater than 1, indicating that the equity is better than that of the agglomeration population. CONCLUSION: The number of TCM medical institutions and TCM beds tends to regions with low economic development levels, while the number of practitioners (assistants) of TCM and Chinese pharmacists tends to regions with high economic development levels. The equity of the allocation of TCM health resources by population is better than that by geography, and the inequity of the allocation by geography mainly comes from within region. The allocation of health resources of TCM in the four regions is different, and there is a contradiction between equity and actual medical needs.

[Spatial Distribution of Nitrogen and Phosphorus Nutrients in the Main Stream and Typical Tributaries of Tuojiang River and Fujiang River].

The Tuojiang River and Fujiang River, two important tributaries of the upper reaches of the Yangtze River, have serious water pollution problems, among which nitrogen (N) and phosphorus (P) are the most important pollutants. Therefore, the aim of this study was to identify the influencing factors of water quality in different spaces and provide a scientific basis for the prevention and control of surface water pollution in the upper reaches of the Yangtze River and its tributaries. Water samples of trunk and tributaries in the Tuojiang River and Fujiang River were collected, and the spatial distribution characteristics of water N and P were analyzed. The results showed that the Tuojiang River and Fujiang River showed serious pollution of total nitrogen (TN), with a water quality worse Ⅴ-section proportion as high as 94% and 50%, respectively. Both rivers showed that TN and TP concentrations in the tributaries were higher than those in the main stream. For both rivers, total phosphorus (TP), with moderate pollution, was mainly concentrated in Ⅱ, Ⅲ, and Ⅳ class water quality, whereas the P pollution was more serious for the Fujiang River compared to that of the Fujiang River. For the Tuojiang River, nitrate nitrogen (NN) concentration from upstream to downstream showed a trend of decreasing after the first increase, with the maximum concentration of ammonium nitrogen (AN) exhibiting at the upstream site. In particular, TP concentration increased significantly after rivers flowed through a city. For the Fujiang River trunk stream, TN and NN concentration exhibited a gradually increasing trend from the middle to lower reaches. Generally, our study revealed that TN, TP, and NN in the rivers were affected by water pH and water temperature (T). Therefore, the control of N and P pollution in rivers should pay attention to the influence of water environmental factors.

Enhanced pH-Responsive Chemo/Chemodynamic Synergistic Cancer Therapy Based on In Situ Cu2+ Di-Chelation.

Considering the chemodynamic therapy and chemotherapy independent of external stimulus witnessing great advantage in the clinical translation, developing a smart nanoplatform that can realize enhanced chemo/chemodynamic synergistic therapy in the tumor microenvironment (TME) is of great significance. Herein, we highlight the enhanced pH-responsive chemo/chemodynamic synergistic cancer therapy based on in situ Cu2+ di-chelation. The alcohol-withdrawal drug disulfiram (DSF) and chemotherapeutic drug mitoxantrone (MTO) were embedded into PEGylated mesoporous CuO (denoted as PEG-CuO@DSF@MTO NPs). The acidic TME triggered the collapse of CuO and the concurrent release of Cu2+, DSF, and MTO. Then, the in situ complexation between Cu2+ and DSF, as well as the coordination between Cu2+ and MTO not only prominently enhanced the chemotherapeutic performance but also triggered the chemodynamic therapy. In vivo mouse model experiments demonstrated that the synergistic therapy can remarkably eliminate tumors. This study provides an interesting strategy to design intelligent nanosystems, which could proceed to clinical translations.

Characteristics of annual NH3 emissions from a conventional vegetable field under various nitrogen management strategies.

High N-fertilizer applications to conventional vegetable production systems are associated with substantial emissions of NH3, a key substance that triggers haze pollution and ecosystem eutrophication and thus, causing considerable damage to human and ecosystem health. While N fertilization effects on NH3 volatilization from cereal crops have been relatively well studied, little is known about the magnitude and yield-scaled emissions of NH3 from vegetable systems. Here we report on a 2-year field study investigating the effect of various types and rates of fertilizer application on NH3 emissions and crop yields for a pepper-lettuce-cabbage rotation system in southwest China. Our results show that both NH3 emissions and direct emission factors of applied N varied largely across seasons over the 2-year period, highlighting the importance of measurements spanning entire cropping years. Across all treatments varying from solely applying urea fertilizers to only using organic manures, annual NH3 emissions ranged from 0.64 to 92.4 kg N ha-1 yr-1 (or 0.07-6.84 g N kg-1 dry matter), equivalent to 0.05-5.99% of the applied N. At annual scale, NH3 emissions correlated positively with soil δ15N values, indicating that soil δ15N may be used as an indicator for NH3 losses. NH3 emissions from treatments fertilized partially or fully with manure were significantly lower compared with the urea fertilized treatment, while vegetable yields remained unaffected. Moreover, full substitution of urea by manure as compared to the partial substitution further reduced the yield-scaled annual NH3 emissions by 79.0-92.4%. Across all vegetable seasons, there is a significant negative relationship between yield-scaled NH3 emissions and crop N use efficiency. Overall, our results suggest that substituting urea by manure and reducing total N inputs by 30-50% allows to reduce NH3 emissions without jeopardizing yields. Such a change in management provides a feasible option to achieve environmental sustainability and food security in conventional vegetable systems.